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At least 613 records · Page 34Linked to original sources
PubMed1995

Thymic nurse cell rescue of early CD4+CD8+ thymocytes from apoptosis.

We have now developed temperature sensitive lines of thymic nurse cells (TNCs), using the SV40 viral mutant tsA58, that maintain the ability to selectively internalize a subpopulation of alpha beta TCR+CD4+CD8+ thymocytes in vitro. One line, tsTNC-1, was shown to be able to rescue a subset of CD4+CD8+ thymocytes from programmed cell death at 32 degrees C, the temperature at which binding and internalization were detected. Rescue was significantly diminished at 38 degrees C, the temperature at which thymocyte binding was not observed. The rescued population of thymocytes showed a reduced level of apoptosis as measured by the DNA fragmentation assay. TNC rescue resulted in a shift of CD4+CD8+ thymocytes from immature TCRlow PNArhigh cells to the more mature TCRint PNArlow phenotype but no changes in cell surface levels of HSA nor CD69 were detected. The rescue activity of tsTNC-1 cells at 32 degrees C was significantly reduced with the addition of antibodies to either class I or class II MHC antigens. These results suggest that we have established TNC lines, using the SV40 viral mutant tsA58, that have the ability to rescue a subset of the TNC interactive thymocyte population from programmed cell death. The thymocyte population rescued by TNCs matures to a phenotype within the double positive stage of development that is indicative of positive selection.

Animals↗
PubMed2004

Population pharmacokinetic modelling of tramadol with application of the NPEM algorithms.

BACKGROUND AND OBJECTIVE: Although the kinetic behaviour of tramadol has been described, the present study is the first to our knowledge, to report specifically on the population pharmacokinetic modelling of tramadol hydrochloride. METHODS: The parametric Iterative Two-stage Bayesian Population Model (IT2B) program followed by the Non-parametric Expectation Maximization Population Model (NPEM2) program was used to determine population pharmacokinetic parameter values of tramadol in 138 postoperative orthopaedic Malaysian patients. All patients had received a 100 mg intravenous dose of tramadol, infused over 2-3 min, as their first postoperative analgesic. Blood was sampled at 0 min and subsequently at 15, 30 min, 1, 2, 4, 8, 16, 20 and 24 h for serum tramadol high-performance liquid chromatography analysis. RESULTS AND DISCUSSION: The one-compartmental model pharmacokinetic parameters--volume of distribution (Vd), elimination rate constant (kel) and the total clearance rates (ClT)--found were: mean Vd = 167.6 +/- 63.84 L; median Vd = 161.48 L; mean kel = 0.1241 +/- 0.056 h(-1); median kel = 0.1138 h(-1); ClT = 19.57 +/- 9.51 L/h; median ClT =18.12 L/h. The interindividual coefficient of variation of ClT (48.56%) was higher than that of Vd (38.09%), indicating the presence of other possible influencing factors on tramadol's ClT such as CYP2D6 polymorphism, gender and age. Overall, NPEM2 suggested more diversity in the population than did IT2B.

Adolescent↗
PubMed1989

Cost-effectiveness index (CEI): a tool to help evaluate mental health programs.

A method for evaluating the cost-effectiveness of mental health programs is presented. The method takes into account the profile of mental health services a patient receives, the frequency of each service and the relative costs of each service in relation to the change in a patient's clinical condition between entrance into and release from a treatment program. It can also be used to assess change over a specified time period. An example compares the cost-effectiveness index (CEI) for similar cohorts of schizophrenia patients treated in two 24-hour acute care psychiatric systems. The CEI can use either actual dollar costs, if known, or a relative value scale associated with different services. Its utility and weaknesses are discussed. The CEI is designed to alert management to differences in the relative cost-effectiveness of programs serving populations of similar patients. Identification of such differences can contribute to improvement in program functioning.

Activities of Daily Living↗
PubMed1997

Population control I: Birth of an ideology.

Population control, as a major international development strategy, is a relatively recent phenomenon. However, its origins reach back to social currents in the 19th and early 20th centuries, culminating in an organized birth control movement in Europe and the United States. The conflicts and contradictions in that movement's history presage many of today's debates over population policy and women's rights. Eugenics had a deep influence on the U.S. birth control movement in the first half of the 20th century. After World War II private agencies and foundations played an important role in legitimizing population control as a way to secure Western control over Third World resources and stem political instability. In the late 1960s the U.S. government became a major funder of population control programs overseas and built multilateral support through establishment of the U.N. Fund for Population Activities. At the 1974 World Population Conference, Third World governments challenged the primacy of population control. While their critique led population agencies to change their strategies, population control remained a central component of international development and national security policies in the United States.

Eugenics↗
PubMedDate not supplied

[Analysis of the indicators of natural trends in the population of the Tatarstan Republic in the years 1994-1998].

A stable tendency to a lower reproduction of population during the studied period has been detected in Tatarstan, both for the entire Republic and for the urban and rural population separately. Coefficients of natural increment of population differed in the regions and some cities of the Republic and varied during the studied period. Negative time course of the natural increment of population is explained by drop of birth rate, increased mortality, and decreased number of new married couples per 1000 in the Republic in general and among the urban and rural population separately. These data are important for evaluating the health status of the population in Tatarstan and can be used for validating regional goal-oriented programs for population health protection.

Adult↗
PubMed1994

Nutritional influences on linear growth: a general review.

The first section of this paper reviews what is known about the roles of specific nutrients in the general linear growth faltering that occurs in developing countries. Those reviewed are energy, protein, zinc, iron, copper, iodine and vitamin A. For none of these nutrients was there clear, consistent evidence that supplementation with the nutrient benefited linear growth. Rather, interventions with each specific nutrient had a positive effect on length gain in some studies, while in others these affected only weight gain or had no effect. Reasons for these conflicting results are suggested, including the strong probability that growth is limited by multiple, simultaneous deficiencies in many populations. This point is illustrated with data from the Nutrition Collaborative Research Support Program (CRSP) and other reports. Most interventions with single nutrients have been tested on children older than the age when linear growth faltering is most rapid, that is, within a few months of birth. Possible reasons why growth stunting begins so early in life are presented, but these are mostly hypothetical because of the paucity of information on this topic.

Body Height↗
PubMed2003

An oral health promotion program for an urban minority population of preschool children.

The objective of this project was to design, implement and evaluate an oral health promotion program for inner-city Vietnamese preschool children in Vancouver, British Columbia, Canada. The project comprised of four general phases: information-gathering, project planning, project implementation, and project evaluation. The information-gathering phase of the project demonstrated extensive tooth decay in young children, bottle use during the day and during sleep-time long past recommended weaning age, and a belief of many parents that primary teeth were not important. Based on this information, the project planning committee designed a program that featured one-to-one counseling supported by community-wide activities. A Vietnamese lay health counselor provided counseling to mothers with telephone follow-up that coincided with scheduled infant immunization visits to a twice-monthly Child Health Clinic for Vietnamese families. At all the follow-up assessment clinics scheduled over the 7-year duration of this continuing project, mothers who had had more than one counseling visit reported significantly less use of sleep-time and daytime bottles for their children, and their children demonstrated significantly reduced prevalence of caries compared to similarly aged children at baseline. One-to-one counseling with regular follow-up provided by a lay person of similar background and culture to the participants is an effective way to facilitate adoption of healthy behaviors and to improve oral health of children.

Attitude to Health↗
PubMedDate not supplied

A comprehensive 30-month preventive dental health program in a pre-adolescent population with Down's syndrome: a longitudinal study.

A comprehensive systematic preventive dental health program was implemented in a young population with Down's Syndrome during a 30-month period. Twenty children (nine boys and 11 girls), ages 8-13 (mean age, 11), participated in the study, which took place in three hostel-like apartments. The main goals of this program were to achieve good plaque control and subsequently prevent periodontal disease as well as to apply fissure sealants and fluorides in an attempt to prevent dental caries. The mean plaque and gingival indices as well as the percentage of bleeding sites decreased significantly (P < 0.01) following the administration of our oral health program. Caries experience, as indicated by DMFS, decreased from 1-35 to 1-05 surfaces per child, and the use of fissure sealants to prevent occlusal caries was proved to be 100% effective. It is concluded that if the children's efforts are integrated with those of a motivated dentist, dental hygienist, and staff, a well-planned preventive dental health program can lead to a high degree of success in the prevention of dental diseases in young populations with Down's Syndrome.

Adolescent↗
PubMed2000

Diphtheria in the Russian Federation in the 1990s.

A resurgence of diphtheria spread throughout the Russian Federation in the early 1990s; diphtheria had been well controlled, but circulation of toxigenic strains of Corynebacterium diphtheriae had persisted since the implementation of universal childhood vaccination in the late 1950s. More than 115,000 cases and 3,000 deaths were reported from 1990 to 1997, and, in contrast to the situation in the prevaccine era, most of the cases and deaths occurred among adults. Contributing factors included the accumulation of susceptible individuals among both adults and children and probably the introduction of new strains of C. diphtheriae. Vaccine quality, vaccine supply, or access to vaccine providers did not significantly contribute to the epidemic. Mass vaccination of adults and improved childhood immunization controlled the epidemic. High levels of population immunity, especially among children, will be needed to prevent and control similar outbreaks in the future.

Adolescent↗
PubMed1998

Awareness of cancer-related programs and services among rural African Americans.

African Americans are at increased risk for cancer and represent an important target population for programs such as Healthy People 2000, the Cancer Information Service (CIS), and the 5 a Day for Better Health Initiative. Yet, awareness of such programs among rural blacks is unknown. This study assessed awareness of these programs and determined related knowledge and beliefs among rural African Americans. It was undertaken as part of the baseline survey for the Black Churches United for Better Health project, a National Cancer Institute-funded initiative. A minority of respondents (n = 3737) demonstrated name recognition of Healthy People 2000 (23.4%), the CIS (42.4%), and the 5 a Day Program (40.7%). Far fewer (7.4%) were able to correctly identify the recommended daily number of servings of fruits and vegetables. Reported family history of cancer was associated with a greater tendency believe that eating more fruits and vegetables can prevent disease. These findings underscore the need for efforts to reach the rural black community with culturally sensitive and stage appropriate cancer prevention messages. Knowledge of family history of cancer may play an important role in targeting subgroups and delivering effective cancer prevention messages.

Black or African American↗
PubMed1986

Poverty and social welfare: an agenda for change.

Actions to reduce the federal deficit in recent years threaten to strand the economically and socially disadvantaged while maintaining generous subsidy programs for populations with little or no financial need. This situation has been brought about in large part because of government's inherent reluctance to scale down programs that are politically popular even if no longer affordable or, in the long run, appropriate. The authors suggest that realistic and responsible social welfare policy reform requires that no sector of the federal budget be exempt from review or change. In the area of health, the importance of reshaping programs such as Medicare and Medicaid and disaggregating trends to focus more on populations with legitimate unmet needs is underscored. The authors make a number of suggestions on how existing social welfare programs can be better targeted.

Adolescent↗
PubMed2002

Genetic relationships of American alligator populations distributed across different ecological and geographic scales.

Although much work has been conducted on coastal populations of the American alligator (Alligator mississippiensis), less is known about the population dynamics and genetic structure of populations of alligators confined to inland habitats. DNA microsatellite loci, derived from the American alligator, were used to investigate patterns of genetic variation within and between populations of alligators distributed at coastal and inland localities in Texas. These data were used to evaluate the genetic discreteness of different alligator stocks relative to their basic ecology at these sites. Observed mean heterozygosities across seven loci for both coastal and inland populations ranged from 0.50-0.61, with both inland and coastal populations revealing similar patterns of variation. Measures of F(st) revealed significant population differentiation among all populations; however, analyses of molecular variance (AMOVAs) failed to demonstrate any apparent geographic pattern relative to the population differentiation indicated by F(st) values. Each population contained unique alleles for at least one locus. Additionally, assignment tests based on the distribution of genotypes placed 76% of individuals to their source population. These genetic data suggest considerable subdivision among alligator populations, possibly influenced by demographic and life history differences as well as barriers to dispersal. These results have clear implications for management. Rather than managing alligators in Texas as a single panmictic population, translocation programs and harvest quotas should consider the ecological and genetic distinctiveness of local alligator populations.

Alligators and Crocodiles↗
PubMed2005

Randomized trial of the Early Start program of home visitation.

OBJECTIVE: To evaluate the extent to which a program of home visitation (Early Start), targeted at families who are facing stress and difficulty, had beneficial consequences for child health, preschool education, service utilization, parenting, child abuse and neglect, and behavioral adjustment. METHODS: The study used a randomized, controlled trial design in which 220 families who were participating in the Early Start program were contrasted with a control series of 223 families who were not participating in the program. Families were enrolled in the program after population screening that was conducted by community health nurses. Families were enrolled in the program for up to 36 months. Outcomes were assessed at 6, 12, 24, and 36 months after trial entry. RESULTS: Families in the Early Start series received a mean of 24 months of service. Comparisons between the Early Start and control series over the 36-month follow-up period revealed that families in the Early Start program showed significant benefits in the areas of improved utilization of child health services, reduced rates of hospital attendance for injury/poisoning, increased preschool education, increased positive and nonpunitive parenting, reduced rates of severe parent/child assaults, and reduced rates of early problem behaviors. Effect sizes (Cohen's "d") were found to be in the small to moderate range, with d ranging from .03 to .31 (median: .22). CONCLUSIONS: The Early Start program was associated with small to moderate benefits in a wide range of areas relating to child health, preschool education, parenting, child abuse, and early behavioral adjustment. Comparisons with other studies are made, and threats to validity are considered.

Adolescent↗
PubMedDate not supplied

Case management for the subacute patient in a skilled nursing facility.

The goal of case management has always been to manage care, cost, and outcomes. The Balanced Budget Act of 1997 and the subsequent implementation of managed care and the prospective payment system have introduced many challenges to the postacute care delivery system. The implementation of sound clinical, fiscal, and operational strategies is critical to the continued delivery of quality services and the maximization of revenue. The implementation of case management principles provides an opportunity to balance care with cost. This article focuses on the development and implementation of a case management program at a skilled nursing facility that specifically addresses the needs of a subacute population. The program's purpose is to promote efficiency, efficacy, and effectiveness of services for short-term subacute patients who will eventually return to the community. The long-term goal of the program is to classify all patients into case management categories and assign them to RN case managers or social workers, based on acuity and need.

Case Management↗
PubMedDate not supplied

HRSA's collaborative efforts with national organizations to expand primary care for the medically underserved.

As the Federal agency that provides leadership in expanding access to primary health care, the Health Resources and Services Administration (HRSA) manages some 50 programs directed toward the delivery of services and strengthening the base of national health resources. An enabling element of the agency's strategy is the expansion of partnerships with national associations, private foundations, and other entities that share a concern for the health care of the medically underserved. Cooperative efforts with national organizations are intended to promote the integration of public and private resources and encourage adoption of efficient approaches to organizing and financing health care. Medical education in the primary care specialties, State programs for women and children, involvement of managed care organizations with low-income populations, and programs concerning the uninsured are the foci of some of these collaborative relationships.

Child↗
PubMed2006

Trends in brain cancer incidence and survival in the United States: Surveillance, Epidemiology, and End Results Program, 1973 to 2001.

OBJECT: An increasing incidence of brain cancer has been reported for the last three decades. In this study of brain cancer incidence and patient survival in the US, the authors attempt to update information on trends by examining data provided by the Surveillance, Epidemiology, and End Results (SEER) Program. METHODS: Population-based data from the SEER Program were used to calculate the incidence of and survival rates for people with brain cancer. The approximate Poisson method was used to calculate relative risks for brain cancer and to determine a 95% confidence interval. Annual age-standardized incidence rates were calculated, and time-trend analysis was conducted using joinpoint regression analysis. The relative risks of brain cancer were 1.48 for men compared with women, 3.18 for elderly persons compared with young adults, 1.86 for Caucasian patients compared with African-American patients, and 1.35 for those in metropolitan counties compared with those in nonmetropolitan counties. The incidence of brain cancer increased until 1987, when the annual percentage of change reversed direction, decreasing from 1.68 to 20.44%. The elderly experienced an increase until 1985, but their rates were stable thereafter. Rising trends were noticed for glioblastoma multiforme (GBM), oligodendroglioma, anaplastic astrocytoma, medulloblastoma, and mixed glioma, and falling trends were observed for astrocytoma not otherwise specified and malignant glioma. The survival rate for patients with GBM has not shown improvement in the last two decades. CONCLUSIONS: Increased risk of brain cancer is associated with being male, Caucasian, elderly, and residing in a metropolitan county. The incidence rate of brain cancer in the US is gradually declining, but the rising trend of GBM combined with its poor survival rate is disconcerting and needs further exploration.

Adult↗
PubMedDate not supplied

Transitions from AFDC to SSI before welfare reform.

The Supplemental Security Income (SSI) and Aid to Families with Dependent Children (AFDC) programs serve populations with similar characteristics. SSI serves adults and children with disabilities who are in low-income families, and AFDC serves low-income families with children. Because of that overlap, policy changes in one program can affect the other. In 1996, Congress enacted the Personal Responsibility and Work Opportunity Reconciliation Act, which transformed AFDC into the Temporary Assistance for Needy Families (TANF) program. Many people have expected that implementing that welfare reform legislation would eventually increase SSI participation, for two reasons. First, TANF includes new work requirements and time limits that induce more AFDC/TANF recipients with disabilities to obtain SSI benefits. Second, the change in the funding mechanism--from open-ended funding on a matching basis for AFDC to cash assistance block grants for TANF--gives states a stronger incentive to shift welfare recipients to SSI. This article examines the interaction between the SSI and AFDC programs in the prereform period (1990 to 1996) and discusses the potential implications of welfare reform on that interaction. Using matched data from the Survey of Income and Program Participation and Social Security Administration (SSA) records, our analysis focuses on how the interaction of those programs affects young women (aged 18 to 40) and children (aged 0 to 17). We find a very strong link between AFDC and SSI for young women and children. Significant portions of young female and child SSI beneficiaries in the 1990-1993 period were in AFDC families or had received AFDC in the past. In addition, a substantial share of young women and children who received AFDC during that period eventually entered SSI. Because the SSI program is now serving a much larger population of families with young women and children than in the past, SSA might need to develop policies to better serve that group. The findings also suggest that the prereform period is a poor baseline against which to measure the impact of TANF, primarily because of the instability in programs and policies.

Adolescent↗