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Andersen, S.R., Belcourt, G.M., and Langwell, K.M. (2005, May). "Building healthy tribal nations in Montana and Wyoming through collaborative research and development." (AHRQ grant HS14034). Government, Politics, and Law 95(5), pp. 784-789.
This paper describes the work of a collaborative consortium formed to reduce health disparities affecting Montana and Wyoming tribal nations, while promoting health-protective practices and interventions among these populations. Under the auspices of the Montana-Wyoming Tribal Leaders Council, the consortium has undertaken activities to establish the research infrastructure needed for conducting ongoing health disparities research and to develop a targeted research agenda that addresses tribally identified priority health issues, such as hepatitis C, West Nile virus, and methamphetamine use.
Atherly, A., Herbert, P.L., and Maciejewski, M.L. (2005, May). "An analysis of disenrollment from Medicare managed care plans by Medicare beneficiaries with diabetes," (AHRQ contract 500-92-0014) Medical Care 43(5), pp. 500-506.
A study of patients with diabetes who were insured through Medicare from 1995-1998 found that those who were at high risk for complications of diabetes tended to disenroll from Medicare HMOs sooner than those who were at low risk. This effect was mitigated by plans offering better prescription drug benefits. Clinical factors such as heart complications and vision complications indicated higher risk for complications and were significantly associated with a shorter duration of HMO enrollment. However, patients at high risk for diabetes complications who enrolled in HMOs in counties with better drug benefits remained in their HMOs longer.
Bolton, L.B., Shihady, I.R., Bennett, C., and others (2005, May). "Engaging nurse leaders in health services research." (AHRQ grant HS11334). Journal of Nursing Administration 35(5), pp. 238-243.
These authors describe effective methods to engage nurse leaders in structured interview research. They interviewed nurse managers and directors of 225 California hospital labor and delivery (L&D) units about hospital organizational factors, clinical policies and staffing on their L&D unit, and nurse satisfaction. They used a multilevel approach to engage nurse leaders in the research, such as endorsements and "detailing" by nurse opinion leaders, followup phone calls and electronic mail to reschedule interviews, and incentives. This was an effective strategy that resulted in 91 percent of the survey interviews being completed by L&D unit managers or directors and only 9 percent being delegated to a staff nurse.
Hyle, E.P., Lipworth, A.D., Zaoutis, T.E., and others (2005, May). "Risk factors for increasing multidrug resistance among extended-spectrum ß-lactamase-producing Escherichia coli and Klebsiella species." (AHRQ grant HS10399). Clinical Infectious Diseases 40, pp. 1317-1324.
This study examined risk factors for multidrug resistance (MDR) among extended-spectrum ß-lactamase-producing Escherichia coli and Klesbsiella species (ESBL-EK) of bacteria. The investigators used clinical cultures to identify patients at one hospital with ESBL-EK from June 1, 1997 through December 31, 2002. They identified MDR ESBL-EK by cultures resistant to trimethoprim-sulfamethoxazole, aminoglycosides, and quinolones. Of 361 total ESBL-EK isolates, 18.8 percent were MDR. However, the prevalence of MDR more than doubled from 12.5 to 26.9 percent during the study period. The only independent risk factor for MDR ESBL-EK was the infecting organism, Klebsiella pneumoniae, suggesting that the epidemiology of K. pneumoniae may be unique.
Pignone, M., DeWalt, D.A., Sheridan, S., and others (2005, February ). "Interventions to improve health outcomes for patients with low literacy." (AHRQ contract 290-00-0016). Journal of General Internal Medicine 20, pp. 185-192.
Several interventions have been developed to improve health for people with low literacy. This systematic review of studies examined the effect of such interventions on the health outcomes of this group. Health knowledge was the most common outcome studied in the 20 articles that met review criteria. Fewer studies examined health behaviors, intermediate markers, or measures of disease prevalence or severity. Only five articles examined the interaction between literacy level and the effect of the intervention. Limitations in study design, interventions tested, and outcomes assessed made drawing conclusions about effectiveness difficult. Further research is required to better understand the most effective and efficient interventions to overcome literacy-related barriers to good health.
Siderowf, A., Newberg, A., Chou, K.L., and others (2005, May). "[99mTc] TRODAT-1 SPECT imaging correlates with odor identification in early Parkinson disease." (AHRQ grant HS00004). Neurology 64, pp. 1716-1720.
Impairment in olfactory function is an early manifestation of Parkinson disease (PD), and an impaired sense of smell may precede development of overt motor symptoms. In vivo imaging of the dopamine transporter with [99mTc]TRODAT-1 and olfactory testing have both been proposed as potential biomarkers in PD. This study examined the relationship between TRODAT SPECT imaging, odor identification skills, and motor function in 24 patients with early PD. Smell identification test scores were correlated with TRODAT uptake in the striatum as a whole. The correlation between dopamine transporter density in the caudate and smell identification test scores was moderate but not significant. The researchers conclude that olfactory function is highly correlated with dopamine transporter imaging abnormalities in early PD.
Current as of August 2005
AHRQ Publication No. 05-0097