Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Multiphasic Screening”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,189 records · Page 66Linked to original sources
PubMedDate not supplied

A collaborative model for community-based health care screening of homeless adolescents.

Because of their survival life-style, homeless youth are at extremely high risk for contracting life-threatening and debilitating diseases, such as acquired immunodeficiency syndrome and hepatitis B, and for engaging in chronic substance abuse; yet health services are often limited and not easily accessed. This article describes an innovative health-screening project for 150 homeless youth between the ages of 11 and 23 years in an urban metroplex. The Homeless Youth Services Project was the initial phase of a multiphase project to investigate the social and health services available to homeless youth. The study project was a collaborative effort between several community agencies that shared the multiple goals of identifying the homeless adolescent population, documenting the rate of human immunodeficiency virus (HIV) seroprevalence and level of risk, and identifying community services and resources. Results of the screening project included the psychosocial and physical risks associated with homeless adolescents as well as the laboratory results of blood and urine screens. Consistent with the literature, the study population had a history of runaway behavior; physical, sexual, and substance abuse; and high rates of HIV seroprevalence and hepatitis B. Implications for advanced practice nurses working with homeless youth are also addressed.

Adolescent↗
PubMedDate not supplied

Psychopathology and personality features in orthopedic patients with boxer's fractures.

A boxer's fracture (BF) is the most common type of metacarpal fracture and is usually an intentional injury. This study aims to investigate the severity of depressive and anxiety symptoms and evaluate the personality features of patients with BF in comparison with patients with fractures other than boxer's fractures [other fractures (OFs)] and a group of healthy controls (C). The study group was comprised of 14 patients who were diagnosed to have BF, 13 patients who were assessed due to OF and 11 C. Patients and controls were assessed with Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-2) was used to screen axis II, personality disorders' symptoms. The results showed that patients with BF had more anxiety as a trait and had higher mean scores for self-defeating, borderline and antisocial personality disorders than both the group of OF and C. Additionally, BF group had higher scores on the anger and cynicism subscales of MMPI-2. These results suggest that maladaptive personality traits and anxiety symptoms are common in patients with BF. Psychiatric assessment of patients who apply to orthopedy clinics with BF should be a part of their treatment plan.

Adult↗
PubMed1989

Evaluation of an intervention aimed at reducing inappropriate use of preoperative blood coagulation tests.

A multiphase intervention trial based on education, implementation of criteria, and restriction, aimed at modifying the established clinical policy of mandatory preoperative screening for coagulation abnormalities, was carried out on five surgical wards of a general hospital. The education period did not influence the ordering of partial thromboplastin time tests, despite a significant posteducational change in surgeons' attitudes. In contrast, administrative restriction of coagulation test orders led to a 50% decline on four of the five study wards. We conclude that an educational intervention followed by administrative restriction may be considered an acceptable means of overcoming clinician reluctance to change well-established but redundant clinical policy.

Attitude of Health Personnel↗
PubMed2002

Value of plasma B type natriuretic peptide measurement for heart disease screening in a Japanese population.

BACKGROUND: Conflict exists regarding the usefulness of measuring plasma B type natriuretic peptide (BNP) concentrations for identifying impaired left ventricular (LV) systolic function during mass screening. Various cardiac abnormalities, regardless of degree of LV dysfunction, are prone to carry a high risk of cardiovascular events. OBJECTIVE: To examine the validity of plasma BNP measurement for detection of various cardiac abnormalities in a population with a low prevalence of coronary heart disease and LV systolic dysfunction. DESIGN AND SETTING: Participants in this cross sectional study attended a health screening programme in Iwate, northern Japan. Plasma BNP concentrations were determined in 1098 consecutive subjects (mean age 56 years) by direct radioimmunoassay. All subjects underwent multiphasic health checkups including physical examination, ECG, chest radiography, and transthoracic echocardiography. RESULTS: Conventional diagnostic methods showed 39 subjects to have a wide range of cardiac abnormalities: lone atrial fibrillation or flutter in 11; previous myocardial infarction in seven; valvar heart disease in seven; hypertensive heart disease in six; cardiomyopathy in six; atrial septal defect in one; and cor pulmonale in one. No subjects had a low LV ejection fraction (< 40%). To assess the utility of plasma BNP measurement for identification of such patients, receiver operating characteristic analysis was performed. The optimal threshold for identification was a BNP concentration of 50 pg/ml with sensitivity of 89.7% and specificity of 95.7%. The area under the receiver operating characteristic curve was 0.970. The positive and negative predictive values at the cutoff level were 44.3% and 99.6%, respectively. CONCLUSION: Measurement of plasma BNP concentration is a very efficient and cost effective mass screening technique for identifying patients with various cardiac abnormalities regardless of aetiology and degree of LV systolic dysfunction that can potentially develop into obvious heart failure and carry a high risk of a cardiovascular event.

Adult↗
PubMed1976

Survival data from a multiphasic mobile cancer detection unit.

Individuals with early cancer rarely have symptoms, through it is at this state that the best prognosis can be afforded. 22 out of 5,232-patients screened in a Mobile Cancer Detection Unit (MCDU) received cancer diagnosis (exclusive of skin cancer). These patients have enjoyed much greater survival than expected. For instance, only three have died versus and expected 7.5. Calculations show that if all cancer patients in the United States had a similar increase in survival, then the lives of at least 120,000-persons could be extended each year. These limited data must be interpreted cautiously. Nevertheless, they do hold promise since only a few percentage points increase in survival when measured against the full impact of the cancer problem will show significant patient benefit.

Adolescent↗
PubMed2002

Multiphase magnetic resonance angiography of the abdominal and pelvic arteries: results of a bicenter multireader analysis.

RATIONALE AND OBJECTIVES: The objective is to assess the diagnostic accuracy and interobserver variability of multiphase 3D gadolinium-enhanced magnetic resonance angiography (3D-Gd-MRA) for assessment of abdominal and pelvic vascular disease. METHODS: In 41 patients from two different institutions multiphase 3D-Gd-MRA of the aorta and pelvis was performed using an identical scanning protocol. In a single breath-hold three to four consecutive phases were acquired. Stenoses in the renal arteries, and aorta and pelvic arteries were independently evaluated by three readers and compared with digital subtraction angiography. Interobserver variability was compared by means of a kappa statistic. RESULTS: Accuracy for stenosis grading consistently ranged between 80% and 90% for all three readers in all vessel segments studied. Good interobserver agreement was found with kappa values exceeding 0.75. Vessel segments with delayed fill-in could be reliably detected on the multiple successive MRA phases. Overall, MRA was rated slightly superior to Digital Subtraction Angiography in terms of interobserver variability, diagnostic confidence and image quality. CONCLUSIONS: Multiphase MRA is a highly robust technique with reproducible accuracy for different observers and different institutions. It can therefore be recommended for screening of atherosclerotic abdominal and pelvic disease.

Aged↗
PubMed1995

Biologic sex as a risk factor for Helicobacter pylori infection in healthy young adults.

Diseases associated with Helicobacter pylori infection, such as peptic ulcer disease and gastric cancer, afflict men more frequently than women. No study, however, has demonstrated any difference in sex-specific rates of H. pylori infection. In a healthy population undergoing multiphasic health evaluations in 1992-1993 as members of the Kaiser Permanente Medical Care Program of Northern California, adults aged 20-39 years were screened for antibodies to H. pylori infection using a serum enzyme-linked immunosorbent assay and were surveyed with regard to their demographic characteristics and health practices. Among 556 African-American, Hispanic, and white men and women, male sex was a significant risk factor for infection. Other risk factors included African-American race and Hispanic ethnicity, increasing age, living with children, birth in a developing country, and lower levels of income and education. Men consistently had a higher prevalence of antibodies across all strata of race/ethnicity, age, education, and income, and in multivariate analysis male sex remained significantly associated with infection (odds ratio = 2.0, 95% confidence interval 1.2-3.1). African-American race, Hispanic ethnicity, increasing age, lower levels of education, and birth in a developing country were also associated with infection in multivariate analysis. Data from previously reported seroprevalence studies support a tendency for men to have a higher risk of infection. The higher prevalence of infection among young males as observed in Northern California may account in part for the increased incidence of H. pylori-related diseases among men in later decades of life.

Adult↗
PubMedDate not supplied

Does screening proctosigmoidoscopy result in reduced mortality from colorectal cancer? A critical review of the literature.

OBJECTIVE: To determine the strength of the evidence in the literature that screening proctosigmoidoscopy reduces colorectal cancer mortality. DESIGN: All English-language studies reporting mortality or survival from screening proctosigmoidoscopy published since 1960 were critically reviewed. DATA EXTRACTION: Fifteen references reported on five studies of screening proctosigmoidoscopy. Two authors independently reviewed each reference using explicit methodologic criteria, particularly for potential sources of bias. MEASUREMENTS AND MAIN RESULTS: Of the five studies, four used historical controls and were susceptible to bias, especially self-selection and lead-time bias. Only the Kaiser-Permanente Multiphasic Health Check-up study collected a representative patient sample from a defined population, had randomly allocated controls, and avoided multiple sources of bias. There was a reduction in mortality from a group of seven potentially postponable causes of mortality, including colorectal cancer, although no difference in overall mortality between screened and control groups was found. This study was not designed to determine specifically the impact of screening proctosigmoidoscopy on mortality from colorectal cancer, and suggested that most of the reduction in colorectal cancer deaths was due to a lower incidence in the screened group, which could not be attributed to polypectomy. The benefit of screening proctosigmoidoscopy in this study, if any, was small. CONCLUSIONS: The evidence in the literature is inadequate to determine whether or not screening proctosigmoidoscopy has an impact on colorectal cancer mortality, but the best available data suggest that the benefit is small, at best.

Colorectal Neoplasms↗
PubMedDate not supplied

Promoting fecal occult blood testing in rural African American women.

PURPOSE: The purpose of this experimental study was to test the effectiveness of a multiphasic culturally relevant intervention, delivered over a 1-year period to increase the rates of participation in fecal occult blood testing (FOBT) at the initial screening opportunity and at the 1-year follow-up screening opportunity among rural African American women. DESCRIPTION OF STUDY: The study used a pretest/post-test design among African American women who attended senior citizen centers in a rural southern state. The centers were randomly assigned to the cultural and self-empowerment group, who received the five-phased intervention, the modified cultural group, who received phase I of the intervention only, or the traditional group, who served as the control group. Data were collected at the initial and 1-year follow-up screenings. Hemoccult kits were distributed, collected, and analyzed at no cost to the participants. Data were analyzed using descriptive statistics, repeated measures, and longitudinal models for binary outcomes. RESULTS: Women in the cultural and self-empowerment group had a significantly higher rate of participation in FOBT than did those in the modified cultural group and the traditional group. The modified cultural group had a significantly higher rate of participation in FOBT than the did the traditional group. Predictors of participation in FOBT were the women's family history of colorectal cancer and the average number of visits to their healthcare provider. CLINICAL IMPLICATIONS: Colorectal cancer screening and diagnostic testing opportunities should be offered consistently to women who visit their provider for routine, nonemergent office visits. As successful interventions to increase colorectal cancer screening are introduced into community settings, these interventions also should be tested within physicians' offices and other community agencies.

Black or African American↗
PubMed2001

Presurgical psychological screening in back pain patients: a review.

OBJECTIVE: The objective of this article is to provide a brief overview of the major psychosocial risk factors impacting recovery from spine surgery. RESULTS: Numerous personality, cognitive, behavioral and historical factors affecting surgical recovery are reviewed. Among the most significant issues that have been found to have an adverse influence on outcome are Minnesota Multiphasic Personality Inventory scale elevations associated with pain sensitivity, depression, anger and anxiety. Maladaptive pain coping strategies, litigation, workers' compensation and reinforcement of pain behavior by the spouse also have been found to reduce spine surgery results. A number of other factors are reviewed, including pre-existing psychological problems, sexual and physical abuse, marital distress and substance abuse. CONCLUSIONS: Presurgical psychological screening should be included in the medical diagnostic process of spine surgery candidates, especially when the major goal is pain reduction, or when the surgeon recognizes the existence of psychosocial risk factors. Suggestions for future directions in the development of presurgical psychological screening procedures are also given.

Back Pain↗
PubMedDate not supplied

Molecular analysis of neural crest formation.

Neural crest cells arise within the ectoderm during neurulation and give rise to most of the peripheral nervous system. Following neural tube closure, they come to lie within the dorsal neural tube from which they emerge and subsequently migrate extensively to numerous and characteristic sites. There, they differentiate into neurons and glia of the peripheral nervous system, cartilage and bone of the face, melanocytes and various other cell types. Fate mapping experiments have demonstrated that the neural crest arises at the juncture between presumptive epidermis and neural plate. However, injection of lineage tracer into individual cells reveals that single neural fold cells are not committed to a neural crest fate; rather these cells can form all ectodermal derivatives (epidermis, neural tube, neural crest). Inductive interactions between the neural and non-neural ectoderm can generate neural crest cells, suggesting that signals travel through the epidermis to generate neural crest cells prior to neural tube closure. Induction of the neural crest appears to be a multiphasic process and involves a combination of an early Wnt signal together with later functions of BMP signaling pathways. We have used a variety of molecular screens to isolate molecular constituents involved in neural crest formation. We have identified a secreted factor, Noelin-1, which is expressed in the prospective avian neural plate and may play a role making the neural tube competent to form neural crest. Noelin-1 mRNA is expressed in a graded pattern in the closing neural tube, with highest expression in the neural folds and no detectable expression at the ventral midline. Its expression precedes that of Slug, a zinc finger transcription factor that represents the earliest known neural crest marker gene. Over-expression of Noelin-1 using recombinant retroviruses causes an excess of neural crest emigration and prolongs the time that the neural tube is competent to generate and regenerate neural crest cells. These results support an important role for Noelin-1 in rendering the neural tube competent to respond to inductive cues to generate neural crest.

Animals↗
PubMed2002

Screening for feigned psychiatric symptoms in a forensic sample by using the MMPI-2 and the structured inventory of malingered symptomatology.

Fifty-five men undergoing pretrial psychological evaluations for competency to stand trial or criminal responsibility in the federal justice system were administered the Structured Interview of Reported Symptoms (SIRS), the Minnesota Multiphasic Personality Inventory--2 (MMPI-2), and the Structured Inventory of Malingered Symptomatology (SIMS). On the basis of results from the SIRS, 31 were classified as honest responders and 24 as feigning. Significant differences between the 2 groups were found on all SIMS scales as well as on all tested MMPI-2 fake bad validity scales. The SIMS total score and the MMPI-2 Backpage Infrequency (Fb) scale had relatively high negative predictive power (100% and 92%, respectively). On the basis of this clinically relevant methodology, both tests have potential usefulness as screens for malingering.

Adult↗
PubMed2005

Controlling nonspecific protein adsorption in a plug-based microfluidic system by controlling interfacial chemistry using fluorous-phase surfactants.

Control of surface chemistry and protein adsorption is important for using microfluidic devices for biochemical analysis and high-throughput screening assays. This paper describes the control of protein adsorption at the liquid-liquid interface in a plug-based microfluidic system. The microfluidic system uses multiphase flows of immiscible fluorous and aqueous fluids to form plugs, which are aqueous droplets that are completely surrounded by fluorocarbon oil and do not come into direct contact with the hydrophobic surface of the microchannel. Protein adsorption at the aqueous-fluorous interface was controlled by using surfactants that were soluble in fluorocarbon oil but insoluble in aqueous solutions. Three perfluorinated alkane surfactants capped with different functional groups were used: a carboxylic acid, an alcohol, and a triethylene glycol group that was synthesized from commercially available materials. Using complementary methods of analysis, adsorption was characterized for several proteins (bovine serum albumin (BSA) and fibrinogen), including enzymes (ribonuclease A (RNase A) and alkaline phosphatase). These complementary methods involved characterizing adsorption in microliter-sized droplets by drop tensiometry and in nanoliter plugs by fluorescence microscopy and kinetic measurements of enzyme catalysis. The oligoethylene glycol-capped surfactant prevented protein adsorption in all cases. Adsorption of proteins to the carboxylic acid-capped surfactant in nanoliter plugs could be described by using the Langmuir model and tensiometry results for microliter drops. The microfluidic system was fabricated using rapid prototyping in poly(dimethylsiloxane) (PDMS). Black PDMS microfluidic devices, fabricated by curing a suspension of charcoal in PDMS, were used to measure the changes in fluorescence intensity more sensitively. This system will be useful for microfluidic bioassays, enzymatic kinetics, and protein crystallization, because it does not require surface modification during fabrication to control surface chemistry and protein adsorption.

Adsorption↗
PubMed2005

A strategy for optimizing and evaluating behavioral interventions.

BACKGROUND: Although the optimization of behavioral interventions offers the potential of both public health and research benefits, currently there is no widely agreed-upon principled procedure for accomplishing this. PURPOSE: This article suggests a multiphase optimization strategy (MOST) for achieving the dual goals of program optimization and program evaluation in the behavioral intervention field. METHODS: MOST consists of the following three phases: (a) screening, in which randomized experimentation closely guided by theory is used to assess an array of program and/or delivery components and select the components that merit further investigation; (b) refining, in which interactions among the identified set of components and their interrelationships with covariates are investigated in detail, again via randomized experiments, and optimal dosage levels and combinations of components are identified; and (c) confirming, in which the resulting optimized intervention is evaluated by means of a standard randomized intervention trial. To make the best use of available resources, MOST relies on design and analysis tools that help maximize efficiency, such as fractional factorials. RESULTS: A slightly modified version of an actual application of MOST to develop a smoking cessation intervention is used to develop and present the ideas. CONCLUSIONS: MOST has the potential to husband program development resources while increasing our understanding of the individual program and delivery components that make up interventions. Considerations, challenges, open questions, and other potential benefits are discussed.

Behavior Therapy↗