Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Empirical Approach”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed1993

Is health care different? Popular support of federal health and social policies.

Over the past several years there has been a striking increase in policy-makers' attention to health care reform. This paper explores whether there has been a corresponding shift in popular attitudes and identifies factors that may have changed these attitudes. The first part of the analysis relies on survey data collected between 1975 and 1989 to estimate a set of regression models, relating support for federal involvement in health care, antipoverty programs, and general domestic policies to a set of sociodemographic characteristics.... The second part of this study explores motivations that might account for these patterns. We identify a half dozen ways in which health care may be viewed as "different," that is, more or less appropriate for federal action. Analysis of survey data from 1987 suggests that there are relatively small differences in the attitudes and perceptions that motivate support for federal health initiatives, relative to federal domestic policies in general. However, there are more striking differences between health programs and more overtly redistributive policies.... We suggest that the growing support for federal intervention in health care, relative to other social policies, is in part an inadvertent by-product of ideological positions popularized during the Reagan and Bush administrations. We draw from these results some predictions about the course of the ongoing debate over federal health policies.

Altruism↗
PubMedDate not supplied

Translating a nonlinear systems theory model for homeopathy into empirical tests.

Various investigators have proposed that nonlinear systems theory, notably chaos and complexity theory, provides a heuristically useful modelfor conceptualizing the way in which complementary and alternative medicine therapies, which purport to modify subtle energies, effect change throughout the individual as a whole. In this paper we apply this theory to classical homeopathy and outline an empirical approach for testing the resultant hypotheses. Such research may advance understanding of the mechanisms of homeopathic remedy effects and provide a direction for homeopathic research that expands the previous emphasis on clinical trials and the remedies themselves. In refocusing attention on the dynamics of the patient as a nonlinear complex system, the proposed research program is consistent with the homeopathic emphasis on the individual rather than the disease. This approach may have additional applications that can elucidate similar effects of other energy medicine modalities (eg, acupuncture) on the healing process of the person as a unified whole.

Homeopathy↗
PubMed2002

[How do Hungarian family physicians think about Helicobacter pylori? Results of national survey].

UNLABELLED: INTRODUCTION, AIMS: In spring of 2000 a national survey was conducted on the diagnostic and therapeutic attitudes of Hungarian family practitioners concerning Helicobacter pylori. RESULTS: Based on responses, endoscopy, urea breath test and serology are easily available to 98, 42 and 48% of family practitioners respectively. Only 45% of responders performs Helicobacter pylori testing him/herself, while 82% prescribes eradication therapy without a gastroenterologist. In the second part of the questionnaire responders had to decide in 15 routine clinical cases, whether to perform Helicobacter pylori testing, and if so, whether to be satisfied with noninvasive testing or also to perform an endoscopy. Responses comply with international and Hungarian national recommendations, reflecting at the same time the uncertainties inherent in medical literature. Five responses of Hungarian family practitioners differed from the recommendations of literature. Two questions were related to screening Helicobacter pylori: in a complaint-free patient family practitioners are not inspired to perform a screening either in the case of familiarity of gastric cancer or in that of duodenal ulcer known from the individual case history. Helicobacter pylori testing is often superfluously suggested to young patients suffering from gastro-esophageal reflux disease. An empirical approach is revealed by the fact, that in cases of Helicobacter pylori positive duodenal ulcer, when eradication eliminates complaints, 41% of family practitioners would not test result of eradication. At the same time it is considered a mistake, that in case of young patients with a Helicobacter pylori positive gastric ulcer, being free of complaints after eradication, 66% of physicians refrains from endoscopic control. CONCLUSIONS: The possibilities, education, diagnostic and therapeutic skills as to diseases due to Helicobacter pylori of Hungarian family practitioners seems to be appropriate. In education emphasis should be primarily placed on screening and post-eradication tasks. Guidelines should be offered to family practitioners concerning controversary issues (gastro-esophageal reflux disease, dyspepsia, administration of non-steroid anti-inflammatory drugs).

Adult↗
PubMed2002

Coping with sexual harassment: reconceptualizing women's resistance.

This study explored the underlying structure of women's coping with sexual harassment from a rational-empirical approach. On the basis of multidimensional scaling, clustering, and confirmatory factor analysis across 8 data sets, 4 clusters of coping behaviors emerged, with little variance across the data sets. These clusters bear resemblance to Moos and colleagues' (C. J. Holahan, R. H. Moos, & J. A. Schaefer, 1996; R. Moos, 1992; R. H. Moos & J. A. Schaefer, 1993) distinction between coping strategies that differ in both method and foci. The four clusters that emerged are behavioral engagement, behavioral disengagement, cognitive engagement, and cognitive disengagement. This framework provides insight into the complex forms that women's coping with sexual harassment takes and has important legal implications.

Adaptation, Psychological↗
PubMed2002

[Intervention strategies in refractory heart failure].

Although the additional therapies with beta-blockers and spironolactone have recently proved to be significantly beneficial for the treatment of advanced heart failure, in the end stages of this disease the prognosis remains quite poor. Moreover, the quality of life of patients with advanced heart failure is still heavily influenced by symptoms and by a high rate of hospitalizations. In selected patients heart transplantation constitutes the only chance, but the low availability of donors limits a wider diffusion of this procedure. Mechanical left ventricular assistance is still considered a bridge to heart transplantation and, at present, technical reasons limit the long-term utilization of these devices. Xenotransplantation and regeneration of cardiac myocytes from bone marrow stem cells remain the greatest hopes for the future. Several other possibilities of offering broader opportunities to patients with end-stage heart failure are under investigation. The expectations regarding the antagonism of cytokines and endothelin were not confirmed by the recent results of several studies. The association between beta-blockers and non-adrenergic inotropes could have a rationale, but needs to be investigated with appropriate trials. Other surgical procedures, such as myocardial revascularization in case of severe ischemic left ventricular dysfunction or repair of severe secondary mitral regurgitation, represent surgical options the use of which may be more widespread, but their indications are still based on a rather empirical approach. The preliminary results of the electrical therapy of ventricular resynchronization are encouraging, but the selection of patients and the long-term advantages need to be defined further on. Moreover, advanced heart failure has a major impact on health costs and organization. This makes mandatory the definition of operative hospital- and home-care models, the use of which in clinical practice is to be proposed.

Heart Failure↗
PubMed2002

Ethics and incentives: an evaluation and development of stakeholder theory in the health care industry.

This paper utilizes a qualitative case study of the health care industry and a recent legal case to demonstrate that stakeholder theory's focus on ethics, without recognition of the effects of incentives, severely limits the theory's ability to provide managerial direction and explain managerial behavior. While ethics provide a basis for stakeholder prioritization, incentives influence whether managerial action is consistent with that prioritization. Our health care examples highlight this and other limitations of stakeholder theory and demonstrate the explanatory and directive power added by the inclusion of the interactive effects of ethics and incentives in stakeholder ordering.

Administrative Personnel↗
PubMed2003

Prevention of odour emergence in sewage networks.

Through increasing central development and through the decrease of specific wastewater production, wastewater systems are more and more prone to odour and corrosion problems. Hydrogen sulphide is produced, particularly in anaerobic flow stretches, which will then escape at turbulent places because of change in the flow direction and create odour harassment. Of particular importance in this respect are the transferring shafts after rising mains. The empirical approaches used for the estimation of the assumed sulphide concentrations yield considerable differences in the calculation and must therefore be used with care. This report presents a methodology for the co-ordination of odour- and corrosion-reducing measures which also includes the area of complaint management. It is crucially important to fine-tune the necessary measures (for instance the application of operational or chemical/biological methods) to the specific frame conditions. The practical comparison of the additional dosage of external water, iron and nitrate served to test the efficiency of these methods. The dosage of iron and nitrate led to considerable reductions in H2S content at the transferring shaft. The online measurement of the spectral adsorption coefficient (SAC) could become one control parameter for saving chemicals. It should be pointed out that it is necessary to consider the relevant measures and effects of odour and corrosion production during the planning stage--from the creation of the development plan of cities and communities. Through the selection of the wastewater disposal method to the planning of details. Moreover, the relevant financial means for these measures must be included in the economic plan.

Corrosion↗
PubMed1992

Central nervous system opportunistic infections in HIV disease: clinical aspects.

Nervous system opportunistic infections are seen in about one fifth of AIDS cases and account for over 40% of the patients with neurological manifestations. Serious infections are seen in severely immunosuppressed patients, usually with CD4 counts of 200 ml-1 or less. The commonest is CMV, which can produce acute encephalitis, sometimes with focal hemisphere or brain-stem signs, dementia, retinitis, optic neuritis and an ascending radiculomyeloencephalitis. Cryptococcal meningitis is the most frequent fungal disease; a high degree of clinical suspicion is required in patients with fever, malaise, headache or seizures. Only CSF cultures are always positive; both serum and CSF cryptococcal antigen tests are highly sensitive and specific. Treatment with amphotericin B and flucytosine is successful in at least 70% of first episodes but side-effects are common. Without maintenance therapy 50% of patients relapse; fluconazole is recommended. Cerebral toxoplasmosis can present with focal cerebral or spinal cord signs but also as a diffuse encephalopathy; negative T. gondii serology is exceptional but positive serum titres are usually unhelpful. Treatment with sulfadiazine, pyrimethamine and folinic acid achieves good results in 90% of the first episodes, but side-effects are common. Appearances on CT scan or MRI may take several weeks to improve. The value of an empirical approach to treatment is well-established; an initial cerebral biopsy is difficult to justify. Without maintenance therapy a relapse rate of 50% can be expected; therapy with sulfadiazine and pyrimethamine may also prevent pneumocystosis. HIV disease appears to increase the likelihood of neurosyphilis, and the risk of relapse after conventional penicillin doses, in patients with syphilis; at least 3-4 weeks of appropriate therapy are recommended. A number of other diseases caused by viruses, fungi, bacteria and parasites are less common; these include progressive multifocal leukoencephalopathy, herpes simplex and zoster infections and tuberculosis.

AIDS-Related Opportunistic Infections↗
PubMed1957

Progress in physiological studies of insecticide resistance.

This study deals first with the progress recently made in investigations on the mode of toxic insecticidal action of DDT, lindane and other chlorinated hydrocarbons, pyrethrins and related chemicals, and organo-phosphates, and secondly with resistance mechanisms to the same insecticides.The author feels that, although good progress is being made towards understanding the physiological mechanisms of resistance, the gaps in present knowledge, the types of insecticide to which resistance is developing, and the number of medically important species involved lead inevitably to the conclusion that the general outlook for insect control is deteriorating. He considers that what is now needed is not so much continuation of the present empirical approach to the problem of resistance as intensification of basic studies of the biology, ecology and physiology of the insect species concerned to provide a foundation for more rational alternative control measures.

Insect Control↗
PubMed2003

Management of gastroesophageal reflux disease.

The primary treatment goals in patients with gastroesophageal reflux disease are relief of symptoms, prevention of symptom relapse, healing of erosive esophagitis, and prevention of complications of esophagitis. In patients with reflux esophagitis, treatment is directed at acid suppression through the use of lifestyle modifications (e.g., elevating the head of the bed, modifying the size and composition of meals) and pharmacologic agents (a histamine H2-receptor antagonist [H2RA] taken on demand or a proton pump inhibitor IPPI] taken 30 to 60 minutes before the first meal of the day). The preferred empiric approach is step-up therapy (treat initially with an H2RA for eight weeks; if symptoms do not improve, change to a PPI) or step-down therapy (treat initially with a PPI; then titrate to the lowest effective medication type and dosage). In patients with erosive esophagitis identified on endoscopy, a PPI is the initial treatment of choice. Diagnostic testing should be reserved for patients who exhibit warning signs (i.e., weight loss, dysphagia, gastrointestinal bleeding) and patients who are at risk for complications of esophagitis (i.e., esophageal stricture formation, Barrett's esophagus, adenocarcinoma). Antireflux surgery, including open and laparoscopic versions of Nissen fundoplication, is an alternative treatment in patients who have chronic reflux with recalcitrant symptoms. Newer endoscopic modalities, including the Stretta and endocinch procedures, are less invasive and have fewer complications than antireflux surgery, but response rates are lower.

Antacids↗
PubMedDate not supplied

[Strongyloidiasis im Moscow region].

The paper presents two cases of infection with Strongyloides stercoralis (in a 13-year-old boy and in a 93-year-old female), occurred in the Moscow Region, which is indicative of the resurgence of stronglyoidiasis in the Moscow Region. Although the likelihood of this infection in this region is little, nevertheless, strongyloidiasis should be borne in mind in examining patients who are not leaving for well-known endemic areas if they have an allergic reaction of unclear etiology, eosinophilia, and digestive disorders. In these cases, the syndromic-and-empiric approach to justifying and performing chemotherapy is recommended due to the inadequate efficiency of parasitological methods for diagnosing strongyloidiasis at the low rate of invasion. These cases are indicative of the rather low virulence of Moscow strains, but at the same time of their capacity for autoinvasion and accordingly for the long-term infection of patients without recurrent infections.

Adolescent↗
PubMedDate not supplied

The functional neuroanatomy of autism.

Autism is a neurodevelopmental syndrome characterized by impaired social and executive functions. Functional magnetic resonance imaging (fMRI) is a non-invasive technique that allows investigation of the neural networks underlying cognitive impairments in autism. In this article, brain imaging studies investigating the functional brain anatomy of autism are reviewed. Face recognition, theory of mind and executive functions have all been explored in functional neuroimaging studies involving autistic patients. The available literature suggests an involvement of abnormal functional mechanisms in face recognition, mentalization and executive functions in adults with high-functioning autism or Asperger's syndrome, possibly due to brain maturation abnormalities, and resulting in dysfunctional reciprocal cortico-subcortical connections. Future functional neuroimaging research should investigate subgroups of autistic children and adolescents longitudinally and attempt to integrate genetic, cognitive and empirical approaches. Such studies will be instrumental in furthering understanding of the pathophysiology of autism and in exploring the importance of dimensional measures of the broader phenotype currently defined as autism.

Adolescent↗