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At least 1,153 records · Page 64Linked to original sources
PubMed2004

HIV in Singapore--past, present, and future.

The first case of HIV infection in Singapore was reported in 1985. Between 1991 and 1998, the number of reported cases of HIV and AIDS increased rapidly before stabilizing from 1999. The epidemiology of the AIDS epidemic in Singapore is characterized by a predominance of male cases (seven to one) and heterosexual transmission. A multipronged control program comprising public education and education of high-risk groups, legislation, protection of the national blood supply, management of cases, and epidemiological surveillance has been put in place. The promotion of condom use among local sex workers has been fairly successful, with very low rates of HIV and other sexually transmitted infections (STIs). However, freelance and potential indirect sex workers such as masseuses and lounge hostesses are a concern in view of their higher prevalence of HIV and STIs. Another concern is the high proportion of cases who are diagnosed only when they develop AIDS. A better understanding of sexual networks among men who have sex with men will enable more effective intervention programs for this group. Fresh innovative approaches are needed to encourage safe sex practices and early screening.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Non-classical 21-hydroxylase deficiency in infancy and childhood: the effect of time of initiation of therapy on puberty and final height.

OBJECTIVE: To review the characteristics of children with non-classical 21-hydroxylase deficiency (NC-21-OHD) diagnosed during infancy and childhood, and to evaluate the relationship of pubertal and bone age maturation at initiation of glucocorticoid therapy with the course of puberty and final height. DESIGN: We retrospectively compared the course of puberty, growth pattern and final height in two groups of patients: group A (two males, six females), hydrocortisone (HC) treatment 7.5-15 mg/m2 per 24 h, initiated > or = 1 year before onset of true puberty and group B (seven females), treatment started with the first signs of true puberty present. PARTICIPANTS: Thirteen girls and two boys with NC-21-OHD diagnosed at age range 0.5-10.6 years were followed-up for 9.0 +/- 3.8 years (mean +/- S.D). Therapy with HC was initiated because of signs of hyperandrogenism, accelerated growth and bone maturation, or true precocious puberty. The HC dose was adjusted according to linear growth and basal plasma androgen levels. RESULTS: Puberty and peak height velocity developed significantly earlier in the girls of group B: gonadarche at 7.9 +/- 1.4 years and peak height velocity at 9.2 +/- 1.4 years vs 10.2 +/- 0.4 years (P = 0.002) and 11.5 +/- 0.7 years (P = 0.006) in group A. Menarche, however, occurred only slightly earlier in group B (12.0 +/- 1.1 vs 12.8 +/- 0.5 years, P = 0.068). All eight children in group A achieved a final height within the range of their mean parental height standard deviation scores (SDS) in comparison with only 1/7 in group B (P = 0.0014). Seven of eight patients who started therapy before a bone age of 9 years achieved a final height within the parental height SDS range, compared with 2/7 who started therapy later (P = 0.041). The final height SDS was significantly better for group A (0.05 +/- 0.19, mean +/- S.E.M.) than group B (-1.63 +/- 0.23, P = 0.0007), even when adjusted for a significant effect of the mean parental height SDS (A. -0.63 +/- 0.28; B, -0.89 +/- 0.31, P = 0.0245, ANCOVA). CONCLUSION: Every child with signs of excess androgen activity or early puberty should be studied for the possibility of NC-21-OHD. Screening programs for populations with a high frequency of the gene for NC-21-OHD would facilitate early diagnosis and treatment. Pubertal stage and bone age at the introduction of therapy dictate height prognosis. Initiation of therapy before puberty with careful follow-up and HC dose adjustment can assure the achievement of genetic adult height.

Adrenal Hyperplasia, Congenital↗
PubMedDate not supplied

[The prevalence of tuberculosis in the state of Acre].

It is a descriptive study with the aim of studying the prevalence of tuberculosis in the State of Acre from 1995 to 2001. The data were collected from the forms of the Program for Tuberculosis Control of the Health and Sanitation Office. The data show that the incidence has been maintaining an average of 343.7 new cases a year. The pulmonary type was the most prevalent one, accounting for 90.0%. Among the age groups, the 20-49 age range, with 1347 (56.0%) and the 60 and over-60 age range, with 412 (17.0%), stand out. From 1998 to 2001 the male sex was the most attacked one by the disease, when the year 2000 accounted for 58.2% of the cases. The average of the cure rate was 71.0% and abandonment of treatment was 14.8% in 2001 and 32.3% in 1995. The smallest percentage of death occurred in 1995 (1.0%) and the largest one in 1997 (7.0%). Five cases were notified for the occurrence of coinfection between TB/AIDS and HIV/TB. The program's population coverage was within 90% every year. From the 22 cities, 6 (27.3%) still do not have any action for controlling the disease.

Adult↗
PubMed2000

[Evaluate of popular knowledge and everyday practices in oral health].

OBJECTIVE: To evaluate the popular knowledge and everyday practices in oral health of public services' users. METHODS: The target population was selected from a stratified sample and included users seeking medical care in health care units in Santa Maria - RS. The data were collected using a semi-structured interview and organized into descriptive categories groups, allowing the distribution in a frequency table. RESULTS: It was verified the predominance of the age group between 21 to 40 years old and females. The socioeconomic pattern is characterized by low schooling and family income. The search for oral diseases control are due to individual awareness of the need of oral hygiene and dental care; fluoride in toothpaste and drinking water and its benefits were not known by the population. CONCLUSIONS: The health programs offered to the population must take into account the knowledge and practices in oral health care to make it possible an improvement of oral health according to their reality. In addition there is a need to promote the collective awareness on health promotion in every level of the society.

Adolescent↗
PubMed2005

Assessment of patient satisfaction with telephone and mail interventions provided by a clinical pharmacy cardiac risk reduction service.

OBJECTIVE: Kaiser Permanente of Colorado developed a population-based program, the Clinical Pharmacy Cardiac Risk Service (CPCRS), to help close the treatment gap for patients with coronary artery disease. CPCRS provides much of its care via telephone. The purpose of this study was to determine the level of satisfaction among patients in this unique service. METHODS: This was a cross-sectional survey of patients enrolled in CPCRS for at least 6 months. A sample of patients who met the inclusion criteria were chosen at random to receive the satisfaction survey via mail. Questions pertained to overall satisfaction and satisfaction with individual components of CPCRS. A Likert-type, 5-point scale was used for the majority of the questions. Analyses of the results were primarily descriptive. RESULTS: Of 1,000 surveys mailed, 491 (49.1%) were returned. The majority of respondents were male (68.5%). The average age of respondents was 71.7 (SD) 9 years. Of those surveyed, 94.6% (95% confidence interval [CI], 92.6%- 96.6%) reported being satisfied (agree or strongly agree) with the care they received for cholesterol management from their CPCRS clinical pharmacy specialist. Respondents reported that their CPCRS clinical pharmacy specialist was easy to contact (83.7%, 95% CI, 80.3%-87.1%), provided timely service (94.8%; 95% CI, 92.8%-96.8%), and addressed all questions or concerns in a way that was easy to understand (85.8%; 95% CI, 82.6%-89.0%). The majority of respondents reported that they were content receiving care over the telephone (86.7%; 95% CI, 83.5%-89.9%) and by mail (90.0%; 95% CI, 87.1%-92.9%). CONCLUSION: Overall, survey respondents indicated a high level of satisfaction with the services provided by CPCRS. Based upon patient satisfaction, the results of this survey suggest that the use of telephone and mail systems to provide patient care can allow clinical pharmacy specialists to manage a large number of patients successfully. Health care systems may wish to explore similar methods to address the needs of patients with coronary artery disease.

Aged↗
PubMed1996

The recovery of Guatemalan children with mild to moderate wasting: factors enhancing the impact of supplementary feeding.

OBJECTIVES: The purpose of this study was to identify factors that enhance the recovery due to supplementary feeding in wasted children. METHODS: Recovery rates were obtained in mild to moderately wasted 6- to 48-month-old rural Guatemalan children living in four villages. Children in two villages received a high protein-energy supplement (supplemented children), while children in the other villages received a low protein-energy supplement (nonsupplemented children). The difference in recovery rates between the groups was the attributable benefit. The net supplementation amounted to 11% of the recommended energy intake and its associated nutrients. RESULTS: Attributable supplement benefits were achieved in younger children (6 to 24 months old) and increased with decreasing weight for length, longer duration of supplementation, and duration of diarrhea, but not with chronicity of wasting. CONCLUSIONS: Supplementation's effectiveness can be improved in similar populations by programs targeted according to these findings.

Body Height↗
PubMed2003

Innovative surveillance methods for rapid detection of disease outbreaks and bioterrorism: results of an interagency workshop on health indicator surveillance.

A system designed to rapidly identify an infectious disease outbreak or bioterrorism attack and provide important demographic and geographic information is lacking in most health departments nationwide. The Department of Defense Global Emerging Infections System sponsored a meeting and workshop in May 2000 in which participants discussed prototype systems and developed recommendations for new surveillance systems. The authors provide a summary of the group's findings, including expectations and recommendations for new surveillance systems. The consensus of the group was that a nationally led effort in developing health indicator surveillance methods is needed to promote effective, innovative systems.

Bioterrorism↗
PubMed1986

New patterns in health sector aid to India.

Criticisms of health aid have largely been derived from African and Latin American experiences. It is suggested that such analyses, while valuable, cannot be applied wholesale to India without detailed examination of the patterns of health sector aid which have actually characterized the period since 1947. This article brings together material on the scale and form that this assistance has taken, and demonstrates that its focus has been preventive in emphasis and oriented towards the primary care sector. In some periods it has contributed a substantial share of total public sector expenditures, and in some spheres, it has played a major role, particularly the control of communicable diseases. However, the impact of less substantial sums going to prestige medical colleges or to population control programs should not be ignored; and several of the aid categories have been of dubious origin (PL-480 counterpart funds and U.S. food surpluses as the prime examples). However, the "new" health aid programs do not deserve the ready dismissal they have received in some quarters.

Communicable Disease Control↗
PubMed2006

The impact of aging on long-term care in Europe and some potential policy responses.

The article examines recent data on the impact of increasing numbers of elderly people in Europe on expenditures for long-term care services. After reviewing recent and projected future costs of long-term care, the authors examine current national strategies for long-term care as well as potential policy options that could reduce future expenditures due to aging. Although long-term care expenditures in Europe will rise over the next several decades, countries can adopt a variety of strategies--many of them in social sectors outside the health system--to reduce or mitigate the overall effects of likely long-term care needs.

Aged↗
PubMed1981

Mode of production and population patterns: policy implications for West African development.

Recent developments in population theory have made possible a re-examination of demographic evidence from West Africa which suggests that population growth and migration are primarily responses to changes in the nature of the production system. Precolonial, colonial, and independence period data provide a series of correlations consistent with the approach and suggest a possible new synthesis of the West African data. The poorest countries of West Africa are those bordering on the Sahara Desert, known as the "Sahel" region. In response to the drought and famine in that region from 1968-1974, numerous proposals have been made for increased attention to reducing population growth. The analysis presented in this paper leads to the conclusion that population policies other than those attempting to lower the birth rate are called for. These would include relocation of populations previously displaced by colonial labor migrations and the re-integration of herding and farming production systems, both of which policies should be considered as population policies. Data are presented from specific projects underway in Senegal, Mauritania, and Mali, to illustrate the argument.

Africa, Western↗
PubMed2004

Is the Canadian health care system fiscally sustainable?

Current concerns over escalating health care costs and the sustainability of the Canadian health care system are based on analytical concepts and models that have their own limitations and deficiencies. Measuring health care costs across subsectors over the long-term period, the authors argue that Canada's health care costs, especially those under the direct control of provincial governments, are relatively stable. Using appropriate measures of sustainability, there is no indication that Canada's public health care expenditure is unsustainable. Nor is there any indication that Canada's public health care expenditures are out of line with those of its main trading competitors, including the United States.

Bankruptcy↗