Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Delaware”

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 1,099 records · Page 61Linked to original sources
PubMed1986

Alternative paths to long-term care: nursing home, geriatric day hospital, senior center, and domiciliary care options.

This paper examines certain quality of life outcomes, as well as comparative costs of care, for selected types of persons entering three very distinct types of alternative service programs that address the long-term care needs of vulnerable elderly persons: nursing homes (NH), geriatric day hospitals (GDH), and senior center (SC) programs. For selected outcomes, based on secondary analysis of the data gathered in another study, it was possible to add to the comparison samples of similar types of persons entering small foster-type domiciliary care homes (DC). From pools of persons entering these programs, six separate sets of comparison samples who were similar at baseline were constructed (GDH-SC, NH-SC, NH-GDH, NH-DC, SC-DC, GDH-DC). Only analyses pertaining to institutionalization and costs were conducted for the last three sets of comparison groups. Except for the issue of institutionalization, quality of life impact analysis showed only a few more post-test differences than would be expected by chance (although the few post-test differences that were observed in each case favored less restrictive settings). This more general similarity of outcome is indeed provocative, suggesting that in many ways the applicants adapted similarly to these quite distinct programs. Cost analyses found that nursing home and geriatric day hospital care, the two most restrictive settings, were also the two most expensive interventions.

Activities of Daily Living↗
PubMed1987

Tuberculosis risk among migrant farm workers on the Delmarva peninsula.

A survey was conducted to ascertain the risk of tuberculosis (TB) among migrant farm workers on the Delmarva peninsula. Relevant histories were obtained from 842 migrants; a total of 709 skin tests were completed, and 239 sputum specimens were examined for acid-fast bacilli (AFB) and culture. No cases of infectious tuberculosis were ascertained by history or AFB examination. One sputum culture was positive for M. tuberculosis and 13 were positive for various species of nontuberculous mycobacteria. Thirty-seven per cent of migrants tested had significant skin test reactions of 10 mm or more. Reaction rates for men were 41 per cent and for women 25 per cent. Age specific rates ranged from 14 per cent in children aged 5-14 to 54 per cent for ages 45-54. Rates for the principal national/ethnic groups were Haitians 55 per cent, Mexicans 36 per cent, US Blacks 29 per cent and US-born Latinos 20 per cent. Based on these results and other information currently available, it is recommended that current Centers for Disease Control (CDC) recommendations for TB prophylaxis continue to be applied for migrant workers, but that mass screening by skin testing in camp populations not be emphasized. Other recommendations focus on: case finding of active disease, improving continuity and follow-up, increasing coordination among involved agencies, and actively supporting improved economic and living conditions for migrant farm workers.

Adolescent↗
PubMed1990

Poison Control Center follow-up of occupational disease.

We followed up 73 of 372 calls to a Regional Poison Control Center (RPCC) that involved workplace disease/exposure(s); most other calls were not made by the workers. An average of 12 additional people per workplace were potentially exposed. Six of the 73 contacted a government agency for investigation of the hazard/illness. Twenty-five percent of callers were still exposed an average of seven months after the original call. The results indicate that poison control centers should develop a public health component to calls about possible workplace poisonings.

Adult↗
PubMed2003

Factors influencing the development of osteonecrosis in patients treated for slipped capital femoral epiphysis.

BACKGROUND: Osteonecrosis is a serious complication of the treatment of slipped capital femoral epiphysis. The purpose of the present study was to identify factors influencing the development of osteonecrosis. METHODS: Two hundred and forty patients who had been treated for slipped capital femoral epiphysis between 1965 and 1999 were retrospectively evaluated. Treatment included stabilization with a spica cast or fixation with one to four pins or screws. Radiographs that had been made at the time of presentation, before and after the operation, and at consecutive follow-up examinations were reviewed. Osteonecrosis was defined retrospectively on the basis of radiographic evidence of sclerosis and collapse of the femoral head. The risk of development of osteonecrosis was correlated with various clinical and radiographic parameters. RESULTS: All twenty-one patients in whom osteonecrosis developed had presented with an unstable slipped capital femoral epiphysis. None of the 204 patients who had presented with a stable slipped capital femoral epiphysis, regardless of grade, had development of osteonecrosis. In the group of patients who had presented with an unstable slipped capital femoral epiphysis, the risk of development of osteonecrosis increased with the severity (grade) of the slip. Osteonecrosis was more likely to develop in patients who had been treated with multiple pins than in those who had been treated with a single cannulated screw. CONCLUSIONS: Patients who have a stable slipped capital femoral epiphysis are not at risk for the development of osteonecrosis when treated with pinning in situ. Patients who have an unstable slipped capital femoral epiphysis have a decreased risk of osteonecrosis when treated with pinning in situ. Complete or partial reduction of an unstable slipped capital femoral epiphysis increases the risk of development of osteonecrosis. Pinning in situ without reduction with a single cannulated screw is the method of choice for the treatment of a slipped capital femoral epiphysis.

Bone Nails↗
PubMedDate not supplied

Atmospheric deposition of pesticides to an agricultural watershed of the Chesapeake Bay.

The Choptank River watershed, located on the Delmarva Peninsula of the Chesapeake Bay, is dominated by agricultural land use, which makes it vulnerable to runoff and atmospheric deposition of pesticides. Agricultural and wildlife areas are in close proximity and off-site losses of pesticides may contribute to toxic effects on sensitive species of plants and animals. High-volume air samples (n = 31) and event-based rain samples (n = 71) were collected from a single location in the watershed representing regional background conditions. Surface water samples were collected from eight stations in the tidal portion of the river on five occasions during 2000. Chlorothalonil, metolachlor, atrazine, simazine, endosulfan, and chlorpyrifos were frequently detected in the air and rain, with maximal concentrations during the period when local or regional crops were planted. The wet deposition load to the watershed was estimated at 150 +/- 16, 61 +/- 7, and 51 +/- 6 kg yr(-1) for chlorothalonil, metolachlor, and atrazine, respectively. The high wet deposition load compared with the estimated annual usage for chlorothalonil (13%) and endosulfan (14-90%) suggests an atmospheric source from outside the watershed. Net air-water gas exchange fluxes for metolachlor varied from -44 +/- 19 to 9.3 +/- 4.1 ng m(-2) d(-1) with negative values indicating net deposition. Wet deposition accounted for 3 to 20% of the total metolachlor mass in the Choptank River and was a more important source to the river than gas exchange. Estimates of herbicide flux presented here are probably a low estimate and actual rates may be significantly higher in areas closer to pesticide application.

Agriculture↗
PubMed1984

Industrialization spawns the Elder Craftsmen Shop.

Research on the Wilmington Senior Center Elder Craftsmen Shop provides the background for this sociological examination of the role of the elder craftsmen shop in our society. The shop is put into historical context by discussing the development of pension plans and the evolution in the means of producing goods. It is argued that, as a social utility, the nonprofit elder craftsmen shop provides a uniquely flexible work situation. It allows for the expression of the work ethic in the framework of retirement.

Aged↗
PubMed2004

An economic analysis of health plan conversions: are they in the public interest?

Over the last decade, managed-care companies have been consolidating on both a regional and national scale. More recently, nonprofit health plans have been converting to for-profit status, and this conversion has frequently occurred as a step to facilitate merger or acquisition with a for-profit company. Some industry observers attribute these managed-care marketplace trends to an industry shakeout resulting from increased competition in the sector. At the same time, these perceived competitive pressures have led to questions about the long-run viability of nonprofit health plans. Furthermore, some industry and government leaders believe that some nonprofits are already conducting themselves like for-profit health plans and question the state premium tax exemption ordinarily accorded to such plans. This paper examines related health policy issues through the lens of a case study of the proposed conversion of the CareFirst Blue Cross Blue Shield company to a for-profit public-stock company and its merger with the Wellpoint Corporation. Company executives and board members argued that CareFirst lacked access to sufficient capital and faced serious threats to its viability as a financially healthy nonprofit health care company. They also argued that CareFirst and its beneficiaries would benefit from merger through enhanced economies of scale and product-line extensions. Critics of the proposed conversion and merger raised concerns about the adverse impacts on access to care, coverage availability, quality of care, safety-net providers, and the cost of health insurance. Analyses demonstrate that CareFirst wields substantial market power in its local market, that it is unlikely to realize cost savings through expanded economies of scale, and that access to capital concerns are largely driven by the perceived need for further expansion through merger and acquisition. Although it is impossible to predict future changes in quality of care for CareFirst, analyses suggest that quality appears to be somewhat lower in for-profit national managed-care companies. Additional research is needed to assess the viability of true nonprofits, the potential effects of nonprofits and for-profit national managed-care plans on the evolution of local insurance and provider markets, and methods for effective oversight of nonprofit health plans.

Algorithms↗
PubMed1988

Serologic incidence of Cryptosporidium in Delmarva broiler flocks.

Banked serum samples collected from an industry-wide serologic survey of eighteen Delmarva broiler flocks conducted in 1985 were evaluated for the presence of Cryptosporidium- specific antibodies in an indirect enzyme-linked immunosorbent assay (ELISA). Evaluation of sera collected at 49-days posthatch showed that 38% of the broiler flocks were serologically positive, whereas 50% of samples obtained from flocks at 63-days during an extended growout were positive. From a performance standpoint, the top nine flocks in the study were essentially negative at the 49-day sampling. In order to more firmly establish the serologic prevalence of Cryptosporidium in Delmarva broiler flocks, a second serologic survey was conducted early in 1987. In this study, an estimated 22% of the 454 broiler flocks sampled at approximately 49 days of age were positive for Cryptosporidium. The negative Cryptosporidium serology in the top 25% of these flocks was associated with better performance, but positive Cryptosporidium serology was not clearly correlated with poor performance. Remarkable differences between Cryptosporidium serologic exposure rates of the growout companies were observed, with some companies having exposure rates as high as 40%, and others rates of less than 3%.

Animals↗
PubMed1997

Relationship between selected discourse strategies and student critical thinking.

This study investigated the relationship between use of selected discourse strategies and level of student critical thinking in nursing clinical post-conferences. Selected discourse strategies included: (a) teacher high-level questions, (b) teacher elaboration of student ideas, (c) teacher probing questions, (d) student participation, and (e) student-to-student participation. The level of student critical thinking was defined as the quartile ranking of students (N = 57) on the Watson-Glaser Critical Thinking Appraisal summative measure. It was hypothesized that greater use of discourse strategies would be associated with high-levels of student critical thinking. All discourse strategies were significantly associated (p < .0001) to student quartile ranking for one taping session (Conference II). Further analysis, however, revealed ambiguous patterns of two-way associations. The more consistent findings suggested a conceptual relationship between less student talk and student-to-student talk and high-levels of student critical thinking.

Adult↗
PubMed2001

The cognitive model. Interventions for improved patient-provider communication.

1. Improving patient-provider interactions mandates an understanding on the part of health care providers of patients' situations, thoughts, feelings, and behaviors. 2. The cognitive model, a cornerstone of cognitive therapy, provides a framework to understand the patient's perspective of his or her situation or illness, which is a necessary component of effective patient-provider interactions. 3. Distance learning formats provide flexibility in meeting continuing education needs and allow learners and presenters to interact in a virtual mode.

Cognitive Behavioral Therapy↗
PubMed1986

Aminoglycoside antibiotics. 7. Dihydrostreptomycin analogues.

Dihydrostreptomycin analogues with structural variations in their guanidino groups were prepared. The analogue with a methyl group on the guanidine at C-1 was nearly as active as dihydrostreptomycin against bacteria. However, the 2-imidazolin-2-ylamino substituent at C-1 eliminated activity. No analogue with a substituent on the C-3 guanidino group was active.

Dihydrostreptomycin Sulfate↗