Second-order interactions included 'transfusion by institution' effects in trauma (P = 0.021) and postoperative (P = 0.0005) patients.
However, the quality-of-institution effect is unlikely to fully explain the findings of this study for at least two reasons.
Separating this quality-of-institution effect from that of bias induced by pressures to publish is difficult, because the two factors are strictly linked: the best universities are also the most competitive, and thus presumably the ones where pressures to produce are highest.
Three comparative dimensions are handled simultaneously: the resident effect, the institution effect, and the country effect.
A very significant institution effect (P < 0.0001) persisted even after multivariate adjustments for age and for APACHE II score, and within four diagnostic categories (cardiovascular disease, respiratory failure, major surgery and trauma; P < 0.0001).
A very significant institution effect (P < 0.0001) persisted even after multivariate adjustments for age, APACHE II score and within four diagnostic categories (cardiovascular disease, respiratory failure, major surgery and trauma) (P < 0.0001).
It is important to note that in Dobbin et al. [ 20] these samples were shown to be comparable because the variability in gene expression values can be attributed more to the biology of the samples than to the institution effect.
The fractional polynomial model for transfusion-associated probability of death, adjusting for any institution effect, is shown in Figure 2. The open dots above and below the fitted line (deviance residuals) represent patients who died (above) and survived (below).
Crusaders against widespread alcoholism (as acute a problem in 1910 as the opioid epidemic is today) advanced to the folly of Prohibition, which created a set of organized-crime institutions whose effects have scarcely just passed.
Contemporary moral theology must confront a variety of problems, including the scope of individual responsibility in large corporate institutions, the effects of human activities on the natural environment, the demands of social justice, the developments in genetics and other biological sciences, and the use of sophisticated technology in warfare.
