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At least 793 records · Page 44Linked to original sources
PubMed1994

Effect of advertising on awareness of symptoms of diabetes among the general public: the British Diabetic Association Study.

OBJECTIVE: To determine the impact of posters advertising symptoms of diabetes on public knowledge of these symptoms. DESIGN: Structured street interviews of members of the general public before, at the end of, and 10 weeks after a campaign advertising the main symptoms of diabetes. SETTING: Basingstoke and Wolverhampton. SUBJECTS: Three samples of 1000 members of the general public were interviewed. Samples were selected randomly but stratified to match the local population's age (20-75), sex, social class, and racial characteristics. MAIN OUTCOME MEASURES: Knowledge of symptoms of diabetes; perceived seriousness of diabetes; and induction of anxiety about symptoms in the target population. RESULTS: Advertising significantly raised knowledge (without prompting) of symptoms: thirst, 245 before v 411 at end of campaign (P < 0.0001) v 341 after (P = 0.0012 v before); polyuria, 72 v 101 (P = 0.0211) v 92 (P = 0.5169); lethargy, 180 v 373 (P < 0.0001) v 298 (P < 0.0001); knowledge of weight loss and visual disturbance was unaffected. The number of subjects lacking knowledge of any symptoms was reduced from 550 to 388 (P < 0.0001). The perceived seriousness of diabetes was unaffected (mean 7.6 in each phase on a scale of 1 (not) to 10 (very). Before advertising, 449 (45%) claimed to have one or more symptoms of diabetes, but this number fell at the end of the campaign (403; P = 0.0419) and 10 weeks afterwards (278; P < 0.0001). CONCLUSIONS: An advertising campaign raised public knowledge of diabetes symptoms without inducing fear of diabetes or anxiety about symptoms. Its potential for achieving earlier detection of non-insulin dependent diabetes should be evaluated.

Adult↗
PubMed1995

Cervical Cancer: Screening and Prevention of Invasive Disease.

Cancer of the cervix is one of the leading causes of cancer-related deaths in women in the United States and accounts for more cancer deaths than any other cancer in third-world countries. Various screening procedures have been developed, but many issues need to be resolved for cervical cancer screening to be effective. Large segments of the population who do not undergo regular screening account for most of the patients with invasive cancers in the United States and worldwide. Allocation of resources and widespread educational programs for these target populations are needed to promote adequate cytologic screening programs and to reduce the death rate from squamous carcinoma of the cervix.

Journal Article↗
PubMed1981

[Guangdong calls for stronger birth control effort].

The Guangzhou Municipal CCP and Revolutionary Committees recently decided that the rural areas of Guangzhou must spend a concentrated period in the second 1/2 of this year in all-round implementation of the policies and measures on planned parenthood, to ensure that this year's target of keeping natural population growth rate below 10.5/1000 is met. Guangzhou Municipality has failed for 4 successive years to meet the population control target assigned by the provincial authorities. The natural population growth rate in 1979 was the highest of 10 major cities. In 1980 the city lagged behind 20 provinces and municipalities in the whole country in this respect. There was a serious rise in the birth rate in the city's suburban counties from January-July this year. As a result, the number of births in the area was 1700 more than in the same period last year. At the same time, there were 39% more marriages in the first 1/2 of the year in the municipality than in the same period last year. Thus, there is bound to be an increase in the number of legal births in the second 1/2 of the year. At present, an extremely conspicuous problem is the many rural pregnancies which are not covered by the plans and involved some 15,000 persons. The municipal CCP and revolutionary committees have therefore issued a circular demanding that all counties and districts spend some time in September and November to concentrate the leaders, cadres, and technical forces, create public opinion in a big way, conduct extensive propaganda, and mobilization, and do a good job in ideological work, to mobilize those who pregnancies are not covered by the plan to take remedial measures, and achieve a big rise in the rate of permanent contraception. The circular reiterated the policy principles in setting population targets, that is, advocating having only 1 child, strictly controlling the birth of a 2nd child according to the conditions, and forbidding the birth of a 3rd. The urban units must vigorously consolidate and increase the percent of people having only 1 child, and mobilize those expecting a 2nd child in circumstances that do not accord with the policies to take remedial measures.

Asia↗
PubMedDate not supplied

Secondary impairments after spinal cord injury: a population-based study.

OBJECTIVE: To determine the prevalence of secondary impairments among individuals with long-standing spinal cord injury in Quebec and the potential relationships between these impairments and several variables. DESIGN: A review of 2,200 medical files was conducted to determine the target population; 976 patients were selected randomly and mailed questionnaires. The results were based on 482 individuals with spinal cord injury who returned the completed questionnaire. The questionnaire included 14 subsections, such as sociodemographic, medical, psychosocial, and environmental information. The medical section, including the type and level of lesion and the presence of secondary impairments, was analyzed. RESULTS: Urinary tract infection, spasticity, and hypotension were the most frequently reported secondary impairments, regardless of the severity of injury. Relationships between the prevalence of secondary impairments and the duration of injury, as well as perceived health status, were observed. CONCLUSIONS: This is the first study to describe secondary impairments after long-standing spinal cord injury in Quebec. Patients with spinal cord injury still present a high prevalence of secondary impairments many years after their rehabilitation, despite preventive education or medical follow-up visits. Further studies are required to determine the specific impact that these impairments have on the patients' social role and their quality-of-life.

Adult↗
PubMed2000

Health promotion in the city: a structured review of the literature on interventions to prevent heart disease, substance abuse, violence and HIV infection in US metropolitan areas, 1980-1995.

To achieve its national public health goals, the US must improve the health of low-income urban populations. To contribute to this process, this study reviewed published reports of health promotion interventions designed to prevent heart disease, HIV infection, substance abuse, and violence in US cities. The study's objectives were to describe the target populations, settings, and program characteristics of these interventions and to assess the extent to which these programs followed accepted principles for health promotion. Investigators searched five computerized databases and references of selected articles for articles published in peer-reviewed journals between 1980 and 1995. Selected articles listed as a main goal primary prevention of one of four index conditions; were carried out within a US city; included sufficient information to characterize the intervention; and organized at least 25% of its activities within a community setting. In general, programs reached a diverse population of low-income city residents in a variety of settings, employed multiple strategies, and recognized at least some of the principles of effective health promotion. Most programs reported a systematic evaluation. However, many programs did not involve participants in planning, intervene to change underlying social causes, last more than a year, or tailor for the subpopulations they targeted, limiting their potential effectiveness. Few programs addressed the unique characteristics of urban communities.

HIV Infections↗
PubMed1995

Breast and cervical cancer screening among underserved women. Baseline survey results from six states. The National Cancer Institute Cancer Screening Consortium for Underserved Women.

OBJECTIVE: To characterize breast and cervical cancer screening rates in selected underserved populations and to compare the rates with objectives for the year 2000. DESIGN: Six random-sample surveys were conducted in underserved populations between 1991 and 1993. Two of the surveys were random-digit-dial telephone surveys; four were conducted using in-person interviews. SETTINGS: The studies were conducted in the following target populations: (1) low-income and minority women residing in urban areas in Minnesota, Rhode Island, and North Carolina; (2) Hispanic women residing in urban communities in Texas; and (3) women residing in rural West Virginia and Wisconsin. PARTICIPANTS: A total of 6648 noninstitutionalized women aged 40 years or older were interviewed. MAIN OUTCOME MEASURES: Self-reported knowledge and practices related to mammograms and Papanicolaou smears. RESULTS: Between 35% and 79% of women had ever had a mammogram, and between 27% and 66% reported having a mammogram in the past 2 years. Between 82% and 95% of women had ever had a Papanicolaou smear, and between 55% and 74% reported having a Papanicolaou smear in the past 3 years. Women with low levels of education, below 200% of the poverty level, with no health insurance, 80 years or older, residing in Appalachian West Virginia, and Hispanic women residing in urban Texas have the farthest to go to reach the cancer screening objectives for the year 2000. CONCLUSIONS: Although access to health care is high among the women studied, screening rates are uneven. Objectives for the year 2000 clearly are attainable for some populations of underserved women, though much work needs to be done if objectives are to be met for all subgroups.

Adult↗
PubMed2003

Instruction of naive CD4+ T cells by polarized CD4+ T cells within dendritic cell clusters.

Cooperation between CD4(+) T cells can enhance the response and modulate the cytokine profile, and defining these parameters has become a major issue for multivalent-vaccine strategies. We explored cooperation using adoptive transfer of two populations of TCR transgenic T cells of different specificity. One was transferred without prior activation, whereas the second was activated for five days by antigen stimulation under polarizing culture conditions. Both populations were transferred into a single adoptive host and then primed by particle-mediated DNA delivery. Polarized Th1 cells (inducers) raised the frequency of IFN-gamma(+) cells within a naive (target) population, whereas Th2 inducers raised the frequency of IL-4(+) and reduced that of IL-2(+) cells. These effects were obtained when the genes for both antigens were on the same particle, favoring presentation by the same dendritic cell, but not when on different particles delivered to different dendritic cells. Autonomy of DC clusters allows linked sets of antigens (e.g. from a single pathogen) to maintain cytokine bias, but allows other independent responses, each with their own set of autonomous clusters.

Adoptive Transfer↗
PubMed1997

Development and implementation of outreach strategies for breast and cervical cancer prevention among African American women. FoCaS Project. Forsyth County Cancer Screening.

BACKGROUND: The purpose of the FoCaS (Forsyth County Cancer Screening) Project was to develop and implement strategies that would improve the beliefs, attitudes, and preventive health habits of populations typically considered hard to reach. Conventional health education methods have not produced substantial results; thus, innovative and unusual strategies are needed. METHODS: The FoCaS project implemented specific methods to reach the targeted population of African American women aged 40 and older that resides in public housing communities. Five outreach strategies were used: 1) educational classes (group setting and one-on-one sessions) on various topics that relate not to breast and cervical cancer but to women's issues in general; 2) media campaigns strategically scheduled throughout the year; 3) the inclusion of religion in educational classes and community outreach; 4) the use of information centers to distribute materials; and 5) a community-wide cancer-awareness event. RESULTS: These strategies reached women in nonthreatening environments that permitted heavy involvement and easy understanding of the importance of breast and cervical cancer screening. CONCLUSION: The effects of these strategies on promoting screening will be evaluated using data from the follow-up survey conducted during the spring of 1996.

Adult↗
PubMed2005

Improving population attributable fraction methods: examining smoking-attributable mortality for 87 geographic regions in Canada.

Smoking-attributable mortality (SAM) is the number of deaths in a population caused by smoking. In this study, the authors examined and empirically quantified the effects of methodological problems in the estimation of SAM through population attributable fraction methods. In addition to exploring common concerns regarding generalizability and residual confounding in relative risks, the authors considered errors in measuring estimates of risk exposure prevalence and mortality in target populations and estimates of relative risks from etiologic studies. They also considered errors resulting from combining these three sources of data. By modifying SAM estimates calculated using smoking prevalence obtained from the 2000-2001 Canadian Community Health Survey, a population-based survey of 131,535 Canadian households, the authors observed the following effects of potential errors on estimated national SAM (and the range of effects on 87 regional SAMs): 1) using a slightly biased, mismatched definition of former smoking: 5.3% (range, 1.8% to 11.6%); 2) using age-collapsed prevalence and relative risks: 6.9% (range, 1.1% to 15.5%) and -15.4% (range, -7.9% to -21.0%), respectively; 3) using relative risks derived from the same cohort but with a shorter follow-up period: 8.7% (range, 4.5% to 11.8%); 4) using relative risks for all diseases with age-collapsed prevalence: 49.7% (range, 24.1% to 82.2%); and 5) using prevalence estimates unadjusted for exposure-outcome lag: -14.5% (range, -20.8% to 42.6%) to -1.4% (range, -0.8% to -2.7%), depending on the method of adjustment. Applications of the SAM estimation method should consider these sources of potential error.

Canada↗
PubMed1993

Sample sizes for prevention trials have been too small.

Planners of several large prevention trials have overestimated the expected incidence of events in the control group, largely because they failed either to recognize or to adequately correct for various effects of population selection. Consequently, the studies have been too small in size or too short in duration to achieve their stated objectives. The selection effects include those engendered by the choice of the target population, the self-selection of volunteers, and protocol exclusions. This paper presents a taxonomy of these effects and the likely direction of their influence on the incidence of events and on mortality rates from other causes. Little information is available to help sample-size planners in adjusting for these effects. A few studies have provided information on the extent to which control group incidence rates have fallen short of expectations. In particular, researchers from the University of Minnesota's Colon Cancer Control Study have provided a detailed comparison of event incidence and all-cause mortality rates with general population rates. (AM J Epidemiol 1993;137:797-810). Other studies should publish similarly detailed information to assist sample-size planners of prevention trials. Until more information is published, this paper provides preliminary guidelines for prevention trial sample-size planning.

Clinical Trials as Topic↗
PubMed1994

Geriatric psychiatry consultation in the community.

While increasing emphasis is being placed on geriatric psychiatry consultation and outreach services, there is considerable variation in terms of the composition and direction of these programs. Programs vary in terms of their objectives, location, target population, use of health professions and other resources and their method of consultation. The purposes of this paper are to review the characteristics of existing programs, to review the needs of the targets of consultation and to consider theoretical and methodological approaches which have been found to be useful in mental health/psychiatric consultation, in continuing medical education, and in program evaluation. On the basis of this review, future directions for effective approaches to consultative outreach in geriatric psychiatry will then be proposed.

Aged↗
PubMed2001

Factors associated with hepatitis B virus immunization coverage at the beginning of a population campaign in the Lazio region, Italy.

BACKGROUND: The hepatitis B virus (HBV) vaccination was introduced in Italy in 1991 as compulsory among newborns and among 11-year-old children. METHODS: We conducted a retrospective study to evaluate the HBV immunization coverage of the two target populations by the public health services in the Lazio region and to analyze factors associated with starting and completing HBV immunization in the initial period of the campaign. We used data registered in the public health services of 7/51 Health Districts. As a proxy indicator of services' performance we used the "expected immunization period," that is, the 6-month period in which each child should have been started on immunization, according to the calendar. RESULTS: HBV vaccine coverage rates were 63% in the younger cohort and 50% in the older one. The results of univariate and multivariate regression analysis showed that starting HBV immunization was associated with being newborn (crude OR = 3.30; 95%CI 2.17-2.44), with living in a small city (crude OR = 6.81; 95%CI 6.12-7.58), and with being assigned to the second (crude OR = 1.77; 95%CI 1.65-1.90) or to the third 6-month period of the expected immunization period (crude OR = 2.58; 95%CI 2.42-2.76). The probability of completing HBV immunization was higher among children who had had the first dose "age-appropriately" or with "acceptable delay" and among those living in small cities. It was lower among children in the second or the third 6-month period. Size of urban area of residence was associated with both outcomes: the city of Rome showed the lowest probabilities of starting and completing HBV immunization, while the small cities showed the highest ones. CONCLUSIONS: The performance of public health services was the most important determinant of recourse to public health services for vaccinations; it varied according to size of urban area; in towns organization difficulties contributed to the delay of starting vaccination, for at least a year. The expected immunization period was a good proxy indicator of services' performance. The timing of the first dose was the strongest predictor of completing vaccination also at the beginning of the campaign.

Child↗
PubMed1992

Population pharmacokinetics.

Traditionally pharmacokinetic studies have been performed in small homogenous groups of subjects, often normal healthy, young male volunteers. These studies are well controlled and generate meaningful baseline data. However, concern has been expressed that insufficient data is collected at an early state in the target population during a drug's development. Logistically studies during Phase III are difficult, control is lacking and what data that is generated is very sparse. In recent years there has been a growing interest in techniques capable of analyzing sparse data and there is now pressure on manufacturers to obtain more kinetic and dynamic information from Phase III studies. The issues, problems and the current status of population based studies will be discussed.

Animals↗
PubMed1995

Impact of population-based selective chemotherapy on prevalence and intensity of Schistosoma mansoni infections in the Nile Delta: Kafr El Sheikh.

The impact of selective treatment with praziquantel (40 mg/kg) on Schistosoma mansoni prevalence and intensity of infection in two annual follow-up examinations was measured. The target population was the entire rural area of the northern Nile Delta Governorate, Kafr El Sheikh, from which a probability sample was drawn. The sample included 44 villages and hamlets (ezba). Baseline prevalence was determined by the examination of stool by two Kato slides and all infected persons treated and reexamined one year later. Those found infected in the second round were treated and examined again one year later. The prevalence and geometric mean egg count declined across all ages in each follow-up (prevalence: 39.3% (SE +/- 3.3), 28.4% (SE +/- 2.6), and 22.4% (SE +/- 2.3), respectively; and GMEC: 72.9 (SE +/- 7.3), 52.5 (SE +/- 4.5), and 41.9 (SE +/- 2.4), respectively). Reduction in prevalence varied considerably by village and ezba and was strongly related to the proportion of the village or ezba population that was infected and treated (r2 = 0.29). This latter observation provides a rationale for the maximum application of chemotherapy in the endemic Nile Delta community.

Adolescent↗
PubMed1997

Action of human interleukin-4 and stem cell factor on erythroid and mixed colony formation by peripheral blood-derived CD34+ c-kit(high) or CD34+ c-kit(low) cells.

We studied the interaction of interleukin (IL)-4 and other burst-promoting activity (BPA) factors, such as IL-3, granulocyte/macrophage colony-stimulating factor (GM-CSF), IL-9 and stem cell factor (SCF), on erythroid burst-forming unit (BFU-E) and erythrocyte-containing mixed (CFU-Mix) colony formation in serum-free culture. IL-4 alone did not support mixed colony formation in the presence of erythropoietin (Epo). However, IL-4 showed weak but significant BPA when peripheral blood (PB)-derived CD34+c-kit(low) cells were used as the target population. The BPA of IL-4 was much weaker than that of IL-3, which exerted the most potent activity, as previously reported. When CD34+c-kit(high) cells were used as the target, four factors known to have BPA, IL-3, GM-CSF, IL-9 and SCF, could express BPA. In contrast, IL-4, alone failed to support erythroid burst formation. Interestingly, IL-4 showed a remarkable enhancing effect with SCF in promoting the development of erythroid burst and erythrocyte-containing mixed colonies from CD34+c-kit(low) and CD34+c-kit(high) cells. Delayed addition of SCF+Epo or IL-4+Epo to the cultures initiated with either IL-4 or SCF alone clearly demonstrated that SCF was a survival factor for both BFU-E and CFU-Mix progenitors. In contrast, the survival effect of IL-4 was much weaker than that of SCF, and appeared to be more important for progenitors derived from CD34+c-kit(low) cells than for those derived from CD34+c-kit(high) cells. It was recently reported that CD34+c-kit(low) cells represent a more primitive population than CD34+c-kit(high) cells. Taken together, these results suggest that IL-4 helps to recruit primitive progenitor cells in the presence of SCF.

Antigens, CD34↗
PubMed2001

Trends in booster seat use among young children in crashes.

INTRODUCTION: Booster seat use in the United States is extremely low among 4- to 8-year-old children, the group targeted for their use. However, more recent attention has been paid to the role of booster seats for children who have outgrown their forward-facing child safety seat. In particular, several states are currently considering upgrades to their child restraint laws to include the use of booster seats for children over 4 years of age. OBJECTIVE: To examine recent trends in booster seat use among children involved in automobile crashes in 3 large regions of the United States. DESIGN: This study was performed as part of the Partners for Child Passenger Safety project, an ongoing, child-specific crash surveillance system that links insurance claims data to telephone survey and crash investigation data. All crashes occurring between December 1, 1998, and November 30, 2000, involving a child occupant between 2 to 8 years of age riding in a model year 1990 or newer vehicle reported to State Farm Insurance Companies from 15 states and Washington, DC, were eligible for this study. A probability sample of eligible crashes was selected for a telephone survey with the driver of the vehicle using a previously validated instrument. The study sample was weighted according to each subject's probability of selection, with analyses conducted on the weighted sample. RESULTS: The weighted study sample consisted of 53 834 children between 2 to 8 years old, 11.5% of whom were using a booster seat at the time of the crash. Booster seat use peaked at age 3 and dropped dramatically after age 4. Over the period of study, booster seat use among 4- to 8-year-olds increased from 4% to 13%. Among 4-year-olds specifically, booster use increased from 14% to 34%. Among children using booster seats, approximately half used shield boosters and half used belt-positioning boosters. CONCLUSIONS: Although overall booster seat use among the targeted population of 4- to 8-year-old children remains low, significant increases have been noted among specific age groups of children over the past 2 years. These data may be useful to pediatricians, legislators, and educators in efforts to target interventions designed to increase appropriate booster seat use in these children.

Accidents, Traffic↗
PubMed1993

Case management for special populations. Moving beyond categorical distinctions.

Case management has evolved as a flexible, pragmatic, and compassionate strategy for improving client access and care continuity within fragmented systems of health and social services. The first-generation case management programs have been designed for various settings that serve different "target" populations with varying social, medical, and psychological needs. This proliferation of categorical case management programs is a mixed blessing. While a categorical focus reflects both historical and public financing priorities, it creates a potentially duplicative and inefficient system in an era of limited resources. As the federal government assumes a more substantial role in supporting case management, greater attention is being given to accountability--demonstrating value-added benefits and identifying best practices for structuring case management. The essential first step is reaching agreement on two critical dimensions of case management, major goals and essential services. This article, based on a review of the literature, examines the extent to which seemingly disparate programs for special populations share common attributes, and thus present opportunities for structuring client-focused rather than categorical case management programs. The authors seek to stimulate a dialogue that would lead to specification of common goals and essential services, and a cross-cutting framework for designing client-focused case management programs.

Adult↗
PubMed2005

Demographics of hemophilia in developing countries.

Demographic datasets pertaining to populations are extremely valuable tools in healthcare planning. They are vital in setting priorities, allocation of resources, measurement of outcomes, and comparison of alternate approaches. Countries with emerging economies especially need information regarding targeted populations when initiating programs designed to deliver care to persons with chronic conditions such as hemophilia. The problems associated with data collection in these countries are huge but surmountable. The World Federation of Haemophilia (WFH) Global Survey provides a valuable synopsis of current global data on hemophilia patients and has provided insight into the extent of the problem with hemophilia worldwide. More and more countries recognize the uses of these data and have established or are in the process of establishing registries for persons with hemophilia to try and improve the quality of the information provided to the WFH. This information will most certainly assist in guiding the future of hemophilia care in these countries with emerging economies.

Blood Coagulation Factors↗