Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Target Population”

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.

At least 523 records · Page 29Linked to original sources
PubMed2001

[Socio-ethic of cancer chemoprevention].

Cancer chemoprevention envisions a reduction in the incidence of the disease through direct action using various chemical products. Chemoprevention trials involve healthy subjects, as a consequence careful ethical consideration must be given to such interventions. The classical contract between the patient and his doctor is altered in this situation and the numerous consequences of extrapolation of results to the general population must be considered. In particular a calculation of the risk-benefit ratio must take into account not only the physical but also the mental and social well being of people whose lives will be medicalised as a result of such intervention. The primacy of collective benefit over individual interest mandates that chemoprevention be based on scientific and well conducted trials. When results are extrapolated to the whole population an evaluation process has also to be permanently performed. The target population must be well informed and the participation based on voluntary consent.

Anticarcinogenic Agents↗
PubMed2006

[Successes and failures of anti-HBV vaccination in France: historical background and questions for research].

The promotion in France, in the mid 90s of hepatitis B vaccination for pre-teenagers and high-risk individuals has been very successful. Between 1994 and 1998, vaccination coverage in pre-teenagers was over 75% and more than one third of the French population has been immunized, indicating that vaccination went well beyond its target. Vaccination of infants has been much less successful. Epidemiological studies, undertaken following notifications of neurological events following vaccination, could neither confirm nor totally disprove an association between the two events, even if the hypothesis of a coincidental temporal relationship remains by far the most likely explanation. This situation led to the stagnation or the decrease of the vaccination coverage for its various target-populations. However other factors may have contributed to this situation. Research in social sciences would be useful to study the contribution of a negative perception of the epidemiological relevancy of hepatitis B vaccination, especially in infants, as well as of the shortcomings in the management of the implementation of the vaccination strategies. The results would help to tailor communication strategies that are needed to support an active promotion of hepatitis B vaccination in France.

Adolescent↗
PubMed1987

Chlamydial infection among females attending an abortion clinic: prevalence and risk factors.

To determine the prevalence of Chlamydia trachomatis infection and the epidemiologic risk factors for chlamydial infection in the Quebec City region, screening was done with an enzyme immunoassay in 920 females who attended an abortion clinic between November 1985 and June 1986. The organism was detected in 105 (11.4%) of the patients. After adjustment for confounding variables, four variables were found to be independent risk factors for chlamydial infection: age 24 years or less (prevalence ratio 3.0 [p less than 0.001]), two or more sexual partners during the previous year (prevalence ratio 1.8 [p = 0.001]), no contraception or the use of a nonbarrier method (prevalence ratio 1.9 [p = 0.030]) and living in an urban area (prevalence ratio 1.6 [p = 0.046]). The results confirm that chlamydial infection is prevalent in this population. The identified risk factors may prove useful in determining the target population for screening programs.

Abortion, Induced↗
PubMed1995

Administration of hepatitis A vaccine to a military population by needle and jet injector and with hepatitis B vaccine.

Military personnel are an important target population for hepatitis A immunization. Soldiers are often given vaccines by jet injector and may be required to receive multiple vaccines at one time. Formalin-inactivated hepatitis A vaccine containing 360 ELISA units of antigen was evaluated at Fort Campbell. Volunteers received vaccine at 0, 1, and 6 months as follows: group 1, hepatitis A vaccine by needle; group 2, hepatitis A vaccine by jet injector; group 3, hepatitis B vaccine by needle; and group 4, both hepatitis vaccines by needle in separate arms. Immune response and reactogenicity were evaluated. After two doses, recipients of vaccine administered by jet injector had a higher prevalence of antibody than those who received vaccine by needle (93% vs. 79%). By the 8th month, the vaccine was 100% immunogenic by either route or with hepatitis B vaccine. No interaction between hepatitis A and B vaccines was detected.

Adult↗
PubMed2004

Autodissemination of the entomopathogenic fungus Metarhizium anisopliae amongst adults of the malaria vector Anopheles gambiae s.s.

BACKGROUND: The entomopathogenic fungus Metarhizium anisopliae is being considered as a biocontrol agent for adult African malaria vectors. In the laboratory, work was carried out to assess whether horizontal transmission of the pathogen can take place during copulation, as this would enhance the impact of the fungus on target populations when compared with insecticides. METHODS: Virgin female Anopheles gambiae sensu stricto were exposed to conidia whilst resting on fungus-impregnated paper. These females were then placed together for one hour with uncontaminated males in proportions of either 1:1 or 1:10 shortly before the onset of mating activity. RESULTS: Males that had acquired fungal infection after mating indicate that passive transfer of the pathogen from infected females does occur, with mean male infection rates between 10.7 +/- 3.2% and 33.3 +/- 3.8%. The infections caused by horizontal transmission did not result in overall differences in survival between males from test and control groups, but in one of the three experiments the infected males had significantly shorter life spans than uninfected males (P < 0.05). CONCLUSION: This study shows that autodissemination of fungal inoculum between An. gambiae s.s. mosquitoes during mating activity is possible under laboratory conditions. Field studies are required next, to assess the extent to which this phenomenon may augment the primary contamination pathway (i.e. direct contact with fungus-impregnated targets) of vector populations in the field.

Animals↗
PubMed1993

[Effect of 2 vaccination strategies on developments during the epidemic of meningococcal A meningitis in N'Djamena (Chad) in 1988].

From February till May 1988, during an epidemic of group-A meningococcal disease, 4542 cases of meningitis were reported in N'Djamena, the capital of Chad (550,000 inhabitants). A first selective vaccination campaign was carried out between 5 and 14 March; 156,500 vaccine doses (polyvalent: group A and C: Institut Mérieux) were given using jet injectors. The target population for this first campaign consisted of groups such as school-children and the armed forces. As the epidemic continued, a mass vaccination campaign was implemented one month later between 8 and 14 April 1988; this was targeted at the whole population above 1 year of age, not previously immunized, and 266,738 doses of vaccine were injected. One week after the start of the second campaign, the number of reported cases fell sharply and, within four weeks, the epidemic was halted. The vaccination coverage rate, evaluated by a WHO cluster survey method in people above one year of age, was 95.5%. These results show (i) the failure of selective vaccination, restricted to only at-risk groups, to halt the epidemic; (ii) the efficacy of the mass vaccination campaign aimed at the whole population; and (iii) the feasibility in tropical Africa of such a mass campaign which must be carried out in a few days.

Adolescent↗
PubMed2003

[Breast and cervical cancer screening: beliefs and behaviors among the female population of the city of Liege (Belgium)].

Several surveys have shown that in Belgium the coverage of the female population for both breast and cervix cancers screening is too low and not evenly distributed in the target population. In order to highlight modifiable behavioural factors about cancer screening and to know the profile of women who exhibit an inadequate preventive behaviour, a postal survey has been conducted in the city of Liège. A self-administrated questionnaire was sent to a randomised sample of 1.000 women from two age groups (25-37 and 45-57 years); 444 women returned the questionnaire (response rate: 45.4%). The results show that the responders who do not comply with the recommendations for cancer screening are more often unemployed women with a low educational level, women who have a poor perception of their health, or women who are not regularly followed by a gynaecologist. Those women have more often poor knowledge and wrong beliefs about prevention, a negative perception of the curability of a cancer detected early and of the efficacy of screening tests. In spite of an overrepresentation of women with an university degree among the responders, it was also observed that more than 1 woman out of 4 in the 25-37 years age group is not convinced of the pap smear efficacy. In view of these results, the design of screening campaigns for cancer prevention has to involve specific efforts targeted at under-privileged subgroups within the female population.

Adult↗
PubMed1998

The epidemiology of urban pediatric neurological trauma: evaluation of, and implications for, injury prevention programs.

OBJECTIVE: To describe the incidence and causes of pediatric head, spinal cord, and peripheral nerve injuries in an urban setting and to assess the implications of these data for injury prevention programs. METHODS: Pediatric deaths and hospital admissions secondary to neurological trauma included in the Northern Manhattan Injury Surveillance System from 1983 to 1992 were linked to census counts to compute incidence rates. Rates before the implementation of a nonspecific injury prevention program were compared with rates after the implementation, and rates for the target population were compared to rates for the control population. Rates were analyzed on the basis of the cause of injury as well as the age, gender, and neighborhood income level of the injured. RESULTS: The incidence of neurological injuries resulting in hospitalization or death was 155 incidents per 100,000 population per year; the mortality rate was 6 people per 100,000 population per year. Neurological injuries represented 18% of all pediatric injuries and accounted for 23% of all traumatic deaths. Spinal cord and peripheral nerve injuries were relatively rare (5%) compared to head injuries (95%). Minor head injuries, including isolated cranial fractures, minor concussions (<1 h loss of consciousness), and unspecified minor head injuries, accounted for the majority of neurological injuries (76%), whereas severe head injuries, including severe concussion (>1 h loss of consciousness), cerebral laceration/contusion, intracerebral hemorrhage, and unspecified major injuries, were less common (18% of all neurological injuries). Boys were more often affected than girls at every age, and this preference increased with age. Children younger than 1 year showed the highest incidence of both major and minor injuries. One- to 4-year olds showed the lowest rates, with steady increases thereafter. Traffic accidents and falls were the leading causes (38 and 34%, respectively), and assaults were the next leading causes (12%). Among children admitted to surveillance system hospitals, falls were most common in children younger than 4 years, pedestrian motor vehicle accidents were most common in late childhood, and assaults were most common in early adolescence. CASE: fatality rates were 5 to 7% for all age groups except 5- to 12-year-olds, for whom the case:fatality rate was 1.9%. Residence in a low-income neighborhood was associated with an increased risk of injury (rate ratio, 1.71; confidence interval, 95%, 1.54, 1.89). The average hospitalization cost per injury was $8502. Medicaid (54%) and other government sources (5%) covered the majority of expenses, including indirect reimbursement of usually uncollected self-pay billing (19%). Although injury incidence rates fell in both the control and intervention cohorts during implementation of a nonspecific injury prevention program, targeted age and population groups demonstrated greater relative reductions in injuries than nontargeted ones, suggesting a positive effect. CONCLUSIONS: Deaths and hospital admissions secondary to pediatric neurological trauma represent a significant public health problem, with the majority of the direct cost being born by government agencies. Future efforts to prevent neurological trauma in children who live in inner cities should focus on families with low incomes and provide novel education programs regarding infant abuse, infant neglect, and infant injury avoidance. Age-appropriate school-based programs should also be developed to address traffic safety and conflict resolution.

Adolescent↗
PubMed2006

Women's perceptions and social barriers determine compliance to cervical screening: results from a population based study in India.

BACKGROUND: Success of cervical screening initiatives depends on high participation of the target population, which in turn is determined by the women's perceptions, health orientation and other socio-cultural issues. The present study identifies the immediate social and cultural barriers that prevent women to attend cervical screening facilities. METHODS: Women non-compliant to a community-based cervical screening program were identified. From them 500 were randomly selected for interview using a structured questionnaire that was designed on the basis of feedbacks received from several focused group discussions. Questionnaire listed 24 possible reasons for non-compliance. The women were asked to select the most pertinent reason(s) for her non-attendance or to reveal if they had any reason other than the listed ones. RESULTS: A total of 469 non-compliant women were interviewed. They had significantly lower literacy rate compared to the compliant women (OR=2.25; 95% CI: 1.23-4.13). Nearly half of the interviewed women responded that they themselves opted to stay away from the program. Most common reasons cited for non-attendance in this group were reluctance to go for medical test in the absence of any symptoms and apprehension to have a test that detects cancer. Second major group of responders comprised of women who were willing, yet could not attend due to various hurdles. Most common hurdles were inability to leave household chores, pre-occupation with family problems and lack of approval from husbands. CONCLUSIONS: Modification of health behavior through education and social empowerment of women are essential for a population based cervical screening program to succeed in India.

Adult↗
PubMedDate not supplied

Diagnostic testing for coronary artery disease in a large population.

Extensive public health programs are often proposed without a full appreciation of their effects on the target population. There is often a problem of confusing medical care that may be of benefit to an individual with care that may be of benefit to a population: care that may be highly beneficial for a selected patient may be substantially less effective for an unselected population. Exposing a large, asymptomatic population to diagnostic screening for coronary artery disease has cost and risk ramifications far beyond those of discovering people who might benefit from treatment of previously unsuspected disease. A program to screen 20 million people, and treat the most severely affected with coronary artery bypass graft, would cost nearly +9.2 billion. About +21,000 is spent to find each person with disease, while the cost is more than +169,000 for each person surviving surgical therapy. The cost per year of life extended is over +43,000. In excess of 8,000 persons have major complications and nearly 2,000 die from diagnostic testing and therapy. About half of major complications and deaths occur in persons without disease. This model integrating epidemiologic, economic, and decision analytic methods is presented to illustrate the potential use of myriad techniques in addressing population-based medical care and policy options; it does not provide the definitive answer, however, to the complex problem.

Adult↗
PubMedDate not supplied

Role of afferents in the development and cell survival of the vertebrate nervous system.

1. During normal development of the vertebrate central nervous system, a considerable number of neurons die. The factors controlling which neurons die and which survive are not fully understood. 2. Target populations are known to maintain their innervating neurons. However, the role of afferents in maintaining their targets is still under review. 3. In the developing nervous system, deafferentation of a neuron population is difficult to achieve because plasticity (structural re-organization) can cause re-innervation of the area. Re-innervation alters, rather than removes, the afferent supply. 4. Afferent input is important for neuronal survival during development because deafferentation increases neuronal death by 20-30% and increasing input diminishes neuronal death. 5. Deafferented neurons die at the normal time for cell death for any given population. This occurs after the arrival of afferent axons but before the completion of connectivity and the onset of function. 6. Neuronal survival is maintained by any input, such as reinnervation by inappropriate fibres, but for optimal survival, morphological maturation and the acquisition of normal physiology, the correct input is required. 7. Afferents maintain their target neurons via a combination of electrical activity and delivery of trophic agents, which adjust intracellular calcium, thereby facilitating protein synthesis, mitochondrial function and suppressing apoptosis. 8. Evidence from animal and in vitro experiments indicates that afferents play an extremely important role in the survival of developing neurons in the immature vertebrate nervous system.

Animals↗
PubMed2005

[Systematic screening tests for Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum in urogenital specimens of infertile couples].

We conducted a prospective study on 100 couples consulting for infertility at the teaching Hospital of Tours, with the scope to determine if there is a benefit for systematic screening of Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum among genito-urinary specimen when exploring couples infertility. C. trachomatis was detected by PCR on sperm, endocervix and urine specimen. M. hominis and U. urealyticum were detected by culture on A7 agar medium and with minigaleries on sperm and endocervix specimen. Standard cultures were also performed on sperm, endocervix, vaginal and urine specimen. Only one specimen (sperm) was positive for C. trachomatis. Three percent of the specimen were positive for U. urealyticum (from which 2,5% of the sperm specimen). No specimen was positive for M. hominis. Our results show that screening of C. trachomatis, M. hominis and U. urealyticum is not systematically required for among check up of infertile couples, given the prevalence of chlamydiosis among the population studied. However, it would be interesting to perform it on a targeted population, according to anamnestic or clinical criteria. In addition, an important modification of vaginal flora was observed in 12% of cases, and 2 vaginosis were diagnosed; the putative consequences of this disequilibrium has to be further investigated.

Cervix Uteri↗
PubMed1993

Screening and prenatal diagnosis of the haemoglobinopathies.

In this paper we have reviewed the social and technical aspects of carrier screening and prenatal diagnosis of the inherited haemoglobinopathies. The characteristics of programmes based on carrier screening and prenatal diagnosis ongoing in a number of at-risk Mediterranean populations have been described. The most relevant and common aspects of these programmes are the continuous educational campaign directed to the population at large, the voluntary basis and non-directive counselling. The target population has been most commonly couples before or after marriage. The vast majority of couples counselled accepted prenatal diagnosis. All programmes have encountered a high degree of success as indicated by the marked reduction in the birth rate of infants with thalassaemia major. No significant adverse effects have been reported. A programme with similar characteristics and for which the preliminary results are encouraging, is operating for sickle cell anaemia in the Cuban population. In a population with high frequency of hydrops fetalis, screening for deletion alpha-thalassaemia is recommended to prevent the negative effects on a pregnant woman of the presence of an hydropic fetus. Thalassaemia carrier screening is now carried out by automatic red cell indices and HbA2 determination. Definition of atypical cases may require iron studies, globin chain synthesis determination and/or alpha, beta- and delta-globin gene analysis. Identification of the carrier state is followed by definition of the mutation on enzymatically amplified DNA. Known mutations may be detected by restriction endonuclease analysis, non-denaturing polyacrylamide gel electrophoresis, allele-specific primers or allele-specific probes. The most promising procedures, which are also amenable to complete automation are reverse oligonucleotide hybridization and primer-specific amplification. Unknown mutations are defined by denaturing gradient gel electrophoresis, single-strand conformation polymorphism analysis, and chemical mismatch cleavage analysis followed by direct sequencing. The same methods on enzymatically amplified chorionic villus DNA are used for prenatal diagnosis. The potential pitfall resulting from maternal contamination can be avoided by careful dissection of the maternal decidua from the chorion and by the simultaneous amplification of a suitable polymorphism.

DNA Restriction Enzymes↗
PubMed2006

Cortisol correlates with metabolic disturbances in a population study of type 2 diabetic patients.

OBJECTIVE: The prevalence of type 2 diabetes mellitus is increasing rapidly in industrialized countries, and adrenal glucocorticoids may intensify this disease. We sought to assess the relationship between diabetes-associated metabolic disturbances and cortisol concentrations in patients with type 2 diabetes. DESIGN: We investigated 190 type 2 diabetic patients who volunteered from a population study of 12,430 people in Luebeck and its suburbs. The target population comprised men and women born between 1939 and 1958 who initially received a postal questionnaire about their health status. We identified 346 subjects with confirmed diabetes mellitus and 216 patients participated in the study. Patients with type 1 diabetes were excluded. METHODS: Five salivary cortisol samples were collected before and after lunch, in the evening and then the next morning before and after standing. Clinical variables associated with diabetes were measured and correlated with cortisol concentrations. RESULTS: None of the cohort had salivary cortisol concentrations that exceeded the normally accepted range. Based on cortisol samples collected just prior to a standard lunch, the cohort was divided into tertiles. Cortisol was positively related to: fasting blood, urinary and postprandial glucose; glycosylated hemoglobin; and systolic and diastolic blood pressures (all P < 0.05). Cortisol concentrations also correlated with the relative abdominal mass (P < 0.05) when patients with marked glucosuria were excluded. CONCLUSIONS: The degree of severity of several clinical measures of type 2 diabetes correlates with cortisol concentrations. Moreover, the results provide evidence for a positive relationship between metabolic disturbances and cortisol concentrations that are within the accepted normal range.

Abdominal Fat↗
PubMed1997

Analyses of factors influencing participation in the cervical cancer screening programme in the community in Japan.

The association between the participation rates of cervical cancer screening programme and implementation methods, concerning data management, participant convenience, promoting participation, and payment, were analyzed. The data regarding the implementation methods were obtained in a nation-wide questionnaire survey. The relationship between the participation rates and implementation methods were assessed using the chi-square test and multiple logistic regression analyses. In small municipalities, with a population < 10,000 items concerning data management, enlisting the assistance of community organizations, fee exemption, and early morning screening were positively associated with the participation. In middle-sized municipalities, with the population 10,000-49,999, early morning screening, community organizations, items concerning data management, and sending out letters were positively associated with participation. Saturday/Sunday screening, community organizations, letters, and postcards were positively associated with the participation of the older group (> or = 50 years) in large municipalities with population of > 50,000. These results indicate that enlisting the assistance of community organizations and establishing a well-organized data management system are likely to improve participation regardless of municipality size. Other implementation methods must be selected taking into account factors such as municipality population size, as well as the age distribution and characteristics of the target population.

Adult↗
PubMed2001

Glucose intolerance is predicted by the high Fasting Insulin-to-Glucose ratio.

OBJECTIVE: To determine whether impaired glucose tolerance (IGT) is predicted by high Fasting Insulin-to-Glucose (FIG) ratio and to establish its correlation with insulin resistance and fasting insulin. MATERIAL AND METHODS: A population-based three-year follow-up study was performed. The target population consisted of healthy volunteers, men and non-pregnant women aged 30 years or over. Participants were required to have normal referenced ranges of OGTT and blood pressure. Previous diagnosis of chronic diseases was an exclusion criterion. At baseline and at the 3-yr of follow-up, an OGTT was performed. The ratio of serum Fasting Insulin (microUI/ml)/Fasting Glucose (mg/dl) was used to calculate the FIG ratio. Insulin action and secretion were estimated by HOMA and Insulinogenic index, respectively. RESULTS: The FIG ratio was directly correlated with the HOMA index (r=0.83, p<0.01) and fasting insulin (r=0.95, p<0.001). Multivariate logistic regression analysis showed that IGT was more likely to develop in subjects with high FIG ratio (RR 5.01; CI(95%) 1.9-12.2, p=0.02), high HOMA index (RR 6.1; CI(95%) 2.1-11.1, p=0.01), and fasting hyperinsulinemia (RR 4.7 CI(95%) 2.7-13.2, p<0.05). The cutoff point of FIG ratio for determining the risk of developing IGT was 0.25 +/- 0.05. CONCLUSIONS: The FIG ratio could be a reliable alternative for the screening of apparently healthy subjects in high risk groups.

Adult↗
PubMed1994

Population policies and the "creation" of Africa.

"This paper will look at the ways in which population policies have played an important role in the ongoing debate about African identities and culture.... In dealing with the construction of Africa, this paper will be limited to the impact of the population discourse on Africans. Three groups will be considered. These are: the target population of (largely rural) women; males (representing the patriarchal dimension); and African intellectuals. Even though membership in each group is not mutually exclusive, each will be dealt with separately for ease of analysis." (SUMMARY IN FRE)

Africa↗
PubMed2004

Quality care improvement program in a community-based participatory research project: example of Project DIRECT.

A continuous quality care improvement program (CQIP) was built into Project DIRECT (Diabetes Interventions Reaching and Educating Communities Together) to improve providers' patterns of diabetes care and patients' glycemic control. Project DIRECT consisted of a comprehensive program aimed at reducing the burden of diabetes in the vulnerable high-risk African-American population of southeast Raleigh, NC. Forty-seven providers caring for this target population of adult diabetes patients were included in this quasi-experimental study. At the initial session, providers learned about the CQIP components, completed a planning worksheet, and chose a CQIP coordinator. Educational events included continuing education in practices and through conferences by experts, and guideline distribution. Follow-up was accomplished through phone calls and visits. Effectiveness was measured by a change in prevalence of selected patterns of care abstracted from 1,006 medical charts. Appropriate statistical methods were used to account for the cluster design and repeated measures. At the fourth follow-up year, approximately 40% of providers still participated in the program. Among the providers who stayed in the program for the whole study period, most selected quality care patterns showed significant upward trends. Glycemic control indicators did not change, however, despite an increased number of hemoglobin A1c tests per year. A diabetes CQI program can be effectively implemented in a community setting. Improved performance measures were not associated with improved outcomes. These results suggest that a patient-centered component should reinforce the provider-centered component.

Adult↗