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PubMed2005

Methods for a population-based study of myopia and other eye conditions in school children: the Sydney Myopia Study.

PURPOSE: The Sydney Myopia Study will establish the prevalence of myopia and other eye diseases in a large representative sample of Sydney school children. It will also examine the relationship between myopia and potential modifiable risk factors and will assess potential gene-environment interactions by examining parents and siblings. METHODS: The target population is a stratified random cluster sample of 1750 Year 1 (age 6 years) and 1500 Year 7 (age 12 years) students from Sydney metropolitan schools. Procedures (comprehensive parent-administered questionnaire and examination) involve standardized protocols to allow for comparison with international population-based data. Examinations include a detailed assessment of visual acuity, cover testing for strabismus, identification of amblyopia, slit-lamp examination, non-contact ocular biometry and cycloplegia (cyclopentolate) followed by autorefraction, optical coherence tomography, retinal thickness measurement, digital mydriatic retinal photography and aberrometry. CONCLUSIONS: The Sydney Myopia Study design and methodology will ensure valid findings on ocular development and health in a large representative sample of Sydney school children, for comparison with other population-based refraction data.

Adolescent↗
PubMed1979

Plasma lipid distributions in selected North American populations: the Lipid Research Clinics Program Prevalence Study. The Lipid Research Clinics Program Epidemiology Committee.

Cross-sectional age- and sex-specific plasma lipid distributions (means, medians and selected percentiles) are given for 48,431 white participants in visit 1 of the Lipid Research Clinics (LRC) Prevalence Study. This study consisted of two visits in which 10 LRCs screened participants selected from well-defined North American target populations that included a broad range of sociodemographic subgroups. These data confirm findings from earlier studies in developed countries, showing age-related differences in plasma lipid levels. However, for overall distributions, the LRC data showed slightly lower cholesterol and markedly higher triglyceride values than those previously reported for North America. Some variation in plasma lipid values was evident among the clinic populations. The large number of participants within most subgroups permitted a variety of analytic and comparative studies. For example, data from the large pediatric population revealed a drop in plasma cholesterol levels in adolescent males and females. Males aged 20--50 years had higher cholesterol levels than females in the same age group, and higher triglyceride levels between ages 20--70 years. Numbers were also sufficient for meaningful comparisons between lipid distributions of females who were taking sex hormones and those who were not: In females taking sex hormones, cholesterol and triglyceride levels were higher for subjects younger than 45 years, but slightly lower after age 45, than lipid levels in females not taking hormones.

Adolescent↗
PubMed2005

Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States.

On May 2, 2005, a new in vitro test, QuantiFERON-TB Gold (QFT-G, Cellestis Limited, Carnegie, Victoria, Australia), received final approval from the U.S. Food and Drug Administration as an aid for diagnosing Mycobacterium tuberculosis infection. This test detects the release of interferon-gamma (IFN-g) in fresh heparinized whole blood from sensitized persons when it is incubated with mixtures of synthetic peptides representing two proteins present in M. tuberculosis: early secretory antigenic target-6 (ESAT-6) and culture filtrate protein-10 (CFP-10). These antigens impart greater specificity than is possible with tests using purified protein derivative as the tuberculosis (TB) antigen. In direct comparisons, the sensitivity of QFT-G was statistically similar to that of the tuberculin skin test (TST) for detecting infection in persons with untreated culture-confirmed tuberculosis (TB). The performance of QFT-G in certain populations targeted by TB control programs in the United States for finding latent TB infection is under study. Its ability to predict who eventually will have TB disease has not been determined, and years of observational study of substantial populations would be needed to acquire this information. In July 2005, CDC convened a meeting of consultants and researchers with expertise in the field to review scientific evidence and clinical experience with QFT-G. On the basis of this review and discussion, CDC recommends that QFT-G may be used in all circumstances in which the TST is currently used, including contact investigations, evaluation of recent immigrants, and sequential-testing surveillance programs for infection control (e.g., those for health-care workers). This report provides specific cautions for interpreting negative QFT-G results in persons from selected populations. This report is aimed at public health officials, health-care providers, and laboratory workers with responsibility for TB control activities in the United States.

Antigens, Bacterial↗
PubMed2002

The effect of Wolbachia-induced cytoplasmic incompatibility on host population size in natural and manipulated systems.

Obligate, intracellular bacteria of the genus Wolbachia often behave as reproductive parasites by manipulating host reproduction to enhance their vertical transmission. One of these reproductive manipulations, cytoplasmic incompatibility, causes a reduction in egg-hatch rate in crosses between individuals with differing infections. Applied strategies based upon cytoplasmic incompatibility have been proposed for both the suppression and replacement of host populations. As Wolbachia infections occur within a broad range of invertebrates, these strategies are potentially applicable to a variety of medically and economically important insects. Here, we examine the interaction between Wolbachia infection frequency and host population size. We use a model to describe natural invasions of Wolbachia infections, artificial releases of infected hosts and releases of sterile males, as part of a traditional sterile insect technique programme. Model simulations demonstrate the importance of understanding the reproductive rate and intraspecific competition type of the targeted population, showing that releases of sterile or incompatible individuals may cause an undesired increase in the adult number. In addition, the model suggests a novel applied strategy that employs Wolbachia infections to suppress host populations. Releases of Wolbachia-infected hosts can be used to sustain artificially an unstable coexistence of multiple incompatible infections within a host population, allowing the host population size to be reduced, maintained at low levels, or eliminated.

Animals↗
PubMed1999

Comprehensive education plan for a discrete stroke population: needs, considerations, and gaps.

The patient population which has the most to gain from comprehensive stroke education is the one which has experienced a stroke with minimal deficit and carries an increased risk for experiencing a second more severe stroke. This is the patient population the author selected, yet little published information is available. Given that in Canada stroke carries the third highest rate of mortality and the highest risk of morbidity there is a role for an advanced practice nurse to develop and deliver a comprehensive stroke education program for this population. This is of special significance given the understanding that stroke is considered to be one of the most preventable diseases. The practice environment for this patient population is shifting out of the hospital and into the community. The learning needs and issues as well as the identification of appropriate patient focussed outcomes needs to be examined. A comprehensive plan for the delivery of patient focussed education which includes content, setting, and timing for this target population needs to be developed, piloted and reported on. Nurses have been identified as appropriate for delivering patient education. An advanced practice nurse is poised to address this need and develop a model for others to incorporate in their practice.

Humans↗
PubMedDate not supplied

[Accessibility to methadone substitution treatment: the role of a low-threshold program].

OBJECTIVE: To evaluate the accessibility to a Montreal low-threshold methadone program (Relais-Méthadone). This program is aimed at a marginalized population of heroin addicts who are injection drug users (IDU). METHOD: The data (n = 141 clients) were collected during the first year of the program implementation with questionnaires administered by the programme workers. RESULTS: Analysis of the characteristics of the clients revealed that the program does reach the target population. The program's clientele is characterized by long-time and frequent heroin use, unstable lifestyles, and the presence of numerous behaviours that put them at high risk for HIV transmission. The retention of clients in the program is very high (88%) within the first 30 days. INTERPRETATION: These results demonstrate the importance and value of flexible intervention programs in reaching a marginalized clientele exposed to the HIV virus, who would not have access to regular programs characterized by restrictive selection criteria and limited availability.

Adult↗
PubMed2004

[Control effect of health education on body mass index of community population].

OBJECTIVE: To examine the effect of community-based health education and health promotion on body mass index (BMI), overweight and obesity. METHODS: We separately selected 100,000 population in Beijing, Shanghai and Changsha Cities during 1991-2000. Each of the cities was then randomly separated intervention and control community of 500,000 population. In the intervention community various kinds of health education and health promotion had been carried out. The level of knowledge, attitude and behavior (KAB) and body mass index (BMI) were evaluated. RESULTS: The net increases of KAB level and regularly exercising rate in three city and different target population were statistically differences in comparison with baseline survey of 1992, and the net decreases of the BMI, overweight rate and obesity rate of the whole population were statistically differences. CONCLUSION: Health education and health promotion can effectively control the rising of population BMI, and have great meaningful for population preventing from cardio-cerebro-vascular diseases.

Body Mass Index↗
PubMed1994

Prevalence and characteristics of alcohol consumption and fetal alcohol syndrome awareness--Alaska, 1991 and 1993.

Fetal alcohol syndrome (FAS) is a leading preventable cause of birth defects and mental retardation in the United States (1). To reduce alcohol exposure to the developing fetus and to modify health-related behaviors, public health professionals and policy makers require effective methodologies to identify at-risk populations and develop strategies for preventing this problem. In Alaska, the prevalence of FAS is higher than the national average (2). Because of the need for information to assist in planning prevention programs, identifying training needs for service providers, and monitoring changes in factors related to FAS in target populations, the Alaska Department of Health and Social Services (ADHSS), the Indian Health Service (IHS), and CDC have conducted surveys to measure relevant knowledge, attitudes, beliefs, and behaviors (KABBs) in selected populations in Alaska. This report summarizes survey findings during 1991 and 1993 regarding the prevalence of alcohol consumption by and characteristics of women of childbearing age in Alaska and FAS-related KABBs in Alaska residents.

Adult↗
PubMed1992

TNF-alpha differentially regulates Ia antigen expression and macrophage tumoricidal activity in two murine macrophage cell lines.

We have assessed tumor necrosis factor-alpha (TNF-alpha) production and its autocrine effects on activation in two murine macrophage cell lines which have distinct responses to the activation stimuli interferon-gamma (IFN-gamma) and bacterial lipopolysaccharide (LPS), and compared these responses to those observed in thioglycollate-elicited peritoneal macrophages. IFN-gamma induced TNF-alpha production in RAW 264.7 cells and this induction was regulated at the transcriptional level. IFN-gamma did not stimulate TNF-alpha production in either WEHI-3 cells or peritoneal macrophages, although MHC class II antigen expression was induced. LPS stimulated TNF-alpha production in the RAW 264.7 cell line and peritoneal macrophages; however, no TNF-alpha was detected in WEHI-3 cells activated with LPS. We also assessed the ability of endogenous TNF-alpha to serve as an autocrine regulator of two aspects of IFN-gamma-mediated macrophage activation, namely, induction of antibody-independent tumoricidal activity and induction of MHC class II antigen expression. These studies revealed that TNF-alpha could act synergistically or antagonistically with IFN-gamma in the regulation of these two functions, depending on both the macrophage population used and the function assessed. The results of our experiments suggest that the mechanism of induction of TNF-alpha production by IFN-gamma or LPS, and the ultimate autocrine contribution of such TNF-alpha to a given activation response, is dependent on the activated macrophage target population under analysis. The WEHI-3 and RAW 264.7 cell lines provide a model system for comparative exploration of the mechanistic basis of this differential regulation.

Animals↗
PubMed2004

[Resurgence of syphilis: a prospective study at an University Hospital, Nimes].

BACKGROUND: Since 2000, the incidence of syphilis has increased in France. The study objective was to estimate the frequency of syphilis in Languedoc Roussillon region in Southern France. METHOD: The prospective study was conducted between January 1, 2003 and June 30, 2003 in different medical wards in a French University Hospital, Nimes. The diseased patients in this study answered to a questionnaire, providing epidemiological and socio-economic data, symptomatology and treatment-seeking behaviour. Blood specimens were tested for syphilis by the serological methods (TPHA, VDRL, FTA). RESULTS: In 6 months, serologic evidence of syphilis infection was found in 30 patients. Men were more than twice as likely as women to be infected with syphilis. Most men (64.7%) acquired the infection homosexually. Four women acquired infection during pregnancy. The mean age of study population was 46.3 years. 40.7% were married. Out of 27 cases, 70.4% cases had an associated sexually transmitted infection (HIV, hepatitis, herpes, and gonorrhoea). CONCLUSIONS: These data confirm the increase of syphilis in south of France and underline the importance of a permanent monitoring of sexually transmitted infection in target populations to allow a timely diagnosis and an appropriate treatment, and to plan preventive strategies.

Adult↗
PubMed2005

Distribution of blood pressure and heart rate among adults in Jordan: a national survey.

Knowledge of population distribution of blood pressure is useful for predicting blood pressure related health burden as well as for planning prevention strategy. The aim of this investigation is to determine the distribution of systolic blood pressure (SBP), diastolic blood pressure (DBP), arterial blood pressure (ABP), and heart rate among normotensive adults resident from all regions of Jordan. This study is the first detailed description of these parameters in Jordan at a national level. A total of 14,310 adult males (7,400) and females (6,910) were selected randomly in various regions of Jordan. For each individual, the SBP, DBP, and heart rate were measured three times with 10-15-minute intervals in the sitting position and at the resting state. The ABP was calculated from the measured SBP and DBP. The mean values were distributed according to age and sex. Student's t-test was used for statistical analysis. Males had significantly higher SBP, DBP, ABP, and heart rate values than females. There also was an increase of these values with advancing age. Moreover, cases of hypotension and bradycardia were higher in the female population than in males, whereas cases of hypertension and tachycardia were higher in males. Distribution of blood pressure and heart rate among adults in Jordan was determined. Cases of undiagnosed hypertension, hypotension, and an increase or a decrease in heart rate were detected through our random screening in the target population. Individuals with these abnormalities require further clinical investigations to confirm or exclude these findings.

Adolescent↗
PubMed2006

Prevalence and management of rheumatoid arthritis in the general population of Greece--the ESORDIG study.

OBJECTIVE: To assess the prevalence and management of rheumatoid arthritis (RA) in the general adult population of Greece. METHODS: This cross-sectional study was conducted on the total adult population (> or =19 yrs old) of seven communities (8,547 subjects), and on 2,100 out of 5,686 randomly selected subjects in two additional communities. The study, based on a standardized questionnaire and clinical evaluation and laboratory investigation when necessary, was carried out by rheumatologists who visited the target population at their homes. Diagnosis of RA was based on the American College of Rheumatology (ACR) 1987 criteria. RESULTS: A total of 8,740 subjects participated (response rate 82.1%). RA was diagnosed in 59 individuals. The prevalence of RA was 0.68% (95% CI 0.51-0.85); it was significantly higher in females than males (P< 0.0005), and increased significantly with age up to and including the 50-59-yr-old group (P< 0.002), and then decreased slightly. On their first medical visit, 19% (95% CI 9.7-30.9) of the RA patients had consulted a rheumatologist, while during the first year after disease onset, 61% (95% CI 48.6-73.4) had done so. Early consultation with a rheumatologist and disease-modifying anti-rheumatic drug (DMARD) combination therapy were negatively associated with ACR functional classes II-IV [adjusted odds ratios 0.18 (95% CI 0.04-0.85) and 0.17 (95% CI 0.04-0.72), respectively]. CONCLUSIONS: The prevalence of RA in the general adult population of Greece is similar to that in many other European countries; early consultation with a rheumatologist and DMARD combination therapy are associated with a better RA outcome.

Adult↗
PubMed1989

Human fetal astrocytes in culture support the growth of the neurotropic human polyomavirus, JCV.

JC virus (JCV) has frequently been described as a tissue specific agent in the human population targeting the myelin producing oligodendrocyte whose destruction results in the demyelinating disease, progressive multifocal leukoencephalopathy (PML). JC virus growth in cell culture systems has generally reflected that observation because its multiplication is most efficient in cultures derived from human fetal brain. These cultures, however, are composed of a mixed population of cells phenotypically categorized as either astrocytes or precursors to oligodendrocytes. We have been able to separate mixed populations of glial cells from human fetal brain in culture and produce a pure population of astrocytes. We then analyzed the astrocyte cell cultures for their ability to support JCV transcription, replication, and virion production. Our results demonstrate that cultures of astrocytic cell types support JCV gene expression leading to virus multiplication. These astrocytic cell cultures also can be passaged several times in culture without loss of their astrocytic phenotypes or susceptibility to JCV infection. These data are consistent with our studies of JCV gene expression in fixed brain tissues of PML patients and virus immortalized astrocytic cell lines. These results strongly suggest that astrocytes as well as oligodendrocytes play a role in the pathogenesis of PML and should focus additional experiments on this particular cell type.

Astrocytes↗
PubMed2006

[Socioanthropological notes on community and health].

The notion of community utilized by planners and healthcare providers is doubly deceptive. On the one hand, it presupposes apparent equality and absence of conflicts between people in the same population group. On the other hand, it supposes a certain possibility of intervention by healthcare services in relation to behavioral patterns that are considered undesirable, from the point of view of disease control or health promotion. Used this way, this concept ends up concealing the "social nature" of the target population: poor people and the setbacks that their condition of poverty causes. To bring to light the problem of the euphemism implicit in this notion of community, the objective of the present article was to present Simmel's radically relational approach for characterizing the subordination of these population groups to healthcare policies and programs. For this purpose, the starting point was the appropriation of the sociological notion of community by the healthcare services, from Tönnies' classic formulation and its influence on the authors of the Chicago school.

Anthropology↗
PubMed2000

Prevalence of soil-transmitted helminth infections in the rural population of Bali, Indonesia.

The objectives of this cross-sectional study were to identify the prevalence of soil-transmitted helminth infection in the rural population of Bali and its relation to age, gender, and geoclimatic conditions. The subjects of study were derived from four villages of different geoclimatic conditions, namely wet lowland, dry lowland, wet highland and dry highland, by a multistage, stratified random sampling technique, based on age and gender of the target populations. The technique of Kato-Katz thick smear was used to determine presence of worm eggs in stools, and modified Harada Mori fecal culture technique was used to identify the species of hookworm larvae in stools. The data were analysed descriptively as well as statistically using chi2 test. Of 2,394 completely examined and analysed samples, the results showed as follows: The prevalences of Ascaris lumbricoides, Trichuris trichiura, hookworms and Strongyloides stercoralis were 73.7%, 62.6%, 24.5%, 1.6%, respectively. Of 2,082 infected samples, 33.1% were single infections and 66.9% were mixed infections. Among the mixed infections, dualfection was most frequent (47.8%), followed by single infection (33.1%), triplefection (18.3%), and quadrifection (0.8%). A combination of A. lumbricoides and T. trichiura was predominant in dualfection, while in triplefection a combination of A. lumbricoides, T. trichiura, and hookworms was most frequently identified. The prevalence in males was not statistically different, except for hookworms where it was higher in males than in females. The differences of prevalence of infection according to age groups for A. lumbricoides, T. trichiura and hookworms proved to be highly significant, but not with Strongyloides stercoralis. The prevalence of hookworm infection increased steadily with age to reach its maximum (37.7%) in adulthood (> 18 years), while A. lumbricoides and T. trichiura reached the highest prevalence level in elementary school age (77.3% and 70.7% respectively). The highest prevalence of S. stercoralis infection was found also in elementary school age, but it was not statistically significant. In wet highland the prevalence of infection of A. lumbricoides was 87.6%, T. trichiura 82.4%, hookworms 44.5%, and S. stercoralis 3.3%; these were significantly higher compared to the prevalence of infection in other areas (wet lowland, dry highland, dry lowland).

Adolescent↗
PubMed1989

The social impact of oral and facial pain in an industrial population.

The aim of this study is to determine the social impact of oral and facial pain in a sample involving an industrial population. Out of a total of 355 subjects interviewed, nearly one-half claimed to have oral and facial pain in the previous one month prior to the survey. The most common type of pain was that related to hot or cold fluids or sweet things followed by toothache. On the average, the pain lasted for 4.2 days (SD = 4.9) per person in the past one-month. About one in five persons with pain reported that it was severe enough to disrupt sleep. About one in ten persons reporting pain had to take sick leave because of the pain. However, only one in four persons with pain consulted a doctor or dentist. More than one-third tried to cope with the pain and did nothing while the rest tried various means of self-cure. It is therefore postulated that in this population, pain per se is a poor predictor of utilisation of dental services. Further research into pain coping behaviour and how this affects of pattern of utilisation of dental services is indicated in order to formulate a strategy to encourage the habit of seeking prompt dental care by the target population.

Absenteeism↗
PubMed1997

Minority issues in Alzheimer disease outcomes research.

Taking account of cultural and linguistic variations among ethnic minority groups (the most rapidly growing segment of the U.S. elderly population) will have both conceptual and methodological impacts on Alzheimer disease outcomes research. At the conceptual level, researchers will need to evaluate whether the definition of Alzheimer disease, treatment approaches, and outcomes (anticipated and desired) central to their research are relevant or appropriate for the ethnic minorities in their target populations. The central methodological impact of cultural and linguistic diversity will be the need to use qualitative techniques as integral parts of the research process and to cross-culturally adapt English assessment instruments for use with ethnic minorities. More labor-intensive efforts will be required at all stages of the research process and, thus, higher costs will be incurred.

Aged↗
PubMedDate not supplied

Mental health services provided through the National Centers of Excellence in Women's Health: do they reach rural women?

The National Centers of Excellence in Women's Health (CoEs) were established in part to provide integrated, comprehensive health care including mental health services to women. The purpose of this study was to identify mental health services currently provided by each of the 19 CoEs throughout the United States and to assess the extent to which these services are targeted to and utilized by rural women. Methods included both website review and semistructured interviews with knowledgeable informants in the CoEs. Center websites varied widely in mental health services mentioned: one CoE described services for nine different types of mental health issues, while one-fourth of the CoEs included no mention of any specific mental health services. Only four websites indicated that rural women were part of the CoE target population. Knowledgeable informant interviews indicated that seven of the CoEs had mental health staff onsite providing mental and behavioral health services. These services most often included treatment for depression and other mood disorders and for stress, as well as counseling for domestic violence issues. None of the CoEs offered mental or behavioral health services specifically targeted to rural women. We conclude that although they have not done so to date, the CoEs would be good sites in which to develop and test mental health outreach services for rural women.

Adult↗