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PubMed2006

Owning a piece of the Doc: State law restraints on lay ownership of healthcare enterprises.

This Article provides an analytical framework for assessing state regulation regarding lay ownership of healthcare entities. The author suggests there are three categories of state regulation restraining lay ownership, each focused on a particular stakeholder in healthcare transactions: provider, patient, and payor. These regulatory paradigms are analyzed through a discussion of three state approaches (California, Illinois, and Florida), each exemplifying a particular stakeholder schema. The Article then highlights shortcomings of the three schemas, pointing out formal frustrations, application inequities, and doctrinal flaws. The author concludes that any successful state regulation of lay ownership in healthcare should incorporate aspects of all approaches in pursuit of accommodating the needs of all three stakeholders.

Government Regulation↗
PubMedDate not supplied

Effects of type of ownership of skilled nursing facilities on residents' mortality rates in Illinois.

The effect of ownership on the quality and cost of care in skilled nursing facilities (SNFs) was examined using unadjusted and adjusted mortality rates for such facilities in Illinois for the 1986-87 reporting year. Results indicated that when using unadjusted mortality rates, for-profit facilities had much lower rates than either government-owned or nonprofit SNFs. When mortality rates were adjusted, using available measures of intervening variables, differences by type of ownership disappeared. The higher percentage of discharges to general hospitals exhibited by for-profit facilities, compared with other types of facility ownership, appears to have the strongest effect on SNF mortality rates.

Aged↗
PubMed1989

The growth of home ownership: 1940-1980.

Housing went through a major transition between 1940 and 1980 as the proportion of home owners nearly doubled. This article examines how that change took place. Compositional changes in the population and process changes led by post--World War II housing policies and programs are tested as explanations for the growth of home ownership. A process analysis and a decomposition of the change in home ownership between cohorts are used to evaluate each interpretation of change. A combination of both explanations accounts for the change in home ownership.

Adolescent↗
PubMed1987

Nursing home cost and ownership type: evidence of interaction effects.

Due to steadily increasing public expenditures for nursing home care, much research has focused on factors that influence nursing home costs, especially for Medicaid patients. Nursing home cost function studies have typically used a number of predictor variables in a multiple regression analysis to determine the effect of these variables on operating cost. Although several authors have suggested that nursing home ownership types have different goal orientations, not necessarily based on economic factors, little attention has been paid to this issue in empirical research. In this study, data from 150 Virginia nursing homes were used in multiple regression analysis to examine factors accounting for nursing home operating costs. The context of the study was the Virginia Medicaid reimbursement system, which has intermediate care and skilled nursing facility (ICF and SNF) facility-specific per diem rates, set according to facility cost histories. The analysis revealed interaction effects between ownership and other predictor variables (e.g., percentage Medicaid residents, case mix, and region), with predictor variables having different effects on cost depending on ownership type. Conclusions are drawn about the goal orientations and behavior of chain-operated, individual for-profit, and public and nonprofit facilities. The implications of these findings for long-term care reimbursement policies are discussed.

Costs and Cost Analysis↗
PubMed1980

Pet ownership in rural Northern California (El Dorado County).

Demographic and economic aspects of pet ownership were studied in 488 households in El Dorado County, California, from May to July 1971. About 60% of households owned dogs or cats, and pet ownership was most prevalent (75%) in two small residential communities in the western end of the county. Among dogs, Poodle and German Shepherd Dog were the most popular breeds; about 36% of the females in the sample were spayed, but only 6% of the males were castrated. Approximately one third of all cats had been neutered. Reported use of veterinary services was higher for dogs (79%) than for cats (53%). The results of the survey indicated pet ownership is most likely to be found in households with children, where the head of household is employed, generally confirming findings from earlier surveys in Yolo, Alameda, and Contra Costa Counties (all in northern California) and later surveys in Champaign County, Illinois, and Garland, Tex. Some community health findings were included for El Dorado County and nearby Yolo County. In these two counties, cancer was reported more frequently by adults without pets (3.9% of those greater than or equal to 65 years old) than by pet owners (1.8% of those greater than or equal to 65 years old). Among children less than 5 years old, "frequent diarrhea" was reported more commonly in homes without pets (9.5% vs 2.6%; P less than 0.01). On the other hand, pet-owning adults, 16 to 64 years of age, living in rural areas or areas with generally lower than average incomes reported "frequent headaches" (21%) more frequently than did adults without pets (17%; P less than 0.025%) who resided in the same areas.

Adolescent↗
PubMed1994

An epidemiological investigation of pet ownership in Ontario.

An epidemiological study was undertaken to elucidate factors associated with pet ownership. The study utilized questionnaires that were mailed to a systematic random sample of 700 households in the city of Guelph and Eramosa township. Reasons for ownership were analyzed by factor analysis while differences between owning and nonowning households were investigated using logistic regression. Sixty-five percent of dogs and 71% of cats were neutered. Only 2% of urban and 3% of rural dogs had never been vaccinated, compared to 12% and 17% for urban and rural cats. Families that included preschoolers were less likely to own pets, as were those from an urban area. The highest scoring reason for ownership was "companionship," followed by "love and affection" and for the "benefit of the children". The highest ranked reason for nonownership was "pets are a problem when I go away," followed by "I don't have enough time to devote to a pet" and "poor housing".

Activities of Daily Living↗
PubMed1990

Previous pet ownership and Paget's disease.

The relationship between pet ownership and Paget's disease (PD) of bone was investigated in 112 patients with PD who were matched with a similar number of community-based controls. There was a significantly increased frequency of dog ownership by patients with PD aged less than 60 years. Multivariate logistic regression analysis revealed that there was a significant age-related increase in risk of PD associated with past or present ownership of either dogs or cats, with younger patients having the greatest risk. These results suggest that slow virus infection of osteoclasts by paramyxoviruses acquired from pets may contribute to the development of Paget's disease in the younger patient.

Age Factors↗
PubMed2004

Firearm ownership and storage practices, U.S. households, 1992-2002. A systematic review.

BACKGROUND: Because the presence and improper storage of household firearms are risk factors for injury, it is important to understand the prevalence of ownership and storage practices within households to help guide intervention development. This systematic review of published articles (1992 to 2002) provides prevalence estimates of firearm ownership and storage practices in U.S. households. METHODS: A search of bibliographic databases (MedLine, CINAHL, PsycInfo, Sociological Abstracts) was completed in January 2003. RESULTS: Although all were cross-sectional, the 42 articles included in this review varied in type; there were seven national and five state prevalence studies, as well as studies using clinic-based convenience samples (n =14) and samples of professionals (n =10). Published studies indicate that firearms are present in about one third of U.S. households. Handguns in particular are present in more than half of U.S. households with firearms, or about 19% of all U.S. households. The prevalence of firearms and handguns in households with young people was similar to the prevalence overall. Firearm ownership was highest in the South. CONCLUSIONS: Although the methodologic rigor of published articles varies substantially, the literature clearly establishes that firearms are common in U.S. households, even in the homes of medical professionals and those with children.

Adolescent↗
PubMed2006

Relationships among dog ownership and leisure-time walking in Western Canadian adults.

BACKGROUND: Dog ownership may be an effective tailored intervention among adults for promoting physical activity. This study examined the relationship between walking, physical activity levels, and potential psychological mediators between people who owned dogs and those who did not own dogs in the Capital Region District of Greater Victoria, British Columbia, Canada. Data were collected in September 2004; analyses were conducted in January 2005. METHODS: A random sample of men (n=177) and women (n=174) aged 20 to 80 years participated. Questionnaires were mailed out in 2004 to collect information about demographics, dog ownership, leisure-time walking, physical activity levels, and theory of planned behavior (TPB) constructs. RESULTS: The analyses revealed that dog owners spent more time in mild and moderate physical activities and walked an average of 300 minutes per week compared to non-dog owners who walked an average of 168 minutes per week. A mediator analysis suggests that dog obligation acts as a mediator between dog ownership and physical activity. Moreover, the theory of planned behavior constructs of intention and perceived behavioral control explained 13% of the variance in walking behavior with an additional 11% variance in walking behavior being explained by dog obligation. Regarding intention to walk, the TPB explained 46% of the variance in intention to walk with dog obligation adding an additional 1% variance. CONCLUSIONS: In this group of Canadians, those who owned a dog participated in more mild to moderate physical activity than those who did not. Acquiring a dog should be explored as an intervention to get people more physically active.

Adult↗
PubMed2005

Border ownership from intracortical interactions in visual area v2.

A border between two image regions normally belongs to only one of the regions; determining which one it belongs to is essential for surface perception and figure-ground segmentation. Border ownership is signaled by a class of V2 neurons, even though its value depends on information coming from well outside their classical receptive fields. I use a model of V2 to show that this visual area is able to generate the ownership signal by itself, without requiring any top-down mechanism or external explicit labels for figures, T junctions, or corners. In the model, neurons have spatially local classical receptive fields, are tuned to orientation, and receive information (from V1) about the location and orientation of borders. Border ownership signals that model physiological observations arise through finite range, intraareal interactions. Additional effects from surface features and attention are discussed. The model licenses testable predictions.

Algorithms↗
PubMed1998

Firearm suicides and homicides in the United States: regional variations and patterns of gun ownership.

Among industrialized countries, the United States has the highest rates of firearm suicide and homicide, as well as the highest rate of gun ownership. The present study compares the differential impact of gun availability on firearm suicides and homicides in the U.S. Using data from the NCHS Mortality Detail Files (1989-1991), the 1990 U.S. census population estimates, and the General Social Surveys (1989-1991) for nine geographic divisions, we computed rates of firearm and non-firearm suicides and homicides as well as rates of gun ownership for four gender-race groups. We tested the strength of the associations between gun availability and firearm suicide and homicide rates by computing the Spearman correlation coefficients. To help elucidate the role of method substitution, we conducted similar analyses on non-firearm suicide and homicide. The results show that gun ownership has a stronger impact on firearm suicides than homicides. These findings held up after stratifying by gender and race. The study suggests that reducing the aggregate level of gun availability may decrease the risk of firearm-related deaths.

Black or African American↗
PubMedDate not supplied

Human health concerns from pet ownership after a tornado.

INTRODUCTION: Although 50% to 60% of North American households own pets and many of these pets are considered family members, there is little information on the impact of pet ownership on pet-owning families affected by disasters. METHODS: This case report describes some of the effects of a tornado on 17 families whose dwellings were destroyed. The setting was a typical urban trailer park. RESULTS: After a tornado at the Sagamore Village Trailer Park in north central Indiana, 104 families were evacuated. Seventeen (16.3%) of these families owned pets. For 14 families (13.5%), pet ownership had an important impact on the families' recovery from the tornado. Public- and mental-health concerns that arose from pet ownership included failure to evacuate a dangerous site, attempts to re-enter a dangerous site, separation anxiety leading to psychosomatic disturbances, and the need for additional animal care. CONCLUSIONS: In urban disasters, the behaviors of families with a human-animal bond are likely to pose a significant risk to their own and others' health and safety in urban disasters. In this small study of families affected by a tornado, the most prominent public-health concerns were failure to evacuate because of a pet and attempts of re-entry to save a pet; the most common mental-health concerns resulted from separation anxiety from a pet and refusal to accept medical treatment until a pet's well-being can be assured. These are thought to be typical issues that will arise out of the human-animal bond in urban disaster situations and differ considerably from traditional public-health concerns over dog bites, spread of zoonotic diseases, and human food contamination. Medical disaster preparedness planning should consider the substantial effects that the human-animal bond is likely to have on human recovery from large-scale urban disasters.

Adult↗
PubMed2001

Pet ownership and childhood acute leukemia (USA and Canada).

OBJECTIVES: For more than three decades there has been speculation regarding a possible role of zoonotic diseases in the development of human leukemia. This study investigated the potential relationship between exposure to pets and the development of childhood leukemia. METHODS: Data from 2359 cases of acute leukemia from two large case-control studies were analyzed. Cases were individually matched to population controls on telephone exchange, age, and race. Conditional logistic regression was used to estimate odds ratios (OR) associated with pet ownership. RESULTS: Overall, there was no association between pet ownership (either "any pet", dog, or cat) and childhood acute leukemia (OR(any pet:) = 1.01, 95% CI 0.89-1.2). Additionally, no relationship was found between exposure to an ill pet and childhood leukemia. CONCLUSION: The results of this analysis suggest that pet ownership (healthy or sick) is unrelated to an increased risk of childhood leukemia.

Adolescent↗
PubMed2003

Heredity, pet ownership, and confounding control in a population-based birth cohort.

BACKGROUND: The association between pet ownership in childhood and subsequent allergic disease is controversial. Bias related to selection of pet exposure has been suggested as a reason for contradictory study results. OBJECTIVE: The purpose of this investigation was to elucidate how pet exposure depends on family history of allergic disease, smoking, and socioeconomic factors in a prospective birth cohort. METHODS: Parents of 4089 two-month-old children answered a questionnaire that included detailed questions about family history of asthma (maternal, paternal, and sibling), rhinoconjunctivitis, atopic eczema/dermatitis syndrome, pollen and pet allergy, smoking habits, parental occupation, and family pet ownership (cat and dog). Dust samples collected from the mothers' beds were analyzed for Fel d 1 and Can f 1 in a subgroup of the cohort. RESULTS: Cats were less frequently kept in families with parental asthma, rhinoconjunctivitis, or pet or pollen allergy (3.5% to 5.8%) than in families without parental allergic disease (10.8% to 11.8%). Dogs were less common in families with (3.3%) than in families without (5.9%) parental atopic eczema/dermatitis syndrome. Families with smoking mothers and those with low socioeconomic index kept cats and dogs more frequently. Cat allergen levels were lower in homes with than in homes without maternal pet allergy, and this tended to hold true even for homes without a cat. Cat ownership decreased from birth to 2 years of age, especially in families with parental history of allergic diseases. CONCLUSION: There seems to be a selection of pet exposure based on parental history of allergy, maternal smoking, and socioeconomic factors. This has to be taken into consideration in evaluations of risk associations between pet exposure and allergic disease in childhood.

Animals↗
PubMed2003

Current mite, cat, and dog allergen exposure, pet ownership, and sensitization to inhalant allergens in adults.

BACKGROUND: Simultaneous exposure to more than one allergen might modify the effect of individual allergens. OBJECTIVE: The purpose of this study was to investigate the effect of current exposures to mite, cat, and dog allergen and pet ownership on sensitization in adults. METHODS: Questionnaires, skin tests, and home visits (Der p 1, Fel d 1, and Can f 1, ELISA; mattresses, living room floors) were performed in 2502 adults. Allergen exposure was treated as a continuous variable and divided into quartiles. To investigate the interaction between allergens, quartiles for 3 allergens were added, creating arbitrary combined exposure categories. RESULTS: In the univariate analysis, mite sensitization was associated with Der p 1 in mattresses (odds ratio [OR], 1.10; 95% CI, 1.01 to 1.19; P =.03) and with Can f 1 in living room floors (OR, 1.08; 95% CI, 1.00 to 1.17; P =.05). In a multivariate regression analysis, Der p 1 in mattresses remained an independent associate of mite sensitization (OR, 1.12; 95% CI, 1.02 to 1.23; P =.03) and pollen sensitization (OR, 1.23; 95% CI, 1.11 to 1.36; P =.0001). The proportion of subjects sensitized to mite increased significantly with the increasing combined exposure categories (P <.0001). The highest prevalence of sensitization to cat and dog was in the medium combined exposure categories. Cat ownership was associated with a reduced prevalence of sensitization to cats (P =.002) and a reduced prevalence of sensitization to dog (P =.003) but had no effect on sensitization to mite and pollen. CONCLUSIONS: Sensitization to dust mites increased with the increasing combined exposure. Cat ownership was associated with a lower prevalence of sensitization to cat and dog but not to mite and grass pollen.

Administration, Inhalation↗
PubMed1999

AIDS diagnosis and depression in the Multicenter AIDS Cohort Study: the ameliorating impact of pet ownership.

The impact of pet ownership on depression was tested among a sample of gay and bisexual men (n = 1,872). Multivariate analyses, controlling for demographics and baseline depressive symptomatology, showed that neither pet ownership nor the presence of HIV infection was associated with depression. Depression was influenced by the presence of AIDS and by having relatively few confidants. Analyses among HIV-infected men only showed that persons with AIDS who owned pets reported less depression than persons with AIDS who did not own pets. This beneficial effect of pet ownership occurred principally among persons who reported fewer confidants. These results suggest that by enhancing companionship for some HIV-infected persons, pets may buffer the stressful impact of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Paget's disease of bone and previous pet ownership in the United States: dogs exonerated.

Paget's disease of bone is currently believed to be the result of a paramyxovirus infection of osteoclasts. Previously reported immunohistological data have suggested that a virus resembling either the measles virus or a respiratory syncytial virus is the probable causative agent, but no organism has been isolated or definitively identified to date. A recent study reporting an increased exposure to dogs during childhood and adolescence in a small series of cases from the North West of England proposed that a canine virus, possibly distemper, might be the primarily infectious agent. To study this hypothesis further, we examined prior dog and cat ownership from childhood through adulthood in 433 cases of Paget's disease and an equal number of matched controls living in the US. We found no differences related to prior pet ownership. We conclude that past dog (or cat) ownership is not a risk factor for the development of Paget's disease.

Adolescent↗
PubMed1988

Gun control, gun ownership, and suicide prevention.

The relationship of the extent of gun ownership and the strictness of gun control laws to suicide and homicide rates in the nine major geographic regions of the United States was explored. Gun ownership, rather than the strictness of gun control laws, was found to be the strongest correlate of the rates of suicide and homicide by guns. Regions with a higher extent of gun ownership had higher rates of suicide and homicide by firearms.

Civil Rights↗