Preventing unwanted pregnancies.
Explore the source record for details and available documents.
Contraception↗
SEARCH · Search PubMed
Results for “Nonclinical Distribution”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Sociodemographic and health status characteristics with prostate cancer screening in a national cohort of middle-aged male veterans.
OBJECTIVES: To characterize variables associated with obtaining prostate cancer screening in a nonclinical, nationally distributed, middle-aged male population. METHODS: Telephone interviews were administered to 2652 individual members of the Vietnam Era Twin Registry in 1992 and 1995. Dependent variables were self-report measures of having had a digital rectal examination (DRE) and/or a prostate-specific antigen (PSA) test in the past 5 years. Independent variables were current measures of age, household income, education, race, insurance, source of care, and lifetime measures of physical condition, psychiatric illness, and alcohol and nicotine dependence. RESULTS: Thirty-five percent of the sample reported having had a PSA and DRE within the past 5 years. Prevalence of obtaining either a PSA or DRE varied with age, income, education, and race. Subjects with a regular source of care, a regular physician, and health insurance reported higher rates of having had a DRE or PSA and DRE. Persons with a physical or psychiatric illness reported more screening. A multiple regression model revealed that having a regular source of care, having a regular physician, physical illness, psychiatric illness, minority status, higher income, and age predicted having had some form of screening. CONCLUSIONS: A substantial portion of middle-aged men have had both a PSA and DRE performed at least once in the preceding 5 years. It may be possible to further improve prostate cancer screening participation by directing educational programs at men who are not in contact with the healthcare system. If the PSA and DRE screening guidelines that are finally adopted discourage screening among low-risk men younger than age 50, educational programs that emphasize age screening criteria may be warranted.
Health Status↗
Prediction of pharmacokinetics prior to in vivo studies. 1. Mechanism-based prediction of volume of distribution.
In drug discovery and nonclinical development the volume of distribution at steady state (V(ss)) of each novel drug candidate is commonly determined under in vivo conditions. Therefore, it is of interest to predict V(ss) without conducting in vivo studies. The traditional description of V(ss) corresponds to the sum of the products of each tissue:plasma partition coefficient (P(t:p)) and the respective tissue volume in addition to the plasma volume. Because data on volumes of tissues and plasma are available in the literature for mammals, the other input parameters needed to estimate V(ss) are the P(t:p)'s, which can potentially be predicted with established tissue composition-based equations. In vitro data on drug lipophilicity and plasma protein binding are the input parameters used in these equations. Such a mechanism-based approach would be particularly useful to provide first-cut estimates of V(ss) prior to any in vivo studies and to explore potential unexpected deviations between sets of predicted and in vivo V(ss) data, when the in vivo data become available during the drug development process. The objective of the present study was to use tissue composition-based equations to predict rat and human V(ss) prior to in vivo studies for 123 structurally unrelated compounds (acids, bases, and neutrals). The predicted data were compared with in vivo data obtained from the literature or at Roche. Overall, the average ratio of predicted-to-experimental rat and human V(ss) values was 1.06 (SD = 0.817, r = 0.78, n = 147). In fact, 80% of all predicted values were within a factor of two of the corresponding experimental values. The drugs can therefore be separated into two groups. The first group contains 98 drugs for which the predicted V(ss) were within a factor of two of those experimentally determined (average ratio of 1.01, SD = 0.39, r = 0.93, n = 118), and the second group includes 25 other drugs for which the predicted and experimental V(ss) differ by a factor larger than two (average ratio of 1.32, SD = 1.74, r = 0.42, n = 29). Thus, additional relevant distribution processes were neglected in predicting V(ss) of drugs of the second group. This was true especially in the case of some cationic-amphiphilic bases. The present study is the first attempt to develop and validate a mechanistic distribution model for predicting rat and human V(ss) of drugs prior to in vivo studies.
Animals↗
Body vigilance in panic disorder: evaluating attention to bodily perturbations.
Body vigilance, consciously attending to internal cues, is a normal adaptive process. The present report investigated whether body vigilance is exaggerated among those with panic disorder, a condition characterized by intense fear and worry regarding bodily sensations. The Body Vigilance Scale is validated in nonclinical and anxiety disorder samples. Study 1 suggests that body vigilance is normally distributed in a nonclinical sample (n = 472) but vigilance is related to a history of spontaneous panic attacks, anxiety symptomatology, and anxiety sensitivity. Study 2 suggests that body vigilance is elevated in panic disorder patients (n = 48) relative to social phobia patients (n = 18) and nonclinical controls (n = 71). During cognitive-behavioral treatment, panic disorder patients show substantial reductions in body vigilance associated with reductions in anxiety symptomatology. Anxiety sensitivity was found to be related to body vigilance and to predict changes in body vigilance during treatment.
Adolescent↗
Goals, design, timing, and future opportunities for nonclinical drug metabolism studies.
The nonclinical ADME (adsorption, distribution, metabolism, and excretion) studies employed during drug development are dependent on the regulatory expectations and the changing development focus from nonclinical to clinical issues. These evolving issues necessitate that the development goals for ADME studies also change during the development process. The rationale for these goal changes and their impact on the timing and design of the ADME studies are discussed in the context of drug development at Glaxo Inc. The progress in the technology and knowledge in drug metabolism and in biology provide new opportunities for pharmaceutical companies in predicting drug toxicities relevant to humans. Two case examples are discussed to illustrate this opportunity.
Animals↗
Attachment representations in mothers, fathers, adolescents, and clinical groups: a meta-analytic search for normative data.
This meta-analysis on 33 studies, including more than 2,000 Adult Attachment Interview (AAI) classifications, presents distributions of AAI classifications in samples of nonclinical fathers and mothers, in adolescents, in samples from different cultures, and in clinical groups. Fathers, adolescents, and participants from different countries show about the same distribution of AAI classifications as nonclinical mothers do. The distribution of nonclinical mothers is as follows: 24% dismissing, 58% autonomous, and 18% preoccupied mothers. About 19% of the nonclinical mothers are unresolved with respect to loss or trauma of other kinds. Mothers from low socioeconomic status show more often dismissing attachment representations and unresolved loss or trauma. Autonomous women and autonomous men are more often married to each other than can be expected by chance, and the same goes for unresolved men and women. Clinical participants show highly deviating distributions of AAI classifications, with a strong overrepresentation of insecure attachment representations, but systematic relations between clinical diagnosis and type of insecurity are absent.
Adolescent↗
Ceylon: continuing practice of contraception by acceptors of oral contraceptives and intrauterine devices in a field programme.
A follow-up study of oral-contraceptive and intrauterine-device acceptors in the early years of the Ceylon family planning programme was undertaken to determine the effect of a 1968 policy decision to cut the per cycle price of oral contraceptives by half and to allow nonclinical prescription and distribution of the pills by trained field midwives under medical supervision. While pill acceptance increased, study findings suggest that continuation did not. On balance, the intrauterine device proved much more effective than oral contraceptives in preventing unplanned pregnancies, reflecting the higher continuation rates of IUD acceptors. Although the availability of both methods clearly contributed to expansion of the programme, the demographic and administrative implications of initial choice of method, and the finding that pregnancy rates for pill users are not lower than for IUD wearers, suggest the need for more realistic counselling by clinic and field staff at the time of choice.
Adult↗
Frequency and distribution of tetracycline resistance genes in genetically diverse, nonselected, and nonclinical Escherichia coli strains isolated from diverse human and animal sources.
Nonselected and natural populations of Escherichia coli from 12 animal sources and humans were examined for the presence and types of 14 tetracycline resistance determinants. Of 1,263 unique E. coli isolates from humans, pigs, chickens, turkeys, sheep, cows, goats, cats, dogs, horses, geese, ducks, and deer, 31% were highly resistant to tetracycline. More than 78, 47, and 41% of the E. coli isolates from pigs, chickens, and turkeys were resistant or highly resistant to tetracycline, respectively. Tetracycline MICs for 61, 29, and 29% of E. coli isolates from pig, chickens, and turkeys, respectively, were >/=233 micro g/ml. Muliplex PCR analyses indicated that 97% of these strains contained at least 1 of 14 tetracycline resistance genes [tetA, tetB, tetC, tetD, tetE, tetG, tetK, tetL, tetM, tetO, tetS, tetA(P), tetQ, and tetX] examined. While the most common genes found in these isolates were tetB (63%) and tetA (35%), tetC, tetD, and tetM were also found. E. coli isolates from pigs and chickens were the only strains to have tetM. To our knowledge, this represents the first report of tetM in E. coli.
Animals↗
Contraceptive social marketing and community-based distribution systems in Colombia.
Three operations research experiments were carried out in three provinces of Colombia to improve the cost-effectiveness of Profamilia's nonclinic-based programs. The experiments tested: (a) whether a contraceptive social marketing (CSM) strategy can replace a community-based distribution (CBD) program in a high contraceptive use area; (b) if wage incentives for salaried CBD instructors will increase contraceptive sales; and (c) whether a specially equipped information, education, and communication (IEC) team can replace a cadre of rural promoters to expand family planning coverage. All three strategies proved to be effective, but only the CSM system yielded a profit. Despite this, Profamilia discontinued its CSM program soon after the experiment was completed. Unexpected government controls regulating the price and sale of contraceptives in Colombia made the program unprofitable. As a result, family planning agencies are cautioned against replacing CBD programs with CSM. Instead, CBD programs might adopt a more commercial approach to become more efficient.
Colombia↗
The time course of nonchronic major depressive disorder. Uniformity across episodes and samples. National Institute of Mental Health Collaborative Program on the Psychobiology of Depression--Clinical Studies.
BACKGROUND: Most natural history studies of affective disorders have emphasized the prediction of eventual recovery. Little is known of changes over time in the immediate probability of recovery. METHODS: To identify regularities in the timing of recovery from nonbipolar major depressive disorders, we considered only episodes that began during follow-up to increase the accuracy with which onsets were timed and to limit the study sample to individuals who had a demonstrably episodic course. Five participating centers conducted baseline assessments and followed probands (N = 605) and nonclinical subjects (relatives, controls, and spouses, N = 826) up for 6 years. During that time, 359 probands had at least one prospectively observed episode, and 181 had two episodes; corresponding numbers for the nonclinical subjects were 216 and 78, respectively. Our analyses considered the distribution of episode lengths across ascertainment source (probands vs nonclinical subjects), center, and episode number (first vs second prospectively observed episode). RESULTS: Distribution was remarkably uniform. Regardless of ascertainment source, center, or episode number, recovery occurred within 3 months in 40% of episodes, within 6 months in 60%, and within 1 year in 80%; 20% had more protracted courses. CONCLUSIONS: Once triggered, the immediate likelihood of recovery changes over time in a predictable fashion. This has practical implications for the study of antidepressant efficacy and theoretical implications for factors involved in affective dysregulation.
Adolescent↗
Evaluating rural Bangladeshi women's perspectives of quality in family planning services.
Several frameworks for understanding the quality of family planning care have been proposed. However, efforts to measure and quantify their components remain underdeveloped, especially with regard to nonclinical care and community-based distribution. This study examines a large-scale field survey conducted among married women of reproductive age in rural Bangladesh in 1989 and 1990 to measure and evaluate rural women's perceptions of the quality of outreach services they received. Initial analysis indicates that rural women are able to distinguish between good and poor quality of care and that these perceptions can be accurately documented and quantified through sample survey approaches. Implications of the use of a survey in the measurement of quality of care are discussed, as well as implications of the results for managers within the Bangladesh government family planning program, which has been regarded by donor agencies as having limited responsiveness to clients' needs.
Bangladesh↗
The use of planimetry to record and score the modified Navy index and other area-based plaque indices. A comparative toothbrush study.
Many plaque-scoring methods are based on a subjective assessment of the amount of tooth surface covered by plaque or the presence or absence of plaque at specific sites. The 2x modified Navy plaque index is an example of the latter and requires chairside decisions from 9 zones of all buccal and lingual tooth surfaces, i.e., up to 576 for a complete dentition. The present study describes a procedural modification to the index, whereby plaque is recorded using an established planimetric plaque area method. Scoring is then performed using an overlay away from the clinic. To test the method, plaque-area measurements were made during a 30-subject, crossover study to compare plaque removal following single toothbrushings with 3 different types of manual toothbrush. Consistent with many such studies, no significant differences in plaque removal were noted between the brushes. The method was found quick and simple at the chairside, provided a permanent record of plaque distribution and could be analysed by clinical or nonclinical personnel under ideal conditions. The same method could be employed for other plaque indices based on area or site subjective decisions.
Cross-Over Studies↗
Obsessive-compulsive characteristics: from symptoms to syndrome.
OBJECTIVE: To assess the distribution and severity of obsessions and compulsions in a nonclinical adolescent population. METHOD: During preinduction military screening, 861 sixteen-year-old Israelis completed a questionnaire regarding the lifetime presence of eight obsessive-compulsive (OC) symptoms and three severity measures. The presence or absence of obsessive-compulsive disorder (OCD) or subclinical OCD was ascertained by an independent interview. RESULTS: Although only 8.0% and 6.3% of respondents reported disturbing and intrusive thoughts, respectively, 27% to 72% of subjects endorsed the six remaining OCD symptoms. Twenty percent of subjects regarded the symptoms they endorsed as senseless and 3.5% found them disturbing; 8% reported spending more than an hour daily on symptoms. OCD and subclinical OCD cases differed significantly from non-OCD cases, but not from each other, in distress and mean number of symptoms. Although the distribution of nine of the items differed for noncases, compared with OCD and subclinical OCD cases, the distributions for all items overlapped markedly across the three groups. CONCLUSIONS: OC phenomena appear to be on a continuum with few symptoms and minimal severity at one end and many symptoms and severe impairment on the other. Defining optimal cutoff points for distinguishing between psychiatric disorder and OC phenomena that are common in the general population remains an open question.
Adolescent↗
Childhood sexual abuse: long-term effects on psychological and sexual functioning in a nonclinical and nonstudent sample of adult women.
The purpose of this study was to explore how the experience of childhood sexual abuse is related to long-term psychological and sexual functioning in a nonclinical and nonstudent community sample of women. Questionnaires were distributed to 1,500 nurses and returned anonymously. Fifty-four women who had been sexually abused as children (age 15 or younger) responded. These subjects were then matched with 54 nonabused control subjects. Although there was no difference on a measure of self-esteem, the abused group reported more symptoms of distress on the Global Severity Index and on seven out of nine subscales of the Derogatis Brief Symptom Inventory. They also reported more disturbance on a scale which examined psychological symptoms that have been commonly reported in the literature to be particularly associated with sexual abuse. These differences between the abused and nonabused groups were evident even after controlling for differences in subjects' perceptions of parental emotional support. Unlike the results for psychological adjustment, however, the abused subjects did not differ from the control subjects on self-reported levels of sexual satisfaction or sexual dysfunction.
Adaptation, Psychological↗
Recovery of different Listeria ribotypes from naturally contaminated, raw refrigerated meat and poultry products with two primary enrichment media.
Isolation rates for Listeria monocytogenes and the other Listeria spp. typically improve when samples are enriched in more than one primary enrichment medium. This study evaluated the abilities of two primary enrichment media, University of Vermont-modified Listeria enrichment broth (UVM) and Listeria repair broth (LRB), to recover different ribotypes of Listeria spp. from raw meat and poultry samples. Forty-five paired 25-g retail samples of ground beef, pork sausage, ground turkey, and chicken (160 samples) underwent primary enrichment in UVM and LRB (30 degrees C for 24 h) followed by secondary enrichment in Fraser broth (35 degrees C for 24 and 40 h) and plating on modified Oxford agar. After 24 h of incubation of 35 degrees C, 608 Listeria colonies from selected positive samples were biochemically confirmed as L. monocytogenes (245 isolates), L innocua (276 isolates), and L. welshimeri (89 isolates) and then ribotyped with the automated Riboprinter microbial characterization system (E. I. du Pont de Nemours & Co., Inc.). Thirty-six different Listeria strains comprising 16 L. monocytogenes (including four known clinical ribotypes), 12 L. innocua, and 8 L. welshimeri ribotypes were identified from selected positive samples (15 samples of each product type; two UVM and two LRB isolates per sample). Twenty-six of 36(13 L. monocytogenes) ribotypes were detected with both UVM and LRB, whereas 3 of 36 (1 L. monocytogenes) and 7 of 36 (3 L. monocytogenes) Listeria ribotypes were observed with only UVM or LRB, respectively. Ground beef, pork sausage, ground turkey, and chicken yielded 22 (8 L. monocytogenes), 21 (12 L. monocytogenes), 20 (9 L. monocytogenes), and 19 (11 L. monocytogenes) different Listeria ribotypes, respectively, with some Listeria ribotypes confined to a particular product. More importantly, major differences in both the number and distribution of Listeria ribotypes, including previously recognized clinical and nonclinical ribotypes of L. monocytogenes, were observed when 10 UVM and 10 LRB isolates from five samples of each product were ribotyped. When a third set of six samples per product type was examined from which two Listeria isolates were obtained by using only one of the two primary enrichment media, UVM and LRB failed to detect L. monocytogenes (both clinical and nonclinical ribotypes) in two and four samples, respectively. These findings stress the importance of using more than one primary enrichment medium and picking a sufficient number of colonies per sample when attempting to isolate specific L. monocytogenes strains during investigations of food-borne listeriosis.
Animals↗
Human organ transplantation: background and consequences.
The story of the renal transplant program of the Peter Bent Brigham Hospital (now the Brigham and Women's Hospital) in Boston weaves together three distinct threads: the study of renal disease, the phenomenon of skin grafting in twins, and the development of surgical procedures ultimately leading to the use of chemical immunosuppression. The common leitmotiv is one of a single event or report proving to be decisive. Unanticipated consequences of successful human organ transplantation include the reorganization of clinical and nonclinical disciplines, national and international cooperation in organ preservation and distribution, tissue-typing as a marker for disease, redefinition of death in terms of brain function, better understanding of disease processes, and new health care quandaries that result from the scarcity of organ donors.
Animal Experimentation↗
Developmental protective and risk factors in borderline personality disorder: a study using the Adult Attachment Interview.
Mental representations and attachment in a sample of adults with Borderline Personality Disorder were assessed using the George, Kaplan and Main (1985) Adult Attachment Interview (AAI). Eighty subjects participated in the study: 40 nonclinical and 40 with Borderline Personality Disorder (BPD). The results obtained showed a specific distribution of attachment patterns in the clinical sample: free/autonomous subjects (F) represented only 7%, dismissing classifications (Ds) reached about 20%, entangled/preoccupied (E) 23% and unresolved with traumatic experiences (U) 50%. The two samples differed in their attachment patterns distribution by two (secure vs. insecure status), three (F, Ds and E) and four-way (F, Ds, E and U) categories comparisons. In order to identify more specific protective or risk factors of BPD, 25 one-way ANOVAs with clinical status as variable (clinical vs. nonclinical) were conducted on each scale of the coding system of the interview. Results support the hypothesis that some developmental relational experiences seem to constitute pivotal risk factors underlying this disorder. Results demonstrated potential benefits in using AAI scales in addition to the traditional categories. Implications for research and treatment are discussed.
Adult↗
Programmed ventricular stimulation using tandem versus simple sequential protocols.
UNLABELLED: The objective was to determine whether two commonly used ventricular stimulation protocols, one more complex than the other, produced concordant results. If such were the case, the simpler protocol would streamline activities in clinical electrophysiology laboratories. BACKGROUND: Two programmed ventricular stimulation protocols were compared. (1) With the tandem method, the first extrastimulus (S2) is moved stepwise to the effective refractory period and then moved out 50 msec; the second extrastimulus (S3) is then decremented until it fails to capture; S2 and S3 are then decremented in a semialternating (tandem) fashion so that both continue to capture. When S2 reaches the refractory period + 10 msec and S3 fails to capture, S3 is then moved out 50 msec, and S4 is decremented as described for S3. (2) With the simple sequential method, the first extrastimulus (S2) is decremented stepwise to the refractory period, and then moved out 10 msec to assure capture; S3 is then similarly decremented to the refractory period and then moved out 10 msec; and S4 is then similarly decremented. METHODS: This was a prospective, randomized, crossover, consecutive series study. Both protocols were tested in each patient on the same day in randomized order. RESULTS: There were 84 matched studies. Fifty-six patients provided data from baseline electrophysiological studies, and 28 of these provided additional data during drug trials. There was a 93% concordance between the two methods, including the primary outcomes of inducibility of clinical arrhythmias, inducibility of nonclinical arrhythmias, and noninducibility (P < 0.001). Discordances were few and evenly distributed between the two protocols (P = NS). Results were similar for baseline studies and drug trials. The simple sequential method required less time to perform (P < or = 0.01). CONCLUSIONS: Tandem and simple sequential protocols provide concordant results. No advantage could be demonstrated for the more complex tandem method.
Adolescent↗