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Biomedical subjects

P J Cunningham

Publications and source records attributed to P J Cunningham.

At least 37 records · Page 2Linked to original sources
PubMed1995

The use of hospital emergency departments for nonurgent health problems: a national perspective.

The use of the hospital emergency department (ED) for nonurgent health problems has been a subject of considerable controversy, in part because there is no widely accepted definition of "nonurgent." Elimination or substantial reduction in nonurgent ED use is frequently offered as a strategy for reducing health expenditures. Previous studies, often limited to individual hospitals or communities, have limited generalizability and do not permit examination of multiple factors likely to influence nonurgent ED utilization or examination of ED use for nonurgent problems in the context of overall outpatient utilization. This analysis of the 1987 National Medical Expenditure Survey (NMES) provides a nationally representative examination of nonurgent ED utilization that describes the frequency of ED use for nonurgent problems, characteristics of individuals that are associated with an increased likelihood of nonurgent ED use, the use of other outpatient physician services, and expenditures associated with nonurgent ED visits.

Cost Control↗
PubMed1995

Medicaid physician fee levels and children's access to care.

This study examines the effects of physician fees on children's use of preventive and illness-related ambulatory physician services under the Medicaid program. Using data from the 1987 National Medical Expenditure Survey (NMES), we examine the effects of Medicaid fee generosity on physician service use and overall ambulatory physician spending. The results indicate that more generous fees are associated with a greater likelihood of having a doctor's office as a usual source of care and a higher number of preventive visits at office-based sites of care. Having a doctor's office as a usual source of care is associated with lower overall ambulatory physician expenditures.

Child↗
PubMed1993

The use of ambulatory health care services by American Indians with disabilities.

Although most American Indians and Alaska Natives have access to health care through the Indian Health Service (IHS), it is uncertain whether IHS is able to provide all necessary health services to those with disabilities. Although IHS eligibles can use health services other than those provided or sponsored by IHS, this may be precluded by high rates of poverty, low rates of other health insurance coverage, and the lack of private providers in many areas inhabited by this population. Using data from the 1987 Survey of American Indians and Alaska Natives--the only nationally representative health care survey of persons eligible for IHS--this study examines the use of ambulatory health care for IHS eligibles with disabilities. Comparisons with the total US population showed similar rates of ambulatory care use for most categories of disability, but a higher frequency of use for the total US population. Findings also show that IHS provides most of the health care for its eligible population, although non-IHS care is also used. After controlling for the effects of sociodemographic characteristics and health insurance coverage, variables indicating disabilities due to health problems were found to have statistically significant effects on the likelihood of using non-IHS care. Furthermore, persons with activity limitations had a higher than average likelihood of using most of their health care at non-IHS providers. These findings suggest that for some persons with disabilities, it is necessary to supplement IHS care with services from other providers.

Adolescent↗
PubMed1993

Access to care in the Indian Health Service.

The Indian Health Service (IHS) is unique among U.S. private and public health programs in that free comprehensive health services are provided to eligible American Indians and Alaska Natives regardless of their ability to pay. However, resource limitations may compel some eligible persons to go outside of the IHS system to receive health care. Although IHS eligibles have comparatively low rates of private or public health care coverage, and much of this population lives in underserved areas, over half of IHS-eligible persons had some type of out-of-plan use in 1987. Furthermore, services received through private providers appear to supplement those received through IHS-sponsored providers. Overall, persons who use both IHS and non-IHS providers have higher levels of health care use than do those who rely exclusively on the IHS.

Adolescent↗
PubMed1993

Dynamic process of movement in residential settings.

Findings from the 1987 National Medical Expenditure Survey show that almost 16% of individuals who spent some time in a residential facility during 1987 moved into other living arrangements during 1987. A smaller number had multiple moves during that period. However, this level of movement did not result in significant changes in the residential population between the beginning and end of 1987. Most movement that occurred was between residential facilities of the same type. For the most part, individuals ended the year in the same type of residential setting where they began the year. These findings suggest that there is considerably more mobility among residential populations than can be observed by examining annual rates of change in residential populations.

Community Mental Health Services↗
PubMed1991

Individuals with mental retardation in residential facilities: findings from the 1987 National Medical Expenditure Survey.

Data from the 1987 National Medical Expenditure Survey, a large survey designed to yield national estimates pertaining to the use of medical care, were used to compare residents of state institutions with residents of other types of residential facilities. Findings concur with past studies: Residents of state institutions were more severely retarded and more likely to have other disabilities and functional impairments than were residents of other residential facilities. However, many residents of other facilities had severe impairments. Relatively more persons with severe impairments resided in these facilities in states where small facility beds were relatively plentiful.

Activities of Daily Living↗
PubMed1989

Clinical evaluation of Scotchbond: three-year results.

In a previous paper, the one-year retention of composite resin in non-undercut Class V abrasion lesions mediated by self-cure Scotchbond dentine bonding agent without enamel etching was reported. The present paper reports the three-year results. Initially, a total of 310 restorations was placed using Silux, Silar, Ketac-Fil and Fuji II. The percentage cumulative loss of the restorations at two and three years, respectively, was: Silux 27, 30; Silar 58, 58; Ketac-Fil 0, 0; Fuji II 4, 14. Over the total study period, there was a high loss rate of composite restorations in the first six months, and a tendency to increased loss over one to three years. There was a significant increase in marginal discoloration, assessed photographically, over the three-year period, and caries was present around some restorations.

Acrylic Resins↗
PubMed1988

Correlated responses of carcass and reproductive traits to selection for rate of lean growth in swine.

Mass selection for an index of increased postweaning average daily gain and decreased backfat thickness was practiced for five generations. Litter size and weight for 221 gilt litters, birth weight and nipple number for 2,242 piglets and weaning weight at 42 d of age for 2,111 pigs were recorded. Carcass measurements were taken on 331 pigs. Differences between means of the lines (select control) were regressed on cumulative selection differential of the index. These regression coefficients were negative (P greater than .10) for total number born, number born alive, number weaned per litter, nipple number and carcass backfat thickness. Coefficients were positive (P greater than .10) for individual pig and litter weights at birth and weaning and for the carcass traits of length, longissimus muscle area and percentage of ham and loin. Absolute values of realized genetic correlations of index with traits evaluated were all .35 or less except the correlation with carcass backfat, which was -.84. None of these was significant; therefore, index selection for lean growth should have little effect on litter size and weight but may have a beneficial effect on carcass backfat.

Adipose Tissue↗
PubMed1980

Inheritance of teat number and its relationship to maternal traits in swine.

The relationship of teat number to seven measures of female reproduction was evaluated in the University of Nebraska Gene Pool population. Teat number was recorded for 7,513 pigs, ovulation rate for 2,794 gilts and litter size and weight at birth and weaning (42 days) for 789 gilts. Paternal half-sib and full-sib analyses were used to estimate heritabilities for each trait and to estimate the genetic and phenotypic correlations of teat number with the measures of reproduction. The direct response to selection for ovulation rate and the correlated response in teat number were also evaluated from the regressions of line differences (Select-Control) on generation number (10 generations of selection) and cumulative selection differential for ovulation rate. The paternal half-sib heritabililty for teat number was .32, and the paternal half-sib heritabilities for ovulation rate and the litter traits were similar to previous estimates from this population. Most of the genetic and phenotypic correlations with teat number were negative and all were nonsignificant. The realized heritability for ovulation rate was .46 +/- .10. The regression of response in teat number on generation number number was .08 +/- .03 (P < .10). An estimate of .44 was obtained for the realized genetic correlation of teat number with ovulation rate.

Animals↗
PubMed1980

Effect of dietary lactose on gain, feed conversion, blood, bone and intestinal parameters in postweaning rats and swine.

Two trials were conducted to determine the effect of lactose on performance, bone integrity and certain blood constituents in postweaning rats and swine. The effect of lactose on calcium and phosphorus and percentage ash content of the small intestine was also determined. In both trials, average daily gains were not influenced by the feeding of diets containing 30% lactose. Feed conversion was depressed in both rats and pigs when 30% lactose was fed. Transitory diarrhea was observed in rats fed 30% lactose, but not in swine. In the rat trial, no significant differences due to treatment were observed for serum Ca of P, but a linear increase (P < .01) in alkaline phosphatase was observed as lactose increased in the diet. Analysis of blood constituents from multiple bleedings during the pig trial showed that in the first 2 weeks, alkaline phosphatase was increased (P < .01) in pigs fed lactose and slightly decreased in those not fed lactose. Lactose affected the change in serum Ca for 0 to 10 weeks (P < .05) as indicated by a marked reduction in serum Ca of pigs not fed lactose and a slight increase for those fed lactoss. Serum calcium decreased in the absence of lactose but increased in the presence of lactose (P < .05) in pigs fed .4% Ca diets. In both trials, breaking strength parameters (peak force and stress) were not affected by dietary lactose. Bones from pigs fed no lactose had a higher stress to strain ratio (P < .05) than those from pigs fed lactose. In the rat trial, stress to strain ratio was variable across all treatments. Percentage of bone ash increased (P < .01) as lactose increased in the diet. Dietary treatments did not affect the mineral content of specific gut segments.

Animals↗