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PubMedDate not supplied

Hospital ownership of post-acute care: does it increase access to post-acute care services?

This study examines the relationship of hospital characteristics and access to post-acute care (PAC) using a comprehensive database that combines hospital characteristics with clinical and demographic information of patients. The data was drawn from 52 hospitals in three urban areas--Minneapolis/St. Paul, Houston, and Pittsburgh--and 2,572 patients within five diagnosis-related groups (DRGs). The analysis found hospital ownership of post-acute care significantly associated with use of PAC for patients discharged after hospitalization for stroke and chronic obstructive pulmonary disease (COPD). We found few significant hospital characteristics influencing use of PAC, but, as expected, for selected DRGs, patients were more likely to receive PAC if they were discharged from a hospital that either owned post-acute care or served a high proportion of Medicare patients. In general, patient characteristics were more consistent predictors of post-acute care use across the DRGs studied.

Activities of Daily Living↗
PubMed2002

The association of handgun ownership and storage practices with safety consciousness.

BACKGROUND: As with other injury prevention practices, education about safe firearm storage is recommended to prevent injuries to children. OBJECTIVE: To assess whether parents who are safety conscious in other respects also practice firearm safety. METHODS: Data come from responses to a baseline survey administered as part of an intervention study. Participants were consenting adults who brought a child into an emergency department. These analyses were restricted to those parents who had young children (<7 years) and who kept a firearm in their house. A safety consciousness score was developed; participants earned a point for each of 7 home and car safety behaviors they reported practicing. The relationship between safety consciousness with handgun ownership and firearm storage practices was assessed with Wilcoxon-Mann-Whitney test. RESULTS: Of the 221 participants, most reported that they keep poisonous substances out of children's reach (92%), always keep children restrained when in cars (90%), have the telephone number for a poison control center (82%), change smoke alarm batteries annually (73%), keep electrical outlets capped (72%), and keep their tap water temperature at 120 degrees F (49 degrees C) or less (65%). Only 22% reported checking smoke alarm batteries monthly. The median safety score was 4 (mean [SD], 3.99 [1.4]). Fifty-six percent said there was a handgun in their home, 27% reported an unlocked gun, 20% reported a loaded gun, and 7% reported a loaded and unlocked gun. Results were not consistent with safety consciousness being associated with safe firearm storage practices or the absence of a handgun. CONCLUSION: Compliance with safety practices may not be associated with safe firearm storage.

Accident Prevention↗
PubMed1982

Multiple sclerosis and dog ownership. A case-control investigation.

In 1977 and 1978 Cook and his associates demonstrated a positive association between ownership of small dogs and both familial and sporadic cases of multiple sclerosis in New Jersey. Because of the far reaching implications of this work, a similar study was carried out and 72 patients with clinically definite multiple sclerosis (MS) who were resident in the area covered by the Oxford Regional Health Authority, were interviewed to ascertain their past exposure to housepets and other animals. Two hospital controls were chosen for each patient matched for age and sex and area of residence, and these were interviewed in the same manner as the MS cases by the same interviewer, usually in the patients' homes. Similar proportions of cases and controls had resided in a household with a dog at some time prior to the onset of their disease and there was no evidence that cases had lived with more dogs or had lived with them for longer periods than had controls. There was no indication that cases had greater exposure than controls to dogs or any other housepet in the early years of their life or in the period immediately prior to disease onset. Our data suggest that exposure to housepets and other domestic animals is unlikely to be an aetiological factor in MS.

Animals↗
PubMed1985

Paradigm shift or change in ownership? The conceptual significance of D.L. Davies's classic paper.

D.L. Davies's paper on 'Normal drinking in recovered alcohol addicts' was published in 1962 (Q.J. Stud. Alcohol, 23, (1962) 94). The 18 commentaries on this report which were published shortly afterwards in the Quarterly Journal of Studies on Alcohol are analysed in terms of the perceived relevance of his findings for clinical practice. This initial and largely negative appraisal of the import of Davies's article is contrasted with later assessments which have seen this study as contributing to a crucial paradigm shift. The question is raised as to whether the concept of paradigm shift can be applied satisfactorily to a field where several different scientific disciplines are defining the nature of the problem, or whether alternatively or in addition the story should be understood in terms of a competition between medicine and psychology for 'ownership' of addiction.

Alcohol Drinking↗
PubMed2005

Illusion of sense of self-agency: discrepancy between the predicted and actual sensory consequences of actions modulates the sense of self-agency, but not the sense of self-ownership.

It is proposed that knowledge of motor commands is used to distinguish self-generated sensation from externally generated sensation. In this paper, we show that the sense of self-agency, that is the sense that I am the one who is generating an action, largely depends on the degree of discrepancy resulting from comparison between the predicted and actual sensory feedback. In Experiment 1, the sense of self-agency was reduced when the presentation of the tone was unpredictable in terms of timing and its frequency, although in fact the tone was self-produced. In Experiment 2, the opposite case was found to occur. That is, participants experienced illusionary sense of self-agency when the externally generated sensations happened to match the prediction made by forward model. In Experiment 3, the sense of self-agency was reduced when there was a discrepancy between the predicted and actual sensory consequences, regardless of presence or absence of a discrepancy between the intended and actual consequences of actions. In all the experiments, a discrepancy between the predicted and actual feedback had no effects on sense of self-ownership, that is the sense that I am the one who is undergoing an experience. These results may suggest that both senses of self are mutually independent.

Adult↗
PubMed2005

Having a body versus moving your body: How agency structures body-ownership.

We investigated how motor agency in the voluntary control of body movement influences body awareness. In the Rubber Hand Illusion (RHI), synchronous tactile stimulation of a rubber hand and the participant's hand leads to a feeling of the rubber hand being incorporated in the participant's own body. One quantifiable behavioural correlate of the illusion is an induced shift in the perceived location of the participant's hand towards the rubber hand. Previous studies showed that the induced changes in body awareness are local and fragmented: the proprioceptive drift is largely restricted to the stimulated finger. In the present study, we investigated whether active and passive movements, rather than tactile stimulation, would lead to similarly fragmented body awareness. Participants watched a projected image of their hand under three conditions: active finger movement, passive finger movement, and tactile stimulation. Visual feedback was either synchronous or asynchronous with respect to stimulation of the hand. A significant overall RHI, defined as greater drifts following synchronous than asynchronous stimulation, was found in all cases. However, the distribution of the RHI across stimulated and non-stimulated fingers depended on the kind of stimulation. Localised proprioceptive drifts, specific to the stimulated finger, were found for tactile and passive stimulation. Conversely, during active movement of a single digit, the proprioceptive drifts were not localised to that digit, but were spread across the whole hand. Whereas a purely proprioceptive sense of body-ownership is local and fragmented, the motor sense of agency integrates distinct body-parts into a coherent, unified awareness of the body.

Body Image↗
PubMed2005

Effects of payment incentives, hospital ownership and competition on hospitalization decisions for ambulatory surgical procedures.

OBJECTIVE: To test the hypotheses that (1) for-profit (FP) and not-for-profit (NFP) hospitals are less likely than public hospitals to admit cases reimbursed by prospective payment favoring ambulatory over inpatient care; (2) admission odds of public, FP and NFP hospitals will converge under increasing hospital competition. METHODS: Retrospective, population-based, cross-sectional study covering 29,699 cases of unilateral, femoral/inguinal hernia operation (major surgical procedure) and 60,626 cases of cataract surgery (local surgical procedure), from Taiwan's National Health Insurance database was used. Diagnosis-wise logistic regression analysis were done to examine associations between admission propensities of FP versus public and NFP hospitals (large teaching hospitals with > or = 250 beds versus district hospitals with < 250 beds) under high and low competition, adjusted for clinical complications, and patient as well as physician demographics. RESULTS: Large public teaching hospitals are significantly more likely than FP district hospitals to admit hernia patients (ORs = 1.9 and 2.6, respectively, under high and low competition), and cataract surgery patients (ORs = 5.0 and 5.4, respectively, under high and low competition). The corresponding odds ratios for public district hospitals (relative to FP district hospitals) are 1.2 and 3.9 for hernia and 4.9 and 2.7 for cataract surgery. Odds ratios show convergence of admission odds across hospital ownership under high competition relative to low competition for hernia (OR range for different hospital types under high competition, 1.0-1.9; and under low competition, 1.0-3.9). Cataract cases show high divergence of admission odds between public and FP/NFP hospitals regardless of competition level (OR range for different hospital types under high competition, 0.3-5.0; and under low competition, 0.3-5.4). CONCLUSION: Overall, our data support the study hypotheses. Differences in the relevance of inpatient care for hernia and cataract surgery may account for the lack of admission convergence of public hospitals and FPs under high competition among cataract surgery group.

Ambulatory Surgical Procedures↗
PubMed2005

The effect of pet ownership on the risk of allergic sensitisation and bronchial asthma.

An increasing volume of evidence suggests that early contact of children with the allergens of furred pets (especially those produced by cats) may determine a lower risk of developing allergic sensitisation to these materials. A possible explanation of this data is that an early inhalation of high levels of the major cat allergen Fel d 1 induces the production of IgG and IgG4 antibodies with a "protective" effect. Other authors have shown that the prevalence of allergic sensitisation to cats, in adults, is reduced in those patients exposed to the lowest and highest levels of the allergens. On the contrary, the risk of developing sensitisation to cats is significantly higher when the patients were exposed to intermediate levels of Fel d 1. Moreover, epidemiological studies have demonstrated a relatively low prevalence of cat allergy (about 10%) in some countries where rates of cat ownership are high. This data confirms the role of indirect exposure to pet allergens in inducing allergic sensitisation. Clothes of pet owners have been indicated as the carriers for the dispersal of these allergens in pet-free environments. However, it is important to point out that exposure of highly sensitised patients to relevant amounts of pet allergens (such as in a pet shows/shops) may determine a dramatic exacerbation of nasal and/or bronchial symptoms.

Adult↗
PubMed2001

Cue interactions, border ownership and illusory contours.

When two retinally adjacent image regions both claim 'ownership' of their common boundary based on different visual cues, their perceptual competition could result in: (1) cue averaging, in which the common boundary is not strongly perceived as owned by either region, or (2) perceptual bistability, in which the competing interpretations alternate in conscious perception over time. We report that when the perception of one or another illusory surface depends on the outcome of such a competition, the alternative percepts primarily exhibit bistability rather than averaging (or mutual weakening). More generally, we suggest that mutually inconsistent perceptual interpretations of sensory data will tend to exhibit bistability to the extent that they require significant constructive activity by vision. When one interpretation is more 'literal' (i.e. less constructive), it will tend to block alternative percepts. Put somewhat differently, when competing visual cues specify different preferred (but not necessary) interpretations, then the likely perceptual outcome is bistability rather than cue averaging. However, inconsistent visual cues can also result in perceptual bistability if the interpretations they specify are so incommensurable that simply averaging them would not provide useful information for perception.

Analysis of Variance↗
PubMed2002

Reduced hearing, ownership, and use of hearing aids in elderly people in the UK--the MRC Trial of the Assessment and Management of Older People in the Community: a cross-sectional survey.

BACKGROUND: Reduced hearing in elderly people is important because it is disabling and potentially treatable. We aimed to assess the prevalence of reduced hearing in elderly people and levels of ownership of hearing aids and use. METHODS: We have done a cross-sectional survey of people aged at least 75 years in 106 family practices in the UK. We obtained self-reported data on hearing difficulties for 32,656 people and gave 14,877 a whispered voice test (response rate 78%). FINDINGS: 2537 (8%) of 32,656 participants reported a lot of difficulty hearing and 13,630 (42%) a little or a lot of difficulty. 3795 (26%) of 14877 participants who completed the whispered voice test (95% CI 23-29) failed the test, the proportion rising sharply with age. Following wax removal, 343 passed a retest, leaving 3452 (23%, 20-26) who failed the test, even after wax removal if present. 998 (46%) of 2180 people wearing a hearing aid at the time of testing failed the whispered voice test. More than half the people who failed the test did not own a hearing aid. 2200 (60%) of 3846 people who owned a hearing aid said they used it regularly. Level of use was strongly related to perceived benefit. INTERPRETATION: Reduced hearing is common and provision of hearing aids inadequate in elderly people. Many people who own a hearing aid do not use it regularly, and even when wearing their aid many still have socially disabling levels of hearing loss. A major source of morbidity in elderly people could be alleviated by improvements in detection and management of reduced hearing.

Aged↗
PubMed1987

Risks of pet ownership. The family practitioner's viewpoint.

In this article, I have tried to give the reader some idea of the variety and the magnitude of problems that exist with pet-related ailments and to present some suggestions as to possible solutions. A recent editorial in a medical journal was titled "Caution: Pets May Be Hazardous to Your Health." Although it is a very appropriate warning, I doubt whether we will ever get it printed on the sides of all pets. Rather, it will be up to us in the medical and veterinary communities to educate the population about the risks of pet ownership and to keep ourselves educated about the problem. That way we can more readily recognize pet-related ailments and provide the appropriate care.

Animals↗
PubMed1998

Supplemental health insurance ownership in Israel: an empirical analysis and some implications.

Many Western nations are implementing (or considering) changes in their health care systems. An integral component of these changes (or debates) refers to the functioning and regulation of the supplementary health insurance market. However, only limited empirical evidence exists on the functioning of the market, which is prone to the problems of moral hazard, adverse selection and risk selection. This paper presents an empirical analysis of ownership patterns of four supplementary insurance policies (acute care, nursing care, dental care and emergency intensive care) in the Israeli population aged 45- 75 in 1993. It further discusses some social policy and regulation issues related to the supplemental health insurance market in the post-1995 era of the Israeli National Health Insurance.

Aged↗
PubMed2001

Ownership pattern and management practices of small ruminants in The Gambia - implications for a breeding programme.

In the framework of a genetic improvement scheme a countrywide survey of small ruminant owners was conducted in The Gambia to obtain information about the ownership pattern, reasons for keeping and especially about breeding and management practices including housing and feeding. The main results were the following: women play a major role in small ruminant production, representing 52% of the owners of sheep, 67% of the owners of goats and 43% of the owners of both sheep and goats. The average number of animals owned is quite low (about six head of sheep and goats each, out of which about three are breeding females). Most of the breeding males are born in their respective flock and there are fewer breeding bucks than breeding rams. However, there are sufficient numbers of breeding males around. Animals are mainly left free to roam around during the dry season, and are either tethered or herded in the rainy season. During night animals are housed or tied under a shelter. Supplementary feeding is not common and vaccination against Pest des Petit Ruminants (PPR) and Pasteurellosis is only partly carried out. Implications for the establishment and structure of a multiplication tier within a three tier breeding scheme, nucleus-->multipliers-->farmers are discussed.

Journal Article↗
PubMed1989

Gun ownership and suicide in the United States.

The circulation of firearm magazines was used as an index of gun ownership in the states of the USA. States with a higher per capita circulation of firearm magazines had higher suicide rates by gun and higher overall suicide rates. Homicide rates were unrelated to this measure of gun availability. Implications for the prevention of suicide are discussed.

Cross-Sectional Studies↗
PubMed2003

Ownership pattern and management practices of cattle herds in the Gambia: implications for a breeding programme.

A questionnaire and a census were carried out in 1998/99 on 201 cattle herds in 44 villages located in three different areas of The Gambia, in order to obtain information about the ownership pattern, management and breeding practices for optimizing and extending a pure breeding scheme for indigenous N'Dama cattle. The herds had an average of 58.5 head, of which 39.3% were cows, and most of them were multiowner herds, having on average 5.5 owners. Overall, women represented 38.3% of the owners, but they owned only 15.9% of the cattle. Some of the senior herdsmen received no payment, as they were family members, but most of them received payment in kind, i.e. milk off-take from the herd. Payment in cash only or cash as well as milk was rare. In larger herds it was quite common for additional herdsmen to be hired throughout the year, their payment shifting towards cash only or cash and milk. Many small herds had no older bulls or breeding bull and almost all breeding bulls were born within the herd. In most cases, it was the herd owner who was responsible for the selection of the breeding bull. Traits related to the growth and milk production of the dam were considered as most important for a good breeding bull. The results are discussed with respect to the extension of a pure breeding scheme for N'Dama cattle.

Animal Husbandry↗
PubMed2006

The bar-cross-ellipse illusion: alternating percepts of rigid and nonrigid motion based on contour ownership and trackable feature assignment.

We present a new multistable stimulus generated by continuously rotating an ellipse behind four fixed occluders. Despite the stimulus remaining constant, observers can alternate between one of four percepts: (1) a continuously morphing cross; (2) two independent perpendicular bars oscillating in depth; (3) a rigidly rotating ellipse observed behind the occluders; (4) a fixed cross observed through a continuously rotating, elliptical aperture. Interestingly, the initial percept naive observers tend to see is percept 1, which is the only nonrigid motion percept. This appears to be a violation of the hypothesized 'rigidity heuristic' in which rigid motion percepts tend to be perceived over retinally equivalent nonrigid ones. Here, we describe the relationships between each of the percepts and the assignment of contour ownership and figure/ground segmentation.

Form Perception↗
PubMed1992

Ethical issues in the ownership of companion animals: an empirical and normative analysis.

This article deals with the ethical aspects of companion animal ownership. Research was done by means of interviews (n = 40) and questionnaires (n = 871). Respondents were randomly chosen from Dutch telephone directories. Euthanasia, docking tails, ear clipping and sterilisation are discussed on the basis of the opinions of respondents. Owners of companion animals very often seem to have insufficient knowledge about animal behaviour. Companion animal owners as a group differ rather strongly in their moral opinions about the acceptability of certain actions towards animals. At the individual level also people are not always consequent in their reasoning as was illustrated by their opinions about ear clipping and the stopping of tail docking and vice versa. Respondents live in a community with animals and usually use a utilitarian balancing model. The different outcomes of the uses of this balancing model indicate how far the respondents are willing to adapt their life style to the needs of an animal; in other words to what extent intrinsic values and integrity are taken into account within the process of (re)creating a living community.

Animal Rights↗
PubMed1989

Ownership and quality of care in residential facilities for the elderly.

The quality of care older people receive in a residential facility is related to its ownership. Nonprofit facilities (N = 44) provided a more comfortable physical environment, more cohesive relationships, and more resident control than proprietary settings (N = 44) matched for size and resident functioning. Veterans facilities (N = 44) offered more services and a more diverse staff, but their policies permitted less resident autonomy and their social climates were less cohesive than community facilities of comparable size and resident functioning.

Aged↗