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 721 records · Page 40Linked to original sources
PubMed1999

[Descriptive analysis (clinical and functional characteristics) of an asthmatic population in a health care district].

OBJECTIVE: To determine the social, demographic, clinical and lung function characteristics of the population of asthmatics living in Health Care District 2 of Madrid. STUDY DESIGN: Transversal (initial visit) phase of a primary care community intervention study. The target population consisted of all asthmatics in District 2 of Madrid who were registered at the public health clinics, were older than 14 and had experienced asthma symptoms within the past year. The selection of patients for the study was systematic (not probabilistic), such that all registered asthmatics seeking care and/or scheduled for check-ups were enrolled. Participation was 96.6% of those on file. We recorded social, demographic, clinical, and lung function variables as well as results of allergy studies, family histories of asthma and/or atopy and type of treatment. RESULTS: Six hundred fifty patients were enrolled, 238 men (36.7%) and 412 women (63.3%). Mean age was 45 +/- 28.1 yr, mean FEV1% was 87.2 +/- 26%. Mean course of disease was 16 +/- 14.6 yr and age of onset was 26 +/- 20 yr. Family history of asthma was present in 34% of cases and a family history of atopy was reported by 21%. Half had allergic rhinitis as an associated factor, with respiratory infections (62.4%) being the most common trigger, followed by pollen (25.3%) and exposure to tobacco smoke (20%). Active smokers accounted for 9.1% of the group, and ex-smokers for 21.6%. Short-term beta-adrenergic drugs on demand were used by 64% of patients, whereas 83.2% reported daily and long-term use of beta-2 drugs and 77% used inhaled steroids. Severity of disease differed significantly by age of patient, age at onset and predominance of perennial asthma (with older age and age of onset and greater seasonality observed among severely asthmatic patients). CONCLUSIONS: a) Most symptomatic asthmatic have mild disease. b) Rationally adjusted, appropriate drug treatment should be graded according to level of disease severity.

Adolescent↗
PubMed2000

Topics in Helicobacter pylori infection: focus on a 'search-and-treat' strategy for ulcer disease.

Several new and interesting issues regarding Helicobacter infection are discussed. Test-and-treat strategies in young dyspeptics will do little to reduce the burden of ulcer disease. The prevalence of Helicobacter infection in young people is low and still declining; the incidence of ulcer disease is therefore low. Ulcer disease has a high prevalence and most cases occur in older people. There is a large pool of people who have suffered from a documented peptic ulcer in the past and most are still intermittently symptomatic. If we are to decrease the prevalence of ulcer disease we ought to promote case finding. Only 'search-and-treat' strategies will help to eliminate ulcer disease. These can focus on patients with an ulcer history or on populations that regularly use acid suppressants. Such strategies, of which several examples are discussed, are cost-effective and lead to improved health in the target population. We also discuss the use of serology as a follow-up instrument after anti-Helicobacter therapy and discuss issues regarding Helicobacter therapy in relation to antimicrobial resistance in The Netherlands.

Antacids↗
PubMed2006

The use of cardiovascular risk factor information in practice databases: making the best of patient data.

BACKGROUND: Primary care teams record cardiovascular risk factor data on their patients to help them identify and treat patients eligible for prevention. However, it is not known to what extent this information is already available to clinicians, or the extent to which it is used. AIM: To assess the extent to which risk factor is recorded, and to determine the cost-effectiveness of using recorded risk factor information in order to identify and treat eligible patients. DESIGN OF STUDY: An Excel-based model of the incremental costs and benefits of assessment and treatment. SETTING: Two general practices in the West Midlands. METHOD: Untreated, non-diabetic patients, aged 35-74 years, were identified from each practice, and risk factor data was uploaded into an Excel spreadsheet. The completeness of risk factor data was assessed. The costs and benefits of assessing and treating patients, in descending order of estimated cardiovascular risk, were then modelled. RESULTS: In each practice, 72.9% and 77.7% of patients had a record of their blood pressure, 26.9% and 25.7% were eligible for at least one treatment: aspirin was the most common treatment followed by antihypertensives. With patients systematically assessed in descending order of cardiovascular risk, 78% of eligible patients and 87% of preventable cardiovascular events are found in the first two deciles of the target population. CONCLUSIONS: Lack of risk factor information is not the principal constraint on cardiovascular prevention. Practices have sufficient risk factor data to inform an efficient, targeted prevention strategy.

Adult↗
PubMed1990

Factors influencing utilization of postdischarge cognitive rehabilitation programs.

A decision to add a new treatment program has widespread and long-lasting implications for both the patient and the organization. Information about the interactions among the institution, the patient, and the treatment modality are seldom available. Cognitive rehabilitation is a relatively new treatment modality that is being adopted in a number of programs. This report examined characteristics of stroke patients that (1) precluded their selection for cognitive rehabilitation treatment and (2) were associated with patient refusal to participate in cognitive rehabilitation. The records of stroke patients treated in three rehabilitation facilities were examined for their ability to participate in an outpatient cognitive rehabilitation program. Due to stringent criteria for the research project, fewer than half of the stroke patient population were cognitively able to participate. Of eligible patients, many declined postdischarge cognitive rehabilitation. Several variables influenced patient participation. Female stroke patients were much less likely to participate than were male patients. In addition, distance from the medical facility providing cognitive rehabilitation was a major barrier to treatment participation. Individuals who opted to participate were well educated, affluent or both. The sample of cognitive rehabilitation patients was not, therefore, representative of the population. These results suggest that medical facilities considering the addition of a centralized outpatient postdischarge cognitive rehabilitation program should first evaluate the characteristics of the target population. Suggestions about the institutional considerations involved in making the decision to add a cognitive rehabilitation program are made.

Adult↗
PubMed1994

Assessments of mortality, morbidity, and nutritional status in Somalia during the 1991-1992 famine. Recommendations for standardization of methods.

OBJECTIVES: To evaluate the various survey methods used in Somalia between 1991 and early 1993 while assessing documentation of mortality and malnutrition rates and common causes of morbidity and mortality. DATA SOURCES: Twenty-three population surveys were identified from the Center for Public Health Surveillance for Somalia, the United Nations Children's Fund, and other humanitarian organizations. STUDY SELECTION: Only surveys with defined populations and apparently systematic methodology that focused on mortality, morbidity, and/or nutritional status were included. RESULTS: Extensive methodological differences were found among the 23 surveys. Target populations and sampling strategies varied widely. Twelve studies were considered not reproducible. Of the 16 studies assessing mortality, only eight assessed cause of death. Use of units of measurement and inclusion of denominators in rate calculations were inconsistent. None of the studies provided confidence intervals around the point estimates of the rates. Of the 11 studies providing information on morbidity, none provided case definitions. And in the 16 studies reporting nutritional status, a variety of measurement methods and definitions of malnutrition were used. Three studies presented information based on mid-upper-arm circumference measurements, and 10 presented weight-for-height data below 70% and 80% of the reference median; only four studies presented z scores. CONCLUSIONS: While the results of some studies may have influenced policy and program management decisions, their effects may have been limited by failure to adequately document results and by differences among studies in objectives, design, parameters measured, methods of measurement, definitions, and analysis methods. We recommend that agencies conducting population studies in emergency situations define clear study objectives, use standard sampling and data collection methods, and ensure precise written documentation of study objectives, methods, and results.

Cause of Death↗
PubMed1993

Oesophageal carcinoma: the need for screening.

Oesophageal cancer is a substantial cause of mortality in the Western world and recent data indicate that the incidence is increasing. Despite better understanding of the pathogenesis and in the surgical management of the disease, little improvement in the survival rates has been achieved anywhere in the world, especially because screening for detection of premalignant lesions cannot, at present, be adequately applied to populations at risk. The present review summarizes current knowledge of the use of conventional screening methods as well as possible applications of new techniques to targeted populations to permit earlier diagnosis of premalignant lesions of the oesophagus.

Adenocarcinoma↗
PubMed1995

Médicarte software developed for the Quebec microprocessor health card project.

The Quebec Patient Smart Card Project is a Provincial Government initiative under the responsibility of the Rgie de l'assurance-maladie du Québec (Quebec Health Insurance Board). Development, implementation, and assessment duties were assigned to a team from Université Laval, which in turn joined a group from the Direction de la santé publique du Bas-St-Laurent in Rimouski, where the experiment is taking place. The pilot project seeks to evaluate the use and acceptance of a microprocessor card as a way to improve the exchange of clinical information between card users and various health professionals. The card can be best described as a résumé containing information pertinent to an individual's health history. It is not a complete medical file; rather, it is a summary to be used as a starting point for a discussion between health professionals and patients. The target population is composed of persons 60 years and over, pregnant women, infants under 18 months, and the residents of a small town located in the target area, St-Fabien, regardless of age. The health professionals involved are general practitioners, specialists, pharmacists, nurses, and ambulance personnel. Participation in the project is on a voluntary basis. Each health care provider participating in the project has a personal identification number (PIN) and must use both an access card and a user card to access information. This prevents unauthorized access to a patient's card and allows the staff to sign and date information entered onto the patient card. To test the microprocessor card, we developed software based on a problem-oriented approach integrating diagnosis, investigations, treatments, and referrals. This software is not an expert system that constrains the clinician to a particular decisional algorithm. Instead, the software supports the physician in decision making. The software was developed with a graphical interface (Windows 3.1) to maximize its user friendliness. A version of the software was developed for each of the four groups of health care providers involved. In addition we designed an application to interface with existing pharmaceutical software. For practical reasons and to make it possible to differentiate between the different access profiles, the information stored on the card is divided in several blocks: Identification, Emergency, History (personal and family), Screening Tests, Vaccinations, Drug Profile, General follow-up, and some Specific follow-ups (Pregnancy, Ophthalmology, Kidney failure, Cardiology, Pediatrics, Diabetes, Pneumology, Specific parameters). Over 14,000 diagnoses and symptoms are classified with four levels of precision, the codification being based on the ICPC (International Classification for Primary Care). The software contains different applications to assist the clinician in decision making. A "Drug Advisor" helps the prescriber by detecting possible interactions between drugs, giving indications (doses) and contraindications, cautions, potential side-effects and therapeutic alternatives. There is also a prevention module providing recommendations for vaccination and periodic examinations based on the patient's age and sex. The pharmaceutical, vaccination, and screening tests data banks are updated every six months. These sections of the software are accessible to access card holders at any times, even without a patient card, and constitute in themselves an interesting clinical tool. We developed a software server (SCAM) allowing the different applications to access the data in a memory card regardless of the type of memory card used. Using a single high level command language, this server provides a standardized utilization of memory cards from various manufacturers. It ensures the compatibility of the applications using the card as a storage medium. (abstract truncated)

Aged↗
PubMed1992

Using college alumni populations in epidemiologic research: the UNC Alumni Heart Study.

The UNC Alumni Heart Study (UNCAHS) is a prospective study of the role of psychosocial factors, in particular hostility, in the development of coronary heart disease. The target population is composed of persons who completed the Minnesota Multiphasic Personality Inventory while attending the University of North Carolina in the mid-1960s. Logistic regression analyses were used to determine whether hostility, demographic and other variables were significant determinants of the subjects' locatability and participation. It was found that MMPI hostility scores at initial testing were unrelated to either potential or actual locatability or participation. Thus there is no evidence that hostility is the source of selection bias in the UNCAHS. Selection into the study was predicted by age, sex, degree status and variables concerned with the conditions under which the MMPI was administered. It is concluded that follow-up studies of college cohorts may have study-specific sources of selection bias.

Adolescent↗
PubMed1986

[Sports and blood pressure: association in a population of wage-earners].

In a cross-sectional epidemiological survey, we examined the association between the practice of sports and blood pressure (BP). The study included 3,388 male employees (representing 90.1% of the target population) who were questioned about their habitual sports activity, in terms of average duration per week and intensity. The proportion of subjects who stated to engage in sports activity decreased with age, from 50.9% in the age class 20-29 years to 16.4% in the age class 50-59 years. We found a negative relationship between both systolic and diastolic BP and the weekly duration of sports activity. However this association increased with age and reached the statistical significance only in the age classes 40-49 years and 50-59 years (p less than 0.01 and p less than 0.001, respectively). Similar results were obtained when intensity of sports was used instead of duration. In order to test the independence of the observed association, the duration of sports activity (hours/week) was included as an independent variable in a multiple linear regression analysis, along with the following potential confounders: age, Quetelet index, alcohol consumption, cigarette smoking, heart rate, and level of education. In this analysis the sports-BP relationship was considerably attenuated or entirely disappeared. It remained statistically significant only in the age class 50-59 (p less than 0.01 for systolic BP an p less than 0.05 for diastolic BP). Our results support those of others showing a modest beneficial effect of leisure time physical exercise on BP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1976

Detection of urinary tract infections in 3- to 5-year-old girls by mothers using a nitrite indicator strip.

A program to detect urinary tract infections among 3- to 5-year-old girls was conducted in Madison-Dane County, Wisconsin using local pharmacies as the distribution site for test kits. Screening was conducted at home by mothers with a nitrite dip-strip on three consecutive first morning specimens. Twenty-one percent of the target population participated during a one-month study period. Eighteen cases were found among 1,573 participants (1.1%). In addition, 243 girls other than those in the target area or age group participated and yielded eight additional cases, for a total of 26 cases among 1,816 total participants. The rate of false-positive nitrite tests was 0.3%. Newspapers were the most effective means of alerting the public to the program. The only factors which were associated with less awareness or participation were low socioeconomic and rural residence. Past history of infection, minor urinary symptoms, and pyuria were common among the bacteriuric girls. Immunoglobulin-coated bacteria suggestive of tissue invasion were present in one third of the cases. Vesico-ureteral reflux was present in five and caliectasis in two of 23 girls studied. Despite the likelihood that some bacteriuric girls, particularly those infected with gram-positive organisms were not detected, screening at home appears to be a highly efficient method of detecting urinary tract infections in large populations of preschool children.

Bacteriuria↗
PubMed2005

Needs assessment of rural communities: a focus on older adults.

High-quality community needs assessments can help focus limited resources on the needs of a rapidly expanding population-older Americans. Based on such assessments, organizations and communities can effectively plan and deliver cost-effective, appropriate health promotion/wellness programs and health/social services to targeted populations. This article, which describes the Arkansas Aging Initiative's (AAI) use of a community needs assessment to identify its constituents' top health needs, provides specific background information for communities with demographics similar to those in Arkansas and offers assessment strategies for communities throughout the US. The AAI used two complementary methodologies to obtain critical input from Arkansas providers and their communities: focus groups of healthcare providers and community members and surveys administered to older adults. The assessment confirmed that health problems in the communities were consistent with leading causes of morbidity and mortality at state and national levels. It indicated that respondents' top three health needs related to affordability, including affordability of prescription medications, medical care, and health insurance, and that needs varied inversely with age. In other findings, married individuals rated their own health as better than their single counterparts; whites rated their health better than non-whites; and more than half of respondents reported leaving their counties to receive healthcare. This community needs assessment has enabled the AAI to address respondents' needs by developing specific educational and interdisciplinary healthcare initiatives, such as increasing access to a prescription drug assistance program.

Aged↗
PubMed2005

Pneumococcal Vaccination in Adults.

Pneumococci remain the most common etiology of community-acquired pneumonia in adults, with significant attendant mortality in the elderly. With the recognition of increasing rates of drug-resistant Streptococcus pneumoniae in recent years, efforts to prevent disease through vaccination have gained greater impetus. The 23-valent pneumococcal vaccine is used widely in the United States and provides effective protection against bacteremic pneumococcal disease, particularly in the immunocompetent host. The 7-valent pneumococcal conjugate vaccine, licensed in the United States in 2000, has had a dramatic impact on pneumococcal disease in the pediatric population, and its use in children has had effects on incidence rates in nonimmunized adults as well. Future directions include efforts to improve vaccination coverage in targeted populations and the development of more immunogenic and efficacious vaccines for high-risk groups.

Journal Article↗
PubMed2005

High prevalence of obesity and diabetes mellitus in Konya, a central Anatolian city in Turkey.

INTRODUCTION: The objective of this study was to determine the prevalence of overweight, obesity, impaired fasting glucose, diabetes and the relationship between adiposity and carbohydrate metabolism, by age and gender in Konya, a city in central Anatolia. METHODS: A cross-sectional population based survey was performed. One month before the field survey a media campaign was started in each district by local municipalities. Ten percent of the target population age 20 and over were invited to participate and the participation rate was 82.1%. Twelve thousand eight hundred and sixty-six inhabitants (7000 women and 5866 men, mean age 46.7+/-15.9 years) were evaluated for height and body weight between May and September of 2001. Two thousand eight hundred and thirty consecutive subjects (1788 women and 1042 men, mean age 48.2+/-15.7 years) were tested for fasting blood glucose in addition to an anthropometric evaluation. RESULTS: The crude IFG rate was 24% (27.1% in women and 18.5% in men) and the diabetes rate 8.4% (8% in women and 9.1% in men). The survey identified previously undiagnosed diabetes in 3.7% (4.3% of women and 2.9% of men). The prevalence of diabetes (p=0.0005) and obesity (p=0.0005) increased with age. Obese men and women had a higher risk of being diabetic than their normal weight counterparts (OR, 2.05; CI 95%, 1.13-3.71; p=0.0186 and OR, 2.53; CI 95%, 1.57-4.07; p=0.0001, respectively). Overall, the overweight rate was 34.2% (33.5% of women and 36.3% of men) and the obesity rate was 23.7% (32.4% of women and 14.1% of men) (n=12,866). Women had a significantly higher risk of being obese than men (OR, 2.84; CI 95%, 2.62-3.08; p=0.0005). The diabesity rate was 3.4% (4.1% in women and 2.1% in men). CONCLUSION: Carbohydrate intolerance and adiposity are highly prevalent in Konya, and the two conditions are positively correlated with each other, by age and gender.

Adult↗
PubMed1996

Agonist-stimulated free calcium in subcellular compartments. Delivery of recombinant aequorin to organelles using a replication deficient adenovirus vector.

Changes in the concentration of calcium ions ([Ca2+]) within cellular organelles play a central role in controlling cellular function. We have engineered the Ca2+ sensitive photoprotein aequorin to monitor selectively [Ca2+] within defined subcellular compartments, namely the cytosol, nucleus and endoplasmic reticulum. DNA encoding the engineered aequorins have been inserted into a replication deficient adenovirus (Ad) type 5 E1-vector, under control of the cytomegalovirus (CMV) major immediate early promoter. The Ad vector provides a simple and efficient method to express the photoproteins in a wide variety of mammalian cell types. Efficient targeting of the photoproteins to the appropriate cellular compartment was established immunocytochemically in COS7 cells, where it was expressed in up to 100% of the target population. Levels of expression could be controlled by virus dose and chemical agents which affect the activity of the CMV promoter. In HeLa cells expressing nuclear targeted aequorin or cytosolic aequorin, ATP or histamine induced immediate biphasic elevations of both nuclear and cytosolic [Ca2+]; subsequent challenge with agonist evoked similar responses. In addition to epithelial type adherent cell lines (COS7 and HeLa), aequorin expression was also readily detected in non-adherent cells of myeloid lineage (K562 and HL60) and non-adherent primary cells polymorphonuclear leucocytes (neutrophils). The Ad vectors can, therefore, be used to express targeted aequorin in a range of different cell types and represents a novel method to monitor changes in free [Ca2+] in cellular organelles.

Adenosine Triphosphate↗
PubMed2000

A population at high risk for esophageal cancer in the north-east of Italy.

Esophageal cancer is generally characterised by relatively low incidence and mortality rates in Europe. However, a high-risk population for this tumour is resident in the north-east of Italy. Several studies have been conducted on this population of males confirming the major role of alcohol and tobacco consumption alone and in combination. The inhabitants of this area of Italy constitute an ideal target population for studies of molecular epidemiology aimed at elucidating the natural history of the disease which is still ill-defined, and the distribution of genetic alterations at a population level.

Adult↗
PubMed1989

Protective efficacy of a recombinant vaccinia virus in vaccinia-immune mice.

Recombinant viral vectors offer a potential means of vaccinating against diseases for which there are no current safe vaccines. One of the criteria on which a viral vaccine vector would be selected is that it either circulates in the human or livestock population without producing overt disease (e.g. adenovirus) or has a history as a safe vaccine (e.g. vaccinia virus). However, this selection criterion also means that the target population is likely to have circulating antibodies that are specific to the vaccine vector. Since a percentage of the world's population has been vaccinated during the World Health Organization's Smallpox Eradication Campaign, such antibody titres, which are likely to lower vaccine efficacy, have been raised as an objection to the use of recombinant vaccinia viruses as vaccines. We have tested the effect of vaccinia-specific immunity on the protective efficacy of a recombinant virus, VV-PR8-HA6 (1) which expresses the haemagglutinin of the influenza virus A/PR/8/34.

Animals↗
PubMedDate not supplied

Postnatal maturation of the direct corticospinal projections in the macaque monkey.

Postnatal changes in the topography of the multiple corticospinal projections in the macaque monkey were followed using retrogradely transported fluorescent tracers, and related to the monkey's acquisition of manual dexterity; both behavioral and anatomical maturation were completed by about 8 postnatal months. Cortical origins of the corticospinal projections were examined by constructing planar projection maps of the distributions of labeled corticospinal neuron somas; these somas were found only in lamina V. At birth elaborate somatotopically organized corticospinal projections from primary motor cortex (area 4), the mesial supplementary motor area and cingulate areas 23 and 24, area 12, dorsolateral area 6a beta, the dorsolateral and ventral area 6a alpha (area F4), parietal areas 2/5, 7b and the peri-insular cortex (including area SII), were clearly defined, with axons extending to all spinal cord segments. While this pattern of regional projections broadly resembled that of the mature macaque, there were, however, substantial maturational changes during the 8 months after birth. These included (1) a halving of the area of cerebral cortex from which the contralateral corticospinal projection originated and (2) a threefold reduction in the number of labeled corticospinal neurons projecting to all segments of the cord. Collateral elimination rather than neuronal cell death was the likely mechanism for this reduction in the population and areal extent of corticospinal neurons in the maturing macaque. The surviving corticospinal axon terminals also developed substantially during the postnatal period. At birth some terminals had invaded the intermediate zone in each spinal segment, but few had penetrated the dorsal and ventral horns. By 6 postnatal months, however, many corticospinal neurons were retrogradely labeled following the injection of fluorescent labels into each of these spinal zones in cervical and lumbar spinal segments. These data demonstrate a considerable postnatal reduction in corticospinal neurons projecting to the contralateral spinal cord, and imply that many of the axons that are eliminated never synapse on spinal neurons. It is suggested that during the middle fetal period the axons of many of the cortical neurons in lamina V that in the mature monkey will terminate on particular neuron populations in the thalamus, brainstem, or spinal cord, traverse a common pathway down through the internal capsule into the spinal cord, passing close to these successive targets, and possibly forming collaterals at these levels. In the postnatal period each such neuron establishes a stable, effective synaptic input to only one or a few of these subcortical target populations, and the remaining collateral branches regress. The postnatal maturation of corticospinal neurons, examined in this study, is compatible with such a model.

Animals↗
PubMed1996

Incidence of inflammatory bowel disease in Italy: a nationwide population-based study. Gruppo Italiano per lo Studio del Colon e del Retto (GISC)

BACKGROUND: The epidemiology of inflammatory bowel disease (IBD) in Southern Europe is still unclear. Sporadic reports suggest a lower incidence of IBD in Italy than in other Western Countries and the USA. METHODS: A nationwide population-based study was carried out to estimate IBD incidence rates in eight Italian cities. All new cases of IBD diagnosed over 4 years in the target populations were collected from multiple information sources. RESULTS: From 1989 to 1992, 509 ulcerative colitis (UC), 222 Crohn's disease (CD) and 10 undefined IBD cases were collected, giving age-adjusted incidence rates (per 100,000 per year) of 5.2 for UC and 2.3 for CD. Using the capture-recapture method, an estimated completeness of 0.81 was obtained for case archives, without appreciable and significant differences between areas. The rates computed after correcting underestimation were 6.8 for UC and 2.8 for CD. The sex ratio M/F was 1.7 for UC and 1.0 for CD. The highest age-specific incidence rates were between 30 and 39 years for UC and between 20 and 29 years for CD. CONCLUSIONS: The incidence rate of CD in italy is homogeneous between the cities investigated and lower than those reported for other Mediterranean countries. In contrast, the UC incidence rate is within the range of those reported in European studies. A wide variability in the UC rates between the cities was also observed. These results could be related to different environmental factors or the genetic background of the populations, or both.

Adolescent↗