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1.  Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit 
BioMed Research International  2014;2014:960575.
Background. Data on long-term outcomes of elderly (≥65 years) patients in ICU are sparse. Materials and Methods. Adult patients (n = 1563, 45.4% elderly) admitted over 28 months were analyzed by competing risks regression model to determine independent factors related to in-hospital and long-term mortality. Results. 414 (26.5%) and 337 (21.6%) patients died in-hospital and during the 52 months following discharge, respectively; the elderly group had higher mortality during both periods. After discharge, elderly patients had 2.3 times higher mortality compared to the general population of the same age-group. In-hospital mortality was independently associated with mechanical ventilation (subdistribution hazard ratio (SHR) 2.74), vasopressors (SHR 2.56), neurological disease (SHR 1.77), and Mortality Prediction Model II score (SHR 1.01) regardless of age and with malignancy (SHR, hematological 3.65, nonhematological 3.4) and prior renal replacement therapy (RRT, SHR 2.21) only in the elderly. Long-term mortality was associated with low hemoglobin concentration (SHR 0.94), airway disease (SHR 2.23), and malignancy (SHR hematological 1.11, nonhematological 2.31) regardless of age and with comorbidities especially among the nonelderly. Conclusions. Following discharge, elderly ICU patients have higher mortality compared to the nonelderly and general population. In the elderly group, prior RRT and malignancy contribute additionally to in-hospital mortality risk. In the long-term, comorbidities (age-related), anemia, airway disease, and malignancy were significantly associated with mortality.
PMCID: PMC4280808  PMID: 25580439
2.  Two cases of atrial flutter with fetal hydrops: successful fetal drug therapy. 
Journal of Korean Medical Science  1998;13(6):676-679.
We describe two cases of fetal atrial flutter associated with severe fetal hydrops which were unresponsive to digoxin but were successfully treated with flecainide acetate. Two cases of fetal atrial flutter were identified in fetuses with severe fetal hydrops on 3rd trimester ultrasonogram(28 weeks' gestation and 30 weeks' gestation). Following failed digoxin monotherapy, flecainide acetate was added to digoxin. On the 7th day and 13th day after combined therapy, fetal heart rate converted to normal sinus rhythm without recurrence. Our cases showed that the combined therapy of digoxin and flecainide acetate can effectively treat fetal atrial flutter associated with fetal hydrops unresponsive to digoxin monotherapy.
PMCID: PMC3054546  PMID: 9886180
3.  The data standardization remedy in Kassebaum-Kennedy. 
Public Health Reports  1997;112(2):114-115.
PMCID: PMC1381856  PMID: 9102657
4.  Federal programs and Indian country: a time for reinvention. 
Public Health Reports  1998;113(1):34-35.
PMCID: PMC1308365  PMID: 9885526
7.  Key components of a statewide Healthy Communities effort. 
Public Health Reports  2000;115(2-3):134-138.
The Healthy Cities/Healthy Communities movement is in its second decade. Examples of both successful and unsuccessful Healthy Communities efforts can be found in large and small communities across the country. What are the key components of a successful effort? Movement leaders from California, Massachusetts, Pennsylvania, and South Carolina as well as the Centers for Disease Control (CDC) and Prevention have contributed their collective experience to identifying the key components of a statewide Healthy Communities effort. Assessing the degree to which a state has these key components in place can help the state take steps to assure support for Healthy Communities.
PMCID: PMC1308701  PMID: 10968744
8.  Assets-oriented community assessment. 
Public Health Reports  2000;115(2-3):205-211.
Determining how to promote community health requires that community health workers first assess where the community stands. The authors maintain that Healthy Communities initiatives are better served by assets-oriented assessment methods than by standard "problem-focused" or "needs-based" approaches. An assets orientation allows community members to identify, support, and mobilize existing community resources to create a shared vision of change, and encourages greater creativity when community members do address problems and obstacles.
PMCID: PMC1308712  PMID: 10968755
10.  Public policy issues: an American perspective. 
PMCID: PMC1295015  PMID: 8815242
12.  A brief history of health care quality assessment and improvement in the United States. 
Western Journal of Medicine  1994;160(3):263-268.
We review the history and current efforts to assess and improve health care in the United States. This process has involved a host of government agencies and commissions, professional organizations, insurance underwriters, corporations, and more recently, market forces. Traditional approaches to quality control have stressed case-by-case analysis and identifying outliers. Newer approaches include creating practice guidelines and profiles of hospitals and physicians. The joint goals of quality improvement and cost control can best be realized if institutions and practitioners embrace these new approaches and use them to enhance their performances.
PMCID: PMC1022402  PMID: 8191769
13.  Costs and coverage. Pressures toward health care reform. 
Western Journal of Medicine  1992;157(5):576-583.
Signs of discontent with the health care system are growing. Calls for health care reform are largely motivated by the continued increase in health care costs and the large number of people without adequate health insurance. For the past 20 years, health care spending has risen at rates higher than the gross national product. As many as 35 million people are without health insurance. As proposals for health care reform are developed, it is useful to understand the roots of the cost problem. Causes of spiraling health care costs include "market failure" in the health care market, expansion in technology, excessive administrative costs, unnecessary care and defensive medicine, increased patient complexity, excess capacity within the health care system, and low productivity. Attempts to control costs, by the federal government for the Medicare program and then by the private sector, have to date been mostly unsuccessful. New proposals for health care reform are proliferating, and important changes in the health care system are likely.
PMCID: PMC1022049  PMID: 1441510

Results 1-16 (16)