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PubMed2007

Amuchina 10% solution, safe antiseptic for preventing infections of exit-site of Tenckhoff catheters, in the pediatric population of a dialysis program.

Although, decreasing in incidence with the disconnection systems, the first complication is still peritonitis in patients with chronic renal failure and the second is infection of Tenckhoff catheter exit-site. All efforts made to diminish the frequency of exit-site infection lower the possibility of peritonitis. The pediatric population is well-known to have a major risk of infectious complications, and making easy and safe the care of the exit-site will prevent the peritonitis that follows. The aim of the study was to evaluate the efficacy of the Amuchina 10% solution vs. pH neutral soap in children with chronic renal failure, on preventing exit-site infection. There were 60 patients who were assigned randomly to one of two groups. One group used Amuchina 10% solution for the daily cleaning of the exit-site, and the other used pH neutral soap, with 14 months of follow-up. Before the study they have to be free of infection for at least 30 days. All were taught by the same nurse how to clean their exit-site. Groups were almost identical in years, sex, and time on dialysis. We had nine infections in the soap group and none in the Amuchina 10% solution group, with an OR: 17 (p = 0.004). From these nine infections, the bacteria isolated were: 4 (13%) were caused by Pseudomona aeruginosa, 1 (3.3%) by Staphylococcus aureus, coagulase-positive staphylococci in 2 (6.6%) and Serratia marcensens in 1 (3.3%). In conclusion, Amuchina 10% solution is effective in preventing infection on the exit-site, without any secondary topical reaction.

Adolescent↗
PubMed2006

Genetic drift and selection effects of modified recurrent full-sib selection programs in two F2 populations of European flint maize.

Selection response of a modified recurrent full-sib (FS) selection scheme conducted in two European flint F(2) maize (Zea mays L.) populations was re-evaluated. Our objectives were to (1) determine the selection response for per se and testcross performance in both populations and (2) separate genetic effects due to selection from those due to random genetic drift. Modified recurrent FS selection was conducted at three locations using an effective population size N(e) = 32 and a selection rate of 25% for a selection index, based on grain yield and grain moisture. Recombination was performed according to a pseudo-factorial mating scheme. Selection response was assessed using a population diallel including the source population and advanced selection cycles, as well as testcrosses with unrelated inbred line testers and the parental F(1) generation. Selection response per cycle was significant for grain yield and grain moisture in both populations. Effects of random genetic drift caused only a small reduction in the selection response. No significant selection response was observed for testcrosses, suggesting that for heterotic traits, such as grain yield, a high frequency of favorable alleles in the elite tester masked the effects of genes segregating in the populations. We conclude that our modified recurrent FS selection is an alternative to other commonly applied intrapopulation recurrent selection schemes, and some of its features may also be useful for increasing the efficiency of interpopulation recurrent selection programs.

Crosses, Genetic↗
PubMed1980

Field test results using the BioPEPR cervical smear prescreening system.

BioPEPR is a cathode ray tube scanning device that has been developed for the prescreening of cervical smears. Cervical samples are collected in suspension, syringed, counted and spread across a microscope slide. Feulgen-Thionine with Congo Red is used as the staining procedure. Fields of 6 X 8 mm are scanned at 1 mu resolution, using an intermediate photographic step. Morphologic parameters of the cells are measured, as called for by a hierarchical decision strategy. Analysis speed is currently about 4 min per smear; improvements of at least a factor of four are expected. A field test of BioPEPR is being undertaken in cooperation with a local population screening program. In the study two smears are made from each woman; the first is prepared according to the Papanicolaou technique while the second is prepared and stained according to the BioPEPR methods. In addition to smears from the population screening program a number of possibly abnormal smears are obtained from several gynecological clinics. To date approximately 3500 "second" smears have been analyzed by the BioPEPR system. The results show a missed positive rate on the order of a few percent (no missed positives were more severe than a slight dysplasia), and a false alarm rate of about 24%. A further analysis of the age distribution of the false alarm rate shows that a large proportion came from women above the age of 50; the false alarm rate is about 20% for women under the age of 50.

Adult↗
PubMed2006

Cross-sectional comparison of an automated hybrid capture 2 assay and the consensus GP5+/6+ PCR method in a population-based cervical screening program.

In this cross-sectional study, clinical performances of the hybrid capture 2 assay using an automated instrument (i.e., rapid capture system) (hc2-RCS) and the high-risk human papillomavirus GP5+/6+ PCR-enzyme immunoassay (EIA) test were compared using cervical scrape specimens from 8,132 women that participated in a population-based screening trial. The hc2-RCS test scored significantly more samples positive (6.8%) than the GP5+/6+ PCR-EIA (4.8%) (P < 0.0005). This could be attributed largely to a higher positivity rate by the hc2-RCS test for women with cytologically normal, borderline, or mild dyskaryosis. A receiver operator characteristics analysis of the semiquantitative hc2-RCS results in relation to different cytology categories revealed that these differences are owing to differences in assay thresholds. For women classified as having moderate dyskaryosis or worse who also had underlying histologically confirmed cervical intraepithelial neoplasia grade 3 or cervical cancer (> or =CIN3), the hc2-RCS scored 97% (31/32) of samples positive, versus 91% (29/32) by GP5+/6+ PCR-EIA. However, this difference was not significant (P = 0.25). After increasing the hc2-RCS cutoff from 1.0 to 2.0 relative light units/cutoff value of the HPV16 calibrator (RLU/CO), no additional CIN3 lesions were missed by hc2-RCS, but the number of test-positive women with normal, borderline, or mild dyskaryosis was significantly decreased (P < 0.0005). However, at this RLU/CO, the difference in test positivity between hc2-RCS and the GP5+/6+ PCR-EIA was still significant (P = 0.02). The use of an RLU/CO value of 3.0 revealed no significant difference between hc2-RCS and GP5+/6+ PCR-EIA results, and equal numbers of smears classified as > or =CIN3 (i.e., 29/32) were detected by both methods. In summary, both assays perform very well for the detection of >or =CIN3 in a population-based cervical screening setting. However, adjustment of the hc2-RCS threshold to an RLU/CO value of 2.0 or 3.0 seems to produce an improved balance between the clinical sensitivity and specificity for > or =CIN3 in population-based cervical screening.

Automation↗
PubMed2002

Community-based organizations and HIV prevention for incarcerated populations: three HIV prevention program models.

Inevitably, challenges result from the disconnect between the objectives of correctional facilities, which are safety and conformity, and community-based organizations (CBOs), whose primary function is to provide inmates with primary and secondary HIV prevention and information. This is cause for concern because prisons have a high potential for serving as a reservoir for HIV transmission. CBOs, when accessible, may be the only source of HIV/AIDS prevention, education, and information for incarcerated populations. People living with HIV/AIDS in correctional settings face unique challenges. Among other populations, condoms and bleach kits have been successful in reducing HIV transmission. However, because these prevention tools are not available to incarcerated populations, new HIV prevention strategies are needed. This article focuses on successful intervention practices such as peer-led education and discharge planning services that have been essential components of HIV prevention and provides a context for operating such programs within correctional facilities. The article also highlights the challenges CBOs encounter in providing HIV prevention in various correctional institutions throughout the United States.

Case Management↗
PubMed1997

Understanding the variability in the effectiveness of community heart health programs: a meta-analysis.

Over the past 25 years, community interventions to reduce cardiovascular disease (CVD) have been conducted around the world with very mixed results. This study uses meta-analysis to assess whether the variation in the observed effectiveness of community heart health programs (CHHP) is related to characteristics of the intervention program, the population under study, or the evaluation methods. A CHHP is defined as any primary prevention program that attempted to reduce the population burden of CVD by shifting the distribution of risk factors in a general population. To be included in the meta-analysis, a study must have utilized a reference group in the evaluation, employed a repeated independent cross-sectional measurement design, and reported sufficient outcome information for at least one of four major risk factors: smoking, total cholesterol, blood pressure, and body weight. Results of these studies are summarized with the effect size measure (Yi1-Yi2)-(Yr1-Yr2)Sr1 where Y = outcome measure, S = standard deviation of the outcome measure, 1 = baseline, 2 = follow-up. i = intervention, and r = reference community. This measure, which reports the net change in the intervention group in terms of the variability in the reference population before the start of the intervention, permits comparison across different outcome measures and facilitates the aggregation of effects across studies. Generalized least squares regression, which permits the incorporation of multiple, dependent effect sizes from a single study, was used to assess the impact of characteristics of the intervention (prevention strategy, type of mass communication, community organization, and environmental change), the population (setting, gender, year of follow-up measurement), and the evaluation design and implementation (the number of communities, matching of communities, the follow-up time, the response rate, and covariate adjustment in the analysis) on the effect sizes. The results of this analysis suggest that the characteristics of the evaluation method account for much of the heterogeneity in the outcome of CHHPs, though some intervention characteristics also play a role.

Blood Pressure↗
PubMed2005

Ten years of breast screening in the Nova Scotia Breast Screening Program, 1991-2001. experience: use of an adaptable stereotactic device in the diagnosis of screening-detected abnormalities.

OBJECTIVE: To evaluate and present 10-year outcomes of the Nova Scotia Breast Screening Program (NSBSP), a population-based screening program in the province of Nova Scotia, Canada, total population 900 000. SETTING: Organized Breast Screening Program in Nova Scotia, Canada. METHODS: Rates of participation, abnormal referrals, cancer detection rates, and benign:malignant (B:M) rates for core biopsy and surgical biopsy were calculated for asymptomatic women receiving a mammogram through the NSBSP 1991-2001. RESULTS: Of 192 454 mammograms performed on 71 317 women, 33% were aged 40 to 49 years, 39% aged 50 to 59 years, 23% aged 60 to 69 years, and 5% aged 70 years and over. Cancer detection rate increased in each age group respectively: 3.7, 5.8, 9.7, and 13.5 per 1000 population on first-time screens. The positive predictive value of an abnormal screen increased with increasing age groups. Benign breast surgery decreased with increased use of needle core breast biopsy (NCBB). Open surgery decreased from 25 to 6 surgeries per 1000 screens. Of 1519 open surgical procedures (1328 women), 878 cancers were removed, with 37% 10 mm or less, and 61% 15 mm or less. In 613 women in whom the node status was assessed, 79% were negative. CONCLUSION: A quality screening program incorporating NCBB in the diagnostic work-up is effective in the early detection of breast cancer and results in less open surgery, particularly in younger women.

Adult↗
PubMed1975

The use-effectiveness of two contraceptive methods in a Navajo population: the problem of program dropouts.

Navajo Indian intrauterine contraceptive device (IUD) and oral contraceptive users between 1966 and 1971 were followed up to estimate life table rates of complications and continuation. Because of high rates of dropping out, 41.6 per cent of 291 oral contraceptive users and 18.2 per cent of 534 IUD users, a 26 per cent sample survey of the dropout population was used to collate the dropout population data into the life table analysis. Estimates of the IUD continuation rates for one, two, and three years are similar to rates published elsewhere; however, continuation rates for the oral contraceptive are clearly lower than those for other populations, which only 33 per cent continuing after one year, 23 per cent after two years, and 12 per cent after three years. The IUD user is two to three times more successful than the oral contraceptive user in this population.

Adolescent↗
PubMedDate not supplied

Dental disease preventive programs in a rural Appalachian population.

The objective of the dental disease prevention and early intervention program at Youngstown State University is to 1) educate future dental hygienists on the provision of primary care in a non-traditional dental care setting and 2) provide access to preventive and simple restorative care for an underserved rural Appalachian population. Through their education in dental public health courses, students are prepared to provide preventive oral healthcare services to underserved populations in non-traditional clinical settings. Senior dental hygiene students in the dental public health course sequence work in pairs, along with a supervising dentist using a mobile dental unit at the Child and Family Health Services Clinic in Lisbon, Ohio. Ninety-eight hours of preventive oral health services and simple restorative care were provided in 1996. Student evaluations of the overall extramural clinical experience were positive. The program is an example of a collaborative community-based approach to meet the oral health needs of low-income families.

Adolescent↗
PubMedDate not supplied

Population-based dementia screening program in Kuopio: the effect of education, age, and sex on brief neuropsychological tests.

A neuropsychological screening battery including the Mini-Mental State Examination and four other brief cognitive tests (Russell's Adaptation of the Visual Reproduction Test, Trail Making Test, Verbal Fluency Tests on letters and category, and the Buschke Selective Reminding Test) was administered to a randomly selected population sample of 403 subjects aged 68 to 77 years to evaluate the effect of education, age, and sex on test scores. The difference in neuropsychological screening tests between various education groups (3 years or less, 4 to 6 years, 7 years or more) was statistically highly significant, even after the adjustment for the effect of age. The subscores and total scores were lowest in the minimal education group on every neuropsychological test. Education correlated more strongly than age with all neuropsychological test scores and subscores. The effect of sex on test results was seen only in some subscores of brief neuropsychological tests but not in a single item of the Mini-Mental State Examination. On the basis of our results, the effects of education, age, and sex have to be evaluated before using brief neuropsychological tests in population-based dementia screening.

Age Factors↗
PubMedDate not supplied

Enhancing the effectiveness of HIV/AIDS prevention programs targeted to unique population groups in Thailand: lessons learned from applying concepts of diffusion of innovation and social marketing.

Diffusion of innovations theory and social marketing theory have been criticized for their limited applicability in influencing unique population groups (e.g., female commercial sex workers (CSWs) working in low-class brothels). This study investigated the applicability of these two theoretical frameworks in outreach efforts directed to unique populations at high risk for HIV/AIDS in Bangkok, Thailand. Further, this study examined Thai cultural characteristics that influence communication about HIV/AIDS prevention. The results suggest that certain concepts and strategies drawn from the two frameworks were used more or less by effective outreach programs, providing several policy-relevant lessons. Cultural constraints, such as the lack of visibility of the disease and traditional sexual practices, influenced communication about HIV/AIDS prevention.

Adolescent↗
PubMed1980

Effects of two simulated semen culling programs on predicted fertility in an artificially inseminated cow population.

Two semen culling programs designed to improve fertility of semen used in an artificial insemination program were compared. First inseminations and return service data on cows inseminated with semen from 21 Holstein bulls during 1 yr were studied. The culling of less fertile ejaculates within bulls, based on any available semen quality test or combination of tests, would bring about less than a 1% increase in nonreturn rate if 40 to 50% of ejaculates were called. If all semen from the 19% low fertility bulls were culled, this would entail culling 22% of the semen used to inseminate the population and would achieve an improvement of 1% in overall fertility. This could be done with no loss in predicted difference for milk yield of bulls used. Culling of bulls is a functionally simpler and less expensive program than is testing and culling ejaculates within bulls, but this requires that fertility of bulls be known and that it will not change substantially from predicted.

Animals↗