Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Population 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 1,585 records · Page 88Linked to original sources
PubMedDate not supplied

A first survey of organized cervical cancer screening programs in Italy. GISCi working group on organization and evaluation. Gruppo Italiano Screening Citologico.

In Italy, where no national screening program for cervical cancer exists, organized programs have developed on a local basis. We performed the first survey of existing organized programs by mailing a standard questionnaire to a large network of possibly involved services. For the present survey, a program was defined as organized if personal invitations were sent. We identified 29 already active organized programs and 4 others in a starting phase. The target population of active programs included 2,074,820 women in the age range 25-64 years, corresponding to 13.5% of the Italian female population of the same age. The situation is rapidly evolving since many regional programs are being implemented. Most programs followed Italian and European recommendations as regards the age limits, interval between screening rounds, presence of a fail-safe system for women referred for colposcopy, presence of protocols for diagnostic workup and treatment, and presence of referral centers for such phases. However, many programs did not meet national guidelines as regards the size of laboratories interpreting smears, which were frequently small. Second-level referral centers also frequently had a very small activity. The average (weighted for size of the invited population) compliance to invitation and coverage (proportion of women with at least one test in the last 3 years) was 32.6% and 66.0%, respectively, therefore needing to be improved. Compliance to colposcopy (weighted for number of referred women) was 81.4%. We found a very high variability in the proportion of women referred for colposcopy that could only be partly explained by different referral protocols and could depend on different criteria of smear interpretation: the average (weighted for number of tested women) was 2.01%. A need for improvement in the process of evaluation and for homogenization of criteria of cytology interpretation was identified: work in this regard is on-going.

Adult↗
PubMedDate not supplied

Weight gain from novel antipsychotic drugs: need for action.

Obesity is common in schizophrenia, and people with schizophrenia appear to be at increased risk for certain obesity-related conditions, such as type 2 diabetes and cardiovascular disease. Antipsychotic drugs, used chronically to control symptoms of schizophrenia, are associated with often-substantial weight gain, a side effect that is a special concern with the latest generation of highly effective "novel" agents. That the most effective (e.g., novel) antipsychotic medications lead to substantial weight gain presents the field with a critical public health problem. Although preliminary data have been reported regarding the beneficial use of behavior therapy programs for short-term weight control in patients with schizophrenia, the available data are quite limited, and there are no data regarding the long-term beneficial effects of these programs in this population. The obesity field recently has developed programs emphasizing "lifestyle changes" (e.g., diet, exercise, and problem-solving skills) to successfully manage weight in patients without schizophrenia. Such programs can be adapted for patients with schizophrenia through the use of highly structured and operationalized modules emphasizing medication compliance, social skills development, and participation in outpatient programs. Moreover, these programs can potentially be combined with the use of adjunctive pharmacotherapy to maximize and maintain weight loss. The field must solve the paradox that some of our most effective medications for schizophrenia produce substantial weight gain and its associated troubling health risks.

Antipsychotic Agents↗
PubMedDate not supplied

Relationship between perinatal counseling and incidence of breastfeeding in an inner-city population.

OBJECTIVE: We hypothesized that the cost of a lactation program can be reduced without significantly affecting the incidence of breastfeeding. STUDY DESIGN: We conducted a retrospective analysis of breastfeeding among all 7942 mothers whose neonates were admitted to the well baby nursery at Jacobi Medical Center (JMC) over a 44-month period. We used multiway frequency analysis to compare the incidence of breastfeeding in three successive models of counseling: (1) full-time lactation coordinator, (2) obstetric personnel trained in breastfeeding counseling and full-time lactation coordinator, and (3) obstetric personnel and half-time lactation coordinator. Mothers were further classified into three groups according to location of prenatal care and attendance at breastfeeding education sessions. RESULTS: Breastfeeding increased with the initiation of education and the involvement of obstetric personnel and did not significantly decrease when the lactation coordinator became half-time. The transition to model 3 resulted in decreased costs without significantly affecting the incidence of breastfeeding. Breastfeeding was significantly associated with counseling by obstetric personnel, with prenatal care at JMC, and with breastfeeding education sessions. CONCLUSION: Involving obstetric personnel in breastfeeding counseling may enhance the effectiveness of a lactation program. In our population, the most cost-conscious model included counseling by trained obstetric personnel and a half-time lactation coordinator.

Breast Feeding↗
PubMed2005

Public dental health care program for persons with disability.

The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means of self-administered questionnaires completed by the person responsible locally for the program in each municipality. The response rate was 84%. The following topics were included: (1) Number of persons attending the program, (2) procedure for identification of persons eligible for the program, (3) payment of service, (4) providers of oral health care, (5) special training of staff, 6) dental services delivered, (7) ethical issues, and (8) patient rights. Less than one-third of persons estimated by the health authorities were enrolled in the program. On average, 0.4% of the municipal population attended the program, ranging from 0.03% to 1.53%. In large municipalities, and where internal providers delivered oral health care, relatively more persons were enrolled in the program (p < 0.001). Overall, more than 20 categories of personnel were involved in the selection procedure; attitude and lack of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large municipalities. To secure equal access for persons with disability, it is recommended that joint collaboration between smaller municipalities should be made regarding procedures of such programs. Special training of dental personnel and of the staff responsible for selecting persons for the program should be systematically organized at a higher administrative level. The pattern of dental services delivered justifies further involvement of oral hygienists in the program.

Aged↗
PubMedDate not supplied

Allozyme variation of Cyclobalanopsis championii (Fagaceae), a narrowly distributed species in southern Taiwan.

Allozyme genetic variability in five natural populations of Cyclobalanopsis championii (Fagaceae) in Taiwan was investigated using 12 loci from 9 enzyme systems. The average values of parameters describing within-population variation, expected heterozygosity (He = 0.151), the percentage of polymorphic loci per individual (P = 50%), the average number of alleles per locus (A = 1.7), effective number of alleles per locus (Ae = 1.25), and the average number of alleles per polymorphic loci (AP = 2.2) are comparable to those of other long-lived woody plants. The overall fixation index (Fis = 0.208) indicates a significant deficiency of heterozygotes at the population level. Allelic frequency deviation from Hardy-Weinberg equilibrium was found for different loci in different populations. An exact test for population differentiation using the Tools for Population Genetic Analyses program also indicates that allelic frequencies among populations are significantly different (P < .001). Among-population variation, Gst, accounted for 9.2% of the total heterozygosity. The population at Shouchia and the southernmost population Nanjenshan had higher inbreeding coefficients (0.177 and 0.153, respectively) than did the northern populations. Genetic drift is supported by the observations of the variance components of linkage disequilibrium and a large proportion of loci in Nanjenshan and Shouchia that show pairwise locus disequilibrium. We believe continuous genetic drift in the southern populations will increase genetic divergence among populations of C. championii in Taiwan. Significant correlation was found between elevation and expected heterozygosity. We therefore inferred that temperature is the most important ecological factor to influence the genetic diversity of C. championii.

Gene Frequency↗
PubMedDate not supplied

Gender differences in referral to cardiac rehabilitation programs after revascularization.

BACKGROUND: This study examines the influence of gender on the healthcare provider's secondary prevention instruction and cardiac rehabilitation (CR) referral after coronary revascularization procedures such as balloon angioplasty/coronary stenting and coronary bypass surgery (CABG). Cardiac rehabilitation decreases mortality and morbidity, yet only a small percentage of women and men are referred to these programs. The patient population of our university-affiliated CR program consisted of 88% men and 12% women. METHODS: In a matched case observational study, 80 patients (40 men, 40 women) who had undergone coronary revascularization procedures between 1997 and 1998 completed a questionnaire on secondary prevention instruction and written referral to CR programs. Patients were matched for age and coronary revascularization procedure. RESULTS: Women were less likely to be instructed on secondary prevention strategies and CR or referred to CR as compared to men despite being matched for age and undergoing the same procedure. The data demonstrate a gender difference in hospital teaching and referral information for CR after revascularization (P < 0.001). Being a woman was associated with a decreased likelihood of receiving a physician referral to CR after revascularization (P < 0.001). CONCLUSION: The instruction of patients concerning secondary prevention and CR postrevascularization procedures is poor. Within that group, women were far less likely to have CR discussed or referrals made by healthcare professionals. This study demonstrates the need for education initiatives of all healthcare providers on the comprehensive nature and benefits of CR in the secondary prevention of cardiovascular disease, with a particular emphasis on women.

Adult↗
PubMed1980

Radiologic diagnosis of oat cell cancer in a high-risk screened population.

A screening program of 10,040 cigarette-smoking men over 45 years of age was undertaken in an attempt to achieve earlier diagnosis, thereby increasing the cure rate, of oat cell lung cancer. Of the 155 men who were found to have lung cancer, 27 (17%) had confirmed oat cell cancer. Only one case was diagnosed at the first examination. The other 26 cases (called incidence cancer) were diagnosed by subsequent examinations. In 24 of the 26 patients, the tumor was not found until it was advanced (Stage III), and of these patients, only one is alive at 21 months follow-up. Two tumors were diagnosed as oat cell carcinoma at an early stage (Stage I), and both patients are alive with no evidence of disease at seven and 24 months. The screening program used in this study did not succeed in detecting oat cell cancer at an early stage.

Aged↗
PubMed2003

Relative survival rates and patterns of diagnosis analyzed by time period for individuals with primary malignant brain tumor, 1973-1997.

OBJECT: The purpose of this study was to examine patterns of diagnosis and relative survival rates in individuals in whom a primary malignant brain tumor was diagnosed between 1973 and 1997; follow-up review of these patients continued through the end of 1999. METHODS: The study population was composed of 21,493 patients with primary malignant brain tumors that were diagnosed between 1973 and 1997. Data on these patients were obtained from the population-based Surveillance, Epidemiology, and End Results Program. The study population was divided into three cohorts based on the year of diagnosis, and these groups were compared with respect to variables of interest by performing chi-square tests and relative survival analysis with the life table method. Over time, there were consistently more men, more Caucasians, more patients undergoing surgery, and more individuals 70 years and older who received the diagnosis of primary malignant brain tumor. An examination of proportions of individuals with astrocytoma, other; oligodendroglioma, other; and oligodendroglioma Grade III showed significant temporal changes with frontal and temporal lobe tumors occurring most often. The diagnosis was obtained at an earlier age in African-American than in Caucasian patients. Caucasians had higher proportions of glioblastoma multiforme (GBM), which was associated with decreased survival times, and of oligodendroglioma, other, whereas African Americans had higher proportions of astrocytoma, other; ependymoma Grade II or III; and medulloblastoma, all of which were associated with increased survival times. The relative survival case demonstrated a continuous improvement over time, although older patients, those who underwent biopsy only, and those with GBMs continue to have the poorest survival times. The relative survival rates of African Americans consistently were similar or worse than those of Caucasians when the groups were stratified by prognostic factors. CONCLUSIONS: Over time, the relative survival rate of individuals with primary malignant brain tumor has improved and differences in survival are seen by examining the race of the patients.

Adolescent↗
PubMedDate not supplied

AIDS awareness in North Dakota--a knowledge and attitude study of the general population.

The AIDS program of the North Dakota Department of Health and Consolidated Laboratories has provided a broad range of information concerning AIDS (acquired immunodeficiency syndrome) and HIV (human immunodeficiency virus) to State residents over the past few years. The ultimate intent of these intervention efforts was to decrease viral transmission. To assess residents' knowledge and attitudes regarding AIDS, a statewide, random telephone study was conducted by AIDS Program personnel in the fall of 1987, 1988, and 1989, with technical assistance from the Bureau of Governmental Affairs, University of North Dakota. Study results indicated a majority of the respondents considered themselves to have at least "some" knowledge about AIDS. Participants' comprehension of viral transmission routes and prevention methods increased over the 3 years, yet misconceptions still exist. Identified areas of misconception were accentuated in subsequent State educational programs. When the results were compared with national studies, knowledge levels in North Dakota were generally similar to but frequently superior to the nationwide levels.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Cervix cancer: incidence, diagnosis, therapeutic principle].

The incidence of cervical cancer is decreasing, wherever screening programs are offered and accepted. Pathogenetic factors for dysplasia and cervical cancer among others are coital activity in early adolescence, promiscuity and low economic status. More than 80 percent of severe cervical dysplasias as a precancerous stage show the oncogenic potential of a sexually transmitted disease. The prognosis of cervical cancer widely depends on the stage found at the time of first detection. The staging procedure which then follows needs gynecological experience and skill. Clinical staging with methods auxiliary to inspection, colposcopy and palpation is still the most common method and remains to be the basis of the international data treasure of the Annual Report of FIGO, although clinical methods and even CT and MRI are insufficient for the evaluation of pelvic and/or paraaortic lymphnode metastases. To overcome the imperfection of clinical staging, surgical procedures are recommended to complete before any therapeutic decision is made, at least in cases thought to be operable. Radical hysterectomy with pelvic lymphadenectomy in stages Ib and IIa is the method of choice in most modern centers of gynecologic oncology. However, radiotherapy is still prevalent in all stages of cervical cancer as the most common therapy around the world. Further development in 5-years survival figures is expected to profit from supporting screening programs in risk populations or from expansions of already existing programs rather than from further modifications of the therapeutic modalities, already highly specialized.

Adenocarcinoma↗
PubMed1971

Genetic studies of a cleft palate clinic population.

The genetic program at the Lancaster Cleft Palate Clinic is briefly described. The aim of the study is to obtain quantitative estimates of various components which contribute to genetic heterogeneity. Of 260 families interviewed, 26.1% of cleft lip, 42.5% of cleft lip and palate and 30.0% of isolated cleft palate propositi had one or more affected relatives. That isolated cleft palate is etiologically distinct from cleft lip with or without cleft palate is once again demonstrated. Eight of the cleft palate propositi are from mixed pedigrees with Van der Woude syndrome. While a majority of the familial cleft cases are compatible with the multifactorial hypothesis, five pedigrees of cleft lip and cleft palate propositi and one of a cleft palate propositus are in apparent agreement with the hypothesis of single autosomal dominant gene in each pedigree. No case of sex-linked inheritance was found.

Cleft Lip↗
PubMed1988

The "diff-if". Use of microcomputer analysis to triage blood specimens for microscopic examination.

Increasingly, all automated blood counts are not accompanied by a microscopic white blood cell differential. A popular strategy is to obtain a manual differential if any part of the automated blood count and differential is outside specified limits (the "diff-if" strategy). The authors compared two sets of criteria to triage blood counts for manual differentials: previously recommended numeric values, and the analysis of a microcomputer program. In a population of subjects with a high percentage of hematologic disorders, the microcomputer program and the numeric criteria were equally specific (excluding normal blood smears); the program was more sensitive for bands, immature granulocytes, monocytes, nucleated red blood cells, reticulocytosis, teardrops, red blood cell fragments, and hypersegmented neutrophils. The numeric criteria were more sensitive for eosinophilia (less than 1.0 X 10(9)/L) and mandated fewer manual differentials. In a population of predominantly normal subjects, the program was more sensitive for increased bands and equally sensitive for eosinophilia, the only abnormalities observed on the smear. In a population of subjects with predominantly abnormal blood counts, but excluding most primary hematologic disorders, there were few blood smears with abnormalities beyond eosinophilia or increased bands. In both of these groups, the computer program mandated more manual differentials than did the numeric criteria. The authors conclude that microcomputer analysis by the program tested was more sensitive than numeric criteria to identify specimens with abnormal blood smears. Specificity depended on the patient population. The choice of a triage strategy should be based on the individual laboratory's patient population.

Blood↗
PubMed1986

[Prevention and treatment of hypertension at the population level: the Minnesota Heart Health Program].

The Minnesota Heart Health Program is a ten year research and demonstration trial for the primary prevention of coronary heart disease. Community wide prevention and control of hypertension is among the major goals of this study. Systematic population screening for hypertension, mass media campaigns, adult and youth education programs, physician and health professional programs, and community organization efforts are part of the multiple strategy approach to prevention. Replication in three sites, annual risk factor surveys and morbidity/mortality surveillance will provide evidence for the value of this community wide approach at the end of ten years.

Adolescent↗
PubMed1987

Recruitment in the hypertension detection and follow-up program.

The Hypertension Detection and Follow-up Program (HDFP), through a two-stage population-based screen for high blood pressure involving over 159,000 persons in 14 U.S. communities, recruited and randomized 11,386 participants. The design initially called for the recruitment of 800-1000 hypertensive individuals per clinic over a 9-month period. The size of the population to be screened was based on an estimated 15% of the general population being age and blood pressure (BP) eligible. All adults 30-69 years of age in defined populations were to be screened, with efforts to enroll into the trial all who met the BP eligibility criteria. Recruitment was carried out by interviewers who enumerated households and screened age-eligible individuals for elevated BP; those meeting BP criteria were invited to a clinic screen for confirmation. Of those persons enumerated, 179,239 were age eligible, and 159,566 of these had home BP measurements. The home screening yielded 22,994 persons who had a diastolic BP at or above 95 mm Hg, and 17,499 attended the clinic screen. At the clinic screen, 11,386 had diastolic BP at or above 90 mm Hg and were randomized into one of two treatment groups. The enumeration goal, and the recruitment yield and cost varied by clinic, primarily due to different characteristics of the defined populations. Overall, the target population approximated U.S. demographic characteristics except that a larger proportion of blacks was included. Because of generally good response rates, the randomized study population was representative of similarly aged hypertensive persons in the target populations. The recruitment results suggest that a population-based screening program for a high prevalence condition such as hypertension is an effective mode of recruitment, particularly when a population-based sample is required.

Adult↗
PubMed1983

Education guidelines for self-care living with diabetes.

Educational processes for those with diabetes can occur in a variety of settings. Major problems in education and implementation of programs for this population continue to be discussed. Methods for assessing programs' effectiveness in establishing adherence to individual regimens are developing. Health care professionals have assumed that individuals who are better informed make better decisions. This assumption implies that exposure to a body of facts and opportunities to develop technical skills provide the necessary elements for self-care and thus responsibility for self-health-care. Until sufficient data either confirm or negate these assumptions, programs to develop these skills and knowledge will continue. Educational program planning should occur in a systematic way with the process of the learning experiences identified along with an evaluation of the outcome of the program objectives. This educational model described (SURVIVAL, HOME MANAGEMENT, and LIFE STYLE) provides a systematic method for developing educational programs in a variety of health care and community settings. Diabetes self-care programs can be evaluated for content, design, and process. Their outcome in terms of short-term health behavior skills can also be measured. The yet unanswered question remains: Do educational programs resulting in desirable individual behaviors (adherence) make a difference in the long-term effects, quality of life, and avoidance of disability in the diabetic population? The answers may come in the future through well controlled and defined evaluative research studies. The profession of dietetics is an important part of the future. Have we been effective in our counseling or educational endeavors and, if so, can that professional function be documented? Current economic trends are stimulating to cost-effective research. Although research studies to demonstrate such effectiveness are difficult to design, the current "Guidelines" provide a model for evaluating outcome of educational programs in terms of the knowledge and skills necessary for self-care.

Diabetes Mellitus↗
PubMed1984

The NIMH Epidemiologic Catchment Area program. Historical context, major objectives, and study population characteristics.

The National Institute of Mental Health multisite Epidemiologic Catchment Area (ECA) program is described in the context of four previous psychiatric epidemiologic surveys that included a combined total of 4,000 subjects from Stirling County, the Baltimore Morbidity Study, Midtown Manhattan, and the New Haven third-wave survey. The ECA program is distinguished by its sample size of at least 3,500 subjects per site (about 20,000 total); the focus on Diagnostic Interview Schedule--defined DSM-III mental disorders; the one-year reinterview-based longitudinal design to obtain incidence and service use data; the linkage of epidemiologic and health service use data; and the replication of design and method in multiple sites. Demographic characteristics of community and sample populations are provided for New Haven, Conn, Baltimore, and St Louis.

Adolescent↗