Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Community-based Distribution”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed1991

A community-based study of incidence, risk factors and outcome of transient ischaemic attacks in Umbria, Italy: the SEPIVAC study.

The SEPIVAC study is a community-based epidemiological survey of incidence and outcome of transient ischaemic attacks (TIAs) and strokes in the territory of the 6th Local Health Unit, Umbria, Italy, where 49,218 people live, from 1 September 1986 to 31 August 1989. All cases were registered with the study either by notification from general practitioners (GPs) or by a check of hospital admission within the study area and in the two hospitals of Perugia. There were 94 incident cases of TIAs (45 males, 49 females), thus giving a crude rate of 0.64 per 1000 per year [95% conficence intervals (CI) 0.52/0.78]. The rate adjusted to the European population is 0.42 (CI 0.33/0.54). Mean age was 69.4 years, and females were significantly older than males. The weighted relative risk for males was 1.19 (CI 0.79/1.79). Thirty-one patients were treated at home by their GPs. Females had hypertension more frequently than males, whereas males smoked more frequently; we did not find any other statistically significant difference in the distribution of risk factors. Twelve patients out of 58 who had CT had an infarct, and 29 out of 54 submitted to Doppler ultrasonography had carotid stenosis. At 1 month, 4 patients had suffered an ischaemic stroke, 1 of whom died. At 6 months, 3 further strokes and 2 further deaths (1 due to myocardial infarction) had occurred.

Aged↗
PubMed1990

Estimation of QT prolongation. A persistent, avoidable error in computer electrocardiography.

A pooled community-based population sample of 17,139 North American children, adolescents, and adults aged from birth to 75 years was used to evaluate a variety of one-, two-, and three-parameter formulas for correction of the QT interval for heart rate throughout a wide range of heart rates in sinus rhythm. QT measurements were made by a computer program from simultaneously sampled standard 12-lead or orthogonal XYZ leads, and all QT measurements were visually verified using a high-resolution display terminal. A random subsample of 1,920 was drawn 3 times by allocating 20 subjects to each heart rate subinterval of 1 beat/min, and the performance of a set of 13 QT prediction formulas was compared by ranking them according to the Akaike Information Criterion. The traditional Bazett's square root formula failed at low heart rates and the cube root formula of Fridericia at high rates. None of the linear two-parameter functions of R-R interval or heart rate performed with adequate accuracy. The best one-parameter formula for predicted QT(QTp) was obtained by regressing the inverse of QT on heart rate, with the expression QTp(ms) = 656/(1 + 0.01 H R), and by adding the term 0.4 x Age - 25 for age-related trend correction in males 15-50 years old. Percentile population distributions for the QT index (QTI = (QT/QTp) x 100) produced a convenient and stable 98 percentile normal QT range spanning 10% above and below the population median QTI = 100 in all major subgroups by age, sex, and race.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women.

The prevalence, incidence and correlates of urinary incontinence were studied in a community-based sample of 541 healthy, middle-aged women 42 to 50 years old. Participants were evaluated on 2 occasions approximately 3 years apart. Of the participants 58% reported urine loss at some time and 30.7% reported incontinence on a regular basis at least once per month. During 3 years the cumulative incidence of regular incontinence in previously continent women was 8.0%. Among those with regular incontinence 64.9% said the volume of loss was 1 or 2 drops, while 35.1% reported that they needed to change their garments. Only 25.5% of the patients had sought treatment. Continence status was significantly related to body mass index and race but not to patient age, parity, caffeine or alcohol intake, smoking, physical activity, prior gynecological surgery or several psychological variables. The results indicate that urinary incontinence is common among middle-aged women. That few seek treatment suggests a need for more information about women's attitudes toward incontinence and more attention to this problem by health care providers.

Adult↗
PubMed1992

The FINMONICA Stroke Register. Community-based stroke registration and analysis of stroke incidence in Finland, 1983-1985.

In the early 1980s, a standardized community-based stroke register was started in three geographic areas in Finland: North Karelia and Kuopio in eastern Finland and Turku/Loimaa in southwestern Finland. The results from the first 3 years, 1983-1985, confirmed the high incidence of stroke in Finland. The incidence of stroke was higher in eastern Finland than in the southwestern part of the country. The age-standardized annual incidence among men aged 25-74 years varied from 206 per 100,000 population in southwestern Finland to 322 per 100,000 population in the province of Kuopio in eastern Finland. Among women aged 25-74, incidence was 119 and 187 per 100,000 population in these two areas, respectively. The age-standardized male:female ratio in incidence was 1.7, slightly higher than that previously reported in Finland. Out of 3,574 stroke events registered, 78% were first events without a history of previous stroke. People aged 65-74 years accounted for 45% of all events among men and 62% of all events among women. The authors' experience shows that the geographic variation in stroke incidence and attack rates is difficult to assess even within a country with a relatively uniform health care system. Rigorous standardization and quality control is needed for the assessment of long-term trends; this is the primary goal of the FINMONICA Stroke Register. The findings of this study suggest that the incidence of stroke is still high in Finland, although mortality from stroke has steeply declined during the past 15-20 years. The number of stroke survivors in Finland may actually be increasing. Since the occurrence of stroke is high in Finland as compared with other countries, intensified primary and secondary prevention measures are needed to reduce it.

Adult↗
PubMed1992

Medication utilization and patient information in homes for the aged.

A random cross-sectional sample of 198 residents was taken from a convenience sample of 20 Flemish, community-based nursing homes for the aged. Twenty trained interviewers reviewed the medication list of these residents and interviewed the nurses responsible for their daily care to assess their activities of daily living (ADL) and cognitive status. Direct interview was possible of 128 residents (65%); communication with the other 70 residents was impossible because of dementia (55 patients) or communication problems, such as aphasia and deafness (15 patients). An average of 4.5 different medicines was mentioned on the medication lists of the 198 residents. Drug use increases with age but stabilises after the age of 80 y. Medicines are ordered from local community pharmacies and are delivered to the ward rooms in original drug dispensing packs. The nursing staff is responsible for distribution inside the institution. Nursing personnel read the inserts of the medicines given to 98% of the residents and keep the inserts of 77% in the nursing office. Only 11% of the residents maintained some autonomy in ordering, keeping and taking their medication, although 42% were evaluated by the nurses as functionally and cognitively fit. Only 4% of the 128 residents able to respond to an interview had a notion of the potential adverse effects of their medication; the two most important sources of information about medicines mentioned by those residents were the general practitioner and the nursing personnel; 4% mentioned relatives and friends, or the pharmacist, as information sources.

Activities of Daily Living↗
PubMed1990

Reduction in pneumonia mortality and total childhood mortality by means of community-based intervention trial in Gadchiroli, India.

In a community-based intervention trial to reduce childhood mortality from pneumonia the intervention area included 58 villages (6176 children aged 0-4 years) and the control area 44 villages (3947 children) in Gadchiroli, India. The interventions included mass education about childhood pneumonia and case-management of pneumonia by paramedics, village health workers, and traditional birth attendants (TBAs) who were trained to recognise childhood pneumonia and treat it with co-trimoxazole. Parents sought treatment, and coverage was 76% without active case-detection efforts. The case-fatality rate among the 612 cases treated by health workers was 0.8%, compared with 13.5% in the control area. After a year of intervention pneumonia-specific childhood mortality was significantly lower in the intervention than in the control area (8.1 vs 17.5 deaths per 1000 children under 5 years); the difference between the areas was greatest in children under 1 year. The differences in infant mortality (89 vs 121 per 1000) and total under-5 mortality (28.5 vs 40.7 per 1000) were highly significant. Mortality from other causes remained similar in the two areas but neonatal mortality due to birth injury and prematurity was significantly lower in the intervention area, presumably owing to the combination of better maternal and neonatal care by the TBAs trained in the project and the availability of treatment for pneumonia. The cost of co-trimoxazole was US $0.025 per child per year ($2.64 per child saved).

Administration, Oral↗
PubMed1991

Reduction in total under-five mortality in western Nepal through community-based antimicrobial treatment of pneumonia.

Pneumonia is a leading cause of death among children world wide but those at highest risk in developing countries have limited access to clinical services; effective and low-cost alternatives are a global public health priority. We have done a controlled intervention trial among 13,404 children under five in Jumla, Nepal, which relied exclusively on indigenous community health workers to detect and treat pneumonia according to the World Health Organisation decision strategy, with a five-day home-treatment course of oral co-trimoxazole. No other health services were provided, and referral of children to hospital was not practicable. During the three-year study, 2101 deaths were recorded. The programme led to a 28% reduction in the risk of death from all causes by the third year of services (relative risk 0.72, 95% confidence interval 0.63-0.82), with a significant trend (p less than 0.02) of lower mortality with greater duration of the programme. The greatest benefit was among infants. In addition to reduction in deaths due to pneumonia, there was a significant reduction in deaths due to diarrhoea and measles, indicating that reduction in pneumonia morbidity had considerable carry-over effect. Our findings show that indigenous community workers can effectively detect and treat pneumonia, and reduce overall child mortality, even without other primary care activities.

Administration, Oral↗
PubMed2026

Indigenous body image amid rapid social and economic change: A reflexive thematic analysis of Wayuu narratives.

The Wayuu, Colombia's largest Indigenous group, are experiencing rapid social, economic, and technological change, including expanding internet access, educational opportunities, and increasing exposure to globalised media. Though the harmful effects of appearance-idealised media imagery on body image are well documented, indigenous body image research remains unevenly distributed across global contexts, with Latin American Indigenous communities particularly underrepresented. This study explored how Wayuu people understand and experience appearance ideals and body image in the context of expanding digital media exposure and rapid sociocultural and economic change. Five focus groups of up to 9 participants were conducted with 29 Wayuu participants (18-68 years; 23 women, 6 men). Using reflexive thematic analysis, three overarching themes were identified: (1) Intersecting sources of appearance pressure: encompassing influences from social media, Wayuu family expectations, and discrimination from non-Indigenous peers; (2) Negotiating and resisting appearance ideals: from body dissatisfaction and restrictive eating to affirmation of cultural identity as protection; and (3) The changing role of appearance in today's Wayuu culture: participants linked globalised appearance ideals to expanding educational opportunities, migration, digital connectivity, and broader socioeconomic transformations occurring within Wayuu territories. While exposure to global ideals fostered comparison and dissatisfaction, cultural pride and collective belonging appeared to buffer against internalised colonial values. Culturally grounded media literacy and education initiatives co-developed with Wayuu communities could foster critical reflection while strengthening heritage. These results highlight the need for decolonial, community-based approaches to body image research and intervention in Indigenous contexts.

Adolescent↗
PubMed1991

Distribution patterns of Opisthorchis viverrini within a human community.

This paper describes patterns of infection with Opisthorchis viverrini within a human community assessed by egg count, parasite-specific antibody levels and worm burden determined by expulsion chemotherapy. All three measurements increased significantly with age, reaching a plateau in young adults. There were no significant sex-associated differences in the prevalence or intensity of infection, antibody levels, or in the frequency of heavy worm burdens. A striking 81.5% of the total Opisthorchis population and 74% of the total egg output were expelled by the most heavily infected 10% of the humans sampled. This extreme over-dispersion, together with recent findings that hepatobiliary disease frequently accompanies heavy infections, argues that the priority for community-based parasite control programmes should be to maximize treatment and health promotion efforts toward heavily infected individuals.

Adolescent↗
PubMed1990

Acute respiratory illness in Adelaide children. II: The relationship of maternal stress, social supports and family functioning.

In a community-based study we investigated the relationships between maternal stress, maternal social supports, family functioning and proneness to acute respiratory illness (AR1) in childhood. 'Prone' and 'not prone' children were identified from the responses to a mail questionnaire sent to the addresses of a randomly selected group of Adelaide children who had been born in 1983. 'Prone' children (n = 255) were defined by a respiratory score (based on frequency and severity of reported symptoms in the preceding 12 months) in the top quintile of the distribution, while 'not prone' children (n = 227) were defined by a score in the bottom 20% of the range. Further information was obtained from a questionnaire administered at a home visit. Maternal stress levels were determined from a combination of major life events, minor life events and psychological distress. Maternal stress was significantly associated with respiratory proneness in a stepwise multiple logistic regression (adjusted odds ratio/high versus low = 3.8; 95% confidence interval 2.0-7.2; p = 0.000), while controlling for the effects of maternal smoking, group child care, early chest illness, number of siblings, breastfeeding, occupation, sex, age, home heating, birthweight and parental history of respiratory illness. Family dysfunction was associated with respiratory proneness in bivariate analyses but not after adjustment for the effects of other psychosocial factors in multivariate analyses. Lack of maternal social support was not associated with having a child who was prone to respiratory illness. These findings raise a number of questions about the nature and direction of the relationship between parental psychological status and child health.

Acute Disease↗
PubMed1991

Community-based questionnaires and health statistics as tools for the cost-efficient identification of communities at risk of urinary schistosomiasis.

Self-administered questionnaires, distributed by existing administrative channels to village party chairmen, head-teachers and schoolchildren, showed good diagnostic performance for the qualitative assessment of urinary schistosomiasis endemicity. At a cost 34 times below that of the WHO-recommended parasitological screening strategy, the schoolchildren's questionnaire allowed the screening of 75 out of 77 schools of a rural Tanzanian district in six weeks, and the exclusion of schools not at high risk for urinary schistosomiasis with over 90% confidence. The headteacher and party questionnaires made it possible to assess the perceived importance of a spectrum of diseases and symptoms, among which was schistosomiasis. The priority rank of schistosomiasis control was strongly correlated with the prevalence rate of the disease in the community. The questionnaires also looked for the prioritization of health among other community issues and thus contributed important information for planning at district level. Standardized monthly disease reports, sent by all primary health services, were also analysed. They allowed a zonal schistosomiasis endemicity classification.

Adolescent↗
PubMed1992

Statistical description of the Mini-Mental State Examination for French elderly community residents. Paquid Study Group.

The distribution of total Mini-Mental State Examination (MMSE) scores, individual items, and groups of items were studied in French elderly community residents from a random sample of 2727 subjects. Serial seven, recall three objects, and copy pentagons had the lowest percentage of correct responses, while orientation to place, naming two objects, and three objects registration had the highest percentage of correct responses. The structure of correlation of the items was studied using Principal Components Analysis. The projection of the items on the first axis reflects the tendency of the items to vary in the same direction and is compatible with the fact that the MMSE items are all indicators of the same concept: cognitive performance. The second and third axes identify clusters of highly correlated variables and provide support for the internal validity of the MMSE score for a French population. The full MMSE score seems to be a valid instrument for the evaluation of cognitive performance in community-based elderly residents.

Aged↗
PubMed1978

Patient outcomes in alternative long-term care settings.

The purpose of this study was to compare health status outcomes in three alternative long-term care settings in the Veterans Administration : 1) home care; 2) community-based nursing home care; and 3) hospital-based nursing home care. Patients were measured on a behavioral index of health status, at two points in time: when transferred from the acute care hospital to one of the three treatment programs (pretest and three months later (posttest). Since patients could not be randomly distributed to programs, two methods were employed to control for potential sample selection bias: the choice of a nonequivalent control group design, and multivariate analytic techniques. First, within each program type, patients were randomly selected from both a hospital that offered only that program as a long-term care alternative and from a hospital that provided all three treatment settings. Second, multiple regression analysis was used to control for pretest differences among patients. Patients placed in the home care program displayed the greatest mean improvement in functional health status, holding all other variables constant. This treatment effect was not uniform, however; patients showed differential rates of improvement across the three programs, based upon both initial health status and prognosis.

Adult↗
PubMed1992

Rubella among the Amish: resurgent disease in a highly susceptible community.

Although the Amish make up less than 0.05% of the United States population, nearly all rubella reported in the United States in 1991 occurred in this population. In early 1991 a large rubella outbreak in a Tennessee Amish community that had experienced no rubella for 17 years afforded an opportunity to describe the epidemiology of rubella in this unique population. Structured interviews were conducted with 54 Amish families. Of 383 persons in the sample 85 (22%) had rubella. Illnesses were mild; 16% of cases lacked fever and 20% of cases reported no symptoms except rash. Children < 17 years of age were 7 times more likely than older individuals to be affected (77 of 214 vs. 8 of 165). All pregnant women in the community were > 20 years of age; none developed rubella. No congenital rubella syndrome was recognized. Although rubella is increasingly a disease of adolescents and young adults, in this outbreak, rubella was again a childhood disease. Illness in this community-based investigation was mild; rubella may be difficult to diagnose and report. Immunity after remote natural infection was durable since the community's last outbreak. Pregnant women probably were protected by the age distribution of immunity; this age distribution may not occur in other Amish populations. If preventable morbidity from rubella and other vaccine preventable diseases is to be avoided in this group, increased attention should be directed to encouraging vaccinations among Amish persons.

Disease Outbreaks↗
PubMed2026

Healthcare-facility-based SARS-CoV-2 genomic surveillance in Brazil: experience from the global action in healthcare network.

UNLABELLED: Genomic sequencing is essential to effectively monitor the SARS-CoV-2 evolution and spread of its lineages. Healthcare-facility-based SARS-CoV-2 genomic surveillance has been proposed as a valuable strategy, considering the characteristics of its target population. As part of the Centers for Disease Control and Prevention's Global Action in Healthcare Network program, this study aimed to describe the distribution and frequency of SARS-CoV-2 lineages in two tertiary-care hospitals in Brazil, where the genomic sequencing capacity is limited. Whole-genome sequencing of SARS-CoV-2 samples obtained from 993 healthcare workers (75.4%) and inpatients (24.6%) was analyzed between February 2023 and August 2024. In total, 113 distinct lineages were identified. Notably, we observed a temporal replacement of predominant lineages corresponding to three distinct epidemic waves: the first wave dominated by XBB.1.5 and XBB.2.3 (February 2023 to June 2023), the second by GK.1.1 and JD.1.1 (September 2023 to December 2023), and the third by JN.1 and JN.1.9 (January 2024 to April 2024). JN.1.9 was the only lineage with a significantly higher prevalence among healthcare workers compared to inpatients. Additionally, we identified cases of co-infection with genetically distinct variants, underscoring the potential for healthcare-based monitoring to capture events relevant to viral evolution. Overall, our findings were consistent with those observed across Brazil, suggesting that this strategy may be valuable for SARS-CoV-2 genomic surveillance. They also indicate a clear temporal pattern of lineage replacement, reflecting successive waves driven by emerging variants and rapid global dissemination. IMPORTANCE: Genomic surveillance of SARS-CoV-2 remains essential for identifying emerging variants with increased transmissibility, immune escape, or pathogenicity. While most genomic surveillance efforts focus on community-based sampling, a healthcare-facility-based strategy may offer a complementary approach. In this study, we describe SARS-CoV-2 lineage dynamics over an 18-month period among healthcare workers and hospitalized patients in southern Brazil. Our findings align closely with regional and national trends, supporting the value of healthcare-facility-based SARS-CoV-2 genomic surveillance for documenting the local genomic landscape and demonstrating the feasibility and value of this approach in settings with limited genome sequencing capacity. Additionally, this approach may be applicable to other respiratory viruses in healthcare settings; however, further studies would be needed to confirm this.

Humans↗
PubMed1992

Relationship of skin test reactivity and eosinophilia to level of pulmonary function in a community-based population study.

We studied the relationship of skin test reactivity (sumscore greater than or equal to 3) and eosinophilia (greater than or equal to 275 cells/mm3 blood), separately and combined, to the level of FEV1 in a community cohort. We used the regression analysis technique, adjusting for age and area of residence, and stratifying by gender and cigarette smoking. Eosinophilia, among men, was associated with lower levels of FEV1 in skin test negative subjects with moderate cigarette smoking (greater than or equal to 10 pack-yr: beta = -250 ml, p = 0.02; greater than or equal to 10 pack-yr: beta = -234 ml, p less than 0.01) and in skin test positive subjects who either never smoked (beta = -228 ml, p = 0.06) or had only a brief history of smoking (beta = -428 ml, p less than 0.01). Eosinophilia, among women, was significantly associated with lower levels of FEV1 in never smokers (beta = -95 ml, p less than 0.01), especially if subjects were skin test positive as well (beta = -289 ml, p less than 0.01). Moderate cigarette smoking was uncommon in women. These data suggest an association of indices of inflammation (eosinophilia alone) and allergic inflammation (eosinophilia combined with skin test reactivity) with lower levels of FEV1, independent of the effect of cigarette smoking.

Age Factors↗
PubMed1991

Low prevalence of delta hepatitis virus infection among blacks in Natal.

The prevalence of delta hepatitis virus (DHV) infection among hepatitis B surface antigen (HBsAg)-positive black subjects in Natal was determined. A total of 172 subjects was tested for the presence of antibodies to DHV; all were HBsAg-positive. They comprised three groups: 51 urban children identified in a community-based seroprevalence survey, 81 subjects identified during a family study, and 40 institutionalised children. None of the 172 subjects was positive for antibodies to DHV. Based on calculations using a binomial distribution of infection, there was a 95% probability that the prevalence of DHV infection was below 30/100,000 HBsAg-positive persons. While DHV infection was found to be rare among blacks in Natal, the risk of delta hepatitis becoming widespread is ever-present, since the high incidence of hepatitis B virus infection in black children provides ample opportunity for the concomitant spread of DHV.

Black or African American↗
PubMedDate not supplied

Services for urban poor families in Kuala Lumpur, Malaysia: a case study.

With 25% of its population living in over 148 squatter settlements, with a high incidence of communicable diseases, teenage pregnancies, and psychological and familial stress, the city of Kuala Lumpur has sought ways to improve conditions. This article describes one particularly promising approach: community-based centers integrating three socioeconomic components--preschool education, maternal and child health clinics, and income-generating activities.

Child Welfare↗