Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Personal utility”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2002

Correlates of service utilization among midlife and older adults with HIV/AIDS: the role of age in the equation.

OBJECTIVES: To determine the role of age on service utilization among persons with HIV/AIDS: METHODS: The study examined 571 individuals diagnosed with symptomatic HIV or AIDS ranging in age from 30 to 81 years. All individuals had been enrolled in case management services from July 1995 through June 1996. It was hypothesized that older persons would utilize higher rates of health and medical services and lower rates of psychosocial services. RESULTS: The study found that in the older age groups the proportion of women, those living alone, and those having private health insurance increased. Mortality also increased in the older age groups, whereas survival time from AIDS diagnosis to death decreased. Age did not emerge as a significant variable in a multiple regression of service utilization. Functional dependence and mortality were significant predictors of medical services, whereas geographical location and insurance coverage explained the majority of variance in home care services.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Long term oxygen therapy adherence and COPD: what we don't know.

Persons utilizing long term oxygen therapy (LTOT) at home suffer from chronic obstructive pulmonary disease (COPD). Adherence to LTOT ranges from 45% to 70% and utilization of 15 hours per day is widely accepted as efficacious. Although studies have reviewed the level of patient adherence with LTOT, few have introduced or evaluated interventions. The paucity of information regarding patients following oxygen prescription is an enormous void that must be tackled to augment clinical effectiveness and cost containment for the long term. A research agenda for LTOT adherence is postulated to help connect treatment adherence variables and concepts with clinical outcomes and quality of life.

Guideline Adherence↗
PubMed1996

Reforming the health care system: implications for health care marketers.

Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.

Cost-Benefit Analysis↗
PubMedDate not supplied

Some subjective reactions of a behavioral scientist involved in thanatological research.

Ethical and pragmatic considerations often preclude the application of classical experimental approaches to in vivo thanatological research. While quasi-experimental and correlational designs may be employed to circumvent a number of potential problems, many more empirically testable research questions simply remain unaskable in the applied setting. Clearly, extra-experimental sources of information are of particular value in such situations. The present paper reports some of the observations and subjective reactions experienced by the writer while engaged in a series of experimental thanatological research studies. The issues addressed include the motivations of thanatological investigators and research participants, personal awareness of death, displacement of grief, anxieties about personal utility, paternalism, and honesty (i.e., frankness) as a primary ethic in facilitating a peaceful, "natural," death in the moribund individual.

Anxiety↗
PubMed2001

[Team management of rheumatoid arthritis].

The main objectives of team management of rheumatoid arthritis are to stop structural damage of joints and to reduce functional, psychological, socioprofessional and economic consequences. Team management requires the collaboration, around the patient, of a rheumatologist, a nurse, a psychologist, a physiotherapist, an occupational therapist, an orthopaedic surgeon at the same time, in the same place. More and more patients wish to manage their disease by themselves. Team care should not be proposed to every patient; it must be reserved to patients whose condition required such an approach because of the severity of the disease, comorbidity, psychological or socioprofessionnal difficulties. Team management should be personalized. Utility of team management is now accepted; out-patient administration is as effective as in-patient one. A good educational program is very important. However, search is still needed to define optimal modalities of team management and tools to measure the efficiency of this approach.

Arthritis, Rheumatoid↗
PubMed2003

[Undergraduate teaching project on clinical laboratory medicine].

Undergraduate teaching in clinical laboratory medicine is at the center of contemporary medical education. Students are expected to learn advanced laboratory medicine and basic diagnostic skills such as blood sampling, peripheral blood cell counting, blood typing, cross match test, urinalysis, electrocardiography, and bacteriological examinations through their training program. In our department, we have compulsory lectures, a basic practical training course and an advanced training course for the medical students. The compulsory lectures are programmed for the students in the fourth grade to obtain basic knowledge of clinical laboratory medicine and the patho-physiology of diseases. The teaching staff makes every effort to make their lectures exciting and interesting. As we experienced as medical students in the past, boring lectures give students nothing but a nap. For every senior teaching staff in our school, it is obligatory to be evaluated on their lectures by the students and other teaching staff every year to improve their teaching skills and materials. Teaching materials utilizing personal computers and the Internet are becoming more and more important. The basic practical training course is for the students in the fifth grade. The laboratory technicians help us teach students basic diagnostic skills in this program. The students in the advanced training course have to attend morning conferences in the department, including reverse clinico-pathological conferences and laboratory investigations. The reversed clinico-pathological conferences are popular among the students. Through our training programs, we hope that the students raise many questions that they solve themselves in the future, as well as learning established clinical laboratory medicine.

Clinical Laboratory Techniques↗
PubMed2004

Evaluating career values of dietetic students. A model for other allied health professions.

Increased job opportunities in health professions make recruitment of students imperative. Effective recruitment requires a knowledge of what students value when making career decisions. This study of dietetic (n = 514) and other college students (n = 352) showed that achievement and economic security were the most important factors in their career selection regardless of major or race. Dietetic majors rated achievement, economic security, ability utilization, personal development, altruism, and working conditions significantly higher than did nondietetic students (p < or = 0.001). Economic security was rated significantly more important by dietetic and allied health majors than by other students. Many of the values important to students in this study are attainable through careers in dietetics and other allied health professions. The results of this study should be examined further with a larger sample of allied health majors to assist educators in recruiting and providing career counseling to students.

Allied Health Personnel↗
PubMedDate not supplied

[Training-induced changes in performance self concept and cognitive abilities in the aged].

204 healthy elderly subjects (age range 65-85) participated in a training and retest programme leading to marked performance increases in two types of fluid intelligence tests (figural relations and inductive thinking). Effects of testing and training on self-perceived abilities and competence beliefs were measured on a battery of more and less situation-specific, task-related self-report instruments. The strongest and most consistent positive changes in self-concept of abilities attributable to training were found on judgements of task-related self-efficacy and beliefs in personal utility of acquired competence. Judgements of ability as causes for success and failure in future tests were also affected. The results support the view that fluid ability training is a valuable instrument to increase subjective as well as objective efficacy in thinking related to fluid intelligence. Training can therefore be considered helpful in supporting compensatory efforts to counteract age-related losses in perceived as well as actual ability.

Achievement↗
PubMed1985

Quantitative analysis of abnormal hemoglobins by agar gel electrophoresis.

Measurement of the proportion of abnormal hemoglobin in a hemolysate is essential for differentiation of simple and compound heterozygotes (e.g., sickle cell trait vs. sickle thalassemia), for differential of alpha- and beta-thalassemia in compound heterozygotes, and for differentiation of various types of beta-thalassemia in such persons. Utilization of such measurements is hampered by the imprecision and inconvenience of current methods. We have adapted a readily available agar electrophoresis method for this purpose, scanning unstained gels at 420 nm. The new method is particularly valuable for rapid estimation of percent of HbS after partial exchange transfusion in patients with sickle cell anemia. It cannot be used for quantitation of HbF or for quantitation of hemoglobins that comigrate with HbA; contrariwise, it can be used for hemoglobins that only separate from HbA on agar (e.g., HbBethesda).

Anemia, Sickle Cell↗
PubMed1997

[Results of periumbilical approach to hypertrophic pyloric stenosis treatment. Personal experience].

BACKGROUND: Ramstedt's pyloromyotomy is the universally accepted treatment for hypertrophic pyloric stenosis. It could be performed through different surgical approaches: Robertson muscle splitting incision, transverse right transrectal incision, median longitudinal incision laparoscopic approach and circumumbilical incision. METHODS: This latter technique was successfully personally utilized for the treatment of 33 consecutive patients; 29 patient were male and 4 female, age ranged from 15 to 52 days (median value 32.6 days), previously full term, normal weighing newborns. In all patients but one, the large pyloric mass bulged through the incision and the Ramstedt's pyloromyotomy was performed as usual. In one case, the pyloromyotomy has been done through the incision by holding the large pylorus firmly beneath the abdominal wall. The operative time has been quite similar to that obtained with the transverse right incision. The mean hospitalization period has been of four days. RESULTS: No operative or postoperative complications were observed. Particularly, despite no antibiotics were used, no wounds infections occurred. CONCLUSIONS: The esthetic result was satisfying in all cases after one month follow-up.

Female↗
PubMed1995

Racial differences in family support and formal service utilization among older persons: a nonrecursive model.

This research examines the relationship between the utilization of family help with activities of daily living and the use of formal community services among elderly persons for both Blacks and Whites. The analysis tests a nonrecursive model proposing a reciprocal relationship between the use of family for help with ADL/IADL tasks and the utilization of services by race. Two contradictory hypotheses are tested: the "compensatory" or "substitution" hypothesis, which suggests a negative reciprocal relationship between the use of informal and formal support, and the "linking" hypothesis, which indicates a positive reciprocal relationship. A multivariate analysis of data from the 1984 Supplement on Aging tested these hypotheses. The results fully support the "substitution" hypothesis for older Whites, but only partially for older Blacks. Receiving formal services is not associated with lower use of informal supports among Blacks.

Activities of Daily Living↗
PubMed1998

Health-care utilization by disabled persons: a survey in rural Bangladesh.

The purpose of the present study was to examine the utilization of health services by disabled persons in rural Bangladesh and to identify associated factors to inform the development of appropriate health services. Household surveys were conducted in two villages of Bangladesh by a trained primary-care specialist who lived in the study area for 4 months. About 81% of the sample had utilized some form of health care with more than half consulting unqualified practitioners of modern medicine. Disabled persons whose families perceived they were disabled were 14 times more likely than others to seek treatment. Being male and in the economically productive age group, having an acquired disability and having some form of belief about disability causation were associated with utilization. The conclusions of the study are that social and cultural barriers prevent certain groups, notably women and demographically dependent age groups, from accessing health care. Those who are economically beneficial to the family usually utilize health services. A combination of educational and economic initiatives such as a disability benefits allowance would strongly promote the health of disabled persons and create a general awareness of disability in Bangladesh. A long-term programme which includes disability training for health-care workers and use of financial institutions and existing local government infrastructure for intensive rehabilitation will improve quality of life for disabled persons and is proposed for urgent implementation.

Adolescent↗
PubMed1998

An investigation of malingering posttraumatic stress disorder on the Personality Assessment Inventory.

Utilizing the Personality Assessment Inventory (PAI; Morey, 1991), this study aimed to isolate a pattern of responding that is indicative of an attempt to malinger posttraumatic stress disorder (PTSD). The PAI profiles of 116 male participants were examined. Profiles of a group of 29 alcohol-abusing veterans with a primary Axis I (American Psychiatric Association, 1994) diagnosis of PTSD and a group of 30 alcohol-abusing veterans with no other diagnoses were compared to those of 27 undergraduate men instructed to feign PTSD. Control data were obtained from another group of 30 undergraduates. The student malingerers produced PAI profiles that were significantly different from the veterans with PTSD. Seven scales distinguished the malingerers from the veterans with an actual diagnosis of PTSD. Malingerers tended to overexaggerate pathology, inflating their scores on many clinical scales greater than the mean of the PTSD sample. Malingerers also scored higher on Morey's (1993) 8-item Malingering Index than either group of veterans and the controls. Only 2 scales reliably differentiated alcohol-abusing veterans with PTSD from those without the disorder. The implications of these findings in the diagnosis of PTSD are discussed.

Adult↗
PubMed2001

Factors associated with the health care utilization of homeless persons.

CONTEXT: Homeless persons face numerous barriers to receiving health care and have high rates of illness and disability. Factors associated with health care utilization by homeless persons have not been explored from a national perspective. OBJECTIVE: To describe factors associated with use of and perceived barriers to receipt of health care among homeless persons. DESIGN AND SETTING: Secondary data analysis of the National Survey of Homeless Assistance Providers and Clients. SUBJECTS: A total of 2974 currently homeless persons interviewed through homeless assistance programs throughout the United States in October and November 1996. MAIN OUTCOME MEASURES: Self-reported use of ambulatory care services, emergency departments, and inpatient hospital services; inability to receive necessary care; and inability to comply with prescription medication in the prior year. RESULTS: Overall, 62.8% of subjects had 1 or more ambulatory care visits during the preceding year, 32.2% visited an emergency department, and 23.3% had been hospitalized. However, 24.6% reported having been unable to receive necessary medical care. Of the 1201 respondents who reported having been prescribed medication, 32.1% reported being unable to comply. After adjustment for age, sex, race/ethnicity, medical illness, mental health problems, substance abuse, and other covariates, having health insurance was associated with greater use of ambulatory care (odds ratio [OR], 2.54; 95% confidence interval [CI], 1.19-5.42), inpatient hospitalization (OR, 2.60; 95% CI, 1.16-5.81), and lower reporting of barriers to needed care (OR, 0.37; 95% CI, 0.15-0.90) and prescription medication compliance (OR, 0.35; 95% CI, 0.14-0.85). Insurance was not associated with emergency department visits (OR, 0.90; 95% CI, 0.47-1.75). CONCLUSIONS: In this nationally representative survey, homeless persons reported high levels of barriers to needed care and used acute hospital-based care at high rates. Insurance was associated with a greater use of ambulatory care and fewer reported barriers. Provision of insurance may improve the substantial morbidity experienced by homeless persons and decrease their reliance on acute hospital-based care.

Adult↗
PubMed1999

Distress, personality, and mammography utilization among women with a family history of breast cancer.

The authors examined the impact of psychological distress and the personality construct of conscientiousness (as measured by the Neuroticism, Extraversion, and Openness-Five Factor Inventory) on mammography utilization among women who were at increased risk for breast cancer. Participants were 200 women who had at least 1 first degree relative with breast cancer. Overall, 80% of the participants had obtained a mammogram in the previous year. Analyses controlling for potential confounders (perceived risk, decisional balance, and physician recommendation for mammography), revealed that distress was negatively associated with mammography utilization among participants who were low in conscientiousness. Distress was not significantly related to mammography utilization among highly conscientious women. The results are discussed in terms of their implications regarding interventions designed to increase mammography utilization in this population.

Adult↗
PubMed2004

Five-factor model prototypes for personality disorders: the utility of self-reports and observer ratings.

The current study examined the prototype-matching technique for using the five-factor model (FFM) of personality to assess personality disorders (PDs) and their correlates. The sample was composed of 69 psychiatric patients, most of whom suffered from affective or anxiety disorders. The participants were predominantly outpatients (78%), Caucasian (94%), and women (58%). NEO Personality Inventory (NEO-PI) data from these patients and informants were available for deriving PD prototype scores. The results supported four conclusions. First, the FFM prototype-matching method is useful for clinical samples. Second, agreement between self-reports and information from significant others (SOs) using this method is good compared to previous results. Third, this agreement varies systematically with the observability of the PD criteria. Fourth, the value of self- and other-reported personality information depends on the rating source of the outcome variables. Other-reported information provides incremental utility in predicting impairment and interpersonal distress rated by clinicians and significant others.

Adult↗
PubMed2006

Healthcare utilization of elderly persons hospitalized after a noninjurious fall in a Swiss academic medical center.

OBJECTIVES: To determine the risk of hospital readmission, nursing home admission, and death, as well as health services utilization over a 6-month follow-up, in community-dwelling elderly persons hospitalized after a noninjurious fall. DESIGN: Prospective cohort study with 6-month follow-up. SETTING: Swiss academic medical center. PARTICIPANTS: Six hundred ninety persons aged 75 and older hospitalized through the emergency department. MEASUREMENTS: Data on demographics and medical, physical, social, and mental status were collected upon admission. Follow-up data were collected from the state centralized billing system (hospital and nursing home admission) and proxies (death). RESULTS: Seventy patients (10%) were hospitalized after a noninjurious fall. Fallers had shorter hospital stays (median 4 vs 8 days, P<.001) and were more frequently discharged to rehabilitation or respite care than nonfallers. During follow-up, fallers were more likely to be institutionalized (adjusted hazard ratio=1.82, 95% confidence interval=1.03-3.19, P=.04) independent of comorbidity and functional and mental status. Overall institutional costs (averaged per day of follow-up) were similar for both groups ($138.5 vs $148.7, P=.66), but fallers had lower hospital costs and significantly higher rehabilitation and long-term care costs ($55.5 vs $24.1, P<.001), even after adjustment for comorbidity, living situation, and functional and cognitive status. CONCLUSION: Elderly patients hospitalized after a noninjurious fall were twice as likely to be institutionalized as those admitted for other medical conditions and had higher intermediate and long-term care services utilization during follow-up, independent of functional and health status. These results provide direction for interventions needed to delay or prevent institutionalization and reduce subsequent costs.

Academic Medical Centers↗
PubMed1993

Urban/rural differences in health service utilization by elderly persons in the United States.

This paper presents the results of a longitudinal analysis of differences between urban and rural elderly persons in the use of hospital, nursing home, and physician services. Multivariate logistic and Tobit utilization models were estimated with data from the National Center for Health Statistics' Longitudinal Study of Aging (a national survey of more than 5,000 elderly, 70 years of age and older) and health resource data from the Bureau of Health Professions' Area Resources File. The research investigated the independent effect of residential location on both the frequency of service use and the likelihood of using a service over the period 1984-1986. Under a trichotomous definition of urban/rural residency and controlling for differences in predisposing, enabling, and need characteristics, the analysis revealed that the utilization pattern of hospital, nursing home, and physician services was unrelated to either rural or urban residential location or the availability of health resources in those areas.

Aged↗