Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Government Programs”

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 1,333 records · Page 74Linked to original sources
PubMed2006

Evaluation of the Voluntary Johne's Disease Herd Status Program as a source of replacement cattle.

The objectives of this study were to evaluate the perceived value that enrolled producers gained from participation in the Voluntary Johne's Disease Herd Status Program (VJDHSP), and to evaluate the risk of infection with Mycobacterium avium ssp. paratuberculosis (MAP) of cattle reared in a presumed Johne's free environment vs. cattle raised in an environment of unknown Johne's status. Producers enrolled in level 3 or 4 of the VJDHSP (98 and 99% probability, respectively, of being free from MAP infection) were interviewed via telephone. Producers were asked questions pertaining to their participation in the VJDHSP, and asked to identify herds to which they had sold replacement heifers. These cattle were presumed to be uninfected before sale. Fifty-nine cattle (identified as having been purchased into infected herds as heifers) were identified as having been raised in uninfected herds and sold to producers with herds of unknown Johne's disease status. On the purchasing farm, fecal and blood samples were collected from each cow of VJDHSP origin and 3 randomly selected home-reared cows per VJDHSP cow matched by lactation as controls. Samples were tested using commercial ELISA (serum) and bacterial culture (feces). Results indicated that enrolled producers saw value in VJDHSP participation, and that cattle reared in VJDHSP herds were less likely to be infected with MAP than herdmates as measured by serum ELISA MAP antibody and by fecal culture. This study provides evidence of the value of the VJDHSP in providing economic value to participants and supports the promotion of VJDHSP herds as a source of replacement cattle of low infection risk for MAP.

Animals↗
PubMed2006

Optimizing resource allocation in United States AIDS drug assistance programs.

BACKGROUND: US acquired immunodeficiency syndrome (AIDS) Drug Assistance programs (ADAPs) provide medications to low-income patients with human immunodeficiency virus (HIV) infection/AIDS. Nationally, ADAPs are in a fiscal crisis. Many states have instituted waiting lists, often serving clients on a first-come, first-served basis. We hypothesized that CD4 cell count-based ADAP eligibility would improve ADAP outcomes, allowing them to serve more-diverse patient populations and to prioritize persons who are at greatest risk of HIV-related mortality. METHODS: We used Massachusetts ADAP administrative data to create a retrospective cohort of Massachusetts ADAP clients from fiscal year 2003. We then used a model-based analysis to apply potential eligibility criteria for a limited program and to compare characteristics of patients included under CD4 cell count-based and first-come, first-served eligibility criteria. RESULTS: In fiscal year 2003, Massachusetts ADAPs served 3560 clients at a direct cost of 10.3 million dollars. With use of CD4 cell count-based eligibility (with an eligibility criterion of a current or nadir CD4 cell count < or = 350 cells/microL), it would have served 2253 clients (37% fewer than in fiscal year 2003) and appreciated savings of 2.7 million dollars. Given the same budget constraint and using first-come, first-served eligibility, Massachusetts ADAPs would have served 2406 clients (32% fewer than in fiscal year 2003). The first-come, first-served approach would have excluded patients with median CD4 cell count of 257 cells/microL (interquartile range, 124-377 cells/microL) in favor of serving patients with median CD4 cell count of 659 cells/microL (interquartile range, 511-841 cells/microL). In addition, a CD4 cell count-based scheme would have served a greater proportion of nonwhite individuals (65% vs. 55%; P<.0001), non-English speakers (24% vs. 19%; P=.03), and unemployed people (69% vs. 61%; P=.0009), compared with the population that would have been served by a first-come, first-served policy. CONCLUSIONS: With limited resources, ADAPs will serve more-diverse populations and patients with significantly more advanced HIV disease by using CD4 cell count-based enrollment criteria rather than a first-come, first-served approach.

Anti-HIV Agents↗
PubMed2006

Evaluation of HUD-funded lead hazard control treatments at 6 years post-intervention.

The Evaluation of the HUD Lead-Based Paint Hazard Control Grant Program (Evaluation) was a HUD-funded study of the effectiveness of lead hazard control (LHC) treatments conducted by 14 grantees in communities across the country. A stratified random sampling scheme was used to select treated units at four grantee sites for continued environmental assessment at 6 years post-intervention. The study compared the relative effectiveness after 6 years of the different classes of interventions used by the grantees, after controlling for such factors as housing conditions and characteristics and resident and neighborhood characteristics. Geometric mean dust-lead levels on floors and window sills were 11% and 23% lower, respectively, at 6 years post-intervention than at any preceding point following the intervention. Although geometric mean window trough dust-lead levels were slightly higher at 6 years post-intervention than at other post-intervention time periods, they were still over 75% lower than before intervention. Treatment at more-intensive levels was associated with lower window sill and window trough dust-lead levels; however, statistical modeling found no significant difference in floor dust-lead loadings over time between the levels of treatment; however, significant differences in window sill and window trough dust-lead levels between treatment levels were evident. Findings from the 6-Year Extension study indicate that across all grantees and treatment strategies the treatments applied were effective at significantly reducing environmental lead levels on floors, window sills, and window troughs at least 6 years following the intervention.

Air Pollution, Indoor↗
PubMed2001

[Dutch Collaborative Epilepsy Surgery Program: reduction of seizures, operative complications and tapering of medication in 338 patients, 1973-1998].

OBJECTIVE: To determine the results of surgical treatment in patients with drug-resistant epilepsy, referred to the Dutch Epilepsy Surgery Program, who were treated in the University Medical Centre Utrecht, the Netherlands, in the period January 1973-December 1998. DESIGN: Retrospective descriptive. METHOD: A total of 338 patients were operated on; 269 underwent temporal lobe resection, 41 extratemporal resection, 12 a functional hemispherectomy and 10 callosotomy. Six patients were treated with vagus nerve stimulation. For seven of the patients no follow-up data was available. RESULTS: After a minimum follow-up of 1 year class I or class II results (in accordance with the University of California in Los Angeles classification (UCLA) where class I = seizure-free and class II < or = 3 seizures per year) were obtained in 91% of patients who underwent temporal lobe resections, 67% of patients who underwent extratemporal resections, 81% of patients who underwent functional hemispherectomy and 10% of patients who underwent anterior callosotomy. In five of these patients an improvement in their behaviour occurred. Of the 6 patients who underwent vagus nerve stimulation only I experienced a beneficial seizure reduction (UCLA class III). Transient physical complications occurred in 4% of the patients treated and permanent damage in 1%. Postoperative psychiatric complications occurred almost exclusively following temporal resections; in 11% of which 7% de novo. After 4 postoperative years this had decreased to 5%. In a group of 143 patients who were seizure-free for 2 or more years, post-surgery medication was tapered in 75 cases, stopped in 33 cases and remained unchanged in 35 cases. The relapse rate following a tapering or stopping of the medication was 30% and with unchanged medication 17%. Although the majority of patients were once again seizure-free upon restarting the medication, a significant number continued to experience seizures. CONCLUSION: For a number of carefully selected epilepsy patients with intractable seizures, surgery is a successful treatment with few serious complications.

Anticonvulsants↗
PubMed1998

Client flow through the Women, Infants, and Children Public Health Program.

The Women, Infants, and Children (WIC) Program, managed by the county boards of health, provides nutrition, limited physical examinations, and food vouchers for pregnant women and for children with nutritional deficiencies. Because federal guidelines for the WIC program leave little maneuvering room to improve the delivery of services, we analyzed the client flow through a WIC clinic in the Atlanta metropolitan area to determine how that flow could be managed more efficiently. The challenge facing the WIC clinic was to increase the efficiency of their operation in an environment characterized by resource constraints, rigid regulations, and dysfunctional client behavior. In a limited physical space, the WIC clinic was expected to provide a number of sequential services to a client population that failed to arrive or arrived late 40 percent-50 percent of the time. The provision of services was further complicated by walk-ins, which were not only common but, according to federal guidelines, also must be accommodated. To analyze the clinic's problem, we used the General Purpose Simulation System for personal computer (GPSS/PC) to simulate client flow through the clinic. Estimates of the average amount of time a client spent in the clinic as well as average waiting times at each station and clerk and nurse utilization rates were generated assuming a variety of staffing levels. For comparison purposes, each version of the model was run with a 20-minute time lag before a late appointment was filled, and then a one-minute lag. The data used for the simulation were collected by clinic personnel during February 1994. It included the number of clerks and nurses available; the waiting time to see clerks and nurses for walk-ins and appointments; the waiting time to get WIC vouchers; the number of appointments met; the number of appointments missed; and the total time in the clinic for walk-ins and appointments. In all three versions of the model that were estimated, the results of the simulations revealed that reducing the time before a late appointment was filled significantly decreased the time spent in the clinic, on average, for all clients. Furthermore, the time spent waiting for both clerks and nurses decreased, the utilization of the clerks decreased, and the utilization of the nurses increased in two of the three estimations.

Child↗
PubMed1999

The relationships among environmental allergen sensitization, allergen exposure, pulmonary function, and bronchial hyperresponsiveness in the Childhood Asthma Management Program.

BACKGROUND: Sensitivity and exposure to indoor allergens constitutes a risk factor for the development and persistence of asthma in children. OBJECTIVE: Our purpose was to evaluate the relationship between sensitivity and exposure to inhalant allergens and lung function and bronchial responsiveness in a group of children (n = 1041) aged 8.9 +/- 2.1 years with mild to moderate asthma enrolled in the Childhood Asthma Management Program (CAMP). METHODS: With use of the extensive CAMP baseline cross-sectional data on spirometry, bronchial responsiveness, allergen sensitivities, and household allergen levels, the relationship of sensitization and exposure to allergens to lung function and methacholine sensitivity was evaluated. Children who enrolled in CAMP stopped all antiasthma medication except rescue use of albuterol and prednisone for exacerbations during the 5- to 16-week screening period. During the last 2 of these weeks they underwent spirometry and methacholine challenge. Indoor allergen exposures were determined from questionnaires completed by the parent. Household levels of indoor allergens (mite, cat, dog, cockroach, mold) were determined on house dust samples. Allergen sensitivity was determined by percutaneous skin testing with a standard battery of allergens plus locally important pollen and fungal spores. Lung function and bronchial hyperresponsiveness were compared for children sensitive and not sensitive to both indoor and outdoor allergens on skin testing and, if sensitive, for exposed and not exposed to the allergens to which they were positive on skin testing. RESULTS: There was a strong direct correlation between increased sensitivity to inhaled methacholine and skin test sensitivity to tree, weed, Alternaria, cat, dog, and indoor molds. When the relationship was examined by stepwise regression, the skin test sensitivities showing the strongest associations with the concentration of methacholine that caused a 20% fall in FEV(1) were dog (P =.003), Alternaria (P =.01), and cat (P =.05). Children sensitive to any one of the aeroallergens tested were compared for the presence or absence of exposure to that allergen at the time that the methacholine challenge was performed. Those who were sensitive and exposed to weed and cat had greater methacholine sensitivity than those similarly sensitive but not exposed (P =.003 and P =.02, respectively). CONCLUSIONS: Sensitivity to dog or cat dander or Alternaria by skin testing was associated with increased bronchial responsiveness but not decreased lung function in children with mild to moderate asthma. These findings support the important role that sensitization to certain allergens plays in modulating bronchial responsiveness.

Adolescent↗
PubMed1988

The National Toxicology Program chemical nomination selection and testing process.

The NTP is an interagency program of the Federal Government which coordinates toxicological programs at the NIH (NIEHS), FDA (NCTR), and CDC (NIOSH) with input from NCI, NIH, OSHA, CPSC, EPA, and ATSDR. The NTP has the capability to completely characterize the toxicologic profile of a chemical, including studies of chemical disposition, genetic toxicity, immunotoxicity, teratology, reproductive toxicity, carcinogenicity, neurotoxicity, and specific organ toxicity. The NTP encourages nominations of chemicals of human health concern from all sectors of the public, including industry, labor, and the general public. The specific process of nomination, evaluation, and selection of chemicals for testing by the NTP is described. It is a multicomponent system with several evaluations and a public peer review step to assure adequate consideration of all nominated chemicals. The results of NTP studies are all peer reviewed and available to the general public as well as to the scientific community.

Animals↗
PubMed2005

[National consensus for management of community acquired pneumonia in adults].

Community acquired pneumonia (CAP) is an acute respiratory infection that affects pulmonary parenchyma, and is caused by community acquired microorganisms. In Chile, pneumonia represents the main cause of death due to infectious diseases and is the third specific cause of mortality in adults. In 1999, an experts committee in representation of "Sociedad Chilena de Enfermedades Respiratorias", presented the first National Guidelines for the Treatment of Adult Community Acquired Pneumonia, mainly based in foreign experience and documents, and adapted it to our National Health System Organization. During the last decade, impressive epidemiological and technological changes have occurred, making the update of guidelines for treatment of NAC by several international scientific societies, necessary. These changes include: new respiratory pathogens that are being identified in CAP and affect adult patients (Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila); the increasing senescent adult population that carries multiple co-morbidities; the emergence of antimicrobial resistance among respiratory pathogens associated to massive antibiotic prescription; the development by the pharmaceutical industry of new drugs that are effective for pneumonia treatment (macrolides, ketolides and respiratory fluorquinolones); and the development of new diagnostic techniques for detection of antigens, antibodies, and bacterial DNA by molecular biology, useful in respiratory infections. Based on these antecedents, an Advisory Committee of "Sociedad Chilena de Enfermedades Respiratorias" and "Sociedad Chilena de Infectología" has reviewed the national and international evidence about CAP management in adults in order to update clinical recommendations for our country.

Acute Disease↗
PubMed2003

[German colonial plans for Africa in the Nazi era].

The German colonial plans concerning Africa in the era of National Socialism ascribed a central role the sciences. Scientists of all possible fields launched into activities. Especially subjects which were directly related to the practice of colonial policies, e.g. African languages, ethnology, law, economic sciences, and medicine, were developed. There were colonial ambitions at nearly every German university, but there was one which designated to become the centre of colonial sciences: the university of Hamburg. It has to be realized that working in this field of studies protected scientists from being drafted by the army for a long time.

Africa↗
PubMed2006

CDC-funded intervention research aimed at promoting colorectal cancer screening in communities.

BACKGROUND: Although strong scientific evidence has shown that screening for colorectal cancer saves lives, most U.S. adults who are at the recommended age are not being screened. Prior studies suggest that barriers to routine screening vary by race, ethnicity, socioeconomic status, urban/rural residence, health insurance status, and factors related to health care providers and the health care environment. Relatively few studies, however, have identified and tested intervention approaches to promote routine colorectal cancer screening among diverse populations. METHODS: The Division of Cancer Prevention and Control at CDC has funded ongoing projects to develop and test interventions to promote routine colorectal cancer screening among medically underserved populations in Appalachia, the Lower Rio Grande Valley in Texas, the High Plains region of Colorado, and other U.S. communities. RESULTS: This article provides an overview of colorectal cancer screening intervention studies currently funded by CDC that focus on a wide range of populations, including medically underserved persons who live in predominately rural areas, Hispanic and non-Hispanic persons, urban African Americans, persons with low health literacy, and persons enrolled in managed care organizations. CONCLUSIONS: These CDC-funded intervention research projects are likely to contribute importantly to evidence about what works to promote colorectal cancer screening in diverse U.S. communities. .

Black or African American↗