PubMed HealthSearch

SEARCH · PubMed Health

Results for “Population Programs”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

Selection of high-risk groups for breast cancer screening. Evidence from an Italian multicentric case control study.

In recent years techniques for the selection of risk groups for high priority breast screening have been evaluated. We used data from a large multicentric case control study in Italy, recently published, to fit a reduced logistic model for predictive purposes, using variables which are easily collected. The predicted probability of being a case obtained through the logistic analysis was then used to classify the same set of data by calculating values of sensitivity and specificity at different cutoff points of the predicted probability. The results showed the low predictive power of the model. The selection of higher risk groups in a screening population program is discussed.

Adult

Roentgenographic evidence for predominant left-sided location of unilateral pleural plaques.

The roentgenographic prevalence and anatomic distribution of pleural plaques were studied in the US Navy Asbestos Medical Surveillance Program population (105,064 individuals as of July 17, 1985). "Definite" or "probable" pleural plaques were noted in 4.4 percent of films. These were unilateral in 19.3 percent of roentgenograms with "definite" pleural plaque and 33.9 percent of films with "probable" pleural plaque. Unilateral findings were more often left-sided than right-sided; a ratio of 287:82 in the "definite" group and 625:287 in the "probable" group. Left-sided predominance of unilateral plaque is a consistent and unexplained epidemiologic finding that may provide clues to pleural pathogenesis following asbestos exposure.

Adult

Transmission of leprosy within households.

As part of the leprosy control program, population follow-up studies were carried out during 1962 to 1970 in Gudiyatham Taluk, an administrative unit in South India (population: 400,000). More than 97% of the 23,285 contacts from 5,088 families having a leprosy patient were clinically examined using accepted methodology and confirmed as having or not having leprosy. New cases developing among household contacts of leprosy (secondary attack rates) were determined and studied in relation to characteristics of the index case and that of contacts. The secondary attack rate is defined as the number of new cases discovered in the contacts of leprosy patients per 1,000 person-years, which is equivalent to observing 1,000 persons per year. Nearly two-thirds of all new cases were of the tuberculoid type of leprosy and another one-sixth of indeterminate type. Lepromatous and borderline cases each constituted about ten percent of the total new cases. The total secondary attack rate was 6.8 per 1,000 person-years. Compared to an annual incidence rate of 0.8 per 1,000 in the total population, this incidence rate among the contacts is nearly ten times higher. Such enhanced risks are observed clearly and consistently when studied by the number of patients within a family for both sexes and in various age-groups. The rate for females (6.3 per 1,000 person-year) though less, was not significantly different from that of males (7.1 per 1,000 person-year). The differences observed between males and females for each type of leprosy were also not statistically significant. The risks for children (less than 15 years) are significantly higher than those for adults. Among boys, the maximum risk was observed in the age-group 5-14 years, whereas for females the risk is highest in the age-group 5-9 years, dropping down significantly after that. Furthermore, it was observed that significant differences existed between children and adults only in males but not in females. The secondary attack rates almost doubled when there were multiple index cases in the family. Regardless of the number of index cases, the male-female differences were not statistically significant. Attack rates were significantly enhanced when there was a bacilliferous type of leprosy (lepromatous or borderline) in the family. This was true for the specific attack rates of each type of leprosy too. However, a significantly higher proportion of lepromatous and borderline types is also seen when there is a bacilliferous type of leprosy present. The study reiterates the differences in susceptibility to leprosy among males and females, especially during younger ages. Further immunological studies are necessary to determine the differences in host responses in males and females that produce such a characteristic sex-ratio in prevalence of leprosy. There is still a great need to obtain more data on incidence rates both in general population and among contacts on the basis of prospective observation using acceptable statistical technics in design and analysis.

Adolescent

Relation between aryl hydrocarbon hydroxylase inducibility, serum gamma-glutamyltransferase and serum cholesterol in middle-aged smokers and non-smokers.

Aryl hydrocarbon hydroxylase (AHH) inducibility, carbon monoxide in expired air (CO), serum gammaglutamyl-transferase (GGT), and total cholesterol were compared in equal-sized, age-matched samples of healthy middle-aged males born in 1921, 1934-1936, and 1946 attending the ongoing preventive medical population program in Malmö. AHH did not differ in various age - and smoking or non-smoking groups, and there were no correlations between AHH, GGT, and cholesterol. The findings provide evidence against the recent hypothesis that low cholesterol may mediate or reflect a carcinogenic mechanism through a state of general enzyme induction in the body.

Aryl Hydrocarbon Hydroxylases

A risk factor approach to the alcohol-related diseases.

Alcohol-related disorders belong to the spectrum of major non-infectious diseases in Western societies which are capable of prevention by means that have not yet been fully implemented. The mortality in a population of 10,353 middle-aged males invited to a preventive medical population program in Malmö was assessed for 1.5-6.5 years (mean 4.5 years) after the time of invitation and analysed in relation to participation or non-participation. The characteristics at entry of the 7948 males who participated in screening were compared in order to evaluate risk factor patterns for the major categories of premature death during the follow-up period. Among the non-participants for screening the mortality rate was twice as high, and the death rate due to alcohol-related diseases was five times higher than among the participants. There were no significant differences between participants and non-participants in the other death causes. The autopsy rate was high, at 87.8%. Even in the males participating in the screening, alcohol-related deaths constituted a major mortality category, comprising 55 of 218 cases, whereas cancer comprised 61 and coronary heart disease 50 of the premature deaths in this group. In these three main categories of male premature mortality, significant and distinctly differential risk factor patterns were found. Risk factors for coronary heart disease involved smoking, serum cholesterol, triglycerides and systolic blood pressure, and for alcohol-related deaths involved gamma-glutamyltransferase, an alcoholism screening questionnaire and, inversely, serum cholesterol and serum creatinine. In both groups of diseases, these risk factors could be combined into a highly predictive multiple logistic risk factor function. The discriminative power of this instrument was higher for the alcohol-related deaths than for the coronary heart disease deaths. Malignant and alcohol-related diseases constituted at least equally prominent categories as the cardiovascular disorders among the deaths that occurred within middle age in these cohorts. All of these conditions are potentially avoidable and are associated with significant and distinctive risk factor patterns. Risk factors may be applied to the alcohol-related disorders as signals for preventive measures in analogy with tested methods for the regulation of blood pressure and serum lipids.

Alcoholism

Molecular basis and prenatal diagnosis of beta-thalassemia.

The molecular characterization of mutations producing beta-thalassemia in world populations is nearing completion. We expect that new rare alleles in thoroughly studied groups and other alleles in less studied groups, eg, inhabitants of New Guinea, Latin America, and certain Pacific Islands, will be found. Knowledge of the molecular basis of the disease and new technology that allows rapid detection of single nucleotide changes in genomic DNA have led to the reality of prenatal diagnosis by direct mutation detection even in the heterogeneous US population. Programs aimed at prevention of beta-thalassemia should be facilitated by these developments.

Humans

A cost-based decision analysis for Chlamydia screening in California family planning clinics.

Antibody-based methods for the diagnosis of Chlamydia trachomatis infection of the cervix have recently made population screening programs possible for this epidemic and frequently asymptomatic problem. We constructed a decision model, using medical care costs as utilities, to determine the total costs of screening and of not screening in California state-funded family planning clinics, and to determine the prevalence of infection at which such screening could be expected to pay for itself. A net savings of $6 million would be realized in the first year, with annual savings eventually increasing to over $13 million, from the prevention of chlamydia-associated pelvic inflammatory disease and other long-term sequelae such as tubal infertility and ectopic pregnancy. Over $60 million could be saved in the first five years of such a statewide screening program. In populations with infection prevalence of 2% or more, such screening will pay for itself and can be considered "cost-effective." Screening of asymptomatic women for chlamydia should be carried out in most American family planning clinics.

Chlamydia Infections

Calculation of survival curves and statistical comparison of two censored populations: a computer program in BASIC.

In experimental aging research the handling of censored data imposes a serious problem in the calculation of survival curves of partly censored populations and the statistical comparison of such populations. The presented computer program combines a method to calculate a corrected survival curve and a test to compare two censored populations. In both methods, the proportion of the animals that survive or die during an interval and the number at risk at the start of that interval is used in the calculation of relative survival or death during that interval. The program is written in an elementary BASIC and will run on practically every computer programmable in BASIC. The presented method can be used for testing the difference between survival characteristics of two animal populations but might also be employed in evaluating the effect of a medical treatment.

Aging

A method of planning a dental treatment program for an institutionalized population.

A dental treatment program, for a subnormal group in an institution near London, England, was designed by applying both epidemiologic data and empirically derived data from the Experimental Dental Care Project at The London Hospital Dental School. For the epidemiologic study, a two-examiner system was developed to help overcome the special problems of examining subnormal adults. The data collected in the study had to be flexible enough to allow the analysis of several alternative treatment strategies. Once these alternative treatment strategies were defined, the data from the Experimental Dental Care Project were applied to analyze the effects of using dental teams of varying composition to carry out the treatment. It was found that to meet the dental needs of the group, a team consisting of one dentist, three New Cross auxiliaries and one dental surgery assistant would be 30% less expensive than a traditional team of one dentist and one assistant. This larger team would also be able to complete the necessary initial treatment in less than half the time that the traditional team would require.

Adolescent

Identification of women at increased risk for breast cancer in a population-based screening program.

A multivariate model to assess breast cancer risk was developed by Gail et al. (M. H. Gail, L. A. Brinton, D. B. Byar, D. K. Corle, S. B. Green, C. Schairer, and J. J. Mulvihill, J. Natl. Cancer Inst., 81: 1879-1886, 1989) based on data analysis of the Breast Cancer Detection and Demonstration Project. We evaluated the model's usefulness for assigning women to risk groups for counseling and follow-up by applying it to the 1987 Texas Breast Screening Project data. We identified 3165 women with one or more first-degree relatives affected with breast cancer. The mean risk score for the group was 3.3 (range, 2.7-11.8), indicating a greater than 3-fold elevated risk. The mean risk score for the remaining 27,439 women without affected first-degree relatives was 1.5 (range, 1.24-3.2). Risk perception was found to be a motivator for participation. Women with a risk score greater than 5 perceived themselves to be at high risk for breast cancer. The perception of risk was related to the type of affected first-degree relatives: 80.0% of the women with three affected first-degree relatives and 71.5% of women whose mother and sister were both affected with breast cancer perceived themselves to be at high risk. The Gail model is potentially useful in the clinical setting because women at high risk for breast cancer can be entered into etiological studies, enrolled in primary prevention trials, or referred to programs seeking to improve compliance with screening mammography. The Gail model needs validation, but it is useful for estimating the risk of breast cancer in large populations.

Adult

[Epidemiologic foundation for population studies of program MZ-XVII].

Epidemiological foundation included: aim of studies, knowledge about epidemiology of thyroid disorders in Poland, evaluation of radioiodine dose accumulated in thyroids of inhabitants of different age living in different par of Poland, information about relative diet iodine deficiency in different parts of Poland and identification of research teams (manpower) capable to carry on population studies. The final identification of epidemiological foundation was proceeded by pilot studies performed in 4 different regions of Poland. Finally it was decided that population studies would be performed in so called Regions of 6 different University Medical Schools (Białystok, Kraków, Lódź, Poznań, Szczecin, Wrocław). The sample will be selected randomly on the base of information from the voting lists (random selection of vovoidoship, then towns and villages, then streets and number of houses, then number of flats. All living in selected flat or house during Czernobyl accident and born between January 1974 and December 1985 (children) and between January 1926 and December 1973 (adults) will be considered "the sample". In all cases the sample will be examined by means of unified questionnaire and protocol of medical and laboratory examination. The same kits (of the same producers) will be used to evaluate serum TSH, T4, T3 and thyroid autoantibodies. The data obtained will be evaluated by unified computerized system. Separate studies involved the sample of newborns exposed to radioiodine during last trimester of pregnancy, found to be euthyroid and given potassium iodide in first days of life. Separate system was also used to investigate effect of radioiodine and of prophylactic dose of potassium iodide in those with past history of thyroid disorders.

Adult

Participation in a smoking cessation program: a population-based perspective.

We examined factors associated with participation in an HMO-based, self-help smoking cessation trial by comparing participants with nonparticipating smokers who responded to a prior health survey. Recruitment to the trial was accomplished through the HMO's monthly magazine sent to all enrollee households, and the health survey involved a random sample of the enrollee population. Participants were more likely to be female, older, better educated, and heavier smokers with more attempts to quit in the past. Participants consistently reported poorer levels of health status (self-perceived health and energy, life satisfaction, depression, and symptoms), less healthy lifestyles (exercise and dietary fat), and a greater conviction that smoking cessation would improve how they feel than nonparticipants. These findings confirm previous suggestions that formal cessation programs attract those with a more extensive history of addiction, prior failure, and pathophysiologic effects and may provide clues to increasing motivation among smokers with a greater likelihood of treatment success.

Adult

The effects of a pesticide program on microbial populations from apple leaf litter.

The leaf litter microbial community was quantitatively and qualitatively changed when a standard pesticide schedule that comprised an insecticide, a bactericide, and a fungicide was applied to McIntosh apple trees in the summer. Effects were observed for two winters by four indirect assays and three direct methods. Populations were altered qualitatively both years, but the most striking difference was the quantitative impact from year to year. Bacteria, filamentous fungi, and yeasts from treated leaves were reduced 10- to 10 000-fold between November 1976 and April 1977 and did not recover until snow cover had melted in March. Reductions in 1977-1978 were negligible. The marked seasonal difference is attributed to meteorological influences. Fluorescent pseudomonads were among the bacteria depressed by chemicals. Of the 49 genera of fungi and yeasts isolated, Coniothyrium sp., Penicillium spp., Arthrobotrys spp., and Nodulisporium sp. were appreciably reduced, whereas Typhula spp., Pleurophomella sp., Sporobolomyces spp., and Rhodotorula spp. were substantially enhanced by the spray program.

Azinphosmethyl

[How can the largest possible number of people be reached by a prophylaxis program in a country with a scattered population?].

Two prophylactic programs are described suited to Icelandic conditions: a basic program for the majority of children and youth, and an additional program for individuals who have unusually high caries activities, -called the risk-group. The basic program consists of a) information distributed to groups on diets, including a restricted use of carbohydrates, b) instructions in dental hygiene, c) regular use of fluoride in the form of mouth-wash or tooth-brushing with a fluoride-solution. The additional program aims at individual motivation, explanation of cause and effect and intensive fluorideutilization.

Feeding Behavior

Cytometric characterization and clinical course of breast cancer diagnosed in a population-based screening program.

A randomized controlled trial evaluating mammographic screening was started in two Swedish counties in 1977. In one of these, Ostergötland county, the authors performed static cytofluorometry on 161 cancers detected at the second and third screening rounds, 50 interval cancers, and 219 cancers appearing in the nonscreened control group during the same time period. The median follow-up time was 42 months. No difference in mean S-phase was found between screening and control group cancers, but interval cancers, appearing between two screenings, had increased mean S-phase levels (P = 0.01) compared to both of the other groups. A high S-phase fraction was associated with distant recurrence in both node-negative and node-positive tumors. Aneuploid tumors were more often found in the control group (67%) and among interval cancers (72%) than among screening detected cancers (55%, P = 0.02). In Cox's multivariate analysis, including all patients, the lymph node status, tumor size, estrogen receptor content, and S-phase all contributed independent prognostic information about the clinical course. DNA ploidy predicted the outcome in simple but not in multivariate Cox's analysis. When analyzing screening-detected cancers separately, only the S-phase significantly predicted distant recurrence in multivariate analysis. In tumors with local recurrence, a high S-phase implicated an increased, although not statistically significant, risk for distant recurrence. Survival with metastatic disease was significantly influenced by the S-phase level (P = 0.002). The authors conclude that S-phase fraction provides valuable kinetic information related to the clinical outcome for all stages of the disease and serves as a prognostic factor in screened populations, which have tumors predominantly in early stages.

Adult