bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Aggressive Medical Treatments Near the End of Life: Differences between Patients with and without Dementia
Authors: Richardson Samuel S. , Sullivan Greer , Hill Ariel , Yu Wei 
Published: August 2006

Objective. To analyze whether acute care patients with dementia are more or less likely to receive each of five aggressive medical services near the end of life, compared with patients without dementia.Data Sources. Two years of Veterans Affairs (VA) and Medicare utilization data for all 169,036 VA users nationwide age 67 and older who died between October 1, 1999 and September 30, 2001.Study Design. We performed a retrospective analysis of acute care stays discharged in the final 30 days of life. The main outcome measure was the patient's likelihood of receiving each of five aggressive services (intensive care unit [ICU] admission, ventilator, cardiac catheterization, pulmonary artery monitor, and dialysis), controlling for demographic and clinical factors in probit regressions.Principal Findings. There were 122,740 acute‐stay discharges during the final 30 days of life, representing 94,100 unique patients (31,654 with dementia). In probit models comparing acute care patients with and without dementia, patients with dementia were 7.5 percentage points less likely to be admitted to the ICU (95 percent confidence interval [CI], 6.9–8.1; percent of stays with ICU admission=36.8 percent), 5.4 percentage points less likely to be placed on a ventilator (95 percent CI, 5.0–5.9; percent of stays with ventilator use=17.1 percent), 0.7 percentage points less likely to receive cardiac catheterization (95 percent CI, 0.6–0.8; percent of stays with cardiac catheterization=2.7 percent), 1.4 percentage points less likely to receive pulmonary artery monitoring (95 percent CI, 1.2–1.5; percent of stays with pulmonary artery monitoring=2.6 percent), and 0.6 percentage points less likely to receive dialysis (95 percent CI, 0.4–0.8; percent of stays with dialysis=4.6 percent).Conclusions. During the final 30 days of life, acute care patients with dementia are treated substantially less aggressively than patients without dementia. Further research is warranted to determine the causes and appropriateness of these patterns of care.
Racial Disparities in Completion Rates from Publicly Funded Alcohol Treatment: Economic Resources Explain More Than Demographics and Addiction Severity
Authors: Jacobson Jerry O. , Robinson Paul L. , Bluthenthal Ricky N. 
Published: August 2006

Objectives. To assess racial and ethnic differences in rates of completion from publicly funded alcohol treatment programs, and to estimate the extent to which any identified racial differences in completion rates are related to differences in patient characteristics.Data Sources. Administrative intake and discharge records from all publicly funded outpatient and residential alcohol treatment recovery programs in Los Angeles County (LAC) during 1998–2000. Study participants (N=10,591) are African American, Hispanic, and white patients discharged from these programs, ages 18 or older, who reported alcohol as their primary substance abuse problem.Study Design. Bivariate tests identified racial and ethnic differences in rates of treatment completion and patient characteristics. Logistic regression models assessed the contribution of differences in patient characteristics to differences in completion.Principal Findings. Significantly lower completion rates by African Americans (17.5 percent) relative to whites (26.7 percent) (odds ratio [OR]=0.58, 95 percent confidence interval [CI]: 0.50–0.68) are partially explained (40 percent) by differences in patient characteristics in outpatient care (adjusted OR=0.75, 95 percent CI: 0.63–0.90), mostly by indicators of economic resources (i.e., employment, homelessness, and Medi‐Cal beneficiary). In residential care, only 7 percent of differences in completion (30.7 versus 46.1 percent) could be explained by the patient‐level measures available (OR=0.52, 95 percent CI: 0.45–0.59; AOR=0.55, 95 percent CI: 0.47–0.65). Differences in completion rates between Hispanic and white patients were not detected.Conclusions. Large differences in rates of outpatient and residential alcohol treatment completion between African American and white patients at publicly funded programs in LAC, the nation's second largest, publicly funded alcohol and drug treatment system, are partially because of economic differences among patients, but remain largely unexplained. These racial disparities merit additional investigation and the attention of health professionals.
Cancer Stage at Diagnosis and Survival among Persons with Social Security Disability Insurance on Medicare
Authors: McCarthy Ellen P. , Ngo Long H. , Chirikos Thomas N. , Roetzheim Richard G. , Li Donglin , Drews Reed E. , Iezzoni Lisa I. 
Published: August 2006

Objective. To examine stage at diagnosis and survival for disabled Medicare beneficiaries diagnosed with cancer under age 65 and compare their experiences with those of other persons diagnosed under age 65.Data Sources. Surveillance, Epidemiology, and End Results (SEER) Program data and SEER‐Medicare linked data for 1988–1999. SEER‐11 Program includes 11 population‐based tumor registries collecting information on all incident cancers in catchment areas. Tumor registry and Medicare data are linked for persons enrolled in Medicare.Study Design. 307,595 incident cases of non‐small cell lung (51,963), colorectal (52,092), breast (142,281), and prostate (61,259) cancer diagnosed in persons under age 65 from 1988 to 1999. Persons who qualified for Social Security Disability Insurance and had Medicare (SSDI/Medicare) were identified from Medicare enrollment files. Ordinal polychotomous logistic regression and Cox proportional hazards regression were used to estimate adjusted associations between disability status and later‐stage diagnoses and mortality (all‐cause and cancer‐specific).Principal Findings. Persons with SSDI/Medicare had lower rates of Stages III/IV diagnoses than others for lung (63.3 versus 69.5 percent) and prostate (25.5 versus 30.8 percent) cancers, but not for breast or colorectal cancers. After adjustment, they remained less likely to be diagnosed at later stages for lung and prostate cancers. Nevertheless, persons with SSDI/Medicare experienced higher all‐cause mortality for each cancer. Cancer‐specific mortality was higher among persons with SSDI/Medicare for breast and colorectal cancer patients.Conclusions. Disabled Medicare beneficiaries are diagnosed with cancer at similar or earlier stages than others. However, they experience higher rates of cancer‐related mortality when diagnosed at the same stage of breast and colorectal cancer.
Women's Satisfaction with Their On‐Going Primary Health Care Services: A Consideration of Visit‐Specific and Period Assessments
Authors: Anderson Roger T. , Weisman Carol S. , Camacho Fabian , Scholle Sarah Hudson , Henderson Jillian T. , Farmer Deborah F. 
Published: August 2006

Objective. To compare and contrast patient ratings of satisfaction with primary care on the day of visit versus over the last 12 months.Data Sources/Study Setting. Survey data were collected from female participants at primary care centers affiliated with the University of Michigan, University of Pittsburgh, and Wake Forest University.Study Design. One thousand and twenty‐one patients attending a primary care visit with at least one prior visit to the study site were consented on site, enrolled in the study, and surveyed at two time points: pre‐ and immediately postvisit.Data Collection. The previsit survey included demographics, self‐rated health, visit history (site continuity), and expectations for health care; the postvisit survey focused on patient experiences during the visit, assessment of health care quality using the Primary Care Satisfaction Survey for Women instrument, and global satisfaction with visit and health care over the past 12 months. Expectation discrepancy scores were constructed from the linked expectation–experience ratings. Path analysis and indices of model fit were used to investigate the strength of theoretical links among the variables in an analytic model considering both day‐of‐visit and past‐year ratings with global measures of patient satisfaction as the dependent variables.Principal Findings. General health, site continuity and fulfillment of patient expectations for care were linked to global ratings of satisfaction through effects on communication, care coordination, and office staff and administration. Importantly, past‐year ratings were mediated largely by care coordination and continuity; day‐of‐visit ratings were mediated by communication.Conclusion. Ratings of health care quality for a specific visit appear to be conceptually distinct from ratings of care over the past 12 months, and thus are not interchangeable.
Defining Interdisciplinary Research: Conclusions from a Critical Review of the Literature
Authors: Aboelela Sally W. , Larson Elaine , Bakken Suzanne , Carrasquillo Olveen , Formicola Allan , Glied Sherry A. , Haas Janet , Gebbie Kristine M. 
Published: August 2006

Objective.To summarize findings from a systematic exploration of existing literature and views regarding interdisciplinarity, to discuss themes and components of such work, and to propose a theoretically based definition of interdisciplinary research.Data Sources/Study Setting.Two major data sources were used: interviews with researchers from various disciplines, and a systematic review of the education, business, and health care literature from January 1980 through January 2005.Study Design.Systematic review of literature, one‐on‐one interviews, field test (survey).Data Collection/Extraction Methods.We reviewed 14 definitions of interdisciplinarity, the characteristics of 42 interdisciplinary research publications from multiple fields of study, and 14 researcher interviews to arrive at a preliminary definition of interdisciplinary research. That definition was then field tested by 12 individuals with interdisciplinary research experience, and their responses incorporated into the definition of interdisciplinary research proposed in this paper.Principal Findings.Three key definitional characteristics were identified: the qualitative mode of research (and its theoretical underpinnings), existence of a continuum of synthesis among disciplines, and the desired outcome of the interdisciplinary research.Conclusion.Existing literature from several fields did not provide a definition for interdisciplinary research of sufficient specificity to facilitate activities such as identification of the competencies, structure, and resources needed for health care and health policy research. This analysis led to the proposed definition, which is designed to aid decision makers in funding agencies/program committees and researchers to identify and take full advantage the interdisciplinary approach, and to serve as a basis for competency‐based formalized training to provide researchers with interdisciplinary skills.
Comparing Self‐Reported Health Status and Diagnosis‐Based Risk Adjustment to Predict 1‐ and 2 to 5‐Year Mortality
Authors: Pietz Kenneth , Petersen Laura A. 
Published: August 2006

Objectives. To compare the ability of two diagnosis‐based risk adjustment systems and health self‐report to predict short‐ and long‐term mortality.Data Sources/Study Setting. Data were obtained from the Department of Veterans Affairs (VA) administrative databases. The study population was 78,164 VA beneficiaries at eight medical centers during fiscal year (FY) 1998, 35,337 of whom completed an 36‐Item Short Form Health Survey for veterans (SF‐36V) survey.Study Design. We tested the ability of Diagnostic Cost Groups (DCGs), Adjusted Clinical Groups (ACGs), SF‐36V Physical Component score (PCS) and Mental Component Score (MCS), and eight SF‐36V scales to predict 1‐ and 2–5 year all‐cause mortality. The additional predictive value of adding PCS and MCS to ACGs and DCGs was also evaluated. Logistic regression models were compared using Akaike's information criterion, the c‐statistic, and the Hosmer–Lemeshow test.Principal Findings. The c‐statistics for the eight scales combined with age and gender were 0.766 for 1‐year mortality and 0.771 for 2–5‐year mortality. For DCGs with age and gender the c‐statistics for 1‐ and 2–5‐year mortality were 0.778 and 0.771, respectively. Adding PCS and MCS to the DCG model increased the c‐statistics to 0.798 for 1‐year and 0.784 for 2–5‐year mortality.Conclusions. The DCG model showed slightly better performance than the eight‐scale model in predicting 1‐year mortality, but the two models showed similar performance for 2–5‐year mortality. Health self‐report may add health risk information in addition to age, gender, and diagnosis for predicting longer‐term mortality.
Determinants of Children's Participation in California's Medicaid and SCHIP Programs
Authors: Kincheloe Jennifer , Frates Janice , Brown E. Richard 
Published: August 2006

Objective. To develop a comprehensive predictive model of eligible children's enrollment in California's Medicaid (Medi‐Cal [MC]) and State Children's Health Insurance Program (SCHIP; Healthy Families [HF]) programs.Data Sources/Study Setting. 2001 California Health Interview Survey data, data on outstationed eligibility workers (OEWs), and administrative data from state agencies and local health insurance expansion programs for fiscal year 2000–2001.Study Design. The study examined the effects of multiple family‐level factors and contextual county‐level factors on children's enrollment in Medicaid and SCHIP.Data Collection/Extraction Methods. Simple logistical regression analyses were conducted with sampling weights. Hierarchical logistic regressions were run to control for clustering.Principal Findings. Participation in MC and HF programs is determined by a combination of family‐level predisposing, perceived need, and enabling/disabling factors, and county‐level enabling/disabling factors. The strongest predictors of MC enrollment were family‐level immigration status, ethnicity, and income, and the presence of a county‐level “expansion program”; and the county‐level ratio of OEWs to eligible children. Important HF enrollment predictors included family‐level ethnicity, age, number of hours a parent worked, and urban residence; and county‐level population size and outreach and media expenditure.Conclusions. MC and HF outreach/enrollment efforts should target poorer and immigrant families (especially Latinos), older children, and children living in larger and urban counties. To reach uninsured eligible children, it is important to further simplify the application process and fund selected outreach efforts. Local health insurance expansion programs increase children's enrollment in MC.
Externalities, Prospect Theory, and Social Construction: When Will Government Act, What Will Government Do?*
Authors: Steinacker Annette 
Published: August 2006

Objectives. Political theories of agenda setting and policy choice are still limited in predicting when an issue will become salient and, once it has, what policy option will be used to address it. This article illustrates that for a large class of externality problems, perspectives from three other social science disciplines can refine those predictions.Methods. A synthesis of implications from economics on assignment of property rights, loss aversion from prospect theory, and image of the policy target from social construction is used to determine the conditions under which issues gain attention and the likely policy solutions.Results. Assignment of property rights establishes a baseline used to assess any further government actions, with losses from that base more likely to generate political attention. The assignment of rights also determines if a problem is defined as a negative or positive externality, which restricts the type of policies used to address the problem. This initial allocation of rights is in turn affected both by the political power and social construction of the groups involved.Conclusions. The result is a bias in policy attention and outcomes strongly influenced by the norms used in assignment of property rights, which typically favor those generating the negative externality.
How Do Voters Form Expectations about the Parties' Chances of Winning the Election?*
Authors: Blais André , Bodet Marc André 
Published: August 2006

Objective. This article examines the factors that form voters' perceptions of the parties' chances of winning at both the national and the local levels.Method. We make use of the 1988 Canadian Election Study and we employ a HLM model to estimate the effect of individual‐level and contextual‐level variables.Results. It is shown that voters' expectations are affected by a combination of “objective” contextual information and personal preferences (projection effects).Conclusion. The basic contextual information that is utilized to ascertain local chances is the outcome of the previous election in the local constituency, whereas polls are crucial in the case of perceived national chances. We also find that the most politically aware are more strongly influenced by “objective” indicators.
Why Do Interest Groups Engage the Judiciary? Policy Wishes and Structural Needs*
Authors: Solberg Rorie Spill , Waltenburg Eric N. 
Published: August 2006

Objectives. We test two competing explanations in order to answer the question: Why do organized interests choose to engage in advocacy behavior? The first turns on the notion that concerns with policy success are the principal forces affecting a group's choice. To a lesser degree, issues of group maintenance have also been identified as entering into organized interests' decisional calculus.Method. Using survey data supplemented with confidential interviews of organized interests, we systematically examine the power of both accounts to explain the decision of groups to locate their energies in the federal judiciary. Consequently, in the penultimate section of the article, we specify and test a comprehensive model of interest group litigation behavior.Results. In the resulting multivariate analysis, we find that forces associated with both avenues of explanation for interest group advocacy behavior have substantial statistical purchase and empirical traction.Conclusion. Our findings did not show a dominate role for maintenance concerns; however, clearly, a group's assessment of where, and possibly whether, to act is not an easy calculation based on the receptiveness of a venue and the available balance in the bank account. Groups must attend to their members and their competition. Explanations of group advocacy omitting such concerns are inherently flawed.
Examining the Administration of Work Sanctions on the Frontlines of the Welfare System*
Authors: Lens Vicki 
Published: August 2006

Objectives. Financial penalties, or sanctions, are a core mechanism for enforcing the work requirements of the Temporary Assistance for Needy Families program and helping clients achieve self‐sufficiency. This study's objective is to examine whether sanctions are being administered consistent with policy goals of encouraging work.Methods. This study uses administrative fair hearing decisions, which are the product of an adversarial‐style procedure triggered when a client appeals an adverse decision by the agency, including work sanctions. Qualitative content analysis is used to analyze the decisions.Results. The study found that despite organizational reforms, local offices had created the welfare‐to‐work version of an eligibility‐compliance culture, where sanctions were based primarily on attendance records and became a paper‐processing function. Transactions between clients and workers were often routinized and mechanical, resulting in improper and arbitrary sanctions that were reversed by the hearing officers nearly 50 percent of the time.Conclusion. This study underscores the importance of scrutinizing and correcting agency errors that may undercut clients' engagement in work activities.
District Segregation, Race Legislation, and Black Enrollment in Charter Schools*
Authors: Renzulli Linda A. 
Published: August 2006

Objective. This article examines how segregation at the school level within districts and charter school legislation predict black enrollment levels at local charter schools.Methods. This study uses the Schools and Staffing Survey Charter School Data 1999–2000, Common Core of Data, and a unique data set of district test scores to estimate OLS regression models of black enrollment in charter schools on district racial segregation and race provisions in charter school legislation.Results. Findings suggest that segregated school districts, those districts where whites and blacks are more unevenly distributed among schools, have a larger percentage of blacks enrolled in local charter schools than districts where schools are integrated. In addition, charter schools in states that do not have a racial clause have a smaller percent of blacks in their charter schools.Conclusion. Findings suggest that black enrollment in charter schools is a function of district segregation and state policy.
Family Transitions, Economic Status, and Voter Turnout Among African‐American Inner‐City Women*
Authors: Plutzer Eric , Wiefek Nancy 
Published: August 2006

Objectives. We examine voter turnout of inner‐city African‐American mothers, many of whom are single parents and endure long‐term, economic hardship. Previous research suggests that income is a more important factor among these groups than in the general population. We seek to understand the interplay of family structure, income, and voter turnout.Methods. We explore these ideas using panel data on 754 mothers living in Chicago and interviewed as part of the 1967–1976 Woodlawn Community Study.Results. We find that marital status has no effect when women are younger but over time single parents' turnout falls behind that of married parents. This is primarily due to factors related to income and income change.Conclusions. Single mothers have lower rates of participation and, given the high rates of single parenthood in segregated inner‐city neighborhoods, this substantially diminishes the political voice of the nation's poor, contributing to class bias in the electorate.
Gender and Science in Developing Areas: Has the Internet Reduced Inequality?*
Authors: Paige Miller B. , Sooryamoorthy R. , Anderson Meredith , Palackal Antony , Shrum Wesley 
Published: August 2006

Objective. This article examines the impact of the Internet on the research careers of female scientists in three developing areas: Ghana, Kenya, and Kerala, India. Most empirical studies of gender and science focus on the developed world, yet theoretical accounts emphasize more extreme differences in developing areas. Limited evidence from Africa and Asia shows gender inequity is restricted to a few key dimensions, broadly related to differences in human and social capital. Specifically, women are less likely to acquire an advanced degree and more likely to experience educational and organizational “localism.” Such localism is related to constraints on physical mobility that are widely expected to diminish with the introduction of the Internet.Methods. Using longitudinal data on 1,147 scientists in Ghana, Kenya, and south India, we examine gender differences in human and social capital by conducting a series of t tests and chi‐square tests.Results. We show that higher education and Internet access increased dramatically, but localism has not been reduced significantly and may be increasing.Conclusions. This finding casts doubt on the presumption that the removal of communication constraints will soon reduce career differentials resulting from the mobility constraints on women professionals.