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PubMed2006

Phase-sensitive stimulated Raman adiabatic passage in dipolar extended lambda systems.

The authors investigate the possible phase-sensitive behavior of (multiphoton) stimulated Raman adiabatic passage population transfer in extended lambda systems, if more than one state of an anharmonic progression of target levels is accessible in transitions of different photonicities. They use a minimal model four-level system (4LS) with one initial state separated from two target states by an apex state. The parameters of the 4LS are adapted from the bend states of the HCN-HNC system. Using a dressed-state analysis within the rotating wave approximation (RWA), the authors identify phase-dependent diabatic transitions between the two dressed states contributing to the state vector as the mechanism leading to phase-sensitive target populations. The essential features giving rise to the phase dependence are found to be different (non-zero-) diagonal elements of the dipole matrix, i.e., permanent dipole moments, and the presence of a direct two-photon overtone coupling between the apex state and the lower target state which formally enters the RWA Hamiltonian upon inclusion of permanent dipole moments. Among the parameters controlling the extent of the effect are the anharmonic properties of the target progression and the absolute values of the field frequencies, so that in view of the requirement to tune the driving fields into the vicinity of resonance, details of the level structure are of importance. A comparative numerical study executed without invoking RWA shows that qualitatively there are similar trends in the appearance of phase sensitivity, although the effects are considerably more pronounced in the full treatment. In the full treatment the authors also explore off-resonance conditions and discuss the signatures of phase sensitivity in the target populations.

Journal Article↗
PubMed2000

The cost to providers of participating in an immunization registry.

INTRODUCTION: The medical and public health communities advocate immunization registries as one tool to achieve national immunization goals. Although substantial resources have been expended to establish registries across the nation, minimal research has been conducted to evaluate provider participation costs. METHODS: The objective of this study was to identify the direct costs to participate in an immunization registry. To estimate labor and equipment costs, we conducted interviews and direct observation at four sites that were participating in one of two immunization registries. We calculated mean data-entry times from direct observation of clinic personnel. RESULTS: The annual cost of participating in a registry varied extremely, ranging from $6083 to $24,246, with the annual cost per patient ranging from $0.65 to $7. 74. Annual per-patient costs were lowest in the site that used an automated data-entry interface. Of the sites requiring a separate data-entry step, costs were lowest for the site participating in the registry that provided more intensive training and had a higher proportion of the target population entered into the registry. CONCLUSIONS: Ease of registry interface, data-entry times, and target population coverage affect provider participation costs. Designing the registry to accept electronic transfers of records and to avoid duplicative data-entry tasks may decrease provider costs.

Ambulatory Care Facilities↗
PubMed1988

Cytolysis mediated by phagocytosing neutrophils. Influence of the presence of an alternative target cell population.

When added to the hypochlorous acid (HOCl)-dependent cytolytic system constituted of opsonized zymosan (OPZ)-triggered neutrophils and chicken erythrocyte (CRBC) targets, human erythrocytes (HRBCs) inhibited the lysis. The replacement of HRBCs with cells pretreated with amino-triazole (AT) to inactivate catalase prevented the HRBC inhibitory effect almost completely. HRBCs, pretreated with carmustine (BCNU) to inhibit glutathione cycle activity, behaved as untreated cells. Thus, HRBCs appear to protect CRBCs via an AT-inhibitable, i.e. catalase-dependent, process. When measured under conditions similar to those used for the lytic assay, both the hydrogen peroxide (H2O2) and the HOCl recovery from the neutrophil-CRBC system was reduced by HRBCs and restored by pulsing HRBCs with AT but not BCNU. The results suggest that HRBC catalase rescues CRBCs from neutrophil-delivered attack by "stealing" H2O2 from the neutrophil HOCl-generating myeloperoxidase (MPO)-H2O2 system.

Animals↗
PubMed1993

Psychogeriatric outreach to rural families: the Iowa and Virginia models.

Elderly residents of rural areas are at significant risk for mental health problems, yet have less access to mental health services. Thus, most mental health problems among rural elderly remain either undiagnosed or untreated. We describe two models of mental health outreach programs to rural elderly in Iowa and Virginia, serving demographically, culturally, and epidemiologically different populations in geographically and economically dissimilar regions. Programs are compared on the basis of initiation, community partnerships, target population, target region, clinical disciplines involved, coordinating discipline, referral sources, operational model, initial home assessment, care planning, sustainability, cost, patient demographics, and primary and secondary diagnosed. Outreach programs are argued to be effective models of delivering services to geographically and/or socially isolated elderly populations. The experiences of our programs, though limited to rural populations, may be of relevance to any outreach program attempting to serve elderly presenting with or at risk for mental health problems.

Aged↗
PubMed1997

A creative approach to HIV/AIDS programs for adolescents.

An empowerment-oriented approach is presented to effectively teach/inform youth about prevention of HIV/AIDS and sexually transmitted diseases. The article describes: an assessment of the target population and its results; steps to comprehensive peer education with this population; an action plan for mobilizing and linking resources for this population through social networks and community; and the importance of empowerment-oriented program evaluation. The target population are youth aged 12-18, housed in alternative settings such as residential child care facilities, psychiatric hospitals, or youth detention centers. This population is reliant upon residential programs for training and services, because they are unlikely to take part in school or other community-based programs.

Acquired Immunodeficiency Syndrome↗
PubMed1975

The use of an information system for community health services planning and management.

The challenge of delivering health care on a more cost-effective and equitable basis has led to the formation of new kinds of organizations, which in turn require new kinds of management information systems. The system described in this article is used for planning resource allocation and monitoring the overall performance of Livingston Community Health Services, Inc., a rural community-owned health service designed to provide comprehensive care to a geographically defined target population. The Health Services Data System processes information on performance and productivity, effectiveness with respect to the target population, and billing and financial activities. Input consists of the results of a community census and two household surveys, patient registrations and patient services operating data, and financial data. Besides billing patients automatically, the system integrates financial, demographic, and health services utilization data to generate monthly summaries for the administrators, medical director, and community board. The article discusses several examples of these summaries, stratifying utilization by geographic location of residence, age, income, and race.

Accounting↗
PubMed2004

Anthropometric changes in elite male water polo players: survey in 1980 and 1995.

AIM: To assess the differences in anthropometric parameters, body fat, body mass index (BMI), and body density induced by sport-specific morphological optimization (adaptation) between two generations (1980 and 1995) of male elite water polo players. METHODS: The survey included a total of 160 elite male water polo players, all members of the top clubs in Croatia. The 1980's generation consisted of 95 players (71.9% of target population) aged between 18 and 32 years, and the 1995's generation included 65 players (50% of target population) aged between 19 and 29 years. Trained and qualified anthropometrists performed the measurements under standardized experimental conditions and in accordance with the procedures described by the International Biological Program. They measured 23 anthropometric variables reflecting basic human body characteristics described by skeletal bone lengths (total leg length, total arm length, hand length, foot length, and height), breadths (hand at proximal phalanges, foot in metatarsal area, biacromial, biiliocristal, biepycondylar femur, biepycondyar humerus, and radio-ulnar wrist breadth), girths (chest, arm, forearm, thigh, and calf girth), skinfold thickness as a measure of subcutaneous adiposity (triceps, subscapular, axillary, calf, and abdominal skinfold thickness), and mass. Additionally, estimates of body mass index (BMI), body density, and percentage of body fat were calculated from the primary measures. RESULTS: Comparison between anthropometric measures of the two generations of water polo players revealed a positive trend in body skeletal measures and negative trend in body adiposity measures. Most noteworthy differences (d) were an increase in height (d=37.3 mm, p<or=0.001), decrease in estimated body fat (d=-1.65%, p<or=0.001) accompanied by higher body density (d=0.01, p<or=0.001), with no significant difference in body mass (d=-0.74 kg, p=0.518). CONCLUSION: Anthropometric characteristics of elite water polo players have changed over the analyzed 15 years. Body shape changed in terms of greater height and more elongated limbs, with thinner waist and broader shoulders. Body mass remained unchanged. Muscle-to-fat mass ratio increased. The observed changes may be a consequence of population secular trend and sport morphological adaptation (optimization).

Adolescent↗
PubMed1983

Epidemiologic characteristics of primary homicides in the United States.

Homicide is one of the five leading causes of death for all persons 1-44 years of age. Over half of the homicides occurring in 1979 did not involve the perpetration of another crime. The authors have defined these as primary homicides and suggest that these deaths require the formulation of public health and social services prevention strategies. An epidemiologic assessment of primary homicides in the United States for 1976 through 1979 showed the following. Sixty per cent of primary homicides were male victim/male offender events; 40% involved a female as a victim and/or as an offender. Three per cent of primary homicides were female victim/female offender events; 97% involved a male as a victim and/or as an offender. Primary homicides involving female victims or offenders were more frequently intrafamilial than those involving males, but rates of intrafamilial homicides by males were greater than those involving females. The preponderance of all primary homicides occurred between acquaintances, but the relationship between victim and offender varied with age, sex, and race. The weapons used varied with the victim's and offender's age, sex, and race, and with the relationship between victim and offender. Based on the described patterns, prevention measures should be divided into three broad areas: intrafamilial violence, extrafamilial violence, and male patterns of aggression. Key target populations for the first area include females, rural households, and the very young or very old. A key target population for the second area is teenage males.

Adolescent↗
PubMed1976

The swine-influenza decision.

We analyzed the economic aspects of mass immunization against swine-like influenza in 1976-1977, and have used the Delphi technic for estimating the likelihood and characteristics of an epidemic. If an epidemic occurs and no preventive efforts are made, total costs could exceed $6 billion for the whole population and $3 billion for those in the high-risk group. Expected net benefits from immunization vary with (1) the target population, (2) costs of vaccine administration and (3) vaccine acceptance rates. With an epidemic probability of 0.10 and with costs of purchasing and administering the vaccine each estimated at $0.50 per person in the target population, maximum net benefits cannot be obtained by an offer of vaccine to the entire population. Economic considerations do not require limitation of vaccination to high-risk groups. If the program is restricted to adults 25 years of age and over, and if acceptance rates exceed 59 per cent, the program is economically justifiable.

Adult↗
PubMed2004

The effects of plant extracts on microbial community structure in a rumen-simulating continuous-culture system as revealed by molecular profiling.

An in vitro study in dual-flow continuous-culture fermentors was conducted with two different concentrations of monensin, cinnamaldehyde or garlic extract added to 1:1 forage-to-concentrate diet in order to determine their effects on selected rumen bacterial populations. Samples were subjected to total DNA extraction, restriction analysis of PCR amplified parts of 16S rRNA genes (ARDRA) and subsequent analysis of the restriction profiles by lab-on-chip technology with the Agilent's Bioanalyser 2100. Eub338-BacPre primer pair was used to select for the bacteria from the genera Bacteroides, Porphyromonas and Prevotella, especially the latter representing the dominant Gram-negative bacterial population in the rumen. Preliminary results of HaeIII restriction analysis show that the effects of monensin, cinnamaldehyde and garlic extract on the BacPre targeted ruminal bacteria are somewhat different in regard to targeted populations and to the nature of the effect. Garlic extract was found to trigger the most intensive changes in the structure of the BacPre targeted population. Comparison of the in silico restriction analysis of BacPre sequences deposited in different DNA databanks and of the results of performed amplified ribosomal DNA restriction analysis showed differences between the predicted and obtained HaeIII restriction profiles, and suggested the presence of novel, still unknown Prevotella populations in studied samples.

Acrolein↗
PubMed1985

Methodological aspects of clinical trials in non-ulcer dyspepsia with special reference to selectional factors.

The sampling process preceding a clinical trial is associated with numerous fallacies. This is especially true in non-ulcer dyspepsia, which is a prevalent but poorly defined condition, probably with heterogenic etiologies. Therefore, in order to make subsequent inferences possible, it is crucial that rigorous criteria for adherence to the target population--and the studied sample--are established in advance. Several factors, however, preclude a strictly random sample from the target population. Firstly, only those who find their way to medical services are included in trials, and different circumstances may affect the patient's decision to seek medical advice. Secondly, the doctor's decision to refer a patient to a study is influenced by a number of factors that might introduce bias. As an example, an on-going study of non-ulcer dyspepsia is presented. With the application of strict symptomatic criteria, and the exclusion of circumscribed organic lesions of the upper gastrointestinal tract by means of endoscopy, it was possible to define a population in which very few additional pathological findings were made at thorough diagnostic work-up.

Clinical Trials as Topic↗
PubMed1999

Cultural sensitivity in public health: defined and demystified.

There is consensus that health promotion programs should be culturally sensitive (CS). Yet, despite the ubiquitous nature of CS within public health research and practice, there has been surprisingly little attention given to defining CS or delineating a framework for developing culturally sensitive programs and practitioners. This paper describes a model for understanding CS from a public health perspective; describes a process for applying this model in the development of health promotion and disease prevention interventions; and highlights research priorities. Cultural sensitivity is defined by two dimensions: surface and deep structures. Surface structure involves matching intervention materials and messages to observable, "superficial" characteristics of a target population. This may involve using people, places, language, music, food, locations, and clothing familiar to, and preferred by, the target audience. Surface structure refers to how well interventions fit within a specific culture. Deep structure involves incorporating the cultural, social, historical, environmental and psychological forces that influence the target health behavior in the proposed target population. Whereas surface structure generally increases the "receptivity" or "acceptance" of messages, deep structure conveys salience. Techniques, borrowed from social marketing and health communication theory, for developing culturally sensitive interventions are described. Research is needed to determine the effectiveness of culturally sensitive programs.

Black or African American↗
PubMed1995

Reducing systematic bias in studies of general practitioners: the use of a medical peer in the recruitment of general practitioners in research.

Reducing systematic bias in any group of study participants should be a priority of any researcher. This can be achieved by ensuring the sampling framework is adequate and by increasing response rates. Response rates in studies of general practitioners have to date tended to be low. Generalization of results to the wider population of GPs is therefore reduced. This paper systematically examines those factors which can reduce bias, recognising accurate identification of the target population, gaining good access to respondents, and maximising response rates as crucial factors. The importance of a medical peer in recruitment is examined. Applying these factors to a study situation, three different recruitment strategies were tested. As the strategy improved, there was an incremental improvement in the response rate (44%, 67%, 78%). These results indicate that by specifically addressing strategies which facilitate access to the target population, and increase the legitimacy and credibility of the study, significant improvements in response rates can be achieved.

Australia↗
PubMed2006

Introducing Vi polysaccharide typhoid fever vaccine to primary school children in North Jakarta, Indonesia, via an existent school-based vaccination platform.

OBJECTIVES: To report results on coverage, safety and logistics of a large-scale, school-based Vi polysaccharide immunization campaign in North Jakarta. METHODS: Of 443 primary schools in North Jakarta, Indonesia, 18 public schools were randomly selected for this study. Exclusion criteria were fever 37.5 degrees C or higher at the time of vaccination or a known history of hypersensitivity to any vaccine. Adverse events were monitored and recorded for 1 month after immunization. Because this was a pilot programme, resource use was tracked in detail. RESULTS: During the February 2004 vaccination campaign, 4828 students were immunized (91% of the target population); another 394 students (7%) were vaccinated during mop-up programmes. Informed consent was obtained for 98% of the target population. In all, 34 adverse events were reported, corresponding to seven events per 1000 doses injected; none was serious. The manufacturer recommended cold chain was maintained throughout the programme. CONCLUSIONS: This demonstration project in two sub-districts of North Jakarta shows that a large-scale, school-based typhoid fever Vi polysaccharide vaccination campaign is logistically feasible, safe and minimally disruptive to regular school activities, when used in the context of an existing successful immunization platform. The project had high parental acceptance. Nonetheless, policy-relevant questions still need to be answered before implementing a widespread Vi polysaccharide vaccine programme in Indonesia.

Antigens, Bacterial↗
PubMed1996

Blood donor centres can effectively publicise cancer screening.

The ability of the blood transfusion service to promote cancer screening using the uptake of colorectal cancer screening offered to blood donors as a model was measured. Blood donors were sent an explanation of colorectal cancer screening with their appointment time to give blood. Free faecal occult blood tests (Haemoccult) were offered by a doctor to donors who attended the Leicester Blood Donor Centre. 556 registered blood donors (309 men, 247 women) aged 51 to 65 years were invited to donate blood over a three month period. Of the subjects who arrived to donate and accepted screening. 63% completed a faecal occult blood test with similar compliance in men and women (66% vs. 59%, chi 2 = 1.0, ns). Compliance was higher in older donors aged 61 to 65 years than those aged 51 to 60 years in both men (90% vs. 60%, chi 2 = 7.0, P < 0.01) and women (87% vs. 51%, chi 2 = 6.2, P < 0.02). The proportion of the total target population screened, which included those donors invited to give blood but who did not attend was 21%. This approach successfully targeted donors who attended to give blood, although only a small proportion of the total target population was screened. Blood donor centres could display cancer screening and health promotion literature and encourage doctors supervising sessions to provide further information and advice to donors.

Aged↗
PubMedDate not supplied

Feasibility of population based screening in Ireland.

Population registers have formed the basis for computerised call/recall registers for screening programmes in many countries and have been important in achieving high uptakes in targeted populations. The absence of a population register for the ECCLES (European Campaign against Cancer, Localisation, Evaluation & Screening) Breast Screening Project necessitated the development of a special register of women in the target age group. The data sources used to build the project register were the Eastern Health Board and North Eastern Health Board General Medical Services database, Voluntary Health Insurance data and self-registration with the project. The register captured 86.3 per cent of the target population. A debate on the merits and difficulties associated with the setting up of a population register in Ireland is now timely.

Breast Neoplasms↗
PubMed2006

Prevalence of symptomatic knee, hand, and hip osteoarthritis in Greece. The ESORDIG study.

OBJECTIVE: To assess the prevalence of symptomatic knee, hand, and hip osteoarthritis (OA) in the general adult population of Greece. METHODS: This cross-sectional population based study was conducted on the total adult population of 7 communities (8547 subjects) and on 2100 out of 5686 randomly selected subjects in an additional 2 communities. Sixteen rheumatologists visited the target population at their homes; an interview based on a standardized questionnaire was conducted and clinical evaluation and laboratory investigations were done, when necessary. ACR classification criteria were used for diagnosing symptomatic OA. RESULTS: Of the final target population of 10,647 subjects, 8740 (82.1%) participated in the study. The age and sex adjusted prevalence of symptomatic knee, hand, and hip OA was 6.0% (95% CI 5.6-6.4), 2% (1.8-2.2), and 0.9% (0.7-1.1), respectively. Symptomatic knee, hand, and hip OA prevalence was significantly higher among women than men and increased significantly with age. Symptomatic knee OA was significantly more common in the rural compared to urban and suburban populations. Logistic regression analysis showed a significant association of female sex and age > or = 50 years with all sites of OA, of obesity with knee and hip OA, and of a low level of education with knee OA. CONCLUSION: Symptomatic knee, hand, and hip OA is common in the general adult population of Greece, showing a female preponderance and a prevalence increasing with age. Female sex and age are risk factors for all sites of OA, obesity for knee and hip OA, and a low level of education for knee OA.

Adult↗
PubMed2001

[Individual genetic counseling and collective screening strategies in particular at-risk populations].

Carrier screening for recessive disorders together with prenatal diagnosis offered in at risk pregnancies can achieve efficient prevention of genetic diseases occurring with particularly high frequencies in specific populations. In this context, genetic counseling, which should be available to each at risk couple, must be integrated into a more elaborate framework geared towards informing the target population. Dramatically different outcomes of carrier screening programmes implemented in the past illustrate the conditions for success or failure. The need to target selected ethnic groups accounts for most of the problems encountered: underpriviledged minorities, risk of discrimination and, most importantly, cultural gaps leading to refusal of prenatal diagnosis and/or of selective abortion. In order to achieve prevention through screening programmes, the tests should therefore be preceded by dissemination of adequate information into the target population, followed by genetic counseling for at risk couples, addressing cultural differences. Prenatal diagnosis should always be proposed, but never imposed on these couples. Finally, these screening programmes must be underpinned by comprehensive subsidies covering not only the tests but also education and counseling that should always be provided with the tests. In terms of public health, this is the price for a cost-effective genetic screening programme.

Abortion, Therapeutic↗