RAND Corporation

About: RAND Corporation is a nonprofit organization based out in Santa Monica, California, United States. It is known for research contribution in the topics: Health care & Population. The organization has 9602 authors who have published 18570 publications receiving 744658 citations.

Does inappropriate use explain geographic variations in the use of health care services? A study of three procedures.

Abstract: We studied the appropriateness of use of coronary angiography, carotid endarterectomy, and upper gastrointestinal tract endoscopy and its relationship to geographic variations in the rates of use of these procedures. We selected geographic areas of high, average, and low use of these procedures and randomly sampled Medicare beneficiaries who had received one of the procedures in 1981. We determined the indications for the procedures using a detailed review of medical records and used previously developed ratings of appropriateness to assign an appropriateness score to each case. Differences among sites in levels of appropriateness were small. For example, in the high-use site for coronary angiography, 72% of the procedures were appropriate, compared with 81% in the low-use site. Coronary angiography was performed 2.3 times as frequently in the high-use site compared with the low-use site. Under the conditions of this study, we did find significant levels of inappropriate use:17% of cases for coronary angiography, 32% for carotid endarterectomy, and 17% for upper gastrointestinal tract endoscopy. We conclude that differences in appropriateness cannot explain geographic variations in the use of these procedures. (JAMA1987;258:2533-2537)

A short-form measure of loneliness.

Abstract: The revised UCLA Loneliness Scale (ULS-20) and a four-item short form (ULS-4) are widely used in personality research (Russell, Peplau, & Cutrona, 1980). In an exploratory factor analysis of the ULS-20, we identified eight items that loaded substantially on the first factor. These items were combined to form an alternative short-form measure, the ULS-8. The results of this study indicate that the ULS-8 is reliable, valid, and a better substitute for the ULS-20 than is the ULS-4. Consistent with the previous research, the loneliness measures (ULS-20, ULS-8, ULS-4) were strongly related to socially undesirable personality characteristics, but loneliness was uncorrelated with the six different health-related behaviors (exercise, meal regularity, alcohol use, hard drug use, smoking, and hours of sleep) assessed in this study.

Acculturation and lifetime prevalence of psychiatric disorders among Mexican Americans in Los Angeles.

Abstract: La prevalence (au cours de l'existence) de trois entites morbides psychiatriques definies par le DSMIII a ete etudiee comme fonction du niveau d'acculturation et du lieu de naissance (Mexique ou USA) dans un vaste echantillon d'adultes americano-mexicains vivant a Los Angeles. On a trouve qu'un degre eleve d'acculturation etait associe a des taux plus hauts de phobie, d'alcoolisme et d'abus de drogues (dans l'anamnese)...

Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea: A Systematic Review and Meta-analysis

Abstract: Context Probiotics are live microorganisms intended to confer a health benefit when consumed. One condition for which probiotics have been advocated is the diarrhea that is a common adverse effect of antibiotic use. Objective To evaluate the evidence for probiotic use in the prevention and treatment of antibiotic-associated diarrhea (AAD). Data Sources Twelve electronic databases were searched (DARE, Cochrane Library of Systematic Reviews, CENTRAL, PubMed, EMBASE, CINAHL, AMED, MANTIS, TOXLINE, ToxFILE, NTIS, and AGRICOLA) and references of included studies and reviews were screened from database inception to February 2012, without language restriction. Study Selection Two independent reviewers identified parallel randomized controlled trials (RCTs) of probiotics (Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, and/or Bacillus) for the prevention or treatment of AAD. Data Extraction Two independent reviewers extracted the data and assessed trial quality. Results A total of 82 RCTs met inclusion criteria. The majority used Lactobacillus -based interventions alone or in combination with other genera; strains were poorly documented. The pooled relative risk in a DerSimonian-Laird random-effects meta-analysis of 63 RCTs, which included 11 811 participants, indicated a statistically significant association of probiotic administration with reduction in AAD (relative risk, 0.58; 95% CI, 0.50 to 0.68; P 2 , 54%; [risk difference, −0.07; 95% CI, −0.10 to −0.05], [number needed to treat, 13; 95% CI, 10.3 to 19.1]) in trials reporting on the number of patients with AAD. This result was relatively insensitive to numerous subgroup analyses. However, there exists significant heterogeneity in pooled results and the evidence is insufficient to determine whether this association varies systematically by population, antibiotic characteristic, or probiotic preparation. Conclusions The pooled evidence suggests that probiotics are associated with a reduction in AAD. More research is needed to determine which probiotics are associated with the greatest efficacy and for which patients receiving which specific antibiotics.

The next 700 programming languages

Abstract: A family of unimplemented computing languages is described that is intended to span differences of application area by a unified framework. This framework dictates the rules about the uses of user-coined names, and the conventions about characterizing functional relationships. Within this framework the design of a specific language splits into two independent parts. One is the choice of written appearances of programs (or more generally, their physical representation). The other is the choice of the abstract entities (such as numbers, character-strings, list of them, functional relations among them) that can be referred to in the language.The system is biased towards “expressions” rather than “statements.” It includes a nonprocedural (purely functional) subsystem that aims to expand the class of users' needs that can be met by a single print-instruction, without sacrificing the important properties that make conventional right-hand-side expressions easy to construct and understand.