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Results for “Secondary Data Analysis”

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At least 361 records · Page 20Linked to original sources

PubMed2005

Multi-cultural surveillance for ectopic pregnancy: California 1991-2000.

BACKGROUND: National surveillance for ectopic pregnancy (EP), the primary cause of maternal death in the first trimester, began in 1970. EP rates peeked during the late 1980s and have been highest for African Americans. However, limited reports on EP rates exist for other racial/ethnic groups. OBJECTIVES: To report state-level, multicultural trends in EP rates from 1991 to 2000. METHODS: Secondary data analysis of the California hospital discharge database collected by the Office of Statewide Health Planning and Development by using codes 633.0-633.9, from the International Classification of Diseases, Ninth Revision. EP rates are reported per 1000 pregnancies. RESULTS: From 1991 to 2000, 62,839 EP were reported in California. Mean EP rate was 11.2/1000, decreased from 15/1000 to 9.3/1000, and varied significantly by race/ethnicity and age. EP rates were highest among African Americans (25/1000) and lowest among Hispanics (7.7/1000); African Americans had higher odds of having EP relative to non-Hispanic Whites (odds ratio [OR] 2.14, 95% confidence interval [CI] 2.09-2.19). Women 35-44 years of age had the highest EP rates (17.6/1000) and higher odds of having EP compared to other age groups (OR 2.45, 95% CI 2.39-2.50). The highest rate of EP was found among African Americans 35-44 years of age (43.1/1000). CONCLUSIONS: The study showed declining EP rates in California for all groups but highlights disparities in EP rates and the attenuated rate of decline for African Americans, which places them at highest risk of death in the first trimester. This study demonstrates the usefulness of analyzing state-level data that may differ from aggregated national data when studying culturally diverse populations.

Adolescent↗

PubMed2005

[Evaluation of a programme for the prenatal screening for Down's syndrome by ultrasonographic nuchal translucency measurement and serum determinations in the first trimester of pregnancy].

OBJECTIVE: To determine the diagnostic value of the combination screening test for Down's syndrome in women in the first trimester of pregnancy. DESIGN: Secondary data analysis. METHOD: The data from 2026 consecutive combination tests that were carried out in the period 1 May 2001-31 October 2003 in the VU Medical Centre in Amsterdam, The Netherlands, were analysed. The combination test comprised ultrasonographic neck fold measurement together with determination of the serum levels of free human beta-chorionic gonadotrophin and pregnancy-associated plasma protein A. The chance of Down's syndrome in the foetus was calculated using the median values of the Fetal Medicine Foundation (FMF) and medians based on the population in the VU Medical Centre. A chance > or = 1:200 was considered elevated. Follow-up data were collected from the medical records and from patient reports. RESULTS: The data from 25 patients were excluded because of incompleteness of the investigation or the presence of diabetes mellitus in the pregnant subject. Follow-up data were obtained from 1759 of the 2001 remaining women (88%). Of the 1759 women, 49% were < or = 35 years old and 51% were > or = 36 years of age. Down's syndrome was diagnosed in 21 pregnancies, 16 of which were in the advanced maternal age group of patients. The detection percentage of Down's syndrome by nuchal translucency measurement was 67 with 3 false-positives when calculated on the basis of the FMF-medians and 76 with 6 false-positives when calculated on the basis of the VU Medical Centre medians. With the combination test, the detection percentage of Down's syndrome was 86 with 11 false-positives when calculated on the basis of the FMF-medians and 90 with 5 false-positives when calculated on the basis of the VU Medical Centre medians. CONCLUSION: The diagnostic value of the first-trimester combination test was greater than that of only nuchal translucency measurement. Moreover, the diagnostic value was greater if the chances were calculated on the basis of the median values of the VU Medial Centre population than when other median values were used.

Adult↗

PubMedDate not supplied

Understanding osteoporosis prevalence in Hispanic women.

CONTEXT: Older Hispanic women at risk for osteoporosis have not been studied using an ecological approach to determine the influential factors linked to this disease. OBJECTIVE: To discover if certain ecological factors influence the prevalence of osteoporosis among older Hispanic women. METHODS: A secondary data analysis was conducted using the National Health and Nutrition Examination Survey data set. The analysis focused on the responses from approximately 413 Hispanic women 60 years and older, a sample that represents 2.2 million U.S. residents. Ecological influence variables, including emotional support, financial support, smoking, housing, milk consumption and self-reported measures of osteoporosis, were chosen to determine if language (read or spoken) indicated a difference among these women. RESULTS: Descriptive results and a binary logistic regression model demonstrated the relationship between the independent variables and the self-reported measures of osteoporosis. The first model predicted an increased prevalence of an osteoporosis diagnosis in older Hispanic women who preferred Spanish, had decreased emotional support, had increased financial support, owned their homes and had been milk drinkers. The second model predicted an increased prevalence of self-reported fractures among older Hispanic women who preferred Spanish, had decreased emotional support, had increased financial support and had not smoked. CONCLUSION: Ecological factors can be considered for older Hispanic women in making decisions about screening for disease as well as preventive health education.

Employment↗

PubMed2006

Comparison of anxiety between smokers and nonsmokers with acute myocardial infarction.

BACKGROUND: Increased anxiety correlates with increased complications after acute myocardial infarction. Anxiety levels and use of anxiolytic agents have not been compared between smokers and nonsmokers hospitalized because of acute myocardial infarction. OBJECTIVES: To compare anxiety level, sociodemographic factors, and clinical variables between smokers and nonsmokers hospitalized with acute myocardial infarction and to examine predictors of use of beta-blockers and anxiolytic agents among smokers and nonsmokers. METHODS: Secondary data analysis of a prospective multisite study on anxiety in 181 smokers and 351 nonsmokers with acute myocardial infarction. Anxiety was measured by using the State Trait Anxiety Inventory and the anxiety subscale of the Basic Symptom Inventory within 72 hours of admission. RESULTS: Smokers reported higher anxiety levels than nonsmokers reported on both anxiety scales. Female smokers reported the highest anxiety and peak pain levels of all, yet women were the least likely to receive anxiolytic agents. Smoking status was not a predictor for anxiety level when sex, peak pain, use of beta-blockers in the hospital, and age were controlled for. However, smokers were twice as likely as nonsmokers to receive an anxiolytic agent and 60% more likely to receive a beta-blocker in the emergency department, and smokers were 80% more likely than nonsmokers to receive an anxiolytic agent during hospitalization when these variables were controlled. CONCLUSIONS: Older female smokers are at risk for complications because they are older than their male counterparts and less likely to receive beta-blockers and antianxiety medications in the emergency department.

Adrenergic beta-Antagonists↗

PubMed2006

Revision of the Belgian Nursing Minimum Dataset: From data to information.

The Ministry of Public Health commissioned a research project to the Catholic University of Leuven and the University Hospital of Liège to revise the Belgian Nursing Minimum Dataset (B-NMDS). The study started in 2000 and will end with the implementation of the revised B-NMDS in January 2007. The study entailed four major phases. The first phase involved the development of a conceptual framework based on a literature review and secondary data analysis. The second phase focused on language development and development of a data collection tool. The third phase focused on data collection and validation of the new tool. In the fourth phase the validity and reliability of the dataset was tested. The new dataset is without avail if it is not leading to new information. Four applications of the dataset has been defined from the beginning: evaluation of the appropriateness of stay (AEP) in the hospital, nurse staffing, hospital financing and quality management. The aim of this paper is to describe how the B-NMDS can contribute to each of these applications.

Belgium↗

PubMed1995

Self-care competence among persons with spinal cord injury.

The authors of this article report the results of a secondary data analysis which examined the self-care competence of persons with spinal cord injury (SCI) and the retention of cognitive and functional skills following discharge from acute rehabilitation as well as additional learning of self-care following discharge. The sample consisted of 48 persons with SCI from two Veterans Affairs Medical Centers and a state university affiliated rehabilitation program. The data collection tool was the Self-Care Assessment Tool (SCAT) which measures cognitive and functional skills in eight self-care areas: bathing/grooming, nutritional management, taking medications, mobility/transfer/safety, skin management, bladder management, bowel management, and dressing. The overall self-care competence of the participants was high (mean = 78.25) as was their competence in the eight self-care areas. In general, participants retained both the cognitive information and functional skills learned in the acute rehabilitation setting and also continued to learn after discharge in both cognitive information and functional skills.

Activities of Daily Living↗

PubMed1995

The correlates of health perceptions in rheumatoid arthritis.

OBJECTIVE: Although measures of health perceptions have been routinely incorporated into assessments of individuals with rheumatoid arthritis (RA), the relationships of other characteristics of these individuals to their health perceptions is not fully understood. We describe the cross sectional associations of sociodemographic, disease, and functional status characteristics with perceived health in individuals with RA. METHODS: This description was generated through a 2-phase secondary data analysis using 2 statistical approaches: recursive partitioning of the sample and standard multivariate logistic regression techniques. RESULTS: Both methodological approaches identified education, race, depression, and physical activity as important correlates of self-assessed health in RA. Each approach, in its own way, also identified an interactive effect between physical activity and education and between depression and race in these models. CONCLUSION: An individual's sociodemographic, disease, and functional status characteristics form a complex model of the correlates of health perceptions of individuals with RA.

Adolescent↗

PubMedDate not supplied

How will changes in health insurance tax policy and employer health plan contributions affect access to health care and health care costs?

OBJECTIVE: To understand how changes in federal taxation of and employer contributions to health insurance benefits affect the decisions of firms to offer insurance, the willingness of households to purchase different health plans, and the resultant health expenditures. DESIGN: Economic policy simulation. SETTING: Secondary data analysis. PARTICIPANTS: A total of 18,343 sampled families (representing 77 million total families throughout the United States) with a working household head from the 1988 Current Population Survey who were not covered by either Medicare, Medicaid, or CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) insurance. INTERVENTIONS: One intervention limits the amounts of tax-free employer contributions to health insurance premiums to 80% of our estimate of the base plan in the market and assumes that employer contributions will also be limited to this maximum. A second intervention eliminates the favorable tax treatment of employer-paid premiums altogether and assumes that employees will pay the full price of insurance. MAIN OUTCOME MEASURES: Change in the number of working families offered employment-based insurance, change in insurance plan choice, and change in medical spending. RESULTS: Capping the favorable tax treatment and employer contributions decreases the number of families offered employment-based insurance by approximately 91,000, increases the number of families selecting the least generous insurance plan from 20% under the current situation to 33%, and reduces overall health spending by less than 2%. By eliminating the tax exemption altogether, the number of families offered employment-based insurance decreases by approximately half a million families, the number of families selecting the least generous plan goes from 20% to 40%, and overall spending falls by about $16 billion. CONCLUSIONS: Eliminating the tax subsidy and limiting employer-paid contributions to the low-cost plan substantially increases the number of low-income uninsured under a voluntary insurance system, decreases overall spending only modestly, but would raise tax revenues by $36 billion. These tax revenues could be used to assist low-income families to obtain insurance coverage.

Competitive Medical Plans↗

PubMed1994

Management of upper respiratory tract infections in Dutch family practice.

BACKGROUND: Family physicians vary in their management of upper respiratory tract infections (URTIs), especially regarding prescription of antimicrobial drugs and patient referral. This study was designed to provide insight into this variation in the management of URTI. METHODS: A secondary data analysis of a nationwide study of morbidity and interventions regarding the management of cases of acute otitis media, otitis media with effusion, acute upper respiratory tract infections (acute URTIs), sinusitis, and acute tonsillitis was performed. One hundred sixty-one Dutch family physicians and 335,000 patients were included in the study. RESULTS: About 10% of all first contacts in this study were house calls, which are most often made to patients in the youngest and oldest age categories. In one third of all first contacts, an antimicrobial drug was prescribed, most frequently for sinusitis (72%) and acute tonsillitis (74%), much less frequently for otitis media and acute URTI. Doxycycline and amoxicillin were prescribed most frequently; two thirds of all antimicrobial prescriptions for the first contact were for one of these two drugs. In 1% of all first contacts and 6% of repeat contacts, patients with URTI were referred to a specialist. CONCLUSIONS: Compared with physicians in other countries, Dutch family physicians show a relatively restrictive and selective prescription behavior in dealing with URTI. This may be why the Netherlands has one of the lowest reported levels of antibiotic resistance. House calls are still important in Dutch family practice.

Adult↗

PubMed1993

Adolescents' risky behavior and mass media use.

OBJECTIVE: To understand better the relationship between adolescents' use of the mass media (including television, radio, and magazines) and their risky or unhealthy behaviors. DESIGN: Secondary data analysis of a 1987 in-home survey of 2760 randomly selected 14- to 16-year-old adolescents in 10 urban areas in the southeastern United States. MEASUREMENT: The extent of participation in eight potentially risky behaviors (sexual intercourse, drinking, smoking cigarettes, smoking marijuana, cheating, stealing, cutting class, and driving a car without permission) and the use of a variety of mass media. RESULTS: Adolescents who had engaged in more risky behaviors listened to radio and watched music videos and movies on television more frequently than those who had engaged in fewer risky behaviors, regardless of race, gender, or parents' education. White male adolescents who reported engaging in five or more risky behaviors were most likely to name a heavy metal music group as their favorite. Adolescents reported reading a wide diversity of magazines, and most reported reading at least one of a few selected magazines. Sports and music magazines were most likely to be read by adolescents who had engaged in many risky behaviors. CONCLUSIONS: Mass media health promotion efforts could more specifically target adolescents who are engaging in multiple risky behaviors.

Adolescent↗

PubMedDate not supplied

Introduction of solid foods to African American and Anglo American low-birth-weight and full-term infants.

A secondary data analysis of 7,174 infants explores the use of cereal, fruits and vegetables, and meats with African-American and Anglo-American very-low-birth-weight (VLBW), low-birth-weight (LBW) and term infants over the first five months after discharge. The first solid foods offered were cereal for African-American infants and fruits and vegetables for Anglo infants. There are statistically significant differences in the number of feedings offered by the two ethnic groups. During the last two-to-three months, African-American term and LBW infants received all solid foods more frequently than Anglo infants. Neither ethnic group followed current feeding practice recommendations on when to introduce solid food.

Black or African American↗

PubMedDate not supplied

An assessment of the nine-month lactational amenorrhea method (MAMA-9) in Rwanda.

This report presents a secondary data analysis based on prospectively collected records gathered during a field assessment that was carried out in Rwanda in August 1993. The assessment used service statistics and follow-up interviews to evaluate the efficacy of a modified lactational amenorrhea method (LAM) as a nine-month introductory postpartum natural family planning method. The program, carried out by Action Familiale Rwandaise (AFR), reflects high efficacy of the method in a compliant sample that sought this method followed by another form of family planning. These results are promising and provide guidance for the extended use of LAM past six months. Programmatic findings suggest that studies be conducted of the contribution of extended LAM to improved weaning practices, the high efficacy of continued reliance on substantial lactation and amenorrhea beyond nine months, and male involvement in LAM and breastfeeding.

Algorithms↗

PubMed1998

Differences in fatigue by treatment methods in women with breast cancer.

PURPOSE/OBJECTIVES: To investigate the differences between various cancer therapies (radiation, hormonal, chemotherapy, and their combinations) and the specific dimensions of fatigue (affective meaning, behavioral/severity, cognitive/mood, and sensory). DESIGN: Descriptive, cross-sectional, mailed survey design. SAMPLE AND SETTING: Data were collected from women who were breast cancer survivors and members of a nonprofit educational organization in the North-east. Criteria for this study included no self-reported disease recurrence, and treatment was within 18 months prior to the mailed survey (N = 322). The typical participant was middle-aged (mean = 52.2; SD = 10.3), Caucasian (93%), postmenopausal (55%), and diagnosed with cancer 2.42 (SD = 2.6) years prior to the study. METHODS: Secondary data analysis from a study using the Piper Fatigue Scale. VARIABLES: Level of fatigue. FINDINGS: Significant differences were found by treatment in total fatigue scores (p < 0.03) and cognitive/mood scores (p < 0.05). Women who received combination therapy had the highest fatigue scores (mean = 4.8; SD = 2.0); those who received only radiation therapy had the lowest fatigue scores (mean = 2.7; SD = 2.0). CONCLUSIONS: Fatigue in breast cancer survivors varies by type of cancer therapy. Future studies are needed to investigate the relationships between fatigue and hormonal therapy, and they need to be designed to examine changes over time. IMPLICATIONS FOR NURSING PRACTICE: Study findings advance knowledge about fatigue in women with breast cancer and aid nurses in providing anticipatory guidance for women undergoing different treatment regimens.

Adult↗

PubMed1998

[Management of psoriasis in family practice is now in closer agreement with the guidelines of the Netherlands Society of Family Physicians].

OBJECTIVE: To assess changes in incidence of psoriasis and to study changes in the management of psoriasis in general practice after the sending of guidelines on management of psoriasis to general practitioners (GPs) by the NHG. DESIGN: Secondary data analysis. SETTING: Netherlands Institute for Health Care Research (NIVEL), Utrecht, the Netherlands. METHOD: Data on the incidence of psoriasis and its management by general practitioners were collected from a file predating the publication of the NHG guideline 'Psoriasis' in 1994, namely the 'Dutch National Survey of General Practice' (NS; 1987/'88), and from a subsequent file, the 'Registration Network Groningen' (RNG; 1995). RESULTS: In the NS there were 106 new patients with psoriasis (incidence: 1.3/1000/year; 95% confidence interval (95% CI): 1.2-1.4) while in the RNG there were 24 (incidence: 1.2/1000/year; 95% CI: 0.7-1.9). In all, there were 466 psoriasis patients in the NS and 125 in the RNG. The number of referrals to dermatologists was halved in 1995 (7.2%) compared with 1987/'88 (14.4%; p < 0.05). The most frequently prescribed dermatologica in psoriasis was in 1995 corticosteroid group 3 (32.8%; in 1987/'88: 28.5%), but the rise was stronger in corticosteroid group 2 (29.6%; in 1987/'88: 16.0%; p < 0.001) and group 4 (16.0%; in 1987/'88: 8.8%; p < 0.05). CONCLUSION: The incidence of psoriasis in general practice had not changed between 1987/'88 en 1995. Referral pattern and prescription shifted towards the guidelines issued by the NHG.

Adrenal Cortex Hormones↗

PubMed1998

The use of patient based outcome measures in clinical decision making.

OBJECTIVE: Three questions were proposed in this presentation. 1) How can existing quality of life measures be used most effectively now? (2) What additional work is needed in their development or application? (3) Can existing data be used for secondary analyses of 'generic questions' concerning the relationships between oral health and quality of life outcomes? CONCLUSIONS: The availability of existing measures can provide directions for future refinement particularly if existing measures are tested across diverse populations and within the community of practising dentists. Additionally the use of existing data for secondary data analysis of 'generic questions' could provide information which would help to sharpen the instruments. However, if patient based outcome measures are to be used in clinical decision making the clinical community must be involved in the development of instruments which are seen as useful to clinicians. A shift toward health status assessments, in order to be accepted by clinicians, must benefit patients and enhance the clinician's ability to function. For clinicians to embrace this idea it must be clear how they can use this information to design therapeutic interventions. The argument for the use of these measures must be made on practical not theoretical grounds. Therefore it is important to prove to clinicians that measuring health status is useful in improving patient care and that these measures are tools in the service of their patients.

Activities of Daily Living↗

PubMed2006

Graphical exploratory data analysis of RNA secondary structure dynamics predicted by the massively parallel genetic algorithm.

Studies indicate that RNA may enter intermediate and multiple conformational states, which may impact gene expression and molecular function. It is known that the biologically functional states of RNA molecules may not correspond to their minimum energy conformations, that kinetic barriers may trap the molecule in a local minimum, that folding often occurs during transcription, and that cases exist in which a molecule will transition between one or more functional conformations. Thus, methods for simulating the folding pathway and dynamic behavior of an RNA molecule are important for the prediction of RNA structure and its associated functions. We have developed several data mining techniques guided by interactive visualization tools associated with our massively parallel genetic algorithm for RNA/DNA secondary structure prediction, MPGAfold, and StructureLab analysis workbench. Most of the methods and tools are also applicable to dynamic programming algorithm (DPA) folding data analysis. When applied to MPGAfold results these methodologies are used to determine the significant intermediate and final structures associated with co-transcriptional and full length RNA folding. Since the genetic algorithm is essentially stochastic, multiple runs are required to develop a consensus understanding of an RNA structure. The interactive visualizations facilitate interpretation of results from sequential or full length individual MPGAfold runs, final results of multiple folding runs, including multiple population sizes, and the results from multiple RNA sequences of one family. This paper describes several of these techniques and shows how they are used to help solve this highly combinatoric problem.

Algorithms↗

PubMed2006

Sexual abstinence, contraception, and condom use by young African women: a secondary analysis of survey data.

BACKGROUND: Drug therapy for people with AIDS is a humanitarian priority but prevention of HIV infection remains essential. Focusing on young single African women, we aimed to assess trends in a set of behaviours-sexual abstinence, contraceptive use, and condom use-that are known to affect the rates of HIV transmission. METHODS: We did a secondary analysis of public-access data sets in 18 African countries (132,800 women), and calculated changes in a set of behavioural indicators over time. We standardised these trends from nationally representative surveys to adjust for within-country changes in age, education, and type of residential location. FINDINGS: Between about 1993 and 2001, the percentage of women reporting no sexual experience changed little. During the same period, the percentage of sexually experienced women who reported no sexual intercourse in the previous 3 months (secondary abstinence) rose significantly in seven of 18 countries and the median for all 18 countries increased from 43.8% to 49.2%. Use of condoms for pregnancy prevention rose significantly in 13 of 18 countries and the median proportion increased from 5.3% to 18.8%. The median rate of annual increase of condom use was 1.41 percentage points (95% CI 1.12-2.25). In the 13 countries with available data, condom use at most recent coitus rose from a median of 19.3% to 28.4%. Over half (58.5%) of condom users were motivated, at least in part, by a wish to avoid pregnancy. INTERPRETATION: Condom promotion campaigns in sub-Saharan Africa have affected the behaviour of young single women; the pace of change has matched the rise in contraceptive use by married couples in developing countries over recent decades. Thus continuing efforts to promote condom use with emphasis on pregnancy prevention are justified.

Adolescent↗

PubMed1996

Linking stress and injury in the farming environment: a secondary analysis of qualitative data.

The first step in injury prevention is to understand the injury problem. This includes examining the nature of the problem from the perspective of the target community. This article uses qualitative methods to explain the nature of the injury problem and identifies prevention strategies through a three-step process: identify a causal model, validate the model, and identify strategies using the causal model. A causal model linking safety performance and safety demand, health decision making, and occupational stress was derived by secondary analysis of farm family focus group data (step 1) and validated by other farm family focus groups (step 2). Prevention strategies identified from the causal model (step 3) include decreasing the number of roles performed exclusively by one individual, developing an easy-to-use planning tool that assists farmers in anticipating and reducing future work demands, and developing an education module that incorporates injury costs into safety decision making.

Accidents, Occupational↗