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PubMed1996

Training to meet the needs of the communicatively impaired population of South Africa: a project of the University of the Witwatersrand.

At a time when South Africa is in the throes of transition, ideologies in the educational, medical, economic and social spheres are being redefined and redirected. The field of speech pathology and audiology is no exception. The Department of Speech Pathology and Audiology, University of the Witwatersrand has acknowledged an urgent need to address the requirements of a multilingual and multicultural South Africa and extend training beyond the white middle-class population. It is the responsibility of the training institutions to redirect the objectives of their curricula in order to meet these needs. This paper describes the changes introduced by the Department. These include teaching of community work principles and primary health care to the speech and hearing therapist, and the training of personnel for an alternative form of service, such as the community speech and hearing worker (CSHW) and the community-based rehabilitation worker (CBRW).

Community Health Services↗
PubMed1986

Department of the Environment (DOE) household projections.

"This article briefly describes the basis of the method of household projections developed by the Department of the Environment and touches on some of the problems and shortcomings." The projections concern England and Wales only.

Developed Countries↗
PubMed2005

Prevalence of low central bone mineral density in a Bulgarian female referral population: a pilot study.

Osteoporosis is one of the most important health problems among elderly women. The prevalence of central osteoporosis in Bulgaria is still unknown. We tried to retrospectively determine the prevalence of osteopenia and osteoporosis at the spine and hip in a female referral population. Bulgarian women (2,600) aged group 25-87 years referred for bone densitometry screening were included. Information about known risk factors for low bone mass was recorded. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (Hologic QDR 4500 A) at the lumbar spine (2,547 participants, 1,954 of whom were postmenopausal) and left hip (723 participants, 605 of whom were postmenopausal). T-scores were calculated from Hologic-provided and own Bulgarian peak BMD data (the latter based on 122 healthy premenopausal 25- to 39-year-old women). Peak lumbar spine BMD was 0.994 g/cm2 (SD 0.095 g/cm2), and thus lower than the manufacturer-provided value of 1.047 g/cm2. The peak BMD of the total hip was 0.959 g/cm2 (SD 0.129 g/cm2) and thus higher than the manufacturer-provided BMD of 0.942. T-scores differed according to the database used. The osteoporosis threshold of -2.5 SD was reached at the spine in the age group 70-74 years. Left hip T-scores showed a much slower decline with age. In women aged 50 and older the prevalence of osteoporosis reached 37.31% at the spine, and 16.14% at the left hip. Osteopenia was found in 39.74% at the spine and in 65.57% at the total hip. This is the first Bulgarian study looking for the prevalence of central osteoporosis in a female referral population. It may become the starting point for future epidemiological work.

Absorptiometry, Photon↗
PubMed1993

Collecting state-level oral health data when resources are limited: an approach to oral health surveillance.

Many states and localities do not have the resources to conduct oral health surveys of their whole populations, but the demands for data collection continue to increase for both program administration and for Maternal and Child Health Block Grant funding. As one response to this problem, the Oral Health Program of the Michigan Department of Public Health developed an oral health surveillance system as a low-cost method of collecting usable data from the service populations of local health agencies providing direct patient care in Michigan. A record form, to be completed by dentists or hygienists in those agencies at initial or recall examinations, was developed and pilot-tested for all patients of target age groups who presented over a specified four-week period. This paper gives the results from 19 agencies that participated in the pilot test in Michigan. Results showed that 40.5 percent of 2-5-year-olds (n = 341) had some caries experience, their d/dft was 78.2 percent, and mean dft was 4.8 (SD +/- 3.5). Among the 6-19-year-olds (n = 710), 61.4 percent had experienced caries, the D/DFT was 41.8 percent, and the mean DFT was 4.2 (SD +/- 3.2). Among the adults examined, 45.1 percent of 20-64-year-olds (n = 820) and 38.1 percent of those 65 years or older (n = 105) had two or more teeth with untreated decay. These data suggest a high level of untreated disease among the service populations of the local dental health agencies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Linkage between AIDS surveillance system and population-based cancer registry data in Italy: a pilot study in Florence, 1985-90.

The role of the Tuscany population-based Cancer Registry (TCR) in the assessment of cancer incidence in AIDS patients, and the completeness of cancer reporting to the Italian AIDS surveillance system (RAIDS) was evaluated through a linkage between the TCR and the RAIDS in the period 1985-90. In the Province of Florence, the incidence of Kaposi's sarcoma in AIDS cases was underestimated by 24% (95% CI; 9.8%-47%; 6/25 cases) by RAIDS in comparison with the TCR. Of kaposi's sarcomas unknown to RAIDS, 2 were incident at the time of AIDS diagnosis ("truly" unreported cases) and 4 were late manifestations of AIDS. Moreover, 1 non-Hodgkin lymphoma unknown to RAIDS and 10 other malignancies (4 lung cancers) were identified through the TCR. In AIDS patients, the incidence of lung cancer was 95-fold (99% CI, 16-310) the expected one on the basis of age-sex-specific incidence rates in the general population of the same area. Altogether, about 25% of AIDS cases developed a cancer during HIV infection. In spite of the small size of the present study, the results confirm the role of population-based cancer registries in the assessment of the occurrence of malignancies in AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Voluntary antenatal HIV testing--results of a pilot study.

Voluntary testing for antibody to human immunodeficiency virus (HIV) was offered to 4929 antenatal patients attending two hospitals in South Manchester during a 12 month period in 1989/90 in order to assess the feasibility of obtaining seroprevalence data by this method. Of these patients, 1728 (35%) agreed to a named test, 1396 (28%) to an unlinked anonymous test and the remaining 37% declined to be tested. The proportion of women tested increased from 22% to 88% over the period, and was similar in those with and without an identified risk factor for infection. One HIV antibody positive patient was found; she was tested anonymously and had no identified risk. The substantial cost in time and money required to establish the universal voluntary testing programme and the incomplete patient compliance confirm the importance of the unlinked anonymous surveys currently being established in the UK to monitor seroprevalence in sentinel populations.

AIDS Serodiagnosis↗
PubMed2005

Perceptions, expectations, and reactions to cleft lip and palate surgery in native populations: a pilot study in rural India.

OBJECTIVE: Many charitable organizations conduct overseas missions to correct cleft lip and palate where surgical care is unavailable. However, little is known about cultural and societal attitudes regarding the cleft deformity. METHOD: A 15-item questionnaire was designed to elicit from parents general knowledge concerning cleft lip and palate, beliefs regarding its causation, and expectations of what surgery would accomplish. Shorter second and third questionnaires were administered after the screening process and after surgery. The initial phase of this project was undertaken in Deesa, a midsized rural town in India. Fifty-two families were selected randomly for the initial questionnaire. These interviews were conducted verbally, assisted by translators. Children in 25 of these 52 families subsequently underwent surgery. RESULTS: The results of the interviews indicated that 64% of parents did not limit their child's social interaction and were not ashamed to be seen in public. Twenty-six percent exercised some constraints, and 10% kept their children totally isolated, not permitting them to leave the house or attend school. Regarding causation, the vast majority (84%) ascribed the cleft to "God's will" and 10% to sins committed in past lives. Only one parent acknowledged the influence of genetics, although several had a positive family history. Environmental factors were not an issue. Most families expected their child's life to be better when the facial deformity was corrected. Marriage prospects were the main concern, more so for girls than boys. Educational opportunity was a second strong theme. CONCLUSIONS: A greater understanding of the beliefs and expectations in this region was gained by means of this study.

Attitude to Health↗
PubMed1996

DIALOG: co-ordination of the annual review process through a District Diabetes Register linked to the FHSA database.

A working party was established by the Population Screening Project Board (UK), in conjunction with the Family Health Services Computer Unit, in order to develop a system for diabetes care (DIALOG) that would create a District Diabetes Register and prompt the process of diabetes annual review across both primary and secondary care. To simplify the creation and maintenance of the Diabetes Register, DIALOG has been designed to interface with the Family Health Services Authority population register to enable realtime download of demographic data. The system will also accumulate clinical information for the continuing audit diabetes services according to the data items specified in the standard UK diabetes dataset and can deliver detailed statistical analyses. Data input can be manual or electronic. DIALOG has been created to complement and integrate with existing diabetes information systems in primary and secondary care; it is not intended to be a clinic management system. It has the potential to become a National Diabetes Register.

Diabetes Mellitus↗
PubMed1984

Hospital bed planning in Canada: a survey analysis.

The need to plan health and especially hospital care delivery systems is becoming more critical in this period of severe financial constraints and even cutbacks of services. This article reports on a survey of hospital planning norms and bed requirements methodologies in Canada conducted in 1977 and 1980. The comparison and assessment of approaches to bed need determination in the Canadian provinces, together with some recommendations, are preceded by a review of basic hospital planning methods and their use in a number of selected countries. The literature review and the analysis conducted reveal that the "formula method" (beds per 1000 population) is the most common approach used to define and to allocate the "optimum" number of beds in the countries reviewed and in Canada. Despite its shortcomings, this method appears to have many advantages (e.g., simplicity, equity, flexibility). In general, provincial authorities use similar factors in the calculation of the number of beds to be provided, the most important ones being the size of the projected geographic population or population served by age groups. The acute care bed guidelines in Canada range from 3.5 per 1000 population in southern Ontario to 5.0 in Saskatchewan and Alberta. Extended care bed guidelines are much more spread between provinces. The analysis underlines the difficulties faced by the planner and the researcher in comparing bed guidelines due to significant definition and content differences between provinces. It finally leads to the observation that hospital planning remains arbitrary and appears to be more designed to ration the supply of services and to contain overall expenditures than to really try to meet the "need" of the population for hospital services.

Bed Occupancy↗
PubMed2005

More on RotaShield and intussusception: the role of age at the time of vaccination.

BACKGROUND: RotaShield, a vaccine intended to prevent severe rotavirus diarrhea, was withdrawn in July 1999, 9 months after it became available in the United States, because of a temporal association with intussusception events that occurred in vaccinated infants. We explore here the effect of age on the risk of intussusception. METHODS: We reanalyzed a case-control database of the Centers for Disease Control and Prevention by use of a 21-day window, to define vaccine-associated events. We obtained data on vaccine use from the National Immunization Survey and estimated the age-stratified background incidence of intussusception by use of Healthcare Cost and Utilization Project data. We combined these data to estimate how absolute risk varies with age and to model the projected population-attributable risk associated with 3 different vaccination schedules. RESULTS: We found that the incidence of intussusception associated with the first dose of vaccine increased with age. Infants > or = 90 days old accounted for 80% of cases of intussusception associated with a first dose but had received only 38% of first doses. Modeling of the recommended schedule of vaccination at ages 2, 4, and 6 months projected 1 intussusception event/11,000-16,000 vaccine recipients; modeling of a 2-dose schedule beginning in the neonatal period projected 1 intussusception event/38,000-59,000 vaccine recipients. CONCLUSIONS: The practice of initiating immunization after age 90 days, which we call "catch-up" vaccination, contributed disproportionately to the occurrence of intussusception associated with the use of RotaShield. A fully implemented 2-dose vaccination schedule begun during the neonatal period would lead to, at most, a 7% increase in the incidence of intussusception above the annual background incidence.

Age Factors↗
PubMed1992

Family planning: the unfinished revolution.

This is a general overview of family planning programs in developing countries, with a focus on east and southeast Asia and Sub-Saharan Africa. The author concludes that "by the year 2000, the number of contraceptive users in developing countries will have to be 40 percent higher if fertility declines are to match projections." Suggestions for program improvement are included.

Africa↗
PubMed1980

Cancer mortality in China, 1975-2000: implications for cancer control.

A recent nationwide cancer survey provided data for an analysis of future cancer mortality in the People's Republic of China. Aging of the population is projected to increase annual cancer mortality from 691,000 deaths in 1975 to 1,169,000 in the year 2000, a rise of 69 percent. Approximately 20,000 more patients will die of cancer each year during this period, placing substantial burdens on limited medical and economic resources in China. Carcinogenesis research and cancer prevention programs are examined as appropriate strategies for cancer control in this populous nation.

Adolescent↗