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PubMed2006

Dose Escalation of Desmoteplase for Acute Ischemic Stroke (DEDAS): evidence of safety and efficacy 3 to 9 hours after stroke onset.

BACKGROUND AND PURPOSE: Desmoteplase is a novel plasminogen activator with favorable features in vitro compared with available agents. This study evaluated safety and efficacy of intravenous (IV) desmoteplase in patients with perfusion/diffusion mismatch on MRI 3 to 9 hours after onset of acute ischemic stroke. METHODS: DEDAS was a placebo-controlled, double-blind, randomized, dose-escalation study investigating doses of 90 microg/kg and 125 microg/kg desmoteplase. Eligibility criteria included baseline National Institute of Health Stroke Scale (NIHSS) scores of 4 to 20 and MRI evidence of perfusion/diffusion mismatch. The safety end point was the rate of symptomatic intracranial hemorrhage. Primary efficacy co-end points were MRI reperfusion 4 to 8 hours after treatment and good clinical outcome at 90 days. The primary analyses were intent-to-treat. Before unblinding, a target population, excluding patients violating specific MRI criteria, was defined. RESULTS: Thirty-seven patients were randomized and received treatment (intent-to-treat; placebo: n=8; 90 microg/kg: n=14; 125 microg/kg: n=15). No symptomatic intracranial hemorrhage occurred. Reperfusion was achieved in 37.5% (95% CI [8.5; 75.5]) of placebo patients, 18.2% (2.3; 51.8) of patients treated with 90 microg/kg desmoteplase, and 53.3% (26.6; 78.7) of patients treated with 125 microg/kg desmoteplase. Good clinical outcome at 90 days occurred in 25.0% (3.2; 65.1) treated with placebo, 28.6% (8.4; 58.1) treated with 90 microg/kg desmoteplase and 60.0% (32.3; 83.7) treated with 125 microg/kg desmoteplase. In the target population (n=25), the difference compared with placebo increased and was statistically significant for good clinical outcome with 125 microg/kg desmoteplase (P=0.022). CONCLUSIONS: Treatment with IV desmoteplase 3 to 9 hours after ischemic stroke onset appears safe. At a dose of 125 microg/kg desmoteplase appeared to improve clinical outcome, especially in patients fulfilling all MRI criteria. The results of DEDAS generally support the results of its predecessor study, Desmoteplase in Acute Ischemic Stroke (DIAS).

Adult↗
PubMed1998

Economic evaluation of an HIV prevention intervention for gay and bisexual male adolescents.

The objective of this study was to evaluate the cost-effectiveness of an HIV prevention intervention for gay and bisexual male adolescents. The intervention included individualized risk assessment and counseling, peer education, optional HIV testing, and referrals to needed services. From 1989 to 1994, 501 male volunteers, 13 to 21 years of age, who self-identified as gay/bisexual or as having had sex with men, completed preintervention and postintervention surveys to assess changes in HIV risk behavior. An HIV transmission model was constructed to project the HIV seroprevalence in the target population over a 10-year period from the self-reported number of partners for unprotected anal intercourse. Cost-effectiveness was analyzed from a societal perspective. Total costs of the intervention, including medical treatment costs saved, were projected to be $1.1 million U.S. for the 10-year period. The number of HIV infections averted and the quality-adjusted life years (QALYs) saved were projected to be 13 and 180, respectively. An incremental cost-effectiveness ratio was projected to be $6180 U.S. per QALY saved. The intervention was found to be cost-effective from the societal perspective. In addition, HIV prevalence in the target population was projected to be 6.1% without and 5.6% with intervention by the end of the 10-year period. This study highlights that an HIV prevention program can be cost-effective even if the effects on behavior are partial and short term.

Adolescent↗
PubMed1984

Towards Nigeria's first National Blood Pressure Survey: a pilot study of arterial blood pressure in members of the National Youth Service Corps.

The need for a National Blood Pressure (BP) Survey in Nigeria prompted this pilot study. It was aimed at a target population of 50,000 Nigerians on National Service representing the 19 States of Nigeria. Five-hundred-and-eighty-five subjects aged 18-54 years (18.3% of study population [465 male (79.5%) and 120 female (20.5%)] from a population of 3,200 Corps members had their BP measured with a mercury sphygmomanometer in August 1982. Of these, 102 subjects (17.4%) and 47 subjects (8.0%) had BO greater than or equal to 140/90 and greater than or equal to 160/95 mmHg respectively. Only 17 subjects (16.7%) came back for a recheck and 14 (13.7%) remained hypertensive. More males had BP greater than or equal to 140/90 (P less than 0.05). There was a rise in BP with age in both sexes but mean systolic and diastolic BP were higher in males in all age groups. With a prevalence of 8.0% of hypertension and the chosen target population, a National BP survey would be a feasible and cost effective programme for Nigeria.

Adolescent↗
PubMed1983

Smoking behavior of high school students in Israel.

To evaluate the recently developed and implemented Israeli educational program "Smoking and Cigarette Smoke" (SACS), data was collected on the current smoking behavior and attitudes of high school adolescents. A representative sample of 1,420 students in 22 high schools participated in the study. Each participant had to respond to 65 items of a specially devised questionnaire with respect to his or her smoking behavior and attitudes. According to age and sex in the school year 1980-81, the percentage of smokers within the target population, the distribution by age of when the student started smoking, as well as the distribution of reasons given for both smoking and not smoking, are recorded and analyzed. Generally, it was found that smoking behavior (and age distribution) of high school students in Israel is comparable to that of high school students in the United States. However, the reasons for smoking and not smoking as perceived by the students themselves are different in the two countries both qualitatively and quantitatively. It is concluded that in order to be successful, any preventive antismoking program should be modified and tailored in accordance with the characteristics and needs of the target population under the particular local set of constraints.

Adolescent↗
PubMed2000

Hierarchical models in generalized synthesis of evidence: an example based on studies of breast cancer screening.

Evidence regarding the potential benefits of a particular health care intervention is often available from a variety of disparate sources. However, formal synthesis of such evidence has traditionally concentrated almost exclusively on that derived from randomized studies, although for a range of conditions the randomized evidence will be less than adequate due to economic, organizational or ethical considerations. In such situations a formal synthesis of the evidence that is available from observational studies can be valuable whilst awaiting higher quality evidence from randomized trials. Consideration of randomized studies alone may be appropriate when assessing the efficacy of an intervention, but assessment of the effectiveness of such an intervention within a more general target population may be improved by consideration of evidence from non-randomized studies as well. Standard meta-analysis methods may allow for both within- and between-study heterogeneity; however when multiple sources of evidence are considered an extra level of complexity is introduced, namely study type. One possible solution to the problem of making inferences, particularly regarding an overall population effect, in such situations is to model the heterogeneity, both quantitative and qualitative, using a Bayesian hierarchical model. The hierarchical nature of such models specifically allows for the quantitative within and between sources of heterogeneity, whilst the Bayesian approach can accommodate a priori beliefs regarding qualitative differences between the various sources of evidence. The use of such methods in practice is illustrated in the context of screening for breast cancer; in this example evidence is available from both randomized clinical trials and observational studies. A particular appeal of a Bayesian approach for this type of problem lies in the prediction of future benefits likely to be observed in a target population. This approach to health service monitoring in general is discussed.

Aged↗
PubMed1995

Development of a cervical cancer education program for native American women in North Carolina.

The North Carolina Native American Cervical Cancer Prevention Project is a five-year, NCI-funded public health education program. The project was developed to address the problem of excess mortality from cervical cancer among Native American women by increasing screening and follow-up of abnormal cervical smears. This paper describes the process of developing and implementing the intervention, an individualized health education program. Development of the intervention was guided by the health belief model, social learning theory, self efficacy theory, and PRECEDE, a planning model. Community analysis revealed that the target populations had limited awareness of cervical cancer as a specific type of cancer, and had an experientially-based pessimistic outlook regarding survival with cancer. Steps in developing the cervical-cancer prevention program included 1) development of objectives, 2) selection of strategies and development of cervical cancer education materials, 3) pretesting and revision, and 4) implementation, monitoring, and further revision. Native American lay health educators were recruited and trained to deliver the program. The experience of developing and implementing the individualized health education program suggests that the design of health education programs for Native Americans should begin with examination of basic assumptions regarding the nature of health and illness in the target population. The unique cultures and the diversity of Native American populations are critical factors in the development of health education programs for them.

Adolescent↗
PubMed1998

Mammography screening for breast cancer in Copenhagen April 1991-March 1997. Mammography Screening Evaluation Group.

A biennial mammography screening programme started for all women aged 50-69 in the municipality of Copenhagen, Denmark, on 1 April 1991. We report here on the outcome of the first three invitation rounds. Copenhagen has approximately 40,000 female residents aged 50-69. The Copenhagen Municipality IT Service runs the data files and issues the invitations based on the daily updated population register. Screening takes place at a special clinic at Bispebjerg Hospital, and since 1 September 1996 all assessment and surgery take place at Rigs-hospitalet. The first invitation round covered the period April 1991 to April 1993, the second invitation round the period May 1993 to May 1995, and the third invitation round the period June 1995 to March 1997. By now in total 120,772 invitations have been issued, 84,036 screening tests have been performed, 4110 women have been assessed with additional tests, 1057 women have undergone surgery, and 697 cases of invasive breast cancer cases or carcinoma in situ have been detected. The number of women screened during each of the three invitation rounds as a percentage of the target population aged 50-69 was 71%, 65% and 63%, respectively. It is possible for a woman to notify the programme if she does not want to be invited, and this caused the coverage to decline. The participation rate among the invited women was 71%, 69% and 70%, respectively. Ninety percent of those screened the first and second times and invited the third time participated. The number of screen detected invasive breast cancers of carcinoma in situ cases per 1000 participants during each invitation round was 11.9; 6.3; and 6.1, respectively. When compared with the incidence of invasive breast cancer in Copenhagen before screening, the ratios were 4-7 for all first time screened and 2 for all second or third time screened. Among the 697 screen detected cases, 84% were invasive breast cancers and 11% carcinoma in situ in women not previously known with breast cancer, and 5% were second primary breast cancers. Fifty two invasive interval cancers were found when women who tested negative during the first invitation round were followed up for two years in the Danish Cancer Register and the files of invasive breast cancers of the Danish Breast Cancer Cooperative Group. Compared with the incidence of invasive breast cancer in Copenhagen before screening this gave a proportionate interval cancer rate of 0.34 (95% confidence interval 0.26-0.45). Eight percent of the women who ever participated in the programme had experienced at least one false positive screening test, and 10% of the women who participated all three times in the programme had experienced at least one false positive test. The assessment was an efficient procedure for the sorting out of the false positive screening tests. During the third invitation round, three quarters of those who underwent surgery had either invasive breast cancer or carcinoma in situ. The participation rate in the present programme is relatively low as are the participation rates in other large cities. However, the programme is well accepted among those who participate, as a high proportion of these women come back. The detection rates compared with the previous incidence of invasive breast cancer indicate a good performance of the programme, and so does the proportionate interval cancer rate following the first invitation round. The programme is thus functioning well. The relatively low coverage and the flow in the target population limit the reduction in breast cancer mortality to be expected from the screening programme in the Copenhagen municipality.

Aged↗
PubMed1995

Participants' characteristics in a French colorectal cancer mass screening campaign.

BACKGROUND: Participation by the target population is clearly a key element in the success of mass screening programs for colorectal cancer. In France, involvement of general practitioners in test distribution is essential to reach a satisfactory participation rate, but other forms of recruitment also have to be organized. The aim of this study was to determine the influence of demographic characteristics such as sex, age, and place of residence on the participation rate in a French mass screening according to different recruitment methods. METHODS: The Hemoccult IIR test was proposed in three consecutive ways: spontaneously by general practitioners and occupational doctors during appointments (phase 1), by postal invitation (phase 2), and finally by direct mailing of the test (phase 3). The target population consisted of 11,947 people between 45 and 74 years of age, living in a district of the French county of Calvados, between March 1991 and April 1993. RESULTS: The overall participation rate was 51.3%. Forty-nine percent of all the tests were done during phase 1, 31% during phase 2, and 20% during phase 3. The overall participation rate varied essentially according to the place of residence, from 65.5% in urban areas and 48.9% in intermediate areas to 27.7% in rural areas. The overall participation rate was also higher for females (57%) than for males (45%) and for those 60 years and older (53.9%) than for those below this age (49.2%). The proportion of tests done during phase 1 was lowest among the youngest and the oldest age groups (37.5% in the 45- to 49-year class and 45.2% in the 70- to 74-year class) and among people living in the rural environment (respectively 55.3%, 45.5%, and 35.9% in urban, intermediate, and rural areas). CONCLUSIONS: This study shows that place of residence strongly influences the global participation rate in mass screening for colorectal cancer in France, whereas sex and age have little influence. Recruitment methods complementary to distribution by general practitioners must be organized, especially for the youngest and oldest age groups (45-49 years and 70-74 years) and above all for people living in rural areas. The social, cultural, and psychological reasons for these differences remain to be investigated, with the aim of adapting mass screening strategies to the different population groups.

Aged↗
PubMed1997

Preventing the spread of AIDS in youth: principles of practice from 11 diverse projects.

PURPOSE: The purpose of this study was to identify the factors that contributed to intervention effectiveness in acquired immunodeficiency syndrome (AIDS) prevention projects targeting youth. METHODS: Eleven AIDS prevention projects funded by the Robert Wood Johnson Foundation whose target populations consisted of at least 60% youth were studied. A blended methodology resulted in quantitative data (i.e., survey responses) from all 11 projects supplemented with qualitative data (i.e., open-ended interviews) drawn from in-depth site visits to six projects. RESULTS: Projects reported using a mean of 16.6 intervention activities (selected from a list of 30). Six activities were used by all 11 projects. Small group discussions were rated as one of three most effective activities by 72.7% of the projects that used them. Project staff identified three elements of effective interventions: involvement of peer educators, recognition of the role of adults (e.g., parents, teachers), and use of structured settings to gain access to the target population (e.g., schools, clubs). CONCLUSIONS: The most powerful strategies described by project staff for reaching adolescents at risk for human immunodeficiency virus (HIV) transmission also bring considerable challenges. Opportunity costs associated with using peer educators, gatekeeper support, and structured settings may include limited control of the message, impaired credibility, and failure to reach those youth at greatest risk of HIV infection, respectively. Health educators will do well to consider the advantages and disadvantages of these factors when developing, implementing, and evaluating AIDS prevention programs for youth.

Acquired Immunodeficiency Syndrome↗
PubMed1995

HeartMate implantable left ventricular assist device: bridge to transplantation and future applications.

The HeartMate implantable left ventricular assist device (LVAD) is approaching the time when it will be implanted permanently. Experience with the HeartMate 1000 IP LVAD at the Cleveland Clinic as a bridge to heart transplantation in 21 patients has shown (1) excellent hemodynamic function [improving cardiac index from a mean +/- standard deviation of 1.6 +/- 0.26 L.min-1.m-2 to 3.0 +/- 0.42 L.min-1.m-2]; (2) 81% survival before transplantation with a mean duration of 64 +/- 34 days of LVAD support; (3) 100% survival after transplantation; (4) New York Heart Association class IV and moribund patients were returned to class I or II status while on the LVAD; and (5) a remarkably low risk of thromboemboli during 1,583 patient-days of support. The multicenter experience (173 patients) confirms the low risk of embolic events (2%, including septic emboli). A "target population" for initial use of the permanent device was outlined from a retrospective review of 570 patients. A subgroup of 74 patients (13%) were between 18 and 75 years of age, had isolated cardiac failure (without multiple comorbidities), and required inotropic medications, intraaortic balloon pump support, or both. Survival for this patient group (mean age, 57 +/- 13 years; 68% male) was poor: median survival was 7 months, 21.6% died during the hospitalization, and 47.3% died after discharge. Of the survivors, only 4 patients (5% of the initial 74 patients) were in New York Heart Association class I. From the bridge-to-transplantation experience we extrapolate that survival and quality of life should improve for patients in the target population treated with the portable LVAD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

[Anlysis on features of dead cases with human Streptococcus suis infections].

OBJECTIVE: To describe the clinical and epidemiological features of dead cases with human Streptococcus suis infections, and to find the target population for preventing death and the related indicators. METHODS: Epidemiological investigation on human Streptococcus suis infections was implemented used unified questionnaires. Analysis on dead cases and survival cases (as contrast) was done. RESULTS: The population with highest fatality rate was in 40-49 age group. 97.37% of dead cases had toxic shock syndrome. The mean interval from onset to admission was 0.76 days, and the mean course was 2.11 days. The progression among dead cases was faster than that among survival cases. Chief clinical manifestations of dead cases that are more frequent than survival cases are purpura (73.68%), diarrhea (50.0%), dyspnea (21.05%), conjunctival congestion (34.21%), etc. Renal impairment and liver involvement in dead cases were more significant than that in survival cases. No significant difference between mean incubation period, exposure rates of main risk factors in dead cases and in survival cases was found. CONCLUSION: Preventing toxic shock syndrome might reduce the fatality rate. The target population for preventing death is aged > or = 40. Liver function and renal function testing might be indicators for monitoring the progression of human Streptococcus suis infections.

Adult↗
PubMed1998

A meta-analysis of clinical studies on the caries-inhibiting effect of fluoride gel treatment.

A meta-analysis was performed on published data on the caries-inhibiting effect of fluoride gel treatment in 6- to 15-year-old children. The purposes of this meta-analysis were: (1) to calculate the overall caries-inhibiting effect of clinical fluoride gel treatment studies, based on explicit selection criteria, and (2) to explore factors potentially modifying the effect of fluoride gel treatment in caries prevention, concerning the baseline caries prevalence of the target population, the general fluoride regimen, and application features. The caries-inhibiting effect of fluoride gel application was assessed by the prevented fraction and the 'number needed to treat'. The overall prevented fraction of the fluoride gel treatment studies, indicating the reduction of caries incidence by fluoride gel treatment relative to the incidence in the control group, was 22% (95% CI = 18-25%). Multiple regression analysis showed no significant influence on the prevented fractions for the variables 'baseline caries prevalence', 'general fluoride regimen', 'application method', and 'application frequency'. The 'number needed to treat' (NNT), indicating the number of patients that need to be treated in order to prevent 1 DMFS, estimated the efficiency of fluoride gel treatment according to the caries incidence of the target population, including cost/effect relations. It was found that the NNT = 18 in a population with caries incidence 0.25 DMFS per year, and NNT = 3 in a population with caries incidence = 1.5 DMFS per year (treatment duration 1 year). From the standpoint of cost-effectiveness, the additional effect of fluoride gel treatment in current low and even moderate caries incidence child populations must be questioned.

Adolescent↗
PubMed2005

Use and misuse of a discount voucher scheme as a subsidy for insecticide-treated nets for malaria control in southern Tanzania.

Since 1997, discount vouchers for insecticide-treated nets (ITNs) have been used in two rural districts of southern Tanzania as a way to target subsidies to children under 5 years and pregnant women. We assessed appropriate use and misuse of discount vouchers through a follow-up study of 104 randomly selected vouchers. We traced these vouchers from their original issue in mother-and-child health (MCH) clinics through to being redeemed at a sales agent. We found that all vouchers that reached the target population (100%, 56/56) were used to buy an ITN. Moreover, 94% of the ITNs bought with vouchers were used by those intended, women and children under 5 years. However, up to 48% (50/104) of the vouchers had been misused at the clinics that issued them. Nevertheless, large-scale misuse occurred only at three of 21 clinics. Although most women slept under a net while pregnant, the use of voucher-subsidized ITNs during pregnancy was low despite widespread knowledge of the scheme. Parents had apparently decided to buy the subsidized ITNs once the child was born and not during pregnancy. Importantly, in 20% of households the only existing net had been bought with a voucher. Our findings suggest that vouchers are properly used by the target population, and that to minimize voucher leakage, control measures are needed at MCH clinics and to a certain extent for commercial sales agents. Increased awareness among the whole community on the right to receive a discount voucher may also help to control misuse at health facilities.

Adolescent↗
PubMed2006

Drowning in a sea of advice: pediatricians and American Academy of Pediatrics policy statements.

OBJECTIVE: The proliferation of policy statements from the American Academy of Pediatrics presents pediatricians with an increasing amount of health advice to deliver, yet no quantitative estimates of pediatric health advice expectations exist in the literature. The objective of this study was to quantify and characterize verbal health advice that pediatricians are expected to deliver to patients/guardians. METHODS: The authors read and coded the 344 American Academy of Pediatrics policy statements that are contained in the American Academy of Pediatrics' Pediatric Clinical Practice Guidelines and Policies, Third Edition, and identified 57 policies that contained health advice directives that are broadly relevant to pediatric practice. We extracted the individual advice text to a database in which we also coded its date of issue, its theme, and whether (1) it was duplicated in another policy, (2) a screening question was required to identify a target population for the advice, (3) handouts or other aids to delivering the advice were referenced in the policy itself, or (4) the text of the statement referred to evidence of the effectiveness of office-based delivery of the advice. RESULTS: These 57 policies were found to contain 192 discrete health advice directives that pediatricians are expected to deliver to patients/guardians. Seven (4%) of these directives originated before 1993, and 185 (96%) were created from 1993 to 2002. After removal of the 30 (16%) duplicates, safety advice composed 67%, media use composed 12%, substance abuse composed 5%, environmental health hazards composed 4%, development/emotional health composed 4%, sexuality and pregnancy composed 3%, nutrition composed 2%, and miscellaneous composed 3%. In 41% of the directives, a screening question was required to identify the target population for the advice. Aids to delivering advice were referenced in 20% of the policies. In no policy statements did the text refer to evidence that office-based counseling was an effective method to achieve the desired health or behavioral outcome. CONCLUSIONS: We examined the American Academy of Pediatrics policy statements and found 162 different verbal health advice directives on which pediatricians should counsel parents and patients throughout childhood. The expectation that delivery of all of this advice can be achieved is unrealistic. Moreover, none of the reviewed statements were found to include an evidence-based discussion of the efficacy of the suggested advice. In light of these findings, we suggest that committees should consider both the feasibility and the evidence of efficacy of office-based health advice when generating future policy statements.

Child↗
PubMed1997

Interaction of spontaneous and organised screening for cervical cancer in Turin, Italy.

In a screening programme for cervical cancer, coverage of the target population is a major determinant of effectiveness and cost-effectiveness and is one of the parameters for programme monitoring recommended by the "European Guidelines for Quality Assurance". An organised screening programme was started in Turin, Italy, in 1992. Spontaneous screening was already largely present, but coverage (proportion of women who had at least a test within 3 years) was low (< 50%) and distribution of smears uneven. No comprehensive registration of spontaneous smears was available. All women were invited for the first round, independently of their previous test history. Coverage was estimated by integrating routine data from the organised programme with data on spontaneous screening obtained by interviews of a random sample of 268 non-compliers to invitation and 167 compliers. Overall (spontaneous + organised) coverage was estimated to be 74% (95% CI, 71-78%). The proportion of the target population covered as an effect of invitation was estimated to be 17% (95% CI, 15-20%). Invitations were successful in increasing coverage in previously poorly screened groups. Although 20-25% of compliers was estimated to have had further tests before the end of the round, we estimated that switching to a 3-year interval saved approximately 0.26 tests per complier. This suggests that invitations to an organised programme even to previously covered women, can be a cost-effective policy. Our method of estimating overall coverage can be useful in many other European areas where a comprehensive registration of smears is not available.

Adult↗
PubMed2007

Evaluation of a combined screening programme for breast, cervical and colorectal cancers in France.

A combined breast, cervical and colorectal cancer screening programme was set up in 1990 in Isère, for women aged 50-69 years (target population 100,000) comprising an initial medical visit. The programme was evaluated in 1997. The evaluation covered uptake results, sensitivity, specificity, two opinion surveys among 1025 physicians and 400 women to measure the impact, and three surveys regarding radiologists', gastroenterologists' and pathologists' attitudes. Sensitivity and specificity rates were 74 and 87% for breast, 83 and 99% for cervical and 43 and 97% for colorectal screening. The number of cervical smears completed by women aged 60-69 years doubled with the programme. Acceptability of the faecal occult blood test was 88%. Eighty percent of physicians were in favour of the programme but 67% said that they often prescribed outside the programme. Overall, 71% of the interviewed women said they had had a breast screen, 69% a Pap smear and 53% a faecal occult blood test when only 25-35% of the target population was actually recorded in the programme. This programme increased the uptake of women not previously screened both within and outside the programme. It showed discrepancies between beliefs and practices of physicians. Protocol changes were implemented after this evaluation.

Aged↗
PubMed1990

[Yes, I'm quitting: a scripto-visual tool on anti-smoking for functionally illiterate women. Problems and educational research].

In Montreal a team of social workers has developed a scripto-visual method for breaking tobacco dependency. It is intended for functionally illiterate women between 18 and 35 years old with less than nine years of schooling. Before testing it on the target population, the team completed a developmental experiment with the goal of evaluating and measuring the efficacity of this method. The article presents the various components of the manual and summarizes the findings. The preparation of the manual naturally took into consideration the diverse factors affecting the decision to begin smoking as well as the arguments advanced for breaking the habit. These included: stressing the personal advantages (increased self-esteem and self-confidence); taking the guilt out of this behaviour by revealing its impact and the link between social and advertising incentives to smoke; offering women a means of verbalizing their situation; dedramatizing relapses to maintain self-respect; presenting specific devices to facilitate this step. Comic strips are the principal support mechanism. These present information on the causes and consequences of tobacco dependency and illustrate its effects. They also introduce practical ways to assist the target population in breaking the habit and provides examples of activities which boost motivation and will power. In order to analyse the manual, sessions were organized with potential users. They were invited to complete a short questionnaire, to participate in mock exercises and to comment on the visuals. Beyond the message conveyed, the intention was to measure interest and assimilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

A novel method of assessing completeness of tumor registration.

A random sampling method of measuring the completeness of registration of cancer patients was tested at a university referral hospital. The target population consisted of all inpatients and nonprivate outpatients with in situ or invasive malignancies. The medical records of a random sample of all hospital records active in the last five years were reviewed to determine their reportability and inclusion in the tumor registry (Method A). Traditional casefinding assessment methods were also employed by conducting a complete review of four commonly used hospital sources for a short time period (Method B). The primary purpose of the study was methodologic; namely, to test the feasibility of Method A and to characterize it relative to the more traditional Method B. The estimated missed case rates using Methods A and B (3% and 5%, respectively) are not directly comparable because not all outpatient information is recorded in the medical record. It is concluded that as a means of completeness assessment, Method A can be feasible, cost effective, and useful in other institutions provided certain conditions are met: (1) an appropriate random sample of the target population can be obtained; (2) all relevant information is available in a unit medical record; (3) the reviewer is fully aware of the reportability criteria.

Data Collection↗