bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing a Quality Measure for Clinical Inertia in Diabetes Care
Authors: Berlowitz Dan R. , Ash Arlene S. , Glickman Mark , Friedman Robert H. , Pogach Leonard M. , Nelson Audrey L. , Wong Ashley T. 
Published: November 2005

Objective. To develop a valid quality measure that captures clinical inertia, the failure to initiate or intensify therapy in response to medical need, in diabetes care and to link this process measure with outcomes of glycemic control.Data Sources. Existing databases from 13 Department of Veterans Affairs hospitals between 1997 and 1999.Study Design. Laboratory results, medications, and diagnoses were collected on 23,291 patients with diabetes. We modeled the decision to increase antiglycemic medications at individual visits. We then aggregated all visits for individual patients and calculated a treatment intensity score by comparing the observed number of increases to that expected based on our model. The association between treatment intensity and two measures of glycemic control, change in HbA1c during the observation period, and whether the outcome glycosylated hemoglobin (HbA1c) was greater than 8 percent, was then examined.Principal Findings. Increases in antiglycemic medications occured at only 9.8percent of visits despite 39percent of patients having an initial HbA1c level greater than 8 percent. A clinically credible model predicting increase in therapy was developed with the principal predictor being a recent HbA1c greater than 8 percent. There were considerable differences in the intensity of therapy received by patients. Those patients receiving more intensive therapy had greater improvements in control (p<.001).Conclusions. Clinical inertia can be measured in diabetes care and this process measure is linked to patient outcomes of glycemic control. This measure may be useful in efforts to improve clinicians management of patients with diabetes.
Assessing Quality of Diabetes Care by Measuring Longitudinal Changes in Hemoglobin A1c in the Veterans Health Administration
Authors: Thompson Wes , Wang Hongwei , Xie Minge , Kolassa John , Rajan Mangala , Tseng Chin‐Lin , Crystal Stephen , Zhang Quanwu , Vardi Yehuda , Pogach Leonard , Safford Monika M. 
Published: November 2005

Context. A1c levels are widely used to assess quality of diabetes care provided by health care systems. Currently, cross‐sectional measures are commonly used for such assessments.Objective. To study within‐patient longitudinal changes in A1c levels at Veterans Health Administration (VHA) facilities as an alternative to cross‐sectional measures of quality of diabetes care.Design. Longitudinal study using institutional data on individual patient A1c level over time (October 1, 1998–September 30, 2000) with time variant and invariant covariates.Setting. One hundred and twenty‐five VHA facilities nationwide, October 1, 1998–September 30, 2000.Patients. Diabetic veteran users with A1c measurement performed using National Glycosylated Hemoglobin Standardization Project certified A1c lab assay methods.Exposures. Characteristics unlikely to reflect quality of care, but known to influence A1c levels, demographics, and baseline illness severity.Main Outcome Measure. Monthly change in A1c for average patient cared for at each facility.Results. The preponderance of facilities showed monthly declines in within‐patient A1c over the study period (mean change of −0.0148 A1c units per month, range −0.074 to 0.042). Individual facilities varied in their monthly change, with 105 facilities showing monthly declines (70 significant at .05 level) and 20 showing monthly increases (5 significant at .05 level). Case‐mix adjustment resulted in modest changes (mean change of −0.0131 case‐mix adjusted A1c units per month, range −0.079 to 0.043). Facilities were ranked from worst to best, with attached 90 percent confidence intervals. Among the bottom 10 ranked facilities, four remained within the bottom decile with 90 percent confidence.Conclusions. There is substantial variation in facility‐level longitudinal changes in A1c levels. We propose that evaluation of change in A1c levels over time can be used as a new measure to reflect quality of care provided to populations of individuals with chronic disease.
Improved Estimates of the Benefits of Breastfeeding Using Sibling Comparisons to Reduce Selection Bias
Authors: Evenhouse Eirik , Reilly Siobhan 
Published: November 2005

Objective. Better measurement of the health and cognitive benefits of breastfeeding by using sibling comparisons to reduce sample selection bias.Data. We use data on the breastfeeding history, physical and emotional health, academic performance, cognitive ability, and demographic characteristics of 16,903 adolescents from the first (1994) wave of the National Longitudinal Study of Adolescent Health. The sample includes 2,734 sibling pairs.Study Design. We examine the relationship between breastfeeding history and 15 indicators of physical health, emotional health, and cognitive ability, using ordinary least squares and logit regression. For each indicator, we estimate, in addition to the usual between‐family model, a within‐family model to see whether differences in siblings' outcomes are associated with differences in the siblings' breastfeeding histories.Principal Findings. Nearly all of the correlations found in the between‐family model become statistically insignificant in the within‐family model. The notable exception is a persistent positive correlation between breastfeeding and cognitive ability. These findings hold whether breastfeeding is measured in terms of duration or as a Yes/No variable.Conclusions. This study provides persuasive evidence of a causal connection between breastfeeding and intelligence. However, it also suggests that nonexperimental studies of breastfeeding overstate some of its other long‐term benefits, even if controls are included for race, ethnicity, income, and education.
What Do Consumers Want to Know about the Quality of Care in Hospitals?
Authors: Sofaer Shoshanna , Crofton Christine , Goldstein Elizabeth , Hoy Elizabeth , Crabb Jenny 
Published: November 2005

Objective. To guide the development of the Consumer Assessments of Healthcare Providers and Systems (CAHPS®) Hospital Survey by identifying which domains of hospital quality included in a survey of recent hospital patients, and which survey items within those domains, would be of greatest interest to consumers and patients.Data Sources/Study Setting. Primary data were collected in four cities (Baltimore, Los Angeles, Phoenix, and Orlando), from a demographically varied mix of people of whom most, but not all, had recently been hospitalized or had a close loved one hospitalized.Study Design/Data Collection Method. A total of 16 focus groups were held in these four cities. Groups were structured to be homogeneous with respect to type of health care coverage (Medicare, non‐Medicare), and type of recent hospital experience (urgent admission, elective admission, maternity admission, no admission). They were heterogeneous with respect to race/ethnicity, gender, and educational attainment. In addition to moderated discussions, focus group participants completed a pregroup questionnaire and various paper and pencil exercises during the groups.Principal Findings. A wide range of features were identified by participants as being relevant to hospital quality. Many were consonant with domains and items in the CAHPS Hospital Survey; however, some addressed structural features of hospitals and hospital outcomes that are not best derived from a patient experience survey. When shown the domains and items being considered for inclusion in the CAHPS Hospital Survey, participants were most interested in items relating to doctor communication with patients, nurse and hospital staff communication with patients, responsiveness to patient needs, and cleanliness of the hospital room and bathroom. Findings were quite consistent across groups regardless of location and participant characteristics.Conclusions. Consumers and patients have a high degree of interest in hospital quality and found a very high proportion of the items being considered for the CAHPS Hospital Survey to be so important they would consider changing hospitals in response to information about them. Hospital choice may well be constrained for patients, but publicly reported information from a patient perspective can also be used to support patient discussions with facilities and physicians about how to ensure patients have the best hospital experience possible.
Review of the Literature on Survey Instruments Used to Collect Data on Hospital Patients' Perceptions of Care
Authors: Castle Nicholas G. , Brown Julie , Hepner Kimberly A. , Hays Ron D. 
Published: November 2005

Objective. To review the existing literature (1980–2003) on survey instruments used to collect data on patients' perceptions of hospital care.Study Design. Eight literature databases were searched (PubMED, MEDLINE Pro, MEDSCAPE, MEDLINEplus, MDX Health, CINAHL, ERIC, and JSTOR). We undertook 51 searches with each of the eight databases, for a total of 408 searches. The abstracts for each of the identified publications were examined to determine their applicability for review.Methods of Analysis. For each instrument used to collect information on patient perceptions of hospital care we provide descriptive information, instrument content, implementation characteristics, and psychometric performance characteristics.Principal Findings. The number of institutional settings and patients used in evaluating patient perceptions of hospital care varied greatly. The majority of survey instruments were administered by mail. Response rates varied widely from very low to relatively high. Most studies provided limited information on the psychometric properties of the instruments.Conclusions. Our review reveals a diversity of survey instruments used in assessing patient perceptions of hospital care. We conclude that it would be beneficial to use a standardized survey instrument, along with standardization of the sampling, administration protocol, and mode of administration.
Equivalence of Mail and Telephone Responses to the CAHPS® Hospital Survey
Authors: de Vries Han , Elliott Marc N. , Hepner Kimberly A. , Keller San D. , Hays Ron D. 
Published: November 2005

Objective. To estimate the effect of survey mode (mail versus telephone) on reports and ratings of hospital care.Data Sources/Study Setting. The total sample included 20,826 patients discharged from a group of 24 distinct hospitals in three states (Arizona, Maryland, New York). We collected CAHPS® data in 2003 by mail and telephone from 9,504 patients, of whom 39 percent responded by telephone and 61 percent by mail.Study Design. We estimated mode effects in an observational design, using both propensity score blocking and (ordered) logistic regression on covariates. We used variables derived from administrative data (either included as covariates in the regression function or used in estimating the propensity score) grouped in three categories: individual characteristics, characteristics of the stay and hospital, and survey administration variables.Data Collection/Extraction Methods. We mailed a 66‐item questionnaire to everyone in the sample and followed up by telephone with those who did not respond.Principal Findings. We found significant (p<.01) mode effects for 13 of the 21 questions examined in this study. The maximum magnitude of the survey mode effect was an 11 percentage‐point difference in the probability of a “yes” response to one of the survey questions. Telephone respondents were more likely to rate care positively and health status negatively, compared with mail respondents. Standard regression‐based case‐mix adjustment captured much of the mode effects detected by propensity score techniques in this application.Conclusions. Telephone mode increases the propensity for more favorable evaluations of care for more than half of the items examined. This suggests that mode of administration should be standardized or carefully adjusted for. Alternatively, further item development may minimize the sensitivity of items to mode of data collection.
Effect of Social Security Payments on Substance Abuse in a Homeless Mentally Ill Cohort
Authors: Rosen Marc I. , McMahon Thomas J. , Lin HaiQun , Rosenheck Robert A. 
Published: November 2005

Objectives. To determine whether receipt of social supplemental security income (SSI) or Social Security disability income (SSDI) disability payments is associated with increased drug and alcohol use.Data Sources/Study Setting. Secondary analysis of data from 6,199 participants in the Access to Community Care and Effective Social Supports and Services demonstration for the homeless mentally ill.Design. Observational, 12‐month, cohort study completed over 4 years. Substance abuse and other outcomes were compared between the participants who did not receive SSI or SSDI during the 12‐month study, those newly awarded benefits, and those without benefits throughout the 12 months.Data Collection Methods. Social Security administrative records were used to corroborate Social Security benefit status. Drug and alcohol use were measured by self‐report and clinician ratings.Principal Findings. Participants who did not receive benefits significantly reduced their substance use over time. In generalized estimating equations models that adjusted for potentially confounding covariates, participants who newly received Social Security benefits showed no greater drug use than those without benefits but had significantly more days housed and fewer days employed. Participants whose benefits antedated the demonstration and continued during the 12 months had more clinician‐rated drug use over time than those without benefits.Conclusions. In this vulnerable population, participants with newly awarded benefits did not have any different drug use changes than those without benefits, and had relatively more days housed. The hypothesis that Social Security benefits facilitate drug use was not supported by longitudinal data in this high‐risk population.
Diet‐associated hepatic failure and immune‐mediated hemolytic anemia in a Weimaraner
Authors: Smith Ashley J. , Stenske Katherine A. , Bartges Joseph W. , Kirk Claudia A. 
Published: November 2005

AbstractObjective: To describe the medical and nutritional management of a 4‐year‐old Weimaraner with acute hepatic failure and immune‐mediated hemolytic anemia (IMHA) associated with consuming a commercial dog food.Case summary: A 4‐year‐old male castrated Weimaraner developed signs of IMHA, hepatic failure, disseminated intravascular coagulopathy, and malnutrition after consuming a commercial dog food. During the course of hospitalization, medical management included immunosuppressive therapy and supportive care. Nutritional support consisted of both enteral and parenteral nutrition. The dog was discharged after 19 days of hospitalization and fully recovered by 6 months. An investigation by the Food and Drug Administration was not able to determine the exact cause of the acute hepatic failure and IMHA.New information provided: This is the first case report documenting the medical and nutritional management of a critically ill animal associated with ingestion of this commercial dog food.
Contrasting Visions of Global Civil Society for Organization and Policy
Authors: Srinivas Nidhi 
Published: November 2005

Books reviewed in this article:Mary Kaldor, Helmut Anheier, and Marlies Glasius, eds., Global Civil Society Yearbook 2003John Keane, Global Civil Society?Lester M. Salamon, Helmut K. Anheier, Regina List, Stefan Toepler, S. Wojcieh Sokolowski, and associates, Global Civil Society: Dimensions of the Nonprofit Sector
Measuring the Impact of State Accountability Programs
Authors: Chester Mitchell D. 
Published: November 2005

“No Child Left Behind is a law that makes good people bad and bad people worse.”
Declaration of the keynote speaker at the public forum on the No Child Left Behind Act in Columbus, Ohio, on November 17, 2004, sponsored by the Kappa Delta Pi International Honor Society in Education, the National Academy of Education, and the National Society for the Study of Education.
The Digital Society and Its Enemies: A Critique of 'On the Internet'
Authors: Champion Erik M. 
Published: November 2005

In his recent publication On the Internet Professor Hubert
Dreyfus makes some interesting criticisms on the effectiveness of
Internet-based distance learning and on the use of the Internet in
general.
There is still relatively little written on the philosophical
and social implications of the Internet that is both clear and
cohesive. Professor Dreyfus' book is exemplary in this regard, and
it has attracted many followers extolling its virtues. However,
there are serious issues with both the metho d and the content of
his approach. His content is arguably restricted by a limited view
of the Internet while his selective method of projecting the
thoughts of long dead writers to a current phenomenon far from
finished or even fully understood, may be considered a perilous
undertaking for a system atic philosopher.
For example, Professor Dreyfus offers the unusual suggestion
that the Internet is the successor to the popular press of the
mid-nineteenth century. It was the popular press that the Danish
philosopher Søren Kierkegaard derided for its instant
opinions, anonymity, and lack of an ethical (or even reli gious)
position.
On the Internet applies Kierkegaard's criticisms to the Internet
and further argues that hypermedia (and Internet information
retrieval) is hype. Dreyfus believes that Internet-based learning
cannot develop mastery or convey a sense of presence of other
people or of reality in general.
This paper will investigate whether we can definitely view the
Internet as analogous to Kierkegaard's enemy, the popular press,
and if there are current examples where the Internet augments our
understanding and experiencing of the world without us actually
being at the `virtual' scene.
An introductory COBOL course with structured programming
Authors: Khailany Asad 
Published: November 2005

ORIS 316 was designed as a core course to teach COBOL programming language and Business Information Systems to students majoring in Business Computer Information Systems. Students from other areas such as Mathematics, Computer Science, Sociology, Economics, Political Science, Marketing, Accounting, Management, etc., take this course to enhance their employment opportunities. Most of the students who take this course have some knowledge of some computer programming language, especially in FORTRAN. In the last four years, I have taught this course eight times. In the beginning, perhaps like many other instructors have done, I took the normal path to teach this course. This path was more or less influenced or determined by some textbooks or manual references. These text and manual references have different approaches; however, to teach the COBOL language, all of them agree on one point, namely, to present the PERFORM statement, the tool of structured programming in COBOL, in the late sections of their texts. And of those sources which I'm familiar with, none had the structured programming approach.
Because of the popularity of structured programming especially in the business data processing environment, and since many of our students start their professional work as a programmer or as a systems analyst, it was determined that the structured programming technique and modular programming concept should be introduced as early as possible in the semester. This has been done in the last three offerings of the course and the results have been impressive. Students' evaluations of the same instructor and the same course were considerably higher than before and their response to the new approach has been encouraging.
Teaching teachers about computers
Authors: Marsh Barbara 
Published: November 2005

I believe computers will continue to expand their areas of application, and so am forced to the conclusion that school curricula will have to deal with them. And if computer curricula are to be introduced into the schools, teacher training institutions must prepare teachers to teach about computers.
The context I choose is education itself. "Education" is of course rather a broad term; computer uses in education are many and varied. Some of these applications are similar enough to those in other areas that some very general principles of computer use will automatically be raised. Others are quite unique, and raise specific questions which teachers will have to deal with in their own professional lives, so that the study of computers can be seen to be very relevant to being a teacher. By teaching about computers in this context instead of more abstractly or generally, and by drawing attention constantly to the educational implications of computer uses, I hope that the teachers who are my students will in turn pass on to their own students the habit of attending to the social implications of what is done by computers.
The structure and use of a test generating system designed to facilitate individually paced instruction
Authors: Palay Roger M. 
Published: November 2005

The structure and use of a test-generating system having the following parameters is described.
1. Each test is a ten item multiple choice instrument where each item has five (5) alternatives.
2. Each test is generated from a relatively small file (most often less than 150 card images).
3. Although the file contains only five (5) disjoint tests, over nine million different tests (each with its own set of correct answers) can be generated from it.
4. The correct answers to each test are stored directly on the test (in coded form).
5. Test responses are machine correctable and such correcting need not be done on the system that generated the test.
6. The reliability of different forms of tests generated from one file is theoretically high (no statistical evidence is available to support a claim of high reliability).
7. The grading program produces a total score as well as giving the correct answers for all items on that test.
Secondary school model automatic test generation
Authors: Muscat Eugene J. 
Published: November 2005

A review of the literature dealing with automatic test generation yields a wide variety of subject matter applications. Most decriptives, however, deal with college level projects. This paper out lines secondary school requirements that may encourage the development of appropriate test generation models. Our discussion will center on a common need for remediation at the secondary level, namely, mathematics skill building (addition, subtraction, multiplication and division). The subject matter selection is only to assure that the suggestions made are as concrete as possible. The paper will concentrate on the structural and procedural aspects of school site test generation and will not deal with the computer programming requirements.
The basic model assumes remedial curriculum that will be directed as a student population of 500 students. This supposes that the entire student population is not utilizing a single test generation package. The recommendations allow for adding additional curriculum services and increasing student use. A test generating laboratory should emerge that would operate as a service bureau. This center will be detailed below.
The discussion will be organized under the following headings:
The discussion will be organized under the following headings:
Hardware Requirements
Turnaround
Personnel
Cost