Clinics in Geriatric Medicine 1995: Vol 11 Index

17 Pages·1995·2.8 MB·English

CUMULATIVE INDEX 1995
Volume 11
February ETHNOGERIATRICS, pages 1-157
May THYROID DISEASES, pages 159-330
August MEDICAL DIRECTION IN LONG-TERM CARE, pages 331-552
November NUTRITION, AGING, AND AGE-DEPENDENT DISEASES, pages
553-765
Note: Page numbers of issue and article titles are in boldface type
Academics, and nursing facility, 503-516 caregiver models for, 114-116
Access to care, among African Americans, deliberative, 115
126 informative, 115
Acculturation, and health care, among His- interpretive, 116
panics, 33 paternalistic, 114
Acquired immunodeficiency syndrome, ef- decision-making capacity among, 124
fect of vitamin E on, 568-570 demographic characteristics of, 1-2
Activities of daily living, assistance with, diversity of, 15
criteria for, 697 economics of medical care among, 124—
facilities for, 535 126
Activity level, with caloric restriction, 555 access to care, 126
Acute care, interface with long-term care, deductibles, 125-126
481-501 medications, 125
Adenoma, of thyroid, 271. See also under preventive medicine, 125
Thyroid. ethical considerations with, 113-129
thyroid carcinoma and, 274 evaluation of, 21-22
Administrative consultant, medical director fundamental values of, 116-121
of home care agency as, 395 autonomy, 116-118
Admissions, approval by medical director, beneficence, 118
in hospital-based transitional care confidentiality, 120
unit, 384, 386 justice, 120-121
Adrenal gland dysfunction, in hypothy- nonmaleficence, 118-119
roidism, 300 truthfulness, 119-120
Adrenergic blocking agents, for hyperthy- futility of treatment of, 123
roidism, 187-188 health beliefs of, 19
Advance directives, by African Americans, health care provider as advocate for, 18
123-124 health concerns of, 16-17
by Asians/Pacific Islanders, 142-143 informed consent by, 121
by Native Americans, 105 mental health issues in, 1-13
Aerobic exercise, capacity of elderly to re- diagnostic bias, 3-5
spond to, 728-730 perception of illness by, 19-21
African Americans, 15-23 physician relationship with, 17-18
access to health care, 18 psychiatric disorders in, 5-9
advance directives by, 123-124 psychosocial characteristics of, 2-3
and ethics committees, 126-127 refusal of care by, 121-122
750 = CUMULATIVE INDEX
withdrawal of care from, 122 ethical considerations in, 139-152
Aging, and cancer, 577-589 background and limitations, 139-140
effect on nutrient requirements, 641-651. dilemmas, 140-149
See also Nutrient(s). autonomy and informed consent,
hypothyroidism vs, 163 140-143
immune response in, vitamin E and, 567— health beliefs and preferences, 145-
576. See also Vitamin E. 149
nutrition and exercise with, 725-734. See life support, 143-145
also under Exercise. recommendations concerning, 149-150
slowing of, caloric restriction in, 553-565 expectations of health providers, 148-149
AIDS, effect of vitamin E on, 568-570 explanatory models of illness among,
Alcohol, metabolism of, in Asians/Pacific 146-148
Islanders, 75 health beliefs and practices of, 56-57, 71-
use of, history of, in Hispanics, 45 72
Alzheimer’s dementia, in African Ameri- health risk behavior among, 77
cans, 7 health screening among, 78
in Chinese woman, 62-63 health status of, 53-67
American Medical Directors Association, heterogeneity of, 139-140
definition of medical director by, 346 medical care of, 73-74
national organizations cooperating with, mental health status of, 60-62
358 pharmacotherapy in, 75-76
Amputations, in Native American diabet- prescribing guidelines for, 76
ics, 89-90 presentation of illness in, 72-73
Anabolic hormones, effect on muscle traditional medications for, 74-75
mass/strength, 735-748 Assisted living facilities, computerization
Analgesics, for osteoporosis, 631 in, 537
Anaplastic carcinoma, of thyroid, 261, 281- for long-term care, 535
282 Atherosclerosis, 591-611
Anemia, in hypothyroidism, 242 intervention studies in elderly, 600-604
Anger camera, thyroid scintigraphy with, clinical trials, 600-601
193 community-based, 601-602
Angina pectoris, in hyperthyroidism, 221 meta-analysis of, 604-605
thyroid surgery in, 306 primary, 600
Angiotensin converting enzyme activity, as secondary, 602-604
index of thyroid hormone action, 163 major risk factors for, 593-600
Anthropometrics, nutrition screening for, cholesterol, 593-594
692 diabetes, 598
Antioxidants, and cancer risk reduction, lipoproteins, 596-597
581-585, 587 prevalence of, 599
Antipsychotic drugs, interpretive guide- prevalence of, 591-593
lines for, under Omnibus Budget treatment of, dietary, 606-609
Reconciliation Act of 1987, 431-432 in elderly, 609
Antithyroid antibodies, in hypothyroidism, recommendations for, 605-606
240 Atrial fibrillation, with hyperthyroidism,
Anxiolytic drugs, interpretive guidelines 222-223
for, under Omnibus Budget Recon- Authority, suspicion of, among Native
ciliation Act of 1987, 429, 431 Americans, 101
Appetite changes, in hyperthyroidism, 183 Autoimmune disorders, thyroid disease
Arrhythmias, thyroid surgery in, 306 and, 316-317
Arthritis, and morbidity and mortality in Autonomy, value of, among African Amer-
Hispanics, 31 icans, 116-118
Asians /Pacific Islanders, 69-82 among Asians/Pacific Islanders, 140—
chronic diseases among, 73-74 143
common cultural characteristics of, 55-56 among Native Americans, 100-101
communication in medical setting, 70-71 in end-of-life decisions, 105
culture, immigation, and gender relation- Autopsy, cultural views of, 103
ships among, 69-70
demographics and historical background
of, 53-56 Balance, as foundation of health, in
diet of, 76-77 Asians / Pacific Islanders, 56, 147
CUMULATIVE INDEX 751
Beck depression inventory, 702-703 diet and, 577-589
Bedrest, in osteoporosis, 630-631 effect of aging on, 578
Beneficence, as African American value, epidemiologic studies on, 581-583
118 literature on, 580
as Mexican American value, 132-134 effect of vitamin E on, 568-570
Benzodiazepines, interpretive guidelines clinical studies of, 570-571
for, under Omnibus Budget Recon- epidemiologic studies of, 568
ciliation Act of 1987, 428-429 environmental causes of, 578-580
betasub2/sub-Adrenergic agonists, increased in Native Americans, 90
muscle mass/strength with, 744-745 mortality rates for, by age, 578
Beta-adrenergic blockers, for hyperthyroid- oxygen radicals and, 581
ism, 187-188, 223, 297 Carbohydrate needs, in older adults, 644
Beta-carotene(s), and decreased cancer risk, Carcinoma, of thyroid, 271-275. See also
581-584 under Thyroid.
dietary contributions of, 586 Cardiac patient, thyroid surgery in, peri-
Billing codes, for nursing facility care, 382 operative management of, 305-307
Biophysical care, for total hip replacement, Cardiovascular changes, in hyperthyroid-
490 ism, 183, 221-225
Bipolar disorder, in African Americans, 3 in hypothyroidism, 298
Bisphosphonates, for osteoporosis, 638 Cardiovascular disease, in Hispanics, mor-
Body mass index, calculation of, 703-704 bidity and mortality of, 28
nutrition screening for, 692 risk factors for, 594
Bone, metabolism of, in hyperthyroidism, Cardiovascular disorders, in nutrition as-
213 sessment, 713
Bone mass, in osteoporosis, 626 with thyroid hormone replacement ther-
Bone mineral density, decline in, with thy- apy, 245
roid hormone replacement therapy, Cardioversion, of atrial fibrillation, in hyper-
246 thyroidism, 224
Bone quality, in osteoporosis, 626-627 Catabolic states, growth hormone during,
Bowel changes, in hyperthyroidism, 182 anabolic effects of, 738-740
Braces/corsets, for osteoporosis, 631 Cellulitis, in long-term care facility, 470
Breast cancer, effect of vitamin E on, 569 Central nervous system changes, in hypo-
vitamin A protection from, 583 thyroidism, 300
Bronchitis, in long-term care facility, 470 Cervical cancer, effect of vitamin E on, 569
Bureau of Indian Affairs, health policy of, Chinese, Alzineimer’s dementia in, 62-63
85 demographics and historical background
of, 54
health status of, 58-59
Caffeine intake, in osteoporosis, 633-634 mental health status of, 60-61
Calcitonin, elevated, in medullary thyroid Cholesterol, as atherosclerosis risk factor,
carcinoma, 280 593-594
for osteoporosis, 638 elevated, in Native Americans, 88
Calcium, metabolism of, in hyperthyroid- percentage of Americans with, 595-596
ism, 213 Chronic care, definition of, 481. See also
Calcium nutrition, in osteoporosis, 633 Long-term care.
Caloric restriction, in adulthood, and in- Chronic obstructive pulmonary disease, in
creased mortality, 560 Hispanics, morbidity and mortality
in prolongation of life, 553-565 of, 30
assessment of effects, 556-560 Clostridum difficile diarrhea/colitis, in long-
current issues in, 555-556 term care facility, 470
possible mechanisms of, 561-562 Cognitive impairment, in African Ameri-
protective action of, 562 cans, 6
research protocols for, 557 Co, nitive status, nutrition screening for,
studies in humans and nonhuman pri- 692, 698
mates, 560-561 Colorectal cancer, effect of vitamin E on,
survival rates with varying protocols, 569
559 Comfort care, for total hip replacement, 490
Cancer, aging and, 577-578 Communication, effective, in treating Na-
by racial groups, with geographic migra- tive Americans, 101, 108
tion, 579
752 CUMULATIVE INDEX
in medical setting, with Asians / Pacific recommendations for, 617
Islanders, 70-71 role of dietitian in, 621-622
Community liaison, medical director of education in, 616
home care agency as, 394-395 in elderly, good glycemic control in, ad-
Competence, and end-of-life decisions, vantages and disadvantages of, 615
among Native Americans, 106 rationale for treating, 613-614
Confidentiality, as fundamental African special dietary considerations in, 619
American value, 120 in Hispanics, morbidity and mortality of,
Congestive heart failure, in hyperthyroid- 29-30
ism, 183, 222 in Native Americans, 89-90
thyroid surgery in, 306 multidisciplinary team approach to, 616
Conversation, unstructured, in treating standards of care for, 614-616
Native Americans, 107 thyroid disease and, 314-315
Coronary artery disease, in hypothyroid- Diagnostic bias, in African American men-
ism, 301-302 tal health, 3-5
male risk for, age and, 597 Diagnostic process, expectations concern-
prevalence of, 592 ing, among Asians/ Pacific Islanders,
Corporate medical director, 403-417. See 148
also under Medical director. Dialysis, withdrawal of, for Mexican Amer-
CPT coding, in long-term care, reimburse- ican patient, 133
ment issues in, 519 Diarrhea, infectious, in long-term care facil-
Cultural sensitivity, to Mexican Americans, ity, 470
134-137 Diet, and cancer, 577-589
to Native Americans, 108 epidemiologic studies on, 581-583
literature on, 580
and diabetes, 613-624. See also Diabetes
mellitus.
Death, discussion of, among Asians/ Pacific guidelines for, 694
Islanders, 142 in atherosclerosis prevention and treat-
rituals ot, expectations concerning, ment, 591-611. See also Atherosclero-
among Asians/Pacific Islanders, 149 sis.
Decision-making capacity, among African recommended intake in, 607
Americans, 124 sample menus and nutrient analysis,
Deductibles, and medical care, among /:fri- 608
can Americans, 125-126 of Asians / Pacific Islanders, 76-77
Deliberative caregiver model, for African Dietitian, role in diabetes management,
Americans, 115 621-622
Dementia, in African Americans, epidemi- Digitalis, for hyperthyroidism, 224
ology of, 6-7 Discharge planning, in total hip replace-
thyroid disease and, 317-320 ment, 490
Depression, among African Americans, 3 Drug allergies, history of, in Hispanics, 45
epidemiology of, 7-9 Drug-nutrient interaction screen, 699
screening instruments for, 8 Drug therapy, guidelines for, under Omni-
among Asians/ Pacific Islanders, 74 bus Budget Reconciliation Act of
in Korean woman, 63 1987, 426-427
inventory for, 702-703 Drug use, nutrition screening for, 692, 698
Depression scale, geriatric, 701
DETERMINE checklist, for nutrition
screening, 683-688 East Indians, demographics and historical
Diabetes mellitus, 613-624 background of, 55
dietary treatment of, 616-621 Eating habits, nutrition screening for, 689-
characteristics of, 617 692
exercise in, 620 Economics, of medical care, among African
food choices in, 618 Americans, 124-126
goals of, 617 Education, by medical director of home
insulin treatment with, 621 care agency, 394
micronutrients, vitamins, and minerals Eicosanoids, production of, effect of vita-
in, 619 min E on, 573
oral hypoglycemic agents with, 620- Elderly, African-American, 15-23, 113-129.
621 See also African Americans.
CUMULATIVE INDEX 753
Asian/Pacific Island, 53-67, 69-82, 139- Eyes, physical abnormalities of, in nutrition
152. See also Asians/Pacific Islanders. assessment, 709-710
changing demographics of, and future of
long-term care, 532
Face, physical abnormalities of, in nutrition
healthy, growth hormone effects in, 737-
assessment, 709
738
Failure to thrive, 653-659
Hispanic, 25-38, 39-52. See also Hispan-
definition of, 654-655
ics.
differential diagnosis of, 656-657
hyperthyroidism in, 181-188
evaluation of, 656
hypothyroidism vs aging in, 163
examples of, 654
Mexican-American, 131-137. See also
functional deficits and, 657-658
Mexican Americans.
general model of, 655-656
Native American, 83-95, 97-111. See also
metabolic abnormalities in, 657
Native Americans.
social factors in, 658
Electrolyte abnormalities, in hypothyroid-
trigger events in, 655-656
ism, 299
Falls, in nursing home, frequency of, chart-
Elimination care, in total hip replacement,
ing of, 444
490
Family, health care decisions by, among
Emergency departments, use by Hispanics,
Asians/ Pacific Islanders, 142
42
recognition of, in treating Native Ameri-
Employee health supervision, by medical
cans, 109
director of home care agency, 395
structure of, among Asians/ Pacific Is-
End-of-life decisions, concerning Native
landers, 69-70
Americans, cultural differences in,
among Hispanics, 46
102-103
Family practice training, in nursing home
surrogate, 106-107
setting, 509
Energy metabolism, with aging, 727-728
Fat requirements, in older adults, 643-644
Energy needs, in older adults, 642
Femoral neck fractures, in osteoporosis, 628
Environmental causes, of cancer, 578-580
Fibrosarcoma, of thyroid, 284
Esophageal cancer, vitamin C protection
Filipinos, demographics and historical
from, 584
background of, 55
Estrogen, for osteoporosis, 638
family values of, and nursing home
Ethical issues, among Asians/ Pacific Is-
placement, 145-146
landers, 139-152
health status of, 59
among Mexican Americans, 134-137
mental health status of, 61
consultation in, by medical director of
Fluid requirements, in older adults, 644-
home care agency, 395
645
medical technology and, in nursing facil-
Fluoride, for osteoporosis, 638
ities, 536-538
18F-Fluorodeoxyglucose, thyroi¢ scanning
Euthyroid sick syndrome, 177-178, 254
with, 205
thyroid stimulating hormone level in,
Folk medicine, among Hispanics, 48
293
Follicular adenoma, of thyroid, 271
Executive consultant, medical director of
Follicular carcinoma, of thyroid, 261, 277-
home care agency as, 395
278
Exercise, and aging, 725-734
Food guide pyramid, 695
effect on energy intake, 732
Fractures, in osteoporosis, 626
in diabetes mellitus, 620
Fruit, and cancer risk reduction, 581-582,
trial of, for atherosclerosis intervention,
587
603-604
Functional capacity, with aging, 726-727
Exercise training, capacity of elderly to re-
Functional performance, extensor power
spond to, 728-732
aerobic exercise, 728-730 and, in nursing home residents, 727
strength training, 730-732 Functional status, nutrition screening for,
Extended care, in total hip replacement, 691, 694-697
Futility, in treatment of African Americans,
490-493
123
pathways of, for integrated care delivery,
486
Extensor power, and functional perfor- Gallium, thyroid scanning with, 205
mance, in nursing home residents, Gastroenteritis, in long-term care facility,
727 470
754 CUMULATIVE INDEX
Gastrointestinal cancer, vitamin C protec- Hispanic American, availability of, 49-50
tion from, 584 Health screening, among Asians/Pacific Is-
Gastrointestinal disorders, in hypothyroid- landers, 78
ism, 299-300 Health status, of Hispanics, 25-38
Gastrointestinal system, physical abnormal- Healthy Hand-y Hints, for nutrition, 696
ities of, in nutrition assessment, 712 Heart, and thyroid disease, 219-229
Geriatric depression scale, 701 Heart attack, prevalence of, 592
Ginseng, as traditional medication, of risk factors for, 599
Asians/ Pacific Islanders, 74 Heart disease, death rate from, 593-594
Glands, physical abnormalities of, in nutri- in Native Americans, 88-89
tion assessment, 711 Hemangioendothelioma, thyroid, 284-285
Glaucoma, in hypothyroidism, 242 Hematologic changes, in hypothyroidism,
Goal definition, in treating Native Ameri- 299
cans, 107 Hepatitis, in long-term care facility, 470
Goiter, multinodular, 265-268 Hip fractures, in osteoporosis, 628
complications of, 265-267 Hispanic American practitioners, availabi-
malignant transformation of, 266-267 lity of, 49-50
scanning of, 202 Hispanics, 39-52
thyroid hormone suppression of, 267- access to health care, 42
268 barriers to health care, 42-43
thyroid carcinoma and, 273-274 culture-bound syndromes in, 43-46
toxic, diffuse, 195-197 demographics of, 25-26, 41-42
nodular, 182 family values of, 34
Graves’ disease, radioisotopes in, 195-197 folk medicine among, 48
thyroid carcinoma and, 274-275 health beliefs of, 34
Growth hormone, anabolic effects of, 735- health data on, sources of, 27
740 health status of, 25-38
during catabolic states, 738-740 healthy aging in, 32-35
in healthy elderly, 737 morbidity and mortality in, causes of,
in hypopituitarism, 736-737 27-31
for muscle mass/strength repair, poten- arthritis, 31
tial use of, 740 cardiovascular disease, 28
reduced secretion of, with aging, 735-736 chronic obstructive pulmonary dis-
side effects of, in healthy elderly, 738 ease, 30
Gums, physical abnormalities of, in nutri- diabetes mellitus, 29-30
tion assessment, 710 liver disease, 30-31
malignant neoplasms, 28-29
tuberculosis, 31
Hair, physical abnormalities of, in nutrition psychological factors in, 32-35
assessment, 709 relationship with health care workers, 47
Health beliefs, among African Americans, social dynamics and health care for, 46—
19 47
among Asians/Pacific Islanders, 71-72, terminology relating to, 26-27, 40-41
145-149 use of medical services by, 31-32
among Hispanics, 34 History taking, with Hispanics, 44
Health care, delivery of, alternative sites Hodgkin’s lymphoma, thyroid involvement
for, 404-405 in, 284
cost of, 404 Home care agencies, for long-term care,
evolution of, 403-405 392-396
for Hispanics, 46-47 medical director of, specific roles of,
network of, nursing facility as part of, 394-396
503-504 Home-health care, definition of, 391
policy /regulation consultation in, by types of, 392
medical director of home care Horner’s syndrome, with multinodular
agency, 395 goiter, 266
Heaith Care Financing Administration, role Hospice, as Medicare benefit, 397-398
in PACE prograrns, 400 definition of, 396-397
Health care practitioners, expectations of, medical director of, responsibilities of,
among Asians/ Pacific Islanders, 398-399
148-149 physician involvement in, 397
CUMULATIVE INDEX 755
Hospital, relationship to continuing care re- perioperative management of, 302-303
tirement community, 368 prevalence and etiology of, 239-241
Hospital-based transitional care unit, medi- radioisotopes in, 198
cal director in, 373-389. See also un- risk of surgery in, 301
der Medical director. signs of, 297-298
Hostility, in family of Mexican American subclinical, 231-238
patient, 136-137 clinical significance of, 233-234
Hydrogen peroxide, production of, effect of definition of, 231-233
aging on, 572 diagnosis and screening for, 234-235
Hyperalimentation, enteral, in acute care natural history of, 235-236
setting, 719-720 prevalence of, 233
side effects of, 720-721 treatment of, 236
Hypercholesterolemia, in hypothyroidism, treatment of, 225-226, 244-246
242, 298-299 effects on serum lipids, 317
Hyperglycemia, complications of, 614
Hyperlipidemia, in hypothyroidism, 298-
299
thyroid disease and, 315-316 Illness, explanatory models of, among
Hypertension, in African Americans, 16 Asians/ Pacific Islanders, 146-148
in Native Americans, 88 perception of, by African Americans,
Hyperthyroidism, 181-188, 294-296 21
and dementia, 318-319 Immune response, in aging, vitamin E and,
and nutrition, 320-321 567-576. See aiso Vitamin E.
bone and calcium metabolism in, 213 AIDS and, 568-570
cardiovascular manifestations of, 221- cancer and, 568-570
225, 294-295 epidemiologic studies of, 568
clinical presentation of, 182-184 Incontinence, assessment and treatment of,
constitutional findings in, 294 total quality management in, 437
diagnosis of, 185-186, 223 Indian Health Services, area offices of, 86
gastrointestinal features of, 295 health policy of, 85
iodine 123 therapy of, 197-198 Infection ccntrol, in long-term care, 467-
laboratory diagnosis of, 295-296 480
neuromuscular findings in, 295 components of, antibiotic use and mi-
ocular findings in, 295 crobial resistance, 473-474
risk of surgery in, 296-297 disease reporting, 476
subclinical, 184-185 education, 475
thyroid enlargement in, 295 employee health program, 475-476
thyroid storm in, 296-297 isolation and precaution system, 473
treatment of, 186-188, 223-225 outbreak detection and control, 473
Hypnotic drugs, interpretive guidelines for, procedures and policies, 474-475
under Omnibus Budget Reconcilia- resident health program, 475-476
tion Act of 1987, 431 surveillance, 472
Hypopituitarism, growth hormone for, an- implementation of, 477-478
abolic effects of, 736-737 rationale for, 469-476
Hypothalamic-pituitary-thyroid axis, physi- requirements for, 469-471
ologic changes in, 160-163 unique factors in, 471
Hypothermia, and myxedema coma, 252 Influenza, in long-term care facility, 470
Hypothyroidism, 225-226, 239-249, 297- Informative caregiver model, for African
300 Americans, 115
aging vs., 163 Informed consent, by African Americans,
and dementia, 317-318 121
and myxedema coma, 251 by Asians/Pacific Islanders, ethical di-
and nutrition, 321 lemmas of, 140-143
cardiovascular manifestations of, 225 Injury risk, with mobility, assessment of,
clinical manifestations of, 241-242 441-442, 444
coronary artery disease in, 301-302 Institutional care, for Hispanics, 46-47
diagnosis of, 242-244, 300-301 for Native Americans, 92
drug-induced, 240 Instrumental activities of daily living, de-
hemodynamic changes in, 298-299 pendence for, criteria for, 697
myxedema coma in, 303 Insulin, for diabetes mellitus, 621
756 © CUMULATIVE INDEX
Insulin-like growth factor I, anabolic effects caloric restriction in, 553-565
of, 740-742 assessment of effects, 556-560
during catabolic states, 740-741 current issues in, 555-556
with growth hormone, 741-742 possible mechanisms of, 561-5562
effect on muscle mass/strength, 735-748 studies in humans and nonhuman
Interdisciplinary team, in hospital-based primates, 560-561
transitional care unit, medical direc- Life support, decisions concerning, among
tor supervision of, 387-389 Asians/ Pacific Islanders, 143-145
Internal medicine training, in nursing Lip(s), physical abnormalities of, in nutri-
home setting, 509 tion assessment, 710
Interpreters, use of, in treating Native Lipid(s), predictive power of, modifying
Americans, 109 factors for, 598
Interpretive caregiver model, for African Lipoprotein(s), fractions of, age trends in,
Americans, 116 596
Iodide, in thyroid hormone synthesis, 171 predictive power of, modifying factors
Iodine 123, for hyperthyroidism, 197-198 for, 598
therapy with, radiation safety precau- Liver disease, in Hispanics, morbidity and
tions in, 198 mortality of, 30-31
Iodine 131, for thyroid cancer ablation, 206 Living environment, nutrition screening
therapy with, complications of, 212 for, 691-694
long-term follow-up, 213 Living wills, cultural views of, 103
procedures with, 210-216 Long-term care, assessment visit in, 519—
room location and preparation, 210- 520
211 assisted living facilities for, 535
computerization in, 536-537
CPT coding in, reimbursement issues in,
Japanese, demographics and historical 519
background of, 54 definition of, 391, 483
health status of, 59 follow-up services in, 520-528
mental health status of, 61 for Native Americans, 92
Joint Commission on Accreditation of future of, role of medical director in,
Health Care Organizations, quality 531-545
assessment by, 538 staff challenges in, 541-543
Justice, as African American value, 120-121 infection control in, 467-480. See also In-
as Mexican American value, 132 fection control.
integration with managed care, 536
interdisciplinary team approach to, 542
Korean(s), demographics and historical interface with acute care, 481-501
background of, 55 administrative and informational, 487-
mental health status of, 61-62 489
Korean woman, depression in, 63 continuum of, 482
factors controlling, 483-484
future of, 489. 494
L-Thyroxine, for hypothyroidism, 244, 302, medical director’s role in, 486-487
303 models of, 489
effects of, 245-246
payment system and, 483
for myxedema coma, 255 subcute care, 484-485
Language, as barrier to health care, among
medical director’s role in, 543-544. See
Hispanics, 43
also Medical director.
Leadership, by corporate medical director,
in multi-level facility, 359-372
405-406, 411 in noninstitutional programs, 391-402
Left ventricular ejection fraction, with thy-
minimum data set assessment in, 520
roid disease, 220 objectives of, 533
Leukemia, treatment of, in Mexican Ameri- payment systems for, 539-541
can patient, 132-134 quality assessment of, 538-539
Licensing / certification, in hospital-based
reimbursement issues in, 517-529. See
transitional care unit, medical direc-
also Reimbursement issues.
tor supervision of, 382
total quality management applications
Life, prolongation of, among Asians/Pa-
in, 438-439
cific Islanders, 142
CUMULATIVE IND! X 757
Longevity, effects of caloric restriction on, factors influencing, 344
assessment of, 556-560 teaching and research by, 352-354
Lung cancer, beta-carotene protection from, in continuing care retirement commu-
583 nity, role of, 368-371
effect of vitamin E on, 569 managing use of hospital services,
vitamin C protection from, 584 368-369
Lymphadenopathy, in papillary thyroid medical education, 369-370
carcinoma, 276 patient education, 370
Lymphoma, of thyroid, 262 primary care, 364-363
research, 370-371
supportive services, 371
Malignant neoplasms, in Hispanics, mor- in hospital-based transitional care unit,
bidity and mortality of, 28-29 373-389
Malnutrition, consequences of, 663 role of, 382-385
Management, by corporate medical direc- admissions approval, 384, 386
tor, 405-406 integrating midlevel practitioners,
Medicaid programs, for long-term care
payment, 540 interdisciplinary team supervision,
Medical care, expectations concerning, 387-389
among Asians/Pacific Islanders, licensing and certification, 382
148-149 medical staff education/liaison, 384
preventive, economics of, among African policy development, 383
Americans, 125 quality assurance, 383
Medical director, corporate, 403-417 staff commmunication, 385-386
attributes of, 405-409 standardized procedures implemen-
contrasting paradigms of, 410 tation, 387
leadership /management skills, 405- in long-term care, 331-341
406 certification program for, 337-338
physician vs businessman, 406-408 functions of, 337
dual role of, 408 in multi-level facility, 359-372
general principles involving, 409-412 in noninstitutional programs, 391-402
constituencies, 409-411 publications concerning, 338-339
leadership, 411 role in future of, 531-545
negotiation, 411-412 role of, 543-544
responsibilities of, 412-416 areas of concern in, 333
building relationships, 412 federal regulations on, 335
determining constituency, 412-413 guidelines for, 334
information management, 414 objectives involving, 340
patient advocacy, 416 training for, 335
physician liaison, 413 of home care agency, 393-394
problem-solving, 413 similarity to position in other settings,
quality improvement, 413-414 396
risk management, 414 specific roles of, 394-396
implications of Omnibus Budget Recon- community liaison, 394-395
ciliation Act of 1987 for, 419-432 employee health, 395
in community-based nursing facilities, ethics consultant, 395
administrative and medical staff re- executive /administrative consultant,
lationships of, 348-349 395
certification of, 346 health policy /regulation consultant,
committee responsibilities of, 349-350 395
community activities of, 354-355 quality improvement—utilization re-
demographics of, 346-348 view, 394
future of, 356 research, 395-396
medical care responsibilities of, 350- of hospice, responsibilities of, 398-399
351 physician interaction with, 457-458
policies and procedures for, 351-352 role of, in integration of care, 486-487
resources of value to, 355-356 in policies/ procedures, case example
role of, 343-358 of, 460-461
as attending physician, 345 in subacute care, 544
demands on, 344-345 total quality management and, 433-448
758 = CUMULATIVE INDEX
Medical ethics, committees dealing with, effect of insulin-like growth factor on,
and African Americans, 126-127 735-748
principles of, application to Mexican increased, with betasub2/sub-adrenergic
Americans, 131-137 agonists, 744
Medical order, signing of, by medical di- loss of, with aging, 725
rector, 434-435 Muscle strength, effect of anabolic hor-
Medical records, procedures with, medical mones on, 735-748
director supervision of, 386 effect of insulin-like growth factor on,
Medical staff, in community-based nursing 735-748
facilities, demographics of, 346-348 increased, with betasub2/sub-adrenergic
in hospital-based transitional care unit, agonists, 744-745
education by medical director, 384 Muscular system, physical abnormalities
Medical technology, and ethical issues, in of, in nutrition assessment, 712
nursing facilities, 536-538 Myocardial contractility, with thyroid dis-
Medicare, hospice benefit of, 397-398 ease, 220
Medication use, economics of, among afri- Myocardial infarction, previous, thyroid
can Americans, 125 surgery in, 306
nutrition screening for, 692, 698 Myopathy, in hyperthyroidism, 183
Medullary carcinoma, of thyroid, 261, 279- Myxedema, in hypothyroidism, 298
281 Myxedema coma, 251-258
Mental health issues, in African Americans, diagnosis of, 252-254
1-13 differential diagnosis of, 254-255
Mental status, nutrition screening for, 692, factors precipitating, 252
698 in hypothyroidism, 303
Metaiodobenzylguanidine, thyroid scan- laboratory findings in, 253
ning with, 203 treatment of, 255-256
Metformin, for diabetes mellitus, 620 Myxedema madness, with hypothyroidism,
Methimazole, for hyperthyroidism, 187, 317
296-297
Mexican Americans, and application of
medical ethics principles, 131-137 Nails, physical abnormalities of, in nutri-
cultural sensitivity to, 134-137 tion assessment, 711
ethical issues among, 134-137 Native Americans, 83-95
principle of beneficence among, 132-134 cancer in, 90
respect for autonomy among, 131-133 clinical decisions concerning, cultural
Micronutrient supplements, and decreased differences in, 102-103
cancer risk, 585-587 common themes among, 100-102
Mid-arm circumference, measurement of, diabetes mellitus in, 89-90
704 diversity of, 99-100
Mineral requirements, in older adults, 648 end-of-life decisions of, clinical practice
Mini-Mental State Examination, 700 in, 104-107
Minimum data set, clinical patient assess- ethical and clinical issues with, 97-111
ment by, 434 end-of-life decisions, 97-98, 104-107
in long-term care, 520 review of literature, 98-99
for integrated care delivery, 486 guidelines for physicians treating, 107—
Mobility care, in total hip replacement, 490 110
Mobility intervention, algorithm for, 441 commitment to commmunication, 108
Morbidity, increased, role of nutrition in, cultural situation, 108
661-674. See also Nutrition. emergence of spokesperson, 110
Mortality, increased, role of nutrition in, goal definition, 107
661-674. See also Nutrition. recognition of family, 109
Multi-infarct dementia, in African Ameri- spiritual well-being, 109-110
cans, 7 unstructured conversation, 107-108
Multi-level long-term care facility, medical use of interpreters, 109
director in, 359-372. See also Medical health policy concerning, history of,
director. 84-87
Muscle changes, in hyperthyroidism, 295 health status of, 87-88
in hypothyroidism, 241 heart disease in, 88-89
Muscle mass, effect of anabolic hormones long-term care for, 92
on, 735-748 nutrition in, 91-92