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PubMed2006

Surrounding suppression and facilitation in the determination of border ownership.

Contextual modulation reported in early- to intermediate-level visual areas could be an essential component to signal border ownership (BO) that specifies the direction of figure along a contour. The surrounding regions that evoke significant suppression or facilitation are highly localized and asymmetric with respect to the center of the classical receptive field (CRF). We propose a hypothesis that such surrounding modulation is a basis for BO-selectivity. Although this idea has been discussed for several years, it is uncertain how many of a vast variety of surrounding organizations could signal correctly the direction of ownership, and how many could signal consistently for various stimuli. We carried out computationally a population study of the surrounding effects to investigate how many cells exhibit effective and consistent BO signals. We tested hundreds of various organizations, and found that most of the asymmetric, iso-orientation suppressive regions, regardless of position or size, lead to surprisingly high consistency in the direction of ownership for various stimuli. The combinations of iso-orientation suppression and cross-orientation facilitation indicate both high robustness and consistency in the ownership determination. We constructed a model for BO-selective neurons based on the surrounding effects, and investigated whether the model reproduces major characteristics of the neuronal responses, including a variety in the BO selectivity among neurons, consistency with respect to various stimuli, invariance to stimulus size, and co-selectivity to BO and contrast. The model reproduced successfully the major characteristics of BO-selective neurons.

Contrast Sensitivity↗
PubMed2005

Border-ownership-dependent tilt aftereffect.

Single-cell recordings from macaque visual cortex have shown orientation-selective neurons in area in V2 code for border ownership [J. Neurosci. 20, 6594 (2000)]: Each piece of contrast border is represented by two pools of neurons whose relative firing rate indicates the side of border ownership. Here we show that the human visual cortex uses a similar coding scheme by demonstrating a border-ownership-contingent tilt aftereffect. The aftereffect was specific for the adapted location, indicating that the adapted neurons have small receptive fields. We conclude that figure-ground organization is represented by border-ownership-selective neurons at early stages in the human visual cortex.

Adaptation, Ocular↗
PubMed1999

A South Australian population survey of the ownership of asthma action plans.

OBJECTIVE: To examine the relationships between ownership of written asthma action plans, asthma morbidity, use of devices, and patients' perceptions of their asthma management. DESIGN AND SETTING: A random population survey (in 1996) of the South Australian population aged 15 years or over, using interviewers to administer a questionnaire. PARTICIPANTS: People who reported that they had current, doctor-diagnosed asthma. MAIN OUTCOME MEASURES: Prevalence of written asthma action plans; night-time awakenings from asthma; ownership of peak flow meters; and people's perceptions of their asthma management. RESULTS: The ownership of asthma action plans by people with self-reported asthma was 33% and has declined since 1995 (42%; P < 0.001). Fifteen per cent were awakened weekly or more frequently by asthma symptoms. These people were more likely to have a peak flow meter and a written action plan, but less likely to consider they had been provided with enough information about their asthma, to feel comfortable managing their asthma, or to find it easy to see their doctor. Having a written asthma action plan was associated with regular corticosteroid use, understanding asthma, having enough information and owning a peak flow meter. CONCLUSIONS: Ownership of asthma action plans in South Australia is suboptimal. Before we develop new strategies to improve asthma outcomes, we must determine whether there is a need to target people with less severe asthma and/or improve the use of guidelines by health professionals.

Asthma↗
PubMed2003

Pet ownership and risk factors for cardiovascular disease: another look.

OBJECTIVE: To test the claim that pet ownership reduces cardiovascular risk. DESIGN: Community survey. PARTICIPANTS: 2528 adults aged 40-44 years and 2551 aged 60-64 years who lived in the Australian Capital Territory and Queanbeyan, New South Wales, and were drawn randomly from the Australian electoral roll in 2000 and 2001. MAIN OUTCOME MEASURES: Sociodemographic measures, including pet ownership, and measures of physical health (including body mass index [BMI], alcohol and cigarette consumption, and levels of physical activity). Two readings of diastolic and systolic blood pressure were also taken. RESULTS: While pet owners and non-pet owners had similar levels of systolic blood pressure, those with pets had significantly higher diastolic blood pressure. Pet owners also had higher BMI and were more likely to smoke. While those with pets undertook more mild physical activity, they continued to have significantly higher diastolic blood pressure after controlling for hypertensive risk factors. CONCLUSIONS: In this study, we found no evidence that pet ownership per se is associated with cardiovascular health benefits. Rather, pet owners had higher diastolic blood pressure than those without pets. It is likely that this increased health risk is linked to other hypertensive risk factors that are only indirectly associated with pet ownership.

Adult↗
PubMed1993

International correlations between gun ownership and rates of homicide and suicide.

OBJECTIVE: To examine international correlations between reported rates of household gun ownership and rates of homicide and suicide with a gun. DESIGN: Survey. POPULATION: People who responded to a telephone survey conducted by the 1989 International Crime Survey in 11 European countries, Australia, Canada and the United States. RESULTS: Positive correlations were obtained between the rates of household gun ownership and the national rates of homicide and suicide as well as the proportions of homicides and suicides committed with a gun. There was no negative correlation between the rates of ownership and the rates of homicide and suicide committed by other means; this indicated that the other means were not used to "compensate" for the absence of guns in countries with a lower rate of gun ownership. CONCLUSION: Larger studies are needed to examine more closely possible confounding factors such as the national tendency toward violent solutions, and more information on the type and availability of guns will be helpful in future studies. Nevertheless, the correlations detected in this study suggest that the presence of a gun in the home increases the likelihood of homicide or suicide.

Australia↗
PubMedDate not supplied

Firearm ownership and health care workers.

OBJECTIVE: Health professionals have increasingly become aware of the public health hazards caused by firearms. This study was designed to determine the firearm ownership and storage practices of a group of health care workers. METHODS: All 6436 nonphysician employees of a large health maintenance organization were surveyed as part of an ongoing effort to enhance the organization's effectiveness. Two questions regarding firearm ownership and storage practices were included in the 85-question survey instrument. A total of 4999 surveys were returned, for a response rate of 78%. RESULTS: Forty-two percent of the health workers surveyed reported keeping a firearm in their home, and 35% of firearm owners stored that firearm loaded. Men were more likely than women to report having a firearm in the home. Firearm ownership and storage of a loaded firearm decreased with higher levels of education in both sexes. A measure of increased alcohol consumption was related to higher rates of firearm ownership and storage of loaded firearms in men. CONCLUSIONS: A substantial number of health care workers had firearms in their homes and did not store them safely. Counseling regarding the risks associated with easy access to firearms should be considered for inclusion in employee health programs as well as in employee assistance and alcohol treatment programs.

Adult↗
PubMed2004

Ownership and use of tissue specimens for research.

Academic and industrial scientists have sharply increased their demand for properly prepared and clinically annotated tissue samples that yield valuable insights into the origins and expressions of human disease. Historically, research on human tissue samples has been relatively unencumbered by federal regulations and occurred without delineation of ownership rights to the specimens, patient data, or research products. As regulations have become increasingly restrictive, and because clear ownership interests have never been established, the presumed right of researchers and institutions to collect, use, and dispose of specimens and their associated patient data has remained undefined and occasionally contentious. Recent examination of these issues by a US federal court resulted in a ruling that individuals do not retain rights of ownership or control of biological materials contributed for research, regardless of whether commercial benefit accrues. This article examines the legal, regulatory, and ethical framework within which human tissue research is currently conducted. We contend that because the benefits of medical knowledge derived from tissue research potentially accrue to all individuals and future generations (rather than a single recipient), society may justify an expansive use of these valuable resources for future studies.

Bioethical Issues↗
PubMed1998

The impact of ownership type on nursing home outcomes.

This paper examines the sorting of residents between for-profit and nonprofit nursing homes and the health outcomes of those residents conditional on ownership type. Using data from the 1987 National Medical Expenditure Survey, we find evidence of systematic sorting of residents by ownership type, and significant effects of ownership type on outcomes. These results are broadly consistent with the hypothesis that for-profit and nonprofit homes exploit their informational advantages to differing extents in a market characterized by asymmetric information.

Aged↗
PubMed1994

The impact of ownership form and regulatory measures on firm behavior: a study of hospices.

This article examines differential responses to the Medicare hospice benefit across ownership types. The analysis reveals little difference in costs or quality of service among government-owned, for-profit, and nonprofit hospices. However, there are significant differences in the numbers of patients served by ownership status. The results are consistent with the hypothesis that nonprofit hospices are patient maximizers, not profit maximizers in disguise who are aiming to circumvent the nondistribution constraint. A comparison of these results with those in the hospital and nursing home industries leads to the conclusion that Medicare regulations and the predominance of Medicare revenues in an industry induce similar outcomes in cost and quality across ownership types.

Costs and Cost Analysis↗
PubMed2005

Social interactions and resource ownership in two private protected areas of Paraguay.

This paper describes the results of field research to dissect how social interactions differ between two reserves in Paraguay having very different styles of governance. The two reserves were Mbaracayú Natural Forest Reserve (Reserva Natural del Bosque de Mbaracayú, RNBM) and San Rafael Managed Resource Reserve (Reserva de Recursos Manejados San Rafael, RRMSR). RNBM is a private reserve owned by a non-governmental organisation, while RRMSR is a publicly-managed reserve, albeit with a substantial degree of private land ownership. Both reserves are intended to protect Atlantic Forest, one of the five world biodiversity 'hotspots', and also one of the most highly threatened. Each reserve and its buffer zone comprises a set of stakeholders, including indigenous communities and farmers, and the paper explores the interactions between these and the management regime. Indeed, while the management regimes of the two reserves are different, one being highly top-down (RNBM) and the other more socially inclusive (RRMSR), the issues that they have to deal with are much the same. However, while both management regimes will readily acknowledge the need to address poverty, inequality appears to be a far more sensitive issue. Whereas this may be expected for the privately-owned RNBM it is perhaps more surprising in RRMSR even when allowing for the fact that much of the land in the latter is in private hands. It is argued that the origins of this sensitivity rest within the broader features of Paraguayan society, and the prevalence of private land ownership. Yet ironically, it is the inequality in land ownership that is perhaps the most significant threat to conservation in both reserves. Therefore, while reserve-level analyses can provide some insight into the driving forces at play in the interaction between conservation and sustainable management, larger scales may be necessary to gain a fuller appreciation of the dynamics operating at site level. Even in a society with a history of centralised control these dynamics may be surprising.

Conservation of Natural Resources↗
PubMed2003

Is discharge policy a balanced decision between clinical considerations and hospital ownership policy? The CABG example.

OBJECTIVES: To explore to what extent patient discharge from the hospital is a balanced decision between clinical considerations and management policy; specifically: (1) to assess the role of patient risk as a determinant of discharge in comparison with administrative factors such as hospital ownership; (2) to evaluate whether variations in discharge policy were translated into differences in clinical outcomes. METHODS: A national study of coronary artery bypass surgery was used as an example. The population included 4778 patients undergoing coronary artery bypass surgery in 14 institutions. The mode of discharge day, rather than the mean, was used as the best indicator of discharge policy. Parametric survival model was used to assess factors associated with the day of discharge. RESULTS: The mode of discharge day varied widely among institutions. This variation between 4 and 7 days after surgery corresponded to hospital ownership. The mode of discharge day was almost invariant to the patients' risk, but serious postoperative complications resulted in prolonged stay for a minority of the patients. The influence of hospital ownership prevailed over patient insurance carriers. Differences in discharge policies were not associated with increased risk of late mortality or rehospitalization. CONCLUSIONS: Discharge policy beyond the rare occurrence of dramatic patient postoperative complications was mainly dependent on hospital owner's cost-effectiveness considerations. However, despite the weight given to administrative factors in the decision-making process, it did not affect the outcome of care.

Coronary Artery Bypass↗
PubMed2002

The effect of hospital ownership choice on patient outcomes after treatment for acute myocardial infarction.

I examine the effect of ownership choice on patient outcomes after the treatment for acute myocardial infarction. I find that for-profit and government hospitals have higher incidence of adverse outcomes than not-for-profit hospitals by 3-4%. In addition, the incidence of adverse outcomes increases by 7-9% after a not-for-profit hospital converts to for-profit ownership, but there is little change in patient outcomes in other forms of ownership conversion. The findings are robust, whether I use the entire sample or subsamples of hospitals that share similar hospital and market characteristics.

Decision Making↗
PubMed1984

Ownership and mental-health services. A reappraisal of the shift toward privately owned facilities.

The mental-health system in the United States is undergoing marked "privatization"--a growth in the importance of both private nonprofit and for-profit providers. Analyzing data collected in earlier surveys, we found that the type of ownership was linked to a number of important aspects of institutional performance: (1) private facilities, both for profit and not-for-profit, are more likely to screen out nonpaying patients than are government-owned providers; (2) services provided under public auspices are more expensive than those provided in private institutions; and (3) compared with private nonprofit facilities, for-profit providers devote fewer staff resources to patient care and offer fewer services with community-wide benefits. We conclude that ownership affects the organizational behavior of mental-health facilities. The contemporary shift from public to private provision of mental-health care raises important questions about ensuring adequate access to care, maintaining the supply of needed services, and adapting systems of reimbursement and regulation to the heterogeneous motivations of providers operating under different forms of ownership.

Community-Institutional Relations↗
PubMed1999

Effect of the ownership of dialysis facilities on patients' survival and referral for transplantation.

BACKGROUND: More than 200,000 patients with end-stage renal disease undergo dialysis in the United States each year, about two thirds in for-profit centers. Economic pressures, such as the decline in inflation-adjusted Medicare payments for dialysis, may compromise the quality of care. Facilities may also be reluctant to refer patients to be evaluated for transplantation because of the loss of revenues from dialysis after patients receive transplants. It is unknown whether for-profit facilities respond more aggressively than not-for-profit facilities to these financial pressures. Therefore, we examined the effect of for-profit ownership of dialysis facilities on patients' survival and referral for possible transplantation. METHODS: We used data from the U.S. Renal Data System to assemble a nationally representative cohort of patients with end-stage renal disease of recent onset. We followed patients for a minimum of three years and a maximum of six years, until death, placement on the waiting list for a renal transplant, or loss to follow-up, or until May 31, 1996. We used proportional-hazards models to assess the effect of the profit status of the dialysis facility on patients' outcomes and adjusted for differences in sociodemographic, clinical, and facility-level characteristics. RESULTS: Of the 3681 patients who were eligible for inclusion, we included 3569 in the analysis of mortality and 3441 in the analysis of the waiting list. The crude mortality rate per 100 person-years of end-stage renal disease was 21.2 for patients treated in for-profit facilities and 17.1 for patients treated in not-for-profit centers (adjusted relative hazard, 1.20; 95 percent confidence interval, 1.02 to 1.42). The likelihood of being placed on the waiting list for a renal transplant was lower for patients treated at for-profit centers (adjusted relative hazard, 0.74; 95 percent confidence interval, 0.56 to 0.98). CONCLUSIONS: In the United States, for-profit ownership of dialysis facilities, as compared with not-for-profit ownership, is associated with increased mortality and decreased rates of placement on the waiting list for a renal transplant.

Adult↗
PubMedDate not supplied

The performance of municipal water utilities: evidence on the role of ownership.

There is growing concern about the operations of the municipal agencies responsible for supplying potable water and treating sewage, spurred by (1) difficulties of maintaining aging capital stocks in times of tightening fiscal constraints, (2) the water pollution generated by these agencies, (3) problems associated with service quality and reliability, and (4) the recognition of the role played by utilities in allocating scarce water resources. These concerns have lead to a heightened scrutiny of these agencies with increased interest in reforming their operations. In particular, this has focused on an examination of whether the ownership of water utilities is a factor explaining their behavior and whether changing their ownership will lead to improvements in their operations. The purpose of this paper was to critically assess what is known regarding the relationship between the ownership and performance of municipal water utilities. There are a number of theoretical arguments that support the prediction that privately owned water utilities will out-perform comparable publicly funded utilities. These arguments draw on property-rights and public choice theories and principle agent models in order to emphasize the difficulty that governments have in monitoring and providing proper incentives for utility managers. Empirical evidence was obtained from the United States, the United Kingdom, and France based on a variety of performance indicators. These data revealed that there was no compelling evidence of private utilities outperforming public utilities or that privatizing water utilities leads to improvements in performance.

France↗
PubMed1998

Ownership and use of assistive devices amongst older people in the community.

AIMS: To determine the ownership and use of various assistive devices by older people living at home. METHOD: A random sample of 1405 elderly people aged 65 years and over, in three health authorities, were asked about ownership and use of a number of disability aids, spectacles and hearing aids. RESULTS: 74% of respondents owned one or more aid, 97% had spectacles and 16% a hearing aid. The most commonly owned assistive devices were a non-slip bath mat (50%), a walking stick (24%) and a bath rail (21%). Many severely disabled people, however, had no aids. For example, 75% had no stair rail, 68% had no lavatory rail and 46% had no non-slip bath mat. Most of the equipment owned was used. Walking frames and wheelchairs were used more by those over 75, as were all bathroom and lavatory appliances. Gender influenced the use of some aids, with more women using their walking frames and bathroom rails than men. CONCLUSION: Our study confirms that ownership and use of aids varies with age, gender, living arrangements and disability. Very disabled people need but do not own certain basic and relatively inexpensive appliances. Community services currently aim to promote autonomy and independence in elderly people in the community. This may be facilitated and enhanced by provision of appropriate equipment and increasing awareness of the value of assistive devices among elderly people, informal carers and health- and social-care professionals. Knowledge of who owns and uses various items of equipment may help improve strategic planning.

Aged↗
PubMed1996

Racial differences in home ownership and home equity among preretirement-aged households.

This article measures the racial disparities in home ownership and home equity among preretirement-aged households. It computes the proportion of the racial gap explained by discrimination in housing and credit markets. Maximum likelihood and nonlinear least squares estimates are obtained for models of home ownership probabilities and home equity, conditional on home ownership, yielding computations for expected home equity for black and white households. The results reveal an average discriminatory gap in expected home equity as a percent of the actual gap of 55%. In the top third of the family income distribution, the measured discriminatory gap is 82%; in the middle third it is 83%; in the lowest third it is 62%.

Black or African American↗
PubMed1999

Patient satisfaction in Bangkok: the impact of hospital ownership and patient payment status.

INTRODUCTION: Patient satisfaction with care received is an important dimension of evaluation that is examined only rarely in developing countries. Evidence about how satisfaction differs according to type of provider or patient payment status is extremely limited. OBJECTIVE: To (i) compare patient perceptions of quality of inpatient and outpatient care in hospitals of different ownership and (ii) explore how patient payment status affected patient perception of quality. METHODS: Inpatient and outpatient satisfaction surveys were implemented in nine purposively selected hospitals: three public, three private for-profit and three private non-profit. RESULTS: Clear and significant differences emerged in patient satisfaction between groups of hospitals with different ownership. Non-profit hospitals were most highly rated for both inpatient and outpatient care. For inpatient care public hospitals had higher levels of satisfaction amongst clientele than private for-profit hospitals. For example 76% of inpatients at public hospitals said they would recommend the facility to others compared with 59% of inpatients at private for-profit hospitals. This pattern was reversed for outpatient care, where public hospitals received lower ratings than private for-profit ones. Patients under the Social Security Scheme, who are paid for on a capitation basis, consistently gave lower ratings to certain aspects of outpatient care than other patients. For inpatient care, patterns by payment status were inconsistent and insignificant. CONCLUSIONS: The survey confirms, to some extent, the stereotypes about quality of care in hospitals of different ownership. The results on payment status are intriguing but warrant further research.

Adolescent↗