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At least 343 records · Page 19Linked to original sources
PubMed2000

Population pharmacokinetic analysis of amikacin and validation on neonates using Monte Carlo method.

AIM: To make programs for population pharmacokinetic analysis and to assess the ability of this method in pharmacokinetic parameter estimation and in the prediction of serum concentrations. METHODS: Data of amikacin as a model drug were collected from 42 neonates with 142 serum samples. A one-compartment open model was used to describe the kinetics of amikacin after the intravenous infusion. Following Sheiner's idea of population pharmacokinetics, we made the programs to evaluate population parameter and individual parameter. The target function minimality was obtained from Monte Carlo algorithm. The validation of the population analysis was performed using classic pharmacokinetic program 3p87 for antithesis. The predictability of the developed method was evaluated by computing precision and accuracy of serum concentration predicted using the parameter estimates. RESULTS: The stability of our self-made program was good. The population parameters obtained from this approach were in conformity with those from 3p87, and the interindividual variability was relatively small. For the learning sample and the validation sample, predicted and observed concentrations were all close with correlation coefficient 0.995 and 0.990, respectively. Most of predicted errors were found < +/- 1 mg/L, and RMSD and BIAS were 0.58 and -0.07 for the validation sample, respectively. The choice of blood sampling time was an important factor for the predictive performance. An early sampling time after the infusion was observed to be the best sampling time. CONCLUSION: The estimation program of population parameter and individual parameter made by us ran stably, and allowed us to use sparse data to estimate population pharmacokinetic parameters. It provided accurate estimates of these parameters and satisfactory ability of serum concentration prediction. Therefore, it can be used for the population pharmacokinetic analysis and individualization of dosage regimen.

Amikacin↗
PubMed1995

Dietary behaviours of volunteers for a nutrition education program, compared with a population sample.

The dietary behaviours of and recent dietary change by volunteers for a nutrition education program were compared with those of a more population-representative sample. The population sample was randomly selected from the electoral rolls of three Australian cities. Those selected received questionnaires which were to be completed and returned by mail. The sample of volunteers was recruited from the electoral rolls of suburbs of either high or low social status in one of these cities. Volunteers were posted a questionnaire, to be returned in person. A quantified food frequency questionnaire was used to estimate relative intake of 19 nutrients, plus energy intake. Occupation, age, sex, reported recent dietary change and diet-related beliefs were also assessed. The population sample was weighted to the age and occupational distribution of the education program sample. Compared to the 874 respondents in the population sample (70.4 per cent response rate), the 487 volunteers (24.2 per cent response rate) for the nutrition education program had healthier nutrient intakes and reported more dietary behaviour changes. Recruitment in the education program was greater in areas of higher social status (32 per cent) than in areas of lower social status (20 per cent). The potential effect of such a program on the whole population was demonstrated by the proportions that volunteered and the characteristics of these volunteers. The need to provide a range of opportunities for changing dietary behaviour, according to the health-related behaviours and beliefs of target groups and their socio-economic circumstances, was highlighted.

Adolescent↗
PubMed2005

State-funded comprehensive primary medical care service programs for medically underserved populations: 1995 vs 2000.

OBJECTIVES: We analyzed responses to the 2000 Comprehensive Primary Medical Care programs for Medically Underserved Populations Survey and compared them with the 1995 survey results to identify trends. METHODS: Surveys were mailed to all primary care program offices. State primary care program associations reviewed primary care program offices' responses and completed surveys for offices that did not respond. RESULTS: We identified 30 qualified primary care programs in 24 states that had an overall funding level of $215 million. Most states allowed funds to be spent on expanding service areas, buying equipment, and hiring and training staff. CONCLUSIONS: Although state funding has increased overall, many states do not have comprehensive primary care programs, and an increasing number of states are experiencing budget deficits that may lead to reductions in existing programs.

Budgets↗
PubMed2002

Projected impact of implementing the results of the diabetes prevention program in the U.S. population.

OBJECTIVE: To determine the feasibility of using either fasting plasma glucose or HbA(1c) to identify individuals in the U.S. population who meet the Diabetes Prevention Program (DPP) criteria for intervention, defined as BMI >/=24 kg/m(2), fasting plasma glucose level 96-125 mg/dl, and 2-h glucose level 140-199 mg/dl in an oral glucose tolerance test (OGTT). RESEARCH DESIGN AND METHODS: Analysis of a representative sample of U.S. adults aged 40-74 years with no medical history of diabetes for whom data on height, weight, fasting plasma glucose, HbA(1c), and 2-h plasma glucose during an OGTT were obtained. Sensitivity, specificity, positive predictive value (PPV), and receiver operator characteristic (ROC) curves for fasting glucose and HbA(1c) were determined. RESULTS: Using BMI <24 kg/m(2) as an initial criterion eliminated 27.2% of U.S. adults from further testing. Of the remaining group, 41.1% did not have to be considered for an OGTT because their fasting glucose level was below or above 96-125 mg/dl. Overall, 10.6% of adults aged 40-74 years without medical history of diabetes met the DPP eligibility criteria for intervention. Among individuals with BMI >/=24 kg/m(2) and fasting glucose level 96-125 mg/dl, applying a fasting plasma glucose cutoff of >/=105 mg/dl excluded 62.5% of this group and resulted in 56.0% of those with 2-h glucose level 140-199 mg/dl in this group being identified, with a specificity of 72.0% and a PPV of 17.1%. Similar values were obtained for an HbA(1c) cutoff value of >/=5.5%. CONCLUSIONS: Using data on BMI and setting cutoff values for fasting glucose and HbA(1c) would greatly reduce the number of individuals who would need to undergo an OGTT while achieving adequate sensitivity, specificity, and PPV.

Adult↗
PubMed1984

Two methods of estimating the target population for public maternity services programs.

One difficulty in estimating the target population for public health programs is identifying a current and appropriate indicator of the low-income population. Using data from Mississippi and Maryland, we determined that educational attainment of women giving birth is a feasible substitute for census data in estimating the low-income maternity population, and that vital statistics data offer several advantages for estimating the maternity services target population over census data.

Educational Status↗
PubMed2000

Perception of and attitudes toward the Nigerian federal population policy, family planning program and family planning in Kaduna State, Nigeria.

This paper discusses the perceptions of the Nigerian population policy, family planning program and family planning using data obtained from a 1995 survey of 600 Atyap women aged 15-49 years, in Nigeria. Additional qualitative data were obtained from married and unmarried women and men, clergymen, government officials, and respected community elders. The predominantly Christian and rural Atyap community generally accepts modern contraception and the need for family size reduction but considers the "four-is-enough" policy to be unacceptable. Religion may be important in determining the success of the federal government to reduce family size to four children by the year 2000.

Adolescent↗
PubMedDate not supplied

Fall prevention in frail elderly nursing home residents: a challenge to case management: part I.

Parts I and II of this article examine the impact of a falls prevention program on the fall incidents among the residents in a nursing home. It was hypothesized that a diagnostic, therapeutic, and preventive approach should be used for nursing home residents identified as being at high risk for falls in order to reduce the number of fall incidents and to improve quality of life for this vulnerable population. The program effectively targeted both intrinsic and extrinsic factors to reduce risks facing the residents. The effectiveness of the program was evaluated by examining changes in the rate of falls after the program was implemented. The results identified that a multifaceted program, one that utilized multiple personalized interventions, was effective in reducing the falls rate of frail (those with complex medical and psychosocial problems) nursing home residents, and that muscle-strengthening interventions may be beneficial for this vulnerable population. Program outcomes verified that case managers can impact quality of life for frail elderly nursing home residents by promoting their independence and safety, and postponing problems resulting from inactivity. Part I discusses the background and process of a falls program and factors contributing to the occurrence of falls. Part II will examine the interdisciplinary team approach to assessment, method, and implementing strategies for an effective fall prevention program. Tools used for prevention, monitoring, and investigation of falls will be detailed in Part II.

Accident Prevention↗
PubMedDate not supplied

Fall prevention in frail elderly nursing home residents: a challenge to case management: part II.

Parts I and II of this article examine the impact of a falls prevention program on the fall incidents among the residents in a nursing home. It was hypothesized that a diagnostic, therapeutic, and preventive approach should be used for nursing home residents identified as being at high risk for falls in order to reduce the number of fall incidents and to improve quality of life for this vulnerable population. The program effectively targeted both intrinsic and extrinsic factors to reduce risks facing the residents. The effectiveness of the program was evaluated by examining changes in the rate of falls after the program was implemented. The results identified that a multifaceted program, one that utilized multiple personalized interventions, was effective in reducing the falls rate of frail (those with complex medical and psychosocial problems) nursing home residents, and that muscle-strengthening interventions may be beneficial for this vulnerable population. Program outcomes verified that case managers can impact quality of life for frail elderly nursing home residents by promoting their independence and safety, and postponing problems resulting from inactivity. Part I (LCM, Nov-Dec 2001) discussed the background and process of a falls program and factors contributing to the occurrence of falls. This month we examine the interdisciplinary team approach to assessment, method, and implementing strategies for an effective fall prevention program. Tools used for prevention, monitoring, and investigation of falls are also detailed.

Accident Prevention↗
PubMed2026

Artificial intelligence-supported double reading in European population breast cancer screening: A systematic review and meta-analysis of prospective programs.

BACKGROUND: Most European population mammography screening programs rely on double reading with arbitration, a model that delivers mortality benefit but is increasingly challenged by radiologist workload, variable specificity, and interval cancers. Artificial intelligence (AI) is being evaluated to support or optimize these established European screening pathways. PURPOSE: To synthesize prospective or program-embedded evaluations of AI conducted within European-style population screening programs and to estimate exploratory program-level absolute risk differences (RDs) per 1000 examinations for cancer detection rate (CDR) and recall. MATERIALS AND METHODS: We performed a prespecified, focused evidence synthesis of three large studies embedded within routine population screening programs operating under European-relevant workflows: MASAI (randomized AI-supported risk triage within a national program), ScreenTrustCAD (prospective paired-reader evaluation with AI as an independent reader in a double-reading framework), and PRAIM (nationwide decision-referral implementation). Outcomes were harmonized as AI-control RDs per 1000 examinations. Random-effects pooling used Hartung-Knapp-Sidik-Jonkman models. For the paired-reader design, sensitivity analyses applied a Kish effective sample-size approach across plausible within-examination correlations (&#x3c1;&#xa0;=&#xa0;0.3-0.8). Positive predictive value (PPV) and workflow/time outcomes were summarized descriptively. RESULTS: Across 597,419 examinations, the pooled CDR RD was +0.9 per 1000 (95% CI -0.0 to +1.8; I2&#xa0;&#x2248;&#xa0;12%), consistent with a modest directional increase with borderline statistical uncertainty. The pooled recall RD was -0.6 per 1000 (95% CI -3.1 to +2.1; I2&#xa0;&#x2248;&#xa0;41-43%), indicating no consistent recall increase across screening programs. Where reported, PPV was higher with AI-supported screening. Efficiency signals included 44.3% fewer total readings in MASAI and shorter reading times for AI-normal examinations in PRAIM; in PRAIM, a program-level safety-net mechanism recovered 204 cancers that would otherwise have been missed. CONCLUSION: In European population screening programs characterized by double reading and arbitration, prospective program-embedded evidence suggests that AI integration may yield a small absolute increase in cancer detection (&#x2248;1/1000) without a consistent increase in recall, alongside improved PPV and efficiency signals. These findings suggestAI primarily as a complementary reader within European screening workflows, with implementation requiring explicit quality assurance and monitoring of interval cancers and stage distribution.

Humans↗
PubMed2006

Special Populations Networks--how this innovative community-based initiative affected minority and underserved research programs.

The Special Populations Networks (SPN) Program was created to address both community needs for cancer information and NCI's desire to obtain community-based answers to research questions and promote training opportunities for racial/ethnic minority and underserved researchers in populations with an unequal burden of cancer. The SPN program included 3 components: 1) infrastructure and capacity building combined with cancer awareness, 2) community-based research, and 3) community-centered training. The 18 SPN grantees conducted more than 1000 cancer awareness activities. More than 2000 community lay health workers were trained. Communities formalized more than 300 partnerships with Memoranda of Understanding (MOU). More than 255 pilot research project applications were submitted by junior researchers and over 135 were funded. Approximately 90% of the applications were submitted by minority junior researchers; of which more than 100 were funded. More than 290 scientific publications thus far have resulted from the work of the SPNs. In the first 3 years of the program, the SPNs also secured an additional $20 million in outside funding. The SPN program effected a paradigm shift for minority research programs by combining community-based cancer awareness, research, and training into a single program. By engaging research leaders of minority and underserved populations to aid their own, train their own, and develop research to help their own, the SPN program activated the power of their commitment to their own. That commitment was reflected in the trust and participation offered by their communities. Cancer 2006. (c) 2006 American Cancer Society.

Community Networks↗
PubMed2004

Stabilizing selection on genomic divergence in a wild fish population.

Conservation programs use breeding protocols to increase genomic divergence (by mating genetically dissimilar individuals) in an attempt to circumvent population declines resulting from inbreeding depression. However, disruption of either beneficial gene complexes or local genetic adaptations can lead to outbreeding depression, and thus, there should be a reduction in fitness of individuals at either end of the genomic divergence continuum. Although such simultaneous inbreeding and outbreeding depression has been observed in plant populations, it rarely has been demonstrated in animal populations. Here, I use both genetic and phenotypic measures to show that there is stabilizing selection on genomic divergence in a wild population of bluegill sunfish (Lepomis macrochirus). I also show that breeding individuals that exercise mate choice produce offspring that are closer to the optimal level of genomic divergence than random mating alone would predict.

Animals↗
PubMed1977

Papua New Guinea: first population policy declared.

In its 2nd year after achieving political independence, Papua New Guinea declared a general population policy in October 1976, and inaugurated a population research program to guide policy formulation. Population affairs of the country, which has a population of 2.75 million, have been vested with the Ministry of Environment and Conservation. The research program will be implemented in cooperation primarily with the Institute of Applied Social and Economic Research (IASER) and the University of Papua New Guinea, as well as the Central Planning Office, Department of Public Health, Bureau of Statistics, and Office of Information, among other agencies. The priorities for research will initially fall under 5 main concerns: 1) fertility and population growth, and the causes of local differentials; 2) socioeconomic influences on growth trends; 3) interrelation between population and land resources; 4) internal migration; and 5) individual attitudes regarding family planning practice. The research program is designed to become an integral part of national development planning. However, the Government has declared that both policy and research programs must concur with the needs and desires of the people, to pave the way for successful implementation of development plans.

Developing Countries↗
PubMed1998

Estimation of candidate gene effects in dairy cattle populations.

Standard programs for animal models can be modified to include the effect of a candidate gene, even if only a fraction of the population is genotyped. The elements of the incidence matrix for this effect is 0 or 1 for genotyped individuals and for the probabilities of the candidate gene genotypes for individuals that were not genotyped. The effects of a diallelic candidate gene that were estimated by this method were compared on simulated populations with three alternative estimation methods: analysis of genetic evaluations, yield deviations, and daughter yield deviations, all of which were derived from a standard animal model. The bases of comparison were mean squared error and bias. Four types of experimental designs were considered: genotyping sires only, genotyping cows only, genotyping half of the cows but no sires, and genotyping half of the sires and half of the cows. The estimates that were derived from the three alternative methods all underestimated the simulated effects. The genetic evaluations were more biased than were the yield deviations and the daughter yield deviations. The proposed method was significantly biased only for the design in which half of the daughters, but no sires, were genotyped. Bias and mean squared errors were always lowest by the proposed method.

Animals↗
PubMed2000

Outcomes of a population-based asthma management program: quality of life, absenteeism, and utilization.

BACKGROUND: Despite the availability of the National Asthma Education Program (NAEP) guidelines since 1991, asthma remains inadequately managed. To improve quality of life, functional status, and self-management behavior of asthma patients, a large health maintenance organization (HMO) in California implemented an asthma management program in 1996. OBJECTIVE: To evaluate the effectiveness of an asthma management program in an HMO setting. DESIGN AND SETTING: Prospective study. Survey data from members who participated in the intervention program and data from members who received usual care were analyzed using propensity score technique. RESULTS: A total of 1,043 asthma patients who responded both baseline and follow-up survey were included in the analysis. From baseline to followup, participants in the in-home intervention program reported significant improvement in functional status (improvements range from 0.2 to 7.2), daily use of steroid inhaler (+4.1%), daily peak flow meter use (+6.4%), self-reported knowledge of what to do for an asthma attack (+12.4%), and feeling that their asthma was under control (+10.8%). Absenteeism (-11.8%) and hospitalization due to asthma (-3.5%) were significantly reduced from baseline to follow-up. Participants did not report significant changes in overuse of beta2-agonists and emergency room visits due to asthma. In comparison with the asthmatic patients who received usual care (non-participants), participants had significantly greater improvement on daily use of steroid inhaler (+4.0% versus -6.0%), daily use of home peak flow meter (+6.4% versus 1.9%) and self-reported knowledge on what to do for an asthma attack (+12.4% versus +5.4%). CONCLUSION: These findings suggest that population-based programs can improve functional status, increase self-monitoring and knowledge about asthma, and decrease absenteeism and hospitalization for asthma by directly providing asthmatic patients with educational materials and self-monitoring tools. Such "direct-to-consumer" outreach programs may help bridge the gap between NAEPs 1991 practice guidelines and the reality of current asthma management.

Absenteeism↗