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At least 1,531 records · Page 85Linked to original sources
PubMed2006

Measles, rubella, mumps, and varicella seroprevalence among health care workers in Turkey: is prevaccination screening cost-effective?

BACKGROUND: To investigate the immune status of health care workers (HCWs) against measles, rubella, mumps, and varicella zoster (MMRV) in Turkey and to define an appropriate vaccination program among HCWs. METHODS: Voluntary HCWs from a children's hospital and a general hospital were included in the study between March and May 2005. The specific IgG antibodies against MMRV viruses were screened by ELISA. RESULTS: Three hundred sixty-three HCWs participated in the study; 186 (51%) were physicians, 118 (33%) were nurses, 36 (10%) were housekeeping staff, and 23 (6%) were medical technicians. The proportion of HCWs who had antibodies against measles was 98.6%; rubella, 98.3%; mumps, 92.2%; and varicella, 98%. No association was found between the susceptibility to at least 1 of MMRV virus infections and gender, age, duration of work, profession, and department of work in analysis either among the whole study group, or each hospital. The positive predictive value for the history of varicella was 100%, whereas it was 92% for MMR. The cost of vaccination for varicella was significantly expensive without screening before vaccination. However, there was not much difference for MMR infections. CONCLUSION: A policy based on obtaining the history of varicella infection from the staff and then screening the ones with negative history and vaccination of only seronegative HCWs was found to be appropriate.

Adolescent↗
PubMed1994

[Results of a controlled randomized study on prevention of smoking habit in adolescents].

We describe the results of a randomized controlled study on the efficacy of a smoking prevention program based on behavioral methods (Waterloo Smoking Prevention Program 1, adapted). 792 children of 12-13 years of age from the Health District of Rozzano (MI) were the study base. The program was delivered directly by voluntary teachers during school classes. Two follow-up, at 18 and 36 month from the end of the program were conducted using self-administered questionnaire and telephonic interviews. At 36 months the proportion of non-smokers was higher in the intervention group (55% vs 44%; OR (adjusted for clustering) = 1.7; p = .03) and that of regular (at least one cigarette a week) smokers lower (22% vs 39%) than in the control group. We found no difference of effect between males and females students. Social pressure associated with starting to smoke (friends, sibsters, parents smokers) measured before intervention had no demonstrable influence on efficacy. We propose this kind of intervention for Italian students as an effective and low-cost program, even though more research is needed to maintain effectiveness of these kind of programs beyond adolescence.

Adolescent↗
PubMed1987

Analysis of the costs of school-based mouthrinsing programs.

Previous research on a group of school-based mouthrinsing programs showed costs per participant to increase with program size. This paper examines the behavior of average costs as they relate to wages and labor productivity. Costs are found to increase because of differences in the mix of voluntary and paid labor. As program size increased, administrators substituted relatively high priced paid labor for low priced voluntary labor.

Child↗
PubMed1991

Vaccine choice and program participation rates when two hepatitis B vaccines are offered.

Participation rates of health care workers in voluntary free hepatitis B virus immunization programs are 35% to 40%. University teaching hospital employees at risk for hepatitis B virus and presenting for immunization were surveyed as to vaccine preference. Both plasma-derived and recombinant hepatitis B virus vaccines were available. During a 10-month period, 173 health care workers enrolled in the study. One hundred seventeen received recombinant vaccine, and 56 received plasma-derived vaccine; 66 were immunized postexposure. Concern of a relationship of human immunodeficiency virus to hepatitis B virus plasma-derived vaccine was acknowledged by a small number of health care workers as important in vaccine selection. Recombinant hepatitis B virus vaccine rapidly and substantially supplanted plasma-derived vaccine but did not increase program participation. We suspect that mandatory immunization or proof of immunity will be necessary if hepatitis B virus protection rates in health care workers are to improve.

Hepatitis B↗
PubMed1977

Personality patterns of drug abusers as shown by MMPI profiles.

MMPI and 16 PF patterns of a group of drug abusers who were participating in a voluntary VA Drug Abuse Program were investigated. The MMPI profiles of 91 male veterans who ranged in age from 18-45 years were classified according to two-point code types. A comparison was made of the most frequently occurring code types among drug abusers, medical patients, and psychiatric patients. The two modal profile types among drug abusers were the 4-9/9-4 and the 2-4/4-2, which accounted for 32% of the sample. An additional comparison between the two modal types and responses to the 16 PF was made. Results indicate a closer resemblance to psychiatric patients than to medical patients, and the variety of high point code types is discussed. The similarity between the present sample of modal code types with research on drug abusers undertaken 20 years previously also is discussed.

Adolescent↗
PubMed2000

Hitting a moving target: income-related health insurance subsidies for the uninsured.

New government health insurance programs are likely to emphasize voluntary purchases in a market setting, with subsidies targeted at low-income populations and stress on managed care. Such programs are best structured with a guaranteed enrollment period that is as long as six months to a year. However, given that incomes change over time, errors will be made in awarding income-related subsidies for that long. These errors are assessed in simulations undertaken with longitudinal data from the Survey of Income and Program Participation. Two allocations of the subsidies, based on current income at the beginning of the enrollment period and on actual income assessed at the end, are compared for a variety of program designs. Prospective determination of subsidies is somewhat biased toward overpayment. Net overpayments amount to 5-10 percent of subsidy costs. However, prospective payment encourages participation in the subsidy program. The simulated participation rate for true eligibles is as high as 73 percent with prospective subsidies, compared to 69 percent with retrospective reconciliation. Net overpayments are slightly reduced by testing income less frequently and over longer periods.

Child↗
PubMed1999

Cardiovascular diseases and risk factors in Finland.

We summarize here the evidence from the 1960s and 1970s of exceptionally high risk of cardiovascular disease (CVD) in Finland. In parallel with voluntary and governmental prevention programs, the level of risk factors and CVD attack rates have shown dramatic improvement in the past 25 years, but the decline has slowed in recent years. This experience strongly supports population-wide strategies for primary prevention, and it also highlights the continued need for primordial prevention directed toward youth in high-risk societies.

Cardiovascular Diseases↗
PubMed1976

[Training and dominance in human voluntary movements. Right-left-comparisons of putting and throwing programs (author's transl)].

1. Muscle action potentials and efficiency were measured during shot putting and ball throwing in right and left handed normals. The dominant and the nondominant side were compared in trained and untrained persons in order to investigate motor learning effects. 2. Trained shot putters show a coordinated sequence of activation of trunk, leg and arm muscles of both sides which precedes the final arm extension. After turning the body from an initially inclined and twisted position the final arm extension transfers the force of the accelerated body mass to the shot. 3. When shot putting or throwing is performed by the nondominant arm in subjects trained for the dominant arm the coordination of the contralateral dominant arm is lacking, in contrast to the performance by the trained arm. 4. In untrained persons the shot putting is effected mainly by arm extension on either side. The preceding trunk and leg action is very incomplete and without coordination of the contralateral arm, whereas the shot putting arm shows stronger triceps brachii innervation. The distances achieved by untrained shot putters reach only one-fifth or one-third of those of highly trained persons. 5. In ball throwing the throwing arm shows final coactivation of the biceps and triceps muscles coordinated with trunk and contralateral arm movements. The distances reached by throwing with the untrained arm are about half of those of the trained dominant arm. 6. Trained sportsmen put the shot with the untrained nondominant arm to 73% of the distance achieved by the trained arm. Untrained persons, however, show an approximately equal, smaller range of shot with the dominant and nondominant arm (8% side difference). 7. A biomechanical factor causing different performances of trained and untrained persons in shot putting is the different force of the energy transferring mass: the untrained person thrusts mainly with the arm which has barely 1/20 of the mass of the whole body, used by the trained shot putter. 8. That bilateral training and not hemispheric dominance is the decisive factor producing the improved efficiency is demonstrated by three observations: a) the maximal efficiency and bilateral coordination of shot putting in trained persons, b) the lack of contralateral activation of the dominant arm in shot putting and throwing by the nondominant arm, and c) the minimal left and right side differences in performance of untrained persons.

Action Potentials↗
PubMed2005

Increased risk of HIV in women experiencing physical partner violence in Nairobi, Kenya.

As part of a study on etiology of sexually transmitted infections (STI) among 520 women presenting at the STI clinic in Nairobi, data on partner violence and its correlates were analyzed. Prevalence of lifetime physical violence was 26%, mainly by an intimate partner (74%). HIV seropositive women had an almost twofold increase in lifetime partner violence. Women with more risky sexual behavior such as early sexual debut, number of sex partners, history of condom use and of STI, experienced more partner violence. Parity and miscarriage were associated with a history of lifetime violence. We found an inverse association between schooling and level of violence. Six percent of the women had been raped. Gender-based violence screening and services should be integrated into voluntary counseling and testing programs as well as in reproductive health programs. Multi-sector approaches are needed to change prevailing attitudes towards violence against women.

Adult↗
PubMed2006

Update: preventing mother-to-child transmission of HIV.

The success of antiretroviral therapies for prevention of mother-to-child transmission of HIV in the developed world has prompted a wide array of research efforts, from improved implementation of voluntary counseling and testing programs to innovative approaches for short-course peripartum prophylaxis to understanding the dynamics of HIV transmission via breastfeeding. Clinical trials of modified short-course peripartum regimens which are applicable to resource-limited areas are demonstrating much lower transmission rates and preliminary data are emerging on limiting transmission via breastfeeding. Some of the most recent data on these topics are reviewed. Primary prevention of HIV in women of childbearing age combined with efforts to prevent mother-to-child transmission of HIV offer the best hope for addressing the burden of HIV in women and children.

Anti-HIV Agents↗
PubMed1988

Spectrum of diseases for resident education in internal medicine.

We examined the spectrum of diseases to which medical residents were exposed in a fully integrated residency program comprised of a voluntary and a municipal acute-care hospital. Although circulatory disorders and diseases of the respiratory and nervous systems accounted for the majority of cases, a broad spectrum of diseases was present for residents' training at both institutions. These observations must be considered within the context of the changing nature of medical practice in the United States, with a marked shift from inpatient to outpatient and office medical care.

Cardiovascular Diseases↗
PubMed1987

'Avoidable mortality' from cervical cancer: exploring the concept.

The National Cancer Institute of the United States is encouraging research aimed at reducing 'avoidable mortality' from cancer. This article explores the meaning of the concept from a cancer-control perspective. Using cervical cancer as the focus of discussion, the author examines reference standards and social constraints that can help define the boundaries of avoidable mortality. The article considers the implications of voluntary participation in screening programs, the negative association between risk status and screening frequency, errors in collecting and interpreting Pap smears, improper and incomplete followup, and selected intervals for screening tests. To reach underscreened populations who are at high risk of cervical cancer, prevention strategists must create opportunities for intervention through innovative 'outreach' and 'inreach' programs. Inreach strategies exploit opportunities for cancer screening within the existing health-care process. Possibilities for reducing mortality from cervical cancer depend on more than the state of science. The likelihood of change is also a function of social priorities, social commitments, and the allocation of resources to social technologies that can effect change.

Adult↗
PubMed1996

A cost-benefit analysis of voluntary routine HIV-antibody testing for hospital patients.

The objectives of this paper are threefold: first, to develop a taxonomy of potential benefits from voluntary, routine HIV-antibody testing of hospital patients; second, to inform attending healthcare workers, hospital patients and policy makers of the potential benefits from such testing; and third, to make inferences about whether such testing is warranted by a cost-benefit criterion. Benefits stemming from information about a patient's HIV serostatus accrue to: (1) healthcare workers if extra precautions reduce their HIV-exposure rate; (2) the patient if knowledge of HIV serostatus allows life-extending prophylactic treatment to be initiated; and (3) the patient's sex partners if the patient is less likely to transmit HIV after undergoing HIV testing. Using recent estimates on the value of life, hospital-specific HIV-prevalence rates, the effectiveness of prophylactic treatment, rates of HIV exposure and conversion by healthcare workers, and reduction in high-risk sexual behaviors by seropositive patients, we estimate the benefits of testing as the value of statistical life saved. The opportunity cost of HIV testing is calculated as the reported cost of a standard HIV-test protocol with pre- and post-test counseling. Information about a patient's HIV serostatus provides small expected benefits to healthcare workers ($3.34) because the risk of HIV transmission is small; benefits to attending healthcare workers are insufficient to warrant routine HIV testing on a stand-alone basis even in high HIV-prevalence hospitals. However, an HIV-seropositive test result provides large expected benefits to the patient ($11,202) and to the patient's sex partners ($5271). Adding these nonrivalrous benefits, we find that routine, voluntary HIV-testing of hospital patients passes a cost-benefit test even in low HIV-prevalence hospitals. Four major qualifications of the cost-benefit analysis should be considered. (1) The benefits to some parties can only be achieved if the patient's serostatus is disclosed to them. (2) The net benefits may be negative if HIV-testing induces riskier behavior. (3) The analysis does not incorporate the significant potential for third-parties (employers, insurers, healthcare workers) to use the test to impose costs on HIV-seropositive patients. (4) The sample of inpatients choosing voluntary HIV testing may not be representative of the overall hospital population. These unmeasured factors suggest that policymakers should exercise caution in implementing a voluntary HIV-testing program.

AIDS Serodiagnosis↗
PubMed2003

Children's feeding programs in Atlantic Canada: some Foucauldian theoretical concepts in action.

Since 1989 the number of Canadian children depending on food banks has increased by more than 85%. To combat perceived hunger, breakfast and lunch programs have been initiated by localized volunteer efforts. This paper attempts to show the Foucauldian concepts of power, truths, space and time in action in feeding programs in Atlantic Canada. A potential 'relation of docility-utility' is imposed upon children by providers of feeding programs and ultimately the state. The 'power over life' or 'micro-physics of power' is accomplished through procedures that use food, rules, rewards, reinforcements, space, time, and truths. Children voluntarily subject themselves to this relation while reserving the power to resist through acts of defiance or by not attending at all. This ability to exercise one's agency allows for shifting power relations in the social dynamics of feeding programs. The potentially coercive nature of these relationships is embedded in the pleasurable environment generated by the feeding process.

Canada↗
PubMed1980

An outbreak of rubella among hospital personnel.

An outbreak of 47 cases of rubella occurred among hospital personnel in a large medical-surgical hospital. As a result, one pregnancy was terminated and 475 employee workdays were lost. Epidemiologic investigation of the outbreak suggested a common source; a dietary worker was identified as the probable index case. Serum samples of 12 per cent of women employees were negative for rubella antibody at the time of the outbreak. Neither a history of rubella nor a history of immunization with rubella vaccine was reliable in the prediction of the presence or absence of immunity. Two thirds of all hospital personnel were immunized through a voluntary mass-immunization program, but the response of physicians to the program was disappointing. Outbreaks of rubella that occur in hospitals with prenatal clinics are of special concern. Testing of all employees for rubella antibody and immunization of those determined to be seronegative should be considered.

Adolescent↗
PubMed1993

Elective introduction to oncology.

Since 1974, the St. George Medical Society, a component of the American Cancer Society's Philadelphia Division's Professional Education Program, has sponsored paid summer clinical and research fellowships for Philadelphia medical students completing their first year. Six lectures at the student level are presented throughout the year. Students run a single society, elect officers, and select site and speakers under the guidance of the St. George Medical Society Subcommittee. Faculty from six medical schools and individual faculty preceptors donate time to provide a one-on-one summer experience in medical oncology, surgical oncology, gynecologic oncology, radiation oncology, pathology, and cancer-related research in university hospitals, community hospitals, and private offices. Financial support is provided by directed donations. Currently 50 clinical fellowships are offered. Since its inception, over 750 "fellowships" have been awarded, and over 3,000 students have attended the lectures. The program successfully provides a voluntary one-on-one introduction to clinical oncology in a reproducible format.

American Cancer Society↗
PubMed1994

The International Tuberculosis Campaign: a pioneering venture in mass vaccination and research.

If an American pediatrician's conversation with Dr. Johannes Holm, a Danish pathisiologist and future director of the International Tuberculosis Campaign, had not been interrupted, the campaign would probably not have become a monumental precedent for world health activities. The International Tuberculosis Campaign was conducted under the auspices of the United Nations International Children's Emergency Fund and three Scandinavian voluntary organizations. In a program that started in the war-torn areas of Europe, nearly 30 million persons underwent tuberculin testing, and almost 14 million were given BCG (bacille Calmette-Guérin) vaccine. In addition, a postgraduate school for physicians was initiated, new laboratories were established and old ones were improved, hundreds of young doctors and nurses were introduced to international public health, and, perhaps most important, research and service were successfully integrated. The success of the campaign led to its becoming the first major disease control and research activity of the World Health Organization.

BCG Vaccine↗
PubMed2001

Farm and management variables linked to fecal shedding of Campylobacter and Salmonella in commercial squab production.

A cross-sectional study was performed to determine the relationship of farm variables and management practices to fecal shedding of Campylobacter or Salmonella on commercial squab (young pigeon) farms. A detailed survey provided information on biosecurity, cleaning and disinfection, bird health, vector control, and loft and pen. Twenty pigeons on each of 12 farms were cultured before and after the producers completed a voluntary quality assurance training program (QAP), based on principles of hazard analysis critical control point (HACCP). The prevalence of positive samples for Salmonella and C. jejuni was 1/480 (0.21%) and 19/480 (3.96%), respectively. Campylobacter was present on one farm during both visits; three farms during the first visit, and three farms during the second visit. Analysis by fixed-effects logistic regression showed the probability of having a positive C. jejuni culture was increased by not using dry manure in the nesting material, not cleaning shipping crates, cleaning landing boards, and by increased frequency of chemical disinfection of water. Having a positive parent and higher numbers of squab per pen (density) were also associated with higher odds of being positive for C. jejuni. Factors not associated with a positive C. jejuni culture included, other avian species on the farm, type of shipping crate, covered drinkers, fly problems, bird age, level of nest box within the loft, and QAP training. Prevalence of food safety pathogens was extremely low on the squab facilities tested as compared with reports from commercial broiler or turkey flocks. This observation suggests that one or more farm variables or management practices were effectively reducing infection, or possibly a species-related difference existed in carriage rates and shedding of pathogens. These results emphasize critical control points for food safety pathogens may vary widely, and the formulation of effective QAP programs are dependent on science-based knowledge of diverse animal production systems.

Animal Husbandry↗