[COMPARATIVE ANALYSIS OF EXPERT TESTIMONY ACCORDING TO THE FEDERAL ASSISTANCE LAW AND THE FEDERAL COMPENSATION LAW].
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Defense Mechanisms↗
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[The results of work and experience of the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences, in the pilot areas in controlling, detecting, and treating tuberculosis (a cohort analysis)].
In the Russian Federation, the WHO program was launched in 1994 and it covered the whole country by 2005. Detection and therapeutic efficiency are suboptimal. The proportion of pulmonary tuberculosis averages 34.5% (21.0-61.0%). In terms of cessation of bacterial isolation, therapeutic efficiency averages 61.4% with a scatter of 37.4-75.0%. Social support has a considerable impact on the efficiency of treatment.
Academic Medical Centers↗
Development, prerequisites and specific scope of general thoracic surgery: analysis of requirements and capacity for the Federal Republic of Germany (West). The German Society for Thoracic and Cardiovascular Surgery.
In the 1970s and 1980s the measures for providing the inhabitants of the FRG with regionally distributed facilities in thoracic and cardiovascular surgery took almost only heart surgery into account. In the field of thoracic surgery, by contrast, several centers were closed or used for other purposes. This development was due to the decline in tuberculosis, but also partly to the lack of exact statistics concerning thoracic surgery. The result has been a considerable deficit in the provision of specialized care for the population and stagnation in research. A nationwide questionnaire in 1989 showed that in 78.4% of the surgery departments asked general thoracic surgery was undertaken only occasionally (less than 100 interventions a year); 42.8% of the operations were undertaken by non-specialized surgeons. Malignant diseases dominated the case-load. Because of the lack of sufficient thoracic surgery departments with appropriate specialized knowledge, it must be assumed that many patients with cancer of the thoracic organs are receiving either no, inefficient, or too late a treatment of their disease. Reorganisation of general thoracic surgery is necessary in order to provide the population with adequate facilities in this field. The existing thoracic surgery centers should be enlarged and attached to the universities in order to ensure research and teaching. Specialized treatment of thoracic surgical diseases can be achieved by reorganizing general surgery departments in the regional hospitals which already undertake thoracic interventions and by establishing additional thoracic surgery departments under qualified leadership.
Germany, West↗
[Protozoological analysis of 10 swimming pools in the Federal District and the state of Morelos, Mexico].
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Animals↗
[Epidemiologic pattern of Salmonella enteritidis and Salmonella typhimurium in man--analysis of Salmonella cases in the Brandenburg federal territory].
It is the aim of this study (a study that is part of several investigations suggested and coordinated by the WHO) to highlight the characteristics of transmission of Salmonella in humans. To achieve this, the data collected on the basis of the Federal German Law governing Epidemic Diseases as well as additionally available data (sex, serovar, differentiation between diseased and symptomatic, allocation to the respective place of residence) have been evaluated. In this manner it became possible to determine different patterns of incidence of the presently most frequently occurring salmonella serovars S. enteritidis and S. typhimurium in respect of distribution according to age and sex, as well as the dynamics of distribution and incidence in terms of time. The incidence is particularly remarkable among children, where S. enteritidis is not so frequent as S. typhimurium. There is a distinct trend towards the male sex among children in respect of the infestation. The fact that women are particularly often asymptomatic carriers points to the special nature of the sources and paths of infection. In respect of seasonal dynamics S. typhimurium does not have a specific summer peak, contrary to S. enteritidis, and this too indicates that the mechanisms of transmission or multiplication differ from one another. The study presented here is supplemented by the evaluation of further parameters to support and promote on-target epidemiological investigation into the various problems raised by this and other studies.
Adolescent↗
[Dirofilariasis of the vision organ: registry and analysis of 50 cases in the Russian Federation and in countries of the United Independent States].
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Data Interpretation, Statistical↗
Federally funding human embryonic stem cell research: an administrative analysis.
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Advisory Committees↗
[Permanent survey in the cancerology. Evaluation of the first three years of application of an automated system for recording and analysis of cancer data. Information Unit of the National Federation of French Cancer Control Centers].
A general oncological file system has been perfected and used since 1975 for the recording and analysis of data from twenty French centres. By virtue of the use of common basic language, the structures for the collection of information which have been developed (basic card containing clinical and therapeutic data as well as information concerning the course of the disease) represent a normalised medical record which has proved to be a useful tool in establishing regular statistical reviews (more than 265,000 records have been analysed in 3 years). This automatized system for the collection and exploitation of data offers a method which is suitable for studies aimed at improving knowledge of many aspects of malignant disease and the conditions of treatment. It makes possible the rapid collection of large numbers (more than 65,000 carcinomas in 2 years, including almost 40,000 not yet treated). Thorough analysis aids in revealing valuable facts, carrying out epidemiological studies and in perfecting therapeutic orientations.
Computers↗
Predictors of use of complementary and alternative therapies among patients with cancer.
PURPOSE/OBJECTIVES: To determine predictors of use of complementary and alternative medicine (CAM) therapies among patients with cancer. DESIGN: Secondary analysis of two federally funded panel studies. SETTING: Urban and rural communities in the midwestern United States. SAMPLE: Patients with lung, breast, colon, or prostate cancer (N = 968) were interviewed at two points in time. 97% received conventional cancer treatment, and 30% used CAM. The sample was divided evenly between men and women, who ranged in age from 28-98; the majority was older than 60. METHODS: Data from a patient self-administered questionnaire were used to determine CAM users. Responses indicated use of herbs and vitamins, spiritual healing, relaxation, massage, acupuncture, energy healing, hypnosis, therapeutic spas, lifestyle diets, audio or videotapes, medication wraps, and osteopathic, homeopathic, and chiropractic treatment. MAIN RESEARCH VARIABLES: Dependent variable for analysis was use or nonuse of any of the identified CAM therapies at time of interviews. Independent variables fell into the following categories: (a) predisposing (e.g., gender, age, race, education, marital status), (b) enabling (e.g., income, health insurance status, caregiver presence, geographic location), and (c) need (e.g., cancer stage, site, symptoms, treatment, perceived health need). FINDINGS: Significant predictors of CAM use were gender, marital status, cancer stage, cancer treatment, and number of severe symptoms experienced. CONCLUSIONS: Patients with cancer are using CAM while undergoing conventional cancer treatment. IMPLICATIONS FOR NURSING: Nurses need to assess for CAM use, advocate for protocols and guidelines for routine assessment, increase knowledge of CAM, and examine coordination of services between conventional medicine and CAM to maximize positive patient outcomes.
Adult↗
Carcinoma of the cervix: predictive value of clinical and magnetic resonance (MR) imaging assessment of prognostic factors.
PURPOSE: This retrospective study assesses the predictive value of magnetic resonance imaging (MRI) to identify high risk cervical cancer patients. METHODS AND MATERIALS: The MRI evaluation of morphologic risk factors in patients with invasive cervical carcinoma treated with definitive radiation therapy were correlated with clinical factors and with complete tumor regression (CTR) at 6 months, tumor local control (TLC), and patient outcome at 12 months after irradiation. Sixty-six patients, median age 44.5 years, with bulky Stage I or greater disease were included in the study. RESULTS: In univariate analysis, clinical International Federation of Gynecology and Obstetrics (FIGO) stage had significant correlation with patient outcome, but it correlated poorly with complete tumor regression and tumor local control. In contrast, MRI stage showed significant correlation with complete tumor regression, tumor local control, and disease-free survival at 12 months. When each stage was analyzed separately, the greatest difference was demonstrated between clinical and MRI assignment of stage Ib disease. MRI Stage Ib disease significantly correlated with all three categories analyzed, while clinical Stage Ib did not. Superiority of MRI assessment of low stage disease was also evident in the detection of lymph node metastasis. Significant risk for nodal metastasis was related to tumor size greater than 4 cm, invasion of the parametria and urinary bladder, and stage of the disease. CONCLUSION: The multivariate analysis demonstrated that the most related variables in order of significance were the presence of juxta-regional and paraaortic lymph nodes, patient age, tumor size, and MRI tumor stage. This study demonstrates the value of MR imaging as an adjunct to clinical assessment of bulky invasive cervical cancer, rendering more complete assessment of morphologic risk factors important in patient prognosis.
Adult↗
[Comparison of the legal basis for health prevention and promotion in the school laws of the federal states in Germany].
BACKGROUND: Health prevention and promotion in schools are key public health tasks in most countries. This study focuses on the importance given to prevention and promotion of health in law texts through comparatively analysing school laws for the sixteen federal states in Germany. MATERIAL AND METHODS: The basis for the analysis are the sixteen federal school laws in Germany. A conceptual framework to analyse the law texts has been developed grouped according to the following categories: aims of literacy and education; development of organization; individual and social health; and security and accident prevention. Examples for second level categories include nutrition, motility, alcohol, violence, and road-traffic accident prevention. Based on a point-system of valuation, a ranking for the federal states was derived in terms of an assessment of the importance of health prevention and promotion in federal states' school laws. RESULTS: Berlin, Brandenburg and Mecklenburg-Vorpommern -- three "new" states (i. e. formerly East-German) are leading the ranking. Bavaria and Baden-Württemberg, two states that had been ruled by conservative governments for a long time, had special difficulties to take over new values in their legislation and occupied rank 14 in our ranking. The last place was taken by a state under social-democratic rule -- Nordrhein-Westfalen. However, this law dated from 1952 and a new law has just been passed in August 2005. CONCLUSION AND DISCUSSION: The comparison of the school laws of the federal states in Germany demonstrates that there has been a substantial amount of change in recent years. In some school laws, the impulses of the Ottawa Charta regarding health prevention can be clearly recognised. In others prevention and promotion of health are only subordinated subjects. As in many other areas of social importance, reorientation is taking place. In particular, federal states who have placed little emphasis on school health will have to renew their corresponding legislation.
Germany↗
Multivariable analysis of DNA ploidy, p53, and HER-2/neu as prognostic factors in endometrial cancer.
BACKGROUND: Several molecular-genetic alterations in endometrial cancers, including aneuploidy and aberrant expression of p53 and HER-2/neu, have been associated with poor prognosis. To determine the importance of molecular-genetic factors relative to more traditional surgical-pathologic prognostic factors, a multivariable analysis was performed. METHODS: Immunohistochemical staining for p53, HER-2/neu, estrogen receptor, progesterone receptor, and epidermal growth factor receptor was performed on frozen sections from 100 primary endometrial cancers. DNA ploidy was determined using computerized image analysis of Feulgen-stained touch preparations. In addition, information regarding surgical-pathologic features of the cancers was obtained. Univariable analysis was performed followed by multivariable analysis using Cox's proportional hazards model to identify variables predictive of poor prognosis. RESULTS: With univariable analysis, race, histologic type, stage, grade, myometrial invasion, estrogen receptor, progesterone receptor, ploidy, p53 and HER-2/neu were predictive of the presence of persistent or recurrent disease. In the multivariable analysis, only International Federation of Gynecology and Obstetrics stage (P = 0.005), grade (P = 0.005), myometrial invasion (P = 0.024), and ploidy (P = 0.028) were significant. CONCLUSIONS: Among molecular-genetic prognostic factors, DNA ploidy was the most strongly predictive of persistent or recurrent disease.
Aged↗
[Health and disease in single homeless men: a secondary analysis of findings in a deaconess facility in the Federal German Republic].
Only few empirical investigations on living conditions and health status of single homeless men have been conducted in Germany. The secondary analysis of a sample of 342 homeless men in a welfare hotel was conducted to describe the health status of this group and to gather informations for a possibly higher illness-risk in this group. For this purpose the medical documents and other socio-demographic data were evaluated at one point (one day in February 1985) along the ICD. A relatively high multi-morbidity for the homeless men, especially for the elder ones, could be stated. The results emphasize in etiological perspective the need to take a deeper insight into factors of workload before getting homeless and to strengthen socioepidemiological, socio-therapeutical and political efforts.
Adult↗
Measurements of sulfur in oil using a pressurised wet digestion technique in open vessels and isotope dilution mass spectrometry.
Graz University of Technology has developed a new technique for digesting samples using the well-established high-pressure asher (HPA) from Anton Paar GmbH (Graz, Austria). The digestion is performed in semi-open vessels inside a pressurised autoclave. The new HPA equipment consists of a liner for the autoclave, special sample racks and 30-mL digestion vessels made of quartz, covered with PTFE stoppers. The Laboratory for Isotope Dilution and Nuclear Analysis of the Federal Institute for Materials Research and Testing (BAM, Berlin) tested this new equipment in order to assess its usability for the decomposition of larger sample amounts of gas oils for the measurement of sulfur. Several experiments were carried out using the new sample decomposition technique. In order to test the recovery of the new digestion method, a gas oil material with known sulfur content was chosen, quantified by the validated conventional closed vessel HPA digestion in combination with thermal ionisation mass spectrometry. Isotope dilution mass spectrometry has been applied as analytical method in this investigation. The gas oil was spiked with an isotopic spike material, which is enriched in (34)S, and was then wet digested in the HPA. The oxidized sulfur of the dried samples was reduced to H(2)S and precipitated as As(2)S(3). The sulfur was measured as arsenic monosulfide (AsS(+)). The mass content of sulfur in the gas oil tested is 453.5 mg kg(-1). Recovery tests for increasing masses of gas oils indicate that the recovery using the new measurement technique decreases with increasing mass of gas oil. Results were obtained for approximately 0.3 g sample weight and had less overlap with the result of the old HPA method within the stated uncertainties. At approximately 0.5 g sample weight the yield decreases to about 97% and at approximately 1.0 g sample weight to about 87%. In comparison with the conventional closed vessel HPA digestion, the new technique shows no clear advantages for the certification of the sulfur content in gas oil other than a more convenient handling. The total uncertainty of the sulfur mass fractions (k=2) is about 1.5%. Repeated determination of the oil samples show a relative standard deviation of about 0.8% and indicate that the analytical procedure is robust and reproducible. The demonstrated reproducibility allows the establishment of correction factors for the yield, which in turn enables higher sample masses for routine work. The blank level (0.26 x 10(-6) g) was within the range of the conventional closed HPA digestion procedure.(0.28 x 10(-6) g). Cross contamination could not be detected. In terms of trace metal analysis a good applicability and more advantages over the conventional closed vessel HPA digestion can be assumed.
Journal Article↗
Predicting WRAT scores from the WISC-R for a selected sample of LD children and youth.
Investigated the concurrent validity of the WISC-R 11 subtests and three IQs as related to the WRAT standard scores. Correlations were computed for a sample of 28 children (20 boys, 8 girls), aged 7-9 to 16-5 (means of 11-8), who were diagnosed learning disabled by LEA placement terms according to state and federal guidelines. Regression analysis used all three Wide Range Achievement subtests as criteria, and the 11 subtests and three IQ scale scores of the WISC-R as predictors. The results did not support the concurrent validity of the WISC-R for this sample of disabled children and youth.
Achievement↗
Investigations on rat eyes with diabetic cataract and naphthalene cataract by Zeiss-Scheimpflug measuring system SLC.
Experimental cataract development can be objectively monitored in rats by Scheimpflug slit-image photography and microdensitometric image analysis. Zeiss (Oberkochen, Federal Republic of Germany) has developed a new computerized slit-lamp measuring system that works according to the Scheimpflug principle; we have very successfully applied it to rats with streptozotocin-induced cataracta diabetica vera and with naphthalene-induced opacities. With these cataract models we tested the gyrase inhibitor compound, Ciprofloxacin (Bayer 09867), after 6 weeks' daily peroral application (20 mg/kg body weight) for differences in cataract progression indicating a possible cocataractogenic effect of the compound. When we compared the two different Scheimpflug methods, we found that the Zeiss-Scheimpflug measuring system SLC has some handling advantages with respect to animal cataract studies. If the equipment is to be fully used, complements to the program of the integrated computer part are necessary. The image-analytical results from the animals treated with Ciprofloxacin did not show any indication of cocataractogenic potential with respect to cataracta diabetica vera or naphthalene cataract.
Animals↗
Health education: structural vs. behavioral perspectives.
A study of alternative definitions and interpretations of health education in public policy resulted in the identification of a typology of differing perspectives. The two perspectives, behavioral and structural, are described in this paper, along with the three levels of health education programs. The study found: (1) an over-emphasis of public health education policies on individual behavioral changes and (2) a lack of focus in health education programs at the federal level. An analysis was done of the National Consumer Health Information and Health Promotion Act of 1976 to demonstrate these findings. The paper concludes that a balance between the two perspectives is needed, and it offers policy direction to support this conclusion.
Health Education↗
Stringency of workplace air contaminant exposure limits: a case study of OSHA risk management.
Political context may play a large role in influencing the efficiency of environmental and health regulations. This case study uses data from a 1989 update of the Occupational Safety and Health Administration (OSHA) Permissible Exposure Limits (PELs) program to determine the relative effects of legislative mandates, costly acquisition of information by the agency, and pressure applied by special interest groups upon exposure standards. The empirical analysis suggests that federal agencies successfully thwart legislative attempts to limit agency discretion, and that agencies exercise bounded rationality by placing greater emphasis on more easily obtained information. The 1989 PELs were less significantly related to more costly information, contained "safety factors" for chemicals presenting relatively more ambiguous risks, and the proposed standard stringencies showed evidence of being influenced by vying industry and labor interests.
Air Pollution↗