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PubMed2006

Preweaning mortality risks and recorded causes of death associated with production factors in swine breeding herds in Japan.

Preweaning mortality risks, recorded death reasons and related factors for preweaning mortality were studied in 105 breeding herds. Preweaning mortality risk at the herd level was calculated as the difference between the number of pigs born alive in farrowed litters and the number of weaned pigs divided by the number of pigs born alive in litters that farrowed and weaned. The mean of annual preweaning mortality risk was 10.7%. In regression analysis, higher mortality risks were associated with higher parity at farrowing, greater numbers of pigs born alive, and longer lactation length. The period from July to September had a higher mortality risk than that from April to June. The means of cause-specific proportional mortality ratios (PMR) in trauma with low viability and scours were 80.4 and 6.2%, respectively. Sows with pig age 0-1 day during lactation had the highest daily PMR. Sows with pig age 0 to 7 days had higher PMR due to trauma and low variability than those with pig age 8 days older. Sows with pig age over 7 days had higher PMR due to scours than those with pig age 0-7 days. Careful management at farrowing and in early lactation on high parity sows with large litters should be considered to prevent piglets from death due to trauma and low viability, and appropriate herd health programs should be implemented for reducing preweaning mortality due to scours during late lactation.

Animal Husbandry↗
PubMed1998

Providing the support services needed by students who are deaf or hard of hearing.

When students who are deaf or hard of hearing are appropriately placed, program-level and curriculum-level adaptations may both need to be discussed to ensure social as well as academic progress. Programmatic modifications may involve communication, linguistic, and grading issues, and both the listening and physical settings. Curricular modifications may involve the classroom structure, rapport and affect, the instructional format and language, the lesson format and materials, comprehension monitoring, activity and assignment completion, and placement choices. Professionals should work cooperatively to make and monitor changes.

Adolescent↗
PubMed2000

Achieving a credible health and safety approach to increasing seat belt use among African Americans.

African American youth are 60 percent less likely than children from other racial or ethnic backgrounds to be buckled up. Seat belt use among African American males has largely remained stagnant while that for other groups has increased. Overall, African Americans buckle up less often than other racial or ethnic populations. Seat belt use is a preventive health care action within public health. Clearly, a credible health and safety message is not being communicated effectively to African American communities. This paper proposes a number of possible solutions, including: recognition of the role that health care providers play in shaping patient or consumer attitudes and subsequent behavior in terms of prevention of disease and injury, educating physicians and health care providers to routinely recommend seat belt use especially for children, culturally appropriate educational safety programs, an improved relationship between law enforcement and communities, and zero tolerance for nonuse of seat belts.

Adolescent↗
PubMedDate not supplied

Practitioners' perspectives on effective practices for Hispanic teenage pregnancy prevention.

CONTEXT: In the United States, the pregnancy rate and birthrate of Hispanic teenagers are higher than those of other races and ethnicities. Although recommendations for culturally appropriate pregnancy prevention programs are commonplace, little is known about how practitioners address such recommendations. METHODS: In individual interviews, 58 teenage pregnancy prevention practitioners who work primarily with Mexican American female teenagers from two regions in California were asked about their understanding of recommendations for best practices and discussed the strategies they have used and challenges they have faced in implementing the recommendations. Qualitative methods were used to categorize responses and identify themes. RESULTS: Practitioners indicated that knowledge and awareness of Hispanic culture are essential, as is commitment to teenagers and their needs. They regard activities that encourage educational and career achievement as critical program components, and view both male partners' and family members' involvement in programs as important but challenging. Furthermore, practitioners feel that the implicit program goals of continued education and female self-sufficiency are often at odds with traditional Hispanic cultural values. CONCLUSIONS: Practitioners have valuable insight into the reality of implementing culturally sensitive programs. Programs need to balance the often competing values and goals of prevention programs with those of Hispanic youth culture and experiences.

Adolescent↗
PubMed1993

Surveys of long-term ventilatory support in Minnesota: 1986 and 1992.

To determine the prevalence and some characteristics of persons in Minnesota receiving long-term ventilatory support (ventilator-assisted individuals [VAIs]), we conducted a survey of this population in Minnesota in 1986 and then again in 1992 by canvassing long-term care units and home medical equipment providers. The number of VAIs in 1992 was 110 percent greater than in 1986 (216 vs 103). In 1986, 81 percent of these patients received care at home; the remaining patients were supported in long-term care facilities. By 1992, the percentage had changed to 65 percent supported in the home and 35 percent in long-term care facilities. In both surveys, the largest number of VAIs were in the diagnostic categories of poliomyelitis, cervical trauma, amyotrophic lateral sclerosis (ALS), chronic obstructive pulmonary disease (COPD), and muscular dystrophy. The primary diagnoses with the greatest increase in number of patients were cervical trauma and ALS. When VAIs were categorized by age groups, there was a large increase in the proportion of patients younger than 10 years of age and older than 60 years of age. While the number of patients is small, the total resources required for care of these patients can be substantial. These data suggest that we need to monitor the number and demographic characteristics of VAIs in the United States so that appropriate policies and programs are developed to provide effective support services.

Adolescent↗
PubMed2002

Compliance to antiretroviral medication as reported by AIDS patients assisted at the University Hospital of the Federal University of Mato Grosso do Sul.

Compliance to antiretroviral medication is a problem for AIDS patients. Compliance can be influenced by the characteristics of the therapeutic program, by the health guidance professionals, by the patient, and by society in general. A group of 139 Brazilian AIDS patients from the Infectious-Parasitic Diseases day clinic at the University Hospital of the Federal University of Mato Grosso do Sul were interviewed from September 27, 1999 to January 21, 2000. We identified and evaluated the frequency of noncompliance to antiretroviral medication, as well as the associated motives. Those who ingested 80%, or more, of prescribed dosages during the week previous to the interview were considered compliant. Among the patients interviewed, 70% mentioned loss or misplacement of medicine, and 63% were considered compliant. Average compliance was 75.8%, with no difference between the sexes. The reasons given for non-compliance were: absent-mindedness or forgetfulness (67.7%), lack of medicine (41.9%), side effects (21.5%), complexity of prescribed regimens (12.9%), fatigue (9.7%), and voluntary interruption (7.5%). The non-compliance observed among these patients indicates that health service personnel should promote activities to recuperate these therapeutic programs, employing methodologies appropriate to the characteristics of this population.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Target drug programs and medication use evaluation.

Target drug programs and medication use evaluations are activities that are undertaken to improve the correct use of drugs. These programs should focus on inappropriate drug use, drug use problems, optimizing use of drugs, and improving the level of patient care. To monitor the effects of the programs, several types of outcomes have been evaluated, such as economic and financial, clinical quality, quality of life, patient satisfaction, and collaborative practice. The methodology to classify and monitor drug use incorporates the classification system developed by the World Health Organization, which takes into account each drug's anatomic, therapeutic, and chemical classification. In order to avoid focusing only on drugs and drug costs in these programs, and to allow for monitoring the impact of the programs on clinical practice, linking drug data to patient data is stressed. Target drug programs improve the appropriate use of drugs, and by doing so, contribute to safe and rational use of drugs in society.

Drug Prescriptions↗
PubMed1993

Data analysis in craniofacial biology with special emphasis on longitudinal studies.

Recommendations are made for strengthening data description and analysis in craniofacial biology. Special emphasis is placed on longitudinal data, and PC programs for accomplishing appropriate analyses in this context are described and made available to interested readers. Some more general recommendations are treated in less detail. These include the effective description of data using stem-and-leaf displays and/or boxplots, the use of decision-analytic methods in the management of patients with dentofacial deformities, and the valid application of certain statistical methods in single-subject studies. Finally, it is conjectured that computer-intensive methods such as randomization tests and jackknifing will play an increasingly prominent role in craniofacial research.

Analysis of Variance↗
PubMed2005

Comparison of conventional and integrated pest management programs in public schools.

This study compared an integrated pest management (IPM) program with conventional, calendar-based pest control in nine North Carolina elementary schools. Both programs primarily targeted the German cockroach, Blattella germanica (L.). The IPM program relied heavily on monitoring and baiting, whereas the conventional approach used baseboard and crack-and-crevice sprays of insecticides. Within the constraints of an existing pest management contract, we quantified service duration, materials used, cost, levels of cockroach infestation, and the pesticide residues generated by the two service types. IPM services were significantly more time-consuming than conventional services, resulting in a significantly higher cost associated with labor. Nevertheless, the two types of treatments incurred similar total costs, and the efficacy of both treatments was also similar. Most importantly, pest monitoring, a central element of the IPM program, revealed few cockroaches and indicated that most of the conventional treatments were unnecessary. Environmental residues of the organophosphate pesticides acephate, chlorpyrifos, and propetamphos were significantly higher in swab samples taken in the conventionally treated schools. This study demonstrates that an IPM program is an appropriate and preferable alternative to conventional methods of pest control in the school environment.

Animals↗
PubMed1983

Prevalences of anemia and iron deficiency anemia in Black and White women in the United States estimated by two methods.

Prevalences of anemia were estimated by two methods for 742 Black and 3,074 White nonpregnant women of childbearing age drawn from a large probability sample of the United States civilian noninstitutionalized population (NHANES I). One method defines the prevalence of anemia as the proportion of women with hemoglobin levels below a 12 g/dl "cut-off". The second method defines the prevalence of anemia as the proportion of women whose hemoglobin values are shifted downwards relative to a distribution of hemoglobin values of non-anemic women. Estimates produced by both methods suggest a higher prevalence of anemia in Black than in White women. Estimates produced by the "cut-off" method, however, are higher than those from the "distribution" method for both racial groups, probably because the "cut-off" method results in large overestimates in populations where anemia prevalence is low. The "distribution" method is further used to estimate the contribution of iron deficiency to anemia. Essentially all anemia in White women and a high proportion of anemia in Black women is associated with iron deficiency in the US civilian noninstitutionalized population. Iron supplementation trials are needed in order to define the magnitude of the problem accurately and plan appropriate public health programs.

Adolescent↗
PubMed1999

Evaluating the public health impact of health promotion interventions: the RE-AIM framework.

Progress in public health and community-based interventions has been hampered by the lack of a comprehensive evaluation framework appropriate to such programs. Multilevel interventions that incorporate policy, environmental, and individual components should be evaluated with measurements suited to their settings, goals, and purpose. In this commentary, the authors propose a model (termed the RE-AIM model) for evaluating public health interventions that assesses 5 dimensions: reach, efficacy, adoption, implementation, and maintenance. These dimensions occur at multiple levels (e.g., individual, clinic or organization, community) and interact to determine the public health or population-based impact of a program or policy. The authors discuss issues in evaluating each of these dimensions and combining them to determine overall public health impact. Failure to adequately evaluate programs on all 5 dimensions can lead to a waste of resources, discontinuities between stages of research, and failure to improve public health to the limits of our capacity. The authors summarize strengths and limitations of the RE-AIM model and recommend areas for future research and application.

Community Health Planning↗
PubMed1991

Community action for health promotion: a strategy to empower individuals and communities.

Health status is directly affected by environmental conditions and by personal health-related behaviors, and it is indirectly affected by environmental conditions that themselves influence health behaviors. A comprehensive approach to health promotion, therefore, should encourage individuals to adopt and maintain personal behaviors that would prevent disease and promote health; discourage health-damaging personal behaviors by individuals and facilitate people engaging in health-promoting behaviors; and eliminate health hazards from the physical and social environment and make that environment more health-promoting. This comprehensive approach would require social and community action to change environmental conditions as well as efforts to change individual behavior. A model of health promotion interventions is developed within which community action plays a central role. The author then presents a model of community organization to influence public policy to achieve health promotion goals. The community organization model, previously tested in comparative case-study research, is illustrated with examples drawn from appropriate health promotion programs.

Community Health Services↗
PubMed2002

Cardiac events in 735 type 2 diabetic patients who underwent screening for unknown asymptomatic coronary heart disease: 5-year follow-up report from the Milan Study on Atherosclerosis and Diabetes (MiSAD).

OBJECTIVE: To report the cardiac events in type 2 diabetic outpatients screened for unknown asymptomatic coronary heart disease (CHD) and followed for 5 years. RESEARCH DESIGN AND METHODS: During 1993, 925 subjects aged 40-65 years underwent an exercise treadmill test (ETT). If it was abnormal, the subjects then underwent an exercise scintigraphy. Of the 925 subjects, 735 were followed for 5 years and cardiac events were recorded. RESULTS: At the entry of the study, 638 of the 735 followed subjects had normal ETT, 45 had abnormal ETT with normal scintigraphy, and 52 had abnormal ETT and abnormal scintigraphy. The 52 subjects with abnormal scintigraphy and ETT underwent a cardiological and diabetological follow-up; the subjects with just abnormal ETT had a diabetological follow-up only. During the follow-ups, 42 cardiac events occurred: 1 fatal myocardial infarction (MI), 20 nonfatal MIs, and 10 cases of angina in the 638 subjects with normal ETT; 1 fatal MI in the 45 subjects with normal scintigraphy; and 1 fatal MI and 9 cases of angina in the 52 subjects with abnormal scintigraphy. In these 52 subjects all cardiac events were significantly more frequent (chi(2) = 21.40, P < 0.0001) but the ratio of major (cardiac death and MI) to minor (angina) cardiac events was significantly lower (P = 0.002). Scintigraphy abnormality (hazard ratio 5.47; P < 0.001; 95% CI 2.43-12.29), diabetes duration (1.06; P = 0.021; 1.008-1.106), and diabetic retinopathy (2.371; P = 0.036; 1.059-5.307) were independent predictors of cardiac events on multivariate analysis. CONCLUSIONS: The low ratio of major to minor cardiac events in the positive scintigraphy group may suggest, although it does not prove, that the screening program followed by appropriate management was effective for the reduction of risk of major cardiac events.

Age Distribution↗
PubMed1997

The effects of "decelerated" rehabilitation following anterior cruciate ligament reconstruction on a hyperelastic female adolescent: a case study.

Current concepts in postoperative anterior cruciate ligament (ACL) reconstruction management include participation in an "accelerated" rehabilitation program. There are no published reports examining the effects of accelerated or conservative rehabilitation on subjects with generalized ligamentous hyperelasticity. The purpose of this case study was to examine the effects of a conservative or "decelerated" rehabilitation program on the functional outcome of a hyperelastic female adolescent athlete following ACL reconstruction. The subject was a 15-year-old female basketball player who sustained a unilateral ACL tear and underwent subsequent ACL reconstruction using a patellar tendon autograft. The subject immediately began participation in a "decelerated" rehabilitation program in which the intensity and rate of progression was decelerated, emphasizing a prolonged period of maximum graft protection. Progress was objectively quantified with a battery of diagnosis-specific tests at scheduled intervals. Results at 52 weeks postoperative revealed normal range of motion, proprioception, balance, knee stability, quadriceps strength, hamstring strength, and subjective assessment values, and only a 4.0% deficit in functional scores. Our results suggest a "decelerated" rehabilitation program may be appropriate for the population with generalized ligamentous hyperelasticity by yielding excellent functional results without compromising the integrity of the graft and, ultimately, knee stability.

Adolescent↗
PubMed1995

A review of the significance of animal food products as potential pathways of human exposures to dioxins.

The polychlorinated dibenzo-p-dioxins and dibenzofurans (dioxins) are groups of compounds with similar chemical and toxicological properties. Carcinogenicity was considered the most serious toxic end point when setting previous regulatory policies, but recent concerns have focused on the possible endocrine-disrupting activities of the dioxins. Toxicity is related to the 2,3,7,8 pattern of chlorine substitution, a pattern that also leads to chemical and metabolic stability. Dioxins are practically insoluble in water and concentrate in lipids of biological systems, leading to low background concentrations in fat of the general human population. Major environmental sources of dioxins are emissions from industrial chlorination processes and combustion of materials containing chlorine. Inhalation and water have been ruled out as significant exposure pathways, which suggests that food is the primary source. Pathways of entry into food chains are atmospheric transport of emissions and their subsequent deposition on plants, soils, and water. The major food sources seem to be fat-containing animal products and some seafoods. This conclusion is based on evaluations of potential environmental pathways involving dioxins and related compounds. Generally, dioxins and other lipophilic compounds are not taken up and translocated by plants, so residues in foods and feeds derived from seeds should be negligible. Animals on high-roughage diets, or those that ingest contaminated soil, are the most likely to accumulate dioxin residues from the environment. The conclusion that animal products are a major source of human exposure requires verification by appropriate food sampling programs and animal metabolism studies. If it is desirable to reduce human exposure to dioxins via the food supply, reduction of sources would be a more effective strategy than changing agricultural practices and food consumption patterns.

Animal Feed↗
PubMed1987

Pulmonary and testicular angiotensin-converting isoenzymes.

A variant of angiotensin-converting enzyme occurs in (male) germinal cells. This testicular isozyme is catalytically similar to the widespread pulmonary-type isozyme, but contains a shorter polypeptide chain and does not appear until puberty. The two proteins differ at their NH2- and COOH-termini, but share many tryptic peptides. All antigenic determinants of the testicular form are represented in the pulmonary molecule whereas the latter contains determinants unrelated to catalysis which are lacking in the testicular species. The data indicate that the testicular isozyme corresponds closely to an internal part of the pulmonary polypeptide which includes its active site. The structural and developmental differences between the two polypeptides are pretranslationally determined since they are demonstrable in a cell-free system programmed by the appropriate mRNAs. Characterization of the molecular mechanisms responsible for the relationship of these isozymes may yield useful information regarding cell-specific protein expression.

Animals↗
PubMed2004

The multichannel auditory brainstem implant: how many electrodes make sense?

OBJECT: Development of multichannel auditory brainstem implant (ABI) systems has been based in part on the assumption that audiological outcome can be optimized by increasing the number of available electrodes. In this paper the authors critically analyze this assumption on the basis of a retrospective clinical study performed using the Nucleus 22 ABI surface electrode array. METHODS: The perceptual performances of 61 patients with neurofibromatosis Type 2 were tested approximately 6 weeks after an eight-electrode ABI had been implanted. Of eight implanted electrodes 5.57 +/- 2.57 (mean +/- standard deviation [SD] provided auditory sensations when stimulated. Electrodes were deactivated when stimulation resulted in significant nonauditory side effects or no auditory sensation at all, and also when they failed to provide distinctive pitch sensations. The mean (+/- SD) scores for patients with ABIs were the following: sound-only consonant recognition, 20.4 +/- 14.3 (range 0-65%); vowel recognition, 28.8 +/- 18% (range 0-67%); Monosyllable Trochee Spondee (MTS) word recognition 41.1 +/- 25.3% (range 0-100%); and sentence recognition, 5.3 +/- 11.4% (range 0-64%). Performance in patients in whom between one and three electrodes provided auditory sensation was significantly poorer than that in patients with between four and eight functional electrodes in the vowel, MTS word, and City University of New York (CUNY) sentence recognition tests. The correlation between performance and electrode number did not reach the 0.05 level of significance with respect to the sound effect, consonant, and MTS stress-pattern recognition tests, probably because a satisfactory performance in these tests can be obtained only with temporal cues, that is, without any information about the frequency of the sounds. In the MTS word and the CUNY sentence recognition tests, performance was optimal in the patients with eight functional electrodes. Although all top performers had more than three functional auditory electrodes, no further improvement (asymptotic performance) was seen in those with five or more active electrodes in the consonant, vowel, and sound effect recognition tests. CONCLUSIONS: A minimum of three spectral channels, programmed in the appropriate individual tonotopic order seem to be required for satisfactory speech recognition in most patients with ABI. Due to the limited access to the tonotopic frequency gradient of the cochlear nucleus with surface stimulation, patients with ABI do not receive a wide range of spectral cues (frequency information) with multielectrode (> 5) surface arrays.

Acoustic Stimulation↗
PubMed1991

Essential gerontological content for the associate degree nursing curriculum. A national study.

1. The growing number of associate degree registered nurses caring for the elderly underscores the need for gerontological nursing preparation within associate degree programs. 2. The curriculum content validity theory of Taba and Zoot requires content selection criteria to reflect the relationship of course content to program outcomes. 3. Appropriateness of gerontological content for associate degree nursing was defined by the five practice roles of the associate degree nurse. 4. Gerontological nursing content rated essential by nationwide panels of associate degree nursing educators and practicing nurses includes items within the areas of commonly encountered health problems, ethical issues, chronic illness, long-term care of older adults, and nursing process.

Aged↗