Biomedical subjects

Heibatollah Baghi

Publications and source records attributed to Heibatollah Baghi.

5 recordsLinked to original sources

PubMed2006

Postpartum tobacco use: developing evidence for practice.

Most women who quit smoking during pregnancy return to tobacco use within 6 months after delivery. Findings demonstrate that minimal intervention effectiveness exists with strategies to prevent postpartum smoking relapse. This article provides a synthesis of current research on postpartum tobacco use. Whether in the labor and delivery suite, the postpartum floor, or the neonatal ICU, acute and critical care nurses have a valuable role to help reduce the incidence of tobacco-related maternal and child outcomes.

Acute Disease↗

PubMed2006

Costs and benefits of combining probation and substance abuse treatment.

AIMS OF THE STUDY: We compared seamless combination of probation and treatment (where the probation officer is co-located with treatment provider or is actively engaged in treatment) to traditional probation where treatment is left to the client's choice. METHODS: Clients were randomly assigned to either seamless or traditional probation. We used a decision analytic approach which had two advantages: First it separated estimation of probability of adverse events (e.g. hospitalization) from the daily cost of the adverse event, thereby allowing use of estimates of daily costs available within the literature. Second, the reliance on daily probability of various adverse events also had the benefit of reflecting both length of the event and its intermittent re-occurrence. Subjects were 272 clients on probation in Northern Virginia and Maryland in the United States. Clients were randomly assigned to seamless and traditional probation and were followed for an average of 2.75 years (arrest information was only available for 1 year); 77% of clients participated in the follow-up interviews. At baseline, there was no statistically significant difference among the clients. RESULTS: During the follow-up period, clients in the seamless probation had less recidivism but the cost savings from this component (dollar 2.31 per client per follow-up day) was not sufficient to overcome increased costs due to mental hospitalization of seamless clients (dollar 13.50 per client per follow-up day), cost of delivery of seamless probation (dollar 2.58 per client per follow-up day), more frequent use of jail/prison for clients in the seamless group (dollar 2.08 per client per follow-up day) and additional treatment costs (dollar 1.24 per client per follow-up day). The expected cost of seamless probation and its consequences was dollar 38.84 per follow-up day. The expected cost of traditional probation and its consequences was dollar 21.60 per follow-up day. Seamless probation was dollar 6,293 more expensive than traditional probation per client per year. DISCUSSION: Sensitivity analysis suggested that the analysis was not sensitive to small change in any single cost or probability estimate. Sensitivity analysis suggested that increased supervision intensity and use of sanctions had contributed to lower cost-effectiveness. IMPLICATIONS: One possible way of improving seamless probation is to improve the intensity of the substance abuse treatment while reducing the intensity of supervision to its traditional levels. This analysis was limited to 2.75 years follow-up period and does not address cost savings that might occur after this period.

Adult↗

PubMed2004

Activity based costing of probation with and without substance abuse treatment: a case study.

BACKGROUND: Since many offenders have drug problems, investigators have proposed that drug testing and treatment should be an integral part of probation. In 1994, the Office of National Drug Control Policy (ONDCP) funded a demonstration project designed to integrate drug treatment with traditional supervision services. As part of this demonstration a new procedure called 'seamless' probation was set up in which treatment providers were co-located with probation officers and probation officers coordinated offenders' participation in treatment. AIMS OF THE STUDY: This study examines the cost of providing substance abuse treatment coordination through probation agencies. METHODS: We used Activity Based Costing (ABC) to examine the cost of probation with and without treatment coordination in one probation agency. Agency budget was analyzed and allocated to various programs. A questionnaire was developed to assess probation officer's activities. The cost of coordinating treatment for one offender was calculated by dividing the total cost of the program by units of various activities done by the probation officers. RESULTS: Preliminary test of reliability of the instrument showed that it was accurately portraying the probation officers time allocation. Probation officers spent 6.9% of their time in seamless supervision and 83.3% time in traditional supervision (83.83%). The seamless probation officers had more group meetings and more phone contact with their offenders than traditional probation officers. The average cost per offender per day was 12 dollars for seamless probation and 7 dollars for traditional probation. DISCUSSION: This study is limited because it focuses on one agency at one point in time. Results may not be relevant to other agencies or to the same agency as it makes its operation more efficient. This study provides a method of allocating budget cost to per client costs using survey of probation officer's activities -- a tool developed in this study. Comparison of seamless and traditional supervision activities showed major differences in terms of the probation officers' activities and costs. IMPLICATIONS: There are significant costs associated with asking probation officers to coordinate treatment. Studies should be undertaken to examine the relative benefits that can be derived from this increased cost.

Budgets↗

PubMedDate not supplied

Simulated environment is not appropriate.

In the Spring 2005 issue of Quality Management in Health Care, Borckand et al examined the performance of Tukey's chart in a simulated environment. Unfortunately, the simulated environment does not reflect the type of settings where Tukey's chart has been proposed to be most effective. Tukey's charts are ideally used on relatively small data sets. In these data sets, we hypothesize that it is unlikely to have the high autocorrelations simulated in the Borckand et al study. Furthermore, Tukey's chart will perform well in data coming from non-Normal or non-Uniform distributions. The simulation study was based on random numbers generated with Uniform or Normal distributions. We encourage Borckand et al to examine the performance of Tukey's chart in the modified circumstances.

Computer Simulation↗

PubMedDate not supplied

Construct validity and reliability of scores on scales to measure the impairment of health-related quality of life in persons with asthma.

The purpose of this study was to test the reliability, validity, and effectiveness of a health-related quality of life (HRQOL) instrument--the MiniAQLQ--among persons with asthma who were using a web-based intervention for guided self-management (www.MyAsthma.com). The MiniAQLQ was completed online in 1999 by 307 participants referred to www.MyAsthma.com by their primary care physicians. Construct validity of the MiniAQLQ was assessed by principal components analysis; reliability was estimated using Cronbach's alpha coefficient; and differences in means between pretest and posttest were analyzed using paired t test. The analysis produced four empirically meaningful factors with reliability of scores ranging from 0.65 to 0.94. Participants reported significant improvement in HRQOL after participating in this intervention. The four factors (activities, symptoms, emotions, and environment) generated by the principal components analysis empirically supported the four domains used in the development of the MiniAQLQ. Scores for the four factors were internally consistent and assessed the distinct domains. The MiniAQLQ appears to be a psychometrically sound instrument for measuring HRQOL online among asthma patients who are participating in online interventions.

Adult↗