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[Dengue control as viewed by agents and the target population in São José do Rio Preto, São Paulo, Brazil].

The aim of this article was to identify daily situations experienced by dengue control agents in their relationship to local residents. A cross-sectional study applied questionnaires among vector control agents, community health workers, and a sample of local women. The answers by the dengue control agents and community health workers were grouped in the categories of work, private life, and community. The women were asked about the relationship with the vector control and community health workers. The difficulties cited in the private and work areas by the vector control agents were different from those reported by community health workers. At the community level they coincided and showed that neither group is adequately prepared to deal with these issues. Of the local women interviewed, 87.0% reported that they were well-informed or very well-informed about dengue, 84.0% stated that the work by the vector control agents and community health workers was always helpful, and 54.0% identified inappropriate visiting hours by vector control agents and community health workers as a difficulty. The study identified the need for a new job profile that would recognize and respect the specificities of the areas where their activities are conducted, integrating the community's socio-environmental issues.

Aedes↗

Women with HNPCC: a target population for the chemoprevention of gynecologic cancers.

Hereditary nonpolyposis colorectal cancer syndrome (HNPCC) is an autosomal-dominant inherited cancer susceptibility syndrome that is associated with increased risk of development of endometrial and ovarian cancers. Therefore, women with HNPCC are candidates for chemoprevention of gynecological cancers. Although there have been a number of clinical trials examining chemoprevention strategies for colorectal cancer in HNPCC, the information regarding gynecological cancers in HNPCC remains limited. The purpose of this review is to provide an analytical background about the current knowledge regarding gynecological cancers in patients with HNPCC.

Chemoprevention↗

A mobile clinic for the homeless and mentally ill: meeting the needs of a target population.

Six years ago, a home care nurse doing research for a school project discovered a population of elderly, mentally ill, and homeless people who were not receiving adequate health care. The nurse's efforts resulted in her home care agency's expanding its services to include a mobile clinic program. Today, the program employs five nurses who provide health assessment and group education to over 1,000 people.

Aged↗

Influenza vaccination in Europe: an inventory of strategies to reach target populations and optimise vaccination uptake.

A study was undertaken to assess influenza vaccine uptake in risk groups and to get insight into vaccination practices in European countries. Questionnaires were completed by national influenza experts from 26 countries. Only 14 were able to provide uptake rates for the elderly. For the other risk groups, even fewer could provide data. Vaccines are usually administrated by GPs. Financial incentives for physicians and patients might work as a strategy to increase uptake rates, but due to the small amount of data, it was not possible to carry out thorough multivariate analyses. The development of a uniform influenza vaccination monitoring method was recommended to allow for comparison of uptake data in Europe.

Adolescent↗

Involving the target population and their providers in evaluation of substance abuse videos.

Substance abuse prevention and case finding are serious challenges to nurses who care for pregnant women and their infants. Audiovisual media can be useful in helping these nurses and their patients. This article discusses the insights of pregnant, low-income, minority women and their health care providers regarding selected substance abuse prevention videos. Focus group sessions were used to elicit valuable information, not only about reactions to substance abuse media but on their use in facilitating communication between patients and providers. Through this process, collaborative relationships were fostered among pregnant inner-city women, nurse clinicians, and nursing faculty, all of whom share a concern about substance abuse and an interest in working together to combat the problem.

Attitude to Health↗

Cystic fibrosis. Target population for lung transplantation in North America in the 1990s.

Cystic fibrosis is the most common lethal genetic disease occurring in the white population. It is estimated that 3.5% of the 20,000 individuals with cystic fibrosis in North America will die each year of end-stage lung disease. Lung transplantation (heart-lung or double lung) is becoming more frequent as more patients are referred for this procedure. Since January 1988, we have evaluated 60 patients with cystic fibrosis for lung transplantation and have accepted 30 (50%). Nine patients (30%) died while awaiting a donor. Fifteen patients underwent transplantation (13 heart-lung and two double lung procedures). Actuarial survival at 1, 2, and 3 years is 76%. All survivors are without physical limitations. Pulmonary function, as determined by forced vital capacity, forced expiratory volume in 1 second, and arterial blood gas determinations, is within the normal range. Comparing these data with those of a group of patients without cystic fibrosis who underwent transplantation during the same period did not reveal any significant differences with respect to infection, rejection, and outcome. Preliminary data suggest that obliterative bronchiolitis is less prevalent at 1 year in patients with cystic fibrosis (19%) than in those without cystic fibrosis (41%). Patients with cystic fibrosis present a number of challenges. The problems of pleural adhesions from repeated infections, pleurodesis, and previous thoracic procedures are now readily approached through the bilateral thoracosternotomy (clam shell) incision. Insulin-dependent diabetes mellitus and low-dose corticosteroid therapy are no longer considered absolute contraindications. Both septic lungs must be removed at operation, either with heart-lung transplantation or with double lung transplantation. These data support the therapeutic efficacy of lung transplantation for patients with cystic fibrosis.

Actuarial Analysis↗