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Hopkins University (hopkin + university)
Kinds of Hopkins University Selected AbstractsCapturing the power of academic medicine to enhance health and health care of the elderly in the USAGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2004William R Hazzard As in Japan, the US population is aging progressively, a trend that will challenge the health-care system to provide for the chronic, multiple and complex needs of its elderly citizens. and as in Japan, the US academic health enterprise has only belatedly mounted a response to that challenge. Herein is reviewed a quarter of a century of the author's personal experience in developing new programs in gerontology and geriatric medicine from a base in the Department of Internal Medicine at three US academic health centers (AHC): The University of Washington (as Division Head), Johns Hopkins University (as Vice-Chair), and Wake Forest University (as Chair). Rather than to build a program from a new department of geriatrics, this strategy was chosen to capture the power and resources of the department of internal medicine, the largest university department, to ,gerontologize' the institution, beginning with general internal medicine and all of the medical subspecialties (the approach also chosen to date at all but a handful of US AHC). The keystone of success at each institution has been careful faculty development through fellowship training in clinical geriatrics, education and research. Over the same interval major national progress has occurred, including expanded research and training at the National Institute on Aging and the Department of Veterans Affairs, and accreditation of more than 100 fellowship programs for training and certification of geriatricians. However, less than 1% of US medical graduates elect to pursue such training. Hence such geriatricians will remain concentrated at AHC, and most future geriatric care in the USA will be provided by a broad array of specialists, who will be educated and trained in geriatrics by these academic geriatricians. [source] Interview with a Quality Leader,Karen Davis, Executive Director of The Commonwealth FundJOURNAL FOR HEALTHCARE QUALITY, Issue 2 2009Lecia A. Albright Dr. Davis is a nationally recognized economist, with a distinguished career in public policy and research. Before joining the Fund, she served as chairman of the Department of Health Policy and Management at The Johns Hopkins School of Public Health, where she also held an appointment as professor of economics. She served as deputy assistant secretary for health policy in the Department of Health and Human Services from 1977 to 1980, and was the first woman to head a U.S. Public Health Service agency. Before her government career, Ms. Davis was a senior fellow at the Brookings Institution in Washington, DC; a visiting lecturer at Harvard University; and an assistant professor of economics at Rice University. A native of Oklahoma, she received her PhD in economics from Rice University, which recognized her achievements with a Distinguished Alumna Award in 1991. Ms. Davis is the recipient of the 2000 Baxter-Allegiance Foundation Prize for Health Services Research. In the spring of 2001, Ms. Davis received an honorary doctorate in human letters from John Hopkins University. In 2006, she was selected for the Academy Health Distinguished Investigator Award for significant and lasting contributions to the field of health services research in addition to the Picker Award for Excellence in the Advancement of Patient Centered Care. Ms. Davis has published a number of significant books, monographs, and articles on health and social policy issues, including the landmark books HealthCare Cost Containment, Medicare Policy, National Health Insurance: Benefits, Costs, and Consequences, and Health and the War on Poverty. She serves on the Board of Visitors of Columbia University, School of Nursing, and is on the Board of Directors of the Geisinger Health System. She was elected to the Institute of Medicine (IOM) in 1975; has served two terms on the IOM governing Council (1986,90 and 1997,2000); was a member of the IOM Committee on Redesigning Health Insurance Benefits, Payment and Performance Improvement Programs; and was awarded the Adam Yarmolinsky medal in 2007 for her contributions to the mission of the Institute of Medicine. She is a past president of the Academy Health (formerly AHSRHP) and an Academy Health distinguished fellow, a member of the Kaiser Commission on Medicaid and the Uninsured, and a former member of the Agency for Healthcare Quality and Research National Advisory Committee. She also serves on the Panel of Health Advisors for the Congressional Budget Office. [source] Agreement Between Nosologist and Cardiovascular Health Study Review of Deaths: Implications of Coding DifferencesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2009Diane G. Ives MPH OBJECTIVES: To compare nosologist coding of underlying cause of death according to the death certificate with adjudicated cause of death for subjects aged 65 and older in the Cardiovascular Health Study (CHS). DESIGN: Observational. SETTING: Four communities: Forsyth County, North Carolina (Wake Forest University); Sacramento County, California (University of California at Davis); Washington County, Maryland (Johns Hopkins University); and Pittsburgh, Pennsylvania (University of Pittsburgh). PARTICIPANTS: Men and women aged 65 and older participating in CHS, a longitudinal study of coronary heart disease and stroke, who died through June 2004. MEASUREMENTS: The CHS centrally adjudicated underlying cause of death for 3,194 fatal events from June 1989 to June 2004 using medical records, death certificates, proxy interviews, and autopsies, and results were compared with underlying cause of death assigned by a trained nosologist based on death certificate only. RESULTS: Comparison of 3,194 CHS versus nosologist underlying cause of death revealed moderate agreement except for cancer (kappa=0.91, 95% confidence interval (CI)=0.89,0.93). kappas varied according to category (coronary heart disease, kappa=0.61, 95% CI=0.58,0.64; stroke, kappa=0.59, 95% CI=0.54,0.64; chronic obstructive pulmonary disease, kappa=0.58, 95% CI=0.51,0.65; dementia, kappa=0.40, 95% CI=0.34,0.45; and pneumonia, kappa=0.35, 95% CI=0.29,0.42). Differences between CHS and nosologist coding of dementia were found especially in older ages in the sex and race categories. CHS attributed 340 (10.6%) deaths due to dementia, whereas nosologist coding attributed only 113 (3.5%) to dementia as the underlying cause. CONCLUSION: Studies that use only death certificates to determine cause of death may result in misclassification and potential bias. Changing trends in cause-specific mortality in older individuals may be a function of classification process rather than incidence and case fatality. [source] Life-Sustaining Treatments: What Do Physicians Want and Do They Express Their Wishes to Others?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2003Joseph J. Gallo MD OBJECTIVES: To assess whether older physicians have discussed their preferences for medical care at the end of life with their physicians, whether they have established an advance directive, and what life-sustaining treatment they wish in the event of incapacity to make these decisions for themselves. DESIGN: Mailed survey to a cohort of physicians. SETTING: Physicians who were medical students at the Johns Hopkins University in graduating classes from 1946 to 1964. PARTICIPANTS: Physicians who completed the advance directive questionnaire (mean age 68). MEASUREMENTS: Questionnaires were sent out to known surviving physicians of the Precursors Study, an on-going study that began in 1946, asking physicians about their preferences for life-sustaining treatments. RESULTS: Of 999 physicians who were sent the survey, 765 (77%) responded. Forty-six percent of the physicians felt that their own doctors were unaware of their treatment preferences or were not sure, and of these respondents, 59% had no intention of discussing their wishes with their doctors within the next year. In contrast, 89% thought their families were probably or definitely aware of their preferences. Sixty-four percent reported that they had established an advance directive. Compared with physicians without advance directives, physicians who established an advance directive were more likely to believe that their doctors (odds ratio (OR) = 3.42, 95% confidence interval (CI) = 2.49,4.69) or family members (OR = 9.58, 95% CI = 5.33,17.23) were aware of their preferences for end-of-life care and were more likely to refuse treatments than those without advance directives. CONCLUSION: This survey of physicians calls attention to the gap between preferences for medical care at the end of life and expressing wishes to others through discussion and advance directives, even among physicians. [source] Design and analysis of some nonanthropomorphic, biologically inspired robots: An overviewJOURNAL OF FIELD ROBOTICS (FORMERLY JOURNAL OF ROBOTIC SYSTEMS), Issue 12 2001Gregory S. Chirikjian In this paper, two kinds of biologically inspired robots under investigation at Johns Hopkins University are reviewed. While these designs are reminiscent of designs in nature, they are, however, not anthropomorphic. Rather, they are zoomorphic in macroscopic structure. These two kinds of robots are snakelike "hyper-redundant" manipulators, and amoeboid "metamorphic" robots. In addition to issues in the design of the robots, issues in the dynamics and motion planning of these devices are reviewed. © 2001 John Wiley & Sons, Inc. [source] Fitness, fatness and activity as predictors of bone mineral density in older personsJOURNAL OF INTERNAL MEDICINE, Issue 5 2002K. J. Stewart Abstract. Stewart KJ, DeRegis JR, Turner KL, Bacher AC, Sung J, Hees PS, Tayback M, Ouyang P (Johns Hopkins Bayview Medical Center, Johns Hopkins University, School of Medicine, Baltimore, MD, USA). Fitness, fatness, and activity as predictors of bone mineral density in older persons. J Intern Med 2002; 252: 381,388. Objectives. To determine relationships of bone mineral density (BMD) with fitness, physical activity, and body composition and fat distribution. Design. Cross-sectional. Setting. General Clinical Research Center, Johns Hopkins Bayview Medical Center, Baltimore, Maryland. Subjects. Men (n = 38) and women (n = 46), aged 55,75 years with high normal blood pressure or mild hypertension but otherwise healthy. Methods. Aerobic fitness (oxygen uptake) on a treadmill, muscle strength by one-repetition maximum, activity by questionnaire, abdominal obesity by magnetic resonance imaging; anthropometrics, and body composition by dual energy X-ray absorptiometry (DXA) which measured total fat and lean mass, and BMD for the total skeleton, lumbar spine (L1,L4) and total hip. Results. Aerobic fitness did not correlate with BMD. Using multivariate analysis to ascertain independent contributions to the variance in BMD, in women, with adjustment for hormone replacement therapy (HRT), total skeleton BMD was independently related to muscle strength and abdominal total fat; total hip BMD to body weight; lumbar spine BMD to abdominal total fat. HRT also influenced BMD in the lumbar spine. In men, lumbar spine BMD was independently related to abdominal total fat physical activity and total hip BMD related to lower body strength. P < 0.05 for all of these correlations. Conclusions. Abdominal obesity and muscle strength emerge as predominant correlates of BMD in older persons with stronger relationships seen in women. Body weight and HRT also explained portions of the variance in BMD in women. Whether abdominal obesity is simply a marker for general obesity or has independent protective effects on bone is yet to be determined. [source] The library of the future: Interweaving the virtual and the physical.PROCEEDINGS OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE & TECHNOLOGY (ELECTRONIC), Issue 1 2002SIG DL, SIG ED, Sponsored by SIG USE It is increasingly easy to imagine the time in the future when most of the information and some of the support needed by library users is available electronically. The ways that people will interact with information will change, and libraries will need to design spaces that seamlessly combine the physical and the virtual. Such a library environment of the future is approaching quite rapidly in some disciplines. This panel uses a recent architectural study conducted by Hillier and DEGW Architectural Consultants for the Welch Medical Library of Johns Hopkins University to explore the implications of the library of the future on the design of the physical library facilities, considering especially changing patterns of use and the roles of librarians. [source] Central Effects of Residual Hearing: Implications for Choice of Ear for Cochlear Implantation,THE LARYNGOSCOPE, Issue 10 2004Howard W. Francis MD Abstract Objectives/Hypothesis: The study tested the hypothesis that among patients with similar levels of residual hearing in the nonimplanted ear, speech perception outcome is the same whether or not the implanted ear has profound or severe levels of hearing loss. Study Design: Retrospective. Methods: Levels of hearing loss in postlingually deafened adults who had cochlear implantation at Johns Hopkins University (Baltimore, MD) between 1991 and 2002 were classified according to pure-tone averages as bilateral severe (n = 20), severe-profound (severe in one ear and profound in the other) (n = 23), and bilateral profound (n = 43). There was no significant difference in the age at onset and duration of deafness among the three patient groups. Individuals in the bilateral severe and severe-profound groups had comparable levels of severe hearing loss in their nonimplanted ears, whereas those in severe-profound and bilateral profound groups had comparable levels of profound hearing loss in their implanted ears. Speech perception performance was evaluated using words from the Consonant Nucleus Consonant word list, Hearing in Noise Test sentences in quiet, and Central Institute for the Deaf sentences through recorded presentation at 70 dB sound pressure level (SPL). Results: Despite the profound hearing loss of the implanted ear in the asymmetrical group, there was no significant difference in mean speech perception scores compared with the bilateral severe group within the first year after implant surgery. By comparison, the bilateral profound group had lower speech perception results compared with patients with residual hearing in one or both ears. Conclusion: The study results suggest that implantation of the profoundly deafened ear does not diminish the functional advantage conferred by residual hearing in a patient with asymmetrical hearing loss. Therefore, the central auditory pathway may be the site at which persistent auditory function has its most beneficial effects. [source] Patents and Innovation in Cancer Therapeutics: Lessons from CellProTHE MILBANK QUARTERLY, Issue 4 2002Avital Bar-Shalom How scientific knowledge is translated into diagnostic and therapeutic tools is important to patients with dread diseases as well as to regulators and policymakers. Patents play a crucial role in that process. Indeed, concern that the fruits of federally funded research would languish without commercial application led to the passage of the Bayh-Dole Act (PL 96-517), which reinforced incentives to patent the results of inventions arising from federally funded research (Eisenberg 1996). Subsequently, rates of patenting among U.S. academic institutions have increased (Henderson, Jaffe, and Trajtenberg 1988). A recent survey by the Association of University Technology Managers counted 20,968 licenses and options from 175 academic institutions and 6,375 patent applications filed in fiscal year 2000 (Pressman 2002). Analysis suggests that the number of academic patents was already rising when the Bayh-Dole Act was passed in 1980 (Mowery et al. 2001), but it is clear that the act reinforced the patenting norm in research universities and mandated a technology transfer infrastructure at those universities that had not yet established a technology licensing office. This article discusses the interaction between intellectual property and cancer treatment. CellPro developed a stem cell separation technology based on research at the Fred Hutchinson Cancer Center. A patent with broad claims to bone marrow stem cell antibodies had been awarded to Johns Hopkins University and licensed to Baxter Healthcare under the 1980 Bayh-Dole Act to promote commercial use of inventions from federally funded research. CellPro got FDA approval more than two years before Baxter but lost patent infringement litigation. NIH elected not to compel Hopkins to license its patents to CellPro. CellPro went out of business, selling its technology to its competitor. Decisions at both firms and university licensing offices, and policies at the Patent and Trademark Office, NIH, and the courts influenced the outcome. [source] PUTTING THE CIVIL SOCIETY SECTOR ON THE ECONOMIC MAP OF THE WORLDANNALS OF PUBLIC AND COOPERATIVE ECONOMICS, Issue 2 2010Lester M. Salamon ABSTRACT,:,The past twenty-five years have witnessed a spectacular expansion of philanthropy, volunteering, and civil society organizations throughout the world. Indeed, we seem to be in the midst of a ,global associational revolution,' a worldwide upsurge of organized private voluntary activity. Despite the promise that this development holds, however, the nonprofit or civil society sector remains the invisible subcontinent on the social landscape of most countries, poorly understood by policymakers and the public at large, often encumbered by legal limitations, and inadequately utilized as a mechanism for addressing public problems. One reason for this is the lack of basic information on its scope, structure, financing, and contributions in most parts of the world. This lack of information is due in part to the fact that significant components of the nonprofit sector fall within the non-observed, or informal, economy, and in part to the way even the observed parts of this sector have historically been treated in the prevailing System of National Accounts (SNA). This paper provides an overview of a series of steps that have been taken over the past 20 years by researchers at the Johns Hopkins University in cooperation with colleagues around the world and, more recently, with officials in the United Nations Statistics Division and the International Labour Organization to remedy this situation, culminating in the issuance and initial implementation of a new United Nations Handbook on Nonprofit Institutions in the System of National Accounts and the forthcoming publication of a new International Labour Organization Manual on the Measurement of Volunteer Work. Taken together, these efforts point the way toward putting the civil society sector on the economic map of the world for the first time in a systematically comparative way. [source] | ||||||||||