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PubMed1984

[Effects of a municipal immunization program on the vaccination coverage in a school population].

We report the results of a Municipal Immunisation Program in a industrial community. These results were evaluated through the School Health Program. Our immunisation policies resulted in a substantial increase of immunity covering with particular impact on the less wealthy social layers. Immunity rats rose from 32% to 71% of the population. We conclude that our program is an adequate policy for control of infection diseases.

Adolescent↗
PubMed2003

Case management of human immunodeficiency virus-infected injection drug users: a case study in Rio de Janeiro, Brazil.

The provision of care and support to persons living with human immunodeficiency virus (HIV) in Brazil who also use drugs and/or alcohol represents special challenges because of the combined effects of addiction, poverty, stigma, and discrimination. This paper presents details on a program providing both clinic- and field-based care to HIV-infected injection drug users, highlighting the use of a specialized case management approach to address the clinical and psychosocial needs of this population. This program includes both a mobile case management team that fosters group discussions and provides individual counseling, and provision of medical consultations at 2 major drug treatment centers in Rio de Janeiro. The article also describes the experience of working with injection drug users who regularly attend an outpatient clinic serving marginalized communities through the use of mutual self-help groups and specialized support groups to address to issue of adherence to antiretroviral therapies for the treatment of HIV/acquired immunodeficiency syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Iran records lower growth rate.

The population growth rate in the Islamic Republic of Iran has fallen to 1.8%, according to the Deputy Minister of Health, Treatment and Medical Training, Dr. H. Malek Afzali. The country's total population exceeds 64 million, with a population growth rate of 3%, according to the 1994 ESCAP Population Data Sheet. Dr. Malek Afzali said that, in 50,000 families surveyed from 22 May to 21 June 1994, the birth rate stood at 23 per 1000 and the mortality rate at 5 per 1000. He added that the number of births throughout the country in the year that ended on 21 March stood at 1,385,000, down from 2.2 million in the years before 1993. He said that the only thing to worry about in the growth of the country's population is the high number of people under 15 years of age, which is about 26 million. The present population under the age of 15 would make up 13 million couples within the next few years and, if they choose to have two children each, the country's population will increase by 26 million, he said. The Deputy Health Minister proposed that, in order to tackle the problem, training courses in family planning be set up for the young population. Later, on the occasion of World Population Day (11 July), the Director of the Islamic Republic of Iran Broadcasting, Dr. Ali Larijani, emphasized the important role that radio and television could play to increase public knowledge and awareness through broadcasting programs on population growth and family planning.

Age Distribution↗
PubMed1977

A component analysis of recent fertility decline in singapore.

To aid in achieving demographic goals, since 1968 the government of Singapore has passed a series of laws designed to limit family size. Policies were instituted in 1968 to discourage couples from having more than three children; policies introduced in 1973 discouraged having more than two. Trends in fertility rates and in the numbers of abortions and sterilizations in recent years are consistent with the intent of these social policies. Decline in third and subsequent births was the most important factor in fertility decline after 1972, and the numbers of abortions and sterilizations undergone by higher parity women have increased substantially sin"e 1970. Although other factors have affected fertility in Singapore, the data suggest that the disincentives have played a role in continued fertility decline in recent years.

Abortion, Legal↗
PubMed1988

Long-term body weight fluctuation in an overweight population.

Weight loss programs report such low percentages of overweight subjects who lose weight and maintain the loss that the concern arises whether these results represent anything more than baseline population weight fluctuations. In this study, weights recorded for medical purposes at two clinic visits separated by intervals of 1 to 5 years were analysed for 332 adult patients who were initially at least 20 percent over their ideal body weight. Weight change calculations for this general patient population revealed that 219 (66 percent) had increased in weight by a mean of 5.7 kg, and that 113 (34 percent) had decreased in weight by a mean of 5.3 kg. The 59 patients measured over a 5-year interval showed an 'apparent body weight loss' for 31 percent of this sub-group with a mean decrease of 7.3 kg. Weight loss studies and programs must demonstrate a rate of weight loss maintenance beyond that of a control group before attributing 'weight loss' in a population to any factor other than normal weight fluctuation.

Adult↗
PubMed2003

An assessment of the total population approach for evaluating disease management program effectiveness.

A key challenge currently facing the disease management industry is accurately demonstrating program effectiveness at controlling utilization of services and medical costs of populations with chronic disease. The most common method used in the disease management industry to date for determining financial outcomes is referred to as the "total population approach." This model is a pretest-posttest design, which is a relatively weak research and evaluation technique. This paper describes the "total population approach," details many of the biases and confounding factors that may influence outcomes using this method, and illustrates the potential consequences of these factors.

Bias↗
PubMed1996

The implications for information system design of how health care costs are determined.

As the costs of health care assume increasing importance in national health policy, information systems will be required to supply better information about how costs are generated and how resources are distributed. Costs, as determined by accounting systems, often are inadequate for policy analysis because they represent resources consumed (expenditures) to produce given outputs but do not measure forgone alternative uses of the resources (opportunity costs). To accommodate cost studies at the program level and the system level, relational information systems must be developed that allow costs to be summed across individuals to determine an organization's costs, across providers to determine an individual patient's costs, and across both to determine system and population costs. Program level studies require that cost variables be grouped into variable costs that are tied to changes in volume of output and fixed costs that are allocated rationally. Data sources for program-level analyses are organizational financial statements, cost center accounting records, Medicare cost reports, American Hospital Association surveys, and the Department of Veterans Affairs (VA) cost distribution files. System-level studies are performed to predict future costs and to compare costs of alternative modes of treatment. System-level analyses aggregate all costs associated with individuals to produce population-based costs. Data sources for system-level analyses include insurance claims;n Medicare files; hospital billing records; and VA inpatient, outpatient, and management databases. Future cost studies will require the assessment of costs from all providers, regardless of organizational membership status, for all individuals in defined populations.

Accounting↗
PubMed2005

High prevalence of congenital hypothyroidism in the Greek Cypriot population: results of the neonatal screening program 1990-2000.

OBJECTIVE: To evaluate the results of the screening program for congenital hypothyroidism (CH) in the Greek Cypriot population. CHILDREN AND METHODS: During 1990-2000, 109,532 neonates were screened by TSH determination. Permanent CH was proven with biochemical findings after discontinuation of treatment for scintigraphy at the age of 3 years. RESULTS: Permanent CH was diagnosed in 61 infants, incidence 1/1800, with female/male ratio 2.05/1. The most common clinical findings were omphalocele (61%), large anterior fontanelles (49%) and edema of the eyelids (34%). The more delayed the bone maturation, the lower were initial T4 levels (p = 0.005). Bone maturation tended to be more advanced in thyroid hypoplasia and more delayed in thyroid agenesis (p = 0.049). Scintigraphy of the thyroid with TC99 revealed ectopia in 38%, thyroid agenesis in 36%, thyroid hypoplasia in 24% and dyshormonogenesis in 1.7%. Children with transient CH had significantly lower T4 and higher TSH values initially compared to those with permanent CH after birth; initial TSH level, however, failed to predict the nature of CH. Children with transient CH required less thyroxine dosage to maintain normal thyroid hormone levels and they had a normal thyroid gland on scintigraphy. The TSH level was normalized before the age of 2 months with a starting L-thyroxine dose of 10 microg/kg/daily. CONCLUSIONS: The incidence of primary CH in Greek Cypriots is 1/1800 live births. The most common etiology is thyroid dysgenesis. Initial T4 levels correlated with the degree of skeletal maturation and the etiology. Initial TSH level, although lower in children with transient CH, could not predict the nature of CH.

Bone Development↗
PubMed1997

Dynamics of dog and cat populations in a community.

OBJECTIVE: To describe dynamics of the pet dog and cat populations in a single community in terms of reproductive patterns and turnover. DESIGN: Cross-sectional, random-digit dial telephone survey. SAMPLE POPULATION: Information gathered from 1,272 households in St Joseph County, Ind that owned a dog or cat between Dec 1, 1993 and Nov 30, 1994 was compared with data on 9,571 dogs and cats received by the Humane Society of St Joseph County during the same period. RESULTS: Prevalence of pet ownership was lower than expected, compared with consumer panel surveys. Eight hundred forty-three of 1,335 (63.1%) dogs were neutered, compared with 816 of 1,023 (79.8%) cats. Cost was cited as a reason that 35 of 441 (7.9%) dogs and 34 of 132 (25.8%) cats were not neutered. Only 33 of 968 (3.4%) dog-owning households reported that their dog had had a litter during the past year, whereas 52 of 662 (7.9%) cat-owning households reported their cat had had a litter of kittens. Most cat litters were unplanned, whereas two thirds of dog litters were planned. Annual turnover in owned pets was 191 of 1,354 (14.1%) dogs and 194 of 1,056 (18.4%) cats. Pet owners underreported relinquishing pets to a shelter in the telephone survey. CLINICAL IMPLICATIONS: A combination of animal shelter- and human population-based data are needed to describe pet population dynamics in a community. Information about species-specific reproductive patterns is essential in designing population control programs.

Animal Welfare↗
PubMed1997

Screening and biochemical characterization of transthyretin variants in the Portuguese population.

The study of pathogenic and nonpathogenic transthyretin (TTR) variants is very important for the understanding of such TTR-related diseases as hereditary amyloidosis and also to establish a relationship between the structure and function of the molecule. Variants with clinical manifestations can be easily detected, but clinically silent variants can be detected only by population screening programs using specialized techniques. Hybrid isoelectric focusing (HIEF) in extremely flattened immobilized pH gradients (IPG) allows the detection of even neutral amino acid substitutions and has been used to analyze approximately 5,000 samples from the Portuguese population. Comparison with samples from carriers of three known TTR mutations (Met 30 associated with hereditary amyloidosis, Met 119, and Asn 90) was also made. In this study we detected: (1) 8 individuals carriers of TTR Met 30, (2) 35 carriers of TTR Met 119, (3) 12 carriers of TTR Asn 90, (4) 1 compound heterozygote for TTR Met 30/Met 119, and (5) 5 variants that presented a different pattern from the controls used. We also performed DNA sequencing analyses of two of the variants with the different band pattern in HIEF. The individuals were found to be carriers of TTR Ile 122 and TTR Thr 190, respectively. All the mutations detected, except for Asn 90, result from substitutions in CpG hot spots and thus can be rather frequent in the populations. Studies on the clinical evolution of the compound heterozygotes and on the physical-chemical properties of these hybrid TTRs will help to understand the pathogenicity associated with TTR.

Amyloidosis↗
PubMedDate not supplied

Refugee dynamics: Angolans in Zambia 1966 to 1972.

"The following study of Angolan refugees in Zambia examines the decision-making dynamics of refugee movements, documents a case of extensive self-settlement, describes the background to the refugee movement, and briefly compares the welfare of self-settling refugees and those who are in government schemes."

Africa↗
PubMed1990

A computer program for modeling the kinetics of gene expression.

Enzyme induction may be modeled on the basis of four, quantifiable processes that control the rates at which specific gene products accumulate and decay. These processes include synthesis of functional mRNA, translation and degradation of mRNA, and degradation of the protein product. We present a simple computer program that permits mathematical simulation of gene expression on the basis of experimentally determined rates of synthesis and degradation. The program was implemented as a spreadsheet using Microsoft Excel for Macintosh and MS-DOS operating systems and also was adapted for HyperCard on the Macintosh. It contains a formula to account for growth of tissue or cell populations. The program predicts amounts of individual mRNAs and proteins (or enzyme activities) in cells as a function of time after a stimulus alters their rates of synthesis or degradation.

Animals↗
PubMed1994

Population and family planning in China.

As the most populous country of the world, China pursues an integrated programme for socio-economic development with family planning as a vital part of it. The aim is to ensure that population growth does not outpace the economic development, the availability of natural resources and environmental protection efforts. Current policy on family planning includes: the promotion of late marriage and deferred child bearing, advocating the practice of "one couple, one child", to encourage birth spacing for those who want a second child. Technical guidelines are: contraception as the priority; comprehensive use of various contraceptive methods in men and women; induced abortion allowed on request if no contraindications; state provided contraceptives, barrier devices and technical services. The birth rate of 33.34/1000, death rate of 7.6/1000 and natural increase rate of 25.83/1000 in 1970 was brought down to 21.04/1000, 6.7/1000 and 14.26/1000 respectively in 1985. A total fertility for 1950 of 5.87 was gradually brought down to 2.31 in 1990. 260 million births were averted between 1970-1991; the world's "5-billion population day" was postponed for 2 years and Asian "3-billion population day" was postponed for 3 years. The State Family Planning Commission under the State Council was set up in 1981. The China Family Planning Association, the China Population Association and non-governmental organisations promote family planning work in a coordinated way. The current family planning policy is now well accepted in the urban area, and gaining increasing momentum in the rural area. Persistant education is still important to break the millennia old tradition of having more children and more boys.

Aging↗