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SPRI is dedicated to quality scientific research. Our investigators are continuously developing new programs in the fields of occupational and environmental health, bioethics and civil governance.

At SPRI, collaboration is an organizational value. For every project we work hard to bring together chemists, engineers, epidemiologists, medical sociologists, economists, biostatisticians, clinicians, survey methodologists, and policy experts in order facilitate quality research.

Alcohol is Strongly Associated with Lower Mortality Following an Injury (Manuscript)
The primary finding from this retrospective analysis of a registry including all patients treated for traumatic injuries in level 1 and 2 trauma units in Illinois between 1995 and 2009 is a substantial inverse relationship between in-hospital mortality and blood alcohol concentration. The study includes all patients with blood alcohol toxicological examination levels ranging from below the detectable limit to 500 mg/dl (N=190,612). The reduction in case fatality rates was substantial – up to 50% decline. The strength of the association, the observed dose-response relationship, and the consistency of the findings across the various multivariable models indicate that blood alcohol concentration is associated with a reduction in in-hospital mortality among those that survive long enough to receive treatment in specialized trauma units.

Severe Physical Abuse of the Elderly (Manuscript)
This is the first clinical case-control study detailing clinical outcomes and evaluating risk factors of elderly persons suffering severe physical abuse. We observed that victims of severe traumatic elder abuse were more likely to be female, suffer from a neurological or mental disorder, and drug and/or alcohol abuse. The victims of abuse were assaulted by a wide array of weapons and predominately suffered injuries to the head and torso suggesting an intent to kill -- not injure. Elderly victims of physical abuse suffer more severe injuries than their non-abused counterparts. All the key measures of injury severity—length of hospital stay, treatment in an ICU, assisted breathing, ISS scores, in-hospital case fatality rates – were higher in the cases. These measures of severity are associated with long-term adverse outcomes. In addition, many of the victims returned to the environment in which the abuse occurred and were more likely to die during the first year following the index hospitalization.

Raised Speed Limits on U.S. Roads Result in Higher Road Fatalities (Manuscript)
We estimate that between 1995 and 2005, approximately 12,500 people died as a result of repealing the National Maximum Speed Law. In the 10 states that essentially did not change their posted speed limits, we observed a substantial decline in fatalities and injuries in fatal crashes. Therefore, had the other states not raised their speed limits we expect that similar declines would have been observed. In our study we control for differences between the states, vehicle miles traveled, congestion, and posted speed limits. The repeal of the National Maximum Speed Law is an example of a policy that can have a direct life or death impact on its citizens. Our study clearly shows that policy can directly result in more deaths. The inverse is true as well -- a well guided policy can lead to reduction in deaths on roads.

The Impact of OSHA Recordkeeping Regulation Changes on Occupational Injury And Illness Trends(Manuscript)
The Survey of Occupational Injuries and Illnesses (SOII), based on OSHA logs, indicates that occupational injuries and illnesses in the U.S. have steadily declined by 35.8% between 1992-2003. However, major changes to the OSHA recordkeeping standard occurred in 1995 and 2001. A recent study we published illustrates that the steep decline in reported occupational injuries and illnesses during the past 10 years in the U.S. workforce is an artifact resulting from changes to the recordkeeping rules and regulations rather than an improvement in workplace safety. (Brief Summary)

Conflicts of Interest in Biomedical Research (Manuscript)
We investigate the issue of conflicts of interest (COI) among researchers whose studies have been published in JAMA and NEJM. We found that 32.6% of manuscripts published in these two flagship journals had one or more author with COI. Authors with conflicts of interest were more likely to present positive findings. This relationship was noted for studies investigating drug therapies as well as other non-pharmeceutical interventions.

Commercialization of Peer-Review Journals (Manuscript)
Research from the business sector have shown that journals increase readership in order to entice new media buyers. As advertising revenue begins to represent a larger share of the overall corporate revenue, journals become more dependent on reader opinion and media buyer money. We found evidence this business model applies to two flagship peer-review journals: JAMA and NEJM.
Both journals are dominated by advertising and focus on topics preferred by their readers. The findings indicate that financial considerations may play a significant role in the determination of content of these journals. A manuscript acceptance process based on revenue goals may lead to a distortion of the prioritization of content and loss of editorial control of the journal. Because NEJM and JAMA are frequently cited by the lay press, the national health agenda may be biased towards the issues these journals choose to publish.


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