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Biomedical subjects

J Avorn

Publications and source records attributed to J Avorn.

At least 163 records · Page 9Linked to original sources
PubMed1986

Health education about AIDS among seropositive blood donors.

The New York Blood Center is developing a health education and psychosocial support program for blood donors who are notified that they are HIV antibody positive. The goals of that program are: to provide accurate and intelligible information about the test results to notified donors; to encourage behavior that will reduce the likelihood of spreading the virus; to encourage notified donors to behave in ways that will reduce the probability that they will develop AIDS; and to provide support and facilitate functional coping responses. This article reviews the theoretical and empirical work which informs the intervention program, and it describes how the program is being implemented.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Improving drug-therapy decisions through educational outreach. A randomized controlled trial of academically based "detailing".

Improving precision and economy in the prescribing of drugs is a goal whose importance has increased with the proliferation of new and potent agents and with growing economic pressures to contain health-care costs. We implemented an office-based physician education program to reduce the excessive use of three drug groups: cerebral and peripheral vasodilators, an oral cephalosporin, and propoxyphene. A four-state sample of 435 prescribers of these drugs was identified through Medicaid records and randomly assigned to one of three groups. Physicians who were offered personal educational visits by clinical pharmacists along with a series of mailed "unadvertisements" reduced their prescribing of the target drugs by 14 per cent as compared with controls (P = 0.0001). A comparable reduction in the number of dollars reimbursed for these drugs was also seen between the two groups, resulting in substantial cost savings. No such change was seen in physicians who received mailed print materials only. The effect persisted for at least nine months after the start of the intervention, and no significant increase in the use of expensive substitute drugs was found. Academically based "detailing" may represent a useful and cost-effective way to improve the quality of drug-therapy decisions and reduce unnecessary expenditures.

Cephalexin↗
PubMed1983

Perceived health, life satisfaction, and activity in urban elderly: a controlled study of the impact of part-time work.

To determine whether part-time employment affects the perceived health, life satisfaction and activity of urban retirees, 25 experimental and 30 control subjects were selected randomly from a pool of 98 elderly applicants in a demonstration employment program for retirees. Program participants were hired to perform park maintenance and beautification work for 20 hours per week. Structured interviews conducted at the end of the 6-month program revealed significant, positive effects of paid employment on measures of perceived health and life satisfaction. Only one of the control subjects had found alternative part-time employment 6 months following randomization. These findings suggest that the provision of optional, paid employment opportunities can have demonstrably positive effects upon the well-being of retirees.

Aged↗
PubMed1983

Biomedical and social determinants of cognitive impairment in the elderly.

Studies in age-related cognitive changes do not necessarily take into account the clinical and social phenomena associated with age that may have more effect on cognition than does psychologic senescence. Clinically inapparent biologic deterioration, drugs, mild dementia, and atypically presenting depression may influence cognition. Selection bias may skew the results of studies on the elderly when control groups are made up of undergraduates or of "normal" elderly whose normality is taken for granted rather than verified. The epiphenomena of aging, such as retirement, social isolation, and bereavement, which are not inherent in the aging process, influence cognition, as do labeling and learned helplessness. Laboratory-based tests of cognition may not sufficiently resemble real-life conditions to have validity. Future research will be shaped by how we conceptualize the relation between aging and intellectual function.

Aged↗
PubMed1982

Use of a computer-based Medicaid drug data to analyze and correct inappropriate medication use.

In an experimental controlled trial, prescribing records were obtained from the Medicaid Management Information Systems (MMIS) of four states for all physicians participating in the Medicaid programs of those states. Three categories of drugs that are commonly misprescribed were identified, and moderate to high prescribers of these drugs were identified from the MMIS data set. These physicians were then randomly divided into three groups. One group received no intervention, the second group received an innovative series of print materials urging appropriate drug use, and a third group received the print materials and was visited by consultant pharmacists to discuss the drugs in question. Our experience suggests that use of Medicaid prescribing data can be an efficient and accurate way of conducting large-scale surveillance of misprescribing, and of targeting interventions that can improve such suboptimal drug utilization. Use of the same data set in a follow-up period can monitor the effectiveness of each mode of intervention and will measure the degree of behavior change for each physician.

Computers↗
PubMed1982

Induced disability in nursing home patients: a controlled trial.

Many performance deficits observed in institutionalized elderly patients may be the results of social and environmental factors rather than disease or the aging process. To test this hypothesis, 72 nursing home residents (mean age, 78 years) were randomly assigned to three groups for training in completion of a simple psychomotor task. In four training sessions, members of Group I ("helped") were given extensive assistance in completing the task; members of Group II ("encouraged only") were given verbal encouragement but minimal assistance; members of Group III ("no contact") received no training sessions and served as controls. All subjects were tested on proficiency in completion of the task (a simple jigsaw puzzle) before and after the intervention period. Completeness of performance by Group II improved during the study, but that of Group I deteriorated significantly (P = 0.04 between groups) to a level even below that of the control group (P = 0.03). Similar differences were found in speed of performance, with Group II performing best, Group I performing worst (P = 0.05), and the control group performing intermediately. Perception of task difficulty was greater (P = 0.02) and self-confidence was less (P = 0.06) for Group I than for Group II. The psychosocial environment of long-term facilities can have important effects on the competence of elderly patients. Excessive infantilization of residents and overly intrusive help in self-care beyond clinical requirements can lead to "learned helplessness," with further disability.

Activities of Daily Living↗