bluuebunny/crossref_metadata_2025_split huggingface dataset:
Turbulence measurements from Hi absorption spectra
Authors: Roy Nirupam , Peedikakkandy Leshma , Chengalur Jayaram N. 
Published: April 2008

Abstract
We use the millennium Arecibo 21-cm absorption-line survey measurements to examine the issue of the non-thermal contribution to the observed Galactic H i linewidths. If we assume a simple, constant pressure model for the H i in the Galaxy, we find that the non-thermal contribution to the linewidth, vnt scales as v2nt∝lα, for vnt larger than ∼0.7 km s−1. Here, l is a derived length-scale and α ∼ 0.7 ± 0.1. This is consistent with what one would expect from a turbulent medium with a Kolmogorov scaling. Such a scaling is also predicted by theoretical models and numerical simulations of turbulence in a magnetized medium. For non-thermal linewidths narrower than ∼0.7 km s−1, this scaling breaks down, and we find that the likely reason is ambiguities arising from Gaussian decomposition of intrinsically narrow, blended lines. We use the above estimate of the non-thermal contribution to the linewidth to determine corrected H i kinetic temperature. The new limits that we obtain imply that a significantly smaller (∼40 per cent as opposed to 60 per cent) fraction of the atomic interstellar medium in our Galaxy is in the warm neutral medium phase.
A Prognosis for the Rural Hospital: Part II: Are Rural Hospitals Economically Viable?
Authors: Moscovice Ira , Rosenblatt Roger A. 
Published: April 2008

ABSTRACTThis is the second of a two part series that summarizes what is known about the operation and performance of the rural hospital and discusses potential options and strategies for strengthening the viability of these institutions. In Part II, we focus on the economic viability of the rural hospital and examine external factors that influence the environment within which the rural hospital operates. We conclude that the future will remain precarious for rural hospitals and that they can hope to improve their economic viability only if they are able to determine where they fit as part of the larger health care system.
Evaluation of Medical Center Support for Rural Physicians*
Authors: Cooper James K. , Johnson Timothy P. 
Published: April 2008

ABSTRACTProfessional isolation remains a problem for rural physicians. To address the problem, a university medical center established a Physician Support Office (PSO). The PSO offered rural physicians toll‐free telephone access to patient referral, patient follow‐up, library reference, and drug information services. A newsletter was also published. The service was evaluated using a quasi‐experimental design. Physicians in the experimental area felt there was improvement in several medical center services, compared to physicians in the control area. Provision of library services, referral services and a newsletter contributed significantly to the usefulness of the PSO program. Nevertheless, the PSO did not produce a significant improvement in rural physicians’overall feeling of general medical center support.
Environmental Responses in Small Rural Hospitals*
Authors: Seavey John W. , Berry David E. 
Published: April 2008

ABSTRACTMajor environmental forces are placing increased pressure on community small and rural hospitals to provide access to medical care in rural communities and to survive as free standing non‐profit community institutions. This survey of chief executive officers of small and rural hospitals in two states examines their perceptions of their institution's environment and the degree to which multi‐institutional arrangements are seen as an organizational response to a changing environment. Major differences among small and rural hospitals are explored.
A Practical Approach to Medical Records in a Rural Health Care Setting*
Authors: Tatro Pam 
Published: April 2008

ABSTRACTDeciding on a system for keeping medical records in a new rural health practice, or in an established practice seeking to update an obsolete system, may be confusing because of a multitude of vendors who claim to meet every need. Special circumstances set rural health practices apart from other ambulatory care settings with regard to medical record needs. Practical considerations regarding filing systems, record content and format are offered in view of these special circumstances. Issues involving ownership of the record and access to confidential information are also explored.
Nigerian Heads of Households' Attitudes Toward Modern and Traditional Medicines*
Authors: Airhihenbuwa Collins O. 
Published: April 2008

ABSTRACTTwo hundred and fifty five heads of households were surveyed in Iyekuselu district, Bendel state, Nigeria. Fifteen villages were randomly selected from the list of 107 villages that constitute the district. A total of seventeen heads of households were interviewed in each of the fifteen villages. This survey was conducted to assess the attitudes of subjects toward modern medicine and traditional medicine. The heads of households generally expressed positive attitudes toward the health services provided at the modern medicine facilities. Some of them also reported accepting traditional healing administered by native doctors as legitimate alternative health care. For the illnesses considered in this study, the majority of the respondents were willing to consider modern medicine.
Nurses' Perceptions of Inter‐ and Intra‐Professional Relationships: An Analysis of Support From Nursing and Physician Colleagues in Rural Hospitals*
Authors: Lockyer Jocelyn M. , Parboosingh I. John T. 
Published: April 2008

ABSTRACTNurses employed in ten rural hospitals in Canada completed questionnaires designed to examine their perceptions of the strength of the professional relationship which existed among nurses and between nurses and physicians. Four questions addressed the availability of nursing education programs and the attendance of nurses and physicians at such programs. Seven questions examined the nurses’perception of physician interest in nursing education and the encouragement received from their nursing colleagues to participate in learning activities and medical management decision making. Chi square analysis was undertaken to determine whether the colleagial relationships differed by hospital or medical staff characteristics. Forty percent of the nurses felt that the majority, of physicians were supportive of continuing nursing education. Sixty‐three percent indicated their nursing colleagues encouraged them to attend educational programs. The results indicate that physician participation in nursing continuing education was greatest in communities with the fewest health resources (an acute hospital with fewer than 50 beds). In contrast, encouragement to participate in continuing nursing education was highest in settings where the hospital provided both acute and extended care services, had more patient admissions and a greater availability of educational programming.
Factors Related to Dietary Status of Limited Resource Farm Families: A Case Study*
Authors: Hertzler Ann A. , Caldwell John S. , Mark‐Teo Miew Leng 
Published: April 2008

ABSTRACTA case study approach was used to study 10 limited resource farm families to identify factors relative to the farm family situation that are associated with adequate or inadequate food habits. Dietary measures were developed and adequacy of diets was analyzed in relation to gender, women's off‐ or on‐farm employment, predominant farm activities, and cohesiveness. Traditional families, with two adults present and the women employed on the farm, had the most adequate diets and higher cohesiveness ratings. Families in transition, with women employed off the farm or headed by widowed women farmers, had the poorest diets nutritionally and tended to have lower cohesiveness ratings. The presence of a food source raised or grown for income purposes did not guarantee the use of the food for family consumption.
Residence Differences in the Health Status of Elders*
Authors: Cutler Stephen J. , Coward Raymond T. 
Published: April 2008

ABSTRACT:Using data from the 1984 Supplement on Aging to the National Health Interview Survey, this study examined residential differences on a selected group of health status measures among persons 65 years of age and older (N = 11,497). Mean values on indicators of health and impairment for each of the residence categories were examined before and after adjusting for distributional differences in background and demographic characteristics which are associated with both health and residence. Three important conclusions emerged from the analysis: (1) health status does not vary with residence in a unitary fashion; (2) the relationship between residence and health status does not appear to fall along a straightforward rural‐urban continuum; and (3) there is both diversity in, and a general patterning of, the significant relationships between health and residence with the extremes of health status located in the rural categories.
Differences in Need Among the Rural and Urban Aged: Statistical Versus Practical Significance*
Authors: Leinbach Raymond M. 
Published: April 2008

ABSTRACT:Needs assessment data from two states are analyzed to determine if there are differences between rural and urban older persons. Five different definitions of “rural” are utilized. A test of statistical significance is used to determine if differences exist and a measure of association is used to determine how strong the relationships are between residence and need. It is concluded that, with the exception of one rural definition within one state, there are residential differences in need. However, those differences are so small as to have limited practical significance in the public policy arena.
Use of a State‐Level Pharmaceutical Assistance Program Among Urban and Rural Elders*
Authors: Goodfellow Marianne , Tubman Jon G. , Landry Julie A , Abern Frank , Lago Dan , Smyer Michael A. 
Published: April 2008

ABSTRACT:A number of state‐level pharmaceutical assistance programs have been established as a result of the growing recognition of the role of Pharmaceuticals in the long‐term care of the elderly. However, existing research does not provide a coherent expectation for patterns of use by rural and urban elderly. The data for this analysis are drawn from a larger study of the Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE). PACE provides prescription medicines for elderly who meet income requirements. The research project was designed to assess the characteristics of PACE program participants and non‐participants on a wide range of issues. Chi‐square analysis and regression models were used to assess the association between rural and urban residence and access to the PACE Program. The results indicate that rural/urban status of the elderly is not a significant predictor of the use of PACE. Other traditional variables (e.g., health self‐rating and physician visits) did predict difference in the pattern of use.
Impact of Medicare's Prospective Payment System and the Farm Crisis on the Health Care of the Elderly: A Case Study*
Authors: Sharp Tessa S. , Halpert Burton P. , Breytspraak Linda M. 
Published: April 2008

ABSTRACT:The spectrum of health care for the rural elderly has been negatively affected by recent changes in Medicare reimbursement policies and by the farm crisis. This case study examined the effects of these changes on the ability of rural hospitals, the aging network, and caregivers to provide adequate and continuous care to the elderly. In this case study, three gaps in services were found: a lack of programs designed to meet the needs of terminally ill patients and their families; a lack of education during the crucial transitional period between hospital discharge and home; and a lack of services and programs for the chronically‐ill older adult. More studies are needed to determine if similar service gaps will be found in other rural communities. If so, public attention should be focused on possible solutions.
Necessary Conditions for Supporting a General Surgeon in Rural Areas*
Authors: Glenn John K. , Hicks Lanis L. , Daugird Allen J. , Lawhorne Larry W. 
Published: April 2008

ABSTRACT:Loss of a general surgeon in a rural community can alter the referral patterns, the image and utilization of the local hospital, and even the market share of local primary care physicians. Prior research has not defined the necessary and/or sufficient conditions for a rural county to be able to support a local general surgeon. Based upon empirical analysis of 96 rural Missouri counties and the limited literature available on rural surgeons and physician referral rates, a first approximation of those conditions are offered. We conclude that a rural county with a hospital, a population base of more than 15,000 people, and at least 11 potential referring physicians has sufficient conditions to enable it to support a local general surgeon. Among those rural Missouri counties not meeting the above conditions but having a general surgeon in 1984, we estimate that 8 to 10 potential referring physicians appear to be the minimum necessary condition for supporting a rural general surgeon through patient referral. From those conclusions, we argue that any rural hospital currently without a surgeon should re‐examine its situation. To prepare for a competitive future, such a hospital should take every opportunity to expand the referral base necessary to support a full‐time local surgeon rather than place long‐term reliance upon itinerant general surgeons.
The Rural Hospital Project: Conceptual Background and Current Status*
Authors: Amundson Bruce A. , Rosenblatt Roger A. 
Published: April 2008

ABSTRACT:Rural hospitals are confronting continuing and increasing threats to their inability. A demonstration project for the Washington‐Alaska‐Montana‐Idaho region to address the problems of the rural hospital and health system is described. The assumptions underlying the project are that the rural hospital represents the most important component of the rural health care system, and the role of the rural hospital must be defined in relation to the broad health care needs of the population it serves. However, since the elements of community health services are also interdependent, a comprehensive approach to addressing the broad array of problems which besiege rural health services has been developed. The phases of this comprehensive health services development model are described. This approach is having a substantial impact on the ability of community health care leaders to work together, identify important problems, and initiate a range of interventions, with results that are encouraging for the future of the rural hospital and health care system.
The Effects of Area Health Education Centers on Primary Care Physician‐to‐Population Ratios from 1975 to 1985*
Authors: Hynes Kevin , Givner Nathaniel 
Published: April 2008

ABSTRACT:The purpose of this study was to explore how the primary care (PC) physician‐to‐population ratio changed from 1975 to 1985 in counties that were served by an Area Health Education Center (AHEC) in contrast to those counties that were not. The investigation attempted to determine whether any observed changes in this ratio were dependent upon either degree of urbanization or contiguity to a Standard Metropolitan Statistical Area (SMSA). The data source for this study was the Area Resource File. Results indicated that: (a) irrespective of AHEC status, increased degree of urbanization across counties was associated with relatively more PC physicians in both 1975 and 1985; (b) PC physician‐to‐population ratios increased from 1975 to 1985 for all American Medical Association (AMA) county code categories, regardless of AHEC versus non‐AHEC designation; (c) AHEC counties demonstrated greater (or equivalent) absolute improvement for all AMA county code categories except for several categories which represented more urbanized counties; (d) for the least urbanized counties in the AMA code, the percentage improvement in PC physician‐to‐population ratios for AHEC counties ranged from 3 to 5 percent higher than corresponding percentage improvement in ratios for non‐AHEC counties; and (e) AHEC counties showed greater absolute and percentage improvement in PC physician‐to‐population ratios than did non‐AHEC counties for counties not contiguous to SMSAs.
Competition and Rural Primary Care Programs*
Authors: Ricketts Thomas C. 
Published: April 2008

ABSTRACT:Rural primary care programs were established in areas where there was thought to be no competition for patients. However, evidence from site visits and surveys of a national sample of subsidized programs revealed a pattern of competitive responses by the clinics. In this study of 193 rural primary care programs, mail and telephone surveys produced uniform data on the organization, operation, finances, and utilization of a representative sample of clinics. The programs were found to compete in terms of: (1) price, (2) service mix, (3) staff availability, (4) structural accessibility, (5) outreach, and (6) targeting a segment of the market. The competitive strategies employed by the clinics had consequences that affected their productivity and financial stability. The strategies were related to the perceived missions of the programs, and depended heavily upon the degree of isolation of the program and the targeting of the services. The competitive strategy chosen by a particular program could not be predicted based on service area population and apparent competitors in the service area. The goals and objectives of the programs had more to do with their competitive responses than with market characteristics. Moreover, the chosen strategies may not meet the demands of those markets.
Nonfatal Farm Injuries in North Dakota: A Sociological Analysis*
Authors: Geller Jack M. , Ludtke Richard L. , Stratton Terry 
Published: April 2008

ABSTRACT:The 1980s has not been a particularly prosperous decade for many farm operators. Due to shifts in the agricultural economy, many farmers have experienced farm foreclosure and rural displacement; while many more are at serious risk of losing their farms. Within the context of the agricultural crisis, this study examines the impact of economic hardship on the probability of experiencing a farm injury. Specifically, we hypothesized that farm operators who were experiencing economic distress would be more likely to experience a farm injury. Data from the North Dakota Rural Life Poll (n=450) was used to estimate the incidence of farm accidents, as well as examine the relationship between selected farm operator characteristics and the incidence of a farm accident. The data suggests that younger farm operators with higher debt‐to‐asset ratios are significantly more likely to experience a farm accident. The study goes on to examine some of the dynamics of this relationship, and implications for farm safety education are addressed.
Causes and Consequences of Rural Small Hospital Closures from the Perspectives of Mayors
Authors: Hart L. Gary , Pirani Michael J. , Rosenblatt Roger A. 
Published: April 2008

ABSTRACT: Mayors of rural towns whose small general hospitals closed between 1980 and 1988 were surveyed. Only hospitals that were the sole hospitals in their towns and that had not reopened were included in the survey. Of the 132 hospitals meeting these criteria, 130 (98.5%) of the mayors of their communities responded to the survey.The typical study hospital had 31 beds, with an average daily census of 12. Three fourths of the hospital closures were in the North‐Central and South census regions. Half of the hospital closures were for hospitals that were 20 miles or more from another hospital.Mayors attributed the closure of their hospitals primarily to governmental reimbursement policies, poor hospital management and lack of physicians. To a lesser extent, they also implicated competition from other hospitals, reputation for poor quality care, lack of provider teamwork, and inadequate hospital board leadership.Respondents reported they had little warning that their hospitals were in imminent danger of closing. Warnings of six months or less were reported by 49 percent of the mayors; only 33 percent of mayors of towns with for‐profit hospitals reported having more than six months warning.Of the 132 hospital buildings that closed, only 38 percent were not in use in some capacity in the summer of 1989. Most were being utilized as some form of health care facility such as an ambulatory clinic, nursing home, or emergency room.More than three fourths of the mayors felt access to medical care had deteriorated in their communities after hospital closure, with a disproportionate impact on the elderly and poor. Nearly three fourths of the mayors also perceived that the health status of the community was worse because of the hospital closure, and more than 90 percent felt it had substantially impaired the community's economy.
Rural Adolescent Alcohol Use: An Overview*
Authors: Fanner Frank L. , Kelleher Kelly J. , Rickert Vaughn I. 
Published: April 2008

SummaryUse and abuse of alcohol by rural adolescents is an important problem for those who care for youth and for the future of rural communities. Alcohol use is common and associated with many of the risk factors identified in previous urban‐sampled research. However, there is considerable rural heterogenety, and the specific characteristics of rural families and communities that may predispose certain adolescents to earlier use or problem drinking are not well understood. Identification of these factors are not only critical for the treatment of affected adolescents and their families, but also for the prevention of adolescent problem drinking. While a number of authors have attempted to describe rural adolescent drinking and associated factors, these studies have been limited by sampling only school populations, small samples, use of unstandardized instruments and no long‐term follow‐up. In the same vein, no investigators have described the impact of population density, farm residence, predominant local industry, or sociocultural characteristics of rural families and communities on adolescent alcohol use and other health compromising behaviors. Thus, prospective longitudinal studies are sorely needed. Even more important, no research exists that explores the effectiveness of treatment or prevention services for rural adolescents. Communities and providers are forced to rely on models developed in urban settings that do not take into account the lack of access to other services, the shortage of trained specialists, and the limited economic resources of rural communities. A focused effort by investigators, research agencies, and local communities will be necessary for these barriers to be overcome.
Issues Surrounding the Distribution and Utilization of Nurse Nonphysician Providers in Rural America*
Authors: Conway‐Welch Colleen 
Published: April 2008

ABSTRACTThe cost and quality of health care is an ever‐increasing concern. Responsible people are looking for logical solutions. One solution is the increased involvement of nurse practitioners and certified nurse midwives in the delivery of health care services to patients. This paper reviews the supply, education, and responsibilities of nurse practitioners and certified nurse midwives, government studies of the need for nonphysician providers, the cost‐effectiveness of health care delivered by nurse practitioners and certified nurse midwives, and impediments to practice.