Publications by authors named "Ning J Zhang"

Introduction: Thailand's Universal Coverage Scheme (UCS) has increased overall healthcare use by offering free healthcare for about 76% of the entire population since it was introduced in 2002. However, a considerable number of beneficiaries have continued to depend on private healthcare, and the low use of the UCS has been cited as a challenge to accomplishing the policy's goal of universal access to healthcare. Thus, this study divided healthcare use into three patterns (self-medication, private providers, and UCS) and investigated the socio-demographic characteristics of non-users of the UCS and their reasons for non-use.

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Introduction: Thailand has provided free annual health checkups (AHC) since universal health coverage began in 2002. However, evidence regarding the equitable use of AHC is scarce. Thus, this study explored factors associated with the use of AHC in Thailand.

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This study examined the association between social support and depressive symptoms among U.S. Chinese older adults.

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Quality of care has been a long-standing issue in US nursing homes. The culture change movement attempts to transition nursing homes from health care institutions to person-centered homes. While the adoption of culture change has been spreading across nursing homes, barriers to adoption persist.

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Cardiovascular disease (CVD) is one of the most prevalent chronic diseases nationally and disproportionately affects low-income individuals. There are substantial disparities on CVD outcomes that stem from the lack of health insurance among low-income populations. The Affordable Care Act expands Medicaid health insurance to low-income populations, and aims to increase the utilization of health, social, and economic preventive services to reduce health disparities and prevent chronic diseases.

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Background: Developing and implementing policies to curb and prevent youth tobacco use is of the utmost importance. In Florida, public school districts were authorized to develop tobacco-free school policies through an amendment to the Florida Clean Indoor Air Act in 2011. The purpose of this study is to determine the impact of tobacco-free school policies on smoking rates among youth in Florida.

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In prior studies, newly licensed registered nurses (NLRNs) described their job as being stressful. Little is known about how the hospital work environment affects their job satisfaction. A random sample of NLRNs were surveyed to assess the influence of hospital work environment on job satisfaction.

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This study investigated the impact of state nursing home staffing standards on nurse staffing levels for the year 2011. Specifically, the study attempted to measure state staffing standards at facility level (i.e.

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Background: The large number of uninsured individuals in the United States creates negative consequences for those who are uninsured and for those who are covered by health insurance plans. Young adults between the ages of 18 and 24 are the largest uninsured population subgroup. This subgroup warrants analysis.

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With more than 50% of the nursing workforce close to retirement, it is especially important to keep younger nurses in nursing jobs and careers. This study empirically tests a structural equation model of registered nurse (RN) intent to leave the job and profession using data from a survey of newly licensed RNs (NLRNs). Job demands, difficulties and control, intent to leave the job, and intent to leave the profession were latent variables.

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Through survey data, this study examines job leaving behaviors of newly licensed registered nurses and identifies educational and managerial issues that need to be addressed to retain them. Within 1.5-2.

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Background: Guidelines endorse statin therapy for lowering low-density lipoprotein cholesterol (LDL-C) to recommended levels, in patients with cardiovascular disease (CVD) risk, if needed, after lifestyle changes. Atorvastatin is a common statin with greater LDL-C lowering efficacy than most other statins; its availability in generic form will likely increase its use. This study assessed attainment of guideline-recommended LDL-C levels in high-risk CVD patients treated with atorvastatin monotherapy.

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Background: Statin therapy is recommended as the first-line pharmacotherapeutic approach for lowering LDL-C levels in patients at high cardiovascular risk.

Objective: To assess LDL-C levels among patients at high cardiovascular risk treated with rosuvastatin monotherapy.

Methods: This retrospective cohort study used patient records from the GE Centricity Electronic Medical Records (GE Centricity EMR) database and administrative claims data from Humana Medicare to identify patients at high cardiovascular risk with a first prescription for rosuvastatin monotherapy (index date) from January 1, 2008 through December 31, 2010.

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Objective: To systematically review the literature and estimate the effect size of the relationship between health literacy and medication adherence through meta-analysis.

Data Sources: Databases searched included Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982-2013), International Pharmaceutical Abstracts (IPA; 1970-2013), MEDLINE OVID (1966-2013), PubMed (1966-2013), PsycInfo (1966-2013), and Web of Science (1966-2013).

Study Selection And Data Extraction: Inclusion criteria were as follows: English language; published through May 1, 2013; medication adherence as the outcome variable; use of validated measures of health literacy and medication adherence; availability of a direct (not mediating) relationship between health literacy and medication adherence; and identifiable effect size and statistical significance of the relationship.

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Trends in nurse staffing levels in nursing homes from 1997 to 2011 varied across the category of nurse and the type of nursing home. The gaps found in this study are important to consider because nurses may become overworked and this may negatively affect the quality of services and jeopardize resident safety. Nursing home administrators should consider improving staffing strategically.

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Background: In prior studies, newly licensed registered nurses (RNs) describe their job as being stressful. Little is known about how their perceptions of the hospital work environment affect their commitment to nursing.

Objectives: To assess the influence of hospital work environment on newly licensed RN's commitment to nursing and intent to leave nursing.

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In this article the authors discuss the prevalence of resident abuse and reported violations of care deficiencies and resident maltreatment in nursing homes in the United States. The number of nursing homes in the United States that are cited with abuse violations has increased in recent years. While the authors recognize that treatments (both positive and negative) received by residents are sometimes related to factors other than staff's lack of knowledge and poor attitudes, their purpose in this analysis is to enhance resident integrity through the improvement of staff interpersonal communication skills.

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Previous studies show that the healthcare industry lags behind many other economic sectors in the adoption of information technology. The purpose of this study is to understand differences in structural characteristics between providers that do and that do not adopt Health Information Technology (HIT) applications. Publicly available secondary data were used from three sources: American Hospital Association (AHA) annual survey, Healthcare Information and Management Systems Society (HIMSS) analytics annual survey, and Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) databases.

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This qualitative research using the focus group approach has gathered pertinent perceptions from the stakeholders in Chinese elderly care environment, including community-based and institutionalised elderly, medical providers, administrators and governmental officials. The study found that the elderly are willing to live in nursing homes when they are not in good physical condition and are dependent on others for their activities of daily living. The utilisation of nursing home care has gained acceptance in the community as more elders recognise its advantages.

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Objectives: Nonadherence to prescription medications has been shown to be significantly influenced by three key medication-specific beliefs: patients' perceived need for the prescribed medication, their concerns about the prescribed medication, and perceived medication affordability. Structural equation modeling was used to test the predictors of these three proximal determinants of medication adherence using the proximal-distal continuum of adherence drivers as the organizing conceptual framework.

Methods: In Spring 2008, survey participants were selected from the Harris Interactive Chronic Illness Panel, an internet-based panel of hundreds of thousands of adults with chronic disease.

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As the world's most populous country with the largest aging population and a rapidly growing economy, China is receiving increased attention from both the Chinese government and the governments of other countries that face low fertility and aging problems. This unprecedented shift of demographic structure has repercussions for many aspects of development including economic growth, social welfare, elder care, and other public welfare issues in China. Balancing population aging and economic growth requires innovative strategies and represents both challenges and opportunities for China.

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This paper describes the development, prototyping, and evaluation of RMAIS (RFID-based Medication Adherence Intelligence System). Previous work in this field has resulted in devices that are either costly or too complicated for general (especially elderly) patients to operate. RMAIS provides a practical and economical means for ordinary patients to easily manage their own medications, taking the right dosage of medicine at the prescribed time in a fully automatic way.

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Background: Most studies of the relationship between nurse staffing and patient outcomes in hospitals have shown that worse patient outcomes are associated with lower registered nurse (RN) staffing. However, inconsistent results exist, possibly because of the use of a variety of nurse staffing and patient outcomes measures and because of statistical methods that employ static, instead of change, relationships.

Objectives: The aim of the study was to examine the relationship between changes in RN staffing and patient safety events in Florida hospitals from 1996 through 2004.

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This chapter summarizes the major determinants of health insurance coverage rates among young adults. Socioeconomic status, demographics, actual and perceived health status, perceived value, and perceived need are all examined in order to determine what the literature reveals regarding each variable and how each variable impacts a young adult's decision to purchase health insurance. Results indicate that socioeconomic status, demographics, perceived value, and perceived need were the most significant determinates of health insurance status of young adults.

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