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Results for “Population Programs”

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At least 451 records · Page 25Linked to original sources
PubMed2026

Fecal immunochemical tests from population-based colorectal cancer screening programs support prospective microbiome cohorts.

BACKGROUND: Large, prospective cohorts are needed to research the gut microbiome's role in colorectal cancer (CRC) risk. We evaluated the gut microbiome leveraging residual fecal immunochemical tests (FIT) from a CRC screening program in Turin, Italy, and conducted one of the largest population-based case-control studies across the adenoma-carcinoma sequence to date. METHODS: We extracted DNA from residual FIT stool, used whole-genome shotgun sequencing, and included those with CRC (N = 44), advanced adenomas (N = 269), early adenomas (N = 134), and FIT-negative controls (N = 478). Alpha diversity, beta diversity, and species, gene, and pathway relative abundances were estimated. Multivariable logistic regression models were used to estimate associations of these metrics with colorectal neoplasms. RESULTS: Alpha diversity was mostly inversely associated with colorectal neoplasms, particularly early adenomas (OR: 0.45, 95% CI: 0.25-0.80; P = 0.01). Presence of oral pathogens, including Parvimonas micra, was associated with higher odds of CRC. Furthermore, Escherichia coli and Bacteroides fragilis were strongly associated with higher odds of all colorectal neoplasms. Several genes and pathways were associated with colorectal neoplasms. CONCLUSIONS: Our findings align with smaller studies of the gut microbiome and colorectal neoplasms, supporting that CRC screening programs provide opportunities to prospectively study the gut microbiome's association with cancer risk in large populations.

Humans↗
PubMed1982

Health education program effects on the management of hypertension in the elderly.

Because the elderly are viewed as having more difficulty in complying with therapy, this analysis was directed at the effects of a health education program on their control of primary hypertension when compared with a younger population. The program consisted of three sequential interventions introduced in a randomized factorial design. Depsite the fact that elderly patients had more chronic disease, more complications from hypertension, and were receiving more complex drug therapies than younger patients exposed to the same experimental interventions, they demonstrated significantly higher levels of compliance with drug therapy, significantly higher levels of appointment keeping, and no difference in the proportion having their BP under control at two-year-follow-up. Longitudinal data collected at five-year follow-up indicate no decay effect. These results indicate such programs can be successfully implemented and equally effective for an elderly population.

Aged↗
PubMed1989

Hypertension studies in the Soviet Union.

Arterial hypertension control trials conducted during the last decade in the Soviet Union are reviewed. Epidemiologic data illustrating a considerable prevalence of arterial hypertension in various regions are presented. The results of population hypertension control programs are discussed, and the feasibility of reducing total mortality in the intervention vs reference groups at the community level is demonstrated, with the mortality and morbidity due to stroke showing a two-fold decrease. An outline is given of the major approaches used in population programs started in recent years, which are geared at improving drug and nondrug prevention and altering approaches to hypertension control in public health care.

Adult↗
PubMed2002

Strategies used by interdisciplinary rural health training programs to assure community responsiveness and recruit practitioners.

In this article, the strategies used by five US rural interdisciplinary training grant programs to respond to local needs and to promote recruitment in rural communities are described. The programs provide training to 17 health care disciplines and serve disadvantaged Hispanic, African-American, Amish, Native American, and Anglo populations. Four programs are based in academic institutions; one is based in a community health center. The programs provide services to the rural communities through individual clinical or case management services, population-level interventions, and collaborative research. All programs use specific mechanisms (e.g. case conferences or participation in local coalitions) to facilitate collaboration with residents and to link student activities with community or individual needs. Unique strategies include the use of problem-based learning and community health workers on the interdisciplinary team to increase responsiveness. The programs also provide educational support to students while they work in the rural communities. Finally, the primary strategy used to promote recruitment is the training experience in rural communities. The programs also appear to indirectly improve the environment of rural practice.

Case Management↗
PubMed1984

The relative success of the Kainji resettlement scheme as compared with that of Volta.

The author compares the population resettlement programs undertaken in connection with the construction of dams at Lake Volta in Ghana and Kainji Lake in Nigeria. Data are from published sources and from a 1971 survey conducted by the author in Nigeria. Differences between the policies and procedures are outlined. It is noted that "these differences resulted in the differences in the patterns of adjustment of the resettled people."

Africa↗
PubMed1999

Program closure and change among VA substance abuse treatment programs.

OBJECTIVE: The population of Veterans Affairs (VA) substance abuse treatment programs in 1990 and 1994 was examined to determine which factors-program legitimacy or cost-accounted for program closure and change. Legitimacy is a concept in institutional theory that organizations tend to take on a form appropriate to the environment. METHODS: The study had two competing hypotheses. The first was that if external pressures push programs to produce high-quality and efficient treatment, then those that are initially closer to the legitimate form should be less likely to close later, and among surviving programs they should be less likely to experience change. The second hypothesis was that cost is the primary factor in program closure and change. The study used data from administrative surveys of all VA programs (273 in 1990 and 389 in 1994). Program legitimacy variables measured whether programs offered the prevalent type of treatment, such as 12-step groups or behavioral treatment, and had the prevalent type of staff. RESULTS: Program costs did not explain closure or change. For inpatient programs, the risk of closure increased in facilities with more than one substance abuse treatment program. The risk of closure increased for outpatient programs offering the prevalent type of treatment, contrary to what was predicted by the legitimacy hypothesis. Inpatient programs that offered the prevalent treatment were less likely to change the type of treatment offered. CONCLUSIONS: Patterns of change differed over time for inpatient and outpatient programs. Legitimacy factors, rather than cost, seem to play a role in program closure and change, although the picture is clearer for inpatient programs than for outpatient programs.

Health Facility Closure↗
PubMedDate not supplied

Population health--a new discipline.

A new discipline--population health--has emerged with the potential to profoundly impact the U.S. health care system. Multiple forces stimulating the new population health concept include: (1) the increasing dominance of managed care and critical scrutiny of its development; (2) the continued refinement of clinical effectiveness and outcomes assessment research; (3) increasing public policy emphasis on cost-effectiveness accountability for health care services; and (4) a new focus on the importance of collaboration between the medicine and public health enterprises in this country. The need for sophisticated analysis of population health determinants has never been greater in history. New programs, like the University of Wisconsin-Madison's interdisciplinary Graduate Program in Population Health, address the need for analysis, dissemination, and application of information about the many factors affecting the health of populations.

Community Health Planning↗
PubMed1981

Blue Shield plan physician participation.

Many Blue Shield Plans offer participation agreements to physicians that are structurally similar to the participation provisions of Medicaid programs. This paper examines physicians' participation decisions in two such Blue Shield Plans where the participation agreements were on an all-or-nothing basis. The major results show that increases in the Plans' reasonable fees or fee schedules significantly raise the probability of participation, and that physicians with characteristics associated with "low quality" are significantly more likely to participate than are physicians with characteristics associated with "high quality." In this sense the results highlight the tradeoff that must be faced in administering governmental health insurance policy. On the one hand, restricting reasonable and scheduled fees is the principal current tool for containing expenditures on physicians' services. Yet these restrictions tend to depress physicians' willingness to participate in government programs, thereby reducing access to high quality care by the populations those programs were designed to serve.

Blue Cross Blue Shield Insurance Plans↗
PubMedDate not supplied

Population policy in South Africa.

This report examines the current state and likely future directions of population policy in South Africa with particular reference to family planning activities set against the background of apartheid and its demise. In the apartheid era, population policy was perceived by most blacks as an instrument for the control of their number and movements. Recently, policy has been adjusted by the national Population Development Program in response to the changing sociopolitical situations in the country. A national post-apartheid population policy is likely to retain many of the components of this new program. However, a future nonracist and democratic society would probably invite a review of population activities in the country and raise wider issues concerning rationales, organization, and strategies for the delivery of family planning in South Africa.

Adolescent↗
PubMed2000

The impact of programs for high-risk drinkers on population levels of alcohol problems.

AIMS: Historically, treatment programs and related activities for alcoholics or high-risk drinkers have been viewed as not relevant to efforts to prevent alcohol problems, and in particular population-based prevention efforts. In this review we consider evidence that high-risk programs may have an impact on population or aggregate levels of these problems. DESIGN: We first summarize recent reviews of the clinical impact of programs for high-risk drinkers, since some level of effectiveness at the individual level is necessary for these programs to have an aggregate level impact. Following that, correlational evidence on the impact of high-risk programs on aggregate problem levels is examined. Estimates of the potential impact of high-risk programs on aggregate problem levels, based on available information on the impact of these programs and the numbers of individuals affected, are then considered, as are estimations of the comparative aggregate level impact of high-risk and consumption reduction strategies. FINDINGS: There is increasing evidence that high-risk programs have beneficial effects for individuals. Available correlational evidence supports the proposal that increases in treatment and AA have contributed to the declines in alcohol-related morbidity and mortality observed in some countries in recent years. Studies estimating the recent impact of increases in levels of treatment and AA membership support that interpretation, and studies comparing estimated effects of high-risk and population strategies find similar potential for aggregate effects. CONCLUSIONS: Programs for high-risk drinkers can have beneficial aggregate-level effects and are thus a valuable component of population-based efforts to reduce alcohol problems.

Alcohol-Related Disorders↗
PubMedDate not supplied

Quick response programs: effective management of a population in crisis.

In our present health care system, emergency departments have become the gatekeepers of the acute care system for the elderly. These departments need other alternatives to in-hospital treatment for elderly patients. The Windsor-Essex County Quick Response Program was developed as an innovative alternative to assist Hotel Dieu of St. Joseph Hospital's emergency department with this complex client population. This article describes the program, provides a rationale for this specialized service, offers suggestions for program success and reports on its accomplishments during the first year of operation.

Acute Disease↗
PubMed1994

Screening with total cholesterol: determining sensitivity and specificity of the National Cholesterol Education Program's guidelines from a population survey.

The objective of the study was to determine the sensitivity and specificity of the National Cholesterol Education Program (NCEP) guidelines in identifying at-risk individuals for hypercholesterolemia, using population-based data from the Manitoba Heart Health Survey (MHHS). The MHHS surveyed a representative sample of adult residents of the province of Manitoba, Canada, aged 18-74 (n = 2792), 2212 of whom underwent complete lipoprotein analyses: total cholesterol (TC), high-density (HDL) and low-density (LDL) lipoprotein cholesterol, and triglycerides (TG) after overnight fasting. Following NCEP criteria for risk categories, 618 individuals could be considered as "at risk" based on their HDL and/or LDL levels. However, if the NCEP algorithms were followed, i.e. initial screen for TC only, and determination of HDL and LDL for selected individuals with borderline and high TC, only 438 of the total "at risk" individuals would have been identified (sensitivity = 71%). 1203 of 1594 individuals with acceptable HDL and LDL levels were not considered "at risk" on screening (specificity = 76%). If "at risk" status was determined solely on LDL criteria, the NCEP guidelines result in a higher sensitivity (94%) and comparable specificity (76%). However, when only HDL criteria were used, the sensitivity and specificity declined to 38% and 63% respectively. Compared to a simulated screening study based on the Lipid Research Clinic data reported by Bush and Riedel (1991) the estimates of sensitivity from the MHHS were high. Current NCEP guidelines appear to balance optimally the sensitivity and specificity for selecting individuals based on TC levels for further complete lipoprotein analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2000

Health promotion in the city: a structured review of the literature on interventions to prevent heart disease, substance abuse, violence and HIV infection in US metropolitan areas, 1980-1995.

To achieve its national public health goals, the US must improve the health of low-income urban populations. To contribute to this process, this study reviewed published reports of health promotion interventions designed to prevent heart disease, HIV infection, substance abuse, and violence in US cities. The study's objectives were to describe the target populations, settings, and program characteristics of these interventions and to assess the extent to which these programs followed accepted principles for health promotion. Investigators searched five computerized databases and references of selected articles for articles published in peer-reviewed journals between 1980 and 1995. Selected articles listed as a main goal primary prevention of one of four index conditions; were carried out within a US city; included sufficient information to characterize the intervention; and organized at least 25% of its activities within a community setting. In general, programs reached a diverse population of low-income city residents in a variety of settings, employed multiple strategies, and recognized at least some of the principles of effective health promotion. Most programs reported a systematic evaluation. However, many programs did not involve participants in planning, intervene to change underlying social causes, last more than a year, or tailor for the subpopulations they targeted, limiting their potential effectiveness. Few programs addressed the unique characteristics of urban communities.

HIV Infections↗