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Biomedical subjects

J F Kerner

Publications and source records attributed to J F Kerner.

31 records · Page 2Linked to original sources
PubMed1985

Day hospital service in rehabilitation medicine: an evaluation.

The purpose of this study was to evaluate Day Hospital care in rehabilitation medicine as an alternative to intensive inpatient care. The study design called for two groups of randomly selected patients who met all admission criteria for intensive inpatient rehabilitation, who had Medicare or Medicaid insurance coverage, and who had a responsible other person living in the home. Those in the Day Hospital group were sent home after a short period of family training and then were taken to the hospital for treatment five days a week. The control group remained in the hospital on the rehabilitation service as inpatients and received the routine care provided to all other inpatients on that service. Data on utilization of health services, both during and after rehabilitation, cost of services, medical, functional, psychologic and social outcomes were collected for all study participants and analyzed. Findings showed no essential difference between the two groups in physical or functional outcome; however at full capacity with the research costs removed, the Day Hospital method proved the more cost effective.

Cost-Benefit Analysis↗
PubMed1984

A comparison of primary breast cancer management in small, intermediate and large community hospitals and a comprehensive cancer center.

The results presented above indicate clearly that the size of a hospital is associated not only with the type of patient population treated there in terms of demographic and disease related characteristics but also with the type of treatment given. Smaller hospitals were more likely to have older and later stage disease patients for whom they used fewer diagnostic tests and less conservative surgical procedures than larger hospitals. The patients in smaller hospitals also tended to stay for longer periods of time. Interestingly, in terms of the comparison between the community hospital groups and the comprehensive cancer center, no consistent pattern was found. Large hospitals were more like MSKCC in their patient population and length of stay, but the small hospitals were more like MSKCC in the number of tests and type of surgical procedures performed.

Aged↗
PubMed1981

Activities of daily living: reliability and validity of gross vs specific ratings.

The inter-rater reliability and criterion validity of gross vs specific ratings of activities of daily living (ADL) were compared. Forty-three physical therapy students rated 6 patients performing 16 ADL on videotape. With controls for tape order presentation and order of protocol use, specific ratings were found to be more reliable than gross ratings in terms of total scores, transfers, and personal hygiene activities. Dressing activities were found to be reliably rated on both protocols, but locomotion activities presented problems on both. In terms of criterion validity, both protocols significantly differentiated dependent, middle-range, and independent patients, but the gross ratings were significantly lower for dependent and middle-range patients than specific protocols. It was concluded that when activities can be broken down into independent task components, specific protocols are the assessment method of choice. When activities are made up of highly interdependent task components, a behaviorially anchored gross rating protocol may be more effective. Implications for further research are discussed.

Activities of Daily Living↗
PubMedDate not supplied

Ever vs never smoking among an urban, multiethnic sample of Haitian-, Caribbean-, and U.S.-born blacks.

BACKGROUND: Despite the high rate of current smoking among blacks in the United States, to date there have been no studies comparing smoking rates or predictors of smoking among adults from different black ethnic groups living in the United States. If cancer control programs are to successfully reduce the risk of smoking-related cancers within black communities, more extensive data on demographics, knowledge, attitudes, beliefs, and practices within ethnic groups are needed. METHODS: We conducted a structured telephone interview to assess smoking status, alcohol use, cancer-related attitudes and beliefs, and demographic information among Haitian-born (N = 165), Caribbean-born (N = 354), and U.S.-born (N = 402) blacks living in New York City in 1992. RESULTS: Relative to U.S.-born participants, both Caribbean- and Haitian-born participants were significantly less likely to have ever smoked. Although both groups of foreign-born men were much more likely to have ever smoked relative to their female counterparts, U.S.-born men and women were equally likely to have ever smoked. Alcohol use was consistently related to smoking across ethnic and gender groups, and this association was enhanced among older drinkers. The belief that smoking is not related to cancer was associated with an almost twofold increase of ever smoking. CONCLUSIONS: The rate of ever smoking among urban, foreign-born blacks is considerably lower than among U.S.-born blacks; among the foreign-born participants, ever smoking was lower among women relative to men. Alcohol use is an important predictor of smoking status, particularly among older drinkers.

Adolescent↗
PubMedDate not supplied

Expanding access to cancer screening and clinical follow-up among the medically underserved.

Blacks have the highest cancer incidences and mortality rates in the United States. Higher mortality rates appear due to higher incidence in some sites and to later-stage diagnoses in others. To address these problems, expanded cancer screening in an inner-city public hospital and a patient navigator intervention were proposed. Patient navigators acted as patient advocates for patients with abnormal screening findings. One thousand thirty-four females and 102 males were screened from July 1990 through November 1992; seven breast cancers and one cervical cancer were found. Patient navigators were significantly more likely to have seen patients with suspicious findings than patients with non-suspicious findings. However, even among those with suspicious findings, almost 70% were not seen by a patient navigator. Of those navigated, 87.5% completed recommended breast biopsies, compared with 56.6% of the non-navigated patients. Among those with a biopsy, navigated patients did so in significantly less time than those not navigated. Navigation is one of three phases proposed to reduce cancer mortality among medically underserved populations.

Adolescent↗
PubMedDate not supplied

Cancer control planning and establishment of priorities for intervention by a state health department.

A number of data sources routinely available to State health departments were analyzed as part of a State health department cancer control planning effort. This planning effort consisted of seven steps; the most challenging one was the establishment of priorities for cancer control interventions. Using data from available sources, however, a framework for prioritizing potential cancer control interventions as well as choosing a geographic area in which to implement selected interventions was developed. Factors considered in this framework for setting intervention priorities included the magnitude of the problem; the existence of scientific consensus regarding the efficacy of intervention techniques; the availability of data needed to plan, implement, and evaluate an intervention; the availability of resources within communities to implement an intervention; and the existence of public demand for the intervention. The development and use of this cancer control planning model and framework for setting cancer control intervention priorities in New York State are described in this paper. In using this planning model and framework for setting priorities, quantitative elements were found to be most necessary to define problems, but qualitative elements were most crucial for decision making.

Decision Making, Organizational↗