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At least 1,531 records · Page 85Linked to original sources
PubMed1980

Segregation of Tay-Sachs and Sandhoff alleles in a non-Jewish family.

A non-Jewish family is presented in which the genes for Tay-Sachs disease and Sandhoff disease are segregating. Individuals heterozygous for both alleles have low serum and white cell total hexosaminidase levels together with a proportion of heat-labile hexosaminidase A (HEX A) which falls in the normal range. The individuals would not be detected as carriers of Tay-Sachs disease or Sandhoff disease in a population screening program.

False Negative Reactions↗
PubMed1995

Anaemia in pregnancy: perceptions of patients in Dar-es-Salaam.

This study was performed to assess the pregnant women's knowledge and attitudes towards anaemia, its causes, prophylaxis, and treatment and to describe existing problems with interventions for anaemia in antenatal clinics. A total of 310 women were interviewed from three MCH-clinics in suburban Dar-es-Salaam. Anaemia was considered a major problem by 88% and 75%, respectively in the two peripheral MCH clinics, but by only 44% of attenders in the hospital MCH clinic. Over 85% of interviewees were aware of the causes of and ways of preventing anaemia. The most frequently mentioned cause of anaemia were related to nutrition while intestinal parasites was mentioned by a few women. Only 5% believed that anaemia might not be dangerous for the mother. In all three clinics more than 90% were aware of the advantages of early booking for antenatal care. None of the mothers had received any ferrous supplements during the current pregnancy, and only a minority (38%) in the previous pregnancy though 40% of them said they were informed they had anaemia in the previous pregnancy. Side effects were not reported as a reason for non-compliance. Thus, mothers were aware that anaemia is a health problem in pregnancy. They would accept effective intervention if they were offered them. The irregular and inadequate supply of haematinics to antenatal clinics is a far more important obstacle to the implementation of the anaemia prevention programme than the knowledge and attitudes of the mothers.

Adult↗
PubMed1995

A public-private partnership facilitates accountability and outcomes. Interview by Susan H. Cummings.

The article presents an interview about a unique and successful public-private partnership that uses social and medical case management services to manage the health and social needs of an indigent population. This program, which won the Merck/National Managed Health Care Congress Partnership Award in 1993, has resulted in client satisfaction, quality care, and cost-effective outcomes.

Humans↗
PubMed1995

District health care between quality assurance and crisis management. Possibilities within the limits, Mporokoso and Kaputa District, Zambia.

A tension exists between objectives of health policy makers to achieve high quality standards of care on one hand, and district multi-crisis reality in sub-Saharan Africa on the other hand where sheer survival of the (public) health system is questioned. The collapsing health services as well as the deteriorating living conditions affect the health status of the population and contribute to an increase in (health) inequalities both nationally and internationally. Constraints and some examples of achievements in district health management in two districts in Northern Province, Zambia, are presented. A strong focus on community-based health care, partnership with communities and accelerated health-system support via strengthening of on-site supervision is advocated. Decentralization and self-reliance are potential tools in flexible crisis management, but require continuity in human resource development and appropriate 'care for the carers'. In order to increase operational efficiency, the need is expressed to conceptualize a practical approach of 'minimum primary health care'.

Adult↗
PubMed1995

Benefits and costs of screening and treatment for early breast cancer. Development of a basic benefit package.

OBJECTIVE: To develop a basic benefit package for detection and treatment of early breast cancer by evaluating the effectiveness and costs for screening mammography, primary surgery, adjuvant therapy, and follow-up care. DATA SOURCES: Published articles were retrieved through MEDLINE; additional articles were obtained through searches of their bibliographies. Cancer statistics were taken from Surveillance, Epidemiology, and End Results (SEER) Program data, population statistics were taken from US Census data, and charges from 1993 Southern California Medicare fees were used to represent costs. STUDY SELECTION: Studies were selected on the basis of their design. Preference, in decreasing order, was given to meta-analyses of randomized trials, individual randomized clinical trials, prospective cohort studies, retrospective cohort studies, and case series. DATA EXTRACTION: Studies were examined for the effect of the intervention on overall survival, disease-free survival, and health-related quality of life. We evaluated effects on survival in terms of number of lives saved at 10 years and average years of life saved. Costs were related to the benefits observed and modeled onto a hypothetical health care organization of 500,000 lives. RESULTS: Based on this analysis, we recommend a basic benefit plan for the detection and treatment of early breast cancer that would include the following: (1) screening mammography only for women aged 50 to 69 years; (2) choice of mastectomy or breast-conserving surgery with radiation therapy for all women with early breast cancer; (3) adjuvant therapy for all women at risk of recurrence; and (4) only clinical follow-up without routine testing for metastatic disease. CONCLUSIONS: By choosing which services they provide to specific groups of patients, providers can substantially reduce their expenses and still provide quality health benefits.

Adult↗
PubMedDate not supplied

Public health nurses' quality of worklife: responses to organizational changes.

The Nursing Division of a local health unit in Ontario reorganized its nursing teams into target population based programs. Nurses involved in this reorganization were asked to report their perceptions of job satisfaction, job design and role stress using standardized instruments before the reorganization and at three points in time after the reorganization. No administratively significant differences in these variables were reported by the nurses through the four time periods. The one exception was an unpredicted decrease in their perception of their task identity, that is, their perception of the significance or importance of their work. Major changes in the organization of a nursing division may be possible with minimal impact on perceptions of job satisfaction, job design and role stress. We caution that further assessment of the measurement tools used in this study should be undertaken.

Humans↗
PubMed1994

Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men. The San Francisco/Berkeley Young Men's Survey.

OBJECTIVE: To estimate the prevalence of human immunodeficiency virus (HIV) infection and risk behaviors among young homosexual and bisexual men sampled from public venues in San Francisco and Berkeley, Calif. DESIGN: A survey of 425 young homosexual and bisexual men sampled from 26 locations during 1992 and 1993. Participants were interviewed and blood specimens were drawn and tested for HIV, level of CD4+ T lymphocytes, and markers of hepatitis B and syphilis. SETTING: Public venues in San Francisco and Berkeley, including street corners and sidewalks, dance clubs, bars, and parks. POPULATION STUDIED: Homosexual and bisexual men aged 17 to 22 years. MAIN OUTCOME MEASURES: Prevalence of HIV infection and risk behaviors. RESULTS: The HIV seroprevalence was 9.4% (95% confidence interval, 6.8% to 12.6%). The prevalence of markers for hepatitis B was 19.8% (95% confidence interval, 16.1% to 23.9%), and that for syphilis was 1.0% (95% confidence interval, 0.3% to 2.4%). The HIV seroprevalence was significantly higher among African Americans (21.2%) than among other racial/ethnic groups (P = .002). Approximately one third (32.7%) of the participants reported unprotected anal intercourse, and 11.8% reported injecting drug use in the previous 6 months. At the time of interview, 70.0% of the HIV-infected men did not know that they were HIV seropositive, and only 22.5% were receiving medical care for HIV infection. CONCLUSIONS: The prevalence of HIV infection is high among this young population of homosexual and bisexual men, particularly among young African-American men. The high rates of HIV-related risk behaviors suggest a considerable risk for HIV transmission in this population. Prevention programs and health services need to be tailored to address the needs of a new generation of homosexual and bisexual men.

Adolescent↗
PubMed1994

[Effects of an educational campaign on cardiovascular risk factors in a French town (Epernon, study town). Methods and preliminary results: prevalence and level of risk factors].

The authors report the methods and preliminary findings of a study scheduled to last 5 years, which aims to evaluate cardiovascular risk factor changes in response to an education program. The population sample consisted of 961 subjects, from Epernon itself (the study town) and from two control towns. The assessment criteria were reported at the beginning of the study and then again after 2 and 5 years. They consisted of an analysis of medical events and of biomedical and dietary data and a detailed analysis of behavior with regard to health and socio-economic variables. Preliminary data show that the samples were similar in Epernon and the control towns and also comparable to some French epidemiological data. There is a striking difference between the percentage of subjects aware of their blood pressure (65.5%) and blood cholesterol (13.4%) levels.

Adult↗
PubMed1993

The Kingston Project. III. The effects of high energy supplement and metronidazole on malnourished children rehabilitated in the community: morbidity and growth.

In the Kingston Project malnourished children referred from public health clinics to a metabolic ward were treated at home using community health aides within the existing health service. We have previously provided anthropometric results showing significantly greater gains in weight and length for groups given a high energy supplement (3.31 MJ daily) for 3 months during treatment, and greatest gains for a group treated with metronidazole at the beginning of supplementation [Heikens et al., Eur. J. Clin. Nutr. 43, 145-160 (1989); 47, 160-173 (1993)]. We now present findings on morbidity and relate these to the separate interventions and to growth velocities. Although referral was solely on nutritional criteria, 65% of the sample were found to have additional illnesses at enrollment. During the study period (6 months) upper respiratory tract infections (URTI) were the commonest illness in all groups; there were significantly more gastroenteric infections in the group given the supplement, but not the antibiotic, treatment; the children who received only the standard health service care were ill more often and for longer periods than children in the other groups. Diarrhoea, fever and dysentery prevalences were all found to relate significantly to weight velocity, and although prevalences differed between treatment groups, the detrimental effect on velocity was similar whichever the group.

Child, Preschool↗