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At least 163 records · Page 9Linked to original sources
PubMed1994

Japan lagging in reproductive rights.

Japan is one of only 11 of the world's countries that have not authorized the oral contraceptive pill for contraceptive purposes, noted Margaret Catley-Carlson, president, Population Council. Catley-Carlson made her comments on the low-dose pill at a special lecture meeting in Tokyo on October 14 where she served as guest speaker. The meeting was organized by the Japan Family Planning Association (JFPA) in cooperation with the Family Planning Federation of Japan (FPFJ), and JOICFP. It was attended by medical experts, parliamentarians, representatives of non-governmental organizations (NGOs) and the media. During her lecture, Catley-Carlson noted the emphasis on women's empowerment and reproductive health and rights for women made in the World Population Program of Action adopted at the recent International Conference on Population and Development (ICPD) in Cairo. She emphasized that NGOs have an important role to play in realizing the goals of the program of action. Widening the choice of contraceptives, an important reproductive health issue, is the responsibility of the service providers including NGOs, she added. Noting the relatively high rate of induced abortion in Japan, Catley-Carlson commented that the lack of access to the low-dose pill is not desirable from the perspective of reproductive health and rights. She called for widening the choice of contraceptives in Japan to include the low-dose pill and a wider selection of IUDs to promote reproductive health.

Asia↗
PubMed1998

Development of a computer program, MDGP, for population pharmacokinetic analysis written using ANSI C language on wide platforms.

MDGP, a computer program for population pharmacokinetics, has been developed. This program is based on maximum likelihood estimation with poly-dimensional normal distribution errors, and variable metric methods, direction set methods, conjugate gradient methods and the polytope method are provided as minimizations of objective function. The source codes of MDGP are described using ANSI C language. MDGP is able to run on wide platforms equipped with an ANSI C compiler. Users can use algebraic, ordinary differential and Laplace-transformed equations as descriptions of a pharmacokinetic model. Partial differential equations for each model parameter are not needed. Comparison of the estimated parameters, the iteration counts until convergence and objective function value, using MDGP and NONMEM, revealed that the calculation performance of the two programs are comparable. The MDGP is thought to be useful for the analysis of various pharmacokinetic models, including population pharmacokinetic analysis.

Humans↗
PubMed1996

[Evaluation of the tuberculosis infection screening program in pediatric population].

OBJECTIVE: To evaluate a screening program for tuberculosis (TBC) infection in a pediatric population in Spain using the tuberculin skin test (TST) and to analyze the distribution of the frequencies obtained. DESIGN: The study consists of a descriptive analysis carried out on a sample of the pediatric population from Mostoles and Alcorcon, two towns belonging to the Community of Madrid with 192,353 and 141,292 inhabitants, respectively. PATIENTS AND METHODS: A sample of 2,369 children was analyzed. The TST was performed over a ten-month period by trained, voluntary nurses from primary care units. The following variables were analyzed: risk factors for TBC infection, BCG vaccination and induration (mm) of the TST. In children with positive TST results, a search for infective foci and active tuberculosis was performed. RESULTS: The prevalence of TBC infection in the infantile population without risk factors was 0.7% (C.I. 95%, 0.4-1). No cases were found among children aged 3 months to 2 years. In the sample, 4.2% (C.I. 95%, 3.4-5) of the children had one or more risk factors for TBC-infection. Among children presenting risk factors for TBC, 5.1% (C.I. 95%, 1.6-11.8) had a positive result in the TST. However, 76.2% (C.I. 95%, 52.7-91.8) of children with a positive TST, no risk factors could be detected. CONCLUSIONS: Although a positive TST was more frequent in children with risk factors, as the majority of children in our population lacked risk factors for TBC infection, selective screening based on this parameter would not detect most cases of TBC-infection. Greater efforts should be made to better identify children with risk factors for TBC. According to our results, it is highly advisable to perform the TST once during childhood between 10 and 14 years, the period of highest prevalence, for both epidemiological and clinical reasons.

Adolescent↗
PubMed2005

Randomized trial of a population-based care program for people with bipolar disorder.

BACKGROUND: Despite the availability of efficacious medications and psychotherapies, care of bipolar disorder in everyday practice is often deficient. This trial evaluated the effectiveness of a multi-component care management program in a population-based sample of people with bipolar disorder. METHOD: Four hundred and forty-one patients treated for bipolar disorder during the prior year were randomly assigned to continued usual care or usual care plus a systematic care management program including: initial assessment and care planning, monthly telephone monitoring including brief symptom assessment and medication monitoring, feedback to and coordination with the mental health treatment team, and a structured group psychoeducational program--all provided by a nurse care manager. Blinded quarterly assessments generated week-by-week ratings of severity of depression and mania symptoms using the Longitudinal Interval Follow-Up Evaluation. RESULTS: Participants assigned to the intervention group had significantly lower mean mania ratings averaged across the 12-month follow-up period (Z= 2.44, p=0.015) and approximately one-third less time in hypomanic or manic episode (2.59 weeks v. 1.69 weeks). Mean depression ratings across the entire follow-up period did not differ significantly between the two groups, but the intervention group showed a greater decline in depression ratings over time (Z statistic for group-by-time interaction = 1.98, p = 0.048). CONCLUSIONS: A systematic care program for bipolar disorder significantly reduces risk of mania over 12 months. Preliminary results suggest a growing effect on depression over time, but longer follow-up will be needed.

Adolescent↗
PubMed1985

Incidence of hearing loss in high risk and intensive care nursery infants.

The incidence of hearing impairment in high risk infants is summarized for five programs which use brainstem electric response audiometry (BERA) to detect hearing loss in this population. Programs are compared with respect to the following variables which may affect reported incidence figures: population characteristics, stimulus and recording parameters, criteria for failure on the initial BERA test, and follow-up protocols. Between 10-30% of these infants fail an initial BERA test, with initial failure rate largely dependent on the failure criteria used. Approximately 10% will continue to show some degree of hearing impairment on follow-up tests at 2-5 months of age. Between 2-4% will have a moderate to profound bilateral sensorineural hearing loss requiring amplification and habilitation.

Acoustic Stimulation↗
PubMed1992

Alternate scenarios for population control in Pakistan: the issue of contraceptive method mix.

The authors review Pakistan's population program, with a focus on the ideal mix of contraceptive methods needed to slow population growth. "Our objective in this exercise is to estimate the extent of services required to achieve a certain level of the Contraceptive Prevalence Rate (CPR) necessary to bring fertility down to a level desired by women." Comparison is made between single- and multiple-method approaches.

Asia↗
PubMedDate not supplied

Fetal Down syndrome screening: a cost effectiveness analysis of alternative screening programs.

OBJECTIVE: To compare the efficacy and cost effectiveness of different screening programs for fetal Down syndrome (DS). METHODS: Screening tools evaluated included maternal age, triple screening (TS), and ultrasound (U/S) for fetal markers of DS. Sensitivities used were TS: 55% <35 years, 80% > or = 35 years; U/S: 70%. Average regional fees used were TS: $80, U/S: $200, amniocentesis (AM): $1,000. Five screening programs were evaluated: 1) <35 years, no screening; > or = 35 years, AM; 2) <35 years, TS with AM for screen-positive subjects; > or = 35 years, AM; 3) all patients, TS with AM for screen-positive subjects; 4) <35 years, TS followed by U/S for screen-positive women, AM for women with fetal markers of DS on U/S; > or = 35 years TS with AM for screen-positive subjects; 5) all women, TS followed by U/S for screen-positive women, AM for women with fetal markers of DS on U/S. The sensitivity, total cost, cost/case DS detected (Cost/DS), AM losses, and residual risk (RR, undetected DS fetuses/women not receiving AM) were calculated for each screening program. Population analysis was performed using 1988 IL delivery statistics. RESULTS: It was estimated that 260 cases of DS would occur in the population of 167,654 women (8.4% > or = 35 years at delivery). Sensitivity for programs 1-5 was 30, 69, 62, 51, and 36 percent, respectively, and cost/DS was 181,000, 203,000, 162,000, 151,000, and 194,000 dollars, respectively. CONCLUSIONS: DS screening incorporating TS in all patients with program #4 and without program #3 selective U/S in women <35 years yield the best combination of sensitivity and cost effectiveness while minimizing the number of AM-related losses.

Adult↗
PubMedDate not supplied

A collaborative community-based oral care program for school-age children.

PURPOSE/OBJECTIVES: In Vermont in 2001, less than half of school-age children on Medicaid received dental services. Vermont is a designated resettlement area for refugees, many of whom have never had dental care. A school-based oral health program was designed to meet the needs of this high-risk pediatric population. PROGRAM: A plan was developed to offer dental services to this group of children. Through the efforts of a multidisciplinary committee the Tooth Tutor Program, developed by the Vermont Department of Health, dental care was made available to the children. The Tooth Tutor Program provides cost-effective dental hygienist care to children in the school setting and includes referral to community dentists. OUTCOME: The program was able to provide services to approximately 500 children in the first 2 years with an increase in preventative services and decrease in restorative services from year 1 to year 2. After 3 years, a school-based dental service opened in 1 of the 3 target schools. CONCLUSION: A school-based dental service that includes education, screening, and referral can be an effective program for improving oral health among impoverished children. IMPLICATIONS FOR NURSING PRACTICE: For the community health clinical nurse specialist, the client is the community. Clinical nurse specialist practice in this community resulted in improved oral health for high-risk school-age children. This program can be adapted for other communities.

Child↗
PubMedDate not supplied

Community-based chronic disease management program for African Americans.

Seventy-five predominately African American volunteers were enrolled in a community-based intervention program designed to lower blood pressure and HgbA1C levels in an African American population. Program components consisted of exercise, meal planning, weekly support groups, periodic cooking schools, and service coordination. Significant decreases in initial and 1-year values were seen in both systolic blood pressure (P < .0001) and diastolic blood pressure (P = .000) and HgbA1Cs for those with initial values > 7% (P = .013).

Black or African American↗
PubMedDate not supplied

Management of caries in the child three years of age and younger: a survey of post-doctoral pediatric dentistry program directors.

PURPOSE: The purpose of this study was to report the results of a survey of pediatric dentistry post-doctoral program directors regarding education of post-doctoral students about management of caries in children 3 years-of-age or younger. METHODS: Fifty-two pediatric dentistry advanced education program directors were sent questionnaires inquiring about payer sources in their programs, distribution of caries in children 3 years of age or younger within the payer sources, the methods they teach and use to treat the caries, and the effectiveness of treatment and outcome data about the success of their treatment. RESULTS: Twenty-nine programs responded (56%). On average, two-thirds (66%) of the patients in post-doctoral pediatric dentistry programs are Medicaid patients. Program directors are fairly uniform in how they define methods of caries management, and they rate definitive therapy as the most effective method to manage all types of caries. Literature/textbooks were most frequently cited as the major source of scientific evidence to support treatment decisions. Fewer than 20% of program directors have outcome data on the effectiveness of their methods of treatment. CONCLUSIONS: Medicaid is the major payer source for patients in post-doctoral programs and definitive therapy is considered by program directors to be the most effective approach to managing caries in this patient population. Program directors rely on the literature and textbooks and few have outcome data.

Administrative Personnel↗
PubMed1997

Do training programs help AFDC recipients leave the welfare rolls? An evaluation of New York City's BEGIN (Begin Employment Gain Independence Now) program.

Guided by the Federal Family Support Act of 1988 and the Job Opportunity and Basic Skills Program (JOBS), welfare reform initiatives on state and local levels were designed to foster employability among the public assistance population. Reform has focused on enhancing the supply of labor rather than the demand for labor as a route to labor force participation for the public assistance population. Program reforms assume that, by providing job training, educational services, and training-related expenses, labor market entry of the participating clientele would be facilitated while caseloads and public expenditures would decline. To date, analysis of similar programs in many states indicates that the impact of such programs in reducing public assistance caseloads is marginal. In New York City, despite the large investment of public funds in such programs, prior to this study the outcome of program implementation remained largely unknown. This study evaluates New York City's BEGIN program outcome target defined as the ability of the program to move welfare clients off public assistance and into the labor market. While the results of the study indicate that New York City's BEGIN program does not improve client's odds of leaving welfare, when compared to the odds of a non-participation client, there are several significant findings. The impact of program participation can be distinguished among distinct age groups. While older clients responded positively to BEGIN participation, access to day care was the only factor that significantly improved the probability that clients younger than 36 years of age would leave the welfare rolls within a two-year period. In response to the findings, the researchers suggest that future welfare reform efforts should grant localities broader flexibility to determine their own target population so that resources can be allocated to those groups that are most likely to benefit from specific programs.

Adolescent↗
PubMed2000

[Current nutrition supporting programs of the population in the USA].

In this work main programs of nutrition-supporting in the USA were presented as a part of national and local social and health policy. Following programs were reviewed namely: FSP (The Food Stamp Program), NSLP (The National School Lunch Program), SBP (School Breakfast Program), SMP (The Special Milk Program), WIC Program (The Special Supplemental Food For Women, Infants and Children), SFSP (The Summer Food Service Program). The level of monthly income per person (no more than 130% of poverty line) is the condition for participation in every program. Some programs (e.g. FSP) are addressed to all citizens, who are fulfilling income criteria, whereas other (e.g. WIC, SBP) are available to selected population groups only. Assistance within these programs may occur in various forms (e.g. food stamps for family, possibilities in using of low cost meals, free of cost milk for school children). Authors suggest to utilize some of US experience in nutrition-supporting programs also in Poland.

Health Promotion↗
PubMed1998

A mobile HIV education and testing program: bringing services to hard-to-reach populations.

Few programs exist that offer a range of human immunodeficiency virus (HIV) services to multiple populations (i.e., substance abusers, individuals on probation, sex workers and their clients, court-mandated perpetrators of domestic violence) in multiple settings (i.e., courts, methadone maintenance clinics, residential and outpatient substance abuse treatment programs). The purpose of this article is to describe a model mobile HIV program, highlighting its flexibility in providing services to clients who infrequently present to traditional clinic-based testing sites. This mobile HIV program was developed to provide on-site HIV testing and counseling, education, and linkages to primary care services. The implementation of the program begins with training of agency staff, who then provide preliminary orientation with clients regarding HIV testing. Approximately 3 weeks later, the mobile program staff (HIV nurse specialist and HIV counselors) provide standardized group pretest counseling and education. Clients who decide to be tested meet with mobile program staff for individualized risk assessment and specimen collection. Two weeks later, clients meet with mobile program staff to obtain results and receive posttest counseling; risk reduction strategies are reemphasized at that time. Unique to this program is the provision of referrals for a wide range of primary care services for both seropositive and seronegative clients. Since 1994, the mobile program has been implemented at six sites, and over 1100 clients have been served. Two major outcomes from the program have been observed: 1. With adequate preparation and psychological support, 40% of hard-to-reach populations will elect to be HIV tested. 2. Through social networks of program participants, HIV-positive individuals not previously engaged in care have been referred to a comprehensive HIV primary care program.

Boston↗
PubMedDate not supplied

[Population policy in Thailand].

Population policy may be defined differently by students of demography but it is generally defined as measures aiming at influencing demographic processes--fertility, mortality, and migration--through public and private programs. Population policy may also be classified into different types: direct and indirect policies; population influencing and population responsive policies; explicit and implicit policies; and domestic and international policies. For Thailand, earlier population policies tended to be policies aimed at increasing the size of population through pronatalist and public health measures. However, findings of various studies in the early 1960s indicated that the rate of population growth in Thailand since the end of World War II had been as high as 3% per annum. These had led the government to eventually issue the first national population policy statement "supporting family planning through a voluntary system..." in March 1970. The first 5-year family planning program was included in the health plan of the Third National Economic and Social Development Plan (1972-1976). From the Fourth National Economic and Social Development Plan (1977-1981) onwards, population policies were made more comprehensive to cover all dimensions of population: population growth; quality of population; and population distribution and human settlements. Since population policy is an integral component of overall economic and social policies, conflicts between objectives of sectoral policies have to be minimized as much as possible. Future options of the population policies were briefly discussed.

Asia↗
PubMed1993

To each according to need: a community-based approach to allocating health care resources.

OBJECTIVE: To develop a method of allocating publicly funded health care resources among communities according to their relative levels of need for health care independent of their current patterns of use. DESIGN: For each health care program population mean levels of resource allocation were calculated and were adjusted for age and sex to produce a national age- and sex-adjusted share of program resources. Indices of relative need for health care (for most programs the standardized mortality ratio) were derived from existing data on aspects of illness and death and were then used to weight the age- and sex-adjusted shares for between-community differences in health risks and health care needs. SETTING: The populations of the 49 counties in Ontario were used as the communities among which resources were allocated. Health care expenditures in 1988-89 by the Ontario Ministry of Health were used as the "budget." MAIN RESULTS: Age- and sex-adjusted resource allocations weighted for between-community differences in health care needs differed from allocations based on population size, in certain cases by up to 100%. CONCLUSION: Existing data can be used to propose allocations of health care resources that relate to relative levels of need for care across communities.

Canada↗
PubMed1993

Prediction of gentamicin concentrations in neonates and infants using a Bayesian pharmacokinetic model.

This study retrospectively characterized population-based pharmacokinetic parameters for gentamicin in neonates and young infants, and evaluated the predictive performance of these parameters in a Bayesian forecasting program. Population parameter estimates were determined from the serum concentration-time data of 19 neonates and infants using a one-compartment open infusion model and nonlinear least-squares regression analysis. Univariate and multiple stepwise linear regression analyses were used to determine significant relationships between demographic characteristics and gentamicin pharmacokinetic parameters. Creatinine clearance and postnatal age were the most significant predictors of weight-standardized gentamicin clearance (model r2 = 0.86). The relationships between patient characteristics and population-based parameters were incorporated into the one-compartment Bayesian forecasting model. A second group of 17 neonates and infants receiving 35 courses of gentamicin therapy were used to evaluate the predictive performance of the population-based parameters and a Bayesian forecasting model. The population parameters provided accurate prediction of steady state gentamicin concentrations throughout multiple courses of therapy within the same patient. Bayesian forecasting further minimized the mean prediction error (bias) once a set of steady state peak and trough serum gentamicin concentrations became available (peak concentrations: -0.062 vs. -0.273 mg/l; trough concentrations: -0.006 vs. -0.161 mg/l). The mean absolute error (accuracy) was similar for the two sets of parameters. The observed accuracy of both the population parameters and Bayesian forecasting suggests that monitoring of serum gentamicin concentrations can be kept to minimum in neonates and infants.

Aging↗
PubMed1985

An evaluation of the population and development program in Egypt.

Previous rural surveys analyzing the impact of the Egyptian Population and Development Program on KAP variables (knowledge, attitudes, and practices of contraception) have produced mixed results. In 1982 a survey specifically designed to measure program impact contained refinements in questionnaire measurement, sampling, and analysis. Each refinement intensified the apparent program impact. Fertility itself still appears unresponsive, and attitudes toward family size have changed little, but marked differences between program and nonprogram areas in contraceptive knowledge, attitudes, and practice suggest imminent fertility declines in program areas.

Adolescent↗