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At least 1,369 records · Page 76Linked to original sources

PubMed2004

Graduated driver licensing for reducing motor vehicle crashes among young drivers.

BACKGROUND: Graduated driver licensing (GDL) has been proposed as a means of reducing crash rates among novice drivers by gradually introducing them to higher risk driving situations. OBJECTIVES: To examine the effectiveness of GDL systems in reducing crash rates of young drivers. SEARCH STRATEGY: Studies were identified through searches of MEDLINE, EMBASE, CINAHL, Healthstar, Web of Science, NTIS Bibliographic Database, TRIS Online, SIGLE, the World Wide Web, relevant conference proceedings, consultation with experts and authors, and reference lists. The search was not restricted by language or publication status. SELECTION CRITERIA: Studies were included if: 1) they compared outcomes pre- and post-implementation of a GDL program within the same jurisdiction, 2) comparisons were made between jurisdictions with and without GDL, or 3) both. Studies had to report at least one objective, quantified outcome. Two reviewers independently screened searches and assessed the full text of potentially relevant studies for inclusion using a standard form. DATA COLLECTION AND ANALYSIS: Data were extracted by one reviewer and checked by a second. Additional data were requested from authors. Results were not pooled due to substantial heterogeneity between studies. Percentage change was calculated for each year after the intervention, using one year prior to the intervention as the baseline rate. Results were adjusted by internal controls. Analyses were stratified by different denominators (population, licensed drivers). Results were calculated for the different crash types (overall, injury, fatal, night-time, alcohol, and those resulting in hospitalization). Results were presented for 16 year-olds alone and all teenage drivers combined. MAIN RESULTS: We included 13 studies evaluating 12 GDL programs that were implemented between 1979 and 1998 in the US (n=7), Canada (3), New Zealand (1), and Australia (1). Programs varied in their restrictions during the intermediate stage: e.g. night curfews (8); limitations of extra passengers (2); roadway restrictions (1). Based on the Insurance Institute for Highway Safety classification scheme, no programs were good, six were acceptable, five were marginal, and one was poor. Reductions in crash rates were seen in all jurisdictions and for all crash types. Among 16 year-old drivers, the median decrease in per population overall crash rates during the first year was 31% (range 26-41%). Per population injury crash rates were similar (median 28%, range 4-43%). Results for all teenage drivers, rates per licensed driver, and rates adjusting for internal controls were generally reduced when comparing within jurisdictions. REVIEWERS' CONCLUSIONS: The existing evidence shows that GDL is effective in reducing the crash rates of young drivers, although the magnitude of the effect is unclear. The conclusions are supported by consistent direction of the findings, and the temporal relationship and plausibility of the association. The reviewers have made recommendations for primary research on GDL (e.g. study methods, standardized reporting of outcomes and results, long-term follow-up). The project has also shown what is needed to carry out systematic reviews of observational studies (e.g. quality assessment instruments).

Accidents, Traffic↗

PubMed2001

Realignment of the nation's tobacco agenda: the need to treat tobacco dependence.

BACKGROUND: Tobacco use remains the leading cause of preventable death in the United States. Although comprehensive tobacco control has a number of essential components, support for cessation services can yield the largest short-term public health benefit. While effective treatments for tobacco dependence do exist, they are not currently available to many of the tobacco users who want and need them. Finding cost-effective, science-based strategies for reducing tobacco dependence in the United States should be a national priority. METHODS: Late in 1997 a group of experts in the science of tobacco control was convened by the Center for the Advancement of Health to develop recommendations regarding the use of federal funds for treating tobacco dependence. These recommendations were prepared based on the priority of the actions and the estimated cost and effort required to implement them. Following the Master Settlement Agreement in 1998, the recommendations were adapted to address the needs of state policy makers. RESULTS: Effective treatments for tobacco dependence do exist; however, our nation currently lacks the capacity to deliver these services to the many millions who require them. There is a compelling need for funding from a variety of sources to create this capacity. CONCLUSIONS: The priority must be to develop the systems, competencies, and resources needed to deliver, and to monitor the delivery of, evidence-based treatments to tobacco users. Treatment must be delivered in an integrated manner, consistent with the needs of tobacco users. Additionally, financial barriers to treatment must be reduced, and consistent, high-quality treatment services must be ensured for all tobacco users who seek them.

Evidence-Based Medicine↗

PubMed2004

Toward a scientifically rigorous basis for developing mapped ecological regions.

Despite the wide use of ecological regions in conservation and resource-management evaluations and assessments, a commonly accepted theoretical basis for ecological regionalization does not exist. This fact, along with the paucity of focus on ecological regionalization by professional associations, journals, and faculties, has inhibited the advancement of a broadly acceptable scientific basis for the development, use, and verification of ecological regions. The central contention of this article is that ecological regions should improve our understanding of geographic and ecological phenomena associated with biotic and abiotic processes occurring in individual regions and also of processes characteristic of interactions and dependencies among multiple regions. Research associated with any ecoregional framework should facilitate development of hypotheses about ecological phenomena and dominant landscape elements associated with these phenomena, how these phenomena are structured in space, and how they function in a hierarchy. Success in addressing the research recommendations outlined in this article cannot occur within an ad hoc, largely uncoordinated research environment. Successful implementation of this plan will require activities--coordination, funding, and education--that are both scientific and administrative in nature. Perhaps the most important element of an infrastructure to support the scientific work of ecoregionalization would be a national or international authority similar to the Water and Science Technology Board of the National Academy of Sciences.

Conservation of Natural Resources↗

PubMed2004

MEP (Mars Environment Package): toward a package for studying environmental conditions at the surface of Mars from future lander/rover missions.

In view to prepare Mars human exploration, it is necessary to promote and lead, at the international level, a highly interdisciplinary program, involving specialists of geochemistry, geophysics, atmospheric science, space weather, and biology. The goal of this program will be to elaborate concepts of individual instruments, then of integrated instrumental packages, able to collect exhaustive data sets of environmental parameters from future landers and rovers of Mars, and to favour the conditions of their implementation. Such a program is one of the most urgent need for preparing human exploration, in order to develop mitigation strategies aimed at ensuring the safety of human explorers, and minimizing risk for surface operations. A few main areas of investigation may be listed: particle and radiation environment, chemical composition of atmosphere, meteorology, chemical composition of dust, surface and subsurface material, water in the subsurface, physical properties of the soil, search for an hypothesized microbial activity, characterization of radio-electric properties of the Martian ionosphere. Scientists at the origin of the present paper, already involved at a high degree of responsibility in several Mars missions, and actively preparing in situ instrumentation for future landed platforms (Netlander--now cancelled, MSL-09), express their readiness to participate in both ESA/AURORA and NASA programs of Mars human exploration. They think that the formation of a Mars Environment working group at ESA, in the course of the AURORA definition phase, could act positively in favour of the program, by increasing its scientific cross-section and making it still more focused on human exploration.

Atmosphere↗

PubMed2026

Effects of hospital planning reforms on access, costs, efficiency, and quality of care in OECD countries: Systematic review and meta-analysis.

BACKGROUND: Many OECD countries have implemented hospital planning reforms to rising healthcare costs, demographic changes, and concerns about access, efficiency, and quality of care. Despite broad implementation, evidence on effectiveness remains fragmented and country-specific. OBJECTIVE: To synthesize evidence on the effects of hospital planning reforms aross four outcome domains: access, costs, efficiency, and quality of care. METHODS: We conducted a systematic review following Cochrane methodology, searching PubMed and Web of Science (January 2000 - September 2025). Studies were categorized into four intervention types - centralization, minimum volume requirements (MVR), performance-based targets, and governance and ownership restructuring. Risk of bias was assessed using Joanna Briggs Institute checklist for quasi-experimental designs. Where data permitted, random-effects meta-analyses pooled standardized mean differences (SMD) for access and efficiency and risk differences (RD) for quality outcomes. RESULTS: 26 studies from 12 countries were included. Centralization increased patient travel distances and reduced length of stay (SMD -0.09, 95% CI -0.17 to -0.01) and complications (RD -14.52 pp, -25.95 to -3.09), and, jointly with performance-based targets, 30-day readmissions (RD -0.43 pp, -0.65 to -0.22). Mortality effects varied by timepoint and intervention: short-term endpoints were largely non-significant, whereas 90-day mortality was reduced under centralization (RD -0.80 pp, -1.25 to -0.35) and 60-day mortality under MVR (RD -2.00 pp, -2.82 to -1.18). Survival was non-significant throughout. No study examined costs. CONCLUSION: The absence of cost evidence is a critical gap. Substantial heterogeneity reflects variation in reform design and context, underscoring the need to interpret findings by intervention and country conditions.

Humans↗

PubMed2026

Reframing Proteomics Measurement: Super Mass Spectrometry Framework and the Role of Delayed Electrospray Ionization Technique.

Dynamic range, repeatability, and reproducibility remain the central limitations of data-independent acquisition (DIA) proteomics. Current workflows emphasize protein group identification counts and throughput, but these metrics mask the fundamental measurement challenge: generating a repeatable, reproducible, high-fidelity, and relatively complete digital representation of complex proteomes. In particular, plasma proteomics spans more than 10 orders of magnitude in protein abundance, far exceeding the capacity and dynamic range of any single mass spectrometer. Incremental advances have not closed this gap. In this Perspectives article, I introduce the Super Mass Spectrometry framework and then highlight the Delayed Electrospray Ionization (Delayed-ESI) technique, as a practical approach to address these limitations. By producing compositionally identical but temporally staggered ion beams, the Delayed-ESI technique enables deterministic remeasurement of the same analyte profile, supporting various novel strategies to improve analytical figures of merit. While recent implementations of the Delayed-ESI technique have emphasized throughput, I argue that the broader value of the Delayed-ESI technique lies in extending dynamic range and improving repeatability and reproducibility─objectives that should take precedence if proteomics is to evolve into a robust measurement science capable of supporting population-scale proteomics studies.

Proteomics↗

PubMed2007

An integrative review of Canadian childhood obesity prevention programmes.

To examine successful Canadian nursing and health promotion intervention programmes for childhood obesity prevention during gestation and infancy, an integrative review was performed of the literature from 1980 to September 2005. The following databases were used: PubMed; Cochrane Database of Systematic Reviews; Cochrane Controlled Trials Register; Database of Abstracts of Reviews of Effects; ACP Journal Club; MEDLINE; EMBASE; CINAHL; Web of Science; Scopus; Sociological Abstracts; Sport Discus; PsycInfo; ERIC and HealthStar. MeSH headings included: infancy (0-24 months), gestation, gestational diabetes, nutrition, prenatal care, pregnancy, health education, pregnancy outcome, dietary services with limits of Canadian, term birth. Of 2028 articles found, six Canadian childhood obesity prevention programmes implemented during gestation and/or infancy were found; three addressed gestational diabetes with five targeting low-income Canadian urban and/or Aboriginal populations. No intervention programmes specifically aimed to prevent childhood obesity during gestation or infancy. This paucity suggests that such a programme would be innovative and much needed in an effort to stem the alarming increase in obesity in children and adults. Any attempts either to develop new approaches or to replicate interventions used with obese adults or even older children need careful evaluation and pilot testing prior to sustained use within the perinatal period.

Clinical Trials as Topic↗

PubMed2001

Policy implications for implementing evidence-based practices.

The authors describe the policy and administrative-practice implications of implementing evidence-based services, particularly in public-sector settings. They review the observations of the contributors to the evidence-based practices series published throughout 2001 in Psychiatric Services. Quality and accountability have become the watchwords of health and mental health services; evidence-based practices are a means to both ends. If the objective of accountable, high-quality services is to be achieved by implementing evidence-based practices, the right incentives must be put in place, and systemic barriers must be overcome. The authors use the framework from the U.S. Surgeon General's 1999 report on mental health to describe eight courses of action for addressing the gap between science and practice: continue to build the science base; overcome stigma; improve public awareness of effective treatments; ensure the supply of mental health services and providers; ensure delivery of state-of-the-art treatments; tailor treatment to age, sex, race, and culture; facilitate entry into treatment; and reduce financial barriers to treatment.

Ethnicity↗

PubMed1999

Collaborative community research consortium: a model for HIV prevention.

In 1991, the Center for AIDS Prevention Studies (CAPS) at the University of California, San Francisco, set out to develop a model of community collaborative research that would bring the skills of science to the service of HIV prevention and the knowledge of service providers into the domain of research. Essential elements of the model were training for community-based organizations (CBOs) in research protocol writing, partnership between CBOs and CAPS researchers, program research funding, support to implement studies and analyze results, and a program manager to oversee the effort and foster the relationships between CBOs and researchers. In this article, the authors describe the CAPS model of consortium-based community collaborative research. They also introduce a set of papers, written by researchers and service providers, that describes collaborative research projects conducted by research institutions and CBOs and illustrates how collaboration can change both HIV prevention research and service.

Community Networks↗

PubMed2000

Control of the unilluminated deformable mirror actuators in an altitude-conjugated adaptive optics system

Off-axis observations made with adaptive optics are severely limited by anisoplanatism errors. However, conjugating the deformable mirror to an optimal altitude can reduce these errors; it is then necessary to control, through extrapolation, actuators that are not measured by the wave-front sensor (unilluminated actuators). In this study various common extrapolation schemes are investigated, and an optimal method that achieves a significantly better performance is proposed. This extrapolation method involves a simple matrix multiplication and will be implemented in ALTAIR, the Gemini North Telescope adaptive optics system located on Mauna Kea, Hawaii. With this optimal method, the relative H-band Strehl reduction due to extrapolation errors is only 5%, 16%, and 30% when the angular distance between the guide source and the science target is 20, 40 and 60 arc sec, respectively. For a site such as Mauna Kea, these errors are largely outweighed by the increase in the size of the isoplanatic field.

Journal Article↗

PubMed2001

STEP--a System for Teaching Experimental Psychology using E-Prime.

Students in psychology need to learn to design and analyze their own experiments. However, software that allows students to build experiments on their own has been limited in a variety of ways. The shipping of the first full release of the E-Prime system later this year will open up a new opportunity for addressing this problem. Because E-Prime promises to become the standard for building experiments in psychology, it is now possible to construct a Web-based resource that uses E-Prime as the delivery engine for a wide variety of instructional materials. This new system, funded by the National Science Foundation, is called STEP (System for the Teaching of Experimental Psychology). The goal of the STEP Project is to provide instructional materials that will facilitate the use of E-Prime in various learning contexts. We are now compiling a large set of classic experiments implemented in E-Prime and available over the Internet from http://step.psy.cmu.edu. The Web site also distributes instructional materials for building courses in experimental psychology based on E-Prime.

Humans↗

PubMedDate not supplied

The art and science of medical group turnarounds. Acting in several directions at once, acting at several points in time.

Developing a strategy and turnaround plan for a struggling medical group practice requires a combination of art and science. Orchestrating an effective about-face calls for decisive action on several fronts at once. Too many groups are slow to recognize the need to rescue a perilous situation. And rather than taking immediate action on multiple fronts, they try taking incremental steps over time. Implementing a successful turnaround requires both the diligence of follow-through and the vision to make necessary adjustments throughout the process.

Financial Management↗

PubMed1994

Pediatric injury patterns.

Ten thousand pediatric deaths annually in the United States speak for themselves. There are distinctive patterns and peculiarities of pediatric injuries that are emerging mostly as a result of small epidemiological studies. Trauma research has been and continues to be grossly underfunded relative to its impact on society. Allocation of appropriate funding and the requisite tools must be made available so that targeted and effective prevention campaigns can be designed and vigorously implemented [50, 69-75]. We have started, but the bulk of the work remains to be done. In many instances we should look to other parts of the world for successful examples (United Kingdom, Germany, Australia) [37, 63, 76]. Greater emphasis must be placed on basic science research applicable to trauma and on clinical research designed to improve the care not only of injured children but of all trauma patients. While the need for a comprehensive response to the worldwide trauma epidemic remains at a whisper, we have started shouting.

Adolescent↗

PubMed2004

Reduction through education: the insight of a trainer.

One of the articles contained within European Council Directive 86/609/EEC states that "Persons who carry out experiments or take part in them, and persons who take care of animals used for experiments, including duties of a supervisory nature, shall have appropriate training". In effect, this article stipulates that only competent individuals are allowed to work with laboratory animals. At least three groups of individuals can be identified with different responsibilities toward experimental animals: animal technicians, scientists, and veterinarians/animal welfare officers. The responsibilities and duties of the individuals within each of these categories differ. This paper focuses on the training of scientists. The scientist designs, and often also performs, animal experiments. Therefore, scientists must be educated to develop an attitude of respect toward laboratory animals, and must be trained so that, if an experiment must be performed with animals, it is designed according to the highest possible scientific and ethical standards. In The Netherlands, the law stipulates that scientists intending to work with animals must have completed a course in laboratory animal science. This compulsory course started in 1986. The Department of Laboratory Animal Science at Utrecht University is responsible for the national coordination of this course. Participants must have an academic degree (at the level of MSc) in one of the biomedical sciences, such as biology, medicine or veterinary medicine. Although the course is an intensive 3-week, 120-hour long course, which covers both technical and ethical aspects of laboratory animal experimentation, it cannot provide full competence. It is designed to provide sufficient basic training and knowledge to enable students to design animal experiments, and to develop an attitude that will be conducive to the implementation of the Three Rs. However, full competence will always require further training that can only be acquired as a result of practical experience gained while working in the field of laboratory animal research. Evaluations subsequent to the course have revealed that more than 98% of the students regard the course as indispensable for all scientists working in a research area where animal experiments are performed. They agree that the course not only contributes to the quality of experiments and to the welfare of animals, but also to a decrease in the number of animals used in experiments.

Animal Use Alternatives↗

PubMed2006

From stratospheric ozone to climate change: historical perspective on precaution and scientific responsibility.

The issue of the impact of human activities on the stratospheric ozone layer emerged in the early 1970s. But international regulations to mitigate the most serious effects were not adopted until the mid-1980s. This case holds lessons for addressing more complex environmental problems. Concepts that should inform discussion include 'latency,' 'counter-factual scenario based on the Precautionary Principle,' 'inter-generational burden sharing,' and 'estimating global costs under factual and counter-factual regulatory scenarios.' Stringent regulations were adopted when large scientific uncertainty existed, and the environmental problem would have been prevented or more rapidly mitigated, at relatively modest incremental price, but for a time delay before more rigorous Precautionary measures were implemented. Will history repeat itself in the case of climate change?

Air Pollutants↗

PubMed1990

Population and poverty in dependent states: Latin America considered.

"Malthusians maintain that rapid population growth aggravates poverty, while Marxists contend that social formations determine its nature and extent. Each perspective is incomplete, however, since it ignores the insights of the other. Latin American states, characterized by dependent capitalism formations and dominated by ruling elites, are generally incapable of solving the problems of population and poverty. Since population growth under dependent capitalism weakens labor's bargaining position against capital, reduced population growth is emphasized as a labor empowerment strategy the poor can implement on their own to improve their socioeconomic conditions."

Communism↗

PubMed2001

Evaluation of implementation and effect of primary school based intervention to reduce risk factors for obesity.

OBJECTIVES: To implement a school based health promotion programme aimed at reducing risk factors for obesity and to evaluate the implementation process and its effect on the school. DESIGN: Data from 10 schools participating in a group randomised controlled crossover trial were pooled and analysed. SETTING: 10 primary schools in Leeds. PARTICIPANTS: 634 children (350 boys and 284 girls) aged 7-11 years. MAIN OUTCOME MEASURES: Response rates to questionnaires, teachers' evaluation of training and input, success of school action plans, content of school meals, and children's knowledge of healthy living and self reported behaviour. RESULTS: All 10 schools participated throughout the study. 76 (89%) of the action points determined by schools in their school action plans were achieved, along with positive changes in school meals. A high level of support for nutrition education and promotion of physical activity was expressed by both teachers and parents. 410 (64%) parents responded to the questionnaire concerning changes they would like to see implemented in school. 19 out of 20 teachers attended the training, and all reported satisfaction with the training, resources, and support. Intervention children showed a higher score for knowledge, attitudes, and self reported behaviour for healthy eating and physical activity. CONCLUSION: This programme was successfully implemented and produced changes at school level that tackled risk factors for obesity.

Child↗

PubMed1997

Making borders stick: population transfer and resettlement in the Trans-Curzon territories, 1944-1949.

"Designed in 1919-20 by the British mediator Lord Curzon as an armistice proposal between the then warring powers Poland and Soviet Russia, the Curzon Line served to identify the maximum territorial reach of Soviet political influence in Europe....[The author discusses] a program of resettlement which would target communities on both sides of the new border, a policy eventually affecting some 1.4 million individuals...." The implementation and impact of this population exchange are described.

Demography↗