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PubMed2000

Regression analysis of correlated binary outcomes.

The purpose of this paper is to describe and illustrate a regression approach to the analysis of correlated binary outcomes (Liang & Zeger, 1986). Ignoring the correlations between repeated observations can lead to invalid inferences. This approach extends logistic regression to account for repeated observations in each of a series of individuals. In this paper, I present a nontechnical introduction to the generalized estimating equations (GEE) approach. A fictitious example is used to demonstrate that GEE regression correctly adjusts for the correlations between repeated binary observations. The approach is illustrated with an analysis of safer sex practices among high-risk teenagers.

Adolescent↗
PubMed1984

An analysis of the relationship of seven selected variables to State Board Test Pool Examination performance of the University of Tennessee, Knoxville, College of Nursing.

The study was designed to determine whether any one of seven selected variables or a combination of the variables is predictive of performance on the State Board Test Pool Examination. The selected variables studied were: high school grade point average (HSGPA), The University of Tennessee, Knoxville, College of Nursing grade point average (GPA), and American College Test Assessment (ACT) standard scores (English, ENG; mathematics, MA; social studies, SS; natural sciences, NSC; composite, COMP). Data utilized were from graduates of the baccalaureate program of The University of Tennessee, Knoxville, College of Nursing from 1974 through 1979. The sample of 322 was selected from a total population of 572. The Statistical Analysis System (SAS) was designed to accomplish analysis of the predictive relationship of each of the seven selected variables to State Board Test Pool Examination performance (result of pass or fail), a stepwise discriminant analysis was designed for determining the predictive relationship of the strongest combination of the independent variables to overall State Board Test Pool Examination performance (result of pass or fail), and stepwise multiple regression analysis was designed to determine the strongest predictive combination of selected variables for each of the five subexams of the State Board Test Pool Examination. The selected variables were each found to be predictive of SBTPE performance (result of pass or fail). The strongest combination for predicting SBTPE performance (result of pass or fail) was found to be GPA, MA, and NSC.

Education, Nursing, Baccalaureate↗
PubMed1985

Program planning in the Office of Technology Assessment's Health Program.

This paper describes the Congressional Office of Technology Assessment's Health Program and the role that its process of program planning has played in the selection of studies and the allocation of Program resources. It discusses the primary areas in which studies have been conducted--assessment methods, specific technologies, environmental health, information technologies, and financing/structural aspects of health care--and examines the changes in relative emphasis placed on the areas over time and the factors that lead to changed emphasis. Internal factors--e.g., judgments of whether a topic is of national importance, fiscal and staff resources available, and whether the issue is appropriate for OTA--and thus program planning have played their strongest role in the areas of assessment methods and of specific technologies. Activities in the financing/structural areas and some types of studies in the environmental health areas are being driven more by external factors--e.g., expressed needs of Congress, availability of data, and developments in science and technology.

Government Agencies↗
PubMed2001

[The most frequently cited publications of Czech pharmacologists].

The most cited articles of 100 Czech pharmacologists were determined by analysis of data given in the Science Citation Index in "Web of Science". Ten most cited articles were selected according to the total number of citations till October 2000, the total number of citations during 1980-2000 and the number of citations per year during 1980-2000. The most cited articles found by this analysis represent well the significant part of research orientation of Czech pharmacologists and their major scientific contributions during the 1960s-1990s. Problems with application of citation-analysis to evaluation of research are discussed.

Bibliometrics↗
PubMed2001

[New and emerging rickettsial and bartonella infections].

There have been recently reports on over 10 new and resurgent rickettsioses and bartonelloses in different countries, which reflects both socioeconomic processes in society and a higher methodological level of indication and identification of causative agents. In 1991, the author' laboratory, N. F. Gamaleya Research Institute of Experimental Medicine, Russian Academy of Medical Sciences, established the etiology of the new rickettsiosis Astrakhan spotted fever. It separated and studied 2 strains of Rickettsia sp. nov. from patients and 8 ones from the carrier the Ixodes tick Rhipicephalus pumilio. It is suggested that the natural focus has transformed to the anthropurgic one due to technogenic environmental pollution. The annual increase in morbidity rates (2000 cases in 1983 to 2000) and its area are a challenge to public health care and medical science. The paper presents data on the new bartonellosis cat-scratch disease (caused by Bartonella henselae) detected not only in Russia. There is also information on tick-borne rickettsiosis, epidemic typhus, and trench fever as resurgent infections.

Bartonella↗
PubMed1964

KWIC. IS IT QUICK?

In recent months several widely circulated publications have exploited the concept of key-word-in-context (KWIC) indexing. Indexes prepared through KWIC techniques are based entirely on the permuted titles of material to be analyzed and are produced at high speed with the aid of electronic computers. KWIC indexes appear to have been received with approval by scientists, whereas many librarians regard them with misgivings and are concerned about the discontinuance of certain earlier conventional subject indexes. This paper presents some of the difficulties encountered by reference librarians who have used KWIC indexes in the course of their work. A simple exercise is described which tests the speed with which a KWIC and two other indexes lead to the solution of selected reference problems. KWIC proved to be a tool which led quickly to the desired information.

Abstracting and Indexing↗
PubMed2003

Clinical research databases: getting from current state to best practice.

Clinical research databases reside at the foundation of health sciences, yet experts outside of information science often manage research data. Improper data management presents risks to the researcher, research community, research subjects, and other patients. Data management must aim to preserve or maximize the value of data. We created a checklist tool for researchers and/or data administrators to use when evaluating their database operations. The tool addresses both liabilities and the value of the data.

Biomedical Research↗
PubMed2004

Mechanisms of injury in operative brachial plexus lesions.

OBJECT: The authors focus on injury mechanisms involved in 1019 operative brachial plexus injuries (BPIs) managed between 1968 and 1998 at Louisiana State University Health Sciences Center (LSUHSC). METHODS: Data regarding these mechanisms of injury were obtained via retrospective chart reviews of patients who had undergone operations at LSUHSC. Five main mechanisms of injury to the brachial plexus occurred in the series. These included 509 stretch/contusion injuries (49%) with four patterns of presentation in 366 patients: 208 C5-T1 nerve injuries; 75 C5-7, 55 C5-6 injuries; and 28 involving the C8-T1 or C7-T1 nerves. Stretch/contusion injury was followed in frequency by gunshot wound (GSW), resulting in 118 injuries (12%). Most of the 293 involved plexus elements had some gross continuity when surgically exposed. Seventy-one lacerations involved the brachial plexus (7%), including 83 sharp lacerations caused by knives or glass; 61 blunt transections due to automobile metal, fan, and motor blades, chain saws, or animal bites. Nontraumatic BPIs included 160 cases of thoracic outlet syndrome or 16% of the total of 1019 BPIs. There were 161 tumors (16%) of neural sheath origin including 55 solitary neurofibromas (34%), 32 neurofibromas associated with von Recklinghausen disease (20%), 54 schwannomas (34%), and 20 malignant nerve sheath tumors (20%) removed. Obstetrical BPI was not included in the original series; however, the current literature is reviewed in this paper. CONCLUSIONS: The conclusion of this study is that the brachial plexus can be injured by multiple mechanisms of which stretch/contusion injury is the most frequently encountered, followed by GSWs.

Anastomosis, Surgical↗
PubMed2005

Measuring information technology investment among Canadian academic health sciences centres.

Many recent studies have attempted to accurately measure the expenditure by hospitals in the area of new information technology (IT), for example see Leonard 1998 and Pink et al. 2001. This is usually done as an exercise to compare the healthcare sector with other industries that have had much more success in implementing and leveraging their IT investment (Willcocks 1992; Chan 2000). It is normally hoped that such investigation would help explain some of the differences among the various industries and provide insight into where (and how much) future IT spending should occur in healthcare (Leonard 2004). Herein, we present the results from a study of eight Canadian academic health sciences centres that contributed data in order to analyze the amount of information technology spending in their organizations. Specifically, we focus on one specific indicator: the IT spend ratio. This ratio is defined as the percentage of total IT net costs to total hospital net operating costs, and aims to provide a "relative (or percentage) measure of spending" so as to make the comparisons meaningful. One such comparison shows that hospitals spend only 55% of the amount the financial services sector spends.

Academic Medical Centers↗
PubMed2005

The importance of thin layer chromatography and UV microspectrophotometry in the analysis of reactive dyes released from wool and cotton fibers.

Samples of reactively-dyed wool and cotton were obtained from a range of dye manufacturers, dye distributors and the Forensic Science Service (FSS) Fibre Data Collection. The wool fibers were red in color and had previously been compared using comparison microscopy (CM), visible range microspectrophotometry (VS) and thin layer chromatography (TLC). The cotton fibers were blue and black in color and had not been previously compared. Red, blue and black fibers were chosen because they are often encountered in casework. The usage of reactive dyes to color fibers has increased over the last 10-15 years and these are often seen in casework. Before techniques were available that allowed reactively-dyed fibers to be compared using TLC only CM and microspectrophotometry were routinely carried out. Many laboratories, who had a microspectrophotometer, only had a visible range instrument. It was therefore important to see which techniques provide additional information, that gives greater individuality to fibers, to that obtained from CM. The color was released from the wool and cotton fibres using alkaline hydrolysis and a cellulase enzyme respectively. Many of the red wool samples were differentiated from each other using CM. More differentiation was found using VS and even more when ultraviolet range microspectrophotometry (UV) or TLC was used. Two samples could only be differentiated using TLC because CM, VS and UV failed to separate them. The black cotton samples were predominately differentiated using CM but VS allowed for further differentiation. With the samples used in this project UV and TLC failed to separate the samples further. The blue cotton samples benefited from the use of CM, VS and either UV or TLC to reduce the number of matching pairs. All techniques aided differentiation although with this set TLC and UV proved to be complementary techniques. Results demonstrate that TLC and UV both yield important information over and above that obtained from CM and VS. Although in some parts of the project TLC and UV are complementary if the concentration of the dye in the fiber is not sufficient for TLC or the scientist doesn't wish to 'destroy' the fiber UV would be of more use than TLC.

Journal Article↗
PubMed2005

Polish Registry of Congenital Malformations - aims and organization of the registry monitoring 300 000 births a year.

In 1997, the Polish Registry of Congenital Malformations (PRCM) was established, to fulfil epidemiological, prophylactic, socioeconomic and scientific functions. The PRCM is a population-based registry monitoring currently about 300 000 births a year in 13 provinces. Such a large area and population require a special organizational structure of the Registry. The PRCM Central Working Group and the computer database are located in the Department of Medical Genetics, University of Medical Sciences, Poznań. Here the data are collected, validated, encoded according to the ICD-10, and analysed. Provincial Working Groups are responsible for supervision of data collection in the given province. The PRCM staff has grown from about 250 members in 1997 to more than 400 members today. The PRCM collects information on structural defects diagnosed before the end of the second year of life. Minor anomalies are excluded from the registry. The main source of information is a registration form filled up by the physician diagnosing the anomaly. Since 2004 also electronic reporting has been possible. On 28 September 2005 there were 54 020 entries in the database concerning 33 729 children with at least one congenital malformation and 1261 control entries concerning children without malformations. The PRCM is also an important source of identification of families at genetic risk. Education of physicians and the community in the field of genetic counselling is also an important aim of the PRCM. Since 2001, the PRCM has been a member of the Eurocat. Detailed information on PRCM organization, electronic reporting, and results are available at the PRCM website (www.rejestrwad.pl).

Congenital Abnormalities↗
PubMedDate not supplied

Systematic review of the safety of trimethoprim-sulfamethoxazole for prophylaxis in HIV-infected pregnant women: implications for resource-limited settings.

Daily prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMZ) significantly decreases morbidity and mortality among people living with HIV. Some clinicians are reluctant to use TMP-SMZ in pregnant and breastfeeding HIV-infected women because of concerns about the possible teratogenicity when used in the first trimester and about its potential to induce hyperbilirubinemia near term and during early breastfeeding. We systematically reviewed evidence regarding the toxicity of TMP-SMZ prophylaxis in pregnant and breastfeeding women to help guide practice in resource-limited settings. We identified relevant literature by searching PubMed and MEDLINE via OVID, Embase, and Science Citation Index for data on hyperbilirubinemia, kernicterus, and teratogenicity associated with administration of sulfonamides and TMP-SMZ through July 2005. We also reviewed the reference lists of identified articles. Most studies demonstrated that TMP-SMZ was not associated with hyperbilirubinemia when administered to mothers during pregnancy and breastfeeding. No cases of kernicterus were reported in neonates after maternal ingestion of sulfonamides. There is mixed evidence linking ingestion of TMP-SMZ and other sulfonamides in early pregnancy to elevated risks of oral clefts, neural tube defects, and cardiovascular and urinary tract abnormalities, although some sources found that supplementation with folic acid might ameliorate this potential risk. Existing guidelines recommend that HIV-infected pregnant women receive prophylaxis, but they differ with regards to stage of disease at which to initiate treatment, need for CD4+ T-lymphocyte testing, and prophylaxis during the first trimester. Existing data indicate that the risk of serious injury to neonates from maternal use of daily TMP-SMZ prophylaxis during pregnancy and breastfeeding is small. Given the substantial benefits of TMP-SMZ prophylaxis for HIV-infected women living in resource-limited settings, this review indicates that it is safe to abide by the WHO guidelines recommending daily TMP-SMZ prophylaxis for HIV-infected pregnant women.

Abnormalities, Drug-Induced↗
PubMed1991

Prevention of stroke--a report from collaboration project between Zagreb and Barcelona.

Cerebrovascular disease (CVD) is the main killer in the modern society and the most frequent cause of death and disability. According to the experiences of highly developed Western countries, especially of the U.S.A., the incidence of stroke can be reduced by the development and introduction of preventive actions and change of life style. Incidence of cerebrovascular disease is high in Croatia as well as in Spain (46% in the 46-59 age range) with an increasing tendency in younger population. As prevention is the only way of CVD incidence reduction, it is indispensable to organize an integral preventive neurologic network. Within the W.H.O. project "Health for All by the Year 2000 and the project "Zagreb"--Healthy City" a preventive action under the slogan 'With perfect brain and veins--enjoy the healthy days', has been organized with the aim to reduce the incidence of stroke for 20% during the following 10-year period. A standardized work of preventive network in Zagreb has also been established in Barcelona as a joint work. Using the interdisciplinary counselling approach, medical teams are still making examinations. In Zagreb Center for Neurological Sciences and Brain Research, data of risk factor distributions and trends of stroke incidence changes have been collected and the results have been analyzed. The Zagreb Center has also become a center for continuous evaluation and further planning. In this article functions of preventive centers, the preventive standardized protocol and structural and functional preventive network are introduced. The results of preventive action in Zagreb are also briefly presented.

Aged↗
PubMedDate not supplied

Fracture mechanics principles applied to implant medical devices--a review.

Historically, the fatigue behavior of materials and structures, including biomaterials and implant devices, was analyzed using stress-life (S-N) techniques, i.e. by determining the number of cycles to failure at a calculated peak stress. The development of fracture mechanics technology has made the crack-growth aspect of fatigue analysis a more exact science, providing more precise data on the properties of materials, incorporating more geometric and metallurgical information from the structure, and, in some cases, providing for updated in-service lifetime predictions. Over the past decade, the medical implant industry and researchers have adopted this analytical tool to varying degrees. The result has been the development of some improved materials, operative procedures, and devices, based on a more exact knowledge of the properties most critical to assuring the long-term durability of devices. Examples of the application of fracture mechanics technology to orthopedic and cardiovascular devices and the potential for further applications are reviewed.

Biomechanical Phenomena↗
PubMed1987

Homicide by insulin administration.

This report describes a case of homicide by insulin administration and a study of the effects of storage conditions on insulin in serum. The study revealed insulin to be remarkably stable at refrigerator temperatures. Therefore, for forensic science purposes, insulin immunoassay data are interpretable even when serum is not stored by the standard laboratory method of freezing.

C-Peptide↗
PubMed1987

A comparison of three allied health manpower projection methodologies.

Three manpower projection methodologies most often employed in the allied health sciences were compared: population ratio, occupational matrix, and regression analysis. Comparisons were made among the methodologies themselves, their strengths, and their weaknesses. These methodologies were then applied to the largest allied health discipline - clinical laboratory sciences - using Kentucky statewide data. The resultant projections were then compared with actual data (F.J. Morris, PhD, unpublished data, 1985). The most appropriate methodology to be used by the administrator should be determined by his/her specific needs and goals in relation to the specific strengths and weaknesses of the individual methodology.

Allied Health Personnel↗