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At least 505 records · Page 28Linked to original sources
PubMed1996

A review of crash data analysis in a defect and recall investigation of the general motors C/K pickup trucks.

In the process of assessing the safety of the fuel-containment system of the 1973-1987 General Motors C/K truck, the National Highway Traffic Safety Administration and General Motors Corporation have written and submitted numerous documents to a public file between October 1992 and April 1993. Five substantial reports have been issued by the National Highway Traffic Safety Administration and General Motors Corporation describing data analysis of crashes recorded on state and federal databases. Both the National Highway Traffic Safety Administration and General Motors Corporation have used crash data, in some cases the same data, to examine the claim that a defect in the fuel system design of General Motors Corporation C/K trucks poses an unreasonable risk of death or injury. The comparative analysis presented in this paper demonstrates how crash databases and their summary statistics can be used to support opposed positions in a safety dispute. Understanding differences in the analysis is fundamental to obtaining an insight into the role of field crash data, including its relevance and shortcomings, in defect and recall investigations.

Accidents, Traffic↗
PubMed2001

[The influence of regional differences in drinking style on hazardous use, excessive drinking, abuse and dependence].

INTRODUCTION: Previous research in Germany identified a "north-south" gradient in the hazardous use of alcoholic drinks, but this had methodological limitations. The present study estimates the hazardous use of alcohol more reliably. In addition, regional differences in drinking style and their relation to indicators of problematic alcohol use are examined. METHODS: Data are from 1995 and 1997 representative samples of the non-institutionalised German general population aged 18 to 59 years. Based on 15,017 complete observations prevalence rates for abstinence, hazardous consumption (>30 g ethanol per day for men; >20 g ethanol per day for women), two or more CAGE-symptoms, and heavy episodic drinking (5+ drinks consumed in a day) were calculated and a cluster analysis was performed with regard to the 16 German federal states. RESULTS: Regional differences exist in the prevalence of abstinence and hazardous drinking, but a "north-south" gradient was not evident. However, cluster analysis results suggest a "north-south" difference in drinking style, i.e. the quantity-frequency pattern of beer, wine, and spirits consumption. Compared with the northern German federal states, those in the south experienced more beer and less wine and spirits consumption in combination with a lower frequency of drinking beer and spirits. No cluster difference was found for hazardous drinking, lifetime prevalence of 2+ CAGE items or consumption of 5+ drinks in a day. Yet, mean consumption of ethanol was significantly higher in the north. CONCLUSIONS: Research suggesting more hazardous consumption in southern Germany must be tempered by these findings that found no 'north-south' gradient in several different indicators of problematic alcohol use. Different drinking styles in northern and southern states do not result in differences concerning prevalence of binge drinking nor alcohol-related problems. Drinking style only made a difference in the mean consumption of ethanol. Methodological differences between the reported studies are discussed.

Adolescent↗
PubMed1979

"Advocacy research" versus "management review": a comparative analysis.

The authors compare two policy studies of the federally implemented Community Mental Health Centers program--one by a Ralph Nader study group and one by the U.S. General Accounting Office--in order to develop and illustrate two corresponding concepts or "ideal types" of policy research methodology, termed "advocacy research" and management review". They give special attention to two analytic dimensions: the balance of "extrinsic" to "intrinsic" critisms, and the structural relationship between policy researchers and policymakers.

Community Mental Health Centers↗
PubMedDate not supplied

[An outside assessment of the quality of studies on the chemical composition of the urine within the framework of a single federal system].

The National External Quality Assessment Scheme for analysis of the urine is presented. It includes 9 parameters: protein, glucose, creatinine, urea, uric acid, sodium, potassium, hemoglobin, and pH. Two lyophilized of liquid control samples of urine (normal and abnormal) are distributed to the participating laboratories. An original evaluation protocol for qualitative and semiquantitative methods is proposed in addition to the traditional statistical approach to evaluation of the results of quantitative methods.

Humans↗
PubMed1998

Expression of bcl-2 in invasive and in situ carcinoma of the uterine cervix.

OBJECTIVE: The oncoprotein bcl-2 inhibits apoptosis. The purpose of this study was to assess the expression of bcl-2 in human cervical carcinoma and to correlate this with clinicopathologic parameters. STUDY DESIGN: Immunohistochemical staining for bcl-2 protein (MoAB clone 124) was performed on operative tissue specimens from 22 patients with carcinoma in situ of the cervix and from 137 patients with invasive cervical carcinoma (International Federation of Gynecology and Obstetrics stages I to IV). The immunoreactivity of bcl-2 was scored as positive (> or = 5% staining cells) or negative (< 5% staining cells). RESULTS: Eighty-two percent of in situ carcinomas and 61% of invasive cervical carcinomas were bcl-2 positive. Expression of bcl-2 was correlated to tumor stage (p < 0.001) and to presence of vascular (p < 0.005) or lymphatic tumor (p < 0.023) permeation. In univariate analysis there was a strong relationship between bcl-2 expression and overall survival (p < 0.001). In multivariate analysis bcl-2 expression (p < 0.001), International Federation of Gynecology and Obstetrics stage (p = 0.011), and presence of lymphatic permeation (p = 0.014) proved to be independent prognostic factors. CONCLUSIONS: Expression of bcl-2 is lost during tumor progression and is a strong prognostic parameter, suggesting that the regulation of apoptosis plays an important role in the behavior of cervical carcinomas. Better understanding of the mechanisms involved may lead to improved medical treatment strategies.

Adult↗
PubMedDate not supplied

[The structural and functional changes in therapeutic-preventive services rendered to the population of the Russian Federation in the recent decade].

The article contains the results of a comprehensive analysis of the functional transformations and of the efficiency of the system of therapeutic-and-preventive aid in the Russian Federation during the 90-ies. It is pointed out that the below parameters in the activity of health care institutions have essentially improved during the recent years: days during which the hospital beds are occupied per year, an average duration of treatment, turn-over of hospital beds, and number of visits to the doctor per one citizen. The number of surgical interventions, made in out-patients' clinics, and the scope of activity of day-time hospitals have increased. At the same time, the reduction of the network and activity of therapeutic-and-preventive institutions (TPI) has been primarily taken place in rural areas; the development of the outpatient surgery has been accompanied by an increasing number of surgeries in hospitals; the quantity of hospitalizations and the absolute number of hospitalized patients have been growing during the recent 4 years (1998-2001). The networks of medical rehabilitation institutions and of nurse care are poorly developed, and the share of beds for such networks is insufficient. The TPI staff, which is not replaced by physical persons, has been increasing; the provision of population with doctors remains high, while the number of paramedical personnel has been decreasing; and the coefficient of jobs-combining has been increasing.

Efficiency, Organizational↗
PubMed2005

The MammoGrid Virtual Organisation - Federating Distributed Mammograms.

The MammoGrid project aims to deliver a prototype which enables the effective collaboration between radiologists using grid, service-orientation and database solutions. The grid technologies and service-based database management solution provide the platform for integrating diverse and distributed resources, creating what is called a 'virtual organisation'. The MammoGrid Virtual Organisation facilitates the sharing and coordinated access to mammography data, medical imaging software and computing resources of participating hospitals. Hospitals manage their local database of mammograms, but in addition, radiologists who are part of this organisation can share mammograms, reports, results and image analysis software. The MammoGrid Virtual Organisation is a federation of autonomous multi-centres sites which transcends national boundaries. This paper outlines the service-based approach in the creation and management of the federated distributed mammography database and discusses the role of virtual organisations in distributed image analysis.

Computer Communication Networks↗
PubMedDate not supplied

An examination of regional migration patterns in Mexico: new and old Mexican regions.

This paper examines Mexican regional patterns. Different regional definitions are utilized to examine in-/out-migration patterns in 4 different periods: 1) 1979-1980, 2) 1975-1979, 3) prior to 1975, and 4) lifetime. 5 regional definitions previously used to delineate state level Mexican regions were compared to new regions by a maximum likelihood clustering technique. Previously defined regions do not compare with the empirically delineated regions developed by the cluster analysis. A cluster analysis of in-/out-migration patterns suggests the following: 1) distinct in-/out-migration patterns for both short- and long-term migration patterns, 2) a central region consisting of Mexico and the Federal District having its own distinct regional characteristics for both in-/out-migration patterns, particularly intraregional migration among those 2 states exceeds any other interregional migration patterns, and 3) the unique role played by Jalisco in mediating long-term inflows prior to 1975, and since 1975, out-migration from the same state. Previous research rarely identified the Central region consisting of Mexico and the Federal District. Using net migration for interregional migration analysis may possibly be misleading since immigration and out-migration phenomena show distinct patterns of geographic mobility at the state level, and such regional differences are consistent for the 4 migration periods. A careful analysis accounting for both distinct migration patterns in the Central region and different patterns in in-/out-migration are necessary to obtain an understanding of regional migration patterns in Mexico.

Americas↗
PubMed2006

Adherence to federal guidelines for reporting of sex and race/ethnicity in clinical trials.

BACKGROUND: The National Institutes of Health Revitalization Act of 1993 requires that NIH-funded clinical trials include women and minorities as subjects; other federal agencies have adopted similar guidelines. The objective of this study was to determine the current level of compliance with these guidelines in federally funded randomized controlled trials. METHODS: Randomized controlled trials published in nine influential medical journals in 2004 were identified by PubMed search. Studies where individuals were not the unit of analysis, those begun before 1994, and those not receiving federal funding were excluded. Included studies were examined to determine sample characteristics and presence of subgroup reporting. RESULTS: PubMed located 589 published papers. After exclusion of ineligible papers, 69 remained for analysis. Among 46 clinical studies enrolling both men and women, women were generally underrepresented, comprising on average 37% of the sample and only 24% of the sample when analysis was restricted to drug trials. Eighty-seven percent of the studies did not report any outcomes by sex or include sex as a covariate in modeling. Among all 69 studies, 18% did not break down sample sizes by racial and ethnic groups, and 87% did not provide any analysis by racial or ethnic groups. Only 5 studies indicated that the generalizability of their results may be limited by lack of diversity among those studied. CONCLUSIONS: These findings illustrate inadequate compliance with the NIH guidelines. Researchers, editors, and journal audiences share the responsibility of ensuring compliance with our country's policies regarding federally funded research to effect healthcare improvements for all.

Evidence-Based Medicine↗
PubMedDate not supplied

Smoke yields of tobacco-specific nitrosamines in relation to FTC tar level and cigarette manufacturer: analysis of the Massachusetts Benchmark Study.

OBJECTIVES: This research assessed the relationship between the deliveries of carcinogenic tobacco-specific nitrosamines (TSNAs) and the Federal Trade Commission (FTC) "tar" ratings of US commercial cigarettes. METHODS: Analysis of covariance (ANCOVA) was used to assess the explanatory power of FTC tar, the particular manufacturer, and other cigarette characteristics to predict the yields of four TSNAs (N'-nitrosonornicotine [NNN], 4-(N-methyl-N-nitrosamino)-1-(3-pyridyl)-1-butanone [NNK], N'-nitrosoanatabine [NAT], and N'-nitrosoanabasine [NAB]) in 26 US commercial brands tested in the 1999 Massachusetts Benchmark Study. RESULTS: When FTC tar alone was used to predict TSNA yield, the squared correlation coefficient (R(2)) was only 38% for NNN, 76% for NNK, 46% for NAT, and 49% for NAB. Inclusion of manufacturer-specific variables significantly (p < 0.001) increased the estimated R(2) for three of the four species of nitrosamine to: 78% for NNN, 88% for NNK, and 81% for NAT. Inclusion of other cigarette characteristics (filter type, paper permeability, tobacco weight, tip dilution) did not reduce the significance of the manufacturer-specific effects. Federal Trade Commission nicotine and carbon monoxide (CO) yields were no better at predicting TSNA levels. CONCLUSIONS: FTC ratings for tar, nicotine, and carbon monoxide do not tell the entire story about the comparative yields of toxic agents in marketed cigarette brands. The significant manufacturer-specific effects suggest that proprietary blending and processing of tobacco matter as well. Public, brand-by-brand disclosure of the yields of TSNA and possibly other smoke constituents appears to be warranted.

Analysis of Variance↗
PubMed2026

Secure bioinformatics: privacy-preserving federated analytics using homomorphic encryption.

MOTIVATION: Large-scale bioinformatics analyses increasingly require collaboration across multiple cohorts and institutions, yet existing workflows often rely on data co-localization, which is slow, difficult to scale, and raises privacy concerns. We present a privacy-preserving federated analytics framework that enables secure statistical analysis across distributed datasets without transferring raw data, by performing all computations on encrypted data via cryptographic methods. RESULTS: We evaluate the framework by validating polygenic risk scores and conducting meta-analyses on two real-world cohorts. The proposed solution achieves over 99.9% accuracy relative to plaintext analyses, while maintaining scalable runtime performance with increasing data size and number of participating sites. These results demonstrate the feasibility of secure federated analytics for practical bioinformatics applications involving sensitive data.

Computational Biology↗
PubMed2004

Environmental impacts of dispersed development from federal infrastructure projects.

Dispersed development, also referred to as urban growth or sprawl, is a pattern of low-density development spread over previously rural landscapes. Such growth can result in adverse impacts to air quality, water quality, human health, aquatic and terrestrial ecosystems, agricultural land, military training areas, water supply and wastewater treatment, recreational resources, viewscapes, and cultural resources. The U.S. Environmental Protection Agency (U.S. EPA) is charged with protecting public health and the environment, which includes consideration of impacts from dispersed development. Specifically, because federal infrastructure projects can affect the progress of dispersed development, the secondary impacts resulting from it must be assessed in documents prepared under the National Environmental Policy Act (NEPA). The Council on Environmental Quality (CEQ) has oversight for NEPA and Section 309 of the Clean Air Act requires that U.S. EPA review and comment on federal agency NEPA documents. The adverse effects of dispersed development can be induced by federal infrastructure projects including transportation, built infrastructure, modifications in natural infrastructure, public land conversion and redevelopment of properties, construction of federal facilities, and large traffic or major growth generation developments requiring federal permits. This paper presents an approach that U.S. EPA reviewers and NEPA practitioners can use to provide accurate, realistic, and consistent analysis of secondary impacts of dispersed development resulting from federal infrastructure projects. It also presents 24 measures that can be used to mitigate adverse impacts from dispersed development by modifying project location and design, participating in preservation or restoration activities, or informing and supporting local communities in planning.

Cities↗
PubMed2005

Residency work-hours reform. A cost analysis including preventable adverse events.

BACKGROUND: In response to proposed federal legislation, the Accreditation Council for Graduate Medical Education limited resident work-hours in July 2003. The cost may be substantial but, if successful, the reform might lower preventable adverse event costs in hospital and after discharge. OBJECTIVES: This study sought to estimate the reform's net cost in 2001 dollars, and to determine the reduction in preventable adverse events needed to make reform cost neutral from teaching hospital and societal perspectives. DESIGN: Cost analysis using published literature and data. Net costs were determined for 4 reform strategies and over a range of potential effects on preventable adverse events. RESULTS: Nationwide, transferring excess work to task-tailored substitutes (the lowest-level providers appropriate for noneducational tasks) would cost 673 million dollars; mid-level providers would cost 1.1 billion dollars. Reform strategies promoting adverse events would increase net teaching hospital and societal costs as well as mortality. If task-tailored substitutes decrease events by 5.1% or mid-level providers decrease them by 8.5%, reform would be cost neutral for society. Events must fall by 18.5% and 30.9%, respectively, to be cost neutral for teaching hospitals. CONCLUSIONS: Because most preventable adverse event costs occur after discharge, a modest decline (5.1% to 8.5%) in them might make residency work-hours reform cost neutral for society but only a much larger drop (18.5% to 30.9%) would make it cost neutral for teaching hospitals, unless additional funds are allocated. Future research should evaluate which reform approaches prevent adverse events and at what cost.

Health Care Reform↗
PubMed1989

Long-term technology assessment. Mortality, hospitalization, and work loss due to peptic ulcer and gastritis/duodenitis in the Federal Republic of Germany.

Once the effects of short-term data analysis of new medical technology appear clear, additional or long-term analyses are infrequently performed on subsequent information. This often leads to incomplete understanding of the technology's full medical, social, and economic effects. Available data for the Federal Republic of Germany on mortality, hospitalization, and work loss due to gastric and duodenal ulcer and gastritis/duodenitis allowed long-term analysis of direct and indirect impacts on the population from 1975 through 1984. Mortality rates declined for all ages (p less than 0.01) except for those age 75 and older, and nearly equally for all study diagnoses. Hospital discharge rates for all diagnoses rose slowly and steadily, while those for persons diagnosed with gastric ulcer, duodenal ulcer or gastritis/duodenitis declined sharply (p = 0.04). Declines of hospital discharges were greater for men than for women. The ongoing decline in rates of mortality and hospital discharges increased after 1977. Rates of work loss per 10,000 population-at-risk for study diagnoses were either stable or increasing until 1979, after which there was a marked decline (p = 0.03 for gastric ulcer, p = 0.02 for duodenal ulcer, p = 0.008 for gastritis/duodenitis). Work loss due to study diseases declined as a percentage of work loss for all diseases during the later study years. Only by examining many years' data could the accelerating declines be discerned, not only for mortality and hospitalizations, which have been examined before, but also for work loss, an infrequently analyzed effect of disease.

Absenteeism↗
PubMed2006

Practice locations of graduates of family physician residency and nurse practitioner programs: considerations within the context of institutional culture and curricular innovation through Titles VII and VIII.

BACKGROUND: Studies have described the aggregate results of federal funding for health professions education at the national level, but analysis of the long-term impact of institutional participation in these programs has been limited. PURPOSE: To describe and assess federally supported curricular innovations at East Tennessee State University designed to promote family medicine and nurse practitioner graduate interest in rural and underserved populations. METHODS: Descriptive analysis of a survey to determine practice locations of nurse practitioner graduates (1992-2002) and graduates of 3 family medicine residencies (1978-2002). Graduates' (N = 656) practice locations were documented using specific federal designations relating to health professions shortages and rurality. RESULTS: Overall, 83% of family medicine residency and 80% of nurse practitioner graduates selected practice locations in areas with medically underserved or health professions shortage designations; 48% of family physicians and 38% of nurse practitioners were in rural areas. CONCLUSIONS: Graduates who study in an educational setting with a mission-driven commitment to rural and community health and who participate in curricular activities designed to increase their experience with rural and underserved populations choose, in high numbers, to care for these populations in their professional practice.

Appalachian Region↗
PubMed2006

The association of poverty with the prevalence of albuminuria: data from the Third National Health and Nutrition Examination Survey (NHANES III).

BACKGROUND: Albuminuria is a major risk factor for the development and progression of chronic kidney disease (CKD) and cardiovascular disease. Socioeconomic factors also have been reported to modify CKD and cardiovascular risk factors and clinical outcomes. The extent to which poverty influences the prevalence of albuminuria, particularly among racial/ethnic minority populations, is not well established. The influence of poverty on the prevalence of albuminuria and the implication of this relationship for the racial and/or ethnic differences in the prevalence of albuminuria were examined. METHODS: We examined data from 6,850 male and 7,634 female adults from a national probability survey conducted between 1988 and 1994. RESULTS: In univariate analysis, poverty, defined as less than 200% federal poverty level (FPL), was associated with the presence of both microalbuminuria (odds ratio [OR], 1.35; 95% confidence interval, 1.22 to 1.49) and macroalbuminuria (OR, 1.78; 95% confidence interval, 1.40 to 2.26). The association of less than 200% FPL with microalbuminuria persisted in a multivariate model controlling for age, sex, race, education, obesity, hypertension, diabetes, reduced glomerular filtration rate, and medication use (OR, 1.18; 95% confidence interval, 1.05 to 1.33). FPL less than 200% was not associated with macroalbuminuria in the multivariate model. When multivariate analysis is stratified by FPL (<200% and > or =200%), differences in ORs for microalbuminuria and macroalbuminuria among racial/ethnic minority participants compared with whites were more apparent among the less affluent participants in the FPL-less-than-200% stratum. CONCLUSION: FPL less than 200% is associated with microalbuminuria, and differences in FPL levels may account for some of the observed differences in prevalence of albuminuria between racial/ethnic minority participants and their white counterparts.

Adult↗