Exercise echocardiography is more specific than exercise electrocardiography for diagnosis of coronary artery disease in women and is a cost-effective approach to the diagnosis of coronary artery disease because of the avoidance of inappropriate angiography.

BACKGROUND AND OBJECTIVE New Jersey was the first state to implement legislatively mandated newborn pulse oximetry screening (POxS) in all licensed birthing facilities to detect critical congenital heart defects (CCHDs). The objective of this report was to evaluate implementation of New Jersey’s statewide POxS mandate. METHODS A 2-pronged approach was used to collect data on infants screened in all New Jersey birthing facilities from August 31, 2011, through May 31, 2012. Aggregate screening results were submitted by each birthing facility. Data on failed screens and clinical characteristics of those newborns were reported to the New Jersey Birth Defects Registry (NJBDR). Three indicators were used to distinguish the added value of mandated POxS from standard clinical care: prenatal congenital heart defect diagnosis, cardiology consultation or echocardiogram indicated or performed before PoxS, or clinical findings at the time of POxS warranting a pulse oximetry measurement. RESULTS Of 75 324 live births in licensed New Jersey birthing facilities, 73 320 were eligible for screening, of which 99% were screened. Forty-nine infants with failed POxS were reported to the NJBDR, 30 of whom had diagnostic evaluations solely attributable to the mandated screening. Three of the 30 infants had previously unsuspected CCHDs and 17 had other diagnoses or non-CCHD echocardiogram findings. CONCLUSIONS In the first 9 months after implementation, New Jersey achieved a high statewide screening rate and established surveillance mechanisms to evaluate the unique contribution of POxS. The screening mandate identified 3 infants with previously unsuspected CCHDs that otherwise might have resulted in significant morbidity and mortality and also identified other significant secondary targets such as sepsis and pneumonia.

We explore the role that contracting plays within the careers of managerial workers. Contracting distances workers from organizational coordination and politics, aspects of organizational life that are often central to the managerial role. Nonetheless, managerial workers make up a substantial proportion of the contracting workforce. Qualitative interviews with managerial contractors indicate that the tension between the natures of contracting and managerial work means that managerial contractors carry out substantially more bounded work than regular employees, and that this boundedness can shape the role that contracting plays in their careers. Examining the employment histories of MBA alumni of a U.S. business school, we show that workers with fewer subordinates and greater personal demands are more likely to enter contracting. We also find that contractors report better work–life balance but receive lower pay both while contracting and in subsequent regular employment. Whereas prior research has highlighted the financial benefits and temporal demands of contracting for highly skilled workers, our findings introduce important boundary conditions to our understanding of high-skill contracting: the nature of the occupation is critical.

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