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PubMedDate not supplied

[Analysis of the indicators of natural trends in the population of the Tatarstan Republic in the years 1994-1998].

A stable tendency to a lower reproduction of population during the studied period has been detected in Tatarstan, both for the entire Republic and for the urban and rural population separately. Coefficients of natural increment of population differed in the regions and some cities of the Republic and varied during the studied period. Negative time course of the natural increment of population is explained by drop of birth rate, increased mortality, and decreased number of new married couples per 1000 in the Republic in general and among the urban and rural population separately. These data are important for evaluating the health status of the population in Tatarstan and can be used for validating regional goal-oriented programs for population health protection.

Adult↗
PubMed1994

Nutritional influences on linear growth: a general review.

The first section of this paper reviews what is known about the roles of specific nutrients in the general linear growth faltering that occurs in developing countries. Those reviewed are energy, protein, zinc, iron, copper, iodine and vitamin A. For none of these nutrients was there clear, consistent evidence that supplementation with the nutrient benefited linear growth. Rather, interventions with each specific nutrient had a positive effect on length gain in some studies, while in others these affected only weight gain or had no effect. Reasons for these conflicting results are suggested, including the strong probability that growth is limited by multiple, simultaneous deficiencies in many populations. This point is illustrated with data from the Nutrition Collaborative Research Support Program (CRSP) and other reports. Most interventions with single nutrients have been tested on children older than the age when linear growth faltering is most rapid, that is, within a few months of birth. Possible reasons why growth stunting begins so early in life are presented, but these are mostly hypothetical because of the paucity of information on this topic.

Body Height↗
PubMedDate not supplied

A comprehensive 30-month preventive dental health program in a pre-adolescent population with Down's syndrome: a longitudinal study.

A comprehensive systematic preventive dental health program was implemented in a young population with Down's Syndrome during a 30-month period. Twenty children (nine boys and 11 girls), ages 8-13 (mean age, 11), participated in the study, which took place in three hostel-like apartments. The main goals of this program were to achieve good plaque control and subsequently prevent periodontal disease as well as to apply fissure sealants and fluorides in an attempt to prevent dental caries. The mean plaque and gingival indices as well as the percentage of bleeding sites decreased significantly (P < 0.01) following the administration of our oral health program. Caries experience, as indicated by DMFS, decreased from 1-35 to 1-05 surfaces per child, and the use of fissure sealants to prevent occlusal caries was proved to be 100% effective. It is concluded that if the children's efforts are integrated with those of a motivated dentist, dental hygienist, and staff, a well-planned preventive dental health program can lead to a high degree of success in the prevention of dental diseases in young populations with Down's Syndrome.

Adolescent↗
PubMed2000

Diphtheria in the Russian Federation in the 1990s.

A resurgence of diphtheria spread throughout the Russian Federation in the early 1990s; diphtheria had been well controlled, but circulation of toxigenic strains of Corynebacterium diphtheriae had persisted since the implementation of universal childhood vaccination in the late 1950s. More than 115,000 cases and 3,000 deaths were reported from 1990 to 1997, and, in contrast to the situation in the prevaccine era, most of the cases and deaths occurred among adults. Contributing factors included the accumulation of susceptible individuals among both adults and children and probably the introduction of new strains of C. diphtheriae. Vaccine quality, vaccine supply, or access to vaccine providers did not significantly contribute to the epidemic. Mass vaccination of adults and improved childhood immunization controlled the epidemic. High levels of population immunity, especially among children, will be needed to prevent and control similar outbreaks in the future.

Adolescent↗
PubMed1998

Awareness of cancer-related programs and services among rural African Americans.

African Americans are at increased risk for cancer and represent an important target population for programs such as Healthy People 2000, the Cancer Information Service (CIS), and the 5 a Day for Better Health Initiative. Yet, awareness of such programs among rural blacks is unknown. This study assessed awareness of these programs and determined related knowledge and beliefs among rural African Americans. It was undertaken as part of the baseline survey for the Black Churches United for Better Health project, a National Cancer Institute-funded initiative. A minority of respondents (n = 3737) demonstrated name recognition of Healthy People 2000 (23.4%), the CIS (42.4%), and the 5 a Day Program (40.7%). Far fewer (7.4%) were able to correctly identify the recommended daily number of servings of fruits and vegetables. Reported family history of cancer was associated with a greater tendency believe that eating more fruits and vegetables can prevent disease. These findings underscore the need for efforts to reach the rural black community with culturally sensitive and stage appropriate cancer prevention messages. Knowledge of family history of cancer may play an important role in targeting subgroups and delivering effective cancer prevention messages.

Black or African American↗
PubMed1986

Poverty and social welfare: an agenda for change.

Actions to reduce the federal deficit in recent years threaten to strand the economically and socially disadvantaged while maintaining generous subsidy programs for populations with little or no financial need. This situation has been brought about in large part because of government's inherent reluctance to scale down programs that are politically popular even if no longer affordable or, in the long run, appropriate. The authors suggest that realistic and responsible social welfare policy reform requires that no sector of the federal budget be exempt from review or change. In the area of health, the importance of reshaping programs such as Medicare and Medicaid and disaggregating trends to focus more on populations with legitimate unmet needs is underscored. The authors make a number of suggestions on how existing social welfare programs can be better targeted.

Adolescent↗
PubMed2002

Genetic relationships of American alligator populations distributed across different ecological and geographic scales.

Although much work has been conducted on coastal populations of the American alligator (Alligator mississippiensis), less is known about the population dynamics and genetic structure of populations of alligators confined to inland habitats. DNA microsatellite loci, derived from the American alligator, were used to investigate patterns of genetic variation within and between populations of alligators distributed at coastal and inland localities in Texas. These data were used to evaluate the genetic discreteness of different alligator stocks relative to their basic ecology at these sites. Observed mean heterozygosities across seven loci for both coastal and inland populations ranged from 0.50-0.61, with both inland and coastal populations revealing similar patterns of variation. Measures of F(st) revealed significant population differentiation among all populations; however, analyses of molecular variance (AMOVAs) failed to demonstrate any apparent geographic pattern relative to the population differentiation indicated by F(st) values. Each population contained unique alleles for at least one locus. Additionally, assignment tests based on the distribution of genotypes placed 76% of individuals to their source population. These genetic data suggest considerable subdivision among alligator populations, possibly influenced by demographic and life history differences as well as barriers to dispersal. These results have clear implications for management. Rather than managing alligators in Texas as a single panmictic population, translocation programs and harvest quotas should consider the ecological and genetic distinctiveness of local alligator populations.

Alligators and Crocodiles↗
PubMedDate not supplied

Case management for the subacute patient in a skilled nursing facility.

The goal of case management has always been to manage care, cost, and outcomes. The Balanced Budget Act of 1997 and the subsequent implementation of managed care and the prospective payment system have introduced many challenges to the postacute care delivery system. The implementation of sound clinical, fiscal, and operational strategies is critical to the continued delivery of quality services and the maximization of revenue. The implementation of case management principles provides an opportunity to balance care with cost. This article focuses on the development and implementation of a case management program at a skilled nursing facility that specifically addresses the needs of a subacute population. The program's purpose is to promote efficiency, efficacy, and effectiveness of services for short-term subacute patients who will eventually return to the community. The long-term goal of the program is to classify all patients into case management categories and assign them to RN case managers or social workers, based on acuity and need.

Case Management↗
PubMedDate not supplied

HRSA's collaborative efforts with national organizations to expand primary care for the medically underserved.

As the Federal agency that provides leadership in expanding access to primary health care, the Health Resources and Services Administration (HRSA) manages some 50 programs directed toward the delivery of services and strengthening the base of national health resources. An enabling element of the agency's strategy is the expansion of partnerships with national associations, private foundations, and other entities that share a concern for the health care of the medically underserved. Cooperative efforts with national organizations are intended to promote the integration of public and private resources and encourage adoption of efficient approaches to organizing and financing health care. Medical education in the primary care specialties, State programs for women and children, involvement of managed care organizations with low-income populations, and programs concerning the uninsured are the foci of some of these collaborative relationships.

Child↗
PubMedDate not supplied

Transitions from AFDC to SSI before welfare reform.

The Supplemental Security Income (SSI) and Aid to Families with Dependent Children (AFDC) programs serve populations with similar characteristics. SSI serves adults and children with disabilities who are in low-income families, and AFDC serves low-income families with children. Because of that overlap, policy changes in one program can affect the other. In 1996, Congress enacted the Personal Responsibility and Work Opportunity Reconciliation Act, which transformed AFDC into the Temporary Assistance for Needy Families (TANF) program. Many people have expected that implementing that welfare reform legislation would eventually increase SSI participation, for two reasons. First, TANF includes new work requirements and time limits that induce more AFDC/TANF recipients with disabilities to obtain SSI benefits. Second, the change in the funding mechanism--from open-ended funding on a matching basis for AFDC to cash assistance block grants for TANF--gives states a stronger incentive to shift welfare recipients to SSI. This article examines the interaction between the SSI and AFDC programs in the prereform period (1990 to 1996) and discusses the potential implications of welfare reform on that interaction. Using matched data from the Survey of Income and Program Participation and Social Security Administration (SSA) records, our analysis focuses on how the interaction of those programs affects young women (aged 18 to 40) and children (aged 0 to 17). We find a very strong link between AFDC and SSI for young women and children. Significant portions of young female and child SSI beneficiaries in the 1990-1993 period were in AFDC families or had received AFDC in the past. In addition, a substantial share of young women and children who received AFDC during that period eventually entered SSI. Because the SSI program is now serving a much larger population of families with young women and children than in the past, SSA might need to develop policies to better serve that group. The findings also suggest that the prereform period is a poor baseline against which to measure the impact of TANF, primarily because of the instability in programs and policies.

Adolescent↗
PubMed1995

Determination of stereospecific assignments, torsion-angle constraints, and rotamer populations in proteins using the program AngleSearch.

A general program, AngleSearch, which calculates coupling constants and interproton distances for any molecular fragment and does a grid search to find torsion angles, rotamer populations, and stereospecific assignments which fit the measured data has been developed. The program takes full advantage of the fact that ratios of cross-peak intensities (measured in HNHB and HN(CO)HB experiments) can provide accurate ratios of coupling constants even for large molecules. AngleSearch is capable of: (a) analyzing any type of residue including protein, RNA, DNA, and ligand residues; (b) conformational grid searching in dihedral-angle space using 6 degree steps; (c) averaging coupling constants and (l/r6) distances for rotamers undergoing fast exchange; (d) grid or Monte Carlo searching for populations of staggered rotamers; (e) using all available distance-related data from ROESY and/or NOESY spectra; (f) using any available coupling constant data having known relationships to corresponding dihedral angles; and (g) directly using cross-peak intensities related to values of coupling constants. The program can also assist in the stereospecific assignment of the alpha-CH2 protons of glycine residues. The effects of the quality of the input data on the results of the AngleSearch calculations have been assessed.

Alanine↗
PubMedDate not supplied

Using a focus group to design a diabetes education program for an African American population.

PURPOSE: The purpose of this project was to determine what factors need to be considered in planning a diabetes education program to better meet the needs of African Americans with diabetes in a community served by a suburban community hospital. METHODS: Two focus group sessions were conducted. The sessions were recorded, transcribed, and analyzed by members of the research team. RESULTS: Four themes emerged that had bearing on program development: (1) a sense of personal powerlessness, (2) fear related to complications, (3) recognition of knowledge deficits accompanied by an inability to link behavior to outcomes, and (4) a clear vision of what kind of educational setting would interest and benefit the group. CONCLUSIONS: There were significant differences between what was being offered for diabetes education at the facility and what was desired according to the focus group, including factors of cost and leadership. Recommendations for future program planning are given.

Adult↗
PubMed1993

Developing community-based program alternatives for the seriously and persistently mentally ill elderly.

The deinstitutionalization movement in the United States has traditionally neglected the rehabilitation potential of the seriously mentally ill elderly. With the proliferation of the elderly population, unique programs and community-based settings must be created and expanded to meet the mental health needs of this population in a cost-effective and humane manner. The mental health continuum presented is a model composed of programs that target the seriously mentally ill elderly in a variety of community placements including residential treatment facilities, nursing homes, retirement homes, and permanent housing.

Aged↗
PubMed1998

[Quality control of data produced in biological population surveillance studies on the risk of environmental lead poisoning].

The biological surveys of the general population against the risk of lead intoxication carried out in Italy--in accomplishment both of the EEC directive EEC 77/312 and the Presidential Decree 496/1982--have been always conceived as multicentric activities. Therefore, starting from the first campaign carried out in 1979, strict quality control procedures have been adopted. In brief, each participant laboratory used internal quality control samples and took part in external quality assessment exercises. In addition, ten percent of the blood samples collected during the campaign were analyzed as blind duplicate by both participating laboratories and a reference laboratory. In this paper the quality control procedures adopted will be presented and discussed in detail together with the quality of results obtained in each campaign.

Environmental Exposure↗
PubMed1982

Evaluating the rehabilitation process: an example with the blind.

The research methods presented here were developed for the evaluation of the CBRC (Central Blind Rehabilitation Center) at Hines. These methods are applicable to the evaluation of other blind rehabilitation programs. In addition, most of the strategies are applicable to other kinds of rehabilitation programs. The process of defining goals and of determining outcome variables is a necessary step in effective evaluation regardless of the population and program in question. It is essential to measure the influence of patient variables on treatment outcomes for all populations undergoing rehabilitation. The measures to evaluate these out-come and patient variables must be demonstrably reliable and valid. The methods used to identify and define variables, the research design and methods to produce reliable measures all can be used to evaluate a variety of programs as well as individual treatments and devices.

Blindness↗
PubMedDate not supplied

Implementing program evaluation and accountability for population health: progress of a national diabetes control effort.

Diabetes affects some 16 million Americans at a cost estimated at $100 billion. The Centers for Disease Control and Prevention funds a diabetes control program (DCP) in every state as part of the National Diabetes Control Program (NDCP). In 1999, a new policy added emphasis on evaluation and made NDCP and its DCPs accountable for achieving impacts related to the health of populations with diabetes. The article reports on the experiences of the NDCP in implementing a performance-based program evaluation paradigm. It also discusses potential future directions for national diabetes-control efforts.

Centers for Disease Control and Prevention, U.S.↗
PubMed2001

Simulation studies of detection of a complex disease in a partially isolated population.

Simulation studies were undertaken with POPGEN, a new population simulation program, to explore strategies for detecting loci underlying rare and common disorders in a small population that has been partially isolated for 10 generations. Haplotype-sharing analysis (HSA) and non-parametric linkage analysis (NPL) were applied to the simulated haplotype and pedigree data for 100 cases, 100 controls, and an average of 28 multiplex pedigrees from cases' families, for a 2-5 cM map of markers. When identity by descent (IBD) status was known (using unique founder marker allele designations assigned during simulation), a linkage disequilibrium (LD) signal could be detected under disease-generating models predicting relative risk to sibs of 11.8 (high-RR) or 2.67 (mod-RR). Detection was more difficult when marker alleles were down-coded to resemble microsatellites (heterozygosities 0.75-0.80). False-positive peaks on nondisease chromosomes were uncommon. NPL analysis was more powerful than HSA at this marker density using down-coded alleles and assuming availability of all affected relatives. LD mapping of common disorders is likely to require denser maps of highly polymorphic markers to approximate full IBD information. LD and linkage mapping provide independent information, and strategies that combine these two methods could be useful in studies of small isolated populations.

Computer Simulation↗