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PubMed1999

Perceived ownership in a community coalition.

Coalitions are emerging as a force for change in many communities and offer the opportunity for broad community involvement in the planning and implementation of needed health promotion and health education services. Perceived ownership promotes greater participation by the community but efforts to systematically evaluate ownership are lacking. The aim of this study was to determine ownership of a local ElderCARE Coalition's activities and its health promotion program, Healthy WAY, as perceived by coalition members. Fifteen of the coalition members returned the questionnaire that included the Community Ownership Scale. As shown by mean scores, the agencies perceived as having the most influence or greatest perceived ownership were the university college of nursing and the community action programs. Coalition members represented a wide variety of roles and responsibilities as well as length of time in the coalition (1 month to 6 years). Responses to open-ended questions, analyzed by content analysis, supported the work of the coalition and identified the senior participants in the Healthy WAY program as being "enthusiastic" but also needing to be more "involved." Process measures are important indicators of how close coalitions are staying to their grassroots constituency. Implications for public health nurses include participating as partners in community coalitions and assisting coalitions in determining their sense of ownership and the need for change.

Aged↗
PubMed1995

Ownership and utilization of MR imagers in the Commonwealth of Virginia.

PURPOSE: To assess distribution, operation, and ownership of magnetic resonance (MR) imagers in Virginia in 1991. MATERIALS AND METHODS: Questionnaires regarding ownership, location, hours of operation, annual throughput, sources and amounts of revenue, and expenses were mailed to identified providers. Data, specifically regarding ownership and location, were analyzed. RESULTS: Staff from 95% of MR facilities responded. Most facilities were located in and around major metropolitan areas. Population density per imager ranged from one per 76,000 to one per 222,000 persons. Imagers in larger metropolitan areas were operated for longer hours with higher revenues and greater expenses than were those in lower-population-density areas. Imagers owned by physicians in a position to self-refer had the highest patient throughput, the most revenue, and a much lower percentage of revenues from Medicare and Medicaid than did other ownership types. CONCLUSION: Patient access to MR services in Virginia is inhomogeneous. Important aspects of utilization are location and ownership. Ownership by physicians who can self-refer is associated with higher use, greater overall revenues, and less service to the poor and elderly.

Costs and Cost Analysis↗
PubMedDate not supplied

Pet allergy: how important for Turkey where there is a low pet ownership rate.

Exposure and sensitization to allergens derived from cats/dogs have been shown to represent an important risk factor for allergic respiratory diseases. So far, there has not been any study exploring cat/dog sensitization and related factors in our geographic location. The aim of this study was to determine the sensitization to cats/dogs in a group of patients with rhinitis and/or asthma and to evaluate the relationship between current and childhood exposure and sensitivity to pets. Three hundred twelve consecutive subjects with asthma and/or rhinitis were included in the study and were asked to reply a questionnaire concerning past and current pet ownership and presence of pet-related respiratory symptoms. After performing skin-prick tests, subjects were allocated into three groups: group 1 (n = 103), subjects with nonatopic asthma; group 2 (n = 54), allergic rhinitis and/or asthma patients with pet allergy; group 3 (n = 155), allergic rhinitis and/or asthma patients without pet allergy. Pet hypersensitivity was detected in 54 of 209 atopic subjects (25.8%). There was no difference in the rates of past pet ownership among subjects with (29.6%) and without (23.8%) pet allergy. However, the ratio of current pet ownership was higher in atopic patients with pet allergy (16.6%) than in nonatopic subjects (2.9%; p = 0.02). The prevalence of sensitization to pets in current owners (42.8%) was higher than prevalence of sensitization in patients who never had a pet (22.6%; p = 0.002; odds ratio, 2.67) and who owned a pet at childhood (28.2%; p = 0.038; odds ratio, 1.9). Thirteen subjects (13/54; 24%) described respiratory symptoms when exposed to cats and/or dogs. Rate of past pet ownership was similar in symptomatic and asymptomatic subjects with pet allergy (30.7% versus 29.2%; p > 0.05). Rate of current per ownership was higher in symptomatic subjects than in asymptomatic subjects with pet sensitivity (38.4% versus 9.5%; p < 0.0001). Our data indicate that pet allergens have the potential to become an important source of indoor allergens in our population. Our findings also suggest that current pet ownership--but not childhood pet keeping--seems to be a risk for the development of sensitization to pets.

Adult↗
PubMed2005

Mother and adolescent representations of illness ownership and stressful events surrounding diabetes.

OBJECTIVE: To assess the extent to which adolescents with diabetes and their mothers appraise diabetes as a shared entity across adolescence through (a) assessing appraisals of illness ownership and their relationship to joint responsibility for daily diabetes tasks, (b) exploring whether appraisals of shared illness ownership are associated with congruent views of what is stressful about diabetes, and (c) examining whether age-related declines occur in these shared appraisals across adolescence. METHODS: One hundred twenty-seven adolescents (ages 10-15 years, M = 12.8) and their mothers completed an interview that probed appraisals of illness ownership, the most stressful events surrounding diabetes in the past week, and a questionnaire regarding who was responsible for performing diabetes-related tasks. RESULTS: Dyads, most frequently, agreed that diabetes was a "shared" entity. Shared appraisals of illness ownership reflected the greater joint responsibility of mothers and children in daily diabetes tasks. Shared appraisals of illness ownership were not related to congruent reports of diabetes stressful events, and incongruence in appraisals of stressful events was common. With age adolescents reported less shared illness ownership and congruence regarding stressful events, age differences were not seen in mothers' reports. CONCLUSIONS: Although diabetes is often appraised as a social entity, adolescents and their mothers experience different aspects of the disease as stressful, especially as adolescents age, and become more independent in performing diabetes-related tasks.

Adaptation, Psychological↗
PubMed2004

Cycle helmet ownership and use; a cluster randomised controlled trial in primary school children in deprived areas.

AIMS: To assess the effectiveness of two different educational interventions plus free cycle helmets, in increasing cycle helmet ownership and use. METHODS: A cluster randomised controlled trial was carried out in 28 primary schools in deprived areas of Nottingham, involving 1213 year 5 schoolchildren (age 9 and 10). Children received either a helmet + educational pack (educational pack and order form for free cycle helmet) or a helmet + multifaceted intervention (educational pack, order form for free cycle helmet, school assembly, lesson devoted to cycle helmet education, and an invitation to a school based cycling event). RESULTS: The helmet + educational pack was as effective as the helmet + multifaceted intervention in terms of helmet ownership (OR 1.51, 95% CI 0.50 to 4.58) and wearing (OR 0.98, 95% CI 0.57 to 1.68). Helmet ownership significantly increased from baseline with both interventions, and wearing significantly increased from baseline with the helmet + educational pack. The interventions reduced the inequality in helmet ownership between children residing in deprived and non-deprived areas that had been present prior to the study. CONCLUSIONS: An educational pack plus a form to order a free cycle helmet is an effective way of increasing bicycle helmet ownership and use and reduces inequalities in helmet ownership among children in deprived areas. Further work is needed to determine the length of the effect of such interventions.

Accidents, Traffic↗
PubMed2002

Association of rates of household handgun ownership, lifetime major depression, and serious suicidal thoughts with rates of suicide across US census regions.

OBJECTIVE: Cross sectional studies in the United States often find a significant positive association between levels of household firearm ownership and suicide rates. This study investigates whether the association can be explained by differences in levels of mental health. METHODS: The relationship between household handgun ownership and overall suicide rates across United States regions after accounting for two mental health variables-lifetime prevalence of major depression and serious suicidal thoughts-were examined. Analyses also add another control variable (urbanization, education, unemployment, or alcohol consumption). Data on mental health variables come from the National Comorbidity Study, conducted in the early 1990s. Data on household handgun ownership come from the General Social Surveys. RESULTS: Across the nine regions for the early 1990s (n = 9), household handgun ownership rates are positively correlated with the suicide rate (r = 0.59) and are not correlated with either the lifetime prevalence of major depression or suicidal thoughts. After controlling for major depression and suicidal thoughts (and any of the four additional control variables), handgun ownership rates remain significantly associated with the overall suicide rate. CONCLUSIONS: In United States regions with higher levels of household handgun ownership, there are higher suicide rates. This relationship cannot be explained by differences in the prevalence of two mental health indicators-lifetime rates of either major depression or suicidal thoughts.

Depressive Disorder↗
PubMed1989

Trends in private medical insurance ownership: lessons for the public sector.

Data on ownership of private medical insurance were collected from a fully national sample of over 1000 adults. Findings were compared with those of a study undertaken in 1981. Private medical insurance was owned by 40% of the sample, an increase from the 35% ownership in the earlier study. The increase has been predominantly amongst nonMaori New Zealanders and women have increased ownership more than men. Insurance ownership was most common amongst the middle age group (36-50 years) but it has increased significantly amongst the older groups. Greatest areas of growth in ownership were in Auckland and Wellington where proportionate ownership was 52% and 50% respectively. Medical insurance was employer provided amongst 15% of those with insurance, the same proportion as found in the earlier study. Employer subsidy to insurance was evident also. Major reasons to take out insurance were for primary care purposes, so as to overcome the cost barrier to general practitioner services. Other reasons mentioned included avoidance of waiting for treatment and increase in choice of specialist or hospital. Reasons for giving up insurance were cost of premium, disillusionment with benefits and disqualification through age or illness.

Adolescent↗
PubMed2006

Ownership of alcohol-branded merchandise and initiation of teen drinking.

BACKGROUND: The alcohol industry spends over $5 billion a year on marketing, much of which is accessible to children. The distribution of branded articles of clothing and other personal items is one aspect of alcohol marketing that has not been adequately studied. In this study, the prevalence of ownership of alcohol-branded merchandise (ABM) was determined in a sample of rural northern New England adolescents, and the relationship between ownership of such items and initiation of alcohol use was examined. DESIGN/METHODS: Northern New England middle school students who had not yet initiated alcohol use were captured at baseline in a 1999 school-based survey, and ownership of an ABM item and initiation of alcohol use were determined 1 to 2 years later by telephone. The analysis controlled for demographics (gender, grade in school); characteristics of the child (school performance, sensation seeking, rebelliousness); parenting style; and peer alcohol use. RESULTS: Of 2406 baseline never-drinkers, 15% had initiated alcohol use and 14% owned an ABM item by follow-up. ABM items consisted primarily of articles of clothing such as t-shirts and hats. ABM ownership was associated with higher grade in school, male gender, exposure to peer drinking, having tried smoking, poorer academic performance, higher levels of sensation seeking and rebelliousness, and less-responsive and restrictive parenting styles. Owners of ABM items at follow-up had higher rates of alcohol initiation compared with non-owners (25.5% vs 13.1%, respectively, p<0.001). After adjusting for the above confounders, students who owned an ABM item were significantly more likely to have initiated alcohol use compared with students who did not own one (adjusted odds ratio 1.5, 95% confidence interval, 1.1-2.0). CONCLUSIONS: In this northern New England adolescent sample, ownership of alcohol-branded merchandise was prevalent and exhibited an independent cross-sectional association with onset of adolescent drinking. Further studies are necessary to determine whether the relationship is causal, and whether teen use of ABM items influences peer drinking norms and behavior.

Adolescent↗
PubMed1997

Competition, ownership, and access to hospital services. Evidence from psychiatric hospitals.

OBJECTIVES: This article examines the impact of increasing competition among hospitals on access to inpatient services and preexisting differences in access between nonprofit and for-profit facilities. It tests theoretical propositions that suggest that nonprofit and for-profit hospitals will respond in different ways and to differing degrees to changing competitive pressures. METHODS: Drawing data from a 1987-88 national survey of psychiatric hospitals, the authors measured access in terms of the availability of different types of services and the provision of uncompensated care. The impact of hospital ownership, competition as well as the interaction of ownership and competition was assessed through a set of regression models, controlling for other characteristics of the hospital markets and local service system. RESULTS: Nonprofit psychiatric hospitals provide greater access than their for-profit counterparts under conditions of limited competition. Increased competition reduces the ownership-related differences in uncompensated care, but increases the differences for marginally profitable services. The market share of for-profit hospitals had an independent negative effect on access, holding constant the intensity of competition. CONCLUSIONS: The interaction of ownership and competition explains some seemingly inconsistent finding in the literature and points to the complexity of relying on ownership-based policies to protect access in an increasingly competitive health-care system.

Diagnosis-Related Groups↗
PubMedDate not supplied

Home ownership and the emotional and behavioral problems of children and youth.

This study examined the impact of home ownership on the emotional-behavioral problems of children and youth ages 4 to 16 years. Data came from two large-scale general population surveys conducted in the province of Ontario in 1983, the Ontario Child Health Study (N = 3,325) and the National Longitudinal Study of Children and Youth (N = 12,592). Results showed an inverse association between home ownership and ratings of emotional-behavioral problems. The net effects of home ownership expressed in standard units dropped from the .20 to .43 range for teacher and parent ratings to the .07 to .17 range, after controlling for socioeconomic variables. Furthermore, the concentration of home ownership in neighborhoods was not associated with ratings of child problem behavior in either study. Projects aimed at supporting home ownership among low-income families may provide a means for improving the emotional and behavioral functioning of disadvantaged children.

Adolescent↗
PubMed2006

The association between changes in household firearm ownership and rates of suicide in the United States, 1981-2002.

OBJECTIVE: To explore whether recent declines in household firearm prevalence in the United States were associated with changes in rates of suicide for men, women, and children. METHODS: This time series study compares changes in suicide rates to changes in household firearm prevalence, 1981-2002. Multivariate analyses adjust for age, unemployment, per capita alcohol consumption, and poverty. Regional fixed effects controlled for cross sectional, time invariant differences among the four census regions. Standard errors of parameter estimates are adjusted to account for serial autocorrelation of observations over time. RESULTS: Over the 22 year study period household firearm ownership rates declined across all four regions. In multivariate analyses, each 10% decline in household firearm ownership was associated with significant declines in rates of firearm suicide, 4.2% (95% CI 2.3% to 6.1%) and overall suicide, 2.5% (95% CI 1.4% to 3.6%). Changes in non-firearm suicide were not associated with changes in firearm ownership. The magnitude of the association between changes in household firearm ownership and changes in rates of firearm and overall suicide was greatest for children: for each 10% decline in the percentage of households with firearms and children, the rate of firearm suicide among children 0-19 years of age dropped 8.3% (95% CI 6.1% to 10.5%) and the rate of overall suicide dropped 4.1% (2.3% to 5.9%). CONCLUSION: Changes in household firearm ownership over time are associated with significant changes in rates of suicide for men, women, and children. These findings suggest that reducing availability to firearms in the home may save lives, especially among youth.

Adolescent↗
PubMed1996

Charity and community: the role of nonprofit ownership in a managed health care system.

As American medicine has been transformed by the growth of managed care, so too have questions about the appropriate role of nonprofit ownership in the health care system. The standards for community benefit that are increasingly applied to nonprofit hospitals are, at best, only partially relevant to expectations for nonprofit managed care plans. Can we expect nonprofit ownership to substantially affect the behavior of an increasingly competitive managed care industry dealing with insured populations? Drawing from historical interpretations of tax exemption in health care and from the theoretical literature on the implications of ownership for organizational behavior, we identify five forms of community benefit that might be associated with nonprofit forms of managed care. Using data from a national survey of firms providing third-party utilization review services in 1993, we test for ownership-related differences in these five dimensions. Nonprofit utilization review firms generally provide more public goods, such as information dissemination, and are more "community oriented" than proprietary firms, but they are not distinguishable from their for-profit counterparts in addressing the implications of medical quality or the cost of the review process. However, a subgroup of nonprofit review organizations with medical origins are more likely to address quality issues than are either for-profit firms or other nonprofit agencies. Evidence on responses to information asymmetries is mixed but suggests that some ownership related differences exist. The term "charitable" is thus capable of a definition far broader than merely the relief of the poor. While it is true that in the past Congress and the federal courts have conditioned the hospital's charitable status on the level of free or below cost care that it provided for indigents, there is no authority for the conclusion that the determination of "charitable" status was always so limited. Such an inflexible construction fails to recognize the changing economic, social and technological precepts and values of contemporary society. -Circuit Court of Appeals, District of Columbia, Eastern Kentucky Welfare Rights Organization v. Simon (1974).

Charities↗
PubMed2004

Work environment structure and psychological ownership: the mediating effects of control.

Current theorists on the psychology of possession highlight control as an important route in the development of feelings of ownership. In the present article, the authors hypothesized that the extent to which individuals experience control over their job and work environment is positively associated with feelings of ownership for their job and the organization. The authors used supervisory report data on work environment structure and self-reports on experienced control and psychological ownership to test for the mediating effects of experienced control in the relationship between the work environment structure and psychological ownership. The authors found that experienced control mediates the relationship between 3 sources of work environment structure--technology, autonomy, and participative decision making--and psychological ownership of the job and (to a lesser extent) the organization. The authors proposed implications of the findings and directions of further research.

Adolescent↗
PubMed2003

Antecedents of hospital ownership conversions, mergers, and closures.

This study assesses the determinants of conversions in hospital ownership from 1986 through 1996. To place such changes in context, we also analyze causes of hospital mergers and closures, which are often alternatives to hospital ownership conversion. A consistent result from our analysis is that an important antecedent of ownership conversions is a low profit margin. Conversions from private nonprofit or government ownership to for-profit status are preceded by chronically low margins and high debt-to-asset ratios. By contrast, conversions from for-profit ownership occur quickly following declines in margins. Many mergers seem motivated by a desire to increase market power--a consideration not evident for conversions.

Decision Making, Organizational↗
PubMed1991

The effect of chain ownership on nursing home costs.

Although it is commonly assumed that chain ownership will result in lower costs due to economies of scale, the empirical evidence with respect to the effect of chain ownership on nursing home costs is mixed. Chain for-profit nursing homes will have a cost advantage over independent for-profit homes only if there are firm-level (multiple-home) economies of scale. For the study population of Texas nursing homes in 1983, cost structures differed sufficiently across ownership types to warrant estimating separate cost functions by ownership type. The results indicate that, when other factors affecting cost are held constant, chain homes have lower average costs than independent homes at intermediate and high levels of output, but higher average costs at low and very high levels of output. The results highlight the importance of considering whether or not to pool data across ownership categories when estimating nursing home cost functions.

Costs and Cost Analysis↗
PubMedDate not supplied

Current bicycle helmet ownership, use and related factors among school-aged children in metropolitan Toronto.

A random digit dialing telephone survey was conducted to examine bicycle helmet ownership, use and related factors among 707 children in Metropolitan Toronto. The ownership rate was 22% and use rate 12%. Although ownership was similarly distributed by age and sex, helmet use varied considerably across age strata among boys; only about one fifth of teenaged boys who owned a helmet wore it regularly. Both parental education and annual family income were significantly associated with ownership and use. Past bicycle injuries, although increasing helmet ownership, had no positive impact on use. The strength of a parental role model was reflected in the fact that when parents owned and used a helmet, 93% of their children had a helmet and more than 80% of them always wore it. Since about half of parents are cyclists themselves, helmet promotion activities are likely to maximize their effect if they target both parents and children.

Adolescent↗
PubMed1995

Heart valve ownership: legal, ethical and policy issues.

It is in the interest of parties to be able to test a defective explanted heart valve. This article identifies some of the relevant interests of patients (or their relatives), the manufacturers and society at large, and considers some of the legal issues involved in determining the ownership of valves in English law that arise from the varying nature of heart valves and the setting in which they are purchased and delivered. Ownership of explanted valves may vary according to whether the patient obtains the valve by private purchase, through the National Health Service, or through private health care insurance. It seems that, in the most common scenario (delivery via the National Health Service), the patient owns the valve (once implanted) by way of a gift, but that ownership revests to the health authority once the valve is explanted. The determination of ownership is, however, very complex. It is argued, however, that ownership does not automatically entail the right to test. So, even if it were determined that the patient (or the patient's estate) owned the valve, it would not follow that the patient had the right to control the testing of the valve or otherwise dispose of it. Close attention to the network of interests (both moral and socio-economic) in having explanted valves tested competently, suggests that it should be public policy to place custody of explanted valves (for the purposes of having them tested) in the hands of the Medical Devices Agency. This authority should be incorporated into regulation applying the European Community Medical Devices Directive.(ABSTRACT TRUNCATED AT 250 WORDS)

Autopsy↗
PubMed1995

Pet ownership, social support, and one-year survival after acute myocardial infarction in the Cardiac Arrhythmia Suppression Trial (CAST).

Social support and pet ownership, a nonhuman form of social support, have both been associated with increased coronary artery disease survival. The independent effects of pet ownership, social support, disease severity, and other psychosocial factors on 1-year survival after acute myocardial infarction are examined prospectively. The Cardiac Arrhythmia Suppression Trial provided physiologic data on a group of post-myocardial infarction patients with asymptomatic ventricular arrhythmias. An ancillary study provided psychosocial data, including pet ownership, social support, recent life events, future life events, anxiety, depression, coronary prone behavior, and expression of anger. Subjects (n = 424) were randomly selected from patients attending participating Cardiac Arrhythmia Suppression Trial sites and completed baseline psychosocial questionnaires. One year survival data were obtained from 369 patients (87%), of whom 112 (30.4%) owned pets and 20 (5.4%) died. Logistic regression indicates that high social support (p < 0.068) and owning a pet (p = 0.085) tend to predict survival independent of physiologic severity and demographic and other psychosocial factors. Dog owners (n = 87, 1 died) are significantly less likely to die within 1 year than those who did not own dogs (n = 282, 19 died; p < 0.05); amount of social support is also an independent predictor of survival (p = 0.065). Both pet ownership and social support are significant predictors of survival, independent of the effects of the other psychosocial factors and physiologic status. These data confirm and extend previous findings relating pet ownership and social support to survival among patients with coronary artery disease.

Adult↗