WorldWideScience

Sample records for carrier screening program

  1. Involving consumers in the development of an educational program for cystic fibrosis carrier screening.

    Science.gov (United States)

    Myers, M F; Bernhardt, B A; Tambor, E S; Holtzman, N A

    1994-04-01

    Input from consumers of health care was sought in developing an educational program to be provided to individuals who are considering carrier testing for cystic fibrosis (CF). In addition, we assessed the ability of health professionals to predict consumers' priorities with regard to such information. A focus group of six middle school teachers formulated questions that they would ask in trying to decide whether they wanted carrier screening for CF. Then, other adults with (n = 39) and without (n = 60) a family history of CF were presented with the questions and were asked to select the questions in the order in which they would want them answered if offered the carrier test. After each question was answered, they were asked whether they would want the carrier test if it were offered to them. CF clinic staff, clinical geneticists, and genetic counselors (n = 31) were asked to select the questions in the order in which they believed that an adult from the general population would want them answered. There were no differences in the order in which adults with and without a family history of CF would want questions answered. Consumers would want to learn about the carrier test as well as their risk of being a carrier and of having a child with CF, before receiving information on reproductive options and the effect that a child with CF would have on the family. Of the 44% of consumers who changed their mind about wanting screening during the course of selecting questions, 52% did so after the first question that they selected.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. The frequency of Tay-Sachs disease causing mutations in the Brazilian Jewish population justifies a carrier screening program

    Directory of Open Access Journals (Sweden)

    Roberto Rozenberg

    Full Text Available CONTEXT: Tay-Sachs disease is an autosomal recessive disease characterized by progressive neurologic degeneration, fatal in early childhood. In the Ashkenazi Jewish population the disease incidence is about 1 in every 3,500 newborns and the carrier frequency is 1 in every 29 individuals. Carrier screening programs for Tay-Sachs disease have reduced disease incidence by 90% in high-risk populations in several countries. The Brazilian Jewish population is estimated at 90,000 individuals. Currently, there is no screening program for Tay-Sachs disease in this population. OBJECTIVE: To evaluate the importance of a Tay-Sachs disease carrier screening program in the Brazilian Jewish population by determining the frequency of heterozygotes and the acceptance of the program by the community. SETTING: Laboratory of Molecular Genetics - Institute of Biosciences - Universidade de São Paulo. PARTICIPANTS: 581 senior students from selected Jewish high schools. PROCEDURE: Molecular analysis of Tay-Sachs disease causing mutations by PCR amplification of genomic DNA, followed by restriction enzyme digestion. RESULTS: Among 581 students that attended educational classes, 404 (70% elected to be tested for Tay-Sachs disease mutations. Of these, approximately 65% were of Ashkenazi Jewish origin. Eight carriers were detected corresponding to a carrier frequency of 1 in every 33 individuals in the Ashkenazi Jewish fraction of the sample. CONCLUSION: The frequency of Tay-Sachs disease carriers among the Ashkenazi Jewish population of Brazil is similar to that of other countries where carrier screening programs have led to a significant decrease in disease incidence. Therefore, it is justifiable to implement a Tay-Sachs disease carrier screening program for the Brazilian Jewish population.

  3. Twenty-year outcome analysis of genetic screening programs for Tay-Sachs and beta-thalassemia disease carriers in high schools.

    Science.gov (United States)

    Mitchell, J. J.; Capua, A.; Clow, C.; Scriver, C. R.

    1996-01-01

    Programs for education, screening, and counseling of senior-high-school students, in populations at high risk for Tay-Sachs and beta-thalassemia diseases, have existed for >20 years in Montreal. Four process and outcome variables are reported here: (i) voluntary participation rates in the high-school cohort; (ii) uptake rates for the screening test; (iii) origin of carrier couples seeking the prenatal diagnosis option in the programs; and (iv) change in incidence of the two diseases. Between 1972 and 1992, we screened 14,844 Ashkenazi-Jewish students, identified 521 HexA-deficient carriers (frequency 1:28), reached 89% of the demographic cohort in the educational component of the program, and achieved 67% voluntary participation in the subsequent screening phase. The corresponding data for the beta-thalassemia program are 25,274 students (mainly of Mediterranean origin) representing 67% of the cohort with 61% voluntary participation in the screening phase (693 carriers; frequency 1:36). From demographic data, we deduce that virtually all the carriers identified in the high-school screening program remembered their status, had their partner tested if they did not already know they were a carrier couple, and took up the options for reproductive counseling/prenatal diagnosis. In Montreal, the current origin of all couples using prenatal diagnosis for Tay-Sachs and beta-thalassemia diseases is the corresponding genetic screening/testing program, whereas, at the beginning of the programs, it was always because there was a history of an affected person in the family. Incidence of the two diseases has fallen by 90%-95% over 20 years; the rare new cases are born (with two exceptions) outside the target communities or to nonscreened couples. PMID:8808593

  4. Twenty-year outcome analysis of genetic screening programs for Tay-Sachs and beta-thalassemia disease carriers in high schools.

    OpenAIRE

    Mitchell, J. J.; Capua, A.; Clow, C.; Scriver, C. R.

    1996-01-01

    Programs for education, screening, and counseling of senior-high-school students, in populations at high risk for Tay-Sachs and beta-thalassemia diseases, have existed for >20 years in Montreal. Four process and outcome variables are reported here: (i) voluntary participation rates in the high-school cohort; (ii) uptake rates for the screening test; (iii) origin of carrier couples seeking the prenatal diagnosis option in the programs; and (iv) change in incidence of the two diseases. Between ...

  5. Multimedia messages in genetics: design, development, and evaluation of a computer-based instructional resource for secondary school students in a Tay Sachs disease carrier screening program.

    Science.gov (United States)

    Gason, Alexandra A; Aitken, MaryAnne; Delatycki, Martin B; Sheffield, Edith; Metcalfe, Sylvia A

    2004-01-01

    Tay Sachs disease is a recessively inherited neurodegenerative disorder, for which carrier screening programs exist worldwide. Education for those offered a screening test is essential in facilitating informed decision-making. In Melbourne, Australia, we have designed, developed, and evaluated a computer-based instructional resource for use in the Tay Sachs disease carrier screening program for secondary school students attending Jewish schools. The resource entitled "Genetics in the Community: Tay Sachs disease" was designed on a platform of educational learning theory. The development of the resource included formative evaluation using qualitative data analysis supported by descriptive quantitative data. The final resource was evaluated within the screening program and compared with the standard oral presentation using a questionnaire. Knowledge outcomes were measured both before and after either of the educational formats. Data from the formative evaluation were used to refine the content and functionality of the final resource. The questionnaire evaluation of 302 students over two years showed the multimedia resource to be equally effective as an oral educational presentation in facilitating participants' knowledge construction. The resource offers a large number of potential benefits, which are not limited to the Tay Sachs disease carrier screening program setting, such as delivery of a consistent educational message, short delivery time, and minimum financial and resource commitment. This article outlines the value of considering educational theory and describes the process of multimedia development providing a framework that may be of value when designing genetics multimedia resources in general.

  6. The impact of a national population carrier screening program on cystic fibrosis birth rate and age at diagnosis: Implications for newborn screening.

    Science.gov (United States)

    Stafler, Patrick; Mei-Zahav, Meir; Wilschanski, Michael; Mussaffi, Huda; Efrati, Ori; Lavie, Moran; Shoseyov, David; Cohen-Cymberknoh, Malena; Gur, Michal; Bentur, Lea; Livnat, Galit; Aviram, Micha; Alkrinawi, Soliman; Picard, Elie; Prais, Dario; Steuer, Guy; Inbar, Ori; Kerem, Eitan; Blau, Hannah

    2016-07-01

    Population carrier screening (PCS) has been available in Israel since 1999 and universally subsidized since 2008. We sought to evaluate its impact. A retrospective review of governmental databanks, the national CF registry and CF centers. CF rate per 100,000 live births has decreased from 14.5 in 1990 to 6 in 2011. From 2004-2011 there were 95 CF births: 22 utilized PCS; 68 (72%) had 2 known CFTR mutations; 37% were pancreatic sufficient. At diagnosis, age was 6 (0-98) months; 53/95 had respiratory symptoms, 41/95 failure to thrive and 19/95 pseudomonas. Thirty-four (36%) were Arabs and 19 (20%) orthodox Jews, compared to 20% and 8% respectively, in the general population. PCS markedly reduced CF birth rates with a shift towards milder mutations, but was often avoided for cultural reasons. As children regularly have significant disease at diagnosis, we suggest a balanced approach, utilizing both PCS and newborn screening. Copyright © 2015 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  7. Prenatal genetic carrier testing using triple disease screening.

    Science.gov (United States)

    Eng, C M; Schechter, C; Robinowitz, J; Fulop, G; Burgert, T; Levy, B; Zinberg, R; Desnick, R J

    1997-10-15

    Rapid progress in gene discovery has dramatically increased diagnostic capabilities for carrier screening and prenatal testing for genetic diseases. However, simultaneous prenatal carrier screening for prevalent genetic disease has not been evaluated, and patient acceptance and attitudes toward this testing strategy remain undefined. To evaluate an educational, counseling, and carrier testing program for 3 genetic disorders: Tay-Sachs disease (TSD), type 1 Gaucher disease (GD), and cystic fibrosis (CF) that differ in detectability, severity, and availability of therapy. Potential participants received education and genetic counseling, gave informed consent, chose screening tests, and completed pre-education and posteducation questionnaires that assessed knowledge, attitudes toward genetic testing, and disease testing preferences. Medical genetics referral center. Volunteer sample of 2824 Ashkenazi Jewish individuals enrolled as couples who were referred for TSD testing. Genetic counseling, education, and if chosen, genetic testing for any or all 3 disorders. Acceptance of screening for each of the 3 disorders. Secondary outcomes include attitudes toward genetic testing and reproductive considerations. Of the 2824 individuals tested for TSD, 97% and 95% also chose testing for CF and GD, respectively. The frequency of detected carriers was 1:21 for TSD, 1 :25 for CF, and 1:18 for GD. Twenty-one carriercoupleswere identified, counseled, and all postconception couples opted for prenatal diagnosis. Pre-education and posteducation questionnaires revealed that patients initially knew little about the diseases, but acquired disease information and increased knowledge of genetic concepts. Education and genetic counseling increased understanding and retention of genetic concepts and disease-related information, and minimized test-related anxiety. Although individuals sought screening for all 3 diseases, reproductive attitudes and decisions varied directly with disease

  8. Preconception carrier screening for multiple disorders: evaluation of a screening offer in a Dutch founder population

    NARCIS (Netherlands)

    Mathijssen, Inge B.; Holtkamp, Kim C. A.; Ottenheim, Cecile P. E.; van Eeten-Nijman, Janneke M. C.; Lakeman, Phillis; Meijers-Heijboer, Hanne; van Maarle, Merel C.; Henneman, Lidewij

    2018-01-01

    Technological developments have enabled carrier screening for multiple disorders. This study evaluated experiences with a preconception carrier screening offer for four recessive disorders in a Dutch founder population. Questionnaires were completed by 182 attendees pretesting and posttesting and by

  9. Experiences of a High-Risk Population with Prenatal Hemoglobinopathy Carrier Screening in a Primary Care Setting: a Qualitative Study

    NARCIS (Netherlands)

    Holtkamp, Kim C. A.; Lakeman, Phillis; Hader, Hind; Jans, Suze M. J. P.; Hoenderdos, Maria; Playfair, Henna A. M.; Cornel, Martina C.; Peters, Marjolein; Henneman, Lidewij

    2017-01-01

    Carrier screening for hemoglobinopathies (HbPs; sickle cell disease and thalassemia) aims to facilitate autonomous reproductive decision-making. In the absence of a Dutch national HbP carrier screening program, some primary care midwives offer screening on an ad hoc basis. This qualitative

  10. Influence of risk category and screening round on the performance of an MR imaging and mammography screening program in carriers of the BRCA mutation and other women at increased risk

    NARCIS (Netherlands)

    Vreemann, Suzan; Gubern-Mérida, Albert; Schlooz-Vries, Margrethe S.; Bult, Peter; Van Gils, Carla H.; Hoogerbrugge, Nicoline; Karssemeijer, Nico; Mann, Ritse M.

    2018-01-01

    Purpose: To evaluate the real-life performance of a breast cancer screening program for women with different categories of increased breast cancer risk with multiple follow-up rounds in an academic hospital with a large screening population. Materials and Methods: Screening examinations (magnetic

  11. Carrier screening in the era of expanding genetic technology.

    Science.gov (United States)

    Arjunan, Aishwarya; Litwack, Karen; Collins, Nick; Charrow, Joel

    2016-12-01

    The Center for Jewish Genetics provides genetic education and carrier screening to individuals of Jewish descent. Carrier screening has traditionally been performed by targeted mutation analysis for founder mutations with an enzyme assay for Tay-Sachs carrier detection. The development of next-generation sequencing (NGS) allows for higher detection rates regardless of ethnicity. Here, we explore differences in carrier detection rates between genotyping and NGS in a primarily Jewish population. Peripheral blood samples or saliva samples were obtained from 506 individuals. All samples were analyzed by sequencing, targeted genotyping, triplet-repeat detection, and copy-number analysis; the analyses were carried out at Counsyl. Of 506 individuals screened, 288 were identified as carriers of at least 1 condition and 8 couples were carriers for the same disorder. A total of 434 pathogenic variants were identified. Three hundred twelve variants would have been detected via genotyping alone. Although no additional mutations were detected by NGS in diseases routinely screened for in the Ashkenazi Jewish population, 26.5% of carrier results and 2 carrier couples would have been missed without NGS in the larger panel. In a primarily Jewish population, NGS reveals a larger number of pathogenic variants and provides individuals with valuable information for family planning.Genet Med 18 12, 1214-1217.

  12. Carrier screening for Gaucher disease: lessons for low-penetrance, treatable diseases.

    Science.gov (United States)

    Zuckerman, Shachar; Lahad, Amnon; Shmueli, Amir; Zimran, Ari; Peleg, Leah; Orr-Urtreger, Avi; Levy-Lahad, Ephrat; Sagi, Michal

    2007-09-19

    3 fetuses (67%) with predicted moderate disease. There were significantly fewer pregnancy terminations in couples who in addition to genetic counseling had medical counseling with a GD expert (1 of 13 [8%] vs 3 of 3 with no medical counseling [100%], P = .007). In this study of GD screening among Ashkenazi Jewish couples in Israel, most couples did not terminate affected pregnancies, although screening was associated with a few pregnancy terminations. The main possible benefit was providing couples with knowledge and control. The divergence of these outcomes from stated goals of screening programs is likely to confront carrier screening programs for low-penetrance diseases.

  13. Creation of a National, At-home Model for Ashkenazi Jewish Carrier Screening.

    Science.gov (United States)

    Grinzaid, Karen Arnovitz; Page, Patricia Zartman; Denton, Jessica Johnson; Ginsberg, Jessica

    2015-06-01

    Ethnicity-based carrier screening for the Ashkenazi Jewish population has been available and encouraged by advocacy and community groups since the early 1970's. Both the American College of Medical Genetics and the American Congress of Obstetricians and Gynecologists recommend carrier screening for this population (Obstetrics and Gynecology, 114(4), 950-953, 2009; Genetics in Medicine, 10(1), 55-56, 2008). While many physicians inquire about ethnic background and offer appropriate carrier screening, studies show that a gap remains in implementing recommendations (Genetic testing and molecular biomarkers, 2011). In addition, education and outreach efforts targeting Jewish communities have had limited success in reaching this at-risk population. Despite efforts by the medical and Jewish communities, many Jews of reproductive age are not aware of screening, and remain at risk for having children with preventable diseases. Reaching this population, preferably pre-conception, and facilitating access to screening is critically important. To address this need, genetic counselors at Emory University developed JScreen, a national Jewish genetic disease screening program. The program includes a national marketing and PR campaign, online education, at-home saliva-based screening, post-test genetic counseling via telephone or secure video conferencing, and referrals for face-to-face genetic counseling as needed. Our goals are to create a successful education and screening program for this population and to develop a model that could potentially be used for other at-risk populations.

  14. Preconception carrier screening for multiple disorders: evaluation of a screening offer in a Dutch founder population.

    Science.gov (United States)

    Mathijssen, Inge B; Holtkamp, Kim C A; Ottenheim, Cecile P E; van Eeten-Nijman, Janneke M C; Lakeman, Phillis; Meijers-Heijboer, Hanne; van Maarle, Merel C; Henneman, Lidewij

    2018-02-01

    Technological developments have enabled carrier screening for multiple disorders. This study evaluated experiences with a preconception carrier screening offer for four recessive disorders in a Dutch founder population. Questionnaires were completed by 182 attendees pretesting and posttesting and by 137 non-attendees. Semistructured interviews were conducted with seven of the eight carrier couples. Attendees were mainly informed about the existence of screening by friends/colleagues (49%) and family members (44%). Familiarity with the genetic disorders was high. Knowledge after counseling increased (p influencers (family/friends) can be used to raise awareness of a screening offer. Our findings provide lessons for the implementation of expanded carrier screening panels in other communities and other settings.

  15. Screening in crystalline liquids protects energetic carriers in hybrid perovskites

    Science.gov (United States)

    Zhu, Haiming; Miyata, Kiyoshi; Fu, Yongping; Wang, Jue; Joshi, Prakriti; Niesner, Daniel; Williams, Kristopher; Jin, Song; Zhu, Xiaoyang

    Hybrid lead halide perovskites exhibit carrier properties that resemble those of pristine nonpolar semiconductors despite static and dynamic disorder, but how carriers are protected from efficient scattering with charged defects and optical phonons is unknown. Here, we reveal the carrier protection mechanism by comparing three single-crystal lead bromide perovskites: CH3NH3PbBr3, CH(NH2)2PbBr3, and CsPbBr3. We observed hot fluorescence emission from energetic carriers with 102 picosecond lifetimes in CH3NH3PbBr3 or CH(NH,SUB>2)2PbBr3, but not in CsPbBr3. The hot fluorescence is correlated with liquid-like molecular reorientational motions, suggesting that dynamic screening protects energetic carriers via solvation or large polaron formation on time scales competitive with that of ultrafast cooling. Similar protections likely exist for band-edge carriers. The long-lived energetic carriers may enable hot-carrier solar cells with efficiencies exceeding the Shockley-Queisser limit. This work was supported by U.S. Department of Energy Grant ER46980, National Science Foundation, Grant DMR 1420634 (MRSEC), and Department of Energy Award DE-FG02-09ER46664.

  16. Carrier screening for spinal muscular atrophy in Italian population

    Indian Academy of Sciences (India)

    3Genetica Medica ARNAS Garibaldi Nesima, 95122 Catania, Italy. 5Dipartimento di Fisica e Chimica, Università degli Studi di Palermo, 90128 Palermo, Italy. [Calì F., Ruggeri G., Chiavetta V., Scuderi C., Bianca S., Barone C., Ragalmuto A., Schinocca P., Vitello G. A., Romano V. and Musumeci S. 2014 Carrier screening for ...

  17. Carrier screening for thalassemia and hemoglobinopathies in Canada.

    Science.gov (United States)

    Langlois, Sylvie; Ford, Jason C; Chitayat, David

    2008-10-01

    To provide recommendations to physicians, midwives, genetic counsellors, and clinical laboratory scientists involved in pre-conceptional or prenatal care regarding carrier screening for thalassemia and hemoglobinopathies (e.g., sickle cell anemia and other qualitative hemoglobin disorders). To determine the populations to be screened and the appropriate tests to offer to minimize practice variations across Canada. The Medline database was searched for relevant articles published between 1986 and 2007 on carrier screening for thalassemia and hemoglobinopathies. Key textbooks were also reviewed. Recommendations were quantified using the Evaluation of Evidence guidelines developed by the Canadian Task Force on Preventive Health Care. The evidence collected from the Medline search was reviewed by the Prenatal Diagnosis Committee of the Canadian College of Medical Geneticists (CCMG) and the Genetics Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC). Screening of individuals at increased risk of being carriers for thalassemia and hemoglobinopathies can identify couples with a 25% risk of having a pregnancy with a significant genetic disorder for which prenatal diagnosis is possible. Ideally, screening should be done pre-conceptionally. However, for a significant proportion of patients, the screening will occur during the pregnancy, and the time constraint for obtaining screening results may result in psychological distress. This guideline does not include a cost analysis. 1. Carrier screening for thalassemia and hemoglobinopathies should be offered to a woman if she and/or her partner are identified as belonging to an ethnic population whose members are at higher risk of being carriers. Ideally, this screening should be done pre-conceptionally or as early as possible in the pregnancy. (II-2A) 2. Screening should consist of a complete blood count, as well as hemoglobin electrophoresis or hemoglobin high performance liquid chromatography. This

  18. A pseudodeficiency allele common in non-Jewish Tay-Sachs carriers: Implications for carrier screening

    Science.gov (United States)

    Triggs-Raine, B. L.; Mules, E. H.; Kaback, M. M.; Lim-Steele, J. S. T.; Dowling, C. E.; Akerman, B. R.; Natowicz, M. R.; Grebner, E. E.; Navon, R.; Welch, J. P.; Greenberg, C. R.; Thomas, G. H.; Gravel, R. A.

    1992-01-01

    Deficiency of β-hexosaminidase A (Hex A) activity typically results in Tay-Sachs disease. However, healthy subjects found to be deficient in Hex A activity (i.e., pseudodeficient) by means of in vitro biochemical tests have been described. We analyzed the HEXA gene of one pseudodeficient subject and identified both a C739-to-T substitution that changes Arg247→Trp on one allele and a previously identified Tay-Sachs disease mutation on the second allele. Six additional pseudodeficient subjects were found to have the C739-to-T mutation. This allele accounted for 32% (20/62) of non-Jewish enzyme-defined Tay-Sachs disease carriers but for none of 36 Jewish enzyme-defined carriers who did not have one of three known mutations common to this group. The C739-to-T allele, together with a “true” Tay-Sachs disease allele, causes Hex A pseudodeficiency. Given both the large proportion of non-Jewish carriers with this allele and that standard biochemical screening cannot differentiate between heterozygotes for the C739-to-T mutations and Tay-Sachs disease carriers, DNA testing for this mutation in at-risk couples is essential. This could prevent unnecessary or incorrect prenatal diagnoses. ImagesFigure 1Figure 2Figure 3 PMID:1384323

  19. 76 FR 6688 - Land Border Carrier Initiative Program

    Science.gov (United States)

    2011-02-08

    ... 142 Administrative Practice and Procedure, Canada, Computer technology (Line release), Common carriers... industry partnership program under which participating land and rail commercial carriers would agree to... smuggled into the United States. Because CBP has developed a more comprehensive voluntary industry...

  20. The Dynamics of an HIV/AIDS Model with Screened Disease Carriers

    Directory of Open Access Journals (Sweden)

    S. D. Hove-Musekwa

    2009-01-01

    Full Text Available The presence of carriers usually complicates the dynamics and prevention of a disease. They are not recognized as disease cases themselves unless they are screened and they usually spread the infection without them being aware. We argue that this has been one of the major causes of the spread of human immunodeficiency virus (HIV. We propose, in this paper, a model for the heterogeneous transmission of HIV/acquired immunodeficiency syndrome in the presence of disease carriers. The model allows us to assess the role of screening, as an intervention program that can slow the epidemic. A threshold value ψ*, for the screening rate is obtained. It is shown numerically that if 80% or more of the carrier population is screened, the epidemic can be contained. The qualitative analysis is done in terms of the model reproduction number R. The model has two equilibria, the disease free equilibrium and a unique endemic equilibrium. The disease free equilibrium is globally stable of R  1. A detailed discussion of the model reproduction number is given and numerical simulations are done to show the role of some of the important model parameters.

  1. Costs, effects, and savings of screening for cystic fibrosis gene carriers

    NARCIS (Netherlands)

    Wildhagen, MF; Hilderink, HBM; Verzijl, JG; Verheij, JBGM; Kooij, L; Tijmstra, T; ten Kate, LP; Habbema, JDF

    Study objective-Evaluating the costs, effects, and savings of several strategies for cystic fibrosis (CF) gene carrier screening. Design-A general model for evaluating prenatal, preconceptional, school, and neonatal carrier screening was constructed. For prenatal and preconceptional screening, two

  2. Cystic fibrosis: to screen or not to screen? Involving a Citizens' jury in decisions on screening carrier.

    Science.gov (United States)

    Mosconi, Paola; Castellani, Carlo; Villani, Walter; Satolli, Roberto

    2015-12-01

    In recent years, the continuous improvements in molecular biology techniques have made it possible to detect carriers for several genetic conditions, including cystic fibrosis (CF). In some countries, CF carrier screening is offered to increasing subset of the general population. Offering of carrier screening at a population level should not be decided by local health authorities only, without consulting citizens' preferences. One way to involve citizens in the decision process might be to a Citizens' jury, a method of deliberative democracy. The object of the study is to produce a recommendation statement about CF carrier screening using a Citizens' jury. As this is a new method in the field, the study also provided the opportunity to evaluate its effectiveness. The project is designed and managed by an executive committee. The whole process is superintended by a multidisciplinary scientific committee. The 16 members of the jury attend a 1 day meeting, assisted by a non-medical and unbiased facilitator. Informative material was prepared and distributed 15 days before the jury meeting; during the meeting, experts and witnesses interact directly with all the jurors through questions and answers. All except one member of the jury felt positively about the Health Service actively providing population carrier screening for CF. The final statement was available to public, clinicians, researchers and decision-makers. In general, a Citizens' jury is a feasible method for involving citizens in public health decision-making process and in particular for obtaining a community view about CF carrier screening. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  3. A pseudodeficiency allele common in non-Jewish Tay-Sachs carriers: Implications for carrier screening

    Energy Technology Data Exchange (ETDEWEB)

    Triggs-Raine, B.L.; Akerman, B.R.; Gravel, R.A. (McGill Univ.-Montreal Children' s Hospital Research Institute, Montreal, Quebec (Canada)); Mules, E.H.; Thomas, G.H.; Dowling, C.E. (Johns Hopkins School of Medicine, Baltimore, MD (United States)); Kaback, M.M.; Lim-Steele, J.S.T. (Univ. of California, San Diego, CA (United States)); Natowicz, M.R. (Eunice Kennedy Shriver Center for Mental Retardation, Waltham, MA (United States)); Grebner, E.E. (Thomas Jefferson Univ., Philadelphia, PA (United States)); Navon, R.R. (Tel-Aviv Univ., Kfar-Sava (Israel)); Welch, J.P. (Dalhousie Univ., Halifax, Nova, Scotia (Canada)); Greenberg, C.R. (Univ. of Manitoba, Winnipeg (Canada))

    1992-10-01

    Deficiency of [beta]-hexosaminidase A (Hex A) activity typically results in Tay-Sachs disease. However, healthy subjects found to be deficient in Hex A activity (i.e., pseudodeficient) by means of in vitro biochemical tests have been described. The authors analyzed the HEXA gene of one pseudodeficient subject and identified both a C[sub 739]-to-T substitution that changes Arg[sub 247][yields]Trp on one allele and a previously identified Tay-Sachs disease mutation of the second allele. Six additional pseudodeficient subjects were found to have the C[sub 739]-to-T but for none of 36 Jewish enzyme-defined carries who did not have one of three known mutations common to this group. The C[sub 739]-to-T allele, together with a [open quotes]true[close quotes] Tay-Sachs disease allele, causes Hex A pseudodeficiency. Given both the large proportion of non-Jewish carriers with this allele and that standard biochemical screening cannot differentiate between heterozygotes for the C[sub 739]-to-T mutations and Tay-Sachs disease carriers, DNA testing for this mutation in at-risk couples is essential. This could prevent unnecessary or incorrect prenatal diagnoses. 40 refs., 3 figs., 4 tabs.

  4. Next-generation DNA sequencing of HEXA: a step in the right direction for carrier screening

    OpenAIRE

    Hoffman, Jodi D; Greger, Valerie; Strovel, Erin T; Blitzer, Miriam G; Umbarger, Mark A; Kennedy, Caleb; Bishop, Brian; Saunders, Patrick; Porreca, Gregory J; Schienda, Jaclyn; Davie, Jocelyn; Hallam, Stephanie; Towne, Charles

    2013-01-01

    Tay-Sachs disease (TSD) is the prototype for ethnic-based carrier screening, with a carrier rate of ∼1/27 in Ashkenazi Jews and French Canadians. HexA enzyme analysis is the current gold standard for TSD carrier screening (detection rate ∼98%), but has technical limitations. We compared DNA analysis by next-generation DNA sequencing (NGS) plus an assay for the 7.6 kb deletion to enzyme analysis for TSD carrier screening using 74 samples collected from participants at a TSD family conference. ...

  5. Maryland motor carrier program performance enhancement.

    Science.gov (United States)

    2014-02-01

    Using the inspection summary data (24-1 reports) from SHA for years 2006 to 2010 and inspection and violation : files of Motor Carrier Management Information System (MCMIS) for the same years, the Maryland State Police : (MSP) and Maryland Transporta...

  6. Evaluation of a Tay-Sachs disease screening program.

    Science.gov (United States)

    Gason, A A; Sheffield, E; Bankier, A; Aitken, M A; Metcalfe, S; Barlow Stewart, K; Delatycki, M B

    2003-05-01

    Tay-Sachs Disease (TSD) is an autosomal recessive neurodegenerative disorder. TSD is prevalent in the Ashkenazi Jewish population, and carrier screening programs have been implemented worldwide in these communities. A screening program initiated in 1997 involving the Melbourne Jewish community (Australia) incorporated education, counselling and carrier testing of high-school students aged 15 to 18 years. This study aimed to assess the participation rates, level of knowledge obtained and predicted feelings and attitudes of the students involved. Seven hundred and ten students participated, there was a 67% uptake for testing with a carrier rate of 1 in 28 determined. The level of knowledge of the students following education was high and of relative importance in regard to decision making, as were their feelings and attitudes about genetic testing for carrier status. A significant impediment to test uptake was the need for blood sampling, resulting in a recommendation for the introduction of DNA analysis on cheek brush samples. The evaluation of this program has given a wider scope for further development as well as providing valuable information for the implementation of community screening programs.

  7. Endocrine Disruptor Screening Program Reports to Congress

    Science.gov (United States)

    This page includes EPA reports to congress on pesticide licensing and endocrine disruptor screening activities, Endocrine Disruptor Methods Validation Subcomittee (EDMVS) progress, and Endocrine Disruptor Screening Program (EDSP) implementation progress.

  8. Evaluating genetic ancestry and self-reported ethnicity in the context of carrier screening.

    Science.gov (United States)

    Shraga, Roman; Yarnall, Sarah; Elango, Sonya; Manoharan, Arun; Rodriguez, Sally Ann; Bristow, Sara L; Kumar, Neha; Niknazar, Mohammad; Hoffman, David; Ghadir, Shahin; Vassena, Rita; Chen, Serena H; Hershlag, Avner; Grifo, Jamie; Puig, Oscar

    2017-11-28

    Current professional society guidelines recommend genetic carrier screening be offered on the basis of ethnicity, or when using expanded carrier screening panels, they recommend to compute residual risk based on ethnicity. We investigated the reliability of self-reported ethnicity in 9138 subjects referred to carrier screening. Self-reported ethnicity gathered from test requisition forms and during post-test genetic counseling, and genetic ancestry predicted by a statistical model, were compared for concordance. We identified several discrepancies between the two sources of self-reported ethnicity and genetic ancestry. Only 30.3% of individuals who indicated Mediterranean ancestry during consultation self-reported this on requisition forms. Additionally, the proportion of individuals who reported Southeast Asian but were estimated to have a different genetic ancestry was found to depend on the source of self-report. Finally, individuals who reported Latin American demonstrated a high degree of ancestral admixture. As a result, carrier rates and residual risks provided for patient decision-making are impacted if using self-reported ethnicity. Our analysis highlights the unreliability of ethnicity classification based on patient self-reports. We recommend the routine use of pan-ethnic carrier screening panels in reproductive medicine. Furthermore, the use of an ancestry model would allow better estimation of carrier rates and residual risks.

  9. Enhanced piezoelectric operation of NiO/GaN heterojunction generator by suppressed internal carrier screening

    International Nuclear Information System (INIS)

    Jeong, Dae Kyung; Kang, Jin-Ho; Ryu, Sang-Wan; Ha, Jun-Seok

    2017-01-01

    A NiO/GaN heterojunction piezoelectric generator was fabricated, and the improvement in device performance was analyzed. The electrical properties of NiO were varied by regulating the gas environment during sputtering. An optimized NiO layer was adopted for high piezoelectric voltage generation. Internal carrier screening was revealed to be the dominant mechanism degrading the piezoelectric performance, necessitating the suppression of carrier screening. The highly resistive NiO layer was advantageous in the suppression of carrier transport across the junction that screened the piezoelectric field. The maximum piezoelectric voltage and current density values obtained were 7.55 V and 1.14 µ A cm −2 , respectively. The power obtained was sufficient to operate a light-emitting diode combined with a charging circuit. (paper)

  10. No efficacy of annual gynaecological screening in BRCA1/2 mutation carriers; an observational follow-up study

    NARCIS (Netherlands)

    Hermsen, B. B. J.; Olivier, R. I.; Verheijen, R. H. M.; van Beurden, M.; de Hullu, J. A.; Massuger, L. F.; Burger, C. W.; Brekelmans, C. T.; Mourits, M. J.; de Bock, G. H.; Gaarenstroom, K. N.; van Boven, H. H.; Mooij, T. M.; Rookus, M. A.

    2007-01-01

    BRCA1/ 2 mutation carriers are offered gynaecological screening with the intention to reduce mortality by detecting ovarian cancer at an early stage. We examined compliance and efficacy of gynaecological screening in BRCA1/ 2 mutation carriers. In this multicentre, observational, follow-up study we

  11. Comparison of single-entry and double-entry two-step couple screening for cystic fibrosis carriers

    NARCIS (Netherlands)

    tenKate, LP; Verheij, JBGM; Wildhagen, MF; Hilderink, HBM; Kooij, L; Verzijl, JG; Habbema, JDF

    1996-01-01

    Both single-entry two-step (SETS) couple screening and double-entry two-step (DETS) couple screening have been recommended as methods to screen for cystic fibrosis gene carriers. In this paper we compare the expected results from both types of screening. In general, DETS results in a higher

  12. Prostate screening uptake in Australian BRCA1 and BRCA2 carriers

    Directory of Open Access Journals (Sweden)

    McKinley Joanne M

    2007-09-01

    Full Text Available Abstract Men who carry mutations in BRCA1 or BRCA2 are at increased risk for prostate cancer. However the efficacy of prostate screening in this setting is uncertain and limited data exists on the uptake of prostate screening by mutation carriers. This study prospectively evaluated uptake of prostate cancer screening in a multi-institutional cohort of mutation carriers. Subjects were unaffected male BRCA1 and BRCA2 mutation carriers, aged 40–69 years, enrolled in the Kathleen Cuningham Consortium for Research into Familial Breast Cancer (kConFab and who had completed a mailed, self-report follow-up questionnaire 3 yearly after study entry. Of the 75 male carriers in this study, only 26 (35% had elected to receive their mutation result. Overall, 51 (68% did not recall having received a recommendation to have prostate screening because of their family history, but 41 (55% had undergone a prostate specific antigen (PSA test and 32 (43% a digital rectal examination (DRE in the previous 3 years. Those who were aware of their mutation result were more likely to have received a recommendation for prostate screening (43 vs. 6%, p = 0.0001, and to have had a PSA test (77 vs. 43%, p = 0.005 and a DRE (69 vs. 29%, p = 0.001 in the previous 3 years. The majority of unaffected males enrolled in kConFab with a BRCA1/2 mutation have not sought out their mutation result. However, of those aware of their positive mutation status, most have undergone at least one round of prostate screening in the previous 3 years.

  13. Endocrine Disruptor Screening Program Tier 1 Assessments

    Science.gov (United States)

    EPA has completed weight-of-evidence (WoE) assessments under the Endocrine Distruptor Screening Program (EDSP) for 52 pesticides included in the final list of chemicals for Tier 1 screening. See weight of evidence reports and data evaluation records.

  14. Mammographic screening in BRCA1 mutation carriers postponed until age 40: Evaluation of benefits, costs and radiation risks using models.

    Science.gov (United States)

    Obdeijn, Inge-Marie; Heijnsdijk, Eveline A M; Hunink, M G Myriam; Tilanus-Linthorst, Madeleine M A; de Koning, Harry J

    2016-08-01

    BRCA1 mutation carriers are offered screening with magnetic resonance imaging (MRI) and mammography. The aim of this study was to weigh benefits and risks of postponing mammographic screening until age 40. With the MISCAN microsimulation model two screening protocols were evaluated: 1) the current Dutch guidelines: annual MRI from age 25-60, annual mammography from age 30-60, and biennial mammography in the nationwide program from age 60-74, and 2) the modified protocol: with annual mammography postponed until age 40. A cost-effectiveness analysis was performed. The risks of radiation-induced breast cancer mortality were estimated with absolute and relative exposure-risk models of the 7th Biological Effects of Ionising Radiation Committee. Current screening guidelines prevent 13,139 breast cancer deaths per 100,000 BRCA1 mutation carriers. Postponing mammography until age 40 would increase breast cancer deaths by 23 (0.17%), but would also reduce radiation-induced breast cancer deaths by 15 or 105 using the absolute and relative risk model respectively per 100,000 women screened. The estimated net effect is an increase of eight or a reduction of 82 breast cancer deaths per 100,000 women screened (depending on the risk model used). The incremental cost of mammograms between age 30-39 is €272,900 per life year gained. The modified protocol may be slightly less effective or even better than the current guidelines. The high cost-savings justify a possible small loss of effectiveness. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Adopted Individuals' Views on the Utility and Value of Expanded Carrier Screening.

    Science.gov (United States)

    Spencer, Sara; Ewing, Sarah; Calcagno, Kathryn; O'Neill, Suzanne

    2018-03-30

    Adoptees may not have family medical history and ethnicity information. Carrier screening assesses reproductive risk. Expanded carrier screening (ECS) screens for many genetic conditions regardless of a patient's knowledge of family history and ethnicity. This study aimed to better understand the opinions and attitudes of adopted individuals on the use of ECS in determining a patient's reproductive genetic risks. Specifically, the study assessed how adopted individuals feel that results of ECS may be useful to them and whether adoptees feel that meeting with a genetics professional in the process of undergoing ECS would be useful. Adult adoptees (N = 124) were recruited online. Their opinions on ECS were explored. The majority reported they had never been offered carrier screening (92%). The majority of adoptees wanted ECS (76%). Neither the amount of contact with biological relatives nor having medical knowledge about biological relatives was significantly associated with adoptees' desire to pursue ECS. There was a significant positive correlation between adoptees of higher education levels and the amount they would pay for ECS (p = 0.004). The majority of participants (95%) indicated a genetics professional would be helpful when undergoing ECS. The findings suggest this population may want ECS and support from genetics healthcare professionals. Advocacy for genetic counseling and testing for adoptees appears justifiable.

  16. Automated screening for Fragile X premutation carriers based on linguistic and cognitive computational phenotypes.

    Science.gov (United States)

    Movaghar, Arezoo; Mailick, Marsha; Sterling, Audra; Greenberg, Jan; Saha, Krishanu

    2017-06-01

    Millions of people globally are at high risk for neurodegenerative disorders, infertility or having children with a disability as a result of the Fragile X (FX) premutation, a genetic abnormality in FMR1 that is underdiagnosed. Despite the high prevalence of the FX premutation and its effect on public health and family planning, most FX premutation carriers are unaware of their condition. Since genetic testing for the premutation is resource intensive, it is not practical to screen individuals for FX premutation status using genetic testing. In a novel approach to phenotyping, we have utilized audio recordings and cognitive profiling assessed via self-administered questionnaires on 200 females. Machine-learning methods were developed to discriminate FX premutation carriers from mothers of children with autism spectrum disorders, the comparison group. By using a random forest classifier, FX premutation carriers could be identified in an automated fashion with high precision and recall (0.81 F1 score). Linguistic and cognitive phenotypes that were highly associated with FX premutation carriers were high language dysfluency, poor ability to organize material, and low self-monitoring. Our framework sets the foundation for computational phenotyping strategies to pre-screen large populations for this genetic variant with nominal costs.

  17. Attitudes of physicians and genetics professionals toward cystic fibrosis carrier screening.

    Science.gov (United States)

    Faden, R R; Tambor, E S; Chase, G A; Geller, G; Hofman, K J; Holtzman, N A

    1994-03-01

    With the identification of the cystic fibrosis (CF) gene and its major mutations in 1989, there has been considerable debate among health professionals as to whether population-based carrier testing should be instituted. This paper presents the results of a survey to determine the attitudes of physicians and genetics professionals toward CF carrier testing. Factors associated with differences in attitudes also were examined. A questionnaire was mailed to primary care physicians and psychiatrists in 10 states who graduated from medical school between 1950 and 1985. For comparison, medical geneticists and genetic counselors in the same states also received the questionnaire. A total of 1,140 primary care physicians and psychiatrists (64.8%) and 280 medical geneticists and genetic counselors (79.1%) responded. Although 92% of respondents believed that a couple should be tested after asking about a test that detected 80% of carriers, only 43.9% of respondents believed such a test should be offered routinely. Those specialists most likely to have been involved in genetic services were most opposed to routine screening. The most important reason reported for opposition to routine screening was the consequences of an 80% detection rate. When presented with a hypothetical "error-free" test, 75.9% of respondents favored routine testing. Our findings suggest that there was little support for routinely offering the CF carrier test available at the time of this study among the physicians and professionals most involved in the provision of genetic services.

  18. 'No thanks'-reasons why pregnant women declined an offer of cystic fibrosis carrier screening.

    Science.gov (United States)

    Ioannou, L; Massie, J; Lewis, S; McClaren, B; Collins, V; Delatycki, M B

    2014-04-01

    The objective of this study was to assess attitudes and opinions of women declining the offer of cystic fibrosis (CF) carrier screening through a population-based programme in Victoria, Australia. Between December 2009 and May 2011, women declining an offer of CF carrier screening were invited to participate in a questionnaire-based study. Recruitment was at two private obstetric ultrasound clinics and two private obstetric practices in Melbourne. Of the participants (n = 54), the majority were well educated (76%), aged 30-34 years (54%), with a household income of >AUD$100,000 (76%). Compared to those who accepted screening (reported in a previous study) (Ioannou et al., Public Health Genomics 13:449-56, 2010), knowledge levels were significantly lower in participants declining screening (t = 3.32, p < 0.01). The main reasons for declining screening were having no family history of CF (58%) and not considering a termination of pregnancy for CF (53%). Providers and consumers should be informed that most children born with autosomal-recessive conditions such as CF have no family history of the condition.

  19. Carrier Screening

    Science.gov (United States)

    ... employers are prohibited from using genetic information for hiring, firing, or making any other decisions about a ... parent to offspring. Genetic Counselor: A health care professional with special training in genetics and counseling who ...

  20. Anticipating anonymity in screening program databases.

    Science.gov (United States)

    Caballero, Rafael; Sen, Sagar; Nygård, Jan F

    2017-07-01

    In this paper, we propose a technique for improving anonymity in screening program databases to increase the privacy for the participants in these programs. The data generated by the invitation process (screening centre, appointment date) is often made available to researchers for medical research and for evaluation and improvement of the screening program. This information, combined with other personal quasi-identifiers such as the ZIP code, gender or age, can pose a risk of disclosing the identity of the individuals participating in the program, and eventually their test results. We present two algorithms that produce a set of screening appointments that aim to increase anonymity of the resulting dataset. The first one, based on the constraint programming paradigm, defines the optimal appointments, while the second one is a suboptimal heuristic algorithm that can be used with real size datasets. The level of anonymity is measured using the new concept of generalized k-anonymity, which allows us to show the utility of the proposal by means of experiments, both using random data and data based on screening invitations from the Norwegian Cancer Registry. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Evaluation of two-year Jewish genetic disease screening program in Atlanta: insight into community genetic screening approaches.

    Science.gov (United States)

    Shao, Yunru; Liu, Shuling; Grinzaid, Karen

    2015-04-01

    Improvements in genetic testing technologies have led to the development of expanded carrier screening panels for the Ashkenazi Jewish population; however, there are major inconsistencies in current screening practices. A 2-year pilot program was launched in Atlanta in 2010 to promote and facilitate screening for 19 Jewish genetic diseases. We analyzed data from this program, including participant demographics and outreach efforts. This retrospective analysis is based on a de-identified dataset of 724 screenees. Data were obtained through medical chart review and questionnaires and included demographic information, screening results, response to outreach efforts, and follow-up behavior and preferences. We applied descriptive analysis, chi-square tests, and logistic regression to analyze the data and compare findings with published literature. The majority of participants indicated that they were not pregnant or did not have a partner who was pregnant were affiliated with Jewish organizations and reported 100 % AJ ancestry. Overall, carrier frequency was 1 in 3.9. Friends, rabbis, and family members were the most common influencers of the decision to receive screening. People who were older, had a history of pregnancy, and had been previously screened were more likely to educate others (all p influencers who then encouraged screening in the target population. Educating influencers and increasing overall awareness were the most effective outreach strategies.

  2. A morass of considerations: exploring attitudes towards ethnicity-based haemoglobinopathy-carrier screening in primary care

    NARCIS (Netherlands)

    Jans, S.M.P.J.; Henneman, L.; de Jonge, J.; van El, C.G.; van Tuyl, H.D.; Cornel, M.C.; Lagro-Janssen, A.L.M.

    2013-01-01

    Background: The Netherlands does not have a national haemoglobinopathy (HbP)-carrier screening programme aimed at facilitating informed reproductive choice. HbP-carrier testing for those at risk is at best offered on the basis of anaemia. Registration of ethnicity has proved controversial and may

  3. 'A morass of considerations': exploring attitudes towards ethnicity-based haemoglobinopathy-carrier screening in primary care

    NARCIS (Netherlands)

    Jans, S.M.P.J.; Henneman, L.; Jonge, A. de; El, C.G. van; Tuyl, L.H. van; Cornel, M.C.; Lagro-Janssen, A.L.M.

    2013-01-01

    BACKGROUND: The Netherlands does not have a national haemoglobinopathy (HbP)-carrier screening programme aimed at facilitating informed reproductive choice. HbP-carrier testing for those at risk is at best offered on the basis of anaemia. Registration of ethnicity has proved controversial and may

  4. A systematic analysis of online marketing materials used by providers of expanded carrier screening.

    Science.gov (United States)

    Chokoshvili, Davit; Borry, Pascal; Vears, Danya F

    2017-12-14

    PurposeExpanded carrier screening (ECS) for a large number of recessive disorders is available to prospective parents through commercial providers. This study aimed to analyze the content of marketing materials on ECS providers' websites.MethodsTo identify providers of ECS tests, we undertook a comprehensive online search, reviewed recent academic literature on commercial carrier screening, and consulted with colleagues familiar with the current ECS landscape. The identified websites were archived in April 2017, and inductive content analysis was performed on website text, brochures and educational materials, and video transcripts.ResultsWe identified 18 ECS providers, including 16 commercial genetic testing companies. Providers typically described ECS as an important family planning tool. The content differed in both the tone used to promote ECS and the accuracy and completeness of the test information provided. We found that most providers offered complimentary genetic counseling to their consumers, although this was often optional, limited to the posttest context, and, in some cases, appeared to be available only to test-positive individuals.ConclusionThe quality of ECS providers' websites could be improved by offering more complete and accurate information about ECS and their tests. Providers should also ensure that all carrier couples receive posttest genetic counseling to inform their subsequent reproductive decision making.Genet Med advance online publication, 14 December 2017; doi:10.1038/gim.2017.222.

  5. Controlling the screening process of a nanoscaled space charge region by minority carriers.

    Science.gov (United States)

    Kloth, Philipp; Kaiser, Katharina; Wenderoth, Martin

    2016-01-05

    The miniaturization of future electronic devices is intimately connected to the ability to control electric fields on the atomic scale. In a nanoscopic system defined by a limited number of charges, the combined dynamics of bound and free charges become important. Here we present a model system based on the electrostatic interaction between a metallic tip of a scanning tunnelling microscope and a GaAs(110) semiconductor surface. The system is driven out of equilibrium by optical excitation, which provides ambipolar free charge carriers, and by an optically induced unipolar tunnel current. This combination enables the active control of the density and spatial distribution of free and bound charge in the space-charge region, that is, modifying the screening processes. Temporal fluctuations of single dopants are modified, meaning we are able to control the noise of the system. It is found that free charge carriers suppress the noise level in field-controlled, nanoscopic systems.

  6. Preconception carrier screening and prenatal diagnosis in thalassemia and hemoglobinopathies: challenges and future perspectives.

    Science.gov (United States)

    Traeger-Synodinos, Joanne; Harteveld, Cornelis L

    2017-03-01

    Hemoglobinopathies constitute the most common severe monogenic disorders worldwide, with an increasing global burden each year. The benefit of applying programmes for preconception carrier screening, with the option of prenatal diagnosis, to minimize the incidence of new cases is recognized in many countries. Areas covered: The challenges associated with identifying carrier couples using hematology-based screening, along with DNA diagnosis and prenatal diagnosis were addressed, based on a literature search and the authors expertise. Expert commentary: The hemoglobinopathies are extremely heterogeneous at the haematological, molecular and clinical level, requiring appropriately equipped and staffed laboratories with experience to support comprehensive screening and diagnosis. However complete services with adequate infrastructure to address the associated technical challenges do not exist widely, especially in low-income countries that, coincidentally, are often those with the highest frequency of hemoglobinopathies in their population. Additionally, overcoming limited public awareness, education and absence of systematic dissemination of information also constitutes a challenge. This article aims to highlight these challenges and to evaluate potential future developments that may address at least some of them, focusing mainly on the technical challenges related to molecular diagnostics.

  7. 47 CFR 76.1004 - Applicability of program access rules to common carriers and affiliates.

    Science.gov (United States)

    2010-10-01

    ... Cable Programming § 76.1004 Applicability of program access rules to common carriers and affiliates. (a... 47 Telecommunication 4 2010-10-01 2010-10-01 false Applicability of program access rules to common carriers and affiliates. 76.1004 Section 76.1004 Telecommunication FEDERAL COMMUNICATIONS COMMISSION...

  8. Adult hearing screening: the Cyprus Pilot Program

    Directory of Open Access Journals (Sweden)

    C. Thodi

    2011-03-01

    Full Text Available Hearing loss is the third most common condition affecting adults over 65 (Cruickshanks et al., 1998. It can affect quality of life, limiting the ability to communicate efficiently, and leading to isolation, psychological strain, and functional decline (LaForge, Spector, Sternberg, 1992; Yueh, Shapiro, MacLean, Shekelle, 2003. Communication limitations impinge on the person directly, as well as the family, friends, and social circle. Reports on hearing loss among adults indicate that less than 25% of people who can benefit from amplification are actually using hearing aids, and that people diagnosed with a hearing loss delay seeking amplification by about seven years (Kochkin, 1997. Often, family members are the driving force behind a person with a hearing loss who decides to seek help. Adult hearing screening programs might have a positive effect on raising public awareness on hearing loss and its implications, and shortening delay time for intervention. There is no routine hearing screening for the adult population in Cyprus. The health system provides hearing tests for beneficiaries upon physician recommendation or self-referral. The Cyprus pilot adult hearing screening program (ΑΠΑΣ- EVERYONE- Greek acronym for Screening- Intervention-Hearing-Participation to Life screened hearing in retired adults.

  9. Q Sepharose micro-column chromatography: A simple screening method for identifying beta thalassemia traits and hemoglobin E carriers.

    Science.gov (United States)

    Wong, Peerapon; Sritippayawan, Suchila; Suwannakhon, Narutchala; Tapprom, Akamon; Deoisares, Rawisut; Sanguansermsri, Torpong

    2016-11-01

    For beta thalassemia control program in pregnancy, mass screening of the carrier state by determination of the hemoglobin (Hb) A 2 and Hb E proportions and mutation analysis is a preferred method for making prenatal diagnoses. Q Sepharose micro-column chromatography, developed for the determination of Hb A 2 and Hb E for screening purposes, was compared with high performance liquid chromatography (HPLC) to ascertain its relative accuracy and reliability. Results using Q Sepharose micro-column chromatography in 350 blood specimens, including 50 samples genetically proven to be beta thalassemia heterozygotes, were compared to HPLC for validation. An additional study was conducted to test a clinical application on a large-scale survey for beta thalassemia in 1581 pregnant women and their spouses. The mean (±SD) Hb A 2 proportions in the normal and genetically proven beta thalassemia heterozygotes were 2.70±0.40% and 6.30±1.23%, respectively, as determined by Q-Sepharose micro-column chromatography, and 2.65±0.31% and 5.37±0.96%, respectively, as determined by HPLC. The mean Hb E proportions in the Hb E heterozygotes were 23.25±4.13% and 24.72±3.5% as determined by Q Sepharose micro-column chromatography and HPLC, respectively. In the large-scale survey for beta thalassemia, 23 at risk couples were detected. Seven affected fetuses were identified by prenatal diagnosis. Q Sepharose micro-column chromatography was found to be reliable, reproducible and well-suited for large-scale surveys. Additionally, by being reusable and convenient, this simple and economical chromatography method may be an alternative means to screen for beta thalassemia and Hb E carriers in the mass population. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  10. Breast cancer screening in BRCA1 and BRCA2 mutation carriers after risk reducing salpingo-oophorectomy

    NARCIS (Netherlands)

    Fakkert, I.E.; Jansen, L.; Meijer, K.; Kok, Theo; Oosterwijk, J.C.; Mourits, M.J.E.; de Bock, G.H.

    Breast cancer screening is offered to BRCA1 and BRCA2 mutation carriers from the age of 25 years because of their increased risk of breast cancer. As ovarian cancer screening is not effective, risk-reducing salpingho-oophorectomy (RRSO) is offered after child bearing age. RRSO before menopause

  11. Educating patients about cystic fibrosis carrier screening in a primary care setting.

    Science.gov (United States)

    Bernhardt, B A; Chase, G A; Faden, R R; Geller, G; Hofman, K J; Tambor, E S; Holtzman, N A

    1996-06-01

    To assess the effectiveness of education about cystic fibrosis carrier screening in a primary care setting. Participants were asked to read a brochure, and were offered cystic fibrosis carrier screening. They were assessed for knowledge after reading the brochure and again after having an opportunity to ask questions and reread the brochure at home, at which time consent for testing was obtained. Two sites of a health maintenance organization in the Baltimore, Md, area. Enrollees in a health maintenance organization aged 18 to 44 years. Of 608 enrollees approached, 477 completed an initial knowledge questionnaire, and 143 consented to testing. Change in knowledge score. Knowledge scores improved from a mean of 69% correct initially to 75% at the time of consent (P < 0.1, Student's paired t test). When participants were stratified by educational attainment, significant improvement was observed only for participants with no more than a high school education. However, their final knowledge score was significantly lower than that of college graduates. For people with more formal education, printed materials augmented by a chance to ask questions may be sufficient to ensure informed consent. For less well-educated persons, additional education may be necessary to ensure understanding of difficult concepts.

  12. Antisolvent Recrystallization Strategy to Screen Appropriate Carriers to Stabilize Filgotinib Amorphous Solid Dispersions.

    Science.gov (United States)

    Ren, Fuzheng; Sun, Hanjing; Cui, Lin; Si, Yike; Chen, Ning; Ren, Guobin; Jing, Qiufang

    2018-02-16

    Drugs in amorphous solid dispersions (ASDs) are highly dispersed in hydrophilic polymeric carriers, which also help to restrain recrystallization and stabilize the ASDs. In this study, microscopic observation after antisolvent recrystallization was developed as a rapid screening method to select appropriate polymers for the initial design filgotinib (FTN) ASDs. Using solvent evaporation, FTN ASDs with the polymers were prepared, and accelerated experimentation validated this screening method. Fourier-transform infrared spectroscopy, Raman scattering, and nuclear magnetic resonance revealed hydrogen-bonding formation in the drug-polymer binary system, which was critical for ASDs stabilization. A Flory-Huggins interaction parameter and water sorption isotherms were applied to evaluate the strength of the interaction between FTN and the polymers. The dissolution rate was also significantly improved by ASDs formulation, and the presence of the polymers exerted solubilization effects. These results suggested the efficacy of this screening method as a preliminary tool for polymer selection in ASDs design. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  13. Screening history in women with cervical cancer in a Danish population-based screening program

    DEFF Research Database (Denmark)

    Kirschner, Benny; Poll, Susanne; Rygaard, Carsten

    2011-01-01

    The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer.......The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer....

  14. Targeted prostate cancer screening in BRCA1 and BRCA2 mutation carriers: results from the initial screening round of the IMPACT study.

    Science.gov (United States)

    Bancroft, Elizabeth K; Page, Elizabeth C; Castro, Elena; Lilja, Hans; Vickers, Andrew; Sjoberg, Daniel; Assel, Melissa; Foster, Christopher S; Mitchell, Gillian; Drew, Kate; Mæhle, Lovise; Axcrona, Karol; Evans, D Gareth; Bulman, Barbara; Eccles, Diana; McBride, Donna; van Asperen, Christi; Vasen, Hans; Kiemeney, Lambertus A; Ringelberg, Janneke; Cybulski, Cezary; Wokolorczyk, Dominika; Selkirk, Christina; Hulick, Peter J; Bojesen, Anders; Skytte, Anne-Bine; Lam, Jimmy; Taylor, Louise; Oldenburg, Rogier; Cremers, Ruben; Verhaegh, Gerald; van Zelst-Stams, Wendy A; Oosterwijk, Jan C; Blanco, Ignacio; Salinas, Monica; Cook, Jackie; Rosario, Derek J; Buys, Saundra; Conner, Tom; Ausems, Margreet G; Ong, Kai-ren; Hoffman, Jonathan; Domchek, Susan; Powers, Jacquelyn; Teixeira, Manuel R; Maia, Sofia; Foulkes, William D; Taherian, Nassim; Ruijs, Marielle; Helderman-van den Enden, Apollonia T; Izatt, Louise; Davidson, Rosemarie; Adank, Muriel A; Walker, Lisa; Schmutzler, Rita; Tucker, Kathy; Kirk, Judy; Hodgson, Shirley; Harris, Marion; Douglas, Fiona; Lindeman, Geoffrey J; Zgajnar, Janez; Tischkowitz, Marc; Clowes, Virginia E; Susman, Rachel; Ramón y Cajal, Teresa; Patcher, Nicholas; Gadea, Neus; Spigelman, Allan; van Os, Theo; Liljegren, Annelie; Side, Lucy; Brewer, Carole; Brady, Angela F; Donaldson, Alan; Stefansdottir, Vigdis; Friedman, Eitan; Chen-Shtoyerman, Rakefet; Amor, David J; Copakova, Lucia; Barwell, Julian; Giri, Veda N; Murthy, Vedang; Nicolai, Nicola; Teo, Soo-Hwang; Greenhalgh, Lynn; Strom, Sara; Henderson, Alex; McGrath, John; Gallagher, David; Aaronson, Neil; Ardern-Jones, Audrey; Bangma, Chris; Dearnaley, David; Costello, Philandra; Eyfjord, Jorunn; Rothwell, Jeanette; Falconer, Alison; Gronberg, Henrik; Hamdy, Freddie C; Johannsson, Oskar; Khoo, Vincent; Kote-Jarai, Zsofia; Lubinski, Jan; Axcrona, Ulrika; Melia, Jane; McKinley, Joanne; Mitra, Anita V; Moynihan, Clare; Rennert, Gad; Suri, Mohnish; Wilson, Penny; Killick, Emma; Moss, Sue; Eeles, Rosalind A

    2014-09-01

    Men with germline breast cancer 1, early onset (BRCA1) or breast cancer 2, early onset (BRCA2) gene mutations have a higher risk of developing prostate cancer (PCa) than noncarriers. IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in BRCA1/2 mutation carriers and controls) is an international consortium of 62 centres in 20 countries evaluating the use of targeted PCa screening in men with BRCA1/2 mutations. To report the first year's screening results for all men at enrollment in the study. We recruited men aged 40-69 yr with germline BRCA1/2 mutations and a control group of men who have tested negative for a pathogenic BRCA1 or BRCA2 mutation known to be present in their families. All men underwent prostate-specific antigen (PSA) testing at enrollment, and those men with PSA >3 ng/ml were offered prostate biopsy. PSA levels, PCa incidence, and tumour characteristics were evaluated. The Fisher exact test was used to compare the number of PCa cases among groups and the differences among disease types. We recruited 2481 men (791 BRCA1 carriers, 531 BRCA1 controls; 731 BRCA2 carriers, 428 BRCA2 controls). A total of 199 men (8%) presented with PSA >3.0 ng/ml, 162 biopsies were performed, and 59 PCas were diagnosed (18 BRCA1 carriers, 10 BRCA1 controls; 24 BRCA2 carriers, 7 BRCA2 controls); 66% of the tumours were classified as intermediate- or high-risk disease. The positive predictive value (PPV) for biopsy using a PSA threshold of 3.0 ng/ml in BRCA2 mutation carriers was 48%-double the PPV reported in population screening studies. A significant difference in detecting intermediate- or high-risk disease was observed in BRCA2 carriers. Ninety-five percent of the men were white, thus the results cannot be generalised to all ethnic groups. The IMPACT screening network will be useful for targeted PCa screening studies in men with germline genetic risk variants as they are discovered. These preliminary results support the

  15. Navy Ford (CVN-78) Class Aircraft Carrier Program: Background and Issues for Congress

    Science.gov (United States)

    2015-12-17

    construction of the Ford class aircraft carriers designated CVN–80 and CVN–81 in economic order quantities when cost savings are achievable. (2) LIABILITY ...Navy Ford (CVN-78) Class Aircraft Carrier Program: Background and Issues for Congress Ronald O’Rourke Specialist in Naval Affairs December 17...

  16. Expanded carrier screening : What determines intended participation and can this be influenced by message framing and narrative information?

    NARCIS (Netherlands)

    Voorwinden, Jan S.; Buitenhuis, Anne H.; Birnie, Erwin; Lucassen, Anneke M.; Verkerk, Marian A.; van Langen, Irene M.; Plantinga, Mirjam; Ranchor, Adelita V.

    Next-generation sequencing enabled us to create a population-based expanded carrier screening (ECS) test that simultaneously tests for 50 serious autosomal recessive diseases. Before offering this test universally, we wanted to know what factors are related to intended participation and how the

  17. Endocrine Disruptor Screening Program (EDSP) 1998 Federal Register Notices

    Science.gov (United States)

    EPA outlined the Endocrine Disruptor Screening Program (EDSP), which incorporated many of the Endocrine Disruptor Screening and Testing Advisory Committee's (EDSTAC) recommendations, in two Federal Register Notices published in 1998.

  18. Cascade screening program for familial hypercholesterolemia.

    Science.gov (United States)

    Rubio-Marín, Patricia; Michán-Doña, Alfredo; Maraver-Delgado, Juan; Arroyo-Olivares, Raquel; Barrado Varea, Rosalía; Pérez de Isla, Leopoldo; Mata, Pedro

    2018-03-06

    Early detection of heterozygous familial hypercholesterolemia (HFH) is needed to prevent premature cardiovascular events. Our aim isto describe the course of an HFH screening detection day in the Northern Cadiz Health Area in Spain and to analyze the data recorded. Descriptive study of an FH cascade screening program. Index cases (ICs) and their 1st and 2nd grade relatives were appointed during a weekend by the FH Foundation. Venous blood samples were taken from the subjects for genetic, blood, and chemistry tests; specialized medical consultation and physical examination were performed. The study sample consisted of 132 subjects: 21 ICs and 111 relatives (16 under 18years old), with a mean age of 11.4years (SD4.57). Mean age of subjects over 18years was 45.2years. A gene mutation was found in 90 relatives. Mean age at diagnosis was 25years (SD17.7) for relatives and for 36.4years (SD17.2; P=.01) for ICs. Smoking rate was higher in relatives than in ICs (26.3% vs 4.8%; P=.02) and corneal arcus was more common in ICs as compared to relatives (47.6% vs 12.6%; P<.001). Prior myocardial infarction was recorded in 14.3% of ICs and 4.2% of relatives respectively (P=.07). Maximum lipid lowering treatment was being administered to 43.1%. The screening detection approach identified the estimated 4% population with HFH in the area, and allows for diagnosing HFH 11.4years earlier. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Amblyopia prevention screening program in Northwest Iran (Ardabil

    Directory of Open Access Journals (Sweden)

    Habib Ojaghi

    2016-01-01

    Conclusions: The present investigation showed that coverage of amblyopia screening program was not enough in Ardabil Province. To increase the screening accuracy, standard instruments and examination room must be used; more optometrists must be involved in this program and increasing the validity of obtained results for future programming.

  20. A reliable screening test to identify adult carriers of the (--SEA) alpha zero-thalassemia deletion. Detection of embryonic zeta-globin chains by enzyme-linked immunosorbent assay.

    Science.gov (United States)

    Lafferty, J D; Crowther, M A; Waye, J S; Chui, D H

    2000-12-01

    Homozygous (--SEA) alpha zero-thalassemia deletion, the cause of up to 80% of fetal hydrops in Southeast Asia, is encountered in many other countries. Heterozygous carrier rates of the deletion in Southeast Asian populations range from 4% to 14%. The laboratory screening for adult carriers of (--SEA) and other alpha zero-thalassemia deletions currently rests primarily with microscopic detection of hemoglobin H inclusion bodies within erythrocytes (Hb H screen). This test is laborious and observer dependent and has poor sensitivity. We assessed a colorimetric enzyme-linked immunosorbent assay (ELISA) to detect embryonic zeta-globin chains in adult hemolysates as an alternative to detect (--SEA) alpha zero-thalassemia deletion carriers. Blood samples from 221 adults with a mean corpuscular volume less than 80 micron 3 (80 fL) were studied prospectively by currently accepted hemoglobin screening tests and ELISA. Suspected cases of alpha-thalassemia were confirmed by DNA-based diagnostics. ELISA was highly sensitive (1.0) and specific (0.94) for the detection of adult carriers of (--SEA) alpha zero-thalassemia deletion. The hemoglobin H screen had a sensitivity of 0.47 and specificity of 0.99. The zeta-globin ELISA proved simple to perform, rapid, and applicable to high volume or population-based screening programs.

  1. Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age : individual patient data meta-analysis

    NARCIS (Netherlands)

    Phi, Xuan-Anh; Saadatmand, Sepideh; De Bock, Geertruida H.; Warner, Ellen; Sardanelli, Francesco; Leach, Martin O.; Riedl, Christopher C.; Trop, Isabelle; Hooning, Maartje J.; Mandel, Rodica; Santoro, Filippo; Kwan-Lim, Gek; Helbich, Thomas H.; Tilanus-Linthorst, Madeleine M. A.; van den Heuvel, Edwin R.; Houssami, Nehmat

    2016-01-01

    Background: We investigated the additional contribution of mammography to screening accuracy in BRCA1/2 mutation carriers screened with MRI at different ages using individual patient data from six high-risk screening trials. Methods: Sensitivity and specificity of MRI, mammography and the

  2. Internet-Based Cervical Cancer Screening Program

    National Research Council Canada - National Science Library

    Wilbur, David C; Crothers, Barbara A; Eichhorn, John H; Ro, Min S; Gelfand, Jeffrey A

    2008-01-01

    This project explores the combination of computerized automated primary screening of cervical cytology specimens in remote sites with interpretation of device-selected images transmitted via the Internet...

  3. Internet-Based Cervical Cytology Screening Program

    National Research Council Canada - National Science Library

    Wilbur, David C; Crothers, Barbara A; Eichhorn, John H; Ro, Min S; Gelfand, Jeffrey A

    2006-01-01

    This project explores the combination of computerized automated primary screening of cervical cytology specimens in remote sites with interpretation of device-selected images transmitted via the Internet...

  4. Expanded carrier screening: what determines intended participation and can this be influenced by message framing and narrative information?

    Science.gov (United States)

    Voorwinden, Jan S; Buitenhuis, Anne H; Birnie, Erwin; Lucassen, Anneke M; Verkerk, Marian A; van Langen, Irene M; Plantinga, Mirjam; Ranchor, Adelita V

    2017-06-01

    Next-generation sequencing enabled us to create a population-based expanded carrier screening (ECS) test that simultaneously tests for 50 serious autosomal recessive diseases. Before offering this test universally, we wanted to know what factors are related to intended participation and how the general public can be informed about the test without being influenced in their intention to participate. We studied this by measuring to what extent 'message framing' and 'narrative information' can influence people's intended participation. Data were collected by means of an online survey of 504 potential users, and the factors examined were based on the Theory of Planned Behaviour and on previous research on intended participation in preconception carrier screening. Message framing was manipulated by explaining the risk of couple carriership in different ways, while narrative information was provided to only half of the respondents. The factors most positively related to intended participation were perceiving benefits of the screening, having a positive attitude towards the screening, having no religion, having an actual child wish and experiencing the choice to participate as easy. Perceived benefits and a positive attitude were most influential factors by far. Message framing and narrative information had no significant effect on intended participation, reinforcing that message framing and narrative information can help to inform the general public about ECS without influencing their intended participation. Future research should study if the importance of perceived benefits and a positive attitude can be replicated when other factors are included and when actual participation is measured instead of intended participation.

  5. The Impacts of a Fully Funded Postgraduate Education on Promotion and Command Screen for Fixed-Wing, Carrier-Based Pilots and Naval Flight Officers

    National Research Council Canada - National Science Library

    Phillips, William

    2001-01-01

    This thesis evaluates the effect of fully-funded graduate education on the joint outcome of promote to Pay Grade 5 and screen for squadron command for fixed-wing, carrier-based aviator lieutenant commanders (Pay Grade 4...

  6. Reproductive genetic carrier screening for cystic fibrosis, fragile X syndrome, and spinal muscular atrophy in Australia: outcomes of 12,000 tests.

    Science.gov (United States)

    Archibald, Alison Dalton; Smith, Melanie Jane; Burgess, Trent; Scarff, Katrina Louise; Elliott, Justine; Hunt, Clare Elizabeth; Barns-Jenkins, Caitlin; Holt, Chelsea; Sandoval, Karina; Siva Kumar, Vanessa; Ward, Lisa; Allen, Emily Caroline; Collis, Sarah Valerie; Cowie, Shannon; Francis, David; Delatycki, Martin B; Yiu, Eppie Mildred; Massie, R John; Pertile, Mark Domenic; du Sart, Desirée; Bruno, Damien; Amor, David J

    2017-10-26

    PurposeTo describe our experience of offering simultaneous genetic carrier screening for cystic fibrosis (CF), fragile X syndrome (FXS), and spinal muscular atrophy (SMA).MethodsCarrier screening is offered through general practice, obstetrics, fertility, and genetics settings before or in early pregnancy. Carriers are offered genetic counseling with prenatal/preimplantation genetic diagnosis available to those at increased risk.ResultsScreening of 12,000 individuals revealed 610 carriers (5.08%; 1 in 20): 342 CF, 35 FXS, 241 SMA (8 carriers of 2 conditions), approximately 88% of whom had no family history. At least 94% of CF and SMA carriers' partners were tested. Fifty couples (0.42%; 1 in 240) were at increased risk of having a child with one of the conditions (14 CF, 35 FXS, and 1 SMA) with 32 pregnant at the time of testing. Of these, 26 opted for prenatal diagnosis revealing 7 pregnancies affected (4 CF, 2 FXS, 1 SMA).ConclusionThe combined affected pregnancy rate is comparable to the population risk for Down syndrome, emphasizing the need to routinely offer carrier screening. The availability of appropriate genetic counseling support and a collaborative approach between laboratory teams, genetics services, health professionals offering screening, and support organizations is essential.Genet Med advance online publication, 26 October 2017; doi:10.1038/gim.2017.134.

  7. Screening for Methylated Poly(⌊-histidine with Various Dimethylimidazolium/Methylimidazole/Imidazole Contents as DNA Carrier

    Directory of Open Access Journals (Sweden)

    Shoichiro Asayama

    2015-08-01

    Full Text Available Methylated poly(l-histidine (PLH-Me, our original polypeptide, has controlled the contents of dimethylimidazolium, τ/π-methylimidazole and imidazole groups for efficient gene delivery. The screening for the PLH-Me as DNA carrier has been carried out by use of the PLH with 25 mol% (τ-methyl, 16 mol%; π-methyl, 17 mol%; deprotonated imidazole, 41 mol%, 68 mol% (τ-methyl, 16 mol%; π-methyl, 8 mol%; deprotonated imidazole, 8 mol% and 87 mol% (τ-methyl, 7 mol%; π-methyl, 4 mol%; deprotonated imidazole, 2 mol% dimethylimidazolium groups, that is, PLH-Me(25, PLH-Me(68 and PLH-Me(87, respectively. The screening of the chemical structure of PLH-Me has been carried out for DNA carrier properties, which are the stability of its DNA polyion complexes and gene expression. The DNA complexes with the 25 mol% and 68 mol% dimethylated PLH-Me possessed almost same ability to retain DNA, as compared with the 87 mol% dimethylated PLH-Me, which was examined by competitive exchange with dextran sulfate. From the gene transfection experiment against HepG2 cells, human hepatoma cell line, the PLH-Me(25/DNA complex was revealed to mediate highest gene expression. These results suggest that the dimethyl-imidazolium/methylimidazole/imidazole balance of the PLH-Me is important for DNA carrier design.

  8. The universal newborn hearing screening program of Taipei City.

    Science.gov (United States)

    Huang, Hung-Meng; Chiang, Szu-Hui; Shiau, Yu-Shih; Yeh, Wen-Ying; Ho, Hui Chen; Wang, Lilly; Chen, Shou-Chen; Lin, Hung-Ching; Chen, Kwang-Chao; Chiang, Hung; Yang, Ming-Chuan; Yu, Li-Hui; Lin, Hsiu-Lian; Chiu, Allen Wen-Hsiang; Hsiao, Kwang-Jen

    2013-10-01

    To establish a hearing screening program with high coverage, low referral rate, high follow-up rate, and early intervention in Taipei City. From September 2009 to December 2010, 85% delivery units in Taipei City, which includes 20 hospitals and 14 obstetrics clinics, were recruited into the screening program in two stages. A total of 15,930 babies were born in these participating hospitals and clinics during the program period. Among these neonates, 15,790 underwent hearing screening test with automatic auditory brainstem response (AABR). The screening was free of charge to the parents. The hearing screening examination was performed 24-36 h after birth. The same test was repeated between 36 and 60 h of age if the baby failed the first hearing test. The neonate was referred to the diagnostic hospitals for further investigations if he failed the second test. The screening coverage rate was 99.1% (15,790/15,930). The incidence of bilateral moderate to severe and unilateral hearing loss was 1.4 per 1000 (22/15,790) and 1.5 per 1000 (24/15,790), respectively. Four percent (626/15,790) of newborns failed to pass the initial screening test and 1.0% of newborns failed to pass the second screening test. Therefore, 1.0% newborns were referred for diagnostic assessments. The follow-up rate was 94.4% (151/160). Sixty-four percent (14/22) of babies with bilateral hearing loss completed the full diagnostic hearing tests within 3 months of birth. The universal newborn hearing screening program is an adequate program for Taipei City with high coverage, low referral rate, and good follow-up rate. Screening fees covered by third parties, two-stage screening steps with AABR strategy, and the stringent monitoring system proved to be effective. 2b, individual cohort study. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. 75 FR 77869 - Endocrine Disruptor Screening Program; Second List of Chemicals for Tier 1 Screening; Extension...

    Science.gov (United States)

    2010-12-14

    ... CONTACT. List of Subjects Environmental protection, Chemicals, Drinking water, Endocrine disruptors... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPPT-2009-0477; FRL-8856-5] Endocrine Disruptor Screening... Federal Register issue of November 17, 2010, concerning the Endocrine Disruptor Screening Program's (EDSP...

  10. Quality control in screening programs for cervical cancer

    International Nuclear Information System (INIS)

    Sarduy Napoles, Miguel

    2012-01-01

    The malignancy of the cervix is one of the few locations avoidable cancers, if detected before it progresses to the infiltration. The most efficient way of early detection is through a screening program to provide women undertaking a regular and quality Pap smear. If this test results abnormal, the program offers easier access to specialized care, effective treatment, and follow-up. The objective of this article is to present usefulness of methods for quality control used in screening programs for cervical cancer to detect their inadequacies. Here are some factors and conditions that must be considered in each of the steps to take, for a cervical cancer screening program to be successful and to meet the objectives proposed in reducing mortality due to this cause. This document contains some useful indexes calculated to ensure quality throughout the process. There should be the measurement of quality throughout the screening process that allows collecting of reliable data as well as correcting deficiencies

  11. Financing state newborn screening programs: sources and uses of funds.

    Science.gov (United States)

    Johnson, Kay; Lloyd-Puryear, Michele A; Mann, Marie Y; Ramos, Lauren Raskin; Therrell, Bradford L

    2006-05-01

    Financing for newborn screening is different from virtually all other public health programs. All except 5 screening programs collect fees as the primary source of program funding. A fee-based approach to financing newborn screening has been adopted by most states, to ensure consistent funding for this critical public health activity. Two types of data are reported here, ie, primary data from a survey of 37 state public health agencies and findings from exploratory case studies from 7 states. Most of the programs that participated in this survey (73%) reported that their newborn screening funding increased between 2002 and 2005, typically through increased fees and to a lesser extent through Medicaid, Title V Maternal and Child Health Services Block Grant, and state general revenue funding. All of the responding states that collect fees (n = 31) use such funds to support laboratory expenses, and most (70%) finance short-term follow-up services and program management. Nearly one half (47%) finance longer-term follow-up services, case management, or family support beyond diagnosis. Other states (43%) finance genetic or nutritional counseling and formula foods or treatment. Regardless of the source of funds, the available evidence indicates that states are committed to maintaining their programs and securing the necessary financing for the initial screening through diagnosis. Use of federal funding is currently limited; however, pressure to provide dedicated federal funding would likely increase if national recommendations for a uniform newborn screening panel were issued.

  12. The direct cost of "Thriasio" school screening program

    Directory of Open Access Journals (Sweden)

    Maziotou Christina

    2007-05-01

    Full Text Available Abstract Background There is great diversity in the policies for scoliosis screening worldwide. The initial enthusiasm was succeeded by skepticism and the worth of screening programs has been challenged. The criticisms of school screening programs cite mainly the negative psychological impact on children and their families and the increased financial cost of visits and follow-up radiographs. The purpose of this report is to evaluate the direct cost of performing the school screening in a district hospital. Methods A cost analysis was performed for the estimation of the direct cost of the "Thriasio" school-screening program between January 2000 and May 2006. The analysis involved all the 6470 pupils aged 6–18 years old who were screened at schools for spinal deformities during this period. The factors which were taken into consideration in order to calculate the direct cost of the screening program were a the number of the examiners b the working hours, c the examiners' salary, d the cost of transportation and finally e the cost of examination per child. Results During the examined period 20 examiners were involved in the program and worked for 1949 working hours. The hourly salary for the trainee doctors was 6.80 euro, for the Health Visitors 6.70 euro and for the Physiotherapists 5.50 euro in current prices. The cost of transportation was 32 euro per year. The direct cost for the examination of each child for the above studied period was calculated to be 2.04 euro. Conclusion The cost of our school-screening program is low. The present study provides a strong evidence for the continuation of the program when looking from a financial point of view.

  13. Relevance and efficacy of breast cancer screening in BRCA1 and BRCA2 mutation carriers above 60 years: a national cohort study.

    Science.gov (United States)

    Saadatmand, Sepideh; Vos, Janet R; Hooning, Maartje J; Oosterwijk, Jan C; Koppert, Linetta B; de Bock, Geertruida H; Ausems, Margreet G; van Asperen, Christi J; Aalfs, Cora M; Gómez Garcia, Encarna B; Meijers-Heijboer, Hanne; Hoogerbrugge, Nicoline; Piek, Marianne; Seynaeve, Caroline; Verhoef, Cornelis; Rookus, Matti; Tilanus-Linthorst, Madeleine M

    2014-12-15

    Annual MRI and mammography is recommended for BRCA1/2 mutation carriers to reduce breast cancer mortality. Less intensive screening is advised ≥60 years, although effectiveness is unknown. We identified BRCA1/2 mutation carriers without bilateral mastectomy before age 60 to determine for whom screening ≥60 is relevant, in the Rotterdam Family Cancer Clinic and HEBON: a nationwide prospective cohort study. Furthermore, we compared tumour stage at breast cancer diagnosis between different screening strategies in BRCA1/2 mutation carriers ≥60. Tumours >2 cm, positive lymph nodes, or distant metastases at detection were defined as "unfavourable." Of 548 BRCA1/2 mutation carriers ≥60 years in 2012, 395 (72%) did not have bilateral mastectomy before the age of 60. Of these 395, 224 (57%) had a history of breast or other invasive carcinoma. In 136 BRCA1/2 mutation carriers, we compared 148 breast cancers (including interval cancers) detected ≥60, of which 84 (57%) were first breast cancers. With biennial mammography 53% (30/57) of carcinomas were detected in unfavourable stage, compared to 21% (12/56) with annual mammography (adjusted odds ratio: 4·07, 95% confidence interval [1.79-9.28], p = 0.001). With biennial screening 40% of breast cancers were interval cancers, compared to 20% with annual screening (p = 0.016). Results remained significant for BRCA1 and BRCA2 mutation carriers, and first breast cancers separately. Over 70% of 60-year old BRCA1/2 mutation carriers remain at risk for breast cancer, of which half has prior cancers. When life expectancy is good, continuation of annual breast cancer screening of BRCA1/2 mutation carriers ≥60 is worthwhile. © 2014 UICC.

  14. Offering cystic fibrosis carrier screening to an HMO population: factors associated with utilization.

    Science.gov (United States)

    Tambor, E S; Bernhardt, B A; Chase, G A; Faden, R R; Geller, G; Hofman, K J; Holtzman, N A

    1994-10-01

    We offered cystic fibrosis (CF) carrier testing to reproductive-age enrollees in an HMO, in order to determine factors associated with test utilization in a primarily nonpregnant population. Male and female enrollees either were mailed an invitation to have the test after attending an educational session (N = 2,713) or were approached in waiting rooms at the HMO sites and given the opportunity to have the test without making an additional visit (N = 608). Uptake was considerably higher when testing could be obtained without making an additional visit (23.5%) than when attendance at an educational session was required as a prerequisite for having the test (3.7%). Utilization was higher among respondents who were planning children. Caucasians, and those with higher educational attainment. Among respondents planning to have children, individuals with higher tolerance for test uncertainty, lower fear of stigma, and higher perceived risk of being a carrier were significantly more likely to have the test. Testing decisions were not associated with the perceived burden of a child with CF or with the likelihood of aborting for CF. Although utilization of CF carrier testing is relatively low among nonpregnant individuals, uptake is significantly higher when testing can be obtained with minimal effort. Factors associated with the decision to be tested had more to do with implications of being a carrier per se than with the concerns of having a child with CF.

  15. The role of experiential knowledge within attitudes towards genetic carrier screening: A comparison of people with and without experience of spinal muscular atrophy.

    Science.gov (United States)

    Boardman, Felicity K; Young, Philip J; Warren, Oliver; Griffiths, Frances E

    2018-02-01

    Autosomal recessive conditions, while individually rare, are a significant health burden with limited treatment options. Population carrier screening has been suggested as a means of tackling them. Little is known, however, about the attitudes of the general public towards such carrier screening and still less about the views of people living with candidate genetic diseases. Here, we focus on the role that such experience has on screening attitudes by comparing views towards screening of people with and without prior experience of the monogenetic disorder, Spinal Muscular Atrophy. An exploratory sequential mixed methods design was adopted. In-depth qualitative interviews were used to develop two surveys. The surveys addressed attitudes towards carrier screening (pre-conceptual and prenatal) for SMA. 337 participants with SMA experience completed the SMA Screening Survey (UK) and 336 participants with no prior experience of SMA completed the UK GenPop Survey, an amended version of the SMA Screening Survey (UK). The majority of both cohorts were in favour of pre-conception and prenatal carrier screening, however people with experience of type II SMA were least likely to support either. Key differences emerged around perceptions of SMA, with those without SMA experience taking a dimmer view of the condition than those with. This study underscores the significance of prior experience with the condition to screening attitudes. It highlights the need for accurate and high-quality educational resources to support any future carrier screening programmes, that particularly in relation to rare genetic disorders like SMA that will fall outside the remit of everyday experience for the majority of the population. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  16. Growing complexity of (expanded) carrier screening: Direct-to-consumer, physician-mediated, and clinic-based offers.

    Science.gov (United States)

    Chokoshvili, Davit; Vears, Danya F; Borry, Pascal

    2017-10-01

    Since the introduction of out-of-hospital health-related genetic tests more than a decade ago, the landscape of genetic testing services has grown in complexity. Although initially most genetic tests for health purposes were offered as direct-to-consumer services, that is, without the mediation of a medical professional, currently many commercial providers require that their tests be ordered by a licensed physician. At the same time, some commercially developed health-related genetic tests are gaining support from the professional medical community and are finding their way into clinical practice. Therefore, we differentiated between three types of genetic testing offers: direct-to-consumer, physician-mediated, and clinic-based genetic testing. Expanded carrier screening tests for recessive disorders are currently available through all the three models of genetic testing. Herein, we review the present landscape of expanded carrier screening offers by highlighting the distinct issues associated with each of the three types of genetic testing. Copyright © 2017. Published by Elsevier Ltd.

  17. Knowledge and Attitude of University Students Towards Premarital Screening Program

    Directory of Open Access Journals (Sweden)

    Rahma Al Kindi

    2012-07-01

    Full Text Available Objectives: The aim of this study was to explore the knowledge and attitude of Sultan Qaboos University students towards premarital screening program.Methods: A cross-sectional study conducted at the students’ clinic from January to April 2011. A self-administered questionnaire was distributed to 590 unmarried Omani students of both genders. The questionnaire consisted of 3 main parts; the first part was based on socio-demographic data, the second part dealt with the students’ knowledge about the premarital screening program while the third part explored their attitudes towards the screening program.Results: Most of the participants (n=469; 79% were aware about the availability of premarital screening program in Oman. The main sources of information were: school/college (n=212; 36%, media (n=209; 35%, family and friends (n=197; 33%, and/or health services (n=181, 31%. The vast majority of the participants (n=540; 92% thought it is important to carry out premarital screening and agreed to do it. Around half of the participants (n=313; 53% favored having premarital screening as an obligatory procedure before marriage and about one third (n=212; 36% favored making laws and regulation to prevent marriage in case of positive results.Conclusion: Even though the majority of the participants thought it is important to carry out premarital screening; only half favored making it obligatory before marriage and one third favored making laws and regulations to prevent marriage in case of positive results. This reflects the importance of health education as a keystone in improving knowledge and attitude towards premarital screening program.

  18. Knowledge and Attitude of University Students Towards Premarital Screening Program

    Science.gov (United States)

    Al Kindi, Rahma; Al Rujaibi, Salha; Al Kendi, Maya

    2012-01-01

    Objectives The aim of this study was to explore the knowledge and attitude of Sultan Qaboos University students towards premarital screening program. Methods A cross-sectional study conducted at the students’ clinic from January to April 2011. A self-administered questionnaire was distributed to 590 unmarried Omani students of both genders. The questionnaire consisted of 3 main parts; the first part was based on socio-demographic data, the second part dealt with the students’ knowledge about the premarital screening program while the third part explored their attitudes towards the screening program. Results Most of the participants (n=469; 79%) were aware about the availability of premarital screening program in Oman. The main sources of information were: school/college (n=212; 36%), media (n=209; 35%), family and friends (n=197; 33%), and/or health services (n=181, 31%). The vast majority of the participants (n=540; 92%) thought it is important to carry out premarital screening and agreed to do it. Around half of the participants (n=313; 53%) favored having premarital screening as an obligatory procedure before marriage and about one third (n=212; 36%) favored making laws and regulation to prevent marriage in case of positive results. Conclusion Even though the majority of the participants thought it is important to carry out premarital screening; only half favored making it obligatory before marriage and one third favored making laws and regulations to prevent marriage in case of positive results. This reflects the importance of health education as a keystone in improving knowledge and attitude towards premarital screening program. PMID:23071880

  19. Investigation of newborns with abnormal results in a newborn screening program for four lysosomal storage diseases in Brazil

    Directory of Open Access Journals (Sweden)

    Heydy Bravo

    2017-09-01

    Full Text Available Lysosomal storage diseases (LSDs are genetic disorders, clinically heterogeneous, mainly caused by defects in genes encoding lysosomal enzymes that degrade macromolecules. Several LSDs already have specific therapies that may improve clinical outcomes, especially if introduced early in life. With this aim, screening methods have been established and newborn screening (NBS for some LSDs has been developed. Such programs should include additional procedures for the confirmation (or not of the cases that had an abnormal result in the initial screening. We present here the methods and results of the additional investigation performed in four babies with positive initial screening results in a program of NBS for LSDs performed by a private laboratory in over 10,000 newborns in Brazil. The suspicion in these cases was of Mucopolysaccharidosis I - MPS I (in two babies, Pompe disease and Gaucher disease (one baby each. One case of pseudodeficiency for MPS I, 1 carrier for MPS I, 1 case of pseudodeficiency for Pompe disease and 1 carrier for Gaucher disease were identified. This report illustrates the challenges that may be encountered by NBS programs for LSDs, and the need of a comprehensive protocol for the rapid and precise investigation of the babies who have an abnormal screening result.

  20. Overcoming barriers in HPV vaccination and screening programs

    Directory of Open Access Journals (Sweden)

    Alex Vorsters

    2017-12-01

    Full Text Available The Human Papillomavirus Prevention and Control Board brought together experts to discuss optimizing HPV vaccination and screening programs.Board members reviewed the safety profile of licensed HPV vaccines based on clinical and post-marketing data, reaching a consensus that current safety data is reassuring.Successful vaccination programs used well-coordinated communication campaigns, integrating (social media to spread awareness. Communication of evidence supporting vaccine effectiveness had beneficial effects on the perception of the vaccine. However, anti-vaccination campaigns have threatened existing programs in many countries.Measurement and monitoring of HPV vaccine confidence over time could help understand the nature and scale of waning confidence, define issues and intervene appropriately using context-specific evidence-based strategies. Finally, a broad group of stakeholders, such as teachers, health care providers and the media should also be provided with accurate information and training to help support prevention efforts through enhanced understanding of the risks and benefits of vaccination.Similarly, while cervical cancer screening through population-based programs is highly effective, barriers to screening exist: awareness in countries with population-based screening programs, access for vulnerable populations, and access and affordability in low- and middle-income countries. Integration of primary and secondary prevention has the potential to accelerate the decrease in cervical cancer incidence. Keywords: (max 6 Human papillomavirus, Vaccine, Screening, Barriers, Vaccine confidence

  1. Communication of carrier status information following universal newborn screening for sickle cell disorders and cystic fibrosis: qualitative study of experience and practice.

    Science.gov (United States)

    Kai, J; Ulph, F; Cullinan, T; Qureshi, N

    2009-11-01

    To describe and explore current practice, methods and experience of communicating carrier status information following newborn screening for cystic fibrosis (CF) and sickle cell (SC) disorders, to inform practice and further research. Three linked qualitative studies. All nine health regions in England. Child health screening coordinators in all English health regions, health professionals communicating results to parents and parents of newborn carriers. A preliminary phase of semi-structured telephone interviews with child health screening coordinators in all nine English health regions, and thematic analysis of data; semi-structured face-to-face interviews with purposeful samples of 67 family members of 51 infants identified by universal newborn screening as carriers of CF or SC with data analysis by constant comparison; and semi-structured telephone interviews, and focus groups, with a key informant sample of 16 differing health professionals currently tasked with communicating results to parents in a range of ways, with thematic analysis of data. Methods for and respondents' experiences of communication of carrier results varied considerably within and between regions, and within and between SC and CF contexts. Approaches ranged from letter or telephone call alone, to in-person communication in the clinic or at home, with health professionals from haemoglobinopathy, CF, screening and genetics backgrounds, or from community and primary care, such as health visitors with SC carrier results. Health professionals identified pros and cons of different methods, preferring opportunity for face-to-face communication with parents where possible, particularly for CF carrier results. They were concerned by regional variations in protocols, the lack of availability of translated information on SC carrier results, and the feasibility of sustaining more 'specialist' involvement at current levels, particularly for SC carriers. Parents were often poorly prepared for the

  2. Rescuing compound bioactivity in a secondary cell-based screening by using γ-cyclodextrin as a molecular carrier

    Science.gov (United States)

    Claveria-Gimeno, Rafael; Vega, Sonia; Grazu, Valeria; de la Fuente, Jesús M; Lanas, Angel; Velazquez-Campoy, Adrian; Abian, Olga

    2015-01-01

    In vitro primary screening for identifying bioactive compounds (inhibitors, activators or pharmacological chaperones) against a protein target results in the discovery of lead compounds that must be tested in cell-based efficacy secondary screenings. Very often lead compounds do not succeed because of an apparent low potency in cell assays, despite an excellent performance in primary screening. Primary and secondary screenings differ significantly according to the conditions and challenges the compounds must overcome in order to interact with their intended target. Cellular internalization and intracellular metabolism are some of the difficulties the compounds must confront and different strategies can be envisaged for minimizing that problem. Using a novel screening procedure we have identified 15 compounds inhibiting the hepatitis C NS3 protease in an allosteric fashion. After characterizing biophysically the interaction with the target, some of the compounds were not able to inhibit viral replication in cell assays. In order to overcome this obstacle and potentially improve cellular internalization three of these compounds were complexed with γ-cyclodextrin. Two of them showed a five- and 16-fold activity increase, compared to their activity when delivered as free compounds in solution (while γ-cyclodextrin did not show antiviral activity by itself). The most remarkable result came from a third compound that showed no antiviral activity in cell assays when delivered free in solution, but its γ-cyclodextrin complex exhibited a 50% effective concentration of 5 μM. Thus, the antiviral activity of these compounds can be significantly improved, even completely rescued, using γ-cyclodextrin as carrier molecule. PMID:25834436

  3. Newborn screening program for hemoglobinopathies in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Lobo, Clarisse Lopes de Castro; Ballas, Samir K; Domingos, Ana Carolina Bonini; Moura, Patricia G; do Nascimento, Emilia Matos; Cardoso, Gilberto Perez; de Carvalho, Silvia Maia Farias

    2014-01-01

    Newborn screening for hemoglobinopathy in Brazil has been decentralized until 2001 when the Health Ministry of Brazil established the National Newborn Hemoglobinopathy Screening Program. The State of Rio de Janeiro started a program in collaboration with the State Health Department and the Institute of Hematology in Rio (HEMORIO). The goal of this study was to evaluate the effectiveness of the first 10 years of the Newborn Hemoglobinopathy Screening Program in identifying and managing infants with Sickle cell disease (SCD) in the State of Rio de Janeiro. Blood samples from 1,217,833 neonates were analyzed by High Performance Liquid Chromatography. Infants with SCD were enrolled in comprehensive treatment programs. Data showed that 4.87% of the newborns were heterozygous for a hemoglobin variant, 0.08% were homozygous or doubly heterozygous for abnormal hemoglobins and 95.02% had normal hemoglobin. All the 912 newborns with SCD were referred for treatment at HEMORIO, 34 (3.7%) of these died due to acute chest syndrome, sepsis or splenic sequestration. Four more children died of unknown causes. The implementation of the Rio de Janeiro Newborn Screening Program gradually increased the area of the State covered by the program. Data collected during the 10 years of the program showed reduction in mortality of patients with SCD in comparison to available historical statistical data before the implementation of the national screening program. This 10-year study showed that early diagnosis and treatment of newborns was associated with improved survival and quality of life of Brazilian children with SCD. © 2013 Wiley Periodicals, Inc.

  4. Theoretical study of carrier transport and screening in topological insulator Bi2Se3

    Science.gov (United States)

    Adam, Shaffique; Hwang, E. H.; Stiles, M. D.; Das Sarma, S.

    2012-02-01

    This theoretical work is motivated by two recent experiments on Bi2Se3 examining the charge inhomogeneity [1-2] close to the topologically protected crossing point of surface bands in these bulk topological insulators. Reminiscent of graphene close to charge neutrality [3-4], the energy landscape becomes highly inhomogeneous, forming a sea of electron and hole puddles, which determine the properties at low carrier density. Here, we show that the induced carrier density fluctuations are of order 1 % of the impurity density, providing a small-parameter with which we can perform a controlled perturbation theory. Analytic results are obtained for the minimum conductivity and puddle auto-correlation length. We also find that the band asymmetry between electron and holes states is a necessary ingredient to understand the aforementioned experiments. References: [1] H. Beidenkopf et al, ``Spatial fluctuations of helical Dirac fermions on the surface of topological insulators,'' Nat. Phys. online publ., (2011) [2] D. Kim et al., ``Minimum conductivity and charge inhomogeneity in Bi2Se3,'' arXiv:1105.1410. [3] S. Adam et al., ``A self-consistent theory for graphene transport,'' PNAS 104, 18392 (2007). [4] S. Das Sarma et al., ``Electronic transport in 2D graphene,'' Rev. Mod. Phys. 83, 407 (2011).

  5. Time to stop ovarian cancer screening in BRCA1/2 mutation carriers?

    NARCIS (Netherlands)

    van der Velde, Nienke M.; Mourits, Marian J. E.; Arts, Henriette J. G.; de Vries, J.; Leegte, Beike K.; Dijkhuis, Grieteke; Osterwijk, Jan C.; de Bock, Geertruida H.

    2009-01-01

    Women at high risk of ovarian cancer (file to a genetic predisposition may opt for either surveillance or prophylactic bilateral salpingo-oophorectomy (pBSO). Main objective of our study was to determine the effectiveness of ovarian cancer screening in women with a BRCA1/2 mutation. We evaluated 241

  6. Optimising the expansion of the National Bowel Cancer Screening Program.

    Science.gov (United States)

    Cenin, Dayna R; St John, D James B; Ledger, Melissa J N; Slevin, Terry; Lansdorp-Vogelaar, Iris

    2014-10-20

    To estimate the impact of various expansion scenarios of the National Bowel Cancer Screening Program (NBCSP) on the number of bowel cancer deaths prevented; and to investigate the impact of the expansion scenarios on colonoscopy demand. MISCAN-Colon, a well established, validated computer simulation model for bowel cancer screening, was adjusted to reflect the Australian situation. In July 2013, we simulated the effects of screening over a 50-year period, starting in 2006. The model parameters included rates of participation in screening and follow-up, rates of identification of cancerous and precancerous lesions, bowel cancer incidence, mortality and the outcomes of the NBCSP. Five implementation scenarios, based on biennial screening using an immunochemical faecal occult blood test, were developed and modelled. A sensitivity analysis that increased screening participation to 60% was also conducted. Australian residents aged 50 to 74 years. Comparison of the impact of five implementation scenarios on the number of bowel cancer deaths prevented and demand for colonoscopy. MISCAN-Colon calculated that in its current state, the NBCSP should prevent 35 169 bowel cancer deaths in the coming 40 years. Accelerating the expansion of the program to achieve biennial screening by 2020 would prevent more than 70 000 deaths. If complete implementation of biennial screening results in a corresponding increase in participation to 60%, the number of deaths prevented will increase across all scenarios. The findings strongly support the need for rapid implementation of the NBCSP. Compared with the current situation, achieving biennial screening by 2020 could result in 100% more bowel cancer deaths (about 35 000) being prevented in the coming 40 years.

  7. Performance of a four-step newborn screening strategy for CF in the Dutch screening program: WS 10.4

    NARCIS (Netherlands)

    Dankert-Roelse,J.; Bouva, M.; Winter-de Groot, Y. de; Schönbeck, Y.; Gille, H.; Gulmans, V.A.M.; Verschoof-Puite, R.; Dompeling, E.; Schielen, P.; Verkerk, P.

    2017-01-01

    Workshop. Since May 1, 2011, newborn screening for Cystic Fibrosis (NBSCF) is part of the Dutch NBS program Objectives: To assess the validity of the four-step screening strategy when applied in a routine newborn screening program. Methods: NBSCF was carried out as a 4-step strategy

  8. Self-collection for under-screened women in a National Cervical Screening Program: pilot study

    Science.gov (United States)

    Saville, M.; Hawkes, D; Mclachlan, E.; Anderson, S.; Arabena, K.

    2018-01-01

    Background Commencing 1 December 2017, Australia introduced human papillomavirus (hpv)-based cervical screening. As part of this Australian renewed National Cervical Screening Program (ncsp) women who are either never- or under-screened and who refuse a practitioner collected sample will be able to collect their own sample for cervical screening. The aim of this study is to examine the quantitative results of a pilot study into the acceptability of the self-collection alternative pathway. Methods Eligible participants were offered the opportunity to collect their own sample. Those who agreed were given a flocked swab and an instruction sheet and took their own sample in an area of the health care clinic that afforded them adequate privacy. These samples were then given to clinic staff who returned them to Victorian Cytology Service (vcs) Pathology for hpv nucleic acid testing. Results Of 98 eligible women, seventy-nine undertook self-collection for hpv-based cervical screening. Seventy-seven produced valid results, 14 were positive for oncogenic hpv, with 10 undertaking follow-up. Three women were found to have cervical squamous abnormalities with two of those being high-grade intraepithelial squamous lesions. Conclusion The pilot study for self-collection for cervical screening produced quantitative data that were similar to that already reported in the literature, but had a much higher rate of acceptance compared with self-collection programs based in the home. PMID:29507492

  9. [Cigarette smoking among women attending cervical cancer screening program].

    Science.gov (United States)

    Walentowicz-Sadłecka, Małgorzata; Sadłecki, Paweł; Marszałek, Andrzej; Grabiec, Marek

    2012-01-01

    Cervical cancer is recognized as tobacco-related malignancy. HPV vaccination and introducing screening protocols were found as the best way to decrease cervical cancer related mortality. Besides the cytological screening programs of the uterine cervix smear, nowadays co-factors of carcinogenesis are taken into consideration, also. The aim of our study was to analyse data included in questionnaire of 310 women who underwent cytological examination wi thin cervical cancer screening program in our Department in 2011. There were no differences found between studied groups on rate of oral contraceptive or hormonal therapy use, as well as age and tobacco smoking. However, taking into account education and smoking, there was a significant correlation observed. Patients with higher education level smoked less often. The special attention should be paid to promote smoking cessation in the group of women who finished education on elementary level.

  10. National screening program vs. standardized neurodevelopmental follow-up

    NARCIS (Netherlands)

    Maschke, Cornelia; Ellenrieder, Birte; Hecher, Kurt; Bartmann, Peter

    Background: Long-term follow-up is urgently needed to decide on the consequences of new therapies. Objective: This study assesses the use of a national child development screening program for a follow-up examination of a defined patient group. Patients and methods: Neurodevelopmental outcome of 139

  11. Indicators for monitoring screening programs with primary HPV test.

    Science.gov (United States)

    Zorzi, Manuel; Giorgi Rossi, Paolo

    2017-01-01

    following scientific evidence produced in numerous studies, as well as national and international guidelines, organized cervical cancer screening programs in Italy have gradually introduced the HPV test as primary screening test, replacing cytology. As public health interventions, screening programs must ensure equity, improvement in quality of life, and adequate information for the population involved with regards to benefits and possible risks; therefore, it is essential for quality to be constantly checked at every phase of the project.The Italian Cervical Screening Group (Gruppo Italiano per lo Screening Cervicale, GISCi) has written a handbook for the calculation and interpretation of cervical screening program monitoring indicators that take into account the new protocol based on primary HPV test with cytology triage. based on the European guidelines and Italian recommendations on primary HPVbased screening, the working group, which includes professionals from all the fields involved in cervical screening, identified the essential points needed to monitor the screening process, the accuracy of individual tests, and early outcomes, defining a specific indicator for each aspect. The indicators were grouped as follows: baseline indicators, indicators for test repeat after one year, cumulative indicators, and waiting times. For every indicator, the source of data, calculation formula, any standards or critical thresholds, and interpretation were defined. The standards are based on the results of NTCC trials or Italian pilot studies. the main indicators proposed for the organization are the following: number of invitations, compliance with first invitation, with one-year test repeat and with colposcopy; for test and process accuracy, a cohort approach was utilised, where indicators are based on women who must be followed for at least one year, so as to integrate the results obtained after the first HPV test with the outcome of the test's repetition after one year

  12. FMCSA safety program effectiveness measurement : carrier intervention effectiveness model, version 1.0 : [analysis brief].

    Science.gov (United States)

    2015-01-01

    The Carrier Intervention Effectiveness Model (CIEM) : provides the Federal Motor Carrier Safety : Administration (FMCSA) with a tool for measuring : the safety benefits of carrier interventions conducted : under the Compliance, Safety, Accountability...

  13. Staphylococcus aureus: Screening for Nasal Carriers in a Community Setting with Special Reference to MRSA

    Directory of Open Access Journals (Sweden)

    Yukti Sharma

    2014-01-01

    Full Text Available Introduction. Emergence of MRSA infections among previously healthy persons in community settings (without exposure to health care facilities has been noted recently. MRSA infections are now classified as health care-associated MRSA (HA-MRSA and community-associated MRSA (CA-MRSA infections. Its colonization is an important risk factor for subsequent MRSA infection. Aims and Objectives. The aim was to screen patients and health care workers for staphylococcal carriage, identify risk factors for MRSA colonization, and determine the sensitivity pattern. Materials and Methods. A total of 200 subjects were screened for nasal carriage after obtaining verbal consent. These were both healthy subjects attending various outpatient departments and health care workers. Specimens were collected from the anterior nares using premoistened sterile cotton swabs and inoculated onto blood agar and mannitol salt agar and incubated at 37°C for 24–48 h. Results. Staphylococcus aureus colonisation was found to be 12% (n=24. MRSA was identified in 5% (n=10 which represents 41.66% of SA. A total of 10 strains of MRSA were isolated from 200 subjects, giving an overall positivity rate of 5%. Discussion. Staphylococcal colonization was found to be 12% (MRSA 5%. Fluoroquinolone resistance was remarkable whereas all strains were sensitive to vancomycin, teicoplanin, linezolid, quinupristin-dalfopristin.

  14. Progression of diabetes retinal status within community screening programs and potential implications for screening intervals.

    Science.gov (United States)

    Leese, Graham P; Stratton, Irene M; Land, Martin; Bachmann, Max O; Jones, Colin; Scanlon, Peter; Looker, Helen C; Ferguson, Brian

    2015-03-01

    This study aimed to follow the natural progression of retinal changes in patients with diabetes. Such information should inform decisions with regard to the screening intervals for such patients. An observational study was undertaken linking the data from seven diabetes retinal screening programs across the U.K. for retinal grading results between 2005 and 2012. Patients with absent or background retinopathy were followed up for progression to the end points referable retinopathy and treatable retinopathy (proliferative retinopathy). In total, 354,549 patients were observed for up to 4 years during which 16,196 patients progressed to referable retinopathy. Of patients with no retinopathy in either eye for two successive screening episodes at least 12 months apart, the conditions of between 0.3% (95% CI 0.3-0.8%) and 1.3% (1.0-1.6%) of patients progressed to referable retinopathy, and rates of treatable eye disease were screening episodes were 13-29% and up to 4%, respectively, in the different programs. It may be possible to stratify patients for risk, according to baseline retinal criteria, into groups with low and high risk of their conditions progressing to proliferative retinopathy. Screening intervals for such diverse groups of patients could safely be modified according to their risk. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  15. Fundus Autofluorescence Imaging in an Ocular Screening Program

    Directory of Open Access Journals (Sweden)

    A. M. Kolomeyer

    2012-01-01

    Full Text Available Purpose. To describe integration of fundus autofluorescence (FAF imaging into an ocular screening program. Methods. Fifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640 nm exciter/barrier filters images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images on site to determine need for referral. Visual acuity (VA, intraocular pressure (IOP, and ocular pathology detected by color fundus and FAF imaging modalities were recorded. Results. Mean ± SD age was 47.4 ± 17.3 years. Fifty-two percent were female and 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was 20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15 mmHg bilaterally. Positive color and/or FAF findings were identified in nine (18% individuals with diabetic retinopathy or macular edema (n=4, focal RPE defects (n=2, age-related macular degeneration (n=1, central serous retinopathy (n=1, and ocular trauma (n=1. Conclusions. FAF was successfully integrated in our ocular screening program and aided in the identification of ocular pathology. Larger studies examining the utility of this technology in screening programs may be warranted.

  16. Preconceptional ancestry-based carrier couple screening for cystic fibrosis and haemoglobinopathies: what determines the intention to participate or not and actual participation?

    NARCIS (Netherlands)

    Lakeman, Phillis; Plass, Anne Marie Catharina; Henneman, Lidewij; Bezemer, Pieter Dirk; Cornel, Martina Cornelia; ten Kate, Leo Pieter

    2009-01-01

    This paper explores determinants of the intention to participate or not and of actual participation in preconceptional ancestry-based carrier couple screening for cystic fibrosis (CF) and haemoglobinopathies (HbPs). In total, 9453 individuals from a multi-ethnic population were invited. Invitees who

  17. Differences in Natural History between Breast Cancers in BRCA1 and BRCA2 Mutation Carriers and Effects of MRI Screening-MRISC, MARIBS, and Canadian Studies Combined

    NARCIS (Netherlands)

    Heijnsdijk, E.A.; Warner, E.; Gilbert, F.J.; Tilanus-Linthorst, M.M.; Evans, G.; Causer, P.A.; Eeles, R.A.; Kaas, R.; Draisma, G.; Ramsay, E.A.; Warren, R.M.; Hill, K.A.; Hoogerbrugge-van der Linden, N.; Wasser, M.N.; Bergers, E.; Oosterwijk, J.C.; Hooning, M.J.; Rutgers, E.J.; Klijn, J.G.; Plewes, D.B.; Leach, M.O.; de Koning, H.J.

    2012-01-01

    BACKGROUND: It is recommended that BRCA1/2 mutation carriers undergo breast cancer screening using MRI because of their very high cancer risk and the high sensitivity of MRI in detecting invasive cancers. Clinical observations suggest important differences in the natural history between breast

  18. Cost-effectiveness analysis of neonatal hearing screening program in china: should universal screening be prioritized?

    Directory of Open Access Journals (Sweden)

    Huang Li-Hui

    2012-04-01

    Full Text Available Abstract Background Neonatal hearing screening (NHS has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. Methods A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs, average cost-effectiveness ratio (ACER, and incremental cost-effectiveness ratio (ICER for universal screening compared to targeted screening in eight provinces. Results and discussion A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This

  19. Whole-Genome Screening of Newborns? The Constitutional Boundaries of State Newborn Screening Programs.

    Science.gov (United States)

    King, Jaime S; Smith, Monica E

    2016-01-01

    State newborn screening (NBS) programs routinely screen nearly all of the 4 million newborns in the United States each year for ∼30 primary conditions and a number of secondary conditions. NBS could be on the cusp of an unprecedented expansion as a result of advances in whole-genome sequencing (WGS). As WGS becomes cheaper and easier and as our knowledge and understanding of human genetics expand, the question of whether WGS has a role to play in state NBS programs becomes increasingly relevant and complex. As geneticists and state public health officials begin to contemplate the technical and procedural details of whether WGS could benefit existing NBS programs, this is an opportune time to revisit the legal framework of state NBS programs. In this article, we examine the constitutional underpinnings of state-mandated NBS and explore the range of current state statutes and regulations that govern the programs. We consider the legal refinements that will be needed to keep state NBS programs within constitutional bounds, focusing on 2 areas of concern: consent procedures and the criteria used to select new conditions for NBS panels. We conclude by providing options for states to consider when contemplating the use of WGS for NBS. Copyright © 2016 by the American Academy of Pediatrics.

  20. Screening for Familial Hypercholesterolemia in Children: What Can We Learn From Adult Screening Programs?

    Directory of Open Access Journals (Sweden)

    Lidewij Henneman

    2015-10-01

    Full Text Available Familial hypercholesterolemia (FH, an autosomal dominant atherosclerotic disease, is a common monogenic subtype of cardiovascular disease. Patients with FH suffer an increased risk of early onset heart disease. Early identification of abnormally elevated cholesterol signpost clinicians to interventions that will significantly decrease risk of related morbidity and mortality. Cascade genetic testing can subsequently identify at-risk relatives. Accordingly, a number of screening approaches have been implemented for FH in countries including the UK and the Netherlands. However, incomplete identification of cases remains a challenge. Moreover, the potential for early intervention is now raising questions about the value of implementing universal cholesterol screening approaches that focus on children. In this report, we briefly discuss the potential benefit of such screening. Additionally, we submit that ever increasing genome technological capability will force a discussion of including genetic tests in these screening programs. We discuss the opportunities and challenges presented by such an approach. We close with recommendations that the success of such screening endeavors will rely on a better integrated practice model in public health genomics that bridges stakeholders including practitioners in primary care, clinical genetics and public health.

  1. Breast cancer screening results 5 years after introduction of digital mammography in a population-based screening program.

    NARCIS (Netherlands)

    Karssemeijer, N.; Bluekens, A.M.; Beijerinck, D.; Deurenberg, J.J.; Beekman, M.; Visser, R.; Engen, R. van; Bartels-Kortland, A.; Broeders, M.J.M.

    2009-01-01

    PURPOSE: To compare full-field digital mammography (FFDM) using computer-aided diagnosis (CAD) with screen-film mammography (SFM) in a population-based breast cancer screening program for initial and subsequent screening examinations. MATERIALS AND METHODS: The study was approved by the regional

  2. Program spending to increase adherence: South African cervical cancer screening.

    Directory of Open Access Journals (Sweden)

    Jeremy D Goldhaber-Fiebert

    2009-05-01

    Full Text Available Adherence is crucial for public health program effectiveness, though the benefits of increasing adherence must ultimately be weighed against the associated costs. We sought to determine the relationship between investment in community health worker (CHW home visits and increased attendance at cervical cancer screening appointments in Cape Town, South Africa.We conducted an observational study of 5,258 CHW home visits made in 2003-4 as part of a community-based screening program. We estimated the functional relationship between spending on these visits and increased appointment attendance (adherence. Increased adherence was noted after each subsequent CHW visit. The costs of making the CHW visits was based on resource use including both personnel time and vehicle-related expenses valued in 2004 Rand. The CHW program cost R194,018, with 1,576 additional appointments attended. Adherence increased from 74% to 90%; 55% to 87%; 48% to 77%; and 56% to 80% for 6-, 12-, 24-, and 36-month appointments. Average per-woman costs increased by R14-R47. The majority of this increase occurred with the first 2 CHW visits (90%, 83%, 74%, and 77%; additional cost: R12-R26.We found that study data can be used for program planning, identifying spending levels that achieve adherence targets given budgetary constraints. The results, derived from a single disease program, are retrospective, and should be prospectively replicated.

  3. Should asymptomatic men be included in chlamydia screening programs? Cost-effectiveness of chlamydia screening among male and female entrants to a national job training program.

    Science.gov (United States)

    Blake, Diane R; Quinn, Thomas C; Gaydos, Charlotte A

    2008-01-01

    To compare the cost-effectiveness of various chlamydia screening strategies within a population of male and female youth entering a national job training program. Cost-effectiveness analysis of various chlamydia screening strategies among a cohort of 4000 female and male New England job training students. Strategies for women include (a) no screening, (b) universal endocervical DNA probe screening, (c) universal urine based NAAT screening, and (d) universal endocervical NAAT screening. Strategies for men include (a) no screening, (b) selective urine NAAT screening of leukocyte esterase (LE)-positive urines, and (c) universal urine-based NAAT screening. Universal endocervical NAAT screening of women and universal urine NAAT screening of men were the most effective and cost-effective strategies individually and in combination. Endocervical NAAT screening of women prevented 23 more cases of PID and saved $27,000 more than endocervical DNA probe screening. Likewise, universal urine NAAT screening of men prevented 21 more cases of PID in their female partners and saved $16,000 more than selective urine NAAT screening of LE positive men. Use of a sensitive NAAT to screen both men and women for chlamydia upon entry to a National Job Training Program is cost-effective, cost-saving, and provides a public health opportunity to substantially reduce chlamydia infections among youth at risk for sexually transmitted diseases.

  4. [Problems in mass screening program for prostatic diseases].

    Science.gov (United States)

    Watanabe, H

    1984-05-01

    We developed transrectal ultrasonotomography for practical use in 1967 and started a model trial mass screening program for prostatic diseases with the method in 1975. A mobile unit "Dolphin" for mass screening, in which two sets of special chair-type scanner for the method was loaded, was developed successfully in 1980. Up to March, 1983, 2394 males over the age of 55 were submitted to the primary study. Among them, 12 cases (0.5%) of prostatic cancer (PC) and 755 cases (31.5%) of benign prostatic hypertrophy (BPH) were finally detected in the secondary study. Thus the prevalence of BPH was significant and even the detection rate of PC was still remarkably higher than that in mass screening for other malignancies. The diagnostic accuracy in transrectal ultrasonotomography in PC was calculated from the results of patients visiting our out-patient clinic during 7 years until March, 1983. The sensitivity was 96.5% and the specificity was 84.6%. On the other hand, the sensitivity of digital examination in the same series was 80.7%. We concluded from this study that the efficacy of digital examination was thought to be insufficient for the screening of PC. The cost-benefit balance in our mass screening system was estimated from the above mentioned results. We needed yen 2,000,000 to find out each case of early PC in the system. In our clinic, patients with early PC paid yen 2,000,000 in average for treatments including radical surgery and were cured. On the contrary, patients with advanced PC paid yen 5,000,000 approximately yen 8,000,000 and died eventually. The minimum difference of treatment fee between early and advanced PC was yen 3,000,000, accordingly. Since the cost of detecting each early PC in mass screening was yen 2,000,000, we are contributing approximately yen 1,000,000 to the national finance on each time when we pick up one case of early PC. This doesn't include benefits from detecting BPH and from life prolongation. Thus the balance seems to be

  5. Hazard screening application guide. Safety Analysis Report Update Program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1992-06-01

    The basic purpose of hazard screening is to group precesses, facilities, and proposed modifications according to the magnitude of their hazards so as to determine the need for and extent of follow on safety analysis. A hazard is defined as a material, energy source, or operation that has the potential to cause injury or illness in human beings. The purpose of this document is to give guidance and provide standard methods for performing hazard screening. Hazard screening is applied to new and existing facilities and processes as well as to proposed modifications to existing facilities and processes. The hazard screening process evaluates an identified hazards in terms of the effects on people, both on-site and off-site. The process uses bounding analyses with no credit given for mitigation of an accident with the exception of certain containers meeting DOT specifications. The process is restricted to human safety issues only. Environmental effects are addressed by the environmental program. Interfaces with environmental organizations will be established in order to share information.

  6. Diabetic Retinopathy in Italy: Epidemiology Data and Telemedicine Screening Programs

    Directory of Open Access Journals (Sweden)

    Stela Vujosevic

    2016-01-01

    Full Text Available In Italy, the number of people living with diabetes is about 3.5 million (5.5% of the population, with an increase by about 60% in the last 20 years and with 1 person out of 3 older than 65 years. The Italian Health Service system estimates that 10 billion euros is spent annually on caring for patients with diabetes, a figure that increases yearly. No national data on prevalence and incidence of legal blindness in patients with diabetes and no national registry of patients with diabetic retinopathy (DR are currently available. However, the available epidemiological data (in several locations throughout the country are consistent with those reported in other European countries. The use of telemedicine for the screening of DR in Italy is confined to geographically limited locations. The available data in the literature on implementation and use of telematic screening proved to be successful from patient, caregiver, and authorities point of view. This review addresses the available epidemiological data on DR and telematic screening realities in Italy and thus may help in establishing a national screening program.

  7. Navy CVN-77 and CVX Aircraft Carrier Programs: Background and Issues for Congress

    National Research Council Canada - National Science Library

    O'Rourke, Ronald

    1998-01-01

    ...) class nuclear-powered aircraft carrier to be procured in FY2001, and the CVX, an aircraft carrier planned for procurement in FY2006 that will be a further-evolved version of the Nimitz-class design...

  8. FMCSA safety program effectiveness measurement : Carrier Intervention Effectiveness Model, Version 1.1, technical report.

    Science.gov (United States)

    2017-04-01

    The Federal Motor Carrier Safety Administration (FMCSA), in cooperation with the John A. Volpe National Transportation Systems Center (Volpe), has developed a quantitative model to measure the effectiveness of motor carrier interventions in terms of ...

  9. GPACC program cost work breakdown structure-dictionary. General purpose aft cargo carrier study, volume 3

    Science.gov (United States)

    1985-01-01

    The results of detailed cost estimates and economic analysis performed on the updated Model 101 configuration of the general purpose Aft Cargo Carrier (ACC) are given. The objective of this economic analysis is to provide the National Aeronautics and Space Administration (NASA) with information on the economics of using the ACC on the Space Transportation System (STS). The detailed cost estimates for the ACC are presented by a work breakdown structure (WBS) to ensure that all elements of cost are considered in the economic analysis and related subsystem trades. Costs reported by WBS provide NASA with a basis for comparing competing designs and provide detailed cost information that can be used to forecast phase C/D planning for new projects or programs derived from preliminary conceptual design studies. The scope covers all STS and STS/ACC launch vehicle cost impacts for delivering payloads to a 160 NM low Earth orbit (LEO).

  10. Evaluation of Automated Teleretinal Screening Program for Diabetic Retinopathy.

    Science.gov (United States)

    Walton, O Bennett; Garoon, Robert B; Weng, Christina Y; Gross, Jacob; Young, Alex K; Camero, Kathryn A; Jin, Haoxing; Carvounis, Petros E; Coffee, Robert E; Chu, Yvonne I

    2016-02-01

    Diabetic retinopathy is a leading cause of blindness, but its detrimental effects are preventable with early detection and treatment. Screening for diabetic retinopathy has the potential to increase the number of cases treated early, especially in populations with limited access to care. To determine the efficacy of an automated algorithm in interpreting screening ophthalmoscopic photographs from patients with diabetes compared with a reading center interpretation. Retrospective cohort analysis of 15,015 patients with type 1 or 2 diabetes in the Harris Health System in Harris County, Texas, who had undergone a retinal screening examination and nonmydriatic fundus photography via the Intelligent Retinal Imaging System (IRIS) from June 2013 to April 2014 were included. The IRIS-based interpretations were compared with manual interpretation. The IRIS algorithm population statistics were calculated. Sensitivity and false-negative rate of the IRIS computer-based algorithm compared with reading center interpretation of the same images. A total of 15 015 consecutive patients (aged 18-98 years); mean 54.3 years with known type 1 or 2 diabetes underwent nonmydriatic fundus photography for a diabetic retinopathy screening examination. The sensitivity of the IRIS algorithm in detecting sight-threatening diabetic eye disease compared with the reading center interpretation was 66.4% (95% CI, 62.8%-69.9%) with a false-negative rate of 2%. The specificity was 72.8% (95% CI, 72.0%-73.5%). In a population where 15.8% of people with diabetes have sight-threatening diabetic eye disease, the IRIS algorithm positive predictive value was 10.8% (95% CI, 9.6%-11.9%) and the negative predictive value was 97.8% (95% CI, 96.8%-98.6%). In this large urban setting, the IRIS computer algorithm-based screening program had a high sensitivity and a low false-negative rate, suggesting that it may be an effective alternative to conventional reading center image interpretation. The IRIS algorithm

  11. Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs.

    Science.gov (United States)

    Bray, Jeremy W; Mallonee, Erin; Dowd, William; Aldridge, Arnie; Cowell, Alexander J; Vendetti, Janice

    2014-01-01

    This paper examines the costs of delivering screening, brief intervention, and referral to treatment (SBIRT) services within the first seven demonstration programs funded by the US Substance Abuse and Mental Health Services Administration. Service-level costs were estimated and compared across implementation model (contracted specialist, inhouse specialist, inhouse generalist) and service delivery setting (emergency department, hospital inpatient, outpatient). Program-level costs were estimated and compared across grantee recipient programs. Service-level data were collected through timed observations of SBIRT service delivery. Program-level data were collected during key informant interviews using structured cost interview guides. At the service level, support activities that occur before or after engaging the patient comprise a considerable portion of the cost of delivering SBIRT services, especially short duration services. At the program level, average costs decreased as more patients were screened. Comparing across program and service levels, the average annual operating costs calculated at the program level often exceeded the cost of actual service delivery. Provider time spent in support of service provision may comprise a large share of the costs in some cases because of potentially substantial fixed and quasifixed costs associated with program operation. The cost structure of screening, brief intervention, and referral to treatment is complex and discontinuous of patient flow, causing annual operating costs to exceed the costs of actual service provision for some settings and implementation models.

  12. Carrier testing for autosomal-recessive disorders.

    Science.gov (United States)

    Vallance, Hilary; Ford, Jason

    2003-08-01

    The aim of carrier testing is to identify carrier couples at risk of having offspring with a serious genetic (autosomal recessive) disorder. Carrier couples are offered genetic consultation where their reproductive options, including prenatal diagnosis, are explained. The Ashkenazi Jewish population is at increased risk for several recessively inherited disorders (Tay-Sachs disease, Cystic fibrosis, Canavan disease, Gaucher disease, Familial Dysautonomia, Niemann-Pick disease, Fanconi anemia, and Bloom syndrome). Unlike Tay-Sachs disease, there is no simple biochemical or enzymatic test to detect carriers for these other disorders. However, with the rapid identification of disease-causing genes in recent years, DNA-based assays are increasingly available for carrier detection. Approximately 5% of the world's population carries a mutation affecting the globin chains of the hemoglobin molecule. Among the most common of these disorders are the thalassemias. The global birth rate of affected infants is at least 2 per 1000 (in unscreened populations), with the greatest incidence in Southeast Asian, Indian, Mediterranean, and Middle Eastern ethnic groups. Carriers are detected by evaluation of red cell indices and morphology, followed by more sophisticated hematological testing and molecular analyses. The following issues need to be considered in the development of a carrier screening program: (1) test selection based on disease severity and test accuracy; (2) funding for testing and genetic counselling; (3) definition of the target population to be screened; (4) development of a public and professional education program; (5) informed consent for screening; and (6) awareness of community needs.

  13. Experiences from a pilot program bringing BRCA1/2 genetic screening to theUS Ashkenazi Jewish population.

    Science.gov (United States)

    Wiesman, Chana; Rose, Esther; Grant, Allison; Zimilover, Adam; Klugman, Susan; Schreiber-Agus, Nicole

    2017-05-01

    The notion of offering population-based screening to the Ashkenazi Jewish (AJ) population for the BRCA1/2 founder mutations continues to gain support. A program called the BRCAcommunity initiative was designed to identify the benefits and barriers associated with implementing this screening in a clinical setting. Interested AJ individuals were stratified into high-risk (HR) and low-risk (LR) groups based on self-reported cancer histories. Those at HR were offered traditional genetic counseling/testing; those at LR were offered group genetic counseling and subsidized AJ BRCA founder mutation testing. During the pilot year, 62% of initial registrants and 53% of ultimate study participants were classified into the HR group. Among the 101 HR and 88 LR study participants, 8 and 2 BRCA carriers were identified, respectively. The LR carriers would have been missed by current mechanisms. Survey responses provided insight into the motivations and fears associated with pursuing testing, the efficacy of the initiative design, and challenges that exist on multiple levels, including the community, health-care providers, and insurance coverage. Although the medical value of identifying presymptomatic BRCA carriers in Ashkenazi Jews is evident, further measures need to be taken before this effort can be accomplished on a large scale.Genet Med advance online publication 13 October 2016.

  14. A comprehensive screening program for β-thalassemia and other hemoglobinopathies in the Hooghly District of West Bengal, India, dealing with 21 137 cases.

    Science.gov (United States)

    Bhattacharyya, Kallol Kumar; Chatterjee, Tridip; Mondal, Ujjalendu Bikash

    2016-11-01

    We here present a report of population screening programs (January 2012-December 2015) conducted by the Thalassemia Control Unit, Imambara Sadar Hospital, Chinsurah, Hooghly in the Hooghly District of West Bengal, India for prevention of thalassemia. We screened β-thalassemia (β-thal) heterozygotes and homozygotes, and Hb E (HBB: c.79G > A)-β-thal compound heterozygotes. Among 21 137 cases, we found 1968 heterozygotes and 192 homozygotes or compound heterozygotes. Results were evaluated with standard hematological analyses including red cell indices, hemoglobin (Hb) typing and quantification. The participants of the screening program were divided into six groups (children, pre-marriage cases, post-marital cases, family members of affected individuals, family members of carriers and pregnant women). While considering the average frequency of carriers, many reports recorded both related individuals (family members of trait and affected individuals) as well as unrelated individuals such as school children and pregnant women. These would have to be considered separately and only the unrelated individuals taken to estimate carrier frequencies in this article that would give more realistic data on carrier frequency of unrelated individuals.

  15. Screening synteny blocks in pairwise genome comparisons through integer programming.

    Science.gov (United States)

    Tang, Haibao; Lyons, Eric; Pedersen, Brent; Schnable, James C; Paterson, Andrew H; Freeling, Michael

    2011-04-18

    It is difficult to accurately interpret chromosomal correspondences such as true orthology and paralogy due to significant divergence of genomes from a common ancestor. Analyses are particularly problematic among lineages that have repeatedly experienced whole genome duplication (WGD) events. To compare multiple "subgenomes" derived from genome duplications, we need to relax the traditional requirements of "one-to-one" syntenic matchings of genomic regions in order to reflect "one-to-many" or more generally "many-to-many" matchings. However this relaxation may result in the identification of synteny blocks that are derived from ancient shared WGDs that are not of interest. For many downstream analyses, we need to eliminate weak, low scoring alignments from pairwise genome comparisons. Our goal is to objectively select subset of synteny blocks whose total scores are maximized while respecting the duplication history of the genomes in comparison. We call this "quota-based" screening of synteny blocks in order to appropriately fill a quota of syntenic relationships within one genome or between two genomes having WGD events. We have formulated the synteny block screening as an optimization problem known as "Binary Integer Programming" (BIP), which is solved using existing linear programming solvers. The computer program QUOTA-ALIGN performs this task by creating a clear objective function that maximizes the compatible set of synteny blocks under given constraints on overlaps and depths (corresponding to the duplication history in respective genomes). Such a procedure is useful for any pairwise synteny alignments, but is most useful in lineages affected by multiple WGDs, like plants or fish lineages. For example, there should be a 1:2 ploidy relationship between genome A and B if genome B had an independent WGD subsequent to the divergence of the two genomes. We show through simulations and real examples using plant genomes in the rosid superorder that the quota

  16. Screening synteny blocks in pairwise genome comparisons through integer programming

    Directory of Open Access Journals (Sweden)

    Paterson Andrew H

    2011-04-01

    Full Text Available Abstract Background It is difficult to accurately interpret chromosomal correspondences such as true orthology and paralogy due to significant divergence of genomes from a common ancestor. Analyses are particularly problematic among lineages that have repeatedly experienced whole genome duplication (WGD events. To compare multiple "subgenomes" derived from genome duplications, we need to relax the traditional requirements of "one-to-one" syntenic matchings of genomic regions in order to reflect "one-to-many" or more generally "many-to-many" matchings. However this relaxation may result in the identification of synteny blocks that are derived from ancient shared WGDs that are not of interest. For many downstream analyses, we need to eliminate weak, low scoring alignments from pairwise genome comparisons. Our goal is to objectively select subset of synteny blocks whose total scores are maximized while respecting the duplication history of the genomes in comparison. We call this "quota-based" screening of synteny blocks in order to appropriately fill a quota of syntenic relationships within one genome or between two genomes having WGD events. Results We have formulated the synteny block screening as an optimization problem known as "Binary Integer Programming" (BIP, which is solved using existing linear programming solvers. The computer program QUOTA-ALIGN performs this task by creating a clear objective function that maximizes the compatible set of synteny blocks under given constraints on overlaps and depths (corresponding to the duplication history in respective genomes. Such a procedure is useful for any pairwise synteny alignments, but is most useful in lineages affected by multiple WGDs, like plants or fish lineages. For example, there should be a 1:2 ploidy relationship between genome A and B if genome B had an independent WGD subsequent to the divergence of the two genomes. We show through simulations and real examples using plant genomes

  17. Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs

    Directory of Open Access Journals (Sweden)

    Bray JW

    2014-07-01

    Full Text Available Jeremy W Bray,1 Erin Mallonee,2 William Dowd,2 Arnie Aldridge,2 Alexander J Cowell,2 Janice Vendetti31Department of Economics, Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, NC, USA; 2RTI International, Research Triangle Park, NC, USA; 3Department of Community Medicine and Health Care, School of Medicine, UCONN Health, Farmington, CT, USAAbstract: This paper examines the costs of delivering screening, brief intervention, and referral to treatment (SBIRT services within the first seven demonstration programs funded by the US Substance Abuse and Mental Health Services Administration. Service-level costs were estimated and compared across implementation model (contracted specialist, inhouse specialist, inhouse generalist and service delivery setting (emergency department, hospital inpatient, outpatient. Program-level costs were estimated and compared across grantee recipient programs. Service-level data were collected through timed observations of SBIRT service delivery. Program-level data were collected during key informant interviews using structured cost interview guides. At the service level, support activities that occur before or after engaging the patient comprise a considerable portion of the cost of delivering SBIRT services, especially short duration services. At the program level, average costs decreased as more patients were screened. Comparing across program and service levels, the average annual operating costs calculated at the program level often exceeded the cost of actual service delivery. Provider time spent in support of service provision may comprise a large share of the costs in some cases because of potentially substantial fixed and quasifixed costs associated with program operation. The cost structure of screening, brief intervention, and referral to treatment is complex and discontinuous of patient flow, causing annual operating costs to exceed the costs of actual service

  18. The impact of compression force and pressure at prevalent screening on subsequent re-attendance in a national screening program.

    Science.gov (United States)

    Moshina, Nataliia; Sebuødegård, Sofie; Holen, Åsne S; Waade, Gunvor G; Tsuruda, Kaitlyn; Hofvind, Solveig

    2018-03-01

    Adherence to screening may indirectly help assess whether a prior screening examination deters women from returning for a subsequent examination. We investigated whether compression force and pressure in mammography were associated with re-attendance among prevalently screened women in the organized breast cancer screening program in Norway. Data on compression force (kg) and pressure (kPa) from women's first screening examination in the program (prevalent screening) and subsequent re-attendance were available for 31,225 women aged 50-68, screened during 2007-2013. Crude re-attendance rates and log-binomial regression models estimating the prevalence ratio of re-attendance were used to identify the association between compression force or pressure and re-attendance two-years later. Age and year at prevalent screening, county of residence, screening result (negative or false positive), breast volume, and breast density were included in analyses. Overall, 27,197 (87.1%) women re-attended the program. Re-attendance was highest for women who received a compression force of 10.0-13.9 kg (87.5%) or pressure of 9.0-17.9 kPa (87.8%) and lowest for those who received a compression force of attendance was 3% lower for women who received low compression force (attendance should also include information about women's experience of pain, anxiety and stress, as well as image quality. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. WE-D-207-03: CT Protocols for Screening and the ACR Designated Lung Screening Program

    International Nuclear Information System (INIS)

    McNitt-Gray, M.

    2015-01-01

    In the United States, Lung Cancer is responsible for more cancer deaths than the next four cancers combined. In addition, the 5 year survival rate for lung cancer patients has not improved over the past 40 to 50 years. To combat this deadly disease, in 2002 the National Cancer Institute launched a very large Randomized Control Trial called the National Lung Screening Trial (NLST). This trial would randomize subjects who had substantial risk of lung cancer (due to age and smoking history) into either a Chest X-ray arm or a low dose CT arm. In November 2010, the National Cancer Institute announced that the NLST had demonstrated 20% fewer lung cancer deaths among those who were screened with low-dose CT than with chest X-ray. In December 2013, the US Preventive Services Task Force recommended the use of Lung Cancer Screening using low dose CT and a little over a year later (Feb. 2015), CMS announced that Medicare would also cover Lung Cancer Screening using low dose CT. Thus private and public insurers are required to provide Lung Cancer Screening programs using CT to the appropriate population(s). The purpose of this Symposium is to inform medical physicists and prepare them to support the implementation of Lung Screening programs. This Symposium will focus on the clinical aspects of lung cancer screening, requirements of a screening registry for systematically capturing and tracking screening patients and results (such as required Medicare data elements) as well as the role of the medical physicist in screening programs, including the development of low dose CT screening protocols. Learning Objectives: To understand the clinical basis and clinical components of a lung cancer screening program, including eligibility criteria and other requirements. To understand the data collection requirements, workflow, and informatics infrastructure needed to support the tracking and reporting components of a screening program. To understand the role of the medical physicist in

  20. Neonatal hearing screening program in Ahvaz, Southern Iran

    Directory of Open Access Journals (Sweden)

    Marzieh Amiri

    2014-01-01

    Full Text Available Background and Aim: American Academy of Pediatrics (AAP established standards for neonatal hearing screening programs in 1999. The main purpose of this study was to achieve exact statistical data of this program in Ahvaz, Iran, and to compare these results with the standards of American Academy of Pediatrics.Methods: In this cross-sectional descriptive study, the data of neonatal hearing program in Ahvaz west health center from 2008 to 2011 were reviewed. Data were analysed by descriptive statistics.Results: From 25073 neonates, 25 had hearing loss. The false positive and referral ratio to the diagnosis stage were 2.6 and 0.48 percent, respectively. 92 percent of hard of hearing infants were diagnosed before three months of life.Conclusion: In comparison with the standards of American Academy of Pediatrics, all of the items, except two, were included completely or relatively complete. But, more efforts must be done to achieve the whole standards which are available.

  1. 14 CFR 330.37 - Are carriers which participate in this program subject to audit?

    Science.gov (United States)

    2010-01-01

    ... retain are also subject to audit. (b) Except as provided in paragraph (d) of this section, before you are... the core requirements for the independent public accountant's review: (1) Determine that the earnings... the carrier or the financial statements included in the carrier's Securities and Exchange Commission...

  2. Impact of a CAD system in a screen-film mammography screening program: A prospective study

    International Nuclear Information System (INIS)

    Sanchez Gómez, S.; Torres Tabanera, M.; Vega Bolivar, A.; Sainz Miranda, M.; Baroja Mazo, A.; Ruiz Diaz, M.; Martinez Miravete, P.; Lag Asturiano, E.; Muñoz Cacho, P.; Delgado Macias, T.

    2011-01-01

    Objective: The purpose of our study was to perform a prospective assessment of the impact of a CAD system in a screen-film mammography screening program during a period of 3 years. Materials and methods: Our study was carried out on a population of 21,855 asymptomatic women (45–65 years). Mammograms were processed in a CAD system and independently interpreted by one of six radiologists. We analyzed the following parameters: sensitivity of radiologist's interpretation (without and with CAD), detection increase, recall rate and positive predictive value of biopsy, CAD's marks, radiologist's false negatives and comparative analysis of carcinomas detected and non-detected by CAD. Results: Detection rate was 4.3‰. CAD supposed an increase of 0.1‰ in detection rate and 1% in the total number of cases (p < 0.005). The impact on recall rate was not significant (0.4%) and PPV of percutaneous biopsy was unchanged by CAD (20.23%). CAD's marks were 2.7 per case and 0.7 per view. Radiologist's false negatives were 13 lesions which were initially considered as CAD's false positives. Conclusions: CAD supposed a significant increase in detection, without modifications in recall rates and PPV of biopsy. However, better results could have been achieved if radiologists had considered actionable those cases marked by CAD but initially misinterpreted.

  3. Controlled carrier screening in p-n NiO/GaN piezoelectric generators by an Al2O3 insertion layer

    Science.gov (United States)

    Johar, Muhammad Ali; Jeong, Dae Kyung; Afifi Hassan, Mostafa; Kang, Jin-Ho; Ha, Jun-Seok; Key Lee, June; Ryu, Sang-Wan

    2017-12-01

    The performance of a piezoelectric generator (PG) depends significantly on the internal screening process inside the device. As piezoelectric charges appear on both ends of the piezoelectric crystal, internal screening starts to decrease the piezoelectric bias. Therefore, the piezoelectric energy generated by external stress is not fully utilized by external circuit, which is the most challenging aspect of high-efficiency PGs. In this work, the internal screening effect of a NiO/GaN p-n PG was analyzed and controlled with an Al2O3 insertion layer. Internal screening in the p-n diode PG was categorized into free-carrier screening in neutral regions and junction screening due to charge drift across the junction. It was observed that junction screening could be significantly suppressed by inserting an Al2O3 layer and that effect was dominant in a leaky diode PG. With this implementation, the piezoelectric bias of the NiO/GaN PG was improved by a factor of ~100 for high-leakage diodes and a factor of ~1.6 for low-leakage diodes. Consequently, NiO/Al2O3/GaN PGs under a stress of 5 MPa provided a piezoelectric bias of 12.1 V and a current density of 2.25 µA cm-2. The incorporation of a highly resistive Al2O3 layer between p-NiO and n-GaN layers in NiO/GaN heterojunctions provides an efficient means of improving the piezoelectric performance by controlling the internal screening of the piezoelectric field.

  4. Tay-Sachs disease preconception screening in Australia: self-knowledge of being an Ashkenazi Jew predicts carrier state better than does ancestral origin, although there is an increased risk for c.1421 + 1G > C mutation in individuals with South African heritage

    OpenAIRE

    Lew, Raelia; Burnett, Leslie; Proos, Anné

    2011-01-01

    The Australasian Community Genetics Program provided a preconception screening for Tay-Sachs disease (TSD) to 4,105 Jewish high school students in Sydney and Melbourne over the 12-year period 1995–2007. By correlating the frequencies of mutant HEXA, MIM *606869 (gene map locus 15q23-q24) alleles with subjects’ nominated ethnicity (Ashkenazi/Sephardi/Mixed) and grandparental birthplaces, we established that Ashkenazi ethnicity is a better predictor of TSD carrier status than grandparental ance...

  5. Comprehensive newborn screening program: ARAMCO experience, the national need and recommendations.

    Science.gov (United States)

    Abu-Osba, Y K; Mallouh, A; Salamah, M; Hann, R; Thalji, A; Hamdan, J; Sa'di, A A

    1992-05-01

    Comprehensive screening programs for congenital diseases of newborn infants are lacking at a national or regional level. A comprehensive newborn screening program modified to the needs and resources available was established in ARAMCO Dhahran Health Center. This program includes screening for congenital hypothyroidism, phenylketonuria, abnormal hemoglobins, glucose-6-phosphate dehydrogenase deficienc, and blood group incompatibilities. Several problems were encountered during the operation which required several modifications of the program. The organization and procedures of the program are described. Since the program was started in 1980, more than 70,000 newborn infants have been screened. Valuable epidemiological data have been collected and necessary information for direct clinical use was obtained. A national program to screen all neonates in the Kingdom of Saudi Arabia is achievable and urgently needed. Recommendations based on ARAMCO experience are given.

  6. Epoxy Chip-in-Carrier Integration and Screen-Printed Metalization for Multichannel Microfluidic Lab-on-CMOS Microsystems.

    Science.gov (United States)

    Li, Lin; Yin, Heyu; Mason, Andrew J

    2018-04-01

    The integration of biosensors, microfluidics, and CMOS instrumentation provides a compact lab-on-CMOS microsystem well suited for high throughput measurement. This paper describes a new epoxy chip-in-carrier integration process and two planar metalization techniques for lab-on-CMOS that enable on-CMOS electrochemical measurement with multichannel microfluidics. Several design approaches with different fabrication steps and materials were experimentally analyzed to identify an ideal process that can achieve desired capability with high yield and low material and tool cost. On-chip electrochemical measurements of the integrated assembly were performed to verify the functionality of the chip-in-carrier packaging and its capability for microfluidic integration. The newly developed CMOS-compatible epoxy chip-in-carrier process paves the way for full implementation of many lab-on-CMOS applications with CMOS ICs as core electronic instruments.

  7. A brief review on newborn screening methods for hemoglobinopathies and preliminary results selecting beta thalassemia carriers at birth by quantitative estimation of the HbA fraction.

    Science.gov (United States)

    Mantikou, Eleni; Arkesteijn, Sandra G; Beckhoven van, Jaqueline M; Kerkhoffs, Jean-Louis; Harteveld, Cornelis L; Giordano, Piero Carlo

    2009-12-01

    We present in a brief summary the basic aspects of the most rational technologies used for new born screening (NBS) of the hemoglobinopathies and we report the preliminary results for the identification of beta-thalassemia carriers at birth by measuring the expression of the HbA fraction. Separation and measurement of the Hb fractions in 1.500 cord blood samples collected among the multi-ethnic Dutch population using different methods. By using a cut of thalassemia can be preselected at birth with a reasonable degree of sensitivity and be confirmed by parent analysis.

  8. Targeted prostate cancer screening in BRCA1 and BRCA2 mutation carriers: results from the initial screening round of the IMPACT study

    DEFF Research Database (Denmark)

    Bancroft, Elizabeth K; Page, Elizabeth C; Castro, Elena

    2014-01-01

    /ml were offered prostate biopsy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: PSA levels, PCa incidence, and tumour characteristics were evaluated. The Fisher exact test was used to compare the number of PCa cases among groups and the differences among disease types. RESULTS AND LIMITATIONS: We...... AND PARTICIPANTS: We recruited men aged 40-69 yr with germline BRCA1/2 mutations and a control group of men who have tested negative for a pathogenic BRCA1 or BRCA2 mutation known to be present in their families. All men underwent prostate-specific antigen (PSA) testing at enrollment, and those men with PSA >3 ng...... recruited 2481 men (791 BRCA1 carriers, 531 BRCA1 controls; 731 BRCA2 carriers, 428 BRCA2 controls). A total of 199 men (8%) presented with PSA >3.0 ng/ml, 162 biopsies were performed, and 59 PCas were diagnosed (18 BRCA1 carriers, 10 BRCA1 controls; 24 BRCA2 carriers, 7 BRCA2 controls); 66% of the tumours...

  9. 77 FR 35745 - Highway Safety Programs; Conforming Products List of Screening Devices To Measure Alcohol in...

    Science.gov (United States)

    2012-06-14

    ... the DRIVESAFE alcohol screening device. This is a handheld, battery powered device with a fuel cell...-0062] Highway Safety Programs; Conforming Products List of Screening Devices To Measure Alcohol in... Screening Devices to Measure Alcohol in Bodily Fluids dated, March 31, 2008 (73 FR 16956). DATES: Effective...

  10. Estimation of radiation exposure from lung cancer screening program with low-dose computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Yeon; Jun, Jae Kwan [Graduate School of Cancer Science and Policy, National Cancer Center, Seoul (Korea, Republic of)

    2016-12-15

    The National Lung Screening Trial (NLST) demonstrated that screening with Low-dose Computed Tomography (LDCT) screening reduced lung cancer mortality in a high-risk population. Recently, the United States Preventive Services Task Force (USPSTF) gave a B recommendation for annual LDCT screening for individuals at high-risk. With the promising results, Korea developed lung cancer screening guideline and is planning a pilot study for implementation of national lung cancer screening. With widespread adoption of lung cancer screening with LDCT, there are concerns about harms of screening, including high false-positive rates and radiation exposure. Over the 3 rounds of screening in the NLST, 96.4% of positive results were false-positives. Although the initial screening is performed at low dose, subsequent diagnostic examinations following positive results additively contribute to patient's lifetime exposure. As with implementing a large-scale screening program, there is a lack of established risk assessment about the effect of radiation exposure from long-term screening program. Thus, the purpose of this study was to estimate cumulative radiation exposure of annual LDCT lung cancer screening program over 20-year period.

  11. 75 FR 58203 - Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements...

    Science.gov (United States)

    2010-09-23

    .... Ambulatory surgical centers, end-stage renal disease facilities, Federally qualified health centers... Parts 405, 424, 438, et al. Medicare, Medicaid, and Children's Health Insurance Programs; Additional...-AQ20 Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements...

  12. The impact of stratifying by family history in colorectal cancer screening programs.

    Science.gov (United States)

    Goede, Simon Lucas; Rabeneck, Linda; Lansdorp-Vogelaar, Iris; Zauber, Ann G; Paszat, Lawrence F; Hoch, Jeffrey S; Yong, Jean H E; van Hees, Frank; Tinmouth, Jill; van Ballegooijen, Marjolein

    2015-09-01

    In the province-wide colorectal cancer (CRC) screening program in Ontario, Canada, individuals with a family history of CRC are offered colonoscopy screening and those without are offered guaiac fecal occult blood testing (gFOBT, Hemoccult II). We used microsimulation modeling to estimate the cumulative number of CRC deaths prevented and colonoscopies performed between 2008 and 2038 with this family history-based screening program, compared to a regular gFOBT program. In both programs, we assumed screening uptake increased from 30% (participation level in 2008 before the program was launched) to 60%. We assumed that 11% of the population had a family history, defined as having at least one first-degree relative diagnosed with CRC. The programs offered screening between age 50 and 74 years, every two years for gFOBT, and every ten years for colonoscopy. Compared to opportunistic screening (2008 participation level kept constant at 30%), the gFOBT program cumulatively prevented 6,700 more CRC deaths and required 570,000 additional colonoscopies by 2038. The family history-based screening program increased these numbers to 9,300 and 1,100,000, a 40% and 93% increase, respectively. If biennial gFOBT was replaced with biennial fecal immunochemical test (FIT), annual Hemoccult Sensa or five-yearly sigmoidoscopy screening, both the added benefits and colonoscopies required would decrease. A biennial gFOBT screening program that identifies individuals with a family history of CRC and recommends them to undergo colonoscopy screening would prevent 40% (range in sensitivity analyses: 20-51%) additional deaths while requiring 93% (range: 43-116%) additional colonoscopies, compared to a regular gFOBT screening program. © 2015 UICC.

  13. Second screening for news: Effects of presentation on information processing and program liking

    NARCIS (Netherlands)

    Schaap, G.J.; Kleemans, M.; Cauwenberge, A.M.R. van

    2018-01-01

    This study investigated the effects of second screen presentation mode on information processing and program liking. In an experiment, 121 participants watched a television news program. One group was assigned to a dual screen condition in which participants were required to actively look up

  14. Screening of lipid carriers and characterization of drug-polymer-lipid interactions for the rational design of polymer-lipid hybrid nanoparticles (PLN).

    Science.gov (United States)

    Li, Yongqiang; Taulier, Nicolas; Rauth, Andrew M; Wu, Xiao Yu

    2006-08-01

    The thermodynamics and solid state properties of components and their interactions in a formulation for polymer-lipid hybrid nanoparticles (PLN) were characterized for screening lead lipid carriers and rational design of PLN. Verapamil HCI (VRP) was chosen as a model drug and dextran sulfate sodium (DS) as a counter-ionic polymer. Solubility parameters of VRP, VRP-DS complex, and various lipids were calculated and partition of VRP and VRP-DS in lipids was determined. Thermodynamics of VRP binding to DS was determined by isothermal titration calorimetry (ITC). The solid state properties of individual components and their interactions were characterized using differential scanning calorimetry (DSC) and powder X-ray diffraction (PXRD). Dodecanoic acid (DA) was identified as the best lipid carrier among all lipids tested based on the solubility parameters and partition coefficients. VRP-DS complexation was a thermodynamically favorable process. Maximum binding capacity of DS and the highest drug loading capacity of DA were obtained at an equal ionic molar ratio of DS to VRP. In the PLN formulation, DA remained its crystal structure but had a slightly lower melting point, while VRP-DS complex was in an amorphous form. Drug loading efficiency and capacity of a lipid matrix depend on the VRP-DS binding and the interactions of the complex with the lipid. A combined analysis of solubility parameters and partition coefficients is useful for screening lipid candidates for PLN preparation.

  15. Imparting carrier status results detected by universal newborn screening for sickle cell and cystic fibrosis in England: a qualitative study of current practice and policy challenges

    Directory of Open Access Journals (Sweden)

    Ulph Fiona

    2007-12-01

    Full Text Available Abstract Background Universal newborn screening for early detection of children affected by sickle cell disorders and cystic fibrosis is currently being implemented across England. Parents of infants identified as carriers of these disorders must also be informed of their baby's result. However there is a lack of evidence for most effective practice internationally when doing so. This study describes current or proposed models for imparting this information in practice and explores associated challenges for policy. Methods Thematic analysis of semi-structured interviews with Child Health Coordinators from all English Health Regions. Results Diverse methods for imparting carrier results, both within and between regions, and within and between conditions, were being implemented or planned. Models ranged from result by letter to in-person communication during a home visit. Non-specialists were considered the best placed professionals to give results and a similar approach for both conditions was emphasised. While national guidance has influenced choice of models, other factors contributed such as existing service structures and lack of funding. Challenges included uncertainty about guidance specifying face to face notification; how best to balance allaying parental anxiety by using familiar non-specialist health professionals with concerns about practitioner competence; and extent of information parents should be given. Inadequate consideration of resource and service workload was seen as the main policy obstacle. Clarification of existing guidance; more specific protocols to ensure consistent countrywide practice; integration of the two programmes; and 'normalising' carrier status were suggested as improvements. Conclusion Differing models for communicating carrier results raise concerns about equity and clinical governance. However, this variation provides opportunity for evaluation. Timely and more detailed guidance on protocols with

  16. Colorectal cancer prevention in Europe: burden of disease and status of screening programs.

    Science.gov (United States)

    Altobelli, E; Lattanzi, A; Paduano, R; Varassi, G; di Orio, F

    2014-05-01

    Colorectal cancer is a major public health challenge worldwide. In Europe it is the first malignancy in terms of incidence and the second in terms of mortality in both genders. Despite evidence indicating that removal of premalignant and early-stage cancer lesion scan greatly reduce mortality, remarkable differences are still found among countries both in terms of organized screening programs and of the tests used. In 2003 the European Council recommended that priority be given to activation of organized cancer screening programs, and various states have been making significant efforts to adopt effective prevention programs with international quality standards and centralizing screening organization and result evaluation. After a 2008 European Union report on the state of screening program, activation highlighted that little more than 50% (12/22) of Member States had colorectal cancer screening programs, Screening programs have been adopted or earlier pilot projects have been extended nationwide. This paper examines the state of activation and the screening strategies of colorectal cancer screening programs in EU States as of July 2013. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. What It Means to be a Carrier

    Science.gov (United States)

    ... begins the process with medical tests for any infectious diseases, RH type, thyroid and general health screening, etc. The egg donors go through their own screening, which includes hormone levels, genetic screening usually including FMR1 screening, and other carrier ...

  18. Self-Sampling for Human Papillomavirus Testing: Increased Cervical Cancer Screening Participation and Incorporation in International Screening Programs

    Science.gov (United States)

    Gupta, Sarah; Palmer, Christina; Bik, Elisabeth M.; Cardenas, Juan P.; Nuñez, Harold; Kraal, Laurens; Bird, Sara W.; Bowers, Jennie; Smith, Alison; Walton, Nathaniel A.; Goddard, Audrey D.; Almonacid, Daniel E.; Zneimer, Susan; Richman, Jessica; Apte, Zachary S.

    2018-01-01

    In most industrialized countries, screening programs for cervical cancer have shifted from cytology (Pap smear or ThinPrep) alone on clinician-obtained samples to the addition of screening for human papillomavirus (HPV), its main causative agent. For HPV testing, self-sampling instead of clinician-sampling has proven to be equally accurate, in particular for assays that use nucleic acid amplification techniques. In addition, HPV testing of self-collected samples in combination with a follow-up Pap smear in case of a positive result is more effective in detecting precancerous lesions than a Pap smear alone. Self-sampling for HPV testing has already been adopted by some countries, while others have started trials to evaluate its incorporation into national cervical cancer screening programs. Self-sampling may result in more individuals willing to participate in cervical cancer screening, because it removes many of the barriers that prevent women, especially those in low socioeconomic and minority populations, from participating in regular screening programs. Several studies have shown that the majority of women who have been underscreened but who tested HPV-positive in a self-obtained sample will visit a clinic for follow-up diagnosis and management. In addition, a self-collected sample can also be used for vaginal microbiome analysis, which can provide additional information about HPV infection persistence as well as vaginal health in general. PMID:29686981

  19. Self-Sampling for Human Papillomavirus Testing: Increased Cervical Cancer Screening Participation and Incorporation in International Screening Programs

    Directory of Open Access Journals (Sweden)

    Sarah Gupta

    2018-04-01

    Full Text Available In most industrialized countries, screening programs for cervical cancer have shifted from cytology (Pap smear or ThinPrep alone on clinician-obtained samples to the addition of screening for human papillomavirus (HPV, its main causative agent. For HPV testing, self-sampling instead of clinician-sampling has proven to be equally accurate, in particular for assays that use nucleic acid amplification techniques. In addition, HPV testing of self-collected samples in combination with a follow-up Pap smear in case of a positive result is more effective in detecting precancerous lesions than a Pap smear alone. Self-sampling for HPV testing has already been adopted by some countries, while others have started trials to evaluate its incorporation into national cervical cancer screening programs. Self-sampling may result in more individuals willing to participate in cervical cancer screening, because it removes many of the barriers that prevent women, especially those in low socioeconomic and minority populations, from participating in regular screening programs. Several studies have shown that the majority of women who have been underscreened but who tested HPV-positive in a self-obtained sample will visit a clinic for follow-up diagnosis and management. In addition, a self-collected sample can also be used for vaginal microbiome analysis, which can provide additional information about HPV infection persistence as well as vaginal health in general.

  20. Evaluation Of Cervical Cancer Screening Program At A Rural ...

    African Journals Online (AJOL)

    But the condition is preventable through regular screening of women those are 'at risk\\' for abnormal changes in the cervix and treating them who have positive results. Although screening facilities are ... Keywords: Cervical cancer, Pap smear test, knowledge, practice, programme coverage. East African Journal of Public ...

  1. Community screening and treatment of asymptomatic carriers of Plasmodium falciparum with artemether-lumefantrine to reduce malaria disease burden: a modelling and simulation analysis

    Directory of Open Access Journals (Sweden)

    Ubben David

    2011-07-01

    Full Text Available Abstract Background Asymptomatic carriers of Plasmodium falciparum serve as a reservoir of parasites for malaria transmission. Identification and treatment of asymptomatic carriers within a region may reduce the parasite reservoir and influence malaria transmission in that area. Methods Using computer simulation, this analysis explored the impact of community screening campaigns (CSC followed by systematic treatment of P. falciparum asymptomatic carriers (AC with artemether-lumefantrine (AL on disease transmission. The model created by Okell et al (originally designed to explore the impact of the introduction of treatment with artemisinin-based combination therapy on malaria endemicity was modified to represent CSC and treatment of AC with AL, with the addition of malaria vector seasonality. The age grouping, relative distribution of age in a region, and degree of heterogeneity in disease transmission were maintained. The number and frequency of CSC and their relative timing were explored in terms of their effect on malaria incidence. A sensitivity analysis was conducted to determine the factors with the greatest impact on the model predictions. Results The simulation showed that the intervention that had the largest effect was performed in an area with high endemicity (entomological inoculation rate, EIR > 200; however, the rate of infection returned to its normal level in the subsequent year, unless the intervention was repeated. In areas with low disease burden (EIR Conclusions Community screening and treatment of asymptomatic carriers with AL may reduce malaria transmission significantly. The initial level of disease intensity has the greatest impact on the potential magnitude and duration of malaria reduction. When combined with other interventions (e.g. long-lasting insecticide-treated nets, rapid diagnostic tests, prompt diagnosis and treatment, and, where appropriate, indoor residual spraying the effect of this intervention can be

  2. Targeted prostate cancer screening in BRCA1 and BRCA2 mutation carriers: Results from the initial screening round of the IMPACT study

    NARCIS (Netherlands)

    Bancroft, E.K.; Page, E.C.; Castro, E.; Lilja, H.; Vickers, A.; Sjoberg, D.; Assel, M.; Foster, C.S.; Mitchell, G.; Drew, K.; Maehle, L.; Axcrona, K.; Evans, D.G.; Bulman, B.; Eccles, D.; McBride, D.; van Asperen, C.; Vasen, H.; Kiemeney, L.A.; Ringelberg, J.; Cybulski, C.; Wokolorczyk, D.; Selkirk, C.; Hulick, P.J.; Bojesen, A.; Skytte, A.B.; Lam, J.; Taylor, L.; Oldenburg, R.; Cremers, R.; Verhaegh, G.; van Zelst-Stams, W.A.; Oosterwijk, J.C.; Blanco, I.; Salinas, M.; Cook, J.; Rosario, D.J.; Buys, S.; Conner, T.; Ausems, M.G.; Ong, K.R.; Hoffman, J.; Domchek, S.; Powers, J.; Teixeira, M.R.; Maia, S.; Foulkes, W.D.; Taherian, N.; Ruijs, M.; den Enden, A.T.; Izatt, L.; Davidson, R.; Adank, M.A.; Walker, L.; Schmutzler, R.; Tucker, K.; Kirk, J.; Hodgson, S.; Harris, M.; Douglas, F.; Lindeman, G.J.; Zgajnar, J.; Tischkowitz, M.; Clowes, V.E.; Susman, R.; Ramón Y Cajal, T.; Patcher, N.; Gadea, N.; Spigelman, A.; van Os, T.; Liljegren, A.; Side, L.; Brewer, C.; Brady, A.F.; Donaldson, A.; Stefansdottir, V.; Friedman, E.; Chen-Shtoyerman, R.; Amor, D.J.; Copakova, L.; Barwell, J.; Giri, V.N.; Murthy, V.; Nicolai, N.; Teo, S.H.; Greenhalgh, L.; Strom, S.; Henderson, A.; McGrath, J.; Gallagher, D.; Aaronson, N.K.; Ardern-Jones, A.; Bangma, C.; Dearnaley, D.; Costello, P.; Eyfjord, J.; Rothwell, J.; Falconer, A.; Gronberg, H.; Hamdy, F.C.; Johannsson, O.; Khoo, V.; Kote-Jarai, Z.; Lubinski, J.; Axcrona, U.; Melia, J.; McKinley, J.; Mitra, A.V.; Moynihan, C.; Rennert, G.; Suri, M.; Wilson, P.; Killick, E.; Moss, S.; Eeles, R.A.

    2014-01-01

    Background: Men with germline breast cancer 1, early onset (BRCA1) or breast cancer 2, early onset (BRCA2) gene mutations have a higher risk of developing prostate cancer (PCa) than noncarriers. IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in

  3. Targeted Prostate Cancer Screening in BRCA1 and BRCA2 Mutation Carriers: Results from the Initial Screening Round of the IMPACT Study

    NARCIS (Netherlands)

    Bancroft, E.K.; Page, E.C.; Castro, E.; Lilja, H.; Vickers, A.; Sjoberg, D.; Assel, M.; Foster, C.S.; Mitchell, G.; Drew, K.; Maehle, L.; Axcrona, K.; Evans, D.G.; Bulman, B.; Eccles, D.; McBride, D.; Asperen, C. van; Vasen, H.; Kiemeney, B.; Ringelberg, J.; Cybulski, C.; Wokolorczyk, D.; Selkirk, C.; Hulick, P.J.; Bojesen, A.; Skytte, A.B.; Lam, J.; Taylor, L.; Oldenburg, R.; Cremers, R.; Verhaegh, G.; Zelst-Stams, W.A.G. van; Oosterwijk, J.C.; Blanco, I.; Salinas, M.; Cook, J; Rosario, D.J.; Buys, S.; Conner, T.; Ausems, M.G.; Ong, K.R.; Hoffman, J.; Domchek, S.; Powers, J.; Teixeira, M.R.; Maia, S.; Foulkes, W.D.; Taherian, N.; Ruijs, M.; Enden, A.T. den; Izatt, L.; Davidson, R.; Adank, M.A.; Walker, L.; Schmutzler, R.; Tucker, K.; Kirk, J.; Hodgson, S.; Harris, M.; Douglas, F.; Lindeman, G.J.; Zgajnar, J.; Tischkowitz, M.; Clowes, V.E.; Susman, R.; Ramon, Y.C.T.; Patcher, N.; Gadea, N.; Spigelman, A.; Os, T. van; Liljegren, A.; Side, L.; Brewer, C.; Brady, A.F.; Donaldson, A.; Stefansdottir, V.; Friedman, E.; Chen-Shtoyerman, R.; Amor, D.J.; Copakova, L.; Barwell, J.; Giri, V.N.; Murthy, V.; Nicolai, N.; Teo, S.H.; Greenhalgh, L.; Strom, S.; Henderson, A.; McGrath, J.; Gallagher, D.; Aaronson, N.; Ardern-Jones, A.; Bangma, C.; Dearnaley, D.; Costello, P.; Eyfjord, J.; Rothwell, J.; Falconer, A.; Gronberg, H.; Hamdy, F.C.

    2014-01-01

    BACKGROUND: Men with germline breast cancer 1, early onset (BRCA1) or breast cancer 2, early onset (BRCA2) gene mutations have a higher risk of developing prostate cancer (PCa) than noncarriers. IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in

  4. Targeted Prostate Cancer Screening in BRCA1 and BRCA2 Mutation Carriers : Results from the Initial Screening Round of the IMPACT Study

    NARCIS (Netherlands)

    Bancroft, Elizabeth K.; Page, Elizabeth C.; Castro, Elena; Lilja, Hans; Vickers, Andrew; Sjoberg, Daniel; Assel, Melissa; Foster, Christopher S.; Mitchell, Gillian; Drew, Kate; Maehle, Lovise; Axcrona, Karol; Evans, D. Gareth; Bulman, Barbara; Eccles, Diana; McBride, Donna; van Asperen, Christi; Vasen, Hans; Kiemeney, Lambertus A.; Ringelberg, Janneke; Cybulski, Cezary; Wokolorczyk, Dominika; Selkirk, Christina; Hulick, Peter J.; Bojesen, Anders; Skytte, Anne-Bine; Lam, Jimmy; Taylor, Louise; Oldenburg, Rogier; Cremers, Ruben; Verhaegh, Gerald; van Zelst-Stams, Wendy A.; Oosterwijk, Jan C.; Blanco, Ignacio; Salinas, Monica; Cook, Jackie; Rosario, Derek J.; Buys, Saundra; Conner, Tom; Ausems, Margreet G.; Ong, Kai-ren; Hoffman, Jonathan; Domchek, Susan; Powers, Jacquelyn; Teixeira, Manuel R.; Maia, Sofia; Foulkes, William D.; Taherian, Nassim; Ruijs, Marielle; Helderman-van den Enden, Apollonia T.; Izatt, Louise; Davidson, Rosemarie; Adank, Muriel A.; Walker, Lisa; Schmutzler, Rita; Tucker, Kathy; Kirk, Judy; Hodgson, Shirley; Harris, Marion; Douglas, Fiona; Lindeman, Geoffrey J.; Zgajnar, Janez; Tischkowitz, Marc; Clowes, Virginia E.; Susman, Rachel; Ramon y Cajal, Teresa; Patcher, Nicholas; Gadea, Neus; Spigelman, Allan; van Os, Theo; Liljegren, Annelie; Side, Lucy; Brewer, Carole; Brady, Angela F.; Donaldson, Alan; Stefansdottir, Vigdis; Friedman, Eitan; Chen-Shtoyerman, Rakefet; Amor, David J.; Copakova, Lucia; Barwell, Julian; Giri, Veda N.; Murthy, Vedang; Nicolai, Nicola; Teo, Soo-Hwang; Greenhalgh, Lynn; Strom, Sara; Henderson, Alex; McGrath, John; Gallagher, David; Aaronson, Neil; Ardern-Jones, Audrey; Bangma, Chris; Dearnaley, David; Costello, Philandra; Eyfjord, Jorunn; Rothwell, Jeanette; Falconer, Alison; Gronberg, Henrik; Hamdy, Freddie C.; Johannsson, Oskar; Khoo, Vincent; Kote-Jarai, Zsofia; Lubinski, Jan; Axcrona, Ulrika; Melia, Jane; McKinley, Joanne; Mitra, Anita V.; Moynihan, Clare; Rennert, Gad; Suri, Mohnish; Wilson, Penny; Killick, Emma; Moss, Sue; Eeles, Rosalind A.

    Background: Men with germline breast cancer 1, early onset (BRCA1) or breast cancer 2, early onset (BRCA2) gene mutations have a higher risk of developing prostate cancer (PCa) than noncarriers. IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in

  5. Targeted Prostate Cancer Screening in BRCA1 and BRCA2 Mutation Carriers: Results from the Initial Screening Round of the IMPACT Study

    NARCIS (Netherlands)

    Bancroft, Elizabeth K.; Page, Elizabeth C.; Castro, Elena; Lilja, Hans; Vickers, Andrew; Sjoberg, Daniel; Assel, Melissa; Foster, Christopher S.; Mitchell, Gillian; Drew, Kate; Mæhle, Lovise; Axcrona, Karol; Evans, D. Gareth; Bulman, Barbara; Eccles, Diana; McBride, Donna; van Asperen, Christi; Vasen, Hans; Kiemeney, Lambertus A.; Ringelberg, Janneke; Cybulski, Cezary; Wokolorczyk, Dominika; Selkirk, Christina; Hulick, Peter J.; Bojesen, Anders; Skytte, Anne-Bine; Lam, Jimmy; Taylor, Louise; Oldenburg, Rogier; Cremers, Ruben; Verhaegh, Gerald; van Zelst-Stams, Wendy A.; Oosterwijk, Jan C.; Blanco, Ignacio; Salinas, Monica; Cook, Jackie; Rosario, Derek J.; Buys, Saundra; Conner, Tom; Ausems, Margreet G.; Ong, Kai-Ren; Hoffman, Jonathan; Domchek, Susan; Powers, Jacquelyn; Teixeira, Manuel R.; Maia, Sofia; Foulkes, William D.; Taherian, Nassim; Ruijs, Marielle; Helderman-van den Enden, Apollonia T.; Izatt, Louise; Davidson, Rosemarie; Adank, Muriel A.; Walker, Lisa; Schmutzler, Rita; Tucker, Kathy; Kirk, Judy; Hodgson, Shirley; Harris, Marion; Douglas, Fiona; Lindeman, Geoffrey J.; Zgajnar, Janez; Tischkowitz, Marc; Clowes, Virginia E.; Susman, Rachel; Ramón Y Cajal, Teresa; Patcher, Nicholas; Gadea, Neus; Spigelman, Allan; van Os, Theo; Liljegren, Annelie; Side, Lucy; Brewer, Carole; Brady, Angela F.; Donaldson, Alan; Stefansdottir, Vigdis; Friedman, Eitan; Chen-Shtoyerman, Rakefet; Amor, David J.; Copakova, Lucia; Barwell, Julian; Giri, Veda N.; Murthy, Vedang; Nicolai, Nicola; teo, Soo-Hwang; Greenhalgh, Lynn; Strom, Sara; Henderson, Alex; McGrath, John; Gallagher, David; Aaronson, Neil; Ardern-Jones, Audrey; Bangma, Chris; Dearnaley, David; Costello, Philandra; Eyfjord, Jorunn; Rothwell, Jeanette; Falconer, Alison; Gronberg, Henrik; Hamdy, Freddie C.; Johannsson, Oskar; Khoo, Vincent; Kote-Jarai, Zsofia; Lubinski, Jan; Axcrona, Ulrika; Melia, Jane; McKinley, Joanne; Mitra, Anita V.; Moynihan, Clare; Rennert, Gad; Suri, Mohnish; Wilson, Penny; Killick, Emma; Moss, Sue; Eeles, Rosalind A.; Eeles, Rosalind; Bancroft, Elizabeth; Page, Elizabeth; Taylor, Natalie; Pope, Jenny; Saya, Sibel; Martin, Sue; Keating, Diana; Petelin, Lara; Murphy, Morgan; Doherty, Rebecca; Pratt, Sarah; Murphy, Declan; Cleeve, Laurence; Miller, Cathy; Stapleton, Alan; Chong, Michael; Suthers, Graeme; Tucker, Katherine; Andrews, Lesley; Duffy, Jessica; Millard, Richard; Ward, Robyn; Williams, Rachel; Stricker, Phillip; Bowman, Michelle; Patel, Manish; O'Connell, Shona; Hunt, Clare; Smyth, Courtney; Frydenberg, Mark; Lindeman, Geoffrey; Shackleton, Kylie; McGaughran, Julie; Boon, Melanie; Pachter, Nicholas; Townshend, Sharron; Schofield, Lyn; Gleeson, Margaret; Scott, Rodney; Amor, David; Burke, Jo; Patterson, Briony; Bacic, Sonya; Swindle, Peter; Foulkes, William; Aprikian, Armen; Bojeson, Anders; Cruger, Dorthe; Osther, Palle; Gerdes, Anne-Marie; Rhiem, Kerstin; Luedtke-Heckenkamp, Kerstin; Ochsendorf, Nicole; Fiddike, Kerstin; Sarin, Rajiv; Awatagiri, Kasturi; Ghonge, Sujata; Kowtal, Pradnya; Mulgund, Gouri; Bambury, Richard; Farrell, Michael; Gallagher, Fergal; Ben-Yehoshua, Sagi Josefsberg; Nissani, Rachel; Appelman, Zvi; Moriel, Evyatar; Radice, Paolo; Valdagni, Riccardo; Magnani, Tiziana; teo, Soo Hwang; Tan, Hui Meng; Yoon, Sook-Yee; Thong, Meow Keong; Kiemeney, Bart; van Zelst-Stams, Wendy; Ausems, Margreet G. E. M.; van der Luijt, Rob B.; Oldenburg, Rogier A.; Maehle, Lovise; Moller, Pal; Brennhovd, Bjorn; Medvik, Heidi; Hanslien, Eldbjørg; Ruijs, Mariëlle W. G.; Helderman- van den Enden, A. Paula T. J. M.; Teixeira, Manuel; Peixoto, Ana; Henrique, Rui; Oliveira, Jorge; Gonçalves, Nuno; Araújo, Luís; Seixas, Manuela; Souto, João Paulo; Nogueira, Pedro; Krajc, Mateja; Vrecar, Alenka; Salinas, Mónica; Capella, Gabriel; Fisas, David; Balmaña, Judith; Morote, Juan; Hjälm-Eriksson, Marie; Ekdahl, Karl-Johan; Carlsson, Stefan; Hanson, Helen; Shanley, Susan; Goh, Chee; Wiggins, Jennifer; Kohut, Kelly; van As, Nicholas; Thompson, Alan; Ogden, Chris; Borley, Nigel; Woodhouse, Christopher; Kumar, Pardeep; Mercer, Catherine; Paterson, Joan; Clowes, Virginia; Taylor, Amy; Newcombe, Barbara; Halliday, Dorothy; Stayner, Barbara; Fleming-Brown, D.; Brice, Glen; Homfray, Tessa; Hammond, Carrie; Potter, Alison; Renton, Caroline; Searle, Anne; Hill, Kathryn; Goodman, Selina; Garcia, Lynda; Devlin, Gemma; Everest, Sarah; Nadolski, Maria; Jobson, Irene; Paez, Edgar; Tomkins, Sue; Pichert, Gabriella; Jacobs, Chris; Langman, Caroline; Weston, Michelle; Brady, Angela; Dorkins, Huw; Melville, Athalie; Kosicka-Slawinska, Monika; Cummings, Carole; Kiesel, Vicki; Bartlett, Marion; Randhawa, Kashmir; Ellery, Natalie; Male, Alison; Simon, Kate; Rees, Katie; Compton, Cecilia; Tidey, Lizzie; Nevitt, Louise; Ingram, Stuart; Rosario, Derek; Catto, James; Howson, Joanne; Chapman, Cyril; Cole, Trevor; Heaton, Tricia; Burgess, Lucy; Longmuir, Mark; Watt, Cathy; Duncan, Alexis; Kockelbergh, Roger; Sattar, Ayisha; Kaemba, Beckie; Sidat, Zahirah; Patel, Nafisa; Siguake, Kas; Birt, Angela; Poultney, Una; Umez-Eronini, Nkem; Mom, Jaswant; Roberts, Gillian; Woodward, Anthony; Sutton, Vivienne; Cornford, Philip; Treherne, Katy; Griffiths, Julie; Cogley, Lyn; Hulick, Peter; Rubinstein, Wendy; Brendler, Charles; Helfand, Brian; McGuire, Michael; Kaul, Karen; Shevrin, Daniel; Weissman, Scott; Newlin, Anna; Vogel, Kristen; Weiss, Shelly; Goldgar, David; Venne, Vickie; Stephenson, Robert; Dechet, Christopher; Arun, Banu; Davis, John W.; Yamamura, Yuko; Giri, Veda; Gross, Laura

    2014-01-01

    Background: Men with germline breast cancer 1, early onset (BRCA1) or breast cancer 2, early onset (BRCA2) gene mutations have a higher risk of developing prostate cancer (PCa) than noncarriers. IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in

  6. Implementation of a fall screening program in a high risk of fracture population.

    Science.gov (United States)

    Ritchey, Katherine; Olney, Amanda; Shofer, Jane; Phelan, Elizabeth A; Matsumoto, Alvin M

    2017-10-31

    Fall prevention is an important way to prevent fractures in person with osteoporosis. We developed and implemented a fall screening program in the context of routine osteoporosis care. This program was found to be feasible and showed that a significant proportion of persons with osteoporosis are at risk of falling. Falls are the most common cause of fracture in persons with osteoporosis. However, osteoporosis care rarely includes assessment and prevention of falling. We thus sought to assess the feasibility of a fall screening and management program integrated into routine osteoporosis care. The program was developed and offered to patients with osteoporosis or osteopenia seen at an outpatient clinic between May 2015 and May 2016. Feasibility was measured by physical therapist time required to conduct screening and ease of integrating the screening program into the usual clinic workflow. Self-report responses and mobility testing were conducted to describe the fall and fracture risk profile of osteoporosis patients screened. Effects on fall-related care processes were assessed via chart abstraction of patient participation in fall prevention exercise. Of the 154 clinic patients who presented for a clinic visit, 68% met screening criteria and completed in two thirds of persons. Screening was completed in a third of the time typically allotted for traditional PT evaluations and did not interfere with clinic workflow. Forty percent of those screened reported falling in the last year, and over half had two or more falls in the past year. Over half reported a balance or lower extremity impairment, and over 40% were below norms on one or more performance tests. Most patients who selected a group exercise fall prevention program completed all sessions while only a quarter completed either supervised or independent home-based programs. Implementation of a fall risk screening program in an outpatient osteoporosis clinic appears feasible. A substantial proportion of people

  7. FMCSA Safety Program Effectiveness Measurement: Carrier Intervention Effectiveness Model, Version 1.1-Report for FY 2014 Interventions - Analysis Brief

    Science.gov (United States)

    2018-04-01

    The Carrier Intervention Effectiveness Model (CIEM) provides the Federal Motor Carrier Safety Administration (FMCSA) with a tool for measuring the safety benefits of carrier interventions conducted under the Compliance, Safety, Accountability (CSA) e...

  8. FMCSA safety program effectiveness measurement : carrier intervention effectiveness model, version 1.1 - report for FY 2013 interventions : analysis brief

    Science.gov (United States)

    2017-04-01

    The Carrier Intervention Effectiveness Model (CIEM) provides the Federal Motor Carrier Safety Administration (FMCSA) with a tool for measuring the safety benefits of carrier interventions conducted under the Compliance, Safety, Accountability (CSA) e...

  9. Results of a Targeted Screening Program for Congenital Cytomegalovirus Infection in Infants Who Fail Newborn Hearing Screening.

    Science.gov (United States)

    Vancor, Emily; Shapiro, Eugene D; Loyal, Jaspreet

    2018-01-24

    Congenital cytomegalovirus (CMV) infection is a major cause of sensorineural hearing loss. By law, newborns in Connecticut who fail newborn hearing screening are tested for infection with CMV. This targeted screening is controversial, because most children with congenital CMV infection are asymptomatic, and CMV-related hearing loss can have a delayed onset. Our hospital uses a saliva polymerase chain reaction (PCR) assay (confirmed by a urine PCR assay) to detect CMV. Here, we report the results of the first year of our screening program. We reviewed the medical records of newborns in the Yale New Haven Health System who failed the newborn hearing screening test between January 1 and December 31, 2016. Of 10964 newborns, 171 failed newborn hearing screening, and 3 of these newborns had positive saliva CMV PCR test results. Of these 3 newborns, 2 had positive results on the confirmatory test (for 1 of them the confirmatory test was not performed until the infant was 10 weeks old), and 1 had a negative result on the confirmatory test. Three additional newborns with congenital CMV infection were tested because of clinical indications (1 for ventriculomegaly on prenatal ultrasound and 2 for CMV infection of the mother). Results of audiology follow-up were available for 149 (87.1%) of the 171 newborns who failed newborn hearing screening; 127 (85.2%) had normal results. Our targeted screening program for congenital CMV infection had a low yield. Consideration should be given to other strategies for identifying children at risk of hearing loss as a result of congenital CMV infection. © The Author(s) 2018. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Development of a Newborn Screening Program for Critical Congenital Heart Disease (CCHD) in Taipei.

    Science.gov (United States)

    Tsao, Pei-Chen; Shiau, Yu-Shih; Chiang, Szu-Hui; Ho, Hui-Chen; Liu, Yu-Ling; Chung, Yuan-Fang; Lin, Li-Ju; Chen, Ming-Ren; Chang, Jia-Kan; Soong, Wen-Jue; Lin, Hsiu-Lian; Hwang, Betau; Hsiao, Kwang-Jen

    2016-01-01

    Early detection of critical congenital heart disease (CCHD) can significantly reduce morbidity and mortality among newborns. We investigate the feasibility of implementing a community-based newborn CCHD screening program in Taipei. Twelve birthing facilities in Taipei participated in a trial screening program between October 1, 2013, and March 31, 2014. Newborns underwent pulse oximetry at 24-36 h old, with probes attached to the right hand and one lower limb. Any screening saturation ≥95% in either extremity, with an absolute difference of ≤3% between the right hand and foot, was accepted as a screening pass. A screening result was considered as a fail if the oxygen saturation was <95% at either probe site, on 3 separate occasions, each separated by 30 min or the first result was <95% at either probe site, and any subsequent oxygen saturation measurement was <90%. Public health nurses would follow up all missed or refused cases. Of the 6,387 live births, 6,296 newborns (coverage rate: 6,296/6,387 = 98.6%) underwent appropriate pulse oximetry screening. Sixteen newborns (0.25%) were reported to have a failed screening result. Five of these screen positive newborns were confirmed with CCHD; two of them were diagnosed solely attributed to the failed screening results. The false-positive rate was 0.18%. Implementing a 6-month screening program for CCHD produced good case detection rate, while using efficient screening and referral systems. This program was successful in integrating screening, referral and public health tracking systems. The protocol outlined in this report could provide a community-based model for worldwide implementation.

  11. Newborn screening for congenital cytomegalovirus: Options for hospital-based and public health programs.

    Science.gov (United States)

    Grosse, Scott D; Dollard, Sheila; Ross, Danielle S; Cannon, Michael

    2009-12-01

    Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss (SNHL) and developmental disability in children. Early identification of infected children through screening could allow for early intervention and improvement in functional outcomes among the subset who develop sequelae. To outline potential options and strategies for screening newborns for congenital CMV infection and to discuss barriers to screening and data needs to inform future policy decisions. Commentary based on the literature and expert opinion on newborn dried blood spot screening, newborn hearing screening/Early Hearing Detection and Intervention (EHDI) programs, and congenital CMV. Although no population-based screening for congenital CMV is underway, pilot newborn screening studies using a variety of assays with urine or dried blood spot specimens are underway. Challenges to screening are both practical-uncertain sensitivity of blood spot assays suitable for large-scale screening and lack of infrastructure for collection of urine specimens; and evidentiary-the need to demonstrate improved outcomes and value of screening to offset the expense and potential adverse psychosocial consequences for children and families whose children require periodic monitoring but never develop sequelae. Screening for congenital CMV infection is a potentially important intervention that merits additional research, including the logistical feasibility of different screening options and psychosocial consequences for families.

  12. Screening of oxygen-carrier particles based on iron-, manganese-, copper- and nickel oxides for use in chemical-looping technologies

    Energy Technology Data Exchange (ETDEWEB)

    Johansson, Marcus

    2007-07-01

    Capture and storage of carbon dioxide from combustion will likely be used in the future as a method of reducing emissions of greenhouse gases and thus be part of the overall strategy to stabilize the atmospheric levels of CO{sub 2}. Chemical-looping combustion is a method of combustion where CO{sub 2} is inherently separated from the non-condensable components in the flue gas without the need for an energy intensive air separation unit. This is because nitrogen from the combustion air is never mixed with the fuel. Instead, oxygen carriers, in the form of metal oxide particles, circulate between two interconnected fluidized reactors and transfer oxygen from the air to the fuel through heterogeneous gas-solid redox reactions. The technology could also be adapted for the production of hydrogen from fossil fuels with CO{sub 2} separation, i.e. chemical-looping reforming. 108 different oxygen-carriers based on iron-, manganese-, copper- and nickel oxides have been investigated. These carriers are prepared with inert material to increase the lifetime and performance of the particles. All particles but one have been produced by a freeze-granulation method. In order to optimize the performance of the particles, the sintering temperature of the particles was varied between 950 deg C and 1600 deg C. Normally particles of the size range of 125-180 squarem have been used for the reactivity investigations. Screening tests were performed in a laboratory fluidized-bed reactor of quartz placed in a furnace. The particles were exposed to an environment simulating a real chemical looping combustor, by alternating between reducing (50% CH{sub 4} - 50 % H{sub 2}O) and oxidizing conditions (5% O{sub 2} in N{sub 2}). The temperature was varied in the range 600 - 950 deg C with most experiments conducted at 950 deg C. In addition the particles were characterized with respect to strength, physical appearance and chemical structure before and after the experiments. Some suitable oxygen

  13. 78 FR 66801 - Motor Carrier Safety Advisory Committee; Charter Renewal

    Science.gov (United States)

    2013-11-06

    ... DEPARTMENT OF TRANSPORTATION Federal Motor Carrier Safety Administration [Docket No. FMCSA-2006-26367] Motor Carrier Safety Advisory Committee; Charter Renewal AGENCY: Federal Motor Carrier Safety... and recommendations on motor carrier safety programs and motor carrier safety regulations through a...

  14. The impact of stratifying by family history in colorectal cancer screening programs

    NARCIS (Netherlands)

    S.L. Goede (S. Lucas); L. Rabeneck (L.); I. Lansdorp-Vogelaar (Iris); A. Zauber (Ann); L.F. Paszat (Lawrence F.); J.S. Hoch (Jeffrey S.); J.H.E. Yong (Jean H.E.); F. Van Hees (Frank); J. Tinmouth (Jill); M. van Ballegooijen (Marjolein)

    2015-01-01

    textabstractIn the province-wide colorectal cancer (CRC) screening program in Ontario, Canada, individuals with a family history of CRC are offered colonoscopy screening and those without are offered guaiac fecal occult blood testing (gFOBT, Hemoccult II). We used microsimulation modeling to

  15. Costs of promoting cancer screening: Evidence from CDC's Colorectal Cancer Control Program (CRCCP).

    Science.gov (United States)

    Tangka, Florence K L; Subramanian, Sujha; Hoover, Sonja; Royalty, Janet; Joseph, Kristy; DeGroff, Amy; Joseph, Djenaba; Chattopadhyay, Sajal

    2017-06-01

    The Colorectal Cancer Control Program (CRCCP) provided funding to 29 grantees to increase colorectal cancer screening. We describe the screening promotion costs of CRCCP grantees to evaluate the extent to which the program model resulted in the use of funding to support interventions recommended by the Guide to Community Preventive Services (Community Guide). We analyzed expenditures for screening promotion for the first three years of the CRCCP to assess cost per promotion strategy, and estimated the cost per person screened at the state level based on various projected increases in screening rates. All grantees engaged in small media activities and more than 90% used either client reminders, provider assessment and feedback, or patient navigation. Based on all expenditures, projected cost per eligible person screened for a 1%, 5%, and 10% increase in state-level screening proportions are $172, $34, and $17, respectively. CRCCP grantees expended the majority of their funding on Community Guide recommended screening promotion strategies but about a third was spent on other interventions. Based on this finding, future CRC programs should be provided with targeted education and information on evidence-based strategies, rather than broad based recommendations, to ensure that program funds are expended mainly on evidence-based interventions. Copyright © 2016. Published by Elsevier Ltd.

  16. 76 FR 60022 - Endocrine Disruptor Screening Program; Weight-of-Evidence Guidance Document; Notice of Availability

    Science.gov (United States)

    2011-09-28

    ... identify the need for Tier 2 testing. List of Subjects Environmental protection, Endocrine disruptors... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPPT-2010-0877; FRL-8890-7] Endocrine Disruptor Screening... Agency (EPA). ACTION: Notice. SUMMARY: EPA's Endocrine Disruptor Screening Program (EDSP) is announcing...

  17. 75 FR 81605 - Endocrine Disruptor Screening Program (EDSP); Announcing the Availability of a Draft for Weight...

    Science.gov (United States)

    2010-12-28

    ..., Endocrine disruptors, Screening assays, Weight-of-evidence. Dated: December 20, 2010. Stephen A. Owens... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPPT-2010-0877; FRL-8858-9] Endocrine Disruptor Screening Program (EDSP); Announcing the Availability of a Draft for Weight-of-Evidence Guidance Document...

  18. Parent Reactions to a School-Based Body Mass Index Screening Program

    Science.gov (United States)

    Johnson, Suzanne Bennett; Pilkington, Lorri L.; Lamp, Camilla; He, Jianghua; Deeb, Larry C.

    2009-01-01

    Background: This study assessed parent reactions to school-based body mass index (BMI) screening. Methods: After a K-8 BMI screening program, parents were sent a letter detailing their child's BMI results. Approximately 50 parents were randomly selected for interview from each of 4 child weight-classification groups (overweight, at risk of…

  19. Adherence to the cervical cancer screening program in women living with HIV in Denmark

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristina; Ladelund, Steen; Jensen-Fangel, Søren

    2014-01-01

    BACKGROUND: Women living with HIV (WLWH) are at increased risk of invasive cervical cancer (ICC). International HIV guidelines suggest cervical screening twice the first year after HIV diagnosis and thereafter annually. Adherence to the HIV cervical screening program in Denmark is unknown. METHODS...

  20. A screening program for dancers administered by dancers.

    Science.gov (United States)

    Wilson, Margaret; Deckert, Jennifer L

    2009-01-01

    Students enrolled in a dance kinesiology class were trained to administer a screening protocol on younger dancers in the same department. The dance kinesiology students gained experience assessing alignment and functional symmetry in their peers, and then recommended exercises for gaining awareness and developing balanced patterns of movement. This "low stakes" assessment created both dialogue and peer support centered on helping the screened dancers understand and effectively work with their individual capacities and limitations. The project was designed to contribute to a culture of wellness and education within the dance department.

  1. Screening Doses for Induction of Cancers Calculated with the Interactive RadioEpidemiological Program (IREP)

    National Research Council Canada - National Science Library

    Kocher, David C; Apostoaei, Julian A

    2007-01-01

    .... Screening doses for 32 cancer types were calculated with the Interactive RadioEpidemiological Program, which is used by the Department of Veterans Affairs in adjudicating claims for compensation...

  2. Costs of colorectal cancer screening provision in CDC's Colorectal Cancer Control Program: Comparisons of colonoscopy and FOBT/FIT based screening.

    Science.gov (United States)

    Subramanian, Sujha; Tangka, Florence K L; Hoover, Sonja; Royalty, Janet; DeGroff, Amy; Joseph, Djenaba

    2017-06-01

    We assess annual costs of screening provision activities implemented by 23 of the Centers for Disease Control and Prevention's Colorectal Cancer Control Program (CRCCP) grantees and report differences in costs between colonoscopy and FOBT/FIT-based screening programs. We analysed annual cost data for the first three years of the CRCCP (July 2009-June 2011) for each screening provision activity and categorized them into clinical and non-clinical screening provision activities. The largest cost components for both colonoscopy and FOBT/FIT-based programs were screening and diagnostic services, program management, and data collection and tracking. During the first 3 years of the CRCCP, the average annual clinical cost for screening and diagnostic services per person served was $1150 for colonoscopy programs, compared to $304 for FIT/FOBT-based programs. Overall, FOBT/FIT-based programs appear to have slightly higher non-clinical costs per person served (average $1018; median $838) than colonoscopy programs (average $980; median $686). Colonoscopy-based CRCCP programs have higher clinical costs than FOBT/FIT-based programs during the 3-year study timeframe (translating into fewer people screened). Non-clinical costs for both approaches are similar and substantial. Future studies of the cost-effectiveness of colorectal cancer screening initiatives should consider both clinical and non-clinical costs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Endocrine Disruptor Screening Program (EDSP) Comprehensive Management Plans

    Science.gov (United States)

    The EDSP Comprehensive Management Plan describes the technical review processes that will be used in implementing this program and how the agency intends to factor technology advancements into the program.

  4. The Icelandic and Nordic cervical screening programs: trends in incidence and mortality rates through 1995.

    Science.gov (United States)

    Sigurdsson, K

    1999-07-01

    The objective of cervical cancer screening is to lower the incidence and mortality rates of the disease. This study evaluates the effectiveness of cervical screening and the UICC and EC screening recommendations based on the Nordic screening experience. The study analyzes the features of the Icelandic and the Nordic screening programs and the observed trends in the incidence and mortality rates in these countries through 1995. Organized screening started in all the Nordic countries soon after 1960 and had nation-wide coverage in all these countries, except in Denmark (45% coverage in 1991), by around 1973 but in Norway screening was only spontaneous up to late in 1994. Up to 1985 the target age group and screening interval were most intensive in Iceland, followed by Finland, Sweden and Denmark. All countries except Finland lowered the lower age limit and intensified the screening intervals after 1985. Through the period 1986-1995 the reduction in both the mortality and the incidence rates was greatest in Iceland (mortality: 76% and incidence: 67%) and Finland (73% and 75%, respectively), intermediate in Sweden (60% and 55%, respectively) and Denmark (55% and 54%, respectively), and lowest in Norway (43% and 34%, respectively). The age-specific incidence in the 20-29 age group has been increasing since 1971 in all the Nordic countries, except in Finland, where the yearly registered age-specific incidence has been increasing in the targeted 30-54 age group since 1991. In Iceland screening has greatly affected the rate of all stages of squamous cell carcinoma, but not the rate of adeno- and adenosquamous carcinomas. In fact the rate of adenocarcinoma has been increasing. Organized screening is more effective than spontaneous screening in reducing the risk of cervical cancer. Although differences in environmental, biological and ethnic factors may call for different screening strategies, screening should preferably start soon after age 20 with a screening interval of 2

  5. Screening for Familial Hypercholesterolemia in Children: What Can We Learn From Adult Screening Programs?

    OpenAIRE

    Henneman, Lidewij; McBride, Colleen M.; Cornel, Martina C.; Duquette, Debra; Qureshi, Nadeem

    2015-01-01

    Familial hypercholesterolemia (FH), an autosomal dominant atherosclerotic disease, is a common monogenic subtype of cardiovascular disease. Patients with FH suffer an increased risk of early onset heart disease. Early identification of abnormally elevated cholesterol signpost clinicians to interventions that will significantly decrease risk of related morbidity and mortality. Cascade genetic testing can subsequently identify at-risk relatives. Accordingly, a number of screening approaches hav...

  6. Carrier Diagnosis

    Science.gov (United States)

    ... Inheritance of Hemophilia Definitions & Terminology Bleeding Symptoms Carrier Diagnosis When to Test for Carrier Status Family Planning and Pregnancy Conception Options Prenatal Diagnosis Fetal Sex ...

  7. Effectiveness of a two-step population-based osteoporosis screening program using FRAX

    DEFF Research Database (Denmark)

    Rubin, K H; Rothmann, M J; Holmberg, T

    2018-01-01

    The Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study investigated the effectiveness of a two-step screening program for osteoporosis in women. We found no overall reduction in fractures from systematic screening compared to the current case-finding strategy. The group of moderate......- to high-risk women, who accepted the invitation to DXA, seemed to benefit from the program. INTRODUCTION: The purpose of the ROSE study was to investigate the effectiveness of a two-step population-based osteoporosis screening program using the Fracture Risk Assessment Tool (FRAX) derived from a self......-administered questionnaire to select women for DXA scan. After the scanning, standard osteoporosis management according to Danish national guidelines was followed. METHODS: Participants were randomized to either screening or control group, and randomization was stratified according to age and area of residence. Inclusion...

  8. A Scoping Review of Intimate Partner Violence Screening Programs for Health Care Professionals.

    Science.gov (United States)

    Sprague, Sheila; Slobogean, Gerard P; Spurr, Hayley; McKay, Paula; Scott, Taryn; Arseneau, Erika; Memon, Muzammil; Bhandari, Mohit; Swaminathan, Aparna

    2016-01-01

    Between 38 and 59 percent of women presenting to health care professionals have experienced intimate partner violence. Consequently, multiple intimate partner violence identification or screening programs within health care settings have been developed; however, substantial variations in program content and interpretation of program effectiveness has resulted in conflicting practice guidelines. The purpose of our scoping review is to broadly identify and synthesize the available literature evaluating intimate partner violence identification programs within health care settings to identify key areas for potential evidence-based recommendations and to focus research priorities in the field. We conducted a search of MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and psycINFO. We used broad eligibility criteria to identify studies that evaluated intimate partner violence identification programs in health care settings. We completed all screening and data extraction independently and in duplicate. We used descriptive statistics to summarize all data. We identified 59 eligible studies evaluating intimate partner violence identification programs within health care settings. The most commonly reported outcome themes were IPV disclosure (69%, n = 35), number of patients screened (39%, n = 20), HCP opinions towards screening (37%, n = 19), and patient opinions towards screening (29%, n = 15). The majority of studies (36 studies (70.6%)) reported positive program evaluation results. The majority of studies reported positive program evaluation results. This may suggest that many different intimate partner violence identification programs are beneficial for identifying victims of abuse, however, it remains unknown as to whether identification programs prevent future episodes of abuse. Additionally, the substantial heterogeneity of the intervention characteristics

  9. A Scoping Review of Intimate Partner Violence Screening Programs for Health Care Professionals.

    Directory of Open Access Journals (Sweden)

    Sheila Sprague

    Full Text Available Between 38 and 59 percent of women presenting to health care professionals have experienced intimate partner violence. Consequently, multiple intimate partner violence identification or screening programs within health care settings have been developed; however, substantial variations in program content and interpretation of program effectiveness has resulted in conflicting practice guidelines. The purpose of our scoping review is to broadly identify and synthesize the available literature evaluating intimate partner violence identification programs within health care settings to identify key areas for potential evidence-based recommendations and to focus research priorities in the field.We conducted a search of MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and psycINFO. We used broad eligibility criteria to identify studies that evaluated intimate partner violence identification programs in health care settings. We completed all screening and data extraction independently and in duplicate. We used descriptive statistics to summarize all data.We identified 59 eligible studies evaluating intimate partner violence identification programs within health care settings. The most commonly reported outcome themes were IPV disclosure (69%, n = 35, number of patients screened (39%, n = 20, HCP opinions towards screening (37%, n = 19, and patient opinions towards screening (29%, n = 15. The majority of studies (36 studies (70.6% reported positive program evaluation results.The majority of studies reported positive program evaluation results. This may suggest that many different intimate partner violence identification programs are beneficial for identifying victims of abuse, however, it remains unknown as to whether identification programs prevent future episodes of abuse. Additionally, the substantial heterogeneity of the intervention

  10. Targeted breast cancer screening in women younger than 40: results from a statewide program.

    Science.gov (United States)

    Sarff, MaryClare; Schmidt, Katherine; Vetto, John T

    2008-05-01

    Our state Breast and Cervical Cancer Program (BCCP) has previously reported a paucity of data supporting breast screening for asymptomatic women younger than 40 (cancer detection rate of .25% per screening-year). In partnership with the local Affiliate of the Susan G. Komen for the Cure Foundation, we began a targeted "screening" program to evaluate women younger than 40 referred for symptoms or other concerns. Retrospective data review of program results, including demographics, symptoms, evaluations performed, and outcomes. A total of 176 women, ages 16 to 39 years, were referred to the BCCP/Komen program. Of the women with documented presenting symptoms, the most common was breast lump (81%). Evaluation triggered 75 surgical referrals and 69 biopsies, yielding 16 cancers (a biopsy positive rate of 23% and overall cancer detection rate from the program of 9%). For women younger than age 40, targeted breast cancer screening is a more efficient utilization of screening resources, with a higher cancer detection rate than asymptomatic screening.

  11. Comparing the performance of expert user heuristics and an integer linear program in aircraft carrier deck operations.

    Science.gov (United States)

    Ryan, Jason C; Banerjee, Ashis Gopal; Cummings, Mary L; Roy, Nicholas

    2014-06-01

    Planning operations across a number of domains can be considered as resource allocation problems with timing constraints. An unexplored instance of such a problem domain is the aircraft carrier flight deck, where, in current operations, replanning is done without the aid of any computerized decision support. Rather, veteran operators employ a set of experience-based heuristics to quickly generate new operating schedules. These expert user heuristics are neither codified nor evaluated by the United States Navy; they have grown solely from the convergent experiences of supervisory staff. As unmanned aerial vehicles (UAVs) are introduced in the aircraft carrier domain, these heuristics may require alterations due to differing capabilities. The inclusion of UAVs also allows for new opportunities for on-line planning and control, providing an alternative to the current heuristic-based replanning methodology. To investigate these issues formally, we have developed a decision support system for flight deck operations that utilizes a conventional integer linear program-based planning algorithm. In this system, a human operator sets both the goals and constraints for the algorithm, which then returns a proposed schedule for operator approval. As a part of validating this system, the performance of this collaborative human-automation planner was compared with that of the expert user heuristics over a set of test scenarios. The resulting analysis shows that human heuristics often outperform the plans produced by an optimization algorithm, but are also often more conservative.

  12. Low priority main reason not to participate in a colorectal cancer screening program with a faecal occult blood test.

    NARCIS (Netherlands)

    Rijn, AF van; Rossum, L.G.M. van; Deutekom, M.; Laheij, R.J.F.; Fockens, P.; Bossuyt, P.M.; Dekker, E. den; Jansen, J.B.M.J.

    2008-01-01

    BACKGROUND: Compared with screening programs for breast and cervical cancer, reported participation rates for colorectal cancer (CRC) screening are low. The effectiveness of a screening program is strongly influenced by the participation rate. The aim of this study was to investigate the main

  13. Low priority main reason not to participate in a colorectal cancer screening program with a faecal occult blood test

    NARCIS (Netherlands)

    van Rijn, A. F.; van Rossum, L. G. M.; Deutekom, M.; Laheij, R. J. F.; Fockens, P.; Bossuyt, P. M. M.; Dekker, E.; Jansen, J. B. M. J.

    2008-01-01

    Compared with screening programs for breast and cervical cancer, reported participation rates for colorectal cancer (CRC) screening are low. The effectiveness of a screening program is strongly influenced by the participation rate. The aim of this study was to investigate the main reasons not to

  14. Improved Perinatal Depression Screening, Treatment, and Outcomes With a Universal Obstetric Program.

    Science.gov (United States)

    Avalos, Lyndsay A; Raine-Bennett, Tina; Chen, Hong; Adams, Alyce S; Flanagan, Tracy

    2016-05-01

    To evaluate whether universal prenatal and early postnatal screening for depression leads to increased detection, subsequent intervention, and improved depressive symptom outcomes. We conducted a population-based retrospective cohort study of 97,678 pregnant Kaiser Permanente Northern California members during three phases of the Universal Perinatal Depression Screening Program (preimplementation, rollout, fully implemented) from 2007 through 2014. Depression screening scores (Patient Health Questionnaire-9), depression diagnoses, individual counseling visits, demographic characteristics, and medication dispensings were extracted from electronic health records and pharmacy databases. The percentage of women screened, new depression diagnoses, and women receiving treatment were compared among the three phases (tests of trend). Changes in depressive symptom scores up to 6 months postpartum were assessed (rollout and fully implemented phases). A significant increase emerged in the percentage of women screened over the three phases ranging from less than 1% (n=122) (preimplementation) to 98% (n=41,124) (fully implemented) (PHealth Questionnaire-9 scores of 15 or greater (greater severity), highlighting an increase in expected percentage of women receiving treatment (5.9% [preimplementation] to 81.9% [fully implemented]; Puniversal perinatal depression screening programs regarding depression identification and treatment receipt and suggest improvement in symptom outcomes for women in screening programs, especially among integrated health care systems.

  15. Individual Programming for Children with Learning Disabilities as Determined by Screening, Identification, and Differential Diagnosis.

    Science.gov (United States)

    Guyton, Gladys

    A program for screening, identifying, and diagnosing learning disabilities is described. The multidisciplinary approach is emphasized. The school psychologist or counselor, the coordinator of the language therapy program, the administrative staff, and the classroom teacher meet to share findings and impressions, and the information is synthesized…

  16. [Coverage of a screening program and prevalence of diabetic retinopathy in primary careç].

    Science.gov (United States)

    Covarrubias, Trinidad; Delgado, Iris; Rojas, Daniel; Coria, Marcelo

    2017-05-01

    Diabetic retinopathy is the first cause of blindness during working years. Provide knowledge of screening coverage, prevalence and level of diabetic retinopathy in patients that belong to the Cardiovascular Health Program in primary care. Analysis of retinographies performed to 9076 diabetic patients aged 61 ± 13 years (61% women) adscribed to a Cardiovascular Health program in primary care centers of South-East Metropolitan Santiago. The examination was carried out by the evaluation of retinographies by trained optometrists. The coverage of the screening program was 21%. The prevalence of sight threatening diabetic retinopathy was 3,1%. The prevalence of these entities was 45% higher in people aged between 18 and 44 years than in older people. Their prevalence in urban communities was 32% higher than in rural locations. The coverage of the screening program is low. Diabetic patients aged 18 to 44 years and those coming from urban communities have a higher prevalence of severe non-proliferative and proliferative diabetic retinopathy.

  17. 49 CFR 350.101 - What is the Motor Carrier Safety Assistance Program (MCSAP)?

    Science.gov (United States)

    2010-10-01

    ..., fatalities, and injuries through consistent, uniform, and effective CMV safety programs. Investing grant... factors to accidents. The MCSAP also sets forth the conditions for participation by States and local...

  18. Evaluation of a Colorectal Carcinoma Screening Program in Kota Setar and Kuala Muda Districts, Malaysia.

    Science.gov (United States)

    Abu Hassan, Muhammad Radzi; Leong, Tan Wei; Othman Andu, Delarina Frimawati; Hat, Habshoh; Nik Mustapha, Nik Raihan

    2016-01-01

    A colorectal cancer screening program was piloted in two districts of Kedah in 2013. There is scarcity of information on colorectal cancer screening in Malaysia. Thus, this research was conducted to evaluate the colorectal cancer screening program in the districts to provide insights intop its efficacy. A cross sectional study was conducted using data on the colorectal cancer screening program in 2013 involving Kota Setar and Kuala Muda districts in Malaysia. We determined the response rate of immunochemical fecal occult blood test (iFOBT), colonoscopy compliance, and detection rates of neoplasia and carcinoma. We also compared the response of FOBT by demographic background. The response rate of FOBT for first iFOBT screening was 94.7% while the second iFOBT screening was 90.7%. Participants from Kuala Muda district were 27 times more likely to default while Indians had a 3 times higher risk of default compared to Malays. The colonoscopy compliance was suboptimal among those with positive iFOBT. The most common finding from colonoscopy was hemorrhoids, followed by tubular adenoma. Detection rate of carcinoma and neoplasia for our program was 1.2%. In summary, the response rate of iFOBT was encouraging but the colonoscopy compliance was suboptimal which led to a considerably low detection rate.

  19. Evaluation of staff performance and interpretation of the screening program for prevention of thalassemia.

    Science.gov (United States)

    Prommetta, Simaporn; Sanchaisuriya, Kanokwan; Fucharoen, Goonnapa; Yamsri, Supawadee; Chaiboonroeng, Attawut; Fucharoen, Supan

    2017-06-15

    Thalassemia screening program has been implemented for years in Southeast Asia, but no external quality assessment program has been established. We have developed and initiated the proficiency testing (PT) program for the first time in Thailand with the aim to assess the screening performance of laboratory staff and their competency in interpretation of the screening results. Three PT cycles per year were organized. From the first to the third cycle of the PT scheme, a total number of participant laboratories increased from 59 to 67. In each cycle, 2 PT items (assigned as blood samples of the couple) were provided. Performance evaluation was based on the accuracy of screening results, i.e . mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and the dichlorophenolindophenol (DCIP) test for haemoglobin E, including the competency in interpretation of screening results and assessment of foetal risk. Performance was assessed by comparing the participants' result against the assigned value. Of all 3 cycles, most laboratories reported acceptable MCV and MCH values. From the first to the third cycle, incorrect DCIP test and misinterpretation rates were decreased while incorrect risk assessment varied by cycle to cycle. Combining the accuracy of thalassemia screening and the competency in interpretation and risk assessment, approximately half of participants showed excellent performance. Improved performance observed in many laboratories reflects the achievement and benefit of the PT program which should be regularly provided.

  20. FMCSA Safety Program Effectiveness Measurement: Carrier Intervention Effectiveness Model (CIEM), Version 1.1 Report for Fiscal Year 2014 Interventions

    Science.gov (United States)

    2018-04-01

    The Federal Motor Carrier Safety Administration (FMCSA), in cooperation with the John A. Volpe National Transportation Systems Center (Volpe), has developed a quantitative model to measure the effectiveness of motor carrier interventions in terms of ...

  1. FMCSA safety program effectiveness measurement : compliance review effectiveness model results for carriers with compliance reviews in FY 2007

    Science.gov (United States)

    2012-09-30

    In FY 2007, Federal and State enforcement personnel conducted more than 15,000 CRs on individual motor carriers. It is intended that through education, heightened safety regulation awareness, and the enforcement effects of the CR, carriers will impro...

  2. FMCSA safety program effectiveness measurement : compliance review effectiveness model results for carriers with compliance reviews in FY 2008

    Science.gov (United States)

    2012-09-30

    In FY 2008, Federal and State enforcement personnel conducted 14,906 compliance reviews (CRs) on individual motor carriers. It is intended that through education, heightened safety regulation awareness, and the enforcement effects of the CR, carriers...

  3. FMCSA safety program effectiveness measurement : Carrier Intervention Effectiveness Model (CIEM), Version 1.1, report for fiscal year 2013 interventions.

    Science.gov (United States)

    2017-04-01

    The Federal Motor Carrier Safety Administration (FMCSA), in cooperation with the John A. Volpe National Transportation Systems Center (Volpe), has developed a quantitative model to measure the effectiveness of motor carrier interventions in terms of ...

  4. FMCSA safety program effectiveness measurement: carrier intervention effectiveness model (CIEM), version 1.1 : report for fiscal year 2013 interventions.

    Science.gov (United States)

    2017-04-01

    The Federal Motor Carrier Safety Administration (FMCSA), in cooperation with the John A. Volpe National Transportation Systems Center (Volpe), has developed a quantitative model to measure the effectiveness of motor carrier interventions in terms of ...

  5. DACC program cost and work breakdown structure-dictionary. General purpose aft cargo carrier study, volume 2

    Science.gov (United States)

    1985-01-01

    Results of detailed cost estimates and economic analysis performed on the updated 201 configuration of the dedicated Aft Cargo Carrier (DACC) are given. The objective of this economic analysis is to provide the National Aeronautics and Space Administration (NASA) with information on the economics of using the DACC on the Space Transportation System (STS). The detailed cost estimates for the DACC are presented by a work breakdown structure (WBS) to ensure that all elements of cost are considered in the economic analysis and related subsystem trades. Costs reported by WBS provide NASA with a basis for comparing competing designs and provide detailed cost information that can be used to forecast phase C/D planning for new projects or programs derived from preliminary conceptual design studies. The scope covers all STS and STS/DACC launch vehicle cost impacts for delivering an orbital transfer vehicle to a 120 NM low Earth orbit (LEO).

  6. Newborn Screening

    Science.gov (United States)

    ... Laboratory Sciences Office of Public Health Genomics Publications & Articles Newborn Screening Lab Bulletin Laboratory Partners Multimedia Tools Newborn Screening Program – Role of Laboratories Meet the Scientist Newborn Screening: Family Stories Newborn Screening: Public Health ...

  7. Biochemical screening of 504,049 newborns in Denmark, the Faroe Islands and Greenland - Experience and development of a routine program for expanded newborn screening

    DEFF Research Database (Denmark)

    Lund, Allan Meldgaard; Hougaard, David Michael; Simonsen, Henrik

    2012-01-01

    argue that newborn screening for these disorders should be standard of care, though unresolved issues remain, e.g. about newborns with a potential for remaining asymptomatic throughout life. Well organized logistics of the screening program from screening laboratory to centralized, clinical management......Expanded newborn screening for selected inborn errors of metabolism (IEM) in Denmark, the Faroe Islands and Greenland was introduced in 2002. We now present clinical, biochemical, and statistical results of expanded screening (excluding PKU) of 504,049 newborns during nine years as well...... as diagnoses and clinical findings in 82,930 unscreened newborns born in the same period. The frequencies of diagnoses made within the panel of disorders screened for are compared with the frequencies of the disorders in the decade preceding expanded newborn screening. The expanded screening was performed...

  8. Preferences and satisfaction towards a screening program with self-administered human papilloma virus detection tests

    OpenAIRE

    Morán, Flavia; Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú. Estudiante de Medicina; Cárcamo, César; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia. Lima, Perú. médico, doctor en Epidemiología; Valderrama, María; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia. Lima, Perú. obstetra, magister en Obstetricia; García, Patricia J.; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia. Lima, Perú. médico, doctora en Medicina

    2017-01-01

    Cross-sectional study describing preferences and satisfaction towards a cervical cancer screening program with selfadministered rapid tests for the detection of human papillomavirus (HPV). Of 2 090 users picked by the program in Ventanilla Callao - Peru, 97 were randomly selected to be surveyed. In addition, interviews were conducted with women leaders of the community, in charge of providing the evidence. 74.2% of the users felt, at least, satisfied with the program. 68% of women prefer to t...

  9. A Scoping Review of Intimate Partner Violence Screening Programs for Health Care Professionals

    OpenAIRE

    Sprague, Sheila; Slobogean, Gerard P.; Spurr, Hayley; McKay, Paula; Scott, Taryn; Arseneau, Erika; Memon, Muzammil; Bhandari, Mohit; Swaminathan, Aparna

    2016-01-01

    Introduction Between 38 and 59 percent of women presenting to health care professionals have experienced intimate partner violence. Consequently, multiple intimate partner violence identification or screening programs within health care settings have been developed; however, substantial variations in program content and interpretation of program effectiveness has resulted in conflicting practice guidelines. The purpose of our scoping review is to broadly identify and synthesize the available ...

  10. Simulation of reduced breast cancer mortality in breast cancer screening programs

    International Nuclear Information System (INIS)

    Zamora, L. I.; Forastero, C.; Guirado, D.; Lallena, A. M.

    2011-01-01

    The breast cancer screening programs are an essential tool in the fight against breast cancer. Currently, many questions concerning the setup of these programs are open, namely: age range of women who undergo the same, frequency of mammography, ... The effectiveness of a program should be evaluated in terms of mortality reduction is its systematic implementation in the population. In this sense, we performed Monte Carlo simulations to assess that these reductions.

  11. First Trimester Aneuploidy Screening Program for Preeclampsia Prediction in a Portuguese Obstetric Population

    OpenAIRE

    Teixeira, Cláudia; Tejera, Eduardo; Martins, Helena; Pereira, António Tomé; Costa-Pereira, Altamiro; Rebelo, Irene

    2014-01-01

    Objective. To evaluate the performance of a first trimester aneuploidy screening program for preeclampsia (PE) prediction in a Portuguese obstetric population, when performed under routine clinical conditions. Materials and Methods. Retrospective cohort study of 5672 pregnant women who underwent routine first trimester aneuploidy screening in a Portuguese university hospital from January 2009 to June 2013. Logistic regression-based predictive models were developed for prediction of PE based o...

  12. Knowledge, Attitude, and Satisfaction of University Students Regarding Premarital Screening Programs in Kuwait

    Directory of Open Access Journals (Sweden)

    Khaled Al-Enezi

    2017-12-01

    Full Text Available The prevalence of genetic blood disorders is high, ranging from 10-25%, in Kuwait. This high prevalence is mainly due to a preventable cause, namely, consanguineous marriages. One of the most successful programs in Kuwait implemented to reduce such high prevalence is premarital screening program. The aim of the study was to determine the level of knowledge, attitude and satisfaction among university students regarding premarital screening program, and to find out the factors influencing knowledge, attitude, and satisfaction of the people toward premarital screening program. A cross-sectional study was conducted among 809 students of Kuwait University during July-October 2016. A self-administered questionnaire including 51 questions was handed out to the participants after taking informed consent. The main outcome variables of this study were: knowledge of hereditary diseases, premarital screening, attitude, and satisfaction toward premarital screening program. The mean ± SD of knowledge score about hereditary diseases was 5.80 ± 2.9 out of a total of 14, and the knowledge score for premarital screening was 3.99 ± 1.2 out of 6. In univariate analysis, knowledge scores about hereditary diseases were significantly associated with marital status (P = 0.043, education in medical faculties (P < 0.001, higher education of father (P = 0.027, higher education of mother (P = 0.001, and presence of hereditary disease in the family (P = 0.003. The level of attitude toward premarital screening program was significantly associated with female gender (P < 0.001, marital status (P = 0.023, higher years of study (P = 0.002, higher family income (P = 0.019. In multivariate analysis, education in medical faculties and presence of hereditary disease in the family were significant predictors of knowledge about hereditary disease. This study identified some demographic factors which determined the outcome of knowledge about premarital screening and hereditary

  13. CDC’s Newborn Screening Program - Role of Laboratories

    Centers for Disease Control (CDC) Podcasts

    2013-09-03

    When newborn screening started in the U.S. 50 years ago, many questioned whether it was even possible to test every baby born in every state. Today, all states screen babies for at least 29 disorders that can be detected through laboratory testing. In this podcast, Dr. Carla Cuthbert talks about CDC’s Newborn Screening Quality Assurance Program and the role laboratories play in keeping babies healthy.  Created: 9/3/2013 by National Center for Environmental Health (NCEH).   Date Released: 9/3/2013.

  14. A program evaluation of Kids2Hear, a student-run hearing screening program for school children.

    Science.gov (United States)

    Hu, Tina; Stead, Katherine; Fu, Terence; Papsin, Blake

    2016-09-26

    Hearing deficits in children are demonstrably negatively associated with language acquisition and cognition. Although universal neonatal hearing screening exists, it is not offered equally across Canada. Additionally, children emigrating from other countries are often not assessed. The objective of this study is to evaluate Kids2Hear, a free hearing screening program run by medical students at elementary schools, and to determine the rate of hearing deficits that were identified and referred for evaluation. Retrospective analysis of screening program data from 228 participants seen at three inner-city elementary schools over six months. In our sample, the mean age was 5.8 ± 1.0 years with 48 % males. Approximately 21 participants (9.3 %) were screened positive for a hearing deficit and required referral for supplementary audiological evaluation. About 44 participants (19.3 %) were referred to a family physician for otoscopic abnormalities. Females were significantly more likely to be identified for both hearing deficits and otoscopic abnormalities. Hearing deficits and otoscopic abnormalities are common among young children. Female children may be at higher risk for developing hearing issues or otoscopic abnormalities compared to males. Additional research is needed to determine the effectiveness of hearing screening programs.

  15. Community-Based Multidisciplinary Computed Tomography Screening Program Improves Lung Cancer Survival.

    Science.gov (United States)

    Miller, Daniel L; Mayfield, William R; Luu, Theresa D; Helms, Gerald A; Muster, Alan R; Beckler, Vickie J; Cann, Aaron

    2016-05-01

    Lung cancer is the most common cause of cancer deaths in the United States. Overall survival is less than 20%, with the majority of patients presenting with advanced disease. The National Lung Screening Trial, performed mainly in academic medical centers, showed that cancer mortality can be reduced with computed tomography (CT) screening compared with chest radiography in high-risk patients. To determine whether this survival advantage can be duplicated in a community-based multidisciplinary thoracic oncology program, we initiated a CT scan screening program for lung cancer within an established health care system. In 2008, we launched a lung cancer CT screening program within the WellStar Health System (WHS) consisting of five hospitals, three health parks, 140 outpatient medical offices, and 12 imaging centers that provide care in a five-county area of approximately 1.4 million people in Metro-Atlanta. Screening criteria incorporated were the International Early Lung Cancer Action Program (2008 to 2010) and National Comprehensive Cancer Network guidelines (2011 to 2013) for moderate- and high-risk patients. A total of 1,267 persons underwent CT lung cancer screening in WHS from 2008 through 2013; 53% were men, 87% were 50 years of age or older, and 83% were current or former smokers. Noncalcified indeterminate pulmonary nodules were found in 518 patients (41%). Thirty-six patients (2.8%) underwent a diagnostic procedure for positive findings on their CT scan; 30 proved to have cancer, 28 (2.2%) primary lung cancer and 2 metastatic cancer, and 6 had benign disease. Fourteen patients (50%) had their lung cancer discovered on their initial CT scan, 11 on subsequent scans associated with indeterminate pulmonary nodules growth and 3 patients who had a new indeterminate pulmonary nodules. Only 15 (54%) of these 28 patients would have qualified as a National Lung Screening Trial high-risk patient; 75% had stage I or II disease. Overall 5-year survival was 64% and 5-year

  16. Alcohol Screening among Opioid Agonist Patients in a Primary Care Clinic and an Opioid Treatment Program.

    Science.gov (United States)

    Klimas, Jan; Muench, John; Wiest, Katharina; Croff, Raina; Rieckman, Traci; McCarty, Dennis

    2015-01-01

    Problem alcohol use is associated with adverse health and economic outcomes, especially among people in opioid agonist treatment. Screening, brief intervention, and referral to treatment (SBIRT) are effective in reducing alcohol use; however, issues involved in SBIRT implementation among opioid agonist patients are unknown. To assess identification and treatment of alcohol use disorders, we reviewed clinical records of opioid agonist patients screened for an alcohol use disorder in a primary care clinic (n = 208) and in an opioid treatment program (n = 204) over a two-year period. In the primary care clinic, 193 (93%) buprenorphine patients completed an annual alcohol screening and six (3%) had elevated AUDIT scores. In the opioid treatment program, an alcohol abuse or dependence diagnosis was recorded for 54 (27%) methadone patients. Practitioner focus groups were completed in the primary care (n = 4 physicians) and the opioid treatment program (n = 11 counselors) to assess experience with and attitudes towards screening opioid agonist patients for alcohol use disorders. Focus groups suggested that organizational, structural, provider, patient, and community variables hindered or fostered alcohol screening. Alcohol screening is feasible among opioid agonist patients. Effective implementation, however, requires physician training and systematic changes in workflow.

  17. The Prevalence of Hemoglobinopathies in Young Adolescents in the Province of Muğla in Turkey: Results of a Screening Program.

    Science.gov (United States)

    Topal, Yaşar; Topal, Hatice; Ceyhan, Mustafa Nuri; Azik, Fatih; Çapanoğlu, Murat; Kocabaş, Can Naci

    2015-01-01

    Thalassemia is an autosomal recessive inherited blood disorder. It is prevalent in Mediterranean countries such as Sardinia, Greece, Cyprus, Turkey, Lebanon and also Southeast Asia. Our aim was to investigate the carrier prevalence of thalassemia and other hemoglobinopathies in adolescents who live in Muğla Province, Turkey. We analyzed retrospectively the surveys conducted at primary schools between 1997 and 2013. Complete blood count (CBC) and high performance liquid chromatography (HPLC) were used to screen for thalassemia and hemoglobinopathies. Patients were diagnosed as having thalassemia trait if the mean corpuscular volume (MCV) was ≤ 80.0 fL, mean corpuscular hemoglobin (Hb) was ≤ 27.0 pg and Hb A2 levels were ≥ 3.5%. A total of 164,814 students were analyzed. The median age of the students was 13.5 years (minimum 13.0, maximum 14.0). The total number of students with abnormal HPLC results was 5861 (3.8%). There was a significant decrease in the newborn of new thalassemia patients found with screening programs for hemoglobinopathies in Muğla Province from 1997 to 2013. The number of students with abnormal HPLC results for thalassemia, sickle cell disease and other Hb traits were 3.2, 0.15 and 0.4%, respectively. It is important to recognize that including Hb, MCV, red blood cell (RBC) count and HPLC tests for carrier screening are necessary to find hemoglobinopathies. Our study supported that the number of new patients significantly decreased using these screening programs from 1997 to 2013.

  18. After the Introduction into the National Newborn Screening Program : Who Is Receiving Genetic Counseling for Hemoglobinopathies in The Netherlands?

    NARCIS (Netherlands)

    Kaufmann, J. O.; Krapels, I. P. C.; Van Brussel, B. T. J.; Zekveld-Vroon, R. C.; Oosterwijk, J. C.; van Erp, F.; van Echtelt, J.; Zwijnenburg, P. J. G.; Petrij, F.; Bakker, E.; Giordano, P. C.

    2014-01-01

    OBJECTIVE: Universal newborn screening for hemoglobinopathies started in The Netherlands in 2007. Herewith severe conditions, such as sickle cell disease, β-thalassemia major and hemoglobin H disease are putatively identified. Additionally, at least 1,800 carriers of hemoglobin variants associated

  19. Codeless Screen-Oriented Programming for Enterprise Mobile Applications

    OpenAIRE

    Abadi, Aharon; Dubinsky, Yael; Kirshin, Andrei; Mesika, Yossi; Ben-Harrush, Idan

    2013-01-01

    Designing the user interface (UI) of mobile applications in the enterprise is performed in many cases by the application users who represent the business needs. This is based on existing developed enterprise services that can be accessed by these applications. Design the UI of the mobile applications require programming environments that are as much as possible codeless and easy to use. In this paper, we present NitroGen which is a cloud-based platform-independent tool that provides with no i...

  20. Awareness of cervical cancer and willingness to participate in screening program: Public health policy implications.

    Science.gov (United States)

    Patra, Somdatta; Upadhyay, Madhu; Chhabra, Pragti

    2017-01-01

    Cervical cancer is one of the most common malignancies among women in India. There is a high mortality as patients usually present at an advanced stage because of lack of awareness and nonexistent screening programs. This study was planned to find out awareness about cervical cancer among women and their willingness to utilize screening services in an urban resettlement colony of Delhi, India. A community-based, cross-sectional study was carried out in a resettlement colony of North-West Delhi. Semi-structured interview schedule was used to collect information regarding different aspects of cervical cancer. Analysis was done using SPSS package (SPSS version 16 (UCMS and GTBH, Delhi, India)). A total of 373 women were included in the study. Mean age of study participants was 39.14 years. Two-third of the study population were illiterate. Half of the study population was aware of cervical cancer, and only one-fourth of population were willing to participate in a screening test. Willingness was higher among educated, ever user of family planning method and having knowledge about at least one risk factor, signs or symptoms, or possibility of early diagnosis of cancer cervix. The country's national program advocates for opportunistic and targeted screening of women. An understanding of the factors that influences womens' willingness to participate in screening program is essential for the success of such programs. Hence, this study emphasizes the need for dissemination of knowledge about various aspects of cancer cervix which is critical for uptake of any screening program in a developing country.

  1. Cost-Effectiveness of a Community Pharmacist-Led Sleep Apnea Screening Program - A Markov Model.

    Directory of Open Access Journals (Sweden)

    Clémence Perraudin

    Full Text Available Despite the high prevalence and major public health ramifications, obstructive sleep apnea syndrome (OSAS remains underdiagnosed. In many developed countries, because community pharmacists (CP are easily accessible, they have been developing additional clinical services that integrate the services of and collaborate with other healthcare providers (general practitioners (GPs, nurses, etc.. Alternative strategies for primary care screening programs for OSAS involving the CP are discussed.To estimate the quality of life, costs, and cost-effectiveness of three screening strategies among patients who are at risk of having moderate to severe OSAS in primary care.Markov decision model.Published data.Hypothetical cohort of 50-year-old male patients with symptoms highly evocative of OSAS.The 5 years after initial evaluation for OSAS.Societal.Screening strategy with CP (CP-GP collaboration, screening strategy without CP (GP alone and no screening.Quality of life, survival and costs for each screening strategy.Under almost all modeled conditions, the involvement of CPs in OSAS screening was cost effective. The maximal incremental cost for "screening strategy with CP" was about 455€ per QALY gained.Our results were robust but primarily sensitive to the treatment costs by continuous positive airway pressure, and the costs of untreated OSAS. The probabilistic sensitivity analysis showed that the "screening strategy with CP" was dominant in 80% of cases. It was more effective and less costly in 47% of cases, and within the cost-effective range (maximum incremental cost effectiveness ratio at €6186.67/QALY in 33% of cases.CP involvement in OSAS screening is a cost-effective strategy. This proposal is consistent with the trend in Europe and the United States to extend the practices and responsibilities of the pharmacist in primary care.

  2. Retrospective Evaluation of a Teleretinal Screening Program in Detecting Multiple Nondiabetic Eye Diseases.

    Science.gov (United States)

    Maa, April Y; Patel, Shivangi; Chasan, Joel E; Delaune, William; Lynch, Mary G

    2017-01-01

    Diabetic teleretinal screening programs have been utilized successfully across the world to detect diabetic retinopathy (DR) and are well validated. Less information, however, exists on the ability of teleretinal imaging to detect nondiabetic ocular pathology. This study performed a retrospective evaluation to assess the ability of a community-based diabetic teleretinal screening program to detect common ocular disease other than DR. A retrospective chart review of 1,774 patients who underwent diabetic teleretinal screening was performed. Eye clinic notes from the Veterans Health Administration's electronic medical record, Computerized Patient Record System, were searched for each of the patients screened through teleretinal imaging. When a face-to-face examination note was present, the physical findings were compared to those obtained through teleretinal imaging. Sensitivity, specificity, and positive and negative predictive values were calculated for suspicious nerve, cataract, and age-related macular degeneration. A total of 903 patients underwent a clinical examination. The positive predictive value was highest for cataract (100%), suspicious nerve (93%), and macular degeneration (90%). The negative predictive value and the percent agreement between teleretinal imaging and a clinical examination were over 90% for each disease category. A teleretinal imaging protocol may be used to screen for other common ocular diseases. It may be feasible to use diabetic teleretinal photographs to screen patients for other potential eye diseases. Additional elements of the eye workup may be added to enhance accuracy of disease detection. Further study is necessary to confirm this initial retrospective review.

  3. [Classification and characteristics of interval cancers in the Principality of Asturias's Breast Cancer Screening Program].

    Science.gov (United States)

    Prieto García, M A; Delgado Sevillano, R; Baldó Sierra, C; González Díaz, E; López Secades, A; Llavona Amor, J A; Vidal Marín, B

    2013-09-01

    To review and classify the interval cancers found in the Principality of Asturias's Breast Cancer Screening Program (PDPCM). A secondary objective was to determine the histological characteristics, size, and stage of the interval cancers at the time of diagnosis. We included the interval cancers in the PDPCM in the period 2003-2007. Interval cancers were classified according to the breast cancer screening program protocol, with double reading without consensus, without blinding, with arbitration. Mammograms were interpreted by 10 radiologists in the PDPCM. A total of 33.7% of the interval cancers could not be classified; of the interval cancers that could be classified, 40.67% were labeled true interval cancers, 31.4% were labeled false negatives on screening, 23.7% had minimal signs, and 4.23% were considered occult. A total of 70% of the interval cancers were diagnosed in the year of the period between screening examinations and 71.7% were diagnosed after subsequent screening. A total of 76.9% were invasive ductal carcinomas, 61.1% were stage II when detected, and 78.7% were larger than 10mm when detected. The rate of interval cancers and the rate of false negatives in the PDPCM are higher than those recommended in the European guidelines. Interval cancers are diagnosed later than the tumors detected at screening. Studying interval cancers provides significant training for the radiologists in the PDPCM. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  4. Screening Program Reduced Melanoma Mortality at the Lawrence Livermore National Laboratory, 1984-1996

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, MD, J S; II, PhD, D; MD, PhD, M

    2006-10-12

    Worldwide incidence of cutaneous malignant melanoma has increased substantially, and no screening program has yet demonstrated reduction in mortality. We evaluated the education, self examination and targeted screening campaign at the Lawrence Livermore National Laboratory (LLNL) from its beginning in July 1984 through 1996. The thickness and crude incidence of melanoma from the years before the campaign were compared to those obtained during the 13 years of screening. Melanoma mortality during the 13-year period was based on a National Death Index search. Expected yearly deaths from melanoma among LLNL employees were calculated by using California mortality data matched by age, sex, and race/ethnicity and adjusted to exclude deaths from melanoma diagnosed before the program began or before employment at LLNL. After the program began, crude incidence of melanoma thicker than 0.75 mm decreased from 18 to 4 cases per 100,000 person-years (p = 0.02), while melanoma less than 0.75mm remained stable and in situ melanoma increased substantially. No eligible melanoma deaths occurred among LLNL employees during the screening period compared with a calculated 3.39 expected deaths (p = 0.034). Education, self examination and selective screening for melanoma at LLNL significantly decreased incidence of melanoma thicker than 0.75 mm and reduced the melanoma-related mortality rate to zero. This significant decrease in mortality rate persisted for at least 3 yr after employees retired or otherwise left the laboratory.

  5. An evaluation of a health screening program for migrant women to Taiwan, China

    Directory of Open Access Journals (Sweden)

    Yu-Chu Huang

    2016-05-01

    Full Text Available Objective: We aimed to evaluate an integrated screening program for female migrants to Taiwan. Method: We performed a mixed methodological evaluation of a public health nurse (PHN-led intervention to promote an integrated screening program for female migrants to Taiwan. The clinical case yield was determined by an audit, and staff/client questionnaires were used for the evaluation. Screening comprised surveillance for four untreated chronic diseases (hypertension, diabetes mellitus, tuberculosis, and liver disease, four cancers (mouth, bowel, liver, and cervix, parasitic infection, and hyperlipidemia. Results: Three hundred and thirty-six PHNs and 4751 immigrant women – with an average age of 29.2 years, most of whom were from Vietnam (44% or mainland China (41% – took part in the programme. Two thirds of screened women had no abnormalities. Further investigation was required in 1523 women, of whom 1220 were found to have significant disease. The majority of 280 PHNs (85% found the content, processes, and waiting time to be ‘highly acceptable’ and thought the program was worthwhile and could be incorporated into standard care. Conclusions: The Taipei County Comprehensive Health Screening Programme provided an accessible, free-of-charge, and preventative intervention for female migrants to Taiwan and had a good clinical case yield.

  6. Australia's National Bowel Cancer Screening Program: does it work for Indigenous Australians?

    Directory of Open Access Journals (Sweden)

    Katzenellenbogen Judith M

    2010-06-01

    Full Text Available Abstract Background Despite a lower incidence of bowel cancer overall, Indigenous Australians are more likely to be diagnosed at an advanced stage when prognosis is poor. Bowel cancer screening is an effective means of reducing incidence and mortality from bowel cancer through early identification and prompt treatment. In 2006, Australia began rolling out a population-based National Bowel Cancer Screening Program (NBCSP using the Faecal Occult Blood Test. Initial evaluation of the program revealed substantial disparities in bowel cancer screening uptake with Indigenous Australians significantly less likely to participate in screening than the non-Indigenous population. This paper critically reviews characteristics of the program which may contribute to the discrepancy in screening uptake, and includes an analysis of organisational, structural, and socio-cultural barriers that play a part in the poorer participation of Indigenous and other disadvantaged and minority groups. Methods A search was undertaken of peer-reviewed journal articles, government reports, and other grey literature using electronic databases and citation snowballing. Articles were critically evaluated for relevance to themes that addressed the research questions. Results The NBCSP is not reaching many Indigenous Australians in the target group, with factors contributing to sub-optimal participation including how participants are selected, the way the screening kit is distributed, the nature of the test and comprehensiveness of its contents, cultural perceptions of cancer and prevailing low levels of knowledge and awareness of bowel cancer and the importance of screening. Conclusions Our findings suggest that the population-based approach to implementing bowel cancer screening to the Australian population unintentionally excludes vulnerable minorities, particularly Indigenous and other culturally and linguistically diverse groups. This potentially contributes to exacerbating

  7. [Evaluation on the visual inspection with Lugol's iodine in cervical cancer screening program].

    Science.gov (United States)

    Li, Ni; Ma, Cong-ping; Sun, Li-xin; Zhang, Yong-zhen; Shao, Shu-li; Xing, Ju-xia; Bao, Yan-ping; Huang, Rui-de; He, Li-ji; Qiao, You-lin

    2006-01-01

    To evaluate visual inspection with Lugol's iodine (VILI) in cervical cancer screening program and to provide evidence for designing a cervical cancer screening algorithm in high risk areas of existing low-resource settings to reduce the incidence and mortality of cervical cancer. Women in Yangcheng county, Shanxi province were screened with VILI, colposcopy, liquid-based cytology test and human papilloma virus (HPV) DNA test. The efficacy of different screening tests was compared by Youden's index based on the pathology as the gold standard. In the population being screened, the mean age was 40.80 +/- 10.75 years old. Based on pathological findings, 4.35% (32/735) of the subjects had >or= CIN (cervical intraepithelial neoplasia) II. The sensitivity and specificity for the VILI test (>or= positive) were 53.13 and 82.19, while 56.25 and 79.09 were for colposcopy (>or= low grade dysplasia) respectively. Comparing by the Youden's indexs, there was no statistically significant difference (P > 0.05) between VILI and colposcopy. However, statistical significant difference (P 0.05) found between the experienced doctors and the newly-trained doctors working in the field station. With low sensitivity when using microscope but low cost of equipments, VILI can be one of the primary screening tests in China's rural area with low-resource settings if the screening frequency is to be increased.

  8. Enhancing the quality and efficiency of newborn screening programs through the use of health information technology.

    Science.gov (United States)

    Downing, Gregory J; Zuckerman, Alan E; Coon, Constanze; Lloyd-Puryear, Michele A

    2010-04-01

    A variety of efforts are underway at national, state, regional, and local levels to enhance the performance of programs for early detection of inherited diseases and conditions of newborn infants. Newborn screening programs serve a vital purpose in identifying nonsymptomatic clinical conditions and enabling early intervention strategies that lessen morbidity and mortality. Currently, the programs of most intense focus are early hearing detection and intervention, using physiological techniques for audiology screening and use of newborn dried blood spots for detection of metabolites or proteins representing inherited disorders. One of the primary challenges to effective newborn screening programs to date has been the inability to provide information in a timely and easily accessible way to a variety of users. Other challenging communication issues being faced include the complexity introduced by the diversity of conditions for which testing is conducted and laboratory methods being used by each state's screening programs, lack of an electronic information infrastructure to facilitate information exchange, and variation in policies that enable access to information while protecting patient privacy and confidentiality. In this study, we address steps being taken to understand these challenges, outline progress made to date to overcome them, and provide examples of how electronic health information exchange will enhance the utility of newborn screening. It is likely that future advances in science and technology will bring many more opportunities to prevent and preempt disabilities among children through early detection programs. To take their advantage, effective communication strategies are needed among the public health, primary care practice, referral/specialty service, and consumer advocacy communities to provide continuity of information required for medical decision-making throughout prenatal, newborn, and early childhood periods of patient care. Published by

  9. A Pilot Program Integrating Hepatitis B Virus (HBV) Screening into an Outpatient Endoscopy Unit Improves HBV Screening Among an Ethnically Diverse Safety-Net Hospital.

    Science.gov (United States)

    Campbell, Brendan; Lopez, Aristeo; Liu, Benny; Bhuket, Taft; Wong, Robert J

    2018-01-01

    Safety-net hospitals are enriched in ethnic minorities and provide opportunities for high-impact hepatitis B virus (HBV) screening. We aim to evaluate the impact of a pilot program integrating HBV screening into outpatient endoscopy among urban safety-net populations. From July 2015 to May 2017, consecutive adults undergoing outpatient endoscopy were prospectively assessed for HBV screening eligibility using US Preventative Services Task Force guidelines. Rates of prior HBV screening were assessed, and those eligible but not screened were offered HBV testing. Multivariate logistic regression models evaluated predictors of test acceptance among eligible patients. Among 1557 patients (47.1% male, 69.4% foreign born), 65.1% were eligible for HBV screening, among which 24.5% received prior screening. In our pilot screening program in the endoscopy unit, 91.4% (n = 855) of eligible patients accepted HBV testing. However, only 55.3% (n = 415) of those that accepted actually completed HBV testing. While there was a trend toward higher rates of test acceptance among African-Americans compared to non-Hispanic whites (OR 3.31, 95% CI 0.96-11.38, p = 0.06), no other sex-specific or race/ethnicity-specific disparities in HBV test acceptance were observed. Among those who completed HBV testing, we identified 10 new patients with chronic HBV (2.4% prevalence). Only 24.5% of eligible patients received prior HBV screening among our cohort. Our pilot program integrating HBV screening into outpatient endoscopy successfully tested an additional 415 patients, improving overall HBV screening from 24.5 to 75.6%. Integrating HBV testing into non-traditional settings has potential to bridge the gap in HBV screening among safety-net systems.

  10. Reproductive efficiency of asymptomatic Theileria equi carriers mares submitted to an embryo transfer program

    Directory of Open Access Journals (Sweden)

    Luciana L. Bezerra

    2015-03-01

    Full Text Available This study aimed to assess and evaluate the effects of Theileria equi infection on embryonic recovery, gestation and early embryonic loss. Thirteen Mangalarga Marchador Theileria equi positive donors (diagnosed through nested-PCR and 40 embryos receptors were used. Donors were submitted to two embryo collections in two consecutive estrous cycles (GId; after, the same mares were treated with imidocarb dipropionate (1.2mg/kg IM. in order to collect more embryos in two more estrous cycles (GIId. Receptors were divided into two groups (control and with treated with 20 animals each, where one group was the control (GIr and the other one (GIIr treated with 1.2mg/kg IM of imidocarb dipropionate assessing the gestation rate at 15, 30, 45 and 60 days. After 52 embryo collections, the embryonic recovery rates were 53.84% (14/26 and 65.38% (17/26 (p> 0.05 for GId and GIId, respectively. The gestation rate was 70% (14/20 (p>0.05 at 15, 30, 45 and 60 days in group GIr and for GIIr was 85% (17/20 (p>0.05 at 15 days, 80% (16/20 (p>0.05 at 30, 45 and 60 days. The treatment with imidocarb dipropionate did not cause significant improvement in the reproductive efficiency at an ET program.

  11. Rubella Immunity among Pregnant Women in a Canadian Provincial Screening Program

    Directory of Open Access Journals (Sweden)

    Mark J Kearns

    2009-01-01

    Full Text Available BACKGROUND: There are limited recent data on rubella immunity in women of childbearing age in Canada. In the present paper, the proportion of rubella seroreactivity and redundant testing (testing of women previously seropositive when tested by the same physician in the Alberta prenatal rubella screening program were studied.

  12. Dieting Behavior and Alcohol Use Behaviors among National Eating Disorders Screening Program Participants

    Science.gov (United States)

    Heidelberg, Natalie F.; Correia, Christopher J.

    2009-01-01

    Objective: Research has shown that college students have elevated rates of alcohol use and problematic eating behaviors. The current study focused on the relationships between dieting behaviors and alcohol use among a sample of undergraduates attending National Eating Disorder Screening Program. Method: All participants (n=70, 100% female, average…

  13. Expansion of HIV-1 screening and anti-retroviral treatment programs ...

    African Journals Online (AJOL)

    Objective: To report the expansion of HIV-1 screening, enrollment in an ART program, and treatment outcomes over twelve months among HIV-positive patients at a nonprofit, non-governmental faith-based clinic providing free and holistic care in Jos City, Plateau State, Nigeria. Design: This was a retrospective analysis of ...

  14. Integrating Universal Behavioral Screening within Program-Wide Positive Behavioral Interventions and Supports

    Science.gov (United States)

    Burke, Mack D.; Rispoli, Mandy; Clemens, Nathan H.; Lee, Yuan-Hsuan; Sanchez, Lisa; Hatton, Heather

    2016-01-01

    Universal behavioral screening is a major part of positive behavioral support and response to intervention systems. Program-wide positive behavioral interventions and supports (PBIS) focuses on establishing social, emotional, and behavioral competence through promotion of a small set of behavioral expectations that are agreed upon, taught, and…

  15. Cost-effectiveness of screening programs for Chlamydia trachomatis - A population-based dynamic approach

    NARCIS (Netherlands)

    Welte, R; Kretzschmar, M; Leidl, R; Van den Hoek, A; Jager, JC; Postma, MJ

    2000-01-01

    Background: Models commonly used for the economic assessment of chamydial screening programs do not consider population effects. Goal: To develop a novel dynamic approach for the economic evaluation of chlamydial prevention measures and to determine the cost-effectiveness of a general

  16. Quality Metrics of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program in Korea.

    Science.gov (United States)

    Kim, Dae Ho; Cha, Jae Myung; Kwak, Min Seob; Yoon, Jin Young; Cho, Young-Hak; Jeon, Jung Won; Shin, Hyun Phil; Joo, Kwang Ro; Lee, Joung Il

    2018-03-15

    Knowledge regarding the quality metrics of fecal immunochemical test (FIT)-based colorectal cancer screening programs is limited. The aim of this study was to investigate the performance and quality metrics of a FIT-based screening program. In our screening program, asymptomatic subjects aged ≥50 years underwent an annual FIT, and subjects with positive FIT results underwent a subsequent colonoscopy. The performance of the FIT and colonoscopy was analyzed in individuals with a positive FIT who completed the program between 2009 and 2015 at a university hospital. Among the 51,439 screened participants, 75.1% completed the FIT. The positive rate was 1.1%, and the colonoscopy completion rate in these patients was 68.6%. The positive predictive values of cancer and advanced neoplasia were 5.5% and 19.1%, respectively. The adenoma detection rate in the patients who underwent colonoscopy after a positive FIT was 48.2% (60.0% for men and 33.6% for women). The group with the highest tertile quantitative FIT level showed a significantly higher detection rate of advanced neoplasia than the group with the lowest tertile (odds ratio, 2.6; 95% confidence interval, 1.4 to 5.1; p<0.001). The quality metrics used in the United States and Europe may be directly introduced to other countries, including Korea. However, the optimal quality metrics should be established in each country.

  17. Developmental Review in the Early and Periodic Screening, Diagnosis and Treatment Program. Final Report.

    Science.gov (United States)

    Huntington, Dorothy S.; And Others

    Reported are the recommendations resulting from a review of the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT). The concept of developmental assessment, as used in the EPSDT, is explained. The introduction provides a summary of the recommendations. Areas covered and for which recommendations are discussed include the role…

  18. Assessment of required resources for implementation of national breast cancer screening program in Serbia

    Directory of Open Access Journals (Sweden)

    Majstorović Nemanja

    2014-01-01

    Full Text Available Introduction. High values of standardized mortality and morbidity rates of standardized cancer mortality in Serbia, especially colorectal, cervical and breast cancer led to creation of national programs for their early detection and engagement of the international support for their implementation. Objective. Assessment of required resources (time, personnel, financial to implement the National program for screening of breast cancer in the Republic of Serbia. Methods. Three possible scenarios have been prepared (optimistic, realistic and pessimistic based on the expected coverage by screening of women aged 45 to 69 years, and time, personnel and financial feasibility estimates were made for a two-year screening cycle. Results. Time aspect of feasibility even under conditions of “relaxation” of the assumption on the number of working days during the year did not question feasibility of any of the scenarios. Personnel feasibility is only possible in the pessimistic scenario, while the financial feasibility only makes sense in optimistic scenario as the least unfavorable solution due to economies of scale. Conclusion. Establishment of the initial base of skilled radiologists and radiology technicians and the system for their continuous medical education as well as allocation of specific MoH budget line for screening program expenditures, along with donated mammographs and good organization and coordination, may provide unobstructed implementation of the National program for early detection of breast cancer in the Republic of Serbia.

  19. Culturally Competent Training Program: A Key to Training Lay Health Advisors for Promoting Breast Cancer Screening

    Science.gov (United States)

    Yu, Mei-yu; Song, Lixin; Seetoo, Amy; Cai, Cuijuan; Smith, Gary; Oakley, Deborah

    2007-01-01

    The lay health advisor (LHA) training program for breast cancer screening was conducted among Chinese-English bilingual trainees residing in Southeast Michigan. Guided by Bandura's Social Learning Theory, the development of the training curriculum followed the health communication process recommended by the National Cancer Institute. Data analysis…

  20. Increased knowledge of thalassemia promotes early carrier status examination among medical students

    Directory of Open Access Journals (Sweden)

    Julius Broto Dewanto

    2016-04-01

    A higher thalassemia knowledge score causes medical students to be willing to undergo thalassemia carrier status examination at an earlier point in timing. A well-organized educational program focusing on thalassemia and early screening in young adults may enhance the thalassemia prevention program.

  1. Universal neonatal hearing screening program in Shanghai, China: An inter-regional and international comparison.

    Science.gov (United States)

    Fang, Xingang; Li, Xi; Zhang, Qi; Wan, Jin; Sun, Mei; Chang, Fengshui; Lü, Jun; Chen, Gang

    2016-11-01

    By comparing the Universal Neonatal Hearing Screening (UNHS) program as implemented in Shanghai and other regions in China and countries around the world, this study makes an assessment of the Shanghai model and summarizes the experiences implementing the UNHS program, so as to provide a valuable reference for other countries or regions to carry out UNHS more effectively. Since Shanghai is one of the most developed regions in China, we also examined the relationship between economic development and the UNHS starting year and coverage rate. The study conducted a systematic review of published studies in Chinese and English on the program status of neonatal hearing screening to compare and analyze the implementation of the UNHS program in 20 cities or provinces in China and 24 regions or countries around the world. The literature search in Chinese was conducted in the three most authoritative publication databases, CNKI (China National Knowledge Infrastructure), WANFANGDATA, and CQVIP (http://www.cqvip.com/). We searched all publications in those databases with the keywords "neonatal hearing screening" (in Chinese) between 2005 and 2014. English literature was searched using the same keywords (in English). The publication database included Medline and Web of Science, and the search time period was 2000-2014. Shanghai was one of the first regions in China to implement UNHS, and its coverage rate was among the top regions by international comparison. The starting time of the UNHS program had no relationship with the Gross Domestic Product (GDP) per capita in the same year. Economic level serves as a threshold for carrying out UNHS but is not a linear contributor to the exact starting time of such a program. The screening coverage rate generally showed a rising trend with the increasing GDP per capita in China, but it had no relationship with the area's GDP per capita in selected regions and countries around the world. The system design of UNHS is the key factor

  2. Organization and evaluation of a pilot cervical cancer screening program in Morocco.

    Science.gov (United States)

    Selmouni, Farida; Sauvaget, Catherine; Belakhel, Latifa; Lucas, Eric; Khouchoua, Mohamed; Sankaranarayanan, Rengaswamy

    2016-01-01

    To evaluate a pilot program for early detection of cervical cancer using visual inspection with acetic acid (VIA) and the loop electrosurgical excision procedure (LEEP) in one region of Morocco. A descriptive analysis of the screening outcome measures of 43 participating primary care units and one reference center for LEEP was conducted in Meknès-Tafilalet between January 1, 2011, and December 31, 2013. Data on the number of participants, VIA results, colposcopy, and treatment were used in analyses. Of the 308 197 women in the target age group (30-49 years), 18 586 (6.0%) were screened by VIA. Positive screening test results were recorded for 1628 (8.8%) women, of whom 1144 (70.3%) received diagnostic confirmation by colposcopy. Of the 87 (7.6%) women with cervical intraepithelial neoplasia, only 16 (18.4%) underwent LEEP; three cases of invasive cervical cancer were diagnosed. Issues with implementation of the screening program were found, including low compliance and a low treatment rate of cervical intraepithelial neoplasia by LEEP. By contrast, high rates of colposcopy referral were observed. Screen-and-treat by ablative methods (e.g. thermocoagulation) should be considered to increase treatment rates at national scale-up. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  3. [Screening program for tuberculosis among international exchange students in the Department of Isère].

    Science.gov (United States)

    Albahary, M-V; Blanc-Jouvan, F; Recule, C; Dubey, C; Pavese, P

    2018-01-01

    France is a low-incidence country for tuberculosis (TB). Consequently screening is focused on high-risk populations, in particular migrants. The aim of this study was to evaluate the epidemiology of TB among international exchange students in the Department of Isère and the screening programs used. We carried out an organizational audit based on interviews with physicians involved in the management of TB in Isère. We conducted a retrospective descriptive study based on a case series of foreign students treated for TB from 2003 to 2013 inclusively. Forty-six international exchange students were treated for active TB during this time, representing an average incidence of 284/100,000. Two thirds of our studied population were Africans, 72% were asymptomatic at the time of screening. A quarter of our cohort developed TB after the initial screening. Thirty-one cases were confirmed bacteriologically, mainly through bronchoscopy. Outcome (radiological and clinical) on quadruple therapy was satisfactory in all patients. Two patients relapsed, one of them with multi-drug resistant TB. Our work confirms that international exchange students are a population at high risk of TB and that screening of this population is essential. The significant number of active TB cases diagnosed after the initial screening stresses the importance of diagnosis and follow up of patients with latent TB infection. Copyright © 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  4. Quality control for the mammography screening program in Serbia: Physical and technical aspects

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, O.; Bozovic, P.; Lazarevic, D.; Arandjic, D.; Kosutic, D.

    2012-01-01

    Breast cancer is the major cause of mortality among female population in Serbia. It is presumed that the introduction of screening programme will reduce mortality and therefore, 47 new mammography units were installed for the purpose of population-based screening program in 2011. In parallel, Quality assurance and Quality control (QC) in mammography has received increasing attention as an essential element of the successful breast cancer campaign that is for the first time initialed in Serbia. The purpose of this study is to investigate the need for and the possible implementation of the comprehensive QC programme for the mammography screening in Serbia, with special focus on physical and technical aspect. In the first phase, a QC protocols containing list of parameters, methodology, frequency of tests and reference values for screen-film, computed radiography and full-filed digital mammography) units, were developed. The second phase is focused on the initial implementation of these protocols. The paper presents results of tests of the selected parameters in 35 mammography units, with special emphasis on patient dose and image quality descriptors. After initial implementation at the beginning of the population based breast cancer screening campaign, it is essential to establish system of regular and periodic QC equipment monitoring and to ensure high quality mammograms with minimal possible radiation dose to population included in the screening. (authors)

  5. Cervical Cancer Screening Program by Visual Inspection: Acceptability and Feasibility in Health Insurance Companies

    Science.gov (United States)

    Horo, Apollinaire G.; Didi-Kouko Coulibaly, Judith; Koffi, Abdoul; Tchounga, Boris; Seni, Konan; Aka, Kacou Edèle; Kone, Mamourou

    2015-01-01

    Objective. To assess willingness to participate and diagnostic accuracy of visual inspection for early detection of cervical neoplasia among women in a health insurance company. Patients and Method. Cervical cancer screening was systematically proposed to 800 women after consecutive information and awareness sessions. The screening method was visual inspection with acetic acid (VIA) or Lugol's iodine (VILI). Results. Among the 800 identified women, 640 (82%) have accepted the screening, their mean age was 39 years, and 12.0% of them were involved in a polygamist couple. 28.2% of women had prior cervical screening. VIA has been detected positive in 5.9% of women versus 8.6% for VILI. The sensitivity was 72.9% and specificity was 95.2% for VIA versus 71.2% and 97.3% for VILI respectively. The histological examination highlighted a nonspecific chronic cervicitis in 4.6%, CIN1 lesions in 5.91%, and CIN2/3 in 1.2% of the cases. Conclusion. Cervical cancer screening by visual inspection showed appropriate diagnostic accuracy when used to detect early cervical lesions. It is a simple and easy to perform method that could be introduced progressively in the health insurance policy while waiting for a national screening program. PMID:26167178

  6. Laboratory audit as part of the quality assessment of a primary HPV-screening program.

    Science.gov (United States)

    Hortlund, Maria; Sundström, Karin; Lamin, Helena; Hjerpe, Anders; Dillner, Joakim

    2016-02-01

    As primary HPV screening programs are rolled out, methods are needed for routine quality assurance of HPV laboratory analyzes. To explore the use of similar design for audit as currently used in cytology-based screening, to estimate the clinical sensitivity to identify women at risk for CIN 3 or worse (CIN3+). Population-based cohort study conducted within the cervical screening program in Stockholm, Sweden, in 2011-2012. All women with histopathologically confirmed CIN3+ in the following two years were identified by registry analysis. Primary HPV and cytology screening results were collected. For women who had not been HPV tested, biobanked cytology samples were HPV-tested. If the original HPV result had been negative, the sample and subsequent biopsies were analyzed with broad HPV typing (general primer PCR and Luminex). 154 women had a biobanked prediagnostic cytology sample taken up to 2 years before a histopathologically confirmed CIN3+. The high-risk HPV-positivity was 97% (148/154 women), whereas 143/154 (94%) women had had a cytological abnormality. Among the six HPV-negative samples, one sample was HPV 33 positive in repeat testing whereas the other five cases were HPV-negative also on repeat testing, but HPV-positive in the subsequent tumor tissue. A sensitivity of the HPV test that is higher than the sensitivity of cytology suggests adequate quality of the testing. Regular audits of clinical sensitivity, similar to those of cytology-based screening, should be used also in HPV-based screening programs, in order to continuously monitor the performance of the analyzes. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Implementing a Fee‐for‐Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities

    OpenAIRE

    DeGregorio, Geneva; Manga, Simon; Kiyang, Edith; Manjuh, Florence; Bradford, Leslie; Cholli, Preetam; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Sheldon, Lisa Kennedy; Nulah, Kathleen; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

    2017-01-01

    This report documents the strategies that led to the successful implementation of a nurse‐led cervical cancer screening program using visual inspection with acetic acid enhanced by digital cervicography, describes programmatic challenges, makes recommendations to optimize screening and treatment outcomes, and discusses the unique aspects of the Women's Health Program model developed in Cameroon.

  8. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates

    Science.gov (United States)

    2011-01-01

    Background Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Methods Descriptive study of immigration TB screening programs Results 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. Conclusions In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should

  9. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates

    Directory of Open Access Journals (Sweden)

    Sagebiel Daniel

    2011-01-01

    Full Text Available Abstract Background Tuberculosis (TB in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Methods Descriptive study of immigration TB screening programs Results 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. Conclusions In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas

  10. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates.

    Science.gov (United States)

    Alvarez, Gonzalo G; Gushulak, Brian; Abu Rumman, Khaled; Altpeter, Ekkehardt; Chemtob, Daniel; Douglas, Paul; Erkens, Connie; Helbling, Peter; Hamilton, Ingrid; Jones, Jane; Matteelli, Alberto; Paty, Marie-Claire; Posey, Drew L; Sagebiel, Daniel; Slump, Erika; Tegnell, Anders; Valín, Elena Rodríguez; Winje, Brita Askeland; Ellis, Edward

    2011-01-04

    Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Descriptive study of immigration TB screening programs. 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should facilitate the development of improved

  11. Best practices: implementation of a glucose screening program based on diffusion of innovation theory methods.

    Science.gov (United States)

    Nicol, Ginger E; Morrato, Elaine H; Johnson, Mark C; Campagna, Elizabeth; Yingling, Michael D; Pham, Victor; Newcomer, John W

    2011-01-01

    There is public health interest in the identification and treatment of modifiable cardiometabolic risk factors among patients treated with antipsychotic medications. However, best-practice screening recommendations endorsed by multiple medical organizations have not translated into real-world clinical practice. Quality improvement strategies may help to address the gap between policy and implementation. This column describes the successful implementation of a best-practice glucose screening program in a large network of community mental health centers that was based on Six Sigma and diffusion of innovation theory.

  12. Airport sentinel surveillance and entry quarantine for dengue infections following a fever screening program in Taiwan.

    Science.gov (United States)

    Kuan, Mei-Mei; Chang, Feng-Yee

    2012-08-06

    Dengue has not reached an endemic status in Taiwan; nevertheless, we have implemented a fever screening program at airports for the early detection of febrile passengers with a dengue infection. This study is intended to assess the performance of the airport screening procedures for dengue infection. We analyzed data from the national surveillance system of the Taiwan Centers for Disease Control. We included the imported dengue cases reported by sentinel airports and clinics as well as the domestic cases from 2007-2010. Approximately 44.9% (95%CI: 35.73-54.13%) of the confirmed imported dengue cases with an apparent symptom (febrile) in the viremic stage were detected via the airport fever screening program, with an estimated positive predictive value of 2.36% (95% CI: 0.96- 3.75%) and a negative predictive value > 99.99%. Fluctuations in the number of the symptomatic imported dengue cases identified in the airports (X) were associated with the total number of imported dengue cases (Y) based on a regression analysis of a biweekly surveillance (i.e., n = 104, R(2)(X:Y) = 0.61, P airports examined in this study indicated some limitations of the fever screening program for the prevention of importation. The screening program could assist in the rapid triage for self-quarantine of some symptomatic dengue cases that were in the viremic stage at the borders and contribute to active sentinel surveillance; however, the blocking of viral transmission to susceptible populations (neighbors or family) from all of the viremic travelers, including those with or without symptoms, is critical to prevent dengue epidemics. Therefore, the reinforcement of mosquito bite prevention and household vector control in dengue-endemic or dengue-competent hotspots during an epidemic season is essential and highly recommended.

  13. [Four year follow-up of a screening program for prostate cancer in workers].

    Science.gov (United States)

    Reinoso-Barbero, Luis; Díaz-Garrido, Ramón; Piñaga-Solé, Montserrat; Fernández-Fernández, Miguel; Belanger-Quintana, Diego; Gómez-Gallego, Félix

    2013-01-01

    To analyze our four-year follow-up experience (2008-2011) with a prostate cancer screening program offered to employees of a banking company. Data were obtained from the health examinations carried out by the bank's in-house occupational health service (with centers in Barcelona, Madrid and Valencia). PSA (prostate-specific antigen) blood levels were measured and cases with high levels (>4 ng/ml) were followed through diagnosis and treatment, including a telephone survey of confirmed cases. Personal and occupational characteristics of the participants were analyzed as well. 750 workers (99% with administrative and/or commercial jobs) met the inclusion criteria for the screening program. Of these, 110 had elevated PSA levels on at least one occasion. The diagnosis of prostate cancer was confirmed in 21 cases. There were no associations between a diagnosis of cancer and the remaining analyzed variables. Urology and pathology records were retrieved for 76% of the contacted cases. The most frequent histological type was adenocarcinoma (98%), the most common Gleason grade at diagnosis was 6-7% (88%), and the majority of cases were treated surgically (90%).With respect to adverse effects, 48% of cases described erectile dysfunction and 33% reported urinary incontinence. In our program the observed prevalence of prostate cancer was above that expected (respectively, 21 confirmed cases vs. 12 expected). The identified cases unanimously expressed their support for the screening program. Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.

  14. Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

    DEFF Research Database (Denmark)

    Kristiansen, Bettina Kjær

    2014-01-01

    Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow......-up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone...... will be of great importance to the future organisation of cervical and colorectal cancer screening programmes in Denmark, but will also have international interest because of their similar challenges....

  15. Radionuclide carriers

    International Nuclear Information System (INIS)

    Hartman, F.A.; Kretschmar, H.C.; Tofe, A.J.

    1977-01-01

    The invention provides physiologically acceptable particulate radionuclide carriers comprising a reducing agent bound to an anionic starch derivative, useful in the preparation of organ-specific diagnostic radiopharmaceuticals

  16. Interval breast cancers: Absolute and proportional incidence and blinded review in a community mammographic screening program

    Energy Technology Data Exchange (ETDEWEB)

    Carbonaro, Luca A., E-mail: luca.carbonaro@gmail.com [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Azzarone, Antonio [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Paskeh, Bijan Babaei [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Brambilla, Giorgio [Dipartimento di Radiologia, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Mi) 20089 (Italy); Brunelli, Silvia [Centro di Prevenzione Senologica, ULSS 20, Piazza Lambranzi, Verona 37034 (Italy); Calori, Anna [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Caumo, Francesca [Centro di Prevenzione Senologica, ULSS 20, Piazza Lambranzi, Verona 37034 (Italy); Malerba, Paolo [Dipartimento di Radiologia, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Mi) 20089 (Italy); Menicagli, Laura [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Sconfienza, Luca M. [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano (Italy); Vadalà, Giuseppe [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Brambilla, Gelma; Fantini, Luigi [Servizio di Medicina Preventiva delle Comunità, ASL Milano 2, Via Friuli 2, Lacchiarella (Mi) 20084 (Italy); Ciatto, Stefano [Screening Program, ULSS 16, Padova (Italy); and others

    2014-02-15

    Purpose: To evaluate the performance of the first years since the beginning of a mammographic population-based screening program. Materials and methods: Women aged 49–69 were invited biennially for two-view film-screen mammography and double reading without arbitration was performed. Interval cancers (ICs) from 2001 to 2006 were identified using screening archives, local pathology archives, and hospital discharge records. The proportional incidence of IC was determined considering breast cancers expected without screening. Three offsite radiologists experienced in breast cancer screening blindly evaluated mammograms prior to diagnosis, randomly mixed with negative mammograms (1:2 ratio). Cases unrecalled at review were considered as true ICs, those recalled by only one reviewer as minimal signs, and those recalled by two or three reviewers as missed cancers. T and N stage of the reviewed ICs were evaluated and compared. Results: A total of 86,276 first level mammograms were performed. Mean recall rate was 6.8% at first and 4.6% at repeat screening. We had 476 screen-detected cancers and 145 ICs (10 of them ductal carcinomas in situ). Absolute incidence was 17 per 10,000 screening examinations. Invasive proportional incidence was 19% (44/234) in the first year, 39% (91/234) in the second year, and 29% (135/468) in the two-year interval. Of 145 ICs, 130 (90%) were reviewed mixed with 287 negative controls: 55% (71/130) resulted to be true ICs, 24% (31/130) minimal signs, and 22% (28/130) missed cancers. The rate of ICs diagnosed in the first year interval was 21% (15/71) for true ICs, 46% (13/28) for missed cancers, and 39% (12/31) for minimal signs, with a significant difference of true ICs rate compared to missed cancers rate (p = 0.012). A higher rate of T3 and T4 stages was found for missed cancers (18%, 5/28) compared to minimal signs (6%, 2/31) or true ICs (8%, 6/71), while the rate of N2 and N3 stage for both minimal signs (19%, 6/31) or missed cancers (25

  17. Compression force and radiation dose in the Norwegian Breast Cancer Screening Program

    Energy Technology Data Exchange (ETDEWEB)

    Waade, Gunvor G.; Sanderud, Audun [Department of Life Sciences and Health, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, P.O. 4 St. Olavs Plass, 0130 Oslo (Norway); Hofvind, Solveig, E-mail: solveig.hofvind@kreftregisteret.no [Department of Life Sciences and Health, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, P.O. 4 St. Olavs Plass, 0130 Oslo (Norway); The Cancer Registry of Norway, P.O. 5313 Majorstuen, 0304 Oslo (Norway)

    2017-03-15

    Highlights: • Compression force and radiation dose for 17 951 screening mammograms were analyzed. • Large variations in mean applied compression force between the breast centers. • Limited associations between compression force and radiation dose. - Abstract: Purpose: Compression force is used in mammography to reduce breast thickness and by that decrease radiation dose and improve image quality. There are no evidence-based recommendations regarding the optimal compression force. We analyzed compression force and radiation dose between screening centers in the Norwegian Breast Cancer Screening Program (NBCSP), as a first step towards establishing evidence-based recommendations for compression force. Materials and methods: The study included information from 17 951 randomly selected screening examinations among women screened with equipment from four different venors at fourteen breast centers in the NBCSP, January-March 2014. We analyzed the applied compression force and radiation dose used on craniocaudal (CC) and mediolateral-oblique (MLO) view on left breast, by breast centers and vendors. Results: Mean compression force used in the screening program was 116N (CC: 108N, MLO: 125N). The maximum difference in mean compression force between the centers was 63N for CC and 57N for MLO. Mean radiation dose for each image was 1.09 mGy (CC: 1.04mGy, MLO: 1.14mGy), varying from 0.55 mGy to 1.31 mGy between the centers. Compression force alone had a negligible impact on radiation dose (r{sup 2} = 0.8%, p = < 0.001). Conclusion: We observed substantial variations in mean compression forces between the breast centers. Breast characteristics and differences in automated exposure control between vendors might explain the low association between compression force and radiation dose. Further knowledge about different automated exposure controls and the impact of compression force on dose and image quality is needed to establish individualised and evidence

  18. Screening in asymptomatic SDHx mutation carriers: added value of 18F-FDG PET/CT at initial diagnosis and 1-year follow-up

    International Nuclear Information System (INIS)

    Lepoutre-Lussey, C.; Deandreis, D.; Berdelou, A.; Nascimento, C.; Lumbroso, J.; Schlumberger, M.; Baudin, E.; Leboulleux, S.; Caramella, C.; Bidault, F.; Deschamps, F.; Al Ghuzlan, A.; Hartl, D.; Dumont, F.; Borget, I.; Gimenez-Roqueplo, A.P.; Guillaud Bataille, M.

    2015-01-01

    Specific recommendations on screening modalities for paraganglioma (PGL) and phaeochromocytoma (PCC) in asymptomatic SDHx mutation carriers (relatives) are still lacking. We evaluated the added value of 18 F-FDG PET/CT in comparison with morphological imaging at initial diagnosis and 1 year of follow-up in this population. The study included 30 consecutive relatives with a proven SDHx mutation who were investigated by 18 F-FDG PET/CT, gadolinium-enhanced magnetic resonance angiography of the head and neck, thoracic/abdominal/pelvic (TAP) contrast-enhanced CT and/or TAP MRI. 123 I-MIBG scintigraphy was performed in 20 subjects and somatostatin receptor scintigraphy (SRS) in 20 subjects. The gold standard was based on pathology or a composite endpoint as defined by any other positive imaging method and persistent tumour on follow-up. Images were considered as false-positive when the lesions were not detected by another imaging method or not confirmed at 1 year. At initial work-up, an imaging abnormality was found in eight subjects (27 %). The final diagnosis was true-positive in five subjects (two with abdominal PGL, one with PCC and two with neck PGL) and false-positives in the other three subjects (detected with 18 F-FDG PET/CT in two and TAP MRI in one). At 1 year, an imaging abnormality was found in three subjects of which one was an 8-mm carotid body PGL in a patient with SDHD mutation and two were considered false-positive. The tumour detection rate was 100 % for 18 F-FDG PET/CT and conventional imaging, 80 % for SRS and 60 % for 123 I-MIBG scintigraphy. Overall, disease was detected in 4 % of the subjects at the 1-year follow-up. 18 F-FDG PET/CT demonstrated excellent sensitivity but intermediate specificity justifying combined modality imaging in these patients. Given the slow progression of the disease, if 18 F-FDG PET/CT and MRI are normal at baseline, the second imaging work-up should be delayed and an examination that does not expose the patient to

  19. Screening in asymptomatic SDHx mutation carriers: added value of {sup 18}F-FDG PET/CT at initial diagnosis and 1-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Lepoutre-Lussey, C.; Deandreis, D.; Berdelou, A.; Nascimento, C.; Lumbroso, J.; Schlumberger, M.; Baudin, E.; Leboulleux, S. [Gustave Roussy Institut, Universite Paris-Sud, Department of Nuclear Medicine and Endocrine Oncology, Villejuif (France); Caramella, C.; Bidault, F.; Deschamps, F. [Gustave Roussy Institut, Department of Radiology, Villejuif (France); Al Ghuzlan, A. [Gustave Roussy Institut, Department of Medical Biology and Pathology, Villejuif (France); Hartl, D.; Dumont, F. [Gustave Roussy Institut, Department of Surgery, Villejuif (France); Borget, I. [Gustave Roussy Institut, Department of Biostatistic and Epidemiology, Villejuif (France); Paris-Sud University, Villejuif (France); Gimenez-Roqueplo, A.P. [Assistance Publique-Hopitaux de Paris, Hopital Europeen Georges Pompidou, Department of Genetics, Paris (France); Paris Descartes University, Faculty of Medicine, Paris (France); Guillaud Bataille, M. [Gustave Roussy Institut, Department of Genetics, Villejuif (France)

    2015-05-01

    Specific recommendations on screening modalities for paraganglioma (PGL) and phaeochromocytoma (PCC) in asymptomatic SDHx mutation carriers (relatives) are still lacking. We evaluated the added value of {sup 18}F-FDG PET/CT in comparison with morphological imaging at initial diagnosis and 1 year of follow-up in this population. The study included 30 consecutive relatives with a proven SDHx mutation who were investigated by {sup 18}F-FDG PET/CT, gadolinium-enhanced magnetic resonance angiography of the head and neck, thoracic/abdominal/pelvic (TAP) contrast-enhanced CT and/or TAP MRI. {sup 123}I-MIBG scintigraphy was performed in 20 subjects and somatostatin receptor scintigraphy (SRS) in 20 subjects. The gold standard was based on pathology or a composite endpoint as defined by any other positive imaging method and persistent tumour on follow-up. Images were considered as false-positive when the lesions were not detected by another imaging method or not confirmed at 1 year. At initial work-up, an imaging abnormality was found in eight subjects (27 %). The final diagnosis was true-positive in five subjects (two with abdominal PGL, one with PCC and two with neck PGL) and false-positives in the other three subjects (detected with {sup 18}F-FDG PET/CT in two and TAP MRI in one). At 1 year, an imaging abnormality was found in three subjects of which one was an 8-mm carotid body PGL in a patient with SDHD mutation and two were considered false-positive. The tumour detection rate was 100 % for {sup 18}F-FDG PET/CT and conventional imaging, 80 % for SRS and 60 % for {sup 123}I-MIBG scintigraphy. Overall, disease was detected in 4 % of the subjects at the 1-year follow-up. {sup 18}F-FDG PET/CT demonstrated excellent sensitivity but intermediate specificity justifying combined modality imaging in these patients. Given the slow progression of the disease, if {sup 18}F-FDG PET/CT and MRI are normal at baseline, the second imaging work-up should be delayed and an examination

  20. FMCSA safety program effectiveness measurement : compliance review effectiveness model results for carriers with compliance reviews in fiscal year 2009.

    Science.gov (United States)

    2014-04-01

    In FY 2009, Federal and State enforcement personnel conducted more than 15,000 compliance reviews (CRs) on individual motor carriers. It is intended that through education, heightened safety regulation awareness, and the enforcement effects of the CR...

  1. Patient and System Factors Related to Missed Opportunities for Screening in an Electronic Medical Record-driven, Opt-out HIV Screening Program in the Emergency Department.

    Science.gov (United States)

    Lin, Janet; Baghikar, Sara; Mauntel-Medici, Cammeo; Heinert, Sara; Patel, Daven

    2017-11-01

    Emergency departments (EDs) have implemented HIV screening using a variety of strategies. This study investigates how specific patient and health system factors in the ED impact who is and is not screened in a combined targeted and nontargeted, electronic medical record (EMR)-driven, opt-out, HIV screening program. This was a retrospective, cross-sectional study of ED visits where patients were determined eligible for HIV screening by an EMR algorithm between November 18, 2014, and July 15, 2015. The HIV screening workflow included three sequential events, all of which were required to get screened for HIV at the ED visit. The events were having a blood draw, being informed of the HIV screening policy by an ED nurse at the point of blood draw, and the patient consenting to the HIV test. Each event represented a dichotomous outcome and its association with six patient factors (age, sex, race/ethnicity, marital status, preferred language, and Emergency Severity Index [ESI]) and two health system factors (ED crowding and program phase) was investigated using multivariable modeling. A total of 15,918 ED visits were analyzed. Blood was drawn in 8,388 of 15,918 visits (53%). Of 8,388 visits where blood was drawn, there were 5,947 (71%) visits where ED nurses documented informing patients of the HIV screening policy. Of those visits, patient consent to the HIV test was documented at 3,815 (64%) visits. Patients between 13 and 19 years of age were significantly less likely to have blood drawn, to be informed of the screening policy, and to consent to the HIV test compared to other age groups. Both ED crowding and a patient's ESI were associated with decreased odds of having a blood draw and being informed of HIV screening by an ED nurse, but showed no association with patients consenting to the HIV test. Many patients, particularly adolescents and young adults, are missed in ED HIV screening programs that require blood draw and depend on providers to obtain consent for

  2. Abdominal aortic aneurysm screening program using hand-held ultrasound in primary healthcare.

    Directory of Open Access Journals (Sweden)

    Antoni Sisó-Almirall

    Full Text Available We determined the feasibility of abdominal aortic aneurysm (AAA screening program led by family physicians in public primary healthcare setting using hand-held ultrasound device. The potential study population was 11,214 men aged ≥ 60 years attended by three urban, public primary healthcare centers. Participants were recruited by randomly-selected telephone calls. Ultrasound examinations were performed by four trained family physicians with a hand-held ultrasound device (Vscan®. AAA observed were verified by confirmatory imaging using standard ultrasound or computed tomography. Cardiovascular risk factors were determined. The prevalence of AAA was computed as the sum of previously-known aneurysms, aneurysms detected by the screening program and model-based estimated undiagnosed aneurysms. We screened 1,010 men, with mean age of 71.3 (SD 6.9 years; 995 (98.5% men had normal aortas and 15 (1.5% had AAA on Vscan®. Eleven out of 14 AAA-cases (78.6% had AAA on confirmatory imaging (one patient died. The total prevalence of AAA was 2.49% (95%CI 2.20 to 2.78. The median aortic diameter at diagnosis was 3.5 cm in screened patients and 4.7 cm (p<0.001 in patients in whom AAA was diagnosed incidentally. Multivariate logistic regression analysis identified coronary heart disease (OR = 4.6, 95%CI 1.3 to 15.9 as the independent factor with the highest odds ratio. A screening program led by trained family physicians using hand-held ultrasound was a feasible, safe and reliable tool for the early detection of AAA.

  3. Introduction of a mammography screening program in Germany. Benefit-risk considerarions

    International Nuclear Information System (INIS)

    Nekolla, E.A.; Griebel, J.; Brix, G.

    2005-01-01

    For women between 50 and 70 years of age, X-ray mammography presently represents the most effective method for early breast cancer detection. It is commonly accepted that quality assured mammography examinations conducted at regular intervals can reduce mortality from breast cancer. In the year 2002, the German Bundestag agreed to the implementation of a mammography screening program for Germany based on the European guidelines. The effectiveness of a mammography screening program is controversially discussed and two of the most commonly cited hazards are the occurrence of false-positive results and the so-called overdiagnosis. Another issue of criticism is the radiation risk due to the mammography examinations. However, in women aged 50-70 years the radiation risk has no substantial importance. In contrast to the present situation in Germany in which opportunistic screening is widespread, standardized quality assured screening will guarantee that false-positive rates are kept as low as possible and that further assessment diagnostics are effective and minimally invasive. (orig.) [de

  4. First Trimester Aneuploidy Screening Program for Preeclampsia Prediction in a Portuguese Obstetric Population

    Directory of Open Access Journals (Sweden)

    Cláudia Teixeira

    2014-01-01

    Full Text Available Objective. To evaluate the performance of a first trimester aneuploidy screening program for preeclampsia (PE prediction in a Portuguese obstetric population, when performed under routine clinical conditions. Materials and Methods. Retrospective cohort study of 5672 pregnant women who underwent routine first trimester aneuploidy screening in a Portuguese university hospital from January 2009 to June 2013. Logistic regression-based predictive models were developed for prediction of PE based on maternal characteristics, crown-rump length (CRL, nuchal translucency thickness (NT, and maternal serum levels of pregnancy-associated plasma protein-A (PAPP-A and free beta-subunit of human chorionic gonadotropin (free β-hCG. Results. At a false-positive rate of 5/10%, the detection rate for early-onset (EO-PE and late-onset (LO-PE PE was 31.4/45.7% and 29.5/35.2%, respectively. Although both forms of PE were associated with decreased PAPP-A, logistic regression analysis revealed significant contributions from maternal factors, free β-hCG, CRL, and NT, but not PAPP-A, for prediction of PE. Conclusion. Our findings support that both clinical forms of EO-PE and LO-PE can be predicted using a combination of maternal history and biomarkers assessed at first trimester aneuploidy screening. However, detection rates were modest, suggesting that models need to be improved with additional markers not included in the current aneuploidy screening programs.

  5. Results of a pediatric vision screening program in western South Dakota.

    Science.gov (United States)

    Terveen, Daniel C; Moser, Jess M; Spencer, Terrence S

    2015-03-01

    South Dakota is one of eight states that do not require any vision screening for children. This study describes the results of the first children's vision screening program in the state. Children ages 6 months to 12 years were screened using the SPOT photoscreener by lay volunteers as part of the Northern Plains Eye Foundation's Western South Dakota Children's Vision Screening Initiative (CVSI). Referral criteria were based on the recommendations of the manufacturer. Data was stratified by age group, sex, and percentage of children referred for hyperopia, myopia, astigmatism, anisocoria, anisometropia, and ocular misalignment. The cost benefit of amblyopia treatment in South Dakota was also calculated. Screenings were completed on 4,784 children from August 2012 to May 2014 with 62 excluded due to age. Mean age of the 4,722 (2,373 females) subjects was 6 years 7 months. Overall, the SPOT device referred 563 (11.9 percent) children. There was no significant difference in referral rate based on sex (p = 0.598). Children aged 73-144 months had the highest referral rate (12.2 percent) and children aged 12-30 months had the lowest referral rate (7.9 percent). The suspected reasons for referral based upon the screenings were as follows: 371 (7.9 percent) astigmatism, 24 (0.5 percent) ocular misalignment, 101 (2.1 percent) anisometropia, 135 (2.9 percent) myopia, 36 (0.8 percent) hyperopia, and 16 (0.3 percent) anisocoria. The SPOT photoscreener yielded an acceptable referral rate of 11.9 percent. This study represents an effective model for pediatric vision screening in South Dakota.

  6. The Peru Cervical Cancer Screening Study (PERCAPS): The Design and Implementation of a Mother/Daughter Screen, Treat, and Vaccinate Program in the Peruvian Jungle

    OpenAIRE

    Abuelo, Carolina E.; Levinson, Kimberly L.; Salmeron, Jorge; Sologuren, Carlos Vallejos; Fernandez, Maria Jose Vallejos; Belinson, Jerome L.

    2014-01-01

    Peru struggles to prevent cervical cancer (CC). In the jungle, prevention programs suffer from significant barriers although technology exists to detect CC precursors. This study used community based participatory research (CBPR) methods to overcome barriers. The objective was to evaluate the utility of CBPR techniques in a mother–child screen/treat and vaccinate program for CC prevention in the Peruvian jungle. The CC prevention program used self-sampling for human papillomavirus (HPV) for s...

  7. Economic evaluation of screening programs for hepatitis C virus infection: evidence from literature

    Directory of Open Access Journals (Sweden)

    Coretti S

    2015-04-01

    Full Text Available Silvia Coretti,1 Federica Romano,1 Valentina Orlando,2 Paola Codella,1 Sabrina Prete,1 Eugenio Di Brino,1 Matteo Ruggeri1 1Post-Graduate School of Economics and Management (ALTEMS, Università Cattolica del Sacro Cuore, Rome, Italy; 2Center of Pharmacoeconomics (CIRFF, Department of Pharmacy, Federico II University, Naples, Italy Background: Hepatitis C is a liver infection caused by hepatitis C virus. Its main complications are cirrhosis and liver cancer. According to the World Health Organization (WHO, more than 185 million people worldwide are infected with hepatitis C virus and, of these, 350,000 die every year. Due to the high disease prevalence and the existence of effective (and expensive medical treatments able to dramatically change the prognosis, early detection programs can potentially prevent the development of serious chronic conditions, improve health, and save resources. Objective: To summarize the available evidence on the cost-effectiveness of screening programs for hepatitis C. Methods: A literature search was performed on PubMed and Scopus search engines. Trip database was queried to identify reports produced by the major Health Technology Assessment (HTA agencies. Three reviewers dealt with study selection and data extraction blindly. Results: Ten papers eventually met the inclusion criteria. In studies focusing on asymptomatic cohorts of individuals at general risk the cost/quality adjusted life year of screening programs ranged between US $4,200 and $50,000/quality adjusted life year gained, while in those focusing on specific risk factors the incremental cost-effectiveness ratio ranged between $848 and $128,424/quality adjusted life year gained. Age of the target population and disease prevalence were the main cost-effectiveness drivers. Conclusion: Our results suggest that, especially in the long run, screening programs represent a cost-effective strategy for the management of hepatitis C. Keywords: hepatitis C, screening

  8. Evaluation of a neonatal screening program for sickle-cell disease.

    Science.gov (United States)

    Eller, Rodrigo; da Silva, Denise Bousfield

    2016-01-01

    Evaluate the Neonatal Screening Program of the Health Secretariat of the State of Santa Catarina for sickle-cell disease, from January 2003 to December 2012, regarding program coverage and disease frequency. Descriptive, observational, cross-sectional study with retrospective data collection. The variables analyzed were: number of live births in the State of Santa Catarina; number of screened children; number of children diagnosed with sickle-cell trait and sickle-cell disease; type of sickle-cell disease diagnosed; age at the time of sample collection, ethnicity/skin color, gender, and origin of children with sickle-cell disease. Descriptive measures and frequency tables were used for data analysis. During the study period, there were 848,833 live births and 730,412 samples were screened by the program, resulting in a coverage of 86.0%. There were 6173 samples positive for sickle-cell trait and 39 for sickle-cell disease. Among children with sickle-cell disease, the median age at the time of sample collection was 6 days. Regarding the ethnicity/skin color, 25 (64.1%) children were white, seven were black, and seven others were not specified. The Midwest and the Highland (Planalto Serrano) of Santa Catarina were the regions with the highest incidence of sickle-cell disease. Coverage by the Neonatal Screening Program of Santa Catarina is good, but did not demonstrate an improvement trend over the years. The frequency of sickle-cell disease is low and lower than in the North, Northeast, and Midwest regions. The median age in days at the time of collection is older than the age recommended by the Ministry of Health. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  9. Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness

    OpenAIRE

    Cuadros, Jorge

    2015-01-01

    Jorge A Cuadros Optometry/Vision Science, University of California, Berkeley, CA, USA Abstract: Diabetes is the main cause of blindness among working age adults, although treatment is highly effective in preventing vision loss. Eye examinations are recommended on a yearly basis for most patients for timely detection of retinal disease. Telemedicine-based diabetic retinopathy screening (TMDRS) programs have been developed to identify patients with sight-threatening diabetic eye disease becaus...

  10. Termination of pregnancy: development of a high-risk screening and counseling program.

    Science.gov (United States)

    Gameau, B

    1993-01-01

    The Social Work Department of The Queen Elizabeth Hospital in Adelaide, South Australia, developed a social work service for women presenting for elective termination of pregnancy. They used a high social risk identification and screening process and developed a protocol describing essential elements of the clinical social work practice. Program development was practice-based and empirical, using practice experience and drawing from relevant literature.

  11. [Breast cancer incidence related with a population-based screening program].

    Science.gov (United States)

    Natal, Carmen; Caicoya, Martín; Prieto, Miguel; Tardón, Adonina

    2015-02-20

    To compare breast cancer cumulative incidence, time evolution and stage at diagnosis between participants and non-participant women in a population-based screening program. Cohort study of breast cancer incidence in relation to participation in a population screening program. The study population included women from the target population of the screening program. The source of information for diagnostics and stages was the population-based cancer registry. The analysis period was 1999-2010. The Relative Risk for invasive, in situ, and total cancers diagnosed in participant women compared with non-participants were respectively 1.16 (0.94-1.43), 2.98 (1.16-7.62) and 1.22 (0.99-1.49). The Relative Risk for participants versus non-participants was 2.47 (1.55-3.96) for diagnosis at stagei, 2.58 (1.67-3.99) for T1 and 2.11 (1.38-3.23) for negative lymph node involvement. The cumulative incidence trend had two joint points in both arms, with an Annual Percent of Change of 92.3 (81.6-103.5) between 1999-2001, 18.2 (16.1-20.3) between 2001-2005 and 5.9 (4.0-7.8) for the last period in participants arm, and 72.6 (58.5-87.9) between 1999-2001, 12.6 (7.9-17.4) between 2001-2005, and 8.6 (6.5-10.6) in the last period in the non-participant arm. Participating in the breast cancer screening program analyzed increased the in situ cumulative cancer incidence, but not the invasive and total incidence. Diagnoses were earlier in the participant arm. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  12. Radionuclide carriers

    International Nuclear Information System (INIS)

    Hartman, F.A.; Kretschmar, H.C.

    1976-01-01

    A new carrier for radionuclide technetium 99m has been prepared for scintiscanning purposes. The new preparate consists of physiologically acceptable water-insoluble Tcsup(99m)-carrier containing from 0.2 to 0.8 weight percent of stannic ion as reductor, bound to an anionic starch derivative with about 1-20% of phosphate substituents. (EG)

  13. Weqaya: A Population-Wide Cardiovascular Screening Program in Abu Dhabi, United Arab Emirates

    Science.gov (United States)

    Harrison, Oliver; Al Siksek, Zaid

    2012-01-01

    Objectives. We sought to determine cardiovascular risk factor prevalence rates among adults in Abu Dhabi, United Arab Emirates. Methods. We used self-reported indicators, anthropometric measures, and blood tests to screen 50 138 adults aged 18 years or older taking part in a population-wide cardiovascular screening program. Results. Participants’ mean age was 36.82 years (SD = 14.3); 43% were men. Risk factor prevalence rates were as follows: obesity, 35%; overweight, 32%; central obesity, 55%; diabetes, 18%; prediabetes, 27%; dyslipidemia, 44%; and hypertension, 23.1%. In addition, 26% of men were smokers, compared with 0.8% of women. Age-standardized diabetes and prediabetes rates were 25% and 30%, respectively, and age-standardized rates of obesity and overweight were 41% and 34%. Conclusions. This population-wide cardiovascular screening program demonstrated a high cardiovascular burden for our small sample in Abu Dhabi. The data form a baseline against which interventions can be implemented and progress monitored as part of the population-wide Abu Dhabi Cardiovascular Disease Program. PMID:21940918

  14. Weqaya: a population-wide cardiovascular screening program in Abu Dhabi, United Arab Emirates.

    Science.gov (United States)

    Hajat, Cother; Harrison, Oliver; Al Siksek, Zaid

    2012-05-01

    We sought to determine cardiovascular risk factor prevalence rates among adults in Abu Dhabi, United Arab Emirates. We used self-reported indicators, anthropometric measures, and blood tests to screen 50 ,138 adults aged 18 years or older taking part in a population-wide cardiovascular screening program. Participants' mean age was 36.82 years (SD = 14.3); 43% were men. Risk factor prevalence rates were as follows: obesity, 35%; overweight, 32%; central obesity, 55%; diabetes, 18%; prediabetes, 27%; dyslipidemia, 44%; and hypertension, 23.1%. In addition, 26% of men were smokers, compared with 0.8% of women. Age-standardized diabetes and prediabetes rates were 25% and 30%, respectively, and age-standardized rates of obesity and overweight were 41% and 34%. This population-wide cardiovascular screening program demonstrated a high cardiovascular burden for our small sample in Abu Dhabi. The data form a baseline against which interventions can be implemented and progress monitored as part of the population-wide Abu Dhabi Cardiovascular Disease Program.

  15. Comprehensive evaluation of cervical cancer screening programs: the case of Colombia

    Directory of Open Access Journals (Sweden)

    Raúl Murillo

    2011-12-01

    Full Text Available OBJECTIVE: To identify critical screening program factors for reducing cervical cancer mortality in Colombia. MATERIAL AND METHODS: Coverage, quality, and screening follow-up were evaluated in four Colombian states with different mortality rates. A case-control study (invasive cancer and healthy controls evaluating screening history was performed. RESULTS: 3-year cytology coverage was 72.7%, false negative rate 49%, positive cytology follow-up 64.2%. There was no association between screening history and invasive cancer in two states having high cytology coverage but high false negative rates. Two states revealed association between deficient screening history and invasive cancer as well as lower positive-cytology follow-up. CONCLUSIONS: Reduced number of visits between screening and treatment is more relevant when low access to health care is present. Improved quality is a priority if access to screening is available. Suitable interventions for specific scenarios and proper appraisal of new technologies are compulsory to improve cervical cancer screening. Comprehensive process-failure audits among invasive cancer cases could improve program evaluation since mortality is a late outcome.OBJETIVO: Identificar factores críticos para reducir la mortalidad por cáncer cervical en Colombia. MATERIAL Y MÉTODOS: Se evaluó cobertura, calidad y seguimiento del tamizaje en cuatro departamentos con tasas de mortalidad diferenciales. Un estudio de casos (cáncer invasor y controles (sanos evaluó historia de tamizaje. RESULTADOS: Cobertura 72,7%; falsos negativos 49%; acceso a diagnóstico-tratamiento de HSIL 64,2%. La historia de tamizaje no se asoció con cáncer invasor en dos departamentos con elevada cobertura pero elevada proporción de falsos negativos. Dos departamentos con asociación entre historia de tamizaje deficiente y cáncer invasor tuvieron cobertura aceptable pero bajo acceso a diagnóstico-tratamiento. No hubo relación entre mortalidad

  16. American College of Radiology Accreditation Program for mammographic screening sites: Physical evaluation criteria

    International Nuclear Information System (INIS)

    Hendrick, R.E.; Haus, A.G.; Hubbard, L.B.; Lasky, H.J.; McCrohan, J.; McLelland, R.; Rothenberg, L.N.; Tanner, R.L.; Zinninger, M.D.

    1987-01-01

    The American College of Radiology has initiated a program for the accreditation of mammographic screening sites, which includes evaluation by mail of image quality and average glandular breast dose. Image quality is evaluated by use of a specially designed phantom (a modified RMI 152D Mammographic Phantom) containing simulated microcalcifications, fibrils and masses. Average glandular dose to a simulated 4.5-cm-thick (50% glandular, 50% fat) compressed breast is evaluated by thermoluminescent dosimeter measurements of entrance exposure and half value layer. Standards for acceptable image quality and patient doses are presented and preliminary results of the accreditation program are discussed

  17. Evolution and Innovations of the National Neonatal and High Risk Screening Program in Costa Rica

    OpenAIRE

    Carlos de Céspedes; Manuel Saborío; Rafael Trejos; Gabriela Abarca; Avelino Sánchez

    2004-01-01

    We present the evolution, organization and results of the National Neonatal and High Risk Screening Program in Costa Rica (PNT). This program has been working uninterruptedly for more than fourteen years. Costa Rica currently has a literacy rate of 95%. To August 2004 the rate of infant mortality was 9.74 per 1000 births and to 2003, life expectancy was 76.3 years for men and 81.1 years for women. The control of infectious and parasitic diseases, as well as of severe malnutrition, has given r...

  18. Evolution and Innovations of the National Neonatal and High Risk Screening Program in Costa Rica

    OpenAIRE

    de Céspedes, Carlos; Saborío, Manual; Trejos, Rafael; Abarca, Gabriela; Sánchez, Avelino; Rojas, Laura

    2014-01-01

    We present the evolution, organization and results of the National Neonatal and High Risk Screening Program in Costa Rica (PNT). This program has been working uninterruptedly for more than fourteen years. Costa Rica currently has a literacy rate of 95%. To August 2004 the rate of infant mortality was 9.74 per 1000 births and to 2003, life expectancy was 76.3 years for men and 81.1 years for women. The control of infectious and parasitic diseases, as well as of severe malnutrition, has given r...

  19. Primary HPV testing versus cytology-based cervical screening in women in Australia vaccinated for HPV and unvaccinated: effectiveness and economic assessment for the National Cervical Screening Program.

    Science.gov (United States)

    Lew, Jie-Bin; Simms, Kate T; Smith, Megan A; Hall, Michaela; Kang, Yoon-Jung; Xu, Xiang Ming; Caruana, Michael; Velentzis, Louiza Sofia; Bessell, Tracey; Saville, Marion; Hammond, Ian; Canfell, Karen

    2017-02-01

    Australia's National Cervical Screening Program currently recommends cytological screening every 2 years for women aged 18-69 years. Human papillomavirus (HPV) vaccination was implemented in 2007 with high population coverage, and falls in high-grade lesions in young women have been reported extensively. This decline prompted a major review of the National Cervical Screening Program and new clinical management guidelines, for which we undertook this analysis. We did effectiveness modelling and an economic assessment of potential new screening strategies, using a model of HPV transmission, vaccination, natural history, and cervical screening. First, we evaluated 132 screening strategies, including those based on cytology and primary HPV testing. Second, after a recommendation was made to adopt primary HPV screening with partial genotyping and direct referral to colposcopy of women positive for HPV16/18, we evaluated the final effect of HPV screening after incorporating new clinical guidelines for women positive for HPV. Both evaluations considered both unvaccinated and vaccinated cohorts. Strategies entailing HPV testing every 5 years and either partial genotyping for HPV16/18 or cytological co-testing were the most effective. One of the most effective and cost-effective strategies comprised primary HPV screening with referral of women positive for oncogenic HPV16/18 direct to colposcopy, with reflex cytological triage for women with other oncogenic types and direct referral for those in this group with high-grade cytological findings. After incorporating detailed clinical guidelines recommendations, this strategy is predicted to reduce cervical cancer incidence and mortality by 31% and 36%, respectively, in unvaccinated cohorts, and by 24% and 29%, respectively, in cohorts offered vaccination. Furthermore, this strategy is predicted to reduce costs by up to 19% for unvaccinated cohorts and 26% for cohorts offered vaccination, compared with the current programme

  20. [Cost-benefit analysis of a population-based cervical cancer screening program designed for Cantabria].

    Science.gov (United States)

    Ramos-Barrón, M Á; Vázquez-Rodríguez, J A; García-Garrido, A B

    2014-09-01

    Cervical cancer is the second most common cancer worldwide in women, with an annual mortality of 3.6 per 100.000 women in Spain. An opportunistic screening protocol is currently being developed in Cantabria. The objective of the study is to propose a population-based screening program in Cantabria and assess its cost-benefits. The population-based program design has been carried out according to the description of the natural course of cervical cancer and its incidence and mortality in Cantabria during 2000-2009. There have been some proposals to increase participation in the program and to evaluate its quality. Costs and benefits (direct and indirect) have been analyzed in several scenarios by modifying the frequency of tests (3-5 years), the age at which the program can be accessed (21, 25 or 30 years), the coverage of the program (60-80%), and discount rates (0-3-6%). A program carried out with coverage of 80% and tests performed every 3 years generates annual costs of €893.000 (discount rate of 3%) compared to the current opportunistic protocol. Scenarios with tests performed every 5 years generate an annual benefit higher than €618.000, depending on the age of accessing the program. Scenarios with coverage lower than 60% or with women over 30 years old having access to the program are not of interest because of the lower health benefits. However, performing tests every 5 years is more economically advantageous than every 3 years, with similar health benefits. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  1. Characterization of mortality in children with sickle cell disease diagnosed through the Newborn Screening Program

    Directory of Open Access Journals (Sweden)

    Alessandra P. Sabarense

    2015-06-01

    Full Text Available OBJECTIVE: To characterize the deaths of 193 children with sickle cell disease screened by a neonatal program from 1998 to 2012 and contrast the initial years with the final years. METHODS: Deaths were identified by active surveillance of children absent to scheduled appointments in Blood Bank Clinical Centers (Hemominas. Clinical and epidemiological data came from death certificates, neonatal screening database, medical records, and family interviews. RESULTS: Between 1998 and 2012, 3,617,919 children were screened and 2,591 had sickle cell disease (1:1,400. There were 193 deaths (7.4%: 153 with SS/Sß0-talassemia, 34 SC and 6 Sß+thalassemia; 76.7% were younger than five years; 78% died in the hospital and 21% at home or in transit. The main causes of death were infection (45%, indeterminate (28%, and acute splenic sequestration (14%. In 46% of death certificates, the term "sickle cell" was not recorded. Seven-year death rate for children born between 1998 and 2005 was 5.43% versus 5.12% for those born between 2005 and 2012 (p = 0.72. Medical care was provided to 75% of children; 24% were unassisted. Medical care was provided within 6 hours of symptom onset in only half of the interviewed cases. In 40.5% of cases, death occurred within the first 24 hours. Low family income was recorded in 90% of cases, and illiteracy in 5%. CONCLUSIONS: Although comprehensive and effective, neonatal screening for sickle cell disease was not sufficient to significantly reduce mortality in a newborn screening program. Economic and social development and increase of the knowledge on sickle cell disease among health professionals and family are needed to overcome excessive mortality.

  2. Improving the Sensitivity and Positive Predictive Value in a Cystic Fibrosis Newborn Screening Program Using a Repeat Immunoreactive Trypsinogen and Genetic Analysis.

    Science.gov (United States)

    Sontag, Marci K; Lee, Rachel; Wright, Daniel; Freedenberg, Debra; Sagel, Scott D

    2016-08-01

    To evaluate the performance of a new cystic fibrosis (CF) newborn screening algorithm, comprised of immunoreactive trypsinogen (IRT) in first (24-48 hours of life) and second (7-14 days of life) dried blood spot plus DNA on second dried blood spot, over existing algorithms. A retrospective review of the IRT/IRT/DNA algorithm implemented in Colorado, Wyoming, and Texas. A total of 1 520 079 newborns were screened, 32 557 (2.1%) had abnormal first IRT; 8794 (0.54%) on second. Furthermore, 14 653 mutation analyses were performed; 1391 newborns were referred for diagnostic testing; 274 newborns were diagnosed; and 201/274 (73%) of newborns had 2 mutations on the newborn screening CFTR panel. Sensitivity was 96.2%, compared with sensitivity of 76.1% observed with IRT/IRT (105 ng/mL cut-offs, P diagnosis was 28, 30, and 39.5 days in the 3 states. IRT/IRT/DNA is more sensitive than IRT/IRT because of lower cut-offs (∼97 percentile or 60 ng/mL); higher cut-offs in IRT/IRT programs (>99 percentile, 105 ng/mL) would not achieve sufficient sensitivity. Carrier identification and identification of newborns with CFTR-related metabolic syndrome is less common in IRT/IRT/DNA compared with IRT/DNA. The time to diagnosis is nominally longer, but diagnosis can be achieved in the neonatal period and opportunities to further improve timeliness have been enacted. IRT/IRT/DNA algorithm should be considered by programs with 2 routine screens. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Optical pre-screening in breast screening programs: Can we identify women who benefit most from limited mammography resources?

    Science.gov (United States)

    Walter, Jane; Loshchenov, Maxim; Zhilkin, Vladimir; Peake, Rachel; Stone, Jennifer; Lilge, Lothar

    2017-04-01

    Background: In excess of 60% of all cancers are detected in low and middle-income countries, with breast cancer (BC) the dominant malignancy for women. Incidence rates continue to climb, most noticeably in the less than 50-year-old population. Expansion of mammography infrastructure and resources is lacking, resulting in over 60% of women diagnosed with stage III/IV BC in the majority of these countries. Optical Breast Spectroscopy (OBS) was shown to correlate well with mammographic breast density (MBD). OBS could aid breast screening programs in low- and middle-income countries by lowering the number of mammographs required for complete population coverage. However, its performance needs to be tested in large population trails to ensure high sensitivity and acceptable specificity. Methods: For the planned studies in low- and middle-income countries in different continents, online methods need to be implemented to monitor the performance and data collection by these devices, operated by trained nurses. Based on existing datasets, procedures were developed to validate an individual woman's data integrity and to identify operator errors versus system malfunctions. Results: Using a dataset comprising spectra from 360 women collected by 2 instruments in different locations and with 3 different trained operators, automated methods were developed to identify 100% of the source or photodetector malfunctions as well as incorrect calibrations and 96% of instances of insufficient tissue contact. Conclusions: Implementing the dataset validation locally in each instrument and tethered to a cloud database will allow the planned clinical trials to proceed.

  4. [Pervasive developmental disorders screening program in the health areas of Salamanca and Zamora in Spain].

    Science.gov (United States)

    García Primo, P; Santos Borbujo, J; Martín Cilleros, M V; Martínez Velarte, M; Lleras Muñoz, S; Posada de la Paz, M; Canal Bedia, R

    2014-05-01

    To evaluate the results of the Pervasive Developmental Disorders (PDD) screening program currently ongoing in the public health services in the health area of Salamanca and Zamora, Spain, in terms of feasibility, reliability and costs, with the purpose of extending the program at regional and national levels. A total of 54 paediatric teams (nurses and paediatricians) from the provinces of Salamanca and Zamora participated in the training sessions for the PDD Screening Programme in September 2005, and agreed to administer the questionnaire M-CHAT(1) to all parents attending their clinics in any of these two visits: 18 months and/or 24 months within the Well-baby Check-up Program. A total of 9,524 children have participated up to December 2012. Additionally, we evaluated the participation and opinions of the paediatric teams using questionnaires, and costs per positive case have estimated. Out of a total of 852 (8.9%) children determined as PDD high-risk with the M-CHAT questionnaire results, 61 (7.1%) were confirmed as positive with the M-CHAT follow-up interview. Of these, 22 were diagnosed with a PDD and 31 other disorders of childhood onset according to DSM-IV-TR(2). Almost three-quarters (74%) of respondents felt the program was totally feasible, and 22% viable, but with reservations (n=54). This study has been able to show for the first time in Spain, the feasibility of a population-based PDD screening program within the public health system. Training in social and communicative development, and dissemination of the early signs of PDD among paediatricians, as well as the use of the M-CHAT, is essential for progress in the early detection of these disorders. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  5. Why does cervical cancer occur in a state-of-the-art screening program?

    Science.gov (United States)

    Castle, Philip E; Kinney, Walter K; Cheung, Li C; Gage, Julia C; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas S; Wentzensen, Nicolas; Befano, Brian; Schussler, John; Katki, Hormuzd A; Schiffman, Mark

    2017-09-01

    The goal of cervical screening is to detect and treat precancers before some become cancer. We wanted to understand why, despite state-of-the-art methods, cervical cancers occured in relationship to programmatic performance at Kaiser Permanente Northern California (KPNC), where >1,000,000 women aged ≥30years have undergone cervical cancer screening by triennial HPV and cytology cotesting since 2003. We reviewed clinical histories preceding cervical cancer diagnoses to assign "causes" of cancer. We calculated surrogate measures of programmatic effectiveness (precancers/(precancers and cancers)) and diagnostic yield (precancers and cancers per 1000 cotests), overall and by age at cotest (30-39, 40-49, and ≥50years). Cancer was rare and found mainly in a localized (treatable) stage. Of 623 cervical cancers with at least one preceding or concurrent cotest, 360 (57.8%) were judged to be prevalent (diagnosed at a localized stage within one year or regional/distant stage within two years of the first cotest). Non-compliance with recommended screening and management preceded 9.0% of all cancers. False-negative cotests/sampling errors (HPV and cytology negative), false-negative histologic diagnoses, and treatment failures preceded 11.2%, 9.0%, and 4.3%, respectively, of all cancers. There was significant heterogeneity in the causes of cancer by histologic category (pstate-of-the-art intensive screening program results in very few cervical cancers, most of which are detected early by screening. Screening may become less efficient at older ages. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Functional Genetic Screen to Identify Interneurons Governing Behaviorally Distinct Aspects of Drosophila Larval Motor Programs

    Directory of Open Access Journals (Sweden)

    Matt Q. Clark

    2016-07-01

    Full Text Available Drosophila larval crawling is an attractive system to study rhythmic motor output at the level of animal behavior. Larval crawling consists of waves of muscle contractions generating forward or reverse locomotion. In addition, larvae undergo additional behaviors, including head casts, turning, and feeding. It is likely that some neurons (e.g., motor neurons are used in all these behaviors, but the identity (or even existence of neurons dedicated to specific aspects of behavior is unclear. To identify neurons that regulate specific aspects of larval locomotion, we performed a genetic screen to identify neurons that, when activated, could elicit distinct motor programs. We used 165 Janelia CRM-Gal4 lines—chosen for sparse neuronal expression—to ectopically express the warmth-inducible neuronal activator TrpA1, and screened for locomotor defects. The primary screen measured forward locomotion velocity, and we identified 63 lines that had locomotion velocities significantly slower than controls following TrpA1 activation (28°. A secondary screen was performed on these lines, revealing multiple discrete behavioral phenotypes, including slow forward locomotion, excessive reverse locomotion, excessive turning, excessive feeding, immobile, rigid paralysis, and delayed paralysis. While many of the Gal4 lines had motor, sensory, or muscle expression that may account for some or all of the phenotype, some lines showed specific expression in a sparse pattern of interneurons. Our results show that distinct motor programs utilize distinct subsets of interneurons, and provide an entry point for characterizing interneurons governing different elements of the larval motor program.

  7. Maternal knowledge and attitudes to universal newborn hearing screening: Reviewing an established program.

    Science.gov (United States)

    Lam, Maggie Yee Yan; Wong, Eddie Chi Ming; Law, Chi Wai; Lee, Helena Hui Ling; McPherson, Bradley

    2018-02-01

    To facilitate early diagnosis of infants with hearing loss, a universal newborn hearing screening program (UNHS) has been implemented in Hong Kong's public hospitals for over a decade. However, there have been no known studies investigating parent attitudes to, and satisfaction with, UNHS since its launch in Hong Kong. The present study aimed to investigate knowledge of UNHS as well as infant hearing development, and attitudes and satisfaction with UNHS, in Hong Kong mothers with newborns. The study was designed to help evaluate and improve an established UNHS public hospital program, based on the perspectives of service users. A researcher-developed questionnaire was administered to 102 mothers whose newborn had received UNHS in the postnatal wards of a large public hospital in Hong Kong. The questionnaire considered parental knowledge of UNHS and infant hearing development, attitudes and satisfaction toward public hospital UNHS. In the knowledge dimension, parents' preferred time and location for pre-test information delivery, interpretation of screening results, and knowledge of hearing developmental milestones were surveyed. In addition, maternal attitudes to and satisfaction with UNHS screening services, the potential impact of UNHS on parent emotions and parent-baby bonding, attitudes toward informed consent, and willingness to comply with diagnostic assessment referral were also be surveyed. Mean participant scores on knowledge of infant hearing development were relatively low (M = 2.59/6.0, SD = 0.90). Many mothers also underestimated the potential ongoing risks of hearing impairment in babies. Around 80% of mothers thought an infant could not have hearing impairment after passing the screening. In addition, one-third of mothers thought a baby could not later develop hearing impairment in infancy or childhood. In terms of attitudes and satisfaction, participants gave somewhat negative ratings for questions regarding receiving sufficient information

  8. The effectiveness of scoliosis screening programs: methods for systematic review and expert panel recommendations formulation

    Science.gov (United States)

    2013-01-01

    Background Literature on scoliosis screening is vast, however because of the observational nature of available data and methodological flaws, data interpretation is often complex, leading to incomplete and sometimes, somewhat misleading conclusions. The need to propose a set of methods for critical appraisal of the literature about scoliosis screening, a comprehensive summary and rating of the available evidence appeared essential. Methods To address these gaps, the study aims were: i) To propose a framework for the assessment of published studies on scoliosis screening effectiveness; ii) To suggest specific questions to be answered on screening effectiveness instead of trying to reach a global position for or against the programs; iii) To contextualize the knowledge through expert panel consultation and meaningful recommendations. The general methodological approach proceeds through the following steps: Elaboration of the conceptual framework; Formulation of the review questions; Identification of the criteria for the review; Selection of the studies; Critical assessment of the studies; Results synthesis; Formulation and grading of recommendations in response to the questions. This plan follows at best GRADE Group (Grades of Recommendation, Assessment, Development and Evaluation) requirements for systematic reviews, assessing quality of evidence and grading the strength of recommendations. Conclusions In this article, the methods developed in support of this work are presented since they may be of some interest for similar reviews in scoliosis and orthopaedic fields. PMID:23883346

  9. Worksite-screenings for hypertension with follow-up: experiences from the Munich Blood Pressure Program.

    Science.gov (United States)

    Hense, H W; Keil, U

    1989-01-01

    In 1983/84, the Munich Blood Pressure Program (MBP) performed worksite screenings for arterial hypertension at 18 Munich companies. A participation of 51% (n = 7310) was achieved. After duplicate measurements of casual blood pressure 1084 participants were suspected of having actual hypertension. All suspected cases were invited for a reexamination to reduce the number of false-positive hypertensives. Individuals with persisting hypertension after this two-step-screening were predominantly male, on the average younger than 50 years and showed a low level of antihypertensive drug treatment. About 75% of all detected hypertensives saw a family physician subsequent to the screenings for further management. Referrals and patient compliance were frequently reinforced by a computer based reminder system. A follow-up examination was performed among the MBP participants after two years. It showed that in 417 confirmed hypertensives of the primary screenings a marked increase in the proportion of treated and controlled hypertensives had occurred. This was true for younger and older hypertensives.

  10. Using clinical decision support as a means of implementing a universal postpartum depression screening program.

    Science.gov (United States)

    Loudon, Holly; Nentin, Farida; Silverman, Michael E

    2016-06-01

    A major barrier to the diagnosis of postpartum depression (PPD) includes symptom detection. The lack of awareness and understanding of PPD among new mothers, the variability in clinical presentation, and the various diagnostic strategies can increase this further. The purpose of this study was to test the feasibility of adding clinical decision support (CDS) to the electronic health record (EHR) as a means of implementing a universal standardized PPD screening program within a large, at high risk, population. All women returning to the Mount Sinai Hospital OB/GYN Ambulatory Practice for postpartum care between 2010 and 2013 were presented with the Edinburgh Postnatal Depression Scale (EPDS) in response to a CDS "hard stop" built into the EHR. Of the 2102 women who presented for postpartum care, 2092 women (99.5 %) were screened for PPD in response to a CDS hard stop module. Screens were missing on ten records (0.5 %) secondary to refusal, language barrier, or lack of clarity in the EHR. Technology is becoming increasingly important in addressing the challenges faced by health care providers. While the identification of PPD has become the recent focus of public health concerns secondary to the significant social burden, numerous barriers to screening still exist within the clinical setting. The utility of adding CDS in the form of a hard stop, requiring clinicians to enter a standardized PPD mood assessment score to the patient EHR, offers a sufficient way to address a primary barrier to PPD symptom identification at the practitioner level.

  11. Development and Implementation of a Universal Suicide Risk Screening Program in a Safety-Net Hospital System.

    Science.gov (United States)

    Roaten, Kimberly; Johnson, Celeste; Genzel, Russell; Khan, Fuad; North, Carol S

    2018-01-01

    Many individuals who die by suicide present for nonbehavioral health care prior to death. The risk is often undetected. Universal suicide screening in health care may improve risk recognition. A quality improvement project involving a universal suicide screening program was designed and developed in a large safety-net health care system. The steps in developing and implementing this quality improvement program were gathering intelligence, examining resources, designing the screening program, creating a clinical response, constructing an electronic health record screening protocol, clinical workforce education, and program implementation. This project used the Columbia-Suicide Severity Rating Scale, Clinical Practice Screener-Recent, and a preliminary clinical decision support system. Prevalence data on suicide risk levels are provided for 328,064 adult encounters from the first six months of the screening program. Approximately half of the screens were completed in the outpatient clinics, more than 40% in the emergency department (ED), and slightly less than 5% in the hospital inpatient units. In the ED, 6.3% of the screens were positive, as were 1.6% in the inpatient units, and 2.1% in the outpatient clinics. The odds of a positive suicide screening in the ED was 4.29 times higher than the inpatient units and 3.13 times higher than the outpatient clinics. A new quality improvement program for universal suicide screening was successfully implemented in a large safety-net health care system. The burden to the system from universal screening was not overwhelming and was managed effectively through thoughtful allocation of clinical resources. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  12. Parental Intentions to Enroll Children in a Voluntary Expanded Newborn Screening Program

    Science.gov (United States)

    Paquin, Ryan S.; Peay, Holly L.; Gehtland, Lisa M.; Lewis, Megan A.; Bailey, Donald B.

    2016-01-01

    Background and Objectives Nearly all babies in the United States are tested at birth for rare, serious, and treatable disorders through mandatory state newborn screening (NBS). Recently, there have been calls for an expanded, voluntary model to facilitate early diagnosis and treatment of a wider range of disorders. We applied the reasoned action framework to examine parental intentions to participate in voluntary expanded screening. Methods We recruited a national cohort of recent and expectant parents living in the U.S. who completed a self-administered online survey (N = 1,001). Using a mixed-level fractional factorial experiment, we studied parental participation intentions and preferences for timing of consent, cost, consent format, and testing options. Results We conducted a hierarchical regression analysis assessing parental intentions to participate in voluntary expanded NBS. Attitudes, perceived normative influence, and perceived behavioral control explained substantial variance in intention, with perceived normative influence emerging as the strongest predictor. We found no evidence that the manipulated program features altered mean levels of intention, but timing of parental permission, cost, and permission format moderated the relative importance of reasoned action constructs on intention. Conclusion Program design features may impact the psychological mechanisms underlying parental decision making for voluntary expanded screening. These results have important implications for parent education, outreach, and informed parental permission procedures. PMID:27526258

  13. Parental intentions to enroll children in a voluntary expanded newborn screening program.

    Science.gov (United States)

    Paquin, Ryan S; Peay, Holly L; Gehtland, Lisa M; Lewis, Megan A; Bailey, Donald B

    2016-10-01

    Nearly all babies in the United States are tested at birth for rare, serious, and treatable disorders through mandatory state newborn screening (NBS). Recently, there have been calls for an expanded, voluntary model to facilitate early diagnosis and treatment of a wider range of disorders. We applied the reasoned action framework to examine parental intentions to participate in voluntary expanded screening. We recruited a national cohort of recent and expectant parents living in the U.S. who completed a self-administered online survey (N = 1001). Using a mixed-level fractional factorial experiment, we studied parental participation intentions and preferences for timing of consent, cost, consent format, and testing options. We conducted a hierarchical regression analysis assessing parental intentions to participate in voluntary expanded NBS. Attitudes, perceived normative influence, and perceived behavioral control explained substantial variance in intention, with perceived normative influence emerging as the strongest predictor. We found no evidence that the manipulated program features altered mean levels of intention, but timing of parental permission, cost, and permission format moderated the relative importance of reasoned action constructs on intention. Program design features may impact the psychological mechanisms underlying parental decision making for voluntary expanded screening. These results have important implications for parent education, outreach, and informed parental permission procedures. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. HPV vaccination impact on a cervical cancer screening program: methods of the FASTER-Tlalpan Study in Mexico.

    Science.gov (United States)

    Salmerón, Jorge; Torres-Ibarra, Leticia; Bosch, F Xavier; Cuzick, Jack; Lörincz, Attila; Wheeler, Cosette M; Castle, Philip E; Robles, Claudia; Lazcano-Ponce, Eduardo

    2016-04-01

    To outline the design of a clinical trial to evaluate the impact of HPV vaccination as part of a hrHPV-based primary screening program to extend screening intervals. A total of 18,000 women aged 25-45 years, attending the regular cervical cancer-screening program in primary health care services in Tlalpan, Mexico City, will be invited to the study. Eligible participants will be assigned to one of three comparison groups: 1) HPV16/18 vaccine and hrHPV-based screening; 2) HPV6/11/16/18 vaccine and hrHPV-based screening; 3) Control group who will receive only hrHPV-based screening. Strict surveillance of hrHPV persistent infection and occurrence of precancerous lesions will be conducted to estimate safety profiles at different screening intervals; participants will undergo diagnosis confirmation and treatment as necessary. The FASTER-Tlalpan Study will provide insights into new approaches of cervical cancer prevention programs. It will offer valuable information on potential benefits of combining HPV vaccination and hrHPV-based screening to safety extend screening intervals.

  15. Airport sentinel surveillance and entry quarantine for dengue infections following a fever screening program in Taiwan

    Science.gov (United States)

    2012-01-01

    Background Dengue has not reached an endemic status in Taiwan; nevertheless, we have implemented a fever screening program at airports for the early detection of febrile passengers with a dengue infection. This study is intended to assess the performance of the airport screening procedures for dengue infection. Methods We analyzed data from the national surveillance system of the Taiwan Centers for Disease Control. We included the imported dengue cases reported by sentinel airports and clinics as well as the domestic cases from 2007–2010. Results Approximately 44.9% (95%CI: 35.73-54.13%) of the confirmed imported dengue cases with an apparent symptom (febrile) in the viremic stage were detected via the airport fever screening program, with an estimated positive predictive value of 2.36% (95% CI: 0.96- 3.75%) and a negative predictive value > 99.99%. Fluctuations in the number of the symptomatic imported dengue cases identified in the airports (X) were associated with the total number of imported dengue cases (Y) based on a regression analysis of a biweekly surveillance (i.e., n = 104, R2X:Y = 0.61, P dengue cases (X) with a 1–2 month lead time (t) was in parallel with that of the domestic dengue cases (Y) based on a consecutive 4-year surveillance (i.e., n = 48, R2X(t-1):Y = 0.22, R2X(t-2):Y = 0.31, P dengue at the airports examined in this study indicated some limitations of the fever screening program for the prevention of importation. The screening program could assist in the rapid triage for self-quarantine of some symptomatic dengue cases that were in the viremic stage at the borders and contribute to active sentinel surveillance; however, the blocking of viral transmission to susceptible populations (neighbors or family) from all of the viremic travelers, including those with or without symptoms, is critical to prevent dengue epidemics. Therefore, the reinforcement of mosquito bite prevention and household vector control in

  16. Influencing Cancer Screening Participation Rates—Providing a Combined Cancer Screening Program (a ‘One Stop’ Shop Could Be a Potential Answer

    Directory of Open Access Journals (Sweden)

    Amanda Bobridge

    2017-12-01

    Full Text Available IntroductionParticipation in established cancer screening programs remains variable. Therefore, a renewed focus on how to increase screening uptake, including addressing structural barriers such as time, travel, and cost is needed. One approach could be the provision of combined cancer screening, where multiple screening tests are provided at the same time and location (essentially a ‘One Stop’ screening shop. This cohort study explored both cancer screening behavior and the acceptability of a combined screening approach.MethodsParticipants of the North Western Adelaide Health Study (NWAHS, South Australia were invited to participate in a questionnaire about cancer screening behaviors and the acceptability of a proposed ‘One Stop’ cancer screening shop. Data were collected from 10th August 2015 to 18th January 2016, weighted for selection probability, age, and sex and analyzed using descriptive and multivariable logistic regression analysis.Results1,562 people, 52% female (mean age 54.1 years ± 15.2 participated. Reported screening participation was low, the highest being for Pap Smear (34.4%. Common reasons for screening participation were preventing sickness (56.1%, CI 53.2–59.0%, maintaining health (51%, CI 48–53.9%, and free program provision (30.9%, CI 28.2–33.6%. Females were less likely to state that screening is not beneficial [OR 0.37 (CI 0.21–0.66, p < 0.001] and to cite sickness prevention [OR 2.10 (CI 1.46–3.00, p < 0.001] and free program [OR 1.75 (CI 1.22–2.51, p < 0.003] as reasons for screening participation. Of those who did not participate, 34.6% (CI 30.3–39.1% stated that there was nothing that discouraged them from participation, with 55- to 64-year olds [OR 0.24 (CI 0.07–0.74, p < 0.04] being less likely to cite this reason. 21% (CI 17.2–24.8% thought they did not need screening, while a smaller proportion stated not having time (6.9%, CI 4.9–9.7% and the costs associated

  17. Detection of prostate cancer by an FDG-PET cancer screening program: results from a Japanese nationwide survey

    International Nuclear Information System (INIS)

    Minamimoto, Ryogo; Senda, Michio; Jinnouchi, Seishi; Terauchi, Takashi; Inoue, Tomio

    2014-01-01

    The aim of this study was to analyze detection rates and effectiveness of 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) cancer screening program for prostate cancer in Japan, which is defined as a cancer-screening program for subjects without known cancer. It contains FDG-PET aimed at detection of cancer at an early stage with or without additional screening tests such as prostate-specific antigen (PSA) and magnetic resonance imaging (MRI). A total of 92,255 asymptomatic men underwent the FDG-PET cancer screening program. Of these, 504 cases with findings of possible prostate cancer in any screening method were analyzed. Of the 504 cases, 165 were verified as having prostate cancer. Of these, only 61 cases were detected by FDG-PET, which result in 37.0% relative sensitivity and 32.8% positive predictive value (PPV). The sensitivity of PET/computed tomography (CT) scanner was higher than that of dedicated PET (44.0% vs. 20.4%). However, the sensitivity of FDG-PET was lower than that of PSA and pelvic MRI. FDG-PET did not contribute to improving the sensitivity and PPV when performed as combined screening. PSA should be included in FDG-PET cancer screening programs to screen for prostate cancer

  18. From Cancer Screening to Treatment: Service Delivery and Referral in the National Breast and Cervical Cancer Early Detection Program

    Science.gov (United States)

    Miller, Jacqueline W.; Hanson, Vivien; Johnson, Gale D.; Royalty, Janet E.; Richardson, Lisa C.

    2015-01-01

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies. PMID:25099897

  19. Costs of promoting cancer screening: Evidence from CDC’s Colorectal Cancer Control Program (CRCCP)☆

    Science.gov (United States)

    Tangka, Florence K.L.; Subramanian, Sujha; Hoover, Sonja; Royalty, Janet; Joseph, Kristy; DeGroff, Amy; Joseph, Djenaba; Chattopadhyay, Sajal

    2018-01-01

    The Colorectal Cancer Control Program (CRCCP) provided funding to 29 grantees to increase colorectal cancer screening. We describe the screening promotion costs of CRCCP grantees to evaluate the extent to which the program model resulted in the use of funding to support interventions recommended by the Guide to Community Preventive Services (Community Guide). We analyzed expenditures for screening promotion for the first three years of the CRCCP to assess cost per promotion strategy, and estimated the cost per person screened at the state level based on various projected increases in screening rates. All grantees engaged in small media activities and more than 90% used either client reminders, provider assessment and feedback, or patient navigation. Based on all expenditures, projected cost per eligible person screened for a 1%, 5%, and 10% increase in state-level screening proportions are $172, $34, and $17, respectively. CRCCP grantees expended the majority of their funding on Community Guide recommended screening promotion strategies but about a third was spent on other interventions. Based on this finding, future CRC programs should be provided with targeted education and information on evidence-based strategies, rather than broad based recommendations, to ensure that program funds are expended mainly on evidence-based interventions. PMID:27989647

  20. Superior performance of liquid-based versus conventional cytology in a population-based cervical cancer screening program

    NARCIS (Netherlands)

    Beerman, H.; van Dorst, E. B. L.; Kuenen-Boumeester, V.; Hogendoorn, P. C. W.

    Objective. Liquid-based cytology may offer improvements over conventional cytology for cervical cancer screening. The two cytology techniques were compared in a group of 86,469 women who participated in a population-based screening program. Using a nation-wide pathology database containing both

  1. 14 CFR 399.91 - Air carrier participation in programs of technical assistance to airlines of less developed...

    Science.gov (United States)

    2010-01-01

    ... particular language and culture of the recipient country are important to the success of the project, weight... important national interest objective of the United States, weight should be given to any evidence that an... interfere with the primary business of the subsidized carrier which is to provide air transportation in the...

  2. Low priority main reason not to participate in a colorectal cancer screening program with a faecal occult blood test.

    Science.gov (United States)

    van Rijn, A F; van Rossum, L G M; Deutekom, M; Laheij, R J F; Fockens, P; Bossuyt, P M M; Dekker, E; Jansen, J B M J

    2008-12-01

    Compared with screening programs for breast and cervical cancer, reported participation rates for colorectal cancer (CRC) screening are low. The effectiveness of a screening program is strongly influenced by the participation rate. The aim of this study was to investigate the main reasons not to participate in a population-based, invitational CRC screening program. In the Dutch study program for CRC screening, a random selection of 20 623 persons were invited received a faecal occult blood test. Of the non-participants, 500 were randomly selected and contacted for a standardized telephone interview from November 2006 to May 2007 to document the main reason not to participate. In total, 312 (62%) non-participants could be included for analysis. Most frequently, reported reasons for non-participation were time-related or priority-related (36%), including 'did not notice test in mailbox' (13%) and 'forgot' (8%). Other reasons were health-related issues, such as 'severe illness' (9%), or emotional reasons, such as 'family circumstances' (7%). The majority of the reported reasons not to participate reflect low priority for screening. Adding extra instructions and information, and addressing specific concerns through additional interventions should be considered to improve individual decision-making about participation in future CRC population-based screening programs.

  3. Recommendations for cervical cancer screening programs in developing countries: the need for equity and technological development

    Directory of Open Access Journals (Sweden)

    Lazcano-Ponce Eduardo

    2003-01-01

    Full Text Available The cervical cancer screening programs (CCSP have not been very efficient in the developing countries. This explains the need to foster changes on policies, standards, quality control mechanisms, evaluation and integration of new screening alternatives considered as low and high cost, as well as to regulate colposcopy practices and the foundation of HPV laboratories. Cervical cancer (CC is a disease most frequently found in poverty-stricken communities and reflecting a problem of equity at both levels gender and regional, and this, is not only due to social and economic development inequalities, but to the infrastructure and human resources necessary for primary care. For this reason, the CCSP program must be restructured, a to primarily address unprivileged rural and urban areas; b to foster actions aimed at ensuring extensive coverage as well as a similar quality of that coverage in every region; c to use screening strategies in keeping with the availability of health care services. In countries with a great regional heterogeneity, a variety of screening procedures must be regulated and standardized, including a combination of assisted visual inspection, cervical cytology and HPV detection; d regional community intervention must be set up to assess the effectiveness of using HPV detection as an strategy in addition to cervical cytology (pap smear; e the practice of colposcopy must be regulated to prevent the use of it in healthy women at a population level, thus preventing unnecessary diagnosis and treatment which not only are expensive but also causes unnecessary anxiety to women at risk; f the operation of those clinical laboratories using HPV as a detection strategy must likewise be accredited and regulated and g the CCSP program for assuring health care quality should meet the expectations of its beneficiaries, and increase the knowledge in cervical cancer related matters. Finally, though a variety of clinical tests on prophylactic and

  4. Emergency department patient perceptions and preferences on opt-in rapid HIV screening program components

    Science.gov (United States)

    Merchant, Roland C.; Clark, Melissa A.; Seage, George R.; Mayer, Kenneth H.; DeGruttola, Victor G.; Becker, Bruce M.

    2011-01-01

    The aim of this investigation was to assess emergency department (ED) patients’ perceptions and preferences about an opt-in, universal, rapid HIV screening program and identify patient groups who expressed stronger beliefs about components of the testing program. From July 2005 to July 2006, ED patients in the opt-in, universal, rapid HIV screening program were interviewed in person. Multivariable regression models were used to compare participants on their beliefs about the program components. Of the 561 participants, 62.0% had previously been tested for HIV. The majority of participants (58.8%) believed the rapid and standard/conventional HIV tests to be equally accurate, 27.7% believed the rapid test to be less or much less accurate, and 8.7% believed the rapid test to be more or much more accurate. Almost two-thirds (65.1%) favored having a rapid instead of a standard/conventional HIV test, 94.6% wanted the test results within one hour, and 61.3% would be likely or very likely to undergo testing in the ED if it prolonged their ED visit. Almost all (92.5%) believed that their medical care was “not at all” delayed because of being tested, 94.1% believed that testing did “not at all” divert attention from the reason for their ED visit, and 80.9% thought that testing in the ED was “not at all” stressful. In multivariable logistic regression models, males and those with more than 12 years of formal education showed greater concerns about the rapid HIV test’s accuracy. Hispanic/Latinos, participants with governmental insurance, and those previously HIV tested were more apt to be screened for HIV even if testing delayed their ED departure. Overall, participants were highly accepting of the components of this opt-in rapid HIV screening program. However, concerns regarding the accuracy of the rapid HIV test might limit test acceptance and should be addressed during pre-test information procedures. PMID:19283644

  5. Screening of NiFe2O4 Nanoparticles as Oxygen Carrier in Chemical Looping Hydrogen Production

    DEFF Research Database (Denmark)

    Liu, Shuai; He, Fang; Huang, Zhen

    2016-01-01

    The objective of this paper is to systematically investigate the influences of different preparation methods on the properties of NiFe2O4 nanoparticles as oxygen carrier in chemical looping hydrogen production (CLH). The solid state (SS), coprecipitation (CP), hydrothermal (HT), and sol-gel (SG) ...... analyses....

  6. [Dairy cattle pregnancy rate in fixed time artificial insemination program with and without ultrasonic gynecologic screening.

    Directory of Open Access Journals (Sweden)

    Gustavo Fernandes Grillo

    2016-06-01

    Full Text Available To evaluate the pregnancy rate and the importance of ultrasound gynecological screening (US performed prior to fixed time artificial insemination programs (TAI, 120 Girolando cows, over two breeding seasons (2013 and 2014, were divided into two groups: (C / T; n = 58 and without (S / T; n = 62 gynecological screening by ultrasound, using three protocols, and the same for the groups with and without screening. Protocol I - “OvSynch” (OV in which received 0.025 mg of buserelin acetate in D0; 0.15 mg d-cloprostenol on D7; 0.025 mg buserelin acetate D9; It is inseminated at fixed time in D10. Protocol II - “OvSynch” + progesterone (OP4 and III Protocol - “OvSynch” + LH + P4 (OP4LH. Protocols II and III followed the same dosages of “OvSynch” associated with the introduction of intravaginal device containing 1g first use of progesterone in D0 and D7 in withdrawal. In Protocol III, LH replaced buserelin acetate in ovulation induction (D9; 25mg. Gestation diagnosis was made by US 45 days after TAI, and the animals not pregnant were reinseminated as presented heat. Parameters pregnancy rate at TAI (TP, total pregnancy rate (TPT = TAI + Return heat were analyzed by Chi-square or Fisher’s exact with 5% significance level. The use of progesterone favored the pregnancy rate of cyclic and acyclic animals, this has not occurred with LH job as ovulation inductor, providing no increase in pregnancy rates and overall pregnancy rate of dairy cows referred to the rated protocol. The gynecological screening by ultrasonography allowed evaluating the cyclicity of the studied females, indicating that its previous execution to the TAI, can provide good results with the use of better efficiency protocols for TAI programs.

  7. Unintended adverse consequences of electronic health record introduction to a mature universal HIV screening program.

    Science.gov (United States)

    Medford-Davis, Laura N; Yang, Katharine; Pasalar, Siavash; Pillow, M Tyson; Miertschin, Nancy P; Peacock, William F; Giordano, Thomas P; Hoxhaj, Shkelzen

    2016-01-01

    Early HIV detection and treatment decreases morbidity and mortality and reduces high-risk behaviors. Many Emergency Departments (EDs) have HIV screening programs as recommended by the Centers for Disease Control and Prevention. Recent federal legislation includes incentives for electronic health record (EHR) adoption. Our objective was to analyze the impact of conversion to EHR on a mature ED-based HIV screening program. A retrospective pre- and post-EHR implementation cohort study was conducted in a large urban, academic ED. Medical records were reviewed for HIV screening rates from August 2008 through October 2013. On 1 November 2010, a comprehensive EHR system was implemented throughout the hospital. Before EHR implementation, labs were requested by providers by paper orders with HIV-1/2 automatically pre-selected on every form. This universal ordering protocol was not duplicated in the new EHR; rather it required a provider to manually enter the order. Using a chi-squared test, we compared HIV testing in the 6 months before and after EHR implementation; 55,054 patients presented before, and 50,576 after EHR implementation. Age, sex, race, acuity of presenting condition, and HIV seropositivity rates were similar pre- and post-EHR, and there were no major patient or provider changes during this period. Average HIV testing rate was 37.7% of all ED patients pre-, and 22.3% post-EHR, a 41% decline (p < 0.0001), leading to 167 missed new diagnoses after EHR. The rate of HIV screening in the ED decreased after EHR implementation, and could have been improved with more thoughtful inclusion of existing human processes in its design.

  8. Sensorineural and conductive hearing loss in infants diagnosed in the program of universal newborn hearing screening.

    Science.gov (United States)

    Wroblewska-Seniuk, Katarzyna; Dabrowski, Piotr; Greczka, Grazyna; Szabatowska, Katarzyna; Glowacka, Agata; Szyfter, Witold; Mazela, Jan

    2018-02-01

    The aim of this study was to analyze infants diagnosed with sensorineural or conductive hearing deficit and to identify risk factors associated with these defects. A retrospective analysis of infants diagnosed with hearing deficit based on the database of the universal newborn hearing screening program and medical records of the patients. 27 935 infants were covered by the universal neonatal hearing screening program. 109 (0.39%) were diagnosed with hearing deficit and referred for treatment and rehabilitation. 56 (51.4%) children were diagnosed with conductive, 38 (34.9%) with sensorineural and 15 (13.8%) with mixed type of hearing deficit. Children with sensorineural hearing deficit more frequently suffered from hyperbilirubinemia (p conductive hearing loss were more frequently diagnosed with isolated craniofacial anomalies (p hearing deficit occurred almost 3 times more often bilaterally than unilaterally (p hearing deficit, the difference was not significant. In children with conductive and mixed type of hearing loss the impairment was mainly mild while among those with sensorineural hearing deficit in almost 45% it was severe and profound (p hearing screening test by means of otoacoustic emissions and the final diagnosis of hearing deficit we found that the highest agreement rate was observed in children with sensorineural hearing loss (p hearing deficit was similar in children with sensorineural, conductive and mixed type of hearing loss, only hyperbilirubinemia seemed to predispose to sensorineural hearing deficit and isolated craniofacial malformations seemed to be associated with conductive hearing loss. Sensorineural hearing deficit usually occurred bilaterally and was severe or profound, while conductive and mixed type of hearing deficit were most often of mild degree. Most children with the final diagnosis of sensorineural hearing deficit had positive result of hearing screening by means of otoacoustic emissions. Copyright © 2017 Elsevier B.V. All

  9. Implementing and evaluating a program to facilitate chronic disease prevention and screening in primary care: a mixed methods program evaluation.

    Science.gov (United States)

    Manca, Donna Patricia; Aubrey-Bassler, Kris; Kandola, Kami; Aguilar, Carolina; Campbell-Scherer, Denise; Sopcak, Nicolette; O'Brien, Mary Ann; Meaney, Christopher; Faria, Vee; Baxter, Julia; Moineddin, Rahim; Salvalaggio, Ginetta; Green, Lee; Cave, Andrew; Grunfeld, Eva

    2014-10-08

    The objectives of this paper are to describe the planned implementation and evaluation of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER 2) program which originated from the BETTER trial. The pragmatic trial, informed by the Chronic Care Model, demonstrated the effectiveness of an approach to Chronic Disease Prevention and Screening (CDPS) involving the use of a new role, the prevention practitioner. The desired goals of the program are improved clinical outcomes, reduction in the burden of chronic disease, and improved sustainability of the health-care system through improved CDPS in primary care. The BETTER 2 program aims to expand the implementation of the intervention used in the original BETTER trial into communities across Canada (Alberta, Ontario, Newfoundland and Labrador, the Northwest Territories and Nova Scotia). This proactive approach provides at-risk patients with an intervention from the prevention practitioner, a health-care professional. Using the BETTER toolkit, the prevention practitioner determines which CDPS actions the patient is eligible to receive, and through shared decision-making and motivational interviewing, develops a unique and individualized 'prevention prescription' with the patient. This intervention is 1) personalized; 2) addressing multiple conditions; 3) integrated through linkages to local, regional, or national resources; and 4) longitudinal by assessing patients over time. The BETTER 2 program brings together primary care providers, policy/decision makers and researchers to work towards improving CDPS in primary care. The target patient population is adults aged 40-65. The reach, effectiveness, adoption, implementation, maintain (RE-AIM) framework will inform the evaluation of the program through qualitative and quantitative methods. A composite index will be used to quantitatively assess the effectiveness of the prevention practitioner intervention. The CDPS actions

  10. Impact of opportunistic testing in a systematic cervical cancer screening program: a nationwide registry study.

    Science.gov (United States)

    Tranberg, Mette; Larsen, Mette Bach; Mikkelsen, Ellen M; Svanholm, Hans; Andersen, Berit

    2015-07-21

    Systematic screening for precancerous cervical lesions has resulted in decreased incidence and mortality of cervical cancer. However, even in systematic screening programs, many women are still tested opportunistically. This study aimed to determine the spread of opportunistic testing in a systematic cervical cancer screening program, the impact of opportunistic testing in terms of detecting cytological abnormalities and examine the associations between sociodemography and opportunistic testing. A nationwide registry study was undertaken including women aged 23-49 years (n = 807,624) with a cervical cytology between 2010 and 2013. The women were categorised into: 1) screening after invitation; 2) routine opportunistic testing, if they were either tested more than 9 months after the latest invitation or between 2.5 years and 3 years after the latest cervical cytology and 3) sporadic opportunistic testing, if they were tested less than 2.5 years after the latest cervical cytology. Cytological diagnoses of women in each of the categories were identified and prevalence proportion differences (PPD) and 95% confidence intervals (CIs) were used to explore group differences. Associations between sociodemography and undergoing opportunistic testing were established by multinomial logistic regression. In total, 28.8% of the cervical cytologies were due to either routine (20.7%) or sporadic (8.1%) opportunistic testing. Among women undergoing routine opportunistic testing, a larger proportion had high-grade squamous intraepithelial abnormalities than invited women (PPD: 0.6%, 95 % CI: 0.03-1.17%). A similar proportion of cytological abnormalities among women undergoing sporadic opportunistic testing and invited women was found. In multivariate analyses, younger age, being single or a social welfare recipient and residence region (North Denmark) were especially associated with opportunistic testing (routine or sporadic). One fourth of cervical cytologies in this study were

  11. Diagnosis of retinal detachments by a tele-ophthalmology screening program.

    Science.gov (United States)

    McCord, Sarah A; Lynch, Mary G; Maa, April Y

    2018-01-01

    In 2015, a tele-ophthalmology program was undertaken at the Atlanta Veterans Affairs Medical Center to provide screening eye care for veterans in their primary care clinics. Though this program was developed as a screening tool, the availability of these services in primary care clinics has enabled triage of certain acute eye complaints. These case reports describe two patients who were diagnosed with retinal detachments through this program, although their primary care providers had triaged them as requiring non-urgent referrals to the eye clinic. Although many patients are seen for acute ocular complaints in primary care clinics and emergency departments, providers in such settings may lack the ability to adequately examine eyes and thus triage ocular complaints. These cases demonstrate the ability of tele-ophthalmology to assist in diagnosing urgent ocular conditions in primary care clinics. Though tele-ophthalmology has been accepted in some parts of the world, in the United States of America it remains widely underutilized. These cases highlight the ability of tele-ophthalmology to close the gap in acute eye care coverage that exists in the USA, most prominently in rural regions.

  12. A screening program to test and treat for Helicobacter pylori infection: Cost-utility analysis by age, sex and ethnicity.

    Science.gov (United States)

    Teng, Andrea M; Kvizhinadze, Giorgi; Nair, Nisha; McLeod, Melissa; Wilson, Nick; Blakely, Tony

    2017-02-20

    The World Health Organization recommends all countries consider screening for H. pylori to prevent gastric cancer. We therefore aimed to estimate the cost-effectiveness of a H. pylori serology-based screening program in New Zealand, a country that includes population groups with relatively high gastric cancer rates. A Markov model was developed using life-tables and morbidity data from a national burden of disease study. The modelled screening program reduced the incidence of non-cardia gastric cancer attributable to H. pylori, if infection was identified by serology screening, and for the population expected to be reached by the screening program. A health system perspective was taken and detailed individual-level costing data was used. For adults aged 25-69 years old, nation-wide screening for H. pylori was found to have an incremental cost of US$196 million (95% uncertainty interval [95% UI]: $182-$211 million) with health gains of 14,200 QALYs (95% UI: 5,100-26,300). Cost per QALY gained was US$16,500 ($7,600-$38,400) in the total population and 17% (6%-29%) of future gastric cancer cases could be averted with lifetime follow-up. A targeted screening program for Māori only (indigenous population), was more cost-effective at US$8,000 ($3,800-$18,500) per QALY. This modeling study found that H. pylori screening was likely to be cost-effective in this high-income country, particularly for the indigenous population. While further research is needed to help clarify the precise benefits, costs and adverse effects of such screening programs, there seems a reasonable case for policy-makers to give pilot programs consideration, particularly for any population groups with relatively elevated rates of gastric cancer.

  13. Parkinson's and Alzheimer's diseases in Costa Rica: a feasibility study toward a national screening program.

    Science.gov (United States)

    Wesseling, Catharina; Román, Norbel; Quirós, Indiana; Páez, Laura; García, Vilma; Mora, Ana María; Juncos, Jorge L; Steenland, Kyle N

    2013-12-27

    will increase test specificity and reduce administration time. A routine screening program is feasible within the public healthcare system of Costa Rica.

  14. Automated toxicological screening reports of modified Agilent MSD Chemstation combined with Microsoft Visual Basic application programs.

    Science.gov (United States)

    Choe, Sanggil; Kim, Suncheun; Choi, Hyeyoung; Choi, Hwakyoung; Chung, Heesun; Hwang, Bangyeon

    2010-06-15

    Agilent GC-MS MSD Chemstation offers automated library search report for toxicological screening using total ion chromatogram (TIC) and mass spectroscopy in normal mode. Numerous peaks appear in the chromatogram of biological specimen such as blood or urine and often large migrating peaks obscure small target peaks, in addition, any target peaks of low abundance regularly give wrong library search result or low matching score. As a result, retention time and mass spectrum of all the peaks in the chromatogram have to be checked to see if they are relevant. These repeated actions are very tedious and time-consuming to toxicologists. MSD Chemstation software operates using a number of macro files which give commands and instructions on how to work on and extract data from the chromatogram and spectroscopy. These macro files are developed by the own compiler of the software. All the original macro files can be modified and new macro files can be added to the original software by users. To get more accurate results with more convenient method and to save time for data analysis, we developed new macro files for reports generation and inserted new menus in the Enhanced Data Analysis program. Toxicological screening reports generated by these new macro files are in text mode or graphic mode and these reports can be generated with three different automated subtraction options. Text reports have Brief mode and Full mode and graphic reports have the option with or without mass spectrum mode. Matched mass spectrum and matching score for detected compounds are printed in reports by modified library searching modules. We have also developed an independent application program named DrugMan. This program manages drug groups, lists and parameters that are in use in MSD Chemstation. The incorporation of DrugMan with modified macro modules provides a powerful tool for toxicological screening and save a lot of valuable time on toxicological work. (c) 2010 Elsevier Ireland Ltd. All

  15. Tuberculosis in Antiretroviral Treatment Programs in Lower Income Countries: Availability and Use of Diagnostics and Screening

    Science.gov (United States)

    Fenner, Lukas; Ballif, Marie; Graber, Claire; Nhandu, Venerandah; Dusingize, Jean Claude; Cortes, Claudia P.; Carriquiry, Gabriela; Anastos, Kathryn; Garone, Daniela; Jong, Eefje; Gnokoro, Joachim Charles; Sued, Omar; Ajayi, Samuel; Diero, Lameck; Wools-Kaloustian, Kara; Kiertiburanakul, Sasisopin; Castelnuovo, Barbara; Lewden, Charlotte; Durier, Nicolas; Sterling, Timothy R.; Egger, Matthias

    2013-01-01

    Objectives In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB in ART programs in low- and middle-income countries. Methods and findings We surveyed ART programs treating HIV-infected adults in sub-Saharan Africa, Asia and Latin America in 2012 using online questionnaires to collect program-level and patient-level data. Forty-seven sites from 26 countries participated. Patient-level data were collected on 987 adult TB patients from 40 sites (median age 34.7 years; 54% female). Sputum smear microscopy and chest radiograph were available in 47 (100%) sites, TB culture in 44 (94%), and Xpert MTB/RIF in 23 (49%). Xpert MTB/RIF was rarely available in Central Africa and South America. In sites with access to these diagnostics, microscopy was used in 745 (76%) patients diagnosed with TB, culture in 220 (24%), and chest X-ray in 688 (70%) patients. When free of charge culture was done in 27% of patients, compared to 21% when there was a fee (p = 0.033). Corresponding percentages for Xpert MTB/RIF were 26% and 15% of patients (p = 0.001). Screening practices for active disease before starting ART included symptom screening (46 sites, 98%), chest X-ray (38, 81%), sputum microscopy (37, 79%), culture (16, 34%), and Xpert MTB/RIF (5, 11%). Conclusions Mycobacterial culture was infrequently used despite its availability at most sites, while Xpert MTB/RIF was not generally available. Use of available diagnostics was higher when offered free of charge. PMID:24147059

  16. Cost-Effectiveness of Elderly Health Examination Program: The Example of Hypertension Screening

    Directory of Open Access Journals (Sweden)

    Bing-Hwa Deng

    2007-01-01

    Full Text Available The National Health Insurance (NHI and social welfare agencies have implemented the Elderly Health Examination Program (EHEP for years. No study has ever attempted to evaluate whether this program is cost-effective. The purposes of this study were, firstly, to understand the prevalence and incidence rates of hypertension and, secondly, to estimate the cost and effectiveness of the EHEP, focusing on hypertension screening. The data sources were: (1 hypertension and clinical information derived from the 1996 and 1997 EHEP, which was used to generate prevalence and incidence rates of hypertension; and (2 claim data of the NHI that included treatment costs of stroke patients (in-and outpatients. Hypothetical models were used to evaluate the cost-effectiveness of the hypertension screening program in various conditions. Sensitivity analysis was also employed to evaluate the effect of each estimation indicator on the cost and effectiveness of the hypertension screening program. A total of 28.3% of the elderly population in Kaohsiung (25,174 of 88,812 participated in the 1996 EHEP; 14,915 of them participated in the following 1997 EHEP, with a retention rate of 59.3%. Criteria from the Sixth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI (systolic blood pressure/diastolic blood pressure ≥ 160/95mmHg or taking antihypertensive drugs were used; we found that prevalence and incidence rates of hypertension were 24.6% and 6.6%, respectively. Hypertension rates are increasing in the aging process as shown in both prevalence and incidence models. In comparison with non-participants, the prevalence model indicates that each hypertension patient who had attended the EHEP not only saved NT$34,570–34,890 in medical and associated costs, but also increased their lifespan by 128 days. The present findings suggest that the EHEP is a cost-effective program with health and social welfare policy

  17. The Peru Cervical Cancer Screening Study (PERCAPS): the design and implementation of a mother/daughter screen, treat, and vaccinate program in the Peruvian jungle.

    Science.gov (United States)

    Abuelo, Carolina E; Levinson, Kimberly L; Salmeron, Jorge; Sologuren, Carlos Vallejos; Fernandez, Maria Jose Vallejos; Belinson, Jerome L

    2014-06-01

    Peru struggles to prevent cervical cancer (CC). In the jungle, prevention programs suffer from significant barriers although technology exists to detect CC precursors. This study used community based participatory research (CBPR) methods to overcome barriers. The objective was to evaluate the utility of CBPR techniques in a mother-child screen/treat and vaccinate program for CC prevention in the Peruvian jungle. The CC prevention program used self-sampling for human papillomavirus (HPV) for screening, cryotherapy for treatment and the HPV vaccine Gardasil for vaccination. Community health leaders (HL) from around Iquitos participated in a two half day educational course. The HLs then decided how to implement interventions in their villages or urban sectors. The success of the program was measured by: (1) ability of the HLs to determine an implementation plan, (2) proper use of research forms, (3) participation and retention rates, and (4) participants' satisfaction. HLs successfully registered 320 women at soup kitchens, schools, and health posts. Screening, treatment, and vaccination were successfully carried out using forms for registration, consent, and results with minimum error. In the screen/treat intervention 100% of participants gave an HPV sample and 99.7% reported high satisfaction; 81% of HPV + women were treated, and 57% returned for 6-month followup. Vaccine intervention: 98% of girls received the 1st vaccine, 88% of those received the 2nd, and 65% the 3rd. CBPR techniques successfully helped implement a screen/treat and vaccinate CC prevention program around Iquitos, Peru. These techniques may be appropriate for large-scale preventive health-care interventions.

  18. Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population.

    Science.gov (United States)

    Thorsteinsson, Kristina; Ladelund, Steen; Jensen-Fangel, Søren; Katzenstein, Terese L; Johansen, Isik Somuncu; Pedersen, Gitte; Junge, Jette; Helleberg, Marie; Storgaard, Merete; Lebech, Anne-Mette

    2014-05-13

    Women living with HIV (WLWH) are at increased risk of invasive cervical cancer (ICC). International HIV guidelines suggest cervical screening twice the first year after HIV diagnosis and thereafter annually. Adherence to the HIV cervical screening program in Denmark is unknown. We studied women from a population-based, nationwide HIV cohort in Denmark and a cohort of age-matched females from the general population. Screening behaviour was assessed from 1999-2010. Adjusted odds ratios (OR's) for screening attendance in the two cohorts and potential predictors of attendance to guidelines were estimated. Pathology specimens were identified from The Danish Pathology Data Bank. We followed 1143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. The first year after HIV diagnosis 2.6% of WLWH obtained the recommended two cervical cytologies. During the different calendar intervals throughout the study period between 29-46% of WLWH followed the HIV cervical screening guidelines. Adjusted OR's of attendance to the general population screening program for WLWH aged 30, 40 and 50 years, compared to controls, were 0.69 (95% CI: 0.56-0.87), 0.67 (0.55-0.80) and 0.84 (0.61-1.15). Predictors of attendance to the HIV cervical screening program were a CD4 count > 350 cells/μL and HIV RNA < 500 copies/mL. Calendar period after 2002 and HIV RNA < 500 copies/mL predicted attendance to the general population cervical screening program. The majority of WLWH do not follow the HIV guidelines for cervical screening. We support the idea of cytology as part of an annual review and integration of HIV care and cervical screening in a single clinic setting.

  19. Effect of intervention programs in schools to reduce screen time: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Roberta Roggia Friedrich

    Full Text Available OBJECTIVE:to evaluate the effects of intervention program strategies on the time spent on activities such as watching television, playing videogames, and using the computer among schoolchildren.SOURCES:a search for randomized controlled trials available in the literature was performed in the following electronic databases: PubMed, Lilacs, Embase, Scopus, Web of Science, and Cochrane Library using the following Keywords randomized controlled trial, intervention studies, sedentary lifestyle, screen time, and school. A summary measure based on the standardized mean difference was used with a 95% confidence interval.DATA SYNTHESIS: a total of 1,552 studies were identified, of which 16 were included in the meta-analysis. The interventions in the randomized controlled trials (n = 8,785 showed a significant effect in reducing screen time, with a standardized mean difference (random effect of: -0.25 (-0.37, -0.13, p < 0.01.CONCLUSION:interventions have demonstrated the positive effects of the decrease of screen time among schoolchildren.

  20. A population-wide screening and tailored intervention platform for eating disorders on college campuses: the healthy body image program.

    Science.gov (United States)

    Jones, Megan; Kass, Andrea E; Trockel, Mickey; Glass, Alan I; Wilfley, Denise E; Taylor, C Barr

    2014-01-01

    This article presents a new approach to intervention for eating disorders and body image concerns on college campuses, using a model of integrated eating disorder screening and intervention. Formative data on implementation feasibility are presented. College students enrolled at 2 universities between 2011 and 2012. The Healthy Body Image program is an evidence-based screening and intervention platform, enacted via community and online resources. An online screen was used to identify students at varying levels of risk or eating disorder symptom status; responses were used to direct students to universal or targeted online interventions or further evaluation. Universal prevention programs to improve healthy weight regulation and body image culture were offered to all students. Formative data from 1,551 students illustrates the application of this model. The Healthy Body Image program is feasible to deliver and provides a comprehensive system of screening, evidence-based intervention, and community culture change.

  1. Aircraft Carriers

    DEFF Research Database (Denmark)

    Nødskov, Kim; Kværnø, Ole

    as their purchases of aircraft carrier systems, makes it more than likely that the country is preparing such an acquisition. China has territorial disputes in the South China Sea over the Spratly Islands and is also worried about the security of its sea lines of communications, by which China transports the majority...... of its foreign trade, as well as its oil imports, upon which the country is totally dependent. China therefore has good reasons for acquiring an aircraft carrier to enable it to protect its national interests. An aircraft carrier would also be a prominent symbol of China’s future status as a great power......, then the country will also acquire the capability to project military power into the region beyond Taiwan, which it does not possess today. In this way, China will have the military capability to permit a change of strategy from the mainly defensive, mainland, Taiwan-based strategy to a more assertive strategy...

  2. NEWBORN SCREENING PROGRAM: WHY TO COLLECT IN HIGH THE HOSPITAL ONE?

    Directory of Open Access Journals (Sweden)

    Maria Ribeiro Lacerda

    2003-12-01

    Full Text Available The National Program of Newborn Screening for research of the Phenylketonuria, Congenital Hypothyroidism,Cystic Fibrosis, Sickle Cell Disease and other Hemoglobinopathies, it has as objective precociously todetect and to treat illnesses that, if prevented, prevent sequels as the mental deficiency and others. We intend,through this article, to awake the attention of the health professionals, mainly of the nurses, who act in the attendanceof the just-been newborn, of the gestante, the woman in labor and in puerperium, on the importance of theprecocious diagnosis of the diseases searched in the Program, with primordial purposes to assist the suckle for itsgood physical, neurological, psychological and intellectual development, besides offering to familiar the o geneticadvise. The examination gratuitous and is supported by law, and so that the prevention is effective, all the Maternitiesmust always carry through the collections of sample of blood of the heel of the high baby in the hospital one.

  3. Comparison between different colon cleansing products for screening colonoscopy. A noninferiority trial in population-based screening programs in Italy.

    Science.gov (United States)

    Zorzi, Manuel; Valiante, Flavio; Germanà, Bastianello; Baldassarre, Gianluca; Coria, Bartolomea; Rinaldi, Michela; Heras Salvat, Helena; Carta, Alessandra; Bortoluzzi, Francesco; Cervellin, Erica; Polo, Maria Luisa; Bulighin, Gianmarco; Azzurro, Maurizio; Di Piramo, Daniele; Turrin, Anna; Monica, Fabio

    2016-03-01

    The high volume and poor palatability of 4 L of polyethylene glycol (PEG)-based bowel cleansing preparation required before a colonoscopy represent a major obstacle for patients. The aim of this study was to compare two low volume PEG-based preparations with standard 4 L PEG in individuals with a positive fecal immunochemical test (FIT) within organized screening programs in Italy. A total of 3660 patients with a positive FIT result were randomized to receive, in a split-dose regimen, 4 L PEG or 2 L PEG plus ascorbate (PEG-A) or 2 L PEG with citrate and simethicone plus bisacodyl (PEG-CS). The noninferiority of the low volume preparations vs. 4 L PEG was tested through the difference in proportions of adequate cleansing. A total of 2802 patients were included in the study. Adequate bowel cleansing was achieved in 868 of 926 cases (93.7 %) in the 4 L PEG group, in 872 out of 911 cases in the PEG-A group (95.7 %, difference in proportions  + 1.9 %, 95 % confidence interval [CI]  - 0.1 to 3.9), and in 862 out of 921 cases in the PEG-CS group (93.6 %, difference in proportions  - 0.2 %, 95 %CI  - 2.4 to 2.0). Bowel cleansing was adequate in 95.5 % of cases when the preparation-to-colonoscopy interval was between 120 and 239 minutes, whereas it dropped to 83.3 % with longer intervals. Better cleansing was observed in patients with regular bowel movements (95.6 %) compared with those with diarrhea (92.4 %) or constipation (90.8 %). Low volume PEG-based preparations administered in a split-dose regimen guarantee noninferior bowel cleansing compared with 4 L PEG. Constipated patients require a personalized preparation. EudraCT 2012 - 003958 - 82. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Association Between Socioeconomic Status and Participation in Colonoscopy Screening Program in First Degree Relatives of Colorectal Cancer Patients.

    Science.gov (United States)

    Chouhdari, Arezoo; Yavari, Parvin; Pourhoseingholi, Mohammad Amin; Sohrabi, Mohammad-Reza

    2016-04-01

    Approximately 15% to 25% of colorectal cancer (CRC) cases have positive family history for disease. Colonoscopy screening test is the best way for prevention and early diagnosis. Studies have found that first degree relatives (FDRs) with low socioeconomic status are less likely to participate in colonoscopy screening program. The aim of this study is to determine the association between socioeconomic status and participation in colonoscopy screening program in FDRs. This descriptive cross-sectional, study has been conducted on 200 FDRs who were consulted for undergoing colonoscopy screening program between 2007 and 2013 in research institute for gastroenterology and liver disease of Shahid Beheshti University of Medical Sciences, Tehran, Iran. They were interviewed via phone by a valid questionnaire about socioeconomic status. For data analysis, chi-square, exact fisher and multiple logistic regression were executed by SPSS 19. The results indicated 58.5% participants underwent colonoscopy screening test at least once to the time of the interview. There was not an association between participation in colonoscopy screening program and socioeconomic status to the time of the interview in binomial analysis. But statistical significance between intention to participate and educational and income level were found. We found, in logistic regression analysis, that high educational level (Diploma and University degree in this survey) was a predictor to participate in colonoscopy screening program in FDRs. According to this survey low socioeconomic status is an important factor to hinder participation of FDRs in colonoscopy screening program. Therefore, planned interventions for elevation knowledge and attitude in FDRs with low educational level are necessary. Also, reducing colonoscopy test costs should be a major priority for policy makers.

  5. Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Cuadros JA

    2015-06-01

    Full Text Available Jorge A Cuadros Optometry/Vision Science, University of California, Berkeley, CA, USA Abstract: Diabetes is the main cause of blindness among working age adults, although treatment is highly effective in preventing vision loss. Eye examinations are recommended on a yearly basis for most patients for timely detection of retinal disease. Telemedicine-based diabetic retinopathy screening (TMDRS programs have been developed to identify patients with sight-threatening diabetic eye disease because patients are often noncompliant with recommended live eye examinations. This article reviews the cost-effectiveness of the various forms of TMDRS. A review of relevant articles, mostly published since 2008, shows that societal benefits generally outweigh the costs of TMDRS. However, advances in technology to improve efficacy, lower costs, and broaden screening to other sight-threatening conditions, such as glaucoma and refractive error, are necessary to improve the sustainability of TMDRS within health care organizations. Patient satisfaction with these telemedicine programs is generally high. New models of shared care with primary care providers and staff are emerging to improve patient engagement and follow-up care when individuals are found to have sight-threatening eye disease. TMDRS programs are growing and provide valuable clinical benefit. The cost-utility is currently well proven in locations with limited access to regular eye care services, such as rural areas, poor communities, and prison systems; however, improvements over time are necessary for these programs to be cost-effective in mainstream medical settings in the future. Keywords: telemedicine, diabetes, retinopathy, retinal imaging

  6. Education and screening for chronic kidney disease in Indian youth: pilot program results

    Directory of Open Access Journals (Sweden)

    Rao PS

    2017-04-01

    Full Text Available Panduranga S Rao,1 Julie A Wright Nunes,1 Brenda W Gillespie,2 Rachel L Perlman,1 Rajan Ravichandran3 1Division of Nephrology, Department of Internal Medicine, University of Michigan Health System, 2Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA; 3Department of Nephrology, Madras Institute of Nephrology, Madras Institute of Orthopedics and Trauma Hospitals, Chennai, India Background: There is a paucity of information on kidney education and screening programs in Indian youth.Methods: Participants (n=2,158 from Chennai colleges were educated about the kidneys and chronic kidney disease (CKD and screened in a pilot program from April to May 2013. This entailed: 1 a presentation and educational video and 2 an on-site assessment of weight, blood pressure, and demographic information. Urinalysis (UA kits were distributed and returned in ≤48 hours. We examined participant characteristics and their association with dipstick proteinuria using logistic regression.Results: The mean (standard deviation [SD] age was 18.9 (1.6 years, and 1,451 (68% were men. Mean (SD body mass index (BMI was 21.9 (4.3 kg/m2; 745 (36% had a BMI consistent with being overweight or obese. Mean (SD systolic blood pressure (SBP was 118.7 (13.1 mm Hg, and 94 (5% of the participants had SBP ≥140. Mean (SD diastolic blood pressure (DBP was 70.9 (11.4 mm Hg, with 119 participants (6% having ≥90 mm Hg. A total of 136 participants had glycosuria (UA≥1+ and 120 (6% had proteinuria (UA≥1+. In unadjusted analyses, sex (odds ratio [OR]=1.64 [confidence interval, CI 1.06–2.55]; p=0.026 men vs. women and age (OR=1.13 per year [CI 1.01–1.26]; p=0.032 were significantly associated with proteinuria. In the analysis adjusted for age, sex, SBP, DBP, glycosuria, and BMI, age remained independently associated with higher odds for proteinuria (OR=1.14 per year [1.02–1.29]; p=0.026. Males showed a trend of higher risk compared

  7. Application of Adverse Outcome Pathways to U.S. EPA's Endocrine Disruptor Screening Program.

    Science.gov (United States)

    Browne, Patience; Noyes, Pamela D; Casey, Warren M; Dix, David J

    2017-09-01

    The U.S. EPA's Endocrine Disruptor Screening Program (EDSP) screens and tests environmental chemicals for potential effects in estrogen, androgen, and thyroid hormone pathways, and it is one of the only regulatory programs designed around chemical mode of action. This review describes the EDSP's use of adverse outcome pathway (AOP) and toxicity pathway frameworks to organize and integrate diverse biological data for evaluating the endocrine activity of chemicals. Using these frameworks helps to establish biologically plausible links between endocrine mechanisms and apical responses when those end points are not measured in the same assay. Pathway frameworks can facilitate a weight of evidence determination of a chemical's potential endocrine activity, identify data gaps, aid study design, direct assay development, and guide testing strategies. Pathway frameworks also can be used to evaluate the performance of computational approaches as alternatives for low-throughput and animal-based assays and predict downstream key events. In cases where computational methods can be validated based on performance, they may be considered as alternatives to specific assays or end points. A variety of biological systems affect apical end points used in regulatory risk assessments, and without mechanistic data, an endocrine mode of action cannot be determined. Because the EDSP was designed to consider mode of action, toxicity pathway and AOP concepts are a natural fit. Pathway frameworks have diverse applications to endocrine screening and testing. An estrogen pathway example is presented, and similar approaches are being used to evaluate alternative methods and develop predictive models for androgen and thyroid pathways. https://doi.org/10.1289/EHP1304.

  8. Retinal photography screening programs to prevent vision loss from diabetic retinopathy in rural and urban Australia: a review.

    Science.gov (United States)

    Tapp, Robyn J; Svoboda, Jean; Fredericks, Bronwyn; Jackson, A Jonathan; Taylor, Hugh R

    2015-02-01

    This review assessed the effectiveness of diabetic retinopathy (DR) screening programs, using retinal photography in Australian urban and rural settings, and considered implications for public health strategy and policy. An electronic search of MEDLINE, PubMed, and Embase for studies published between 1 January 1996 and the 30 June 2013 was undertaken. Key search terms were "diabetic retinopathy," "screening," "retinal photography" and "Australia." Twelve peer-reviewed publications were identified. The 14 DR screening programs identified from the 12 publications were successfully undertaken in urban, rural and remote communities across Australia. Locations included a pathology collection center, and Indigenous primary health care and Aboriginal community controlled organizations. Each intervention using retinal photography was highly effective at increasing the number of people who underwent screening for DR. The review identified that prior to commencement of the screening programs a median of 48% (range 16-85%) of those screened had not undergone a retinal examination within the recommended time frame (every year for Indigenous people and every 2 years for non-Indigenous people in Australia). A median of 16% (range 0-45%) of study participants had evidence of DR. This review has shown there have been many pilot and demonstration projects in rural and urban Australia that confirm the effectiveness of retinal photography-based screening for DR.

  9. Calvert Cliffs Nuclear Power Plant Life Cycle Management/License Renewal Program: System, structure, and component screening. Final report

    International Nuclear Information System (INIS)

    Doroshuk, B.W.; Tilden, B.M.

    1994-09-01

    Central to the Life Cycle Management (LCM) Program for the Calvert Cliffs Nuclear Plant is its Integrated Plant Assessment (IPA) process; a comprehensive, systematic evaluation of the effectiveness of age-related degradation management for the plant's important systems, structures, and components. The first step in this process is the screening of functionally important systems, structures that warrant further evaluation of aging issues. A detailed method and procedures for conducting this screening have been developed and thoroughly tested. The development and application of these procedures at Calvert Cliffs should permit other utilities to avoid implementation problems and avoid substantial front-end development costs. The IPA process is initiated by a screening step that identifies important systems, structures, and components for further evaluation. This report contains the screening methodology, provides procedures for System Level Screening and Component Level Screening, and summarizes results for five systems that represent a wide range of use. These are the Reactor Coolant System, Compressed Air System, Saltwater Cooling System, Electrical 4 Kv Transformers and Buses, and the Reactor Protective System. Examples of component screening are included for the Reactor Coolant System. These screening results show how to determine which equipment's maintenance programs should be checked for degradation management effectiveness

  10. An In-Depth Survey of the Screening and Assessment Practices of Highly Regarded Adolescent Substance Abuse Treatment Programs

    Science.gov (United States)

    Gans, Jeremy; Falco, Mathea; Schackman, Bruce R.; Winters, Ken C.

    2010-01-01

    Aims: To examine the quality of screening and assessment practices at some of the most highly regarded adolescent substance use treatment programs in the United States. Methods: Between March and September 2005, telephone surveys were administered to directors of highly regarded programs. Several different publications and databases were then used…

  11. Screening computer-assisted dosage programs for anticoagulation with warfarin and other vitamin K antagonists: minimum safety requirements for individual programs

    DEFF Research Database (Denmark)

    Poller, L; Roberts, C; Ibrahim, S

    2009-01-01

    Based on the results of the previous European Action on Anticoagulation (EAA) multicenter study, a simplified minimum procedure is described for screening the safety and effectiveness of marketed programs for dosage of oral anticoagulant drugs (vitamin K antagonists). The aim was to demonstrate n...... study, that is, 57.5%. The simplified procedure proposed, although not an absolute guide to safety, is designed to screen against gross unreliability of a test program, without the need to repeat a massive clinical endpoint study for each and every program....

  12. Cost-effectiveness and budget impact analysis of a population-based screening program for colorectal cancer.

    Science.gov (United States)

    Pil, L; Fobelets, M; Putman, K; Trybou, J; Annemans, L

    2016-07-01

    Colorectal cancer (CRC) is one of the leading causes of cancer mortality in Belgium. In Flanders (Belgium), a population-based screening program with a biennial immunochemical faecal occult blood test (iFOBT) in women and men aged 56-74 has been organised since 2013. This study assessed the cost-effectiveness and budget impact of the colorectal population-based screening program in Flanders (Belgium). A health economic model was conducted, consisting of a decision tree simulating the screening process and a Markov model, with a time horizon of 20years, simulating natural progression. Predicted mortality and incidence, total costs, and quality-adjusted life-years (QALYs) with and without the screening program were calculated in order to determine the incremental cost-effectiveness ratio of CRC screening. Deterministic and probabilistic sensitivity analyses were conducted, taking into account uncertainty of the model parameters. Mortality and incidence were predicted to decrease over 20years. The colorectal screening program in Flanders is found to be cost-effective with an ICER of 1681/QALY (95% CI -1317 to 6601) in males and €4,484/QALY (95% CI -3254 to 18,163). The probability of being cost-effective given a threshold of €35,000/QALY was 100% and 97.3%, respectively. The budget impact analysis showed the extra cost for the health care payer to be limited. This health economic analysis has shown that despite the possible adverse effects of screening and the extra costs for the health care payer and the patient, the population-based screening program for CRC in Flanders is cost-effective and should therefore be maintained. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  13. Perinatal depression screening in a Women, Infants, and Children (WIC) program: perception of feasibility and acceptability among a multidisciplinary staff.

    Science.gov (United States)

    Tabb, Karen M; Choi, Shinwoo; Pineros-Leano, Maria; Meline, Brandon; McDonald, Hellen G; Kester, Rachel; Huang, Hsiang

    2015-01-01

    Best practices for addressing women's mental health and screening for depression in public health clinics are not available. Clinic staff are often responsible for screening for depression; however, few studies examine staff perceptions on feasibility and acceptability of using perinatal screening for mood disorders in ethnically diverse public health clinics. During December 2012, we conducted four focus groups using a semistructured interview guide with public health clinic staff of varying disciplines (n=25) in a Special Supplemental Nutrition Program for Women, Infants, and Children. All interviews were audio recorded and analyzed using thematic analysis. We found five descriptive themes related to acceptability and feasibility of screening for perinatal depression in a public health clinic. The main themes include (1) literacy barriers, (2) need for referrals and follow-up with outside services, (3) training and capacity needs, (4) stigma of depression, and (5) location and privacy of screening. Although multiple barriers to universal depression screening in a public health clinic were identified, participants found value in practice of screening low-income women for depression. Factors for facilitating implementation of systematic depression screening in a public health clinic have been identified. Implications discuss how policy makers and public health clinic administrators can improve the universal depression screening process. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities.

    Science.gov (United States)

    DeGregorio, Geneva; Manga, Simon; Kiyang, Edith; Manjuh, Florence; Bradford, Leslie; Cholli, Preetam; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Sheldon, Lisa Kennedy; Nulah, Kathleen; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

    2017-07-01

    Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. The WHP provides fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment for reproductive tract infection (RTI). Here, we document the strengths and challenges of the WHP screening program and the unique aspects of the WHP model, including a fee-for-service payment system and the provision of other women's health services. We retrospectively reviewed WHP medical records from women who presented for cervical cancer screening from 2007-2014. In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment for RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. The WHP's experience using a fee-for-service model for cervical cancer screening demonstrates that in Cameroon VIA-DC is acceptable, feasible, and scalable and can be nearly self-sustaining. Integrating other women's health services enabled women to address additional health care needs. The Cameroon Baptist Convention Health Services Women's Health Program successfully implemented a nurse-led, fee-for-service cervical cancer screening program using visual inspection with acetic acid-enhanced by digital cervicography in

  15. Do school physical activity policies and programs have a role in decreasing multiple screen time behaviours among youth?

    Science.gov (United States)

    Katapally, Tarun R; Laxer, Rachel E; Qian, Wei; Leatherdale, Scott T

    2018-05-01

    Screen time in youth has been associated with a wide range of poor health outcomes. Evidence indicates the need to develop physical activity (PA) school policies and programs that are aimed at decreasing youth screen time behaviours. This study aims to understand the association between PA policies and programs embedded into the functioning of 89 schools across two provinces in Canada and multiple screen time behaviours. As part of the COMPASS Study, a total of 44,861 youth aged between 13 and 18years and belonging to 89 schools in two Canadian provinces completed a validated questionnaire for health behaviours and outcomes data. PA policies and programs were measured using the School Policies and Practices Questionnaire, completed by the relevant school administrator. Participation in before-school, noon hour, or after-school intramural programs, participation in varsity sports, and access to indoor areas of PA during non-instructional time, was associated with significantly lower multiple screen time behaviours across both provinces. With exposure to multiple electronic and digital devices only predicted to increase among youth in the future, there is a need to conceptualize and integrate school-based screen time reducing PA policies and programs into the regular functioning of the schools. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Patient and Clinician Perspectives on Shared Decision-making in Early Adopting Lung Cancer Screening Programs: a Qualitative Study.

    Science.gov (United States)

    Wiener, Renda Soylemez; Koppelman, Elisa; Bolton, Rendelle; Lasser, Karen E; Borrelli, Belinda; Au, David H; Slatore, Christopher G; Clark, Jack A; Kathuria, Hasmeena

    2018-02-21

    Guidelines recommend, and Medicare requires, shared decision-making between patients and clinicians before referring individuals at high risk of lung cancer for chest CT screening. However, little is known about the extent to which shared decision-making about lung cancer screening is achieved in real-world settings. To characterize patient and clinician impressions of early experiences with communication and decision-making about lung cancer screening and perceived barriers to achieving shared decision-making. Qualitative study entailing semi-structured interviews and focus groups. We enrolled 36 clinicians who refer patients for lung cancer screening and 49 patients who had undergone lung cancer screening in the prior year. Participants were recruited from lung cancer screening programs at four hospitals (three Veterans Health Administration, one urban safety net). Using content analysis, we analyzed transcripts to characterize communication and decision-making about lung cancer screening. Our analysis focused on the recommended components of shared decision-making (information sharing, deliberation, and decision aid use) and barriers to achieving shared decision-making. Clinicians varied in the information shared with patients, and did not consistently incorporate decision aids. Clinicians believed they explained the rationale and gave some (often purposely limited) information about the trade-offs of lung cancer screening. By contrast, some patients reported receiving little information about screening or its trade-offs and did not realize the CT was intended as a screening test for lung cancer. Clinicians and patients alike did not perceive that significant deliberation typically occurred. Clinicians perceived insufficient time, competing priorities, difficulty accessing decision aids, limited patient comprehension, and anticipated patient emotions as barriers to realizing shared decision-making. Due to multiple perceived barriers, patient

  17. PS2-01: A Multimodal Reminder Program Improves Routine Mammogram Screening Rates

    Science.gov (United States)

    Feldstein, Adrianne C; Perrin, Nancy; Rosales, Gabriella; Schneider, Jennifer; Rix, Mary M; Morgan, Gail; Keels, Kara; Lassi, Michael; Schoap, Stephanie; Glasgow, Russell E.

    2010-01-01

    Background/Aims: This retrospective cohort study evaluated the effectiveness of implementation and maintenance phases of a multimodal reminder program to improve routine mammography screening. Methods: The program used automated reminder calls and was conducted at Kaiser Permanente Northwest, a nonprofit group-model HMO with an electronic medical record. Study participants were women HMO members aged 42 or older who were 20 months past their last mammogram (index date) during three time periods: pre-reminder (2004), post-reminder implementation phase (2006), and post-reminder maintenance phase (Jan 1–July 1, 2007) (Total n=35,104). The program targeted women aged 50–69 with a mammogram due followed by post card, followed by up to 2 automated phone calls and 1 live call for non-responders. Women aged 42–49 (for whom clinical guidelines also recommend mammography) receiving no reminders constituted the primary comparison group (CG 1). The primary outcome was time until mammogram in the 10 months following the index date. Results: Pre-reminder, 63.4% of targeted women completed a mammogram; this number increased to 75.4% in the post-reminder implementation; 80.6% completed a mammogram in the maintenance phases. After controlling for demographics and clinic visits, intervention women were 1.51 times more likely to complete a mammogram (CI 1.40–1.62) post-reminder implementation, compared to CG 1. The effect was maintained in 2007 (HR 1.81 [CI 1.65–1.99]). Women of other races (Asian, Pacific Island, or Native American) were less likely to complete a mammogram, as were those taking a greater number of medications. Women with a college education, who were married, or who had visited a primary care provider or gynecologist during follow-up were more likely to complete a mammogram. Conclusions: We found that a multimodal reminder system could be effectively implemented and maintained in a large health system. If widely implemented, this intervention could

  18. School program for screening students at risk for diabetes: the School Nurse Childhood Obesity Prevention Education program.

    Science.gov (United States)

    Schantz, Shirley; Bobo, Nichole

    2009-07-01

    Accurate height and weight and BMI assessment by the school nurse is the first step in identifying students at risk for developing type 2 diabetes or other health consequences. Additional screening for children at or above the 95th percentile for BMI identifies those students most at risk. MAP affiliate sites indicate that when this assessment and communication is done in a private, sensitive, and caring manner--with emphasis on the health of the child-parents/ guardians are receptive to the information. School nurses, with the knowledge and skills provided by the S.C.O.P.E. program, alert parents/guardians to address their children's health risks and contact their health care providers. School nurses are also taught how they can provide guidance for school leadership and community coalitions to incorporate effective changes to food and physical activity offerings to students. The S.C.O.P.E. program can enhance the role of the school nurse in the global fight against childhood obesity so school-age children are healthy and ready to learn.

  19. [Efficacy of the population-based pilot colorectal screening program. Hungary, Csongrád county, 2015].

    Science.gov (United States)

    Rutka, Mariann; Molnár, Tamás; Bor, Renáta; Farkas, Klaudia; Fábián, Anna; Győrfi, Márk; Bálint, Anita; Milassin, Ágnes; Szűcs, Mónika; Tiszlavicz, László; Nagy, Ferenc; Szepes, Zoltán

    2017-10-01

    In Hungary, a nationwide colorectal screening program is about to be introduced in order to improve the extremely high mortality rate of colorectal cancer (CRC). The aim of our study was to summarize experiences and assess short-term efficacy of the population-based pilot colorectal screening program in 2015 in Csongrád County, Hungary. Asymptomatic individuals between the ages of 50 and 70 with average risk of colorectal cancer participated in the program that was based on the two-step screening method (i.e. immune fecal blood test and colonoscopy). The short-term efficacy of the screening program was assessed as the change in total CRC incidence and initial tumor stage in the screening year (2015) compared to a control year (2013) in Szeged and its surroundings. Participation rate, positive predictive value of the screening methods and tumor detection rate was assessed. 22,130 individuals were invited, the participation rate was 46.4%. Immune fecal blood test proved to be non-negative in 1,343 cases (13%), screening colonoscopy was performed in 766 of them (7.5%). Total colonoscopy was performed in 711 individuals. Based on the reports, adenoma was detected in 358 (50.3%) and malignancy in 42 (5.9%) individuals. In the background population, the incidence of colon cancer was significantly higher (183 vs. 228; p = 0.026) and was diagnosed at significantly earlier stage (p = 0.002). Lymph node involvement was significantly lower in 2015 (48.3% vs. 37.1%; p = 0.049). The Csongrád county population-based colorectal cancer screening was evidently successful on the short term considering participation rate, and the changes in CRC incidence and stage, thus its national extension is necessary. Orv Hetil. 2017; 158(42): 1658-1667.

  20. From cancer screening to treatment: service delivery and referral in the National Breast and Cervical Cancer Early Detection Program.

    Science.gov (United States)

    Miller, Jacqueline W; Hanson, Vivien; Johnson, Gale D; Royalty, Janet E; Richardson, Lisa C

    2014-08-15

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies. © 2014 American Cancer Society.

  1. Evaluation of Cannabidiol in Animal Seizure Models by the Epilepsy Therapy Screening Program (ETSP).

    Science.gov (United States)

    Klein, Brian D; Jacobson, Catherine A; Metcalf, Cameron S; Smith, Misty D; Wilcox, Karen S; Hampson, Aidan J; Kehne, John H

    2017-07-01

    Cannabidiol (CBD) is a cannabinoid component of marijuana that has no significant activity at cannabinoid receptors or psychoactive effects. There is considerable interest in CBD as a therapy for epilepsy. Almost a third of epilepsy patients are not adequately controlled by clinically available anti-seizure drugs (ASDs). Initial studies appear to demonstrate that CBD preparations may be a useful treatment for pharmacoresistant epilepsy. The National Institute of Neurological Disorders and Stroke (NINDS) funded Epilepsy Therapy Screening Program (ETSP) investigated CBD in a battery of seizure models using a refocused screening protocol aimed at identifying pharmacotherapies to address the unmet need in pharmacoresistant epilepsy. Applying this new screening workflow, CBD was investigated in mouse 6 Hz 44 mA, maximal electroshock (MES), corneal kindling models and rat MES and lamotrigine-resistant amygdala kindling models. Following intraperitoneal (i.p.) pretreatment, CBD produced dose-dependent protection in the acute seizure models; mouse 6 Hz 44 mA (ED 50 164 mg/kg), mouse MES (ED 50 83.5 mg/kg) and rat MES (ED 50 88.9 mg/kg). In chronic models, CBD produced dose-dependent protection in the corneal kindled mouse (ED 50 119 mg/kg) but CBD (up to 300 mg/kg) was not protective in the lamotrigine-resistant amygdala kindled rat. Motor impairment assessed in conjunction with the acute seizure models showed that CBD exerted seizure protection at non-impairing doses. The ETSP investigation demonstrates that CBD exhibits anti-seizure properties in acute seizure models and the corneal kindled mouse. However, further preclinical and clinical studies are needed to determine the potential for CBD to address the unmet needs in pharmacoresistant epilepsy.

  2. Effect of socioeconomic status on cardio-respiratory fitness: data from a health screening program.

    Science.gov (United States)

    Shmueli, Hezzy; Rogowski, Ori; Toker, Sharon; Melamed, Shmuel; Leshem-Rubinow, Eran; Ben-Assa, Eyal; Shapira, Itzhak; Berliner, Shlomo; Steinvil, Arie

    2014-06-01

    Lower socioeconomic status (SES) is associated with reduced cardio-respiratory fitness (CRF) and predicts adverse cardiovascular outcomes. We questioned whether this association remains significant among an apparently healthy population with a presumed higher SES. This cross-sectional study enrolled attendees of a health screening program between September 2002 and November 2010. Linear regression models included the metabolic equivalents achieved during an exercise treadmill stress test as the dependent variable and adjusted for self-reported SES parameters (level of education, occupational status, financial strain and a combined variable), cardiovascular risk factors, as well as to multiple potential confounders. Data on 8471 individuals (5463 men and 3008 women) with a mean (SD) age of 44 (11) years were collected. We found a statistically significant difference in mean exercise capacity between the categories of SES, especially for the level of education and occupation, when adjusted for age, sex, cardiovascular risk factors, SES variables and multiple confounders. Multiple factors affect CRF in apparently healthy screened individuals. When adjusted for those factors, SES correlates with CRF even within a more specific highly educated cohort.

  3. Breast cancer correlates in a cohort of breast screening program participants in Riyadh, KSA

    International Nuclear Information System (INIS)

    Al-Amri, F.; Saeedi, M.Y.; Al-Tahan, F.M.; Alomary, S.A.; Kassim, K.A.; Ali, A.M.; Mostafa Arafa, M.; Ibrahim, A.K.; Ali, A.M.

    2015-01-01

    Background: Breast cancer is the first cancer among females in the Kingdom of Saudi Arabia, accounting for 27.4% of all newly diagnosed female cancers in 2010. There are several risk factors affecting the incidence of breast cancer where some factors influence the risk more than the others. Aim: We aimed to identify the different risk factors related to breast cancer among females participating in the breast-screening program in Riyadh, KSA. Methods: Based on data from phase-I of the breast-screening program, a case-control study was conducted on women living in Riyadh, KSA. A sample of 349 women (58 cases and 290 controls) was recruited to examine the different breast cancer correlates. Multivariate regression model was built to investigate the most important risk factors. Results: The mean age of cases was 48.5 ± 7.1 years. Age at marriage, number of pregnancy, age at menopause, oral contraceptive pills, breast feeding and family history of breast cancer in first-degree relative were identified as the most important correlates among the studied cohort. Conclusions: The findings of the current work suggested that age at marriage, age at menopause ≥50 years, and 1st degree family history of breast cancer were risk factors for breast cancer, while, age at menopause<50 years, number of pregnancies and practicing breast feeding were protective factors against breast cancer. There was no effect of body mass index or physical inactivity. Further studies are needed to explore the hereditary, familial and genetic background risk factors in Saudi population.

  4. The rationale behind screening programs for early detection of hepatitis C virus

    Directory of Open Access Journals (Sweden)

    Małgorzata Leźnicka

    2014-10-01

    Full Text Available Background: The objective of the study was to collect the data on undetected hepatitis C virus (HCV in the frequently hospitalized residents of the Kujawsko-Pomorskie Voivodeship. Material and Methods: The analysis focused on empirical data. The research was conducted in 2013 among 6332 citizens of the Kujawsko-Pomorskie Voivodeship who had been hospitalized at least twice. The blood was tested for the presence of anti-HCV antibodies. The diagnostic survey with an anonymous questionnaire was developed and used for the purpose of the study. For the statistical analysis Statistica 10.0 was used. The hypothesis was verified using the Mann- -Whitney U test and Chi2 test of independence. A level of statistical significance was assumed at α = 0.05. The results were considered to be statistically significant if the probability fulfilled the inequality of p < 0.05. Results: Positive anti-HCV antigens were detected in 91 (1.44% examined individuals. The relationship was found between blood transfusions provided before 1992, the use of intravenous narcotics and doping, and minor surgical procedures and the infection. Conclusions: Asymptomatic infection was detected in 91 citizens of the Kujawsko-Pomorskie Voivodeship. The highest risk of HCV infection occurs during small surgery and usage of intravenous narcotics and doping. The percentage of positive results is slightly higher in the group of people with cosmetic and beauty treatments. Planning screening programs special attention should be paid to this group of risk. Blood and blood products transfusions before 1992 were associated with a higher risk of HCV infection. People with above-mentioned interventions should become a particular group of screening program participants. Occupational medicine service plays an important role in prevention. Med Pr 2014;65(5:633–637

  5. Risk factors for presumptive melanoma in skin cancer screening: American Academy of Dermatology National Melanoma/Skin Cancer Screening Program experience 2001-2005.

    Science.gov (United States)

    Goldberg, Matthew S; Doucette, John T; Lim, Henry W; Spencer, James; Carucci, John A; Rigel, Darrell S

    2007-07-01

    Since its inception in 1985, the American Academy of Dermatology (AAD) National Melanoma/Skin Cancer Screening Program has strived to enhance early detection of cutaneous malignant melanoma (MM) by providing nationwide skin cancer education campaigns in combination with free skin cancer screenings. To analyze the AAD screening data from 2001 to 2005 in order to identify factors associated with MM detection, and thereby derive a model of increased likelihood for MM detection through visual skin examinations at screenings. Patients completed a standardized AAD pre-screening form with historical and phenotypic information. Clinicians then recorded suspected clinical findings noted at visual skin examination. Statistical analyses were conducted using SPSS 14 (SPSS Inc., Chicago, Ill). Five factors, which can be remembered with the acronym HARMM, independently increased the likelihood of suspected MM being found in the 362,804 persons screened: History of previous melanoma (odds ratio [OR] = 3.3; 95% confidence interval [CI], 2.9-3.8); Age over 50 (OR = 1.2; 95% CI, 1.1-1.3); Regular dermatologist absent (OR = 1.4; 95% CI, 1.3-1.5); Mole changing (OR = 2.0; 95% CI, 1.9-2.2); and Male gender (OR = 1.4; 95% CI, 1.3-1.5). Individuals at highest risk (4 or 5 factors) comprised only 5.8% of the total population, yet accounted for 13.6% of presumptive MM findings, and were 4.4 times (95% CI, 3.8-5.1) more likely to be diagnosed with suspected MM than individuals at lowest risk (0 or 1 factor). Receipt of a total skin examination at screening independently increased the likelihood for identifying suspected MM (OR = 1.4; 95% CI, 1.3-1.6). However, significantly fewer screenees in the highest risk group versus those in the lowest risk group underwent total skin examinations (53.7% vs 62.5%). Risk factors studied limited to variables collected in screenee enrollment form. A higher-risk subgroup of the skin cancer screening population can be identified through assessment of MM

  6. New software for collecting data from the organized cervical cancer screening program in Serbia. Are we on the threshold of a new screening registry? - A multicentric study.

    Science.gov (United States)

    Naumovic, Tamara; Lakic, Vesna; Jovicevic, Ana; Ilic, Dragan; Milosevic, Predrag; Stevic-Gajic, Vesna; Antonijevic, Ana; Milovanovic, Nada; Magdic, Ivica; Koricanac, Rajko; Malkov, Sasa; Grkavac, Igor; Mihajlovic, Milos; Djuricic, Slavisa; Zivkovic, Branislava; Stegic, Uros; Milovanovic, Zorka; Opric, Dejan; Knezevic, Marija; Jovanovic, Verica; Todorovic, Zoran; Todorovic, Dusan

    2017-01-01

    The purpose of this study was to present the Screening Registry and the results of organized cervical cancer screening program (OCCSP) in the Republic of Serbia using a database made as an output model, linked with the Screening Registry. Data were respectively collected over a onemonth period from 3 state primary health care centers (and related hospitals/clinical center) in central Serbia in which OCCSP was conducted. The sample consisted of women of the target population (25 to 64 years old) who responded the call for Pap test. The most frequent abnormal cytological diagnosis was in the 38-50 years age group, and consisted of atypical squamous cells of undetermined significance - ASCUS (7.5%) and low grade squamous intraepithelial lesions - L-SIL (7.3%). The most frequent abnormal colposcopic finding in the youngest age group of women (25-37 years) was iodine negative epithelium (35.7%) and in the group of women aged 38-50 and 51-64 years acid-white epithelium. The most common histopathological diagnosis was L-SIL. Positive predictive value of colposcopy in relation to the Pap test was 0.64 (95% CI=0.56-0.70). Interrater agreement (between cytotechnicians and supervisors) measured by the Cohen's coefficient was 0.94 (95% CI=0.91 to 0.97), but between cytology (supervisors) and pathology findings it was 0.83 (95% CI = 0.67 to 0.99). The existence of a screening registry contributes to a better epidemiological surveillance of a screening program, and to a possibility for development of various epidemiological researches.

  7. Evaluation of a HIV voluntary opt-out screening program in a Singapore hospital.

    Directory of Open Access Journals (Sweden)

    Xin Quan Tan

    Full Text Available BACKGROUND: Early diagnosis of human immunodeficiency virus (HIV allows for appropriately timed interventions with improved outcomes, but HIV screening among asymptomatic persons and the general population in Singapore remains low. In 2008, Singapore's Ministry of Health implemented HIV voluntary opt-out screening (VOS for hospitalised adults. We evaluated the outcome of VOS and surveyed reasons for its low uptake in our institution. METHODS: We assessed the outcomes of the VOS programme from January 2010 to December 2013 at National University Hospital, a 1081-bed tertiary hospital in Singapore. We also examined reasons for opting-in and opting-out using an interviewer-administered structured questionnaire in a representative sample in January 2013. RESULTS: 107,523 patients fulfilled VOS criteria and were offered HIV screening, of which 5215 (4.9% agreed to testing. 4850 (93.1% of those who opted-in had an HIV test done. Three (0.06% tested positive for HIV. 238 patients (14.2% were surveyed regarding reasons for opting-in or out of VOS. 21 (8.8% had opted-in. Patients who opted-in were likely to be younger, more educated and reported having more regular sexual partners. Type of housing, number of casual sexual partners, sexual orientation, intravenous drug use, condom use and previous sexually transmitted infection were not associated with deciding to opt-in/out. Patients' most common reasons for opting-out were: belief that they were at low risk (50.2%, belief that they were too old (26.8%, cost (6.9% and aversion to venepuncture (6.5%. The most common reason for opting-in was desire to know their HIV status (47.6%. CONCLUSION: The success of an HIV-VOS program is largely determined by test uptake. Our study showed that the majority of eligible VOS patients opted-out of HIV screening. Given the considerable cost and low yield of this programme, more needs to be done to better equip patients in self-risk assessment and opting in to testing.

  8. Evaluation of a HIV voluntary opt-out screening program in a Singapore hospital.

    Science.gov (United States)

    Tan, Xin Quan; Goh, Wei-Ping; Venkatachalam, Indumathi; Goh, Diana; Sridhar, Revathi; Chan, Hwang Ching; Archuleta, Sophia

    2015-01-01

    Early diagnosis of human immunodeficiency virus (HIV) allows for appropriately timed interventions with improved outcomes, but HIV screening among asymptomatic persons and the general population in Singapore remains low. In 2008, Singapore's Ministry of Health implemented HIV voluntary opt-out screening (VOS) for hospitalised adults. We evaluated the outcome of VOS and surveyed reasons for its low uptake in our institution. We assessed the outcomes of the VOS programme from January 2010 to December 2013 at National University Hospital, a 1081-bed tertiary hospital in Singapore. We also examined reasons for opting-in and opting-out using an interviewer-administered structured questionnaire in a representative sample in January 2013. 107,523 patients fulfilled VOS criteria and were offered HIV screening, of which 5215 (4.9%) agreed to testing. 4850 (93.1%) of those who opted-in had an HIV test done. Three (0.06%) tested positive for HIV. 238 patients (14.2%) were surveyed regarding reasons for opting-in or out of VOS. 21 (8.8%) had opted-in. Patients who opted-in were likely to be younger, more educated and reported having more regular sexual partners. Type of housing, number of casual sexual partners, sexual orientation, intravenous drug use, condom use and previous sexually transmitted infection were not associated with deciding to opt-in/out. Patients' most common reasons for opting-out were: belief that they were at low risk (50.2%), belief that they were too old (26.8%), cost (6.9%) and aversion to venepuncture (6.5%). The most common reason for opting-in was desire to know their HIV status (47.6%). The success of an HIV-VOS program is largely determined by test uptake. Our study showed that the majority of eligible VOS patients opted-out of HIV screening. Given the considerable cost and low yield of this programme, more needs to be done to better equip patients in self-risk assessment and opting in to testing.

  9. Impact of Gene Patents and Licensing Practices on Access to Genetic Testing and Carrier Screening for Tay-Sachs and Canavan Disease

    OpenAIRE

    Colaianni, Alessandra; Chandrasekharan, Subhashini; Cook-Deegan, Robert

    2010-01-01

    Genetic testing for Tay-Sachs and Canavan disease is particularly important for Ashkenazi Jews, as both conditions are more frequent in that population. This comparative case study was possible because of different patenting and licensing practices. The role of DNA testing differs between Tay-Sachs and Canavan diseases. The first-line screening test for Tay-Sachs remains an enzyme activity test, rather than genotyping. Genotyping is used for preimplantation diagnosis and confirmatory testing....

  10. Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses.

    Science.gov (United States)

    Choma, Kim; McKeever, Amy E

    2015-02-01

    The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

  11. Impact of the Introduction of Digital Mammography in an Organized Screening Program on the Recall and Detection Rate.

    Science.gov (United States)

    Campari, Cinzia; Giorgi Rossi, Paolo; Mori, Carlo Alberto; Ravaioli, Sara; Nitrosi, Andrea; Vacondio, Rita; Mancuso, Pamela; Cattani, Antonella; Pattacini, Pierpaolo

    2016-04-01

    In 2012, the Reggio Emilia Breast Cancer Screening Program introduced digital mammography in all its facilities at the same time. The aim of this work is to analyze the impact of digital mammography introduction on the recall rate, detection rate, and positive predictive value. The program actively invites women aged 45-74 years. We included women screened in 2011, all of whom underwent film-screen mammography, and all women screened in 2012, all of whom underwent digital mammography. Double reading was used for all mammograms, with arbitration in the event of disagreement. A total of 42,240 women underwent screen-film mammography and 45,196 underwent digital mammography. The recall rate increased from 3.3 to 4.4% in the first year of digital mammography (relative recall adjusted by age and round 1.46, 95% CI = 1.37-1.56); the positivity rate for each individual reading, before arbitration, rose from 3 to 5.7%. The digital mammography recall rate decreased during 2012: after 12 months, it was similar to the recall rate with screen-film mammography. The detection rate was similar: 5.9/1000 and 5.2/1000 with screen-film and digital mammography, respectively (adjusted relative detection rate 0.95, 95% CI = 0.79-1.13). The relative detection rate for ductal carcinoma in situ remained the same. The introduction of digital mammography to our organized screening program had a negative impact on specificity, thereby increasing the recall rate. The effect was limited to the first 12 months after introduction and was attenuated by the double reading with arbitration. We did not observe any relevant effects on the detection rate.

  12. The Outcomes of an Educational Program Involving Men as Motivators to Encourage Women to Be Screened for Cervical Cancer.

    Science.gov (United States)

    Rwamugira, Jeniffer; Maree, Johanna E; Mafutha, Nokuthula

    2017-11-14

    Cervical cancer is a major health problem in South Africa. Despite having a national, population-based screening program, screening coverage is as low as 13%. Based on the role men could play in increasing cervical cancer screening and the low level of knowledge, men living in the study setting had about this health issue, we developed and pilot tested an educational program aimed at empowering men to teach their female partners and family members about cervical cancer and motivate them to be screened. The study setting was Ward 23 in Muldersdrift, a semi-urban, resource poor area situated northeast of Johannesburg. We used an intervention research design to assess the outcomes of our educational program. The primary outcome was screening uptake, with knowledge the secondary outcome. Statistics and face-to-face and telephone interviews, guided by questionnaires, were used to collect the data which were analyzed by means of descriptive statistics and content analysis. A total of 120 men (n = 120) participated in the educational program and 100 (n = 100) completed the post-test questionnaire. Only 30 women (n = 30) reported for screening. The men's knowledge improved after the education program but did not guarantee that they would educate women about cervical cancer as only 55% (n = 66) indicated they taught a female family member or their partner. Cultural restrictions were the most common reason presented for not teaching women about this health issue. Ways of supporting men to overcome cultural barriers prohibiting them from discussing matters related to sexuality should be explored, before refining and replicating the intervention.

  13. Navy Radon Assessment and Mitigation Program: Work/quality assurance project plan screening phase

    International Nuclear Information System (INIS)

    1991-03-01

    In 1987, the military services of the United States were tasked to take appropriate action to establish an indoor radon assessment and mitigation program. As a result, the Naval Facilities Engineering Command (NAVFACENGCOM) was assigned the responsibility of identifying potential hazards to personnel from exposure to naturally occurring radon gas and prioritizing corrective actions and to coordinating these actions with the major claimants. NAVRAMP is based upon current US Environmental Protection Agency (EPA) guidelines. The program has been separated into four phases. The screening phase will concentrate on evaluating radon levels, based on statistical samples, in those buildings that have been determined to be at most at risk to elevated levels of radon, such as base housing, schools, day-care centers, hospitals, brigs, Base Officer Quarters, and Base Enlisted Quarters. During the assessment phase, every building that contains personnel for over 4 h/day will be evaluated. Mitigation work will be accomplished by Navy or Navy-contracted personnel. HAZWRAP services during the mitigation phase will consist of determining the extent of reduction in radon levels after the mitigation effort. 7 refs., 11 figs

  14. Improving work-up of the abnormal mammogram through organized assessment: results from the ontario breast screening program.

    Science.gov (United States)

    Quan, May Lynn; Shumak, Rene S; Majpruz, Vicky; Holloway, Claire M D; O'Malley, Frances P; Chiarelli, Anna M

    2012-03-01

    Women with an abnormal screening mammogram should ideally undergo an organized assessment to attain a timely diagnosis. This study evaluated outcomes of women undergoing work-up after abnormal mammogram through a formal breast assessment affiliate (BAA) program with explicit care pathways compared with usual care (UC) using developed quality indicators for screening mammography programs. Between January 1 and December 31, 2007, a total of 320,635 women underwent a screening mammogram through the Ontario Breast Screening Program (OBSP), of whom 25,543 had an abnormal result requiring further assessment. Established indicators assessing timeliness, appropriateness of follow-up, and biopsy rates were compared between women who were assessed through either a BAA or UC using χ(2) analysis. Work-up of the abnormal mammogram for patients screened through a BAA resulted in a greater proportion of women attaining a definitive diagnosis within the recommended time interval when a histologic diagnosis was required. In addition, use of other quality measures including specimen radiography for both core biopsies and surgical specimens and preoperative core needle biopsy was greater in BAA facilities. These findings support future efforts to increase the number of BAAs within the OBSP, because the pathways and reporting methods associated with them result in improvements in our ability to provide timely and appropriate care for women requiring work-up of an abnormal mammogram.

  15. FMCSA safety program effectiveness measurement : carrier intervention effectiveness model, version 1.0, summary report for fiscal years 2009, 2010, 2011.

    Science.gov (United States)

    2015-01-01

    The Federal Motor Carrier Safety Administration (FMCSA), in cooperation with the John A. Volpe National : Transportation Systems Center (Volpe), has developed a quantitative model to measure the effectiveness of motor : carrier interventions in terms...

  16. Distribution of a pseudodeficiency allele among Tay-Sachs carriers

    Energy Technology Data Exchange (ETDEWEB)

    Tomczak, J.; Grebner, E.E. (Thomas Jefferson Univ., Philadelphia, PA (United States)); Boogen, C. (Univ. of Essen Medical School (Germany))

    1993-08-01

    Recently Triggs-Raine et al. (1992) identified a new mutation in the gene coding for the [alpha]-subunit of [beta]-hexosaminidase A (hex A), the enzyme whose deficiency causes Tay-Sachs disease. This mutation, a C[sub 739]-to-T transition in exon 7, results in an altered enzyme that is active (albeit at reduced levels) in cells but that has essentially no activity in serum. This so-called pseudodeficient allele was first detected in compound heterozygotes who also carried a Tay-Sachs disease allele and therefore had no detectable hex A in their serum but who were in good health. Carriers of this apparently benign mutation are generally indistinguishable from carriers of a lethal mutation by means of routine enzyme-based screening tests, because the product of the pseudodeficient allele is not detectable in serum and has decreased activity in cells. This suggests that some individuals who have been classified as Tay-Sachs carriers are actually carriers of the pseudodeficient allele and are not at risk to have a child affected with Tay-Sachs disease. The pseudodeficient allele may also be responsible for some inconclusive diagnoses, where leukocyte values fall below the normal range but are still above the carrier range. The fact that there are now two mutant alleles (the psuedodeficient and the adult) that are indistinguishable from the lethal infantile mutations by means of enzyme assay yet that are phenotypically very different and that together may account for as much as 12% of enzyme-defined carriers on the basis of the data here suggests that DNA analysis should be part of a comprehensive screening program. It will be particularly useful to identify the mutations in couples at risk, before they undergo prenatal diagnosis. DNA analysis will also resolve some inconclusive diagnoses.

  17. Costs of colorectal cancer screening provision in CDC’s Colorectal Cancer Control Program: Comparisons of colonoscopy and FOBT/FIT based screening☆

    Science.gov (United States)

    Subramanian, Sujha; Tangka, Florence K.L.; Hoover, Sonja; Royalty, Janet; DeGroff, Amy; Joseph, Djenaba

    2018-01-01

    We assess annual costs of screening provision activities implemented by 23 of the Centers for Disease Control and Prevention’s Colorectal Cancer Control Program (CRCCP) grantees and report differences in costs between colonoscopy and FOBT/FIT-based screening programs. We analysed annual cost data for the first three years of the CRCCP (July 2009–June 2011) for each screening provision activity and categorized them into clinical and non-clinical screening provision activities. The largest cost components for both colonoscopy and FOBT/FIT-based programs were screening and diagnostic services, program management, and data collection and tracking. During the first 3 years of the CRCCP, the average annual clinical cost for screening and diagnostic services per person served was $1150 for colonoscopy programs, compared to $304 for FIT/FOBT-based programs. Overall, FOBT/FIT-based programs appear to have slightly higher non-clinical costs per person served (average $1018; median $838) than colonoscopy programs (average $980; median $686). Colonoscopy-based CRCCP programs have higher clinical costs than FOBT/FIT-based programs during the 3-year study timeframe (translating into fewer people screened). Non-clinical costs for both approaches are similar and substantial. Future studies of the cost-effectiveness of colorectal cancer screening initiatives should consider both clinical and non-clinical costs. PMID:28190597

  18. The work of nurse case managers in a cancer and cardiovascular disease risk screening program.

    Science.gov (United States)

    Fawcett, Jacqueline; Schutt, Russell K; Gall, Gail B; Cruz, Elizabeth Riley; Woodford, Mary Lou

    2007-01-01

    The purpose of this conceptual model of nursing and health policy-based study was to identify the frequency and correlates of activities performed by nurse case managers. Massachusetts Women's Health Network (WHN) contracting organization sites for breast and cervical cancer and cardiovascular disease risk screening. Twenty nurse case managers were interviewed. More time was spent performing client service activities than bureaucratic activities. Frequently performed client service activities were tracking test results, finding/connecting with clients, assessing client needs, and educating clients. The most frequently performed activity was documenting services; the least, discharging clients. Client service activity frequency was correlated with client caseload size, social barriers, overall workload, satisfaction with the way activities are carried out in the WHN, special training in WHN policies and procedures, and contracting organization service delivery arrangements. Bureaucratic activity frequency was correlated with caseload size, workload, months as a WHN case manager, system barriers, satisfaction with the way activities were carried out in the WHN, and special training. Documentation requires a great deal of WHN nurse case managers' time, which perhaps could be more productively spent with clients. Thus, more efficient ways to document services need to be identified. Additional research is needed to determine similarities and differences in activities performed by WHN nurse case managers and other case managers working in cancer and cardiovascular disease screening programs. Strategies need to be identified to remove all barriers that interfere with performance of case manager practice activities. Strategies are needed to reduce client fear of bills, overcome scheduling constraints, and improve translation services to lessen language barriers to effective communication.

  19. Outcome of Congenitally Hypothyroid Screening Program in Isfahan: Iran From Prevention to Treatment

    Directory of Open Access Journals (Sweden)

    Mahin Hashemipour

    2010-01-01

    Full Text Available Objectives: Early and proper treatment is crucial to prevent neuropsychologic deficits in congenital hypothyroidism (CH. Considering the high prevalence of CH in Isfahan, the aim of this study was to evaluate the outcome of treatment in CH patients.Methods: In this study CH neonates diagnosed during screening program in Isfahan from May 2002 to September 2009 were studied. Frequent visits were performed to CH patients to monitor and follow their treatments. Quality of treatment was assessed by evaluating mean age of treatment initiation and mean TSH and T4 levels before and after treatment and during the first and second years according to their normal reference ranges.Results: Of 225,224 screened neonates, 536 were diagnosed as CH patients. The prevalence of CH was 1/420 live births. Mean age at starting treatment was 22.9  13.2 days. In 93.7% of patients, treatment was begun before the 45th day of life. In the first measurement after initiating the treatment, T4 and TSH were not in their acceptable range in 3.9% and 9.8% of CH patients, respec-tively. Mean T4 and TSH reached to normal range during the treatment period. T4 reached the normal range earlier than TSH.Conclusions: The mean age of treatment initiation was in acceptable range but the findings suggest that both early and high-dose treatments are crucial for optimal treatment, especially in patients with severe CH. Further studies are needed to determine the outcome of treatment specially regarding to different etiologies of CH.

  20. Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program.

    Science.gov (United States)

    Castells, Xavier; Domingo, Laia; Corominas, Josep María; Torá-Rocamora, Isabel; Quintana, María Jesús; Baré, Marisa; Vidal, Carmen; Natal, Carmen; Sánchez, Mar; Saladié, Francina; Ferrer, Joana; Vernet, Mar; Servitja, Sonia; Rodríguez-Arana, Ana; Roman, Marta; Espinàs, Josep Alfons; Sala, María

    2015-01-01

    Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.

  1. 75 FR 67963 - Endocrine Disruptor Screening Program (EDSP); Announcing the Availability of a Draft for Weight...

    Science.gov (United States)

    2010-11-04

    .... 321(q)(1)). List of Subjects Environmental protection, Endocrine disruptors, Screening assays, Weight... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPPT-2010-0877; FRL-8849-8] Endocrine Disruptor Screening...-tiered paradigm for screening and testing chemicals for endocrine activity (i.e., estrogen, androgen, and...

  2. City and County Solar PV Training Program, Module 2: Screening and Identifying PV Projects

    Energy Technology Data Exchange (ETDEWEB)

    Elgqvist, Emma M [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-04-09

    When screening and identifying PV projects, cities and counties should understand the different factors that impact the technical and economic potential of a PV project, the steps of the PV screening process, and how to use REopt Lite to screen a site for PV and storage project potential.

  3. The programmed cell death GLuc PCA library – a powerful tool for pathway discovery and drug screening

    Science.gov (United States)

    Gilad, Yuval; Kimchi, Adi

    2014-01-01

    A programmed cell death library based on the Gaussia luciferase protein-fragment complementation assay (GLuc PCA) enables detection of protein–protein interactions (PPI) within the cell death network and quantitative assessments of these interactions. Among future applications for the GLuc PCA cell death library is its potential use as a platform for PPI-targeted drug screening. PMID:27308378

  4. Effectiveness of the Brief Alcohol and Screening Intervention for College Students (BASICS) Program with a Mandated Population

    Science.gov (United States)

    DiFulvio, Gloria T.; Linowski, Sally A.; Mazziotti, Janet S.; Puleo, Elaine

    2012-01-01

    Objective: This study evaluated the effectiveness of a large-scale intervention designed to reduce alcohol abuse among adjudicated college students. Participants: Participants were college students mandated to attend a Brief Alcohol Screening and Intervention for College Students (BASICS) program and a randomly selected comparison group of…

  5. Cigarette, Water-pipe, and Medwakh Smoking Prevalence Among Applicants to Abu Dhabi's Pre-marital Screening Program, 2011.

    Science.gov (United States)

    Aden, Bashir; Karrar, Sara; Shafey, Omar; Al Hosni, Farida

    2013-11-01

    This study assesses self-reported tobacco use prevalence (cigarette, water-pipe, and medwakh) among applicants to Abu Dhabi's Premarital Screening program during 2011. Premarital Screening data reported to the Health Authority - Abu Dhabi from April to December 2011 were utilized to estimate tobacco use prevalence among applicants. Smoking prevalence was examined by nationality, age group and gender. Overall, 24.7% of Premarital Screening Program applicants were current smokers; 11.5% smoked cigarettes, 5.9% smoked medwakh (hand-held pipe), 4.8% smoked water-pipe and 2.5% smoked a combination (more than one type). Men (19.2%) were more likely than women (3.5%) to be current cigarette smokers. Women were much less likely to smoke medwakh (0.1%) than men (11.5%), with male UAE Nationals having the highest medwakh smoking prevalence (16.1%). The overall prevalence of water-pipe smoking was 6.8% among men and 2.8% for women with the highest water-pipe smoking prevalence (10.2%) among Arab expatriate men. Variations in tobacco use prevalence among Premarital Screening Program applicants reflect preferences for different modes of tobacco consumption by nationality, age group and gender. Enforcement of tobacco control laws, including implementation of clean indoor air laws and tobacco tax increases, and targeted health education programs are required to reduce tobacco consumption and concomitant tobacco-related morbidity and mortality.

  6. Follow-up evaluation of a high school eating disorders screening program: knowledge, awareness and self-referral.

    Science.gov (United States)

    D'Souza, Cheryl M; Forman, Sara F; Austin, S Bryn

    2005-03-01

    To conduct a regional, follow-up evaluation to assess the implementation and effectiveness of the National Eating Disorders Screening Program (NEDSP), conducted in high schools nationwide in the spring of 2000. Four New England high schools participated in a postscreen evaluation 1 to 2 months after implementation of NEDSP. A 35-item, self-report postscreen survey was administered to students in classrooms with assistance from school health staff and teachers. School staff involved in the screening were also interviewed. Logistic regression was used to estimate the odds that students talked to an adult or peers about their screening score. Data from 592 girls and 435 boys were included in the analysis in the four high schools participating in the program evaluation. NEDSP helped to identify students at risk and encouraged students to speak to others about their screening score and eating disorder symptoms. One-quarter of girls and one-fifth of boys reported talking with at least one adult about their EAT-26 screening score. Girls felt more strongly than boys that the program helped them learn about eating disorders, change their thinking related to eating disorders and body image, and talk to friends about eating disorders. Overall, the students felt that the program was helpful and would recommend it to their friends. Early detection of eating disorders in adolescents may shorten the interval between onset of symptoms and treatment, which has the potential to reduce the length of illness and morbidity associated with untreated eating disorders. Our findings suggest that high-school-based screening may be an effective way to facilitate early detection of eating disorder symptoms in adolescents.

  7. Infrastructure and Educational Needs of Newborn Screening Short-Term Follow-Up Programs within the Southeast Regional Newborn Screening & Genetics Collaborative: A Pilot Survey

    Directory of Open Access Journals (Sweden)

    Cecelia A. Bellcross

    2015-10-01

    Full Text Available Newborn screening (NBS follow-up protocols vary significantly by state, and there is a need to better understand the infrastructure and communication flow of NBS programs. In addition, assessment of the educational needs of families and providers with regard to the implications of NBS results is required to inform the development of appropriate informational resources and training opportunities. To begin to address these issues, we administered a web-based survey to state NBS coordinators within the Southeast Regional Newborn Screening & Genetics Collaborative (SERC. Fourteen coordinators responded to the survey, including at least one from each of the 10 SERC states/territories. Over one-third of respondents had never received formal training regarding the metabolic conditions identified on NBS. Most communicated results via telephone or fax, though two centers indicated use of a web-based platform. Only two programs were involved in directly reporting results to the family. Four programs reported a long-term follow-up protocol. Deficits were noted for primary care provider (PCP knowledge of metabolic disorders identified on NBS, and how to inform parents of abnormal results. Close to half indicated that the adequacy of the number of genetic counselors, dietitians, and medical/biochemical geneticists was minimal to insufficient. Respondents uniformly recognized the importance of providing additional educational and informational resources in multiple categories to NBS staff, PCPs, and families.

  8. Grant award program partnerships with your professional liability insurance carrier: an innovative approach to loss prevention and improved patient safety.

    Science.gov (United States)

    Cox, Phillip M; Rebstock, Jan; Jenkins, Randall C; Dewar, Marvin A; Gruber, Laura

    2014-01-01

    The financial success of a malpractice insurance program is directly influenced by how effectively the covered providers respond to risk. This article describes a University Self-Insurance Program partnership to provide small grants to providers who have the expertise and passion for a specific risk reduction activity that is cost effective and measurable and has a high probability of improving patient care and reducing claims or lawsuits. Implementation of this small grant concept can be tailored to become operational in virtually any setting from an independent medical practice to a multistate healthcare system. © 2014 American Society for Healthcare Risk Management of the American Hospital Association.

  9. Evolution and Innovations of the National Neonatal and High Risk Screening Program in Costa Rica

    Directory of Open Access Journals (Sweden)

    Carlos de Céspedes

    2004-09-01

    Full Text Available We present the evolution, organization and results of the National Neonatal and High Risk Screening Program in Costa Rica (PNT. This program has been working uninterruptedly for more than fourteen years. Costa Rica currently has a literacy rate of 95%. To August 2004 the rate of infant mortality was 9.74 per 1000 births and to 2003, life expectancy was 76.3 years for men and 81.1 years for women. The control of infectious and parasitic diseases, as well as of severe malnutrition, has given room to a prevalence of chronic diseases with a pathology profile similar to that of a developed country. The clinical observation, mainly starting from early 70s, of a growing number of patients with mental retardation and other disabilities caused by congenital hypothyroidism and hereditary metabolic diseases that could have been prevented in many cases with an early diagnosis and opportune treatment, led us to the decision to implement a systematically massive neonatal screening for these diseases. The presence of a single Public System of Social Security in Costa Rica, which currently includes from primary health care up to the hospitals of tertiary attention, with a single Children’s Hospital for the whole country, as well as communication facilities, are factors that offered, in principle, favorable conditions for this effort, even for a developing country. To September 2004, 835,217 children have been screened. There is a coverage of 95.1% of the newborns in the country. Also to this date, 259 children with congenital hypothyroidism, 18 with phenylketonuria, 20 with the maple syrup disease, 30 with congenital adrenal hyperplasia and 10 with galactosemia have been detected, confirmed and treated, for a total of 337 children that were spared of mental retardation, other disabilities and even death. Massive neonatal screening for organic acidemias recently started in June of 2004. Cystic fibrosis is under a pilot study and the screening for

  10. Impact of gene patents and licensing practices on access to genetic testing and carrier screening for Tay-Sachs and Canavan disease.

    Science.gov (United States)

    Colaianni, Alessandra; Chandrasekharan, Subhashini; Cook-Deegan, Robert

    2010-04-01

    Genetic testing for Tay-Sachs and Canavan disease is particularly important for Ashkenazi Jews, because both conditions are more frequent in that population. This comparative case study was possible because of different patenting and licensing practices. The role of DNA testing differs between Tay-Sachs and Canavan diseases. The first-line screening test for Tay-Sachs remains an enzyme activity test rather than genotyping. Genotyping is used for preimplantation diagnosis and confirmatory testing. In contrast, DNA-based testing is the basis for Canavan screening and diagnosis. The HEXA gene for Tay-Sachs was cloned at the National Institutes of Health, and the gene was patented but has not been licensed. The ASPA gene for Canavan disease was cloned and patented by Miami Children's Hospital. Miami Children's Hospital did not inform family members and patient groups that had contributed to the gene discovery that it was applying for a patent, and pursued restrictive licensing practices when a patent issued in 1997. This led to intense controversy, litigation, and a sealed, nonpublic 2003 settlement that apparently allowed for nonexclusive licensing. A survey of laboratories revealed a possible price premium for ASPA testing, with per-unit costs higher than for other genetic tests in the Secretary's Advisory Committee on Genetics, Health, and Society case studies. The main conclusion from comparing genetic testing for Tay-Sachs and Canavan diseases, however, is that patenting and licensing conducted without communication with patients and advocates cause mistrust and can lead to controversy and litigation, a negative model to contrast with the positive model of patenting and licensing for genetic testing of cystic fibrosis.

  11. Systematic Review of Screening and Surveillance Programs to Protect Workers from Nanomaterials.

    Directory of Open Access Journals (Sweden)

    Mary Gulumian

    Full Text Available Screening and surveillance approaches for workers exposed to nanomaterials could aid in early detection of health effects, provide data for epidemiological studies and inform action to decrease exposure. The aim of this review is to identify such screening and surveillance approaches, in order to extract available data regarding (i the studies that have successfully been implemented in present day, (ii identification of the most common and/or toxic nano-related health hazards for workers and (iii possible exposure surveillance markers. This review contributes to the current understanding of the risk associated with nanomaterials by determining the knowledge gap and making recommendations based on current findings.A systematic review was conducted. PubMed and Embase were searched to identify articles reporting on any surveillance-related study that described both exposure to nanomaterials and the health indicators that were measured. Four reviewers worked in pairs to independently assess the eligibility of studies and risk of bias before extraction of data. Studies were categorised according to the type of study and the medical surveillance performed, which included the type of nanomaterial, any exposure details provided, as well as health indicators and biomarkers tested.Initially 92 studies were identified, from which 84 full texts were assessed for eligibility. Seven studies met all the inclusion criteria, i.e. those performed in Taiwan, Korea, Czech Republic and the US. Of these, six compared health indicators between exposed and unexposed workers and one study described a surveillance program. All studies were at a high risk of bias. Workers were exposed to a mix of nanomaterials in three studies, carbon-based nanomaterials in two studies, nano-silver in one study and nano-titanium oxide in the other study. Two studies did not find a difference in biomarkers between exposed and unexposed workers. In addition, differences in early effects on

  12. Systematic Review of Screening and Surveillance Programs to Protect Workers from Nanomaterials.

    Science.gov (United States)

    Gulumian, Mary; Verbeek, Jos; Andraos, Charlene; Sanabria, Natasha; de Jager, Pieter

    2016-01-01

    Screening and surveillance approaches for workers exposed to nanomaterials could aid in early detection of health effects, provide data for epidemiological studies and inform action to decrease exposure. The aim of this review is to identify such screening and surveillance approaches, in order to extract available data regarding (i) the studies that have successfully been implemented in present day, (ii) identification of the most common and/or toxic nano-related health hazards for workers and (iii) possible exposure surveillance markers. This review contributes to the current understanding of the risk associated with nanomaterials by determining the knowledge gap and making recommendations based on current findings. A systematic review was conducted. PubMed and Embase were searched to identify articles reporting on any surveillance-related study that described both exposure to nanomaterials and the health indicators that were measured. Four reviewers worked in pairs to independently assess the eligibility of studies and risk of bias before extraction of data. Studies were categorised according to the type of study and the medical surveillance performed, which included the type of nanomaterial, any exposure details provided, as well as health indicators and biomarkers tested. Initially 92 studies were identified, from which 84 full texts were assessed for eligibility. Seven studies met all the inclusion criteria, i.e. those performed in Taiwan, Korea, Czech Republic and the US. Of these, six compared health indicators between exposed and unexposed workers and one study described a surveillance program. All studies were at a high risk of bias. Workers were exposed to a mix of nanomaterials in three studies, carbon-based nanomaterials in two studies, nano-silver in one study and nano-titanium oxide in the other study. Two studies did not find a difference in biomarkers between exposed and unexposed workers. In addition, differences in early effects on pulmonary

  13. The Evolution of Teleophthalmology Programs in the United Kingdom: Beyond Diabetic Retinopathy Screening.

    Science.gov (United States)

    Sim, Dawn A; Mitry, Danny; Alexander, Philip; Mapani, Adam; Goverdhan, Srini; Aslam, Tariq; Tufail, Adnan; Egan, Catherine A; Keane, Pearse A

    2016-02-01

    Modern ophthalmic practice in the United Kingdom is faced by the challenges of an aging population, increasing prevalence of systemic pathologies with ophthalmic manifestations, and emergent treatments that are revolutionary but dependent on timely monitoring and diagnosis. This represents a huge strain not only on diagnostic services but also outpatient management and surveillance capacity. There is an urgent need for newer means of managing this surge in demand and the socioeconomic burden it places on the health care system. Concurrently, there have been exponential increases in computing power, expansions in the strength and ubiquity of communications technologies, and developments in imaging capabilities. Advances in imaging have been not only in terms of resolution, but also in terms of anatomical coverage, allowing new inferences to be made. In spite of this, image analysis techniques are still currently superseded by expert ophthalmologist interpretation. Teleophthalmology is therefore currently perfectly placed to face this urgent and immediate challenge of provision of optimal and expert care to remote and multiple patients over widespread geographical areas. This article reviews teleophthalmology programs currently deployed in the United Kingdom, focusing on diabetic eye care but also discussing glaucoma, emergency eye care, and other retinal diseases. We examined current programs and levels of evidence for their utility, and explored the relationships between screening, teleophthalmology, disease detection, and monitoring before discussing aspects of health economics pertinent to diabetic eye care. The use of teleophthalmology presents an immense opportunity to manage the steadily increasing demand for eye care, but challenges remain in the delivery of practical, viable, and clinically proven solutions. © 2016 Diabetes Technology Society.

  14. Defense by-products production and utilization program: noble metal recovery screening experiments

    International Nuclear Information System (INIS)

    Hazelton, R.F.; Jensen, G.A.; Raney, P.J.

    1986-03-01

    Isotopes of the platinum metals (rutheium, rhodium, and palladium) are produced during uranium fuel fission in nuclear reactors. The strategic values of these noble metals warrant considering their recovery from spent fuel should the spent fuel be processed after reactor discharge. A program to evaluate methods for ruthenium, rhodium, and palladium recovery from spent fuel reprocessing liquids was conducted at Pacific Northwest Laboratory (PNL). The purpose of the work reported in this docuent was to evaluate several recovery processes revealed in the patent and technical literature. Beaker-scale screening tests were initiated for three potential recovery processes: precipitation during sugar denitration of nitric acid reprocessing solutions after plutonium-uranium solvent extraction, adsorption using nobe metal selective chelates on active carbon, and reduction forming solid noble metal deposits on an amine-borane reductive resin. Simulated reprocessing plant solutions representing typical nitric acid liquids from defense (PUREX) or commercial fuel reprocessing facilities were formulated and used for evaluation of the three processes. 9 refs., 3 figs., 9 tabs

  15. Quality Assessment of Colonoscopy Reporting: Results from a Statewide Cancer Screening Program

    Directory of Open Access Journals (Sweden)

    Jun Li

    2010-01-01

    Full Text Available This paper aimed to assess quality of colonoscopy reports and determine if physicians in practice were already documenting recommended quality indicators, prior to the publication of a standardized Colonoscopy Reporting and Data System (CO-RADS in 2007. We examined 110 colonoscopy reports from 2005-2006 through Maryland Colorectal Cancer Screening Program. We evaluated 25 key data elements recommended by CO-RADS, including procedure indications, risk/comorbidity assessments, procedure technical descriptions, colonoscopy findings, specimen retrieval/pathology. Among 110 reports, 73% documented the bowel preparation quality and 82% documented specific cecal landmarks. For the 177 individual polyps identified, information on size and morphology was documented for 87% and 53%, respectively. Colonoscopy reporting varied considerately in the pre-CO-RADS period. The absence of key data elements may impact the ability to make recommendations for recall intervals. This paper provides baseline data to assess if CO-RADS has an impact on reporting and how best to improve the quality of reporting.

  16. Newborn screening for six lysosomal storage disorders in a cohort of Mexican patients: Three-year findings from a screening program in a closed Mexican health system.

    Science.gov (United States)

    Navarrete-Martínez, Juana Inés; Limón-Rojas, Ana Elena; Gaytán-García, Maria de Jesús; Reyna-Figueroa, Jesús; Wakida-Kusunoki, Guillermo; Delgado-Calvillo, Ma Del Rocío; Cantú-Reyna, Consuelo; Cruz-Camino, Héctor; Cervantes-Barragán, David Eduardo

    2017-05-01

    To evaluate the results of a lysosomal newborn screening (NBS) program in a cohort of 20,018 Mexican patients over the course of 3years in a closed Mexican Health System (Petróleos Mexicanos [PEMEX] Health Services). Using dried blood spots (DBS), we performed a multiplex tandem mass spectrometry enzymatic assay for six lysosomal storage disorders (LSDs) including Pompe disease, Fabry disease, Gaucher disease, mucopolysaccharidosis type I (MPS-I), Niemann-Pick type A/B, and Krabbe disease. Screen-positive cases were confirmed using leukocyte enzymatic activity and DNA molecular analysis. From July 2012 to April 2016, 20,018 patients were screened; 20 patients were confirmed to have an LSD phenotype (99.9 in 100,000 newborns). Final distributions include 11 Pompe disease, five Fabry disease, two MPS-I, and two Niemann-Pick type A/B patients. We did not find any Gaucher or Krabbe patients. A final frequency of 1 in 1001 LSD newborn phenotypes was established. NBS is a major public health achievement that has decreased the morbidity and mortality of inborn errors of metabolism. The introduction of NBS for LSD presents new challenges. This is the first multiplex Latin-American study of six LSDs detected through NBS. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. The Kidney Disease Screening and Awareness Program (KDSAP): a novel translatable model for increasing interest in nephrology careers.

    Science.gov (United States)

    Hsiao, Li-Li; Wu, Jingshing; Yeh, Albert C; Shieh, Eric C; Cui, Cheryl; Li, Ang; Polding, Laura C; Ahmed, Rayhnuma; Lim, Kenneth; Lu, Tzong-Shi; Rhee, Connie M; Bonventre, Joseph V

    2014-09-01

    Despite the increasing prevalence of CKD in the United States, there is a declining interest among United States medical graduates in nephrology as a career choice. Effective programs are needed to generate interest at early educational stages when career choices can be influenced. The Kidney Disease Screening and Awareness Program (KDSAP) is a novel program initiated at Harvard College that increases student knowledge of and interest in kidney health and disease, interest in nephrology career paths, and participation in kidney disease research. This model, built on physician mentoring, kidney screening of underserved populations, direct interactions with kidney patients, and opportunities to participate in kidney research, can be reproduced and translated to other workforce-challenged subspecialties. Copyright © 2014 by the American Society of Nephrology.

  18. Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women.

    Science.gov (United States)

    Gultekin, Murat; Zayifoglu Karaca, Mujdegul; Kucukyildiz, Irem; Dundar, Selin; Boztas, Guledal; Semra Turan, Hatice; Hacikamiloglu, Ezgi; Murtuza, Kamil; Keskinkilic, Bekir; Sencan, Irfan

    2018-05-01

    To evaluate the Turkey's nationwide HPV DNA screening program on the basis of first 1 million screened women. Women over age 30 were invited for population based screening via HPV DNA and conventional cytology. Samples were collected by family physicians and the evaluations and reports had been performed in the National Central HPV laboratories. The acceptance rate for HPV based cervical cancer screening after first invitation was nearly 36.5%. Since HPV DNA tests have been implemented, cervical cancer screening rates have shown 4-5-fold increase in primary level. Through the evaluation of all, HPV positivity was seen in 3.5%. The commonest HPV genotypes were 16, followed by 51, 31, 52 and 18. Among the 37.515 HPV positive cases, cytological abnormality rate was 19.1%. Among HPV positive cases, 16.962 cases had HPV 16 or 18 or other oncogenic HPV types with abnormal cytology (>ASC-US). These patients were referred to colposcopy. The colposcopy referral rate was 1.6%. Among these, final clinico-pathological data of 3.499 patients were normal in 1.985 patients, CIN1 in 708, CIN2 in 285, CIN3 in 436 and cancer in 85 patients and only pap-smear program could miss 45.9% of ≥CIN3 cases. The results of 1 million women including the evaluation of 13 HPV genotypes with respect to prevalence, geographic distribution and abnormal cytology results shows that HPV DNA can be used in primary level settings to have a high coverage rated screening program and is very effective compared to conventional pap-smear. © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

  19. Use of risk projection models to estimate mortality and incidence from radiation-induced breast cancer in screening programs

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, M [Chemical and Nuclear Engineering Department, Polytechnic University of Valencia, Camino de Vera s/n 46022 Valencia (Spain); Ferrer, S [Chemical and Nuclear Engineering Department, Polytechnic University of Valencia, Camino de Vera s/n 46022 Valencia (Spain); Villaescusa, J I [Radiation Protection Service, Hospital Universitario La Fe, Avda Campanar, 21 46009 Valencia (Spain); Verdu, G [Chemical and Nuclear Engineering Department, Polytechnic University of Valencia, Camino de Vera s/n 46022 Valencia (Spain); Salas, M D [Public Health General Direction, Conselleria de Sanitat de Valencia, C/Micer Masco, 31 46021 Valencia (Spain); Cuevas, M D [Assistential Service General Direction, Conselleria de Sanitat de Valencia, C/Micer Masco, 31 46021 Valencia (Spain)

    2005-02-07

    The authors report on a method to calculate radiological risks, applicable to breast screening programs and other controlled medical exposures to ionizing radiation. In particular, it has been applied to make a risk assessment in the Valencian Breast Cancer Early Detection Program (VBCEDP) in Spain. This method is based on a parametric approach, through Markov processes, of hazard functions for radio-induced breast cancer incidence and mortality, with mean glandular breast dose, attained age and age-at-exposure as covariates. Excess relative risk functions of breast cancer mortality have been obtained from two different case-control studies exposed to ionizing radiation, with different follow-up time: the Canadian Fluoroscopy Cohort Study (1950-1987) and the Life Span Study (1950-1985 and 1950-1990), whereas relative risk functions for incidence have been obtained from the Life Span Study (1958-1993), the Massachusetts tuberculosis cohorts (1926-1985 and 1970-1985), the New York post-partum mastitis patients (1930-1981) and the Swedish benign breast disease cohort (1958-1987). Relative risks from these cohorts have been transported to the target population undergoing screening in the Valencian Community, a region in Spain with about four and a half million inhabitants. The SCREENRISK software has been developed to estimate radiological detriments in breast screening. Some hypotheses corresponding to different screening conditions have been considered in order to estimate the total risk associated with a woman who takes part in all screening rounds. In the case of the VBCEDP, the total radio-induced risk probability for fatal breast cancer is in a range between [5 x 10{sup -6}, 6 x 10{sup -4}] versus the natural rate of dying from breast cancer in the Valencian Community which is 9.2 x 10{sup -3}. The results show that these indicators could be included in quality control tests and could be adequate for making comparisons between several screening programs.

  20. Use of risk projection models to estimate mortality and incidence from radiation-induced breast cancer in screening programs

    International Nuclear Information System (INIS)

    Ramos, M; Ferrer, S; Villaescusa, J I; Verdu, G; Salas, M D; Cuevas, M D

    2005-01-01

    The authors report on a method to calculate radiological risks, applicable to breast screening programs and other controlled medical exposures to ionizing radiation. In particular, it has been applied to make a risk assessment in the Valencian Breast Cancer Early Detection Program (VBCEDP) in Spain. This method is based on a parametric approach, through Markov processes, of hazard functions for radio-induced breast cancer incidence and mortality, with mean glandular breast dose, attained age and age-at-exposure as covariates. Excess relative risk functions of breast cancer mortality have been obtained from two different case-control studies exposed to ionizing radiation, with different follow-up time: the Canadian Fluoroscopy Cohort Study (1950-1987) and the Life Span Study (1950-1985 and 1950-1990), whereas relative risk functions for incidence have been obtained from the Life Span Study (1958-1993), the Massachusetts tuberculosis cohorts (1926-1985 and 1970-1985), the New York post-partum mastitis patients (1930-1981) and the Swedish benign breast disease cohort (1958-1987). Relative risks from these cohorts have been transported to the target population undergoing screening in the Valencian Community, a region in Spain with about four and a half million inhabitants. The SCREENRISK software has been developed to estimate radiological detriments in breast screening. Some hypotheses corresponding to different screening conditions have been considered in order to estimate the total risk associated with a woman who takes part in all screening rounds. In the case of the VBCEDP, the total radio-induced risk probability for fatal breast cancer is in a range between [5 x 10 -6 , 6 x 10 -4 ] versus the natural rate of dying from breast cancer in the Valencian Community which is 9.2 x 10 -3 . The results show that these indicators could be included in quality control tests and could be adequate for making comparisons between several screening programs

  1. Long-Term Impact of the Dutch Colorectal Cancer Screening Program on Cancer Incidence and Mortality-Model-Based Exploration of the Serrated Pathway

    NARCIS (Netherlands)

    Greuter, Marjolein J. E.; Demirel, Erhan; Lew, Jie-Bin; Berkhof, Johannes; Xu, Xiang-Ming; Canfell, Karen; Dekker, Evelien; Meijer, Gerrit A.; Coupé, Veerle M. H.

    2016-01-01

    We aimed to predict the long-term colorectal cancer incidence, mortality, and colonoscopy demand of the recently implemented Dutch colorectal cancer screening program. The Adenoma and Serrated pathway to Colorectal Cancer model was set up to simulate the Dutch screening program consisting of

  2. Only a minority of sex chromosome abnormalities are detected by a national prenatal screening program for Down syndrome

    DEFF Research Database (Denmark)

    Viuff, Mette Hansen; Krag, Kirstine Stochholm; Uldbjerg, Niels

    2015-01-01

    STUDY QUESTION: How does a national prenatal screening program for Down syndrome (DS) perform in detecting sex chromosome abnormalities (SCAs)-Turner syndrome (TS), Klinefelter syndrome, 47,XXX and 47,XYY syndromes. SUMMARY ANSWER: The SCA detection rate resulting from DS screening was below 50...... of accompanying conditions. There is limited information about pre- and perinatal status that distinguishes SCA embryogenesis from normal fetal development. STUDY DESIGN, SIZE, DURATION: A register-based case-control study from the Danish Central Cytogenetic Register (DCCR), cross-linked with the Danish Fetal...

  3. Tuberculosis in Pediatric Antiretroviral Therapy Programs in Low- and Middle-Income Countries: Diagnosis and Screening Practices.

    Science.gov (United States)

    Ballif, Marie; Renner, Lorna; Claude Dusingize, Jean; Leroy, Valeriane; Ayaya, Samuel; Wools-Kaloustian, Kara; Cortes, Claudia P; McGowan, Catherine C; Graber, Claire; Mandalakas, Anna M; Mofenson, Lynne M; Egger, Matthias; Kumara Wati, Ketut Dewi; Nallusamy, Revathy; Reubenson, Gary; Davies, Mary-Ann; Fenner, Lukas

    2015-03-01

    The global burden of childhood tuberculosis (TB) is estimated to be 0.5 million new cases per year. Human immunodeficiency virus (HIV)-infected children are at high risk for TB. Diagnosis of TB in HIV-infected children remains a major challenge. We describe TB diagnosis and screening practices of pediatric antiretroviral treatment (ART) programs in Africa, Asia, the Caribbean, and Central and South America. We used web-based questionnaires to collect data on ART programs and patients seen from March to July 2012. Forty-three ART programs treating children in 23 countries participated in the study. Sputum microscopy and chest Radiograph were available at all programs, mycobacterial culture in 40 (93%) sites, gastric aspiration in 27 (63%), induced sputum in 23 (54%), and Xpert MTB/RIF in 16 (37%) sites. Screening practices to exclude active TB before starting ART included contact history in 41 sites (84%), symptom screening in 38 (88%), and chest Radiograph in 34 sites (79%). The use of diagnostic tools was examined among 146 children diagnosed with TB during the study period. Chest Radiograph was used in 125 (86%) children, sputum microscopy in 76 (52%), induced sputum microscopy in 38 (26%), gastric aspirate microscopy in 35 (24%), culture in 25 (17%), and Xpert MTB/RIF in 11 (8%) children. Induced sputum and Xpert MTB/RIF were infrequently available to diagnose childhood TB, and screening was largely based on symptom identification. There is an urgent need to improve the capacity of ART programs in low- and middle-income countries to exclude and diagnose TB in HIV-infected children. © The Author 2014. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Social and Cultural Barriers to Women's Participation in Pap Smear Screening Programs in Low- and Middle-Income Latin American and Caribbean Countries: An Integrative Review.

    Science.gov (United States)

    Liebermann, Erica J; VanDevanter, Nancy; Hammer, Marilyn J; Fu, Mei R

    2018-01-01

    Pap smear screening programs have been ineffective in reducing cervical cancer mortality in most Latin American and Caribbean countries, in part due to low screening rates. The purpose of this review was to analyze recent studies to identify demographic, social, and cultural factors influencing women's participation in Pap screening programs in Latin America and the Caribbean. For this integrative review, cervical cancer screening in Latin America and the Caribbean was searched using PubMed, CINAHL, EMBASE, and PsycINFO databases. Findings/Results: Demographic barriers to screening were socioeconomic status, education, race/ethnicity, and geography. Social barriers included lack of uniformity in screening guidelines, lack of knowledge regarding cervical cancer, and lack of preventive culture. Cultural barriers were fear/embarrassment and gender roles. There are multilevel barriers to Pap smear utilization among women in Latin America and the Caribbean. Findings highlight a need for health system engagement, promotion of preventive care, and community-generated educational programs and solutions.

  5. The Quick Peek Program: A Model for Developmental Screening within Underserved Communities

    Science.gov (United States)

    Harris, Jill; Norton, Amy

    2016-01-01

    Developmental screening of young children is important in all populations, especially underserved communities with known health care disparities. The American Academy of Pediatrics created guidelines and a toolkit for pediatricians to conduct developmental surveillance and screening, yet these guidelines are not uniformly implemented within…

  6. Learning Effectiveness and Cognitive Loads in Instructional Materials of Programming Language on Single and Dual Screens

    Science.gov (United States)

    Hsu, Jenq-Muh; Chang, Ting-Wen; Yu, Pao-Ta

    2012-01-01

    The teaching and learning environment in a traditional classroom typically includes a projection screen, a projector, and a computer within a digital interactive table. Instructors may apply multimedia learning materials using various information communication technologies to increase interaction effects. However, a single screen only displays a…

  7. Use of the National Cancer Institute Community Cancer Centers Program screening and accrual log to address cancer clinical trial accrual.

    Science.gov (United States)

    St Germain, Diane; Denicoff, Andrea M; Dimond, Eileen P; Carrigan, Angela; Enos, Rebecca A; Gonzalez, Maria M; Wilkinson, Kathy; Mathiason, Michelle A; Duggan, Brenda; Einolf, Shaun; McCaskill-Stevens, Worta; Bryant, Donna M; Thompson, Michael A; Grubbs, Stephen S; Go, Ronald S

    2014-03-01

    Screening logs have the potential to help oncology clinical trial programs at the site level, as well as trial leaders, address enrollment in real time. Such an approach could be especially helpful in improving representation of racial/ethnic minority and other underrepresented populations in clinical trials. The National Cancer Institute Community Cancer Centers Program (NCCCP) developed a screening log. Log data collected from March 2009 through May 2012 were analyzed for number of patients screened versus enrolled, including for demographic subgroups; screening methods; and enrollment barriers, including reasons for ineligibility and provider and patient reasons for declining to offer or participate in a trial. User feedback was obtained to better understand perceptions of log utility. Of 4,483 patients screened, 18.4% enrolled onto NCCCP log trials. Reasons for nonenrollment were ineligibility (51.6%), patient declined (25.8%), physician declined (15.6%), urgent need for treatment (6.6%), and trial suspension (0.4%). Major reasons for patients declining were no desire to participate in trials (43.2%) and preference for standard of care (39%). Major reasons for physicians declining to offer trials were preference for standard of care (53%) and concerns about tolerability (29.3%). Enrollment rates onto log trials did not differ between white and black (P = .15) or between Hispanic and non-Hispanic patients (P = .73). Other races had lower enrollment rates than whites and blacks. Sites valued the ready access to log data on enrollment barriers, with some sites changing practices to address those barriers. Use of screening logs to document enrollment barriers at the local level can facilitate development of strategies to enhance clinical trial accrual.

  8. An adverse event in a well-established cervical cancer screening program: an observational study of 19,000 females unsubscribed to the program

    Directory of Open Access Journals (Sweden)

    Larsen MB

    2016-10-01

    Full Text Available Mette Bach Larsen,1 Hans Svanholm,1,2 Berit Andersen1 1Department of Public Health Programmes, 2Department of Pathology, Randers Regional Hospital, Randers, Denmark Introduction: In Denmark, an organized approach to cervical cancer screening has had national coverage since 1998. However, in 2013, it was discovered that 19,000 females had been unsubscribed from the Danish National Cervical Cancer Screening Program and had thus not received invitations or reminders as recommended by the health authorities. The study aims to report the essence of this adverse event and describe the outcomes of reestablishing invitations in terms of participation rates and screening results. Furthermore, patient compensations to affected females diagnosed with cervical cancer and coverage in the mass media was reported.Methods: An observational study based on information from the Danish Pathology Databank, the Department of Public Health Programs, and Infomedia (a Danish database of media coverage was carried out.Results: A total of 19,106 females were affected. Of those still in the screening age, 37.7% had been tested within 3 years or 5 years despite not receiving any invitation. A total of 21.6% reconfirmed their status as unsubscribed. Of the remaining females, 55.6% were tested within a year, and 94.6% of these test results were normal. Among females aged >64 years, 12.7% accepted the offer of a final screening test. Totally, 90% of these tests were normal. Nineteen females diagnosed with cervical cancer were compensated by the Danish Patient Compensation Association with a total of €693,000, ranging from €8,900 to €239,700. Coverage of cervical cancer screening in the mass media increased from 25 items in the 3 months prior to this adverse event to 590 items in the month when it became public.Conclusion: Even though more than one-third of the affected females were tested despite not receiving regular invitations to participate in the screening

  9. Sociodemographic characteristics of nonparticipants in the Danish colorectal cancer screening program: a nationwide cross-sectional study

    Directory of Open Access Journals (Sweden)

    Larsen MB

    2017-06-01

    Full Text Available Mette Bach Larsen,1 Ellen M Mikkelsen,2 Morten Rasmussen,3 Lennart Friis-Hansen,4 Anders U Ovesen,5 Hans Bjarke Rahr,6 Berit Andersen1 1Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region, Randers NO, 2Department of Clinical Epidemiology, Aarhus University Hospital, Central Denmark Region, Aarhus N, 3Digestive Disease Center K, Bispebjerg Hospital, The Capital Region of Denmark, Copenhagen NV, 4Department of Clinical Biochemistry, Nordsjællands Hospital, The Capital Region of Denmark, Hillerød, 5Department of Surgical Gastroenterology, Aalborg University Hospital, North Denmark Region, Aalborg, 6Department of Surgery, Vejle Hospital, Region of Southern Denmark, Vejle, Denmark Introduction: Fecal occult blood tests are recommended for colorectal cancer (CRC screening in Europe. Recently, the fecal immunochemical test (FIT has come into use. Sociodemographic differences between participants and nonparticipants may be less pronounced when using FIT as there are no preceding dietary restrictions and only one specimen is required. The aim of this study was to examine the associations between sociodemographic characteristics and nonparticipation for both genders, with special emphasis on those who actively unsubscribe from the program. Methods: The study was a national, register-based, cross-sectional study among men and women randomized to be invited to participate in the prevalence round of the Danish CRC screening program between March 1 and December 31, 2014. Prevalence ratios (PRs were used to quantify the association between sociodemographic characteristics and nonparticipation (including active nonparticipation. PRs were assessed using Poisson regression with robust error variance.Results: The likelihood of being a nonparticipant was highest in the younger part of the population; however, for women, the association across age groups was U-shaped. Female immigrants were more likely to be

  10. Cost-Benefit Comparison of Two Proposed Overseas Programs for Reducing Chronic Hepatitis B Infection among Refugees: Is Screening Essential?

    Science.gov (United States)

    Jazwa, Amelia; Coleman, Margaret S.; Gazmararian, Julie; Wingate, La’Marcus T.; Maskery, Brian; Mitchell, Tarissa; Weinberg, Michelle

    2015-01-01

    Background Refugees are at an increased risk of chronic Hepatitis B Virus (HBV) infection because many of their countries of origin, as well as host countries, have intermediate-to-high prevalence rates. Refugees arriving to the US are also at risk of serious sequelae from chronic HBV infection because they are not routinely screened for the virus overseas or in domestic post-arrival exams, and may live in the US for years without awareness of their infection status. Methods A cohort of 26,548 refugees who arrived in Minnesota and Georgia during 2005–2010 was evaluated to determine the prevalence of chronic HBV infection. This prevalence information was then used in a cost-benefit analysis comparing two variations of a proposed overseas program to prevent or ameliorate the effects of HBV infection, titled ‘Screen, then vaccinate or initiate management’ (SVIM) and ‘Vaccinate only’ (VO). The analyses were performed in 2013. All values were converted to US 2012 dollars. Results The estimated six year period-prevalence of chronic HBV infection was 6.8% in the overall refugee population arriving to Minnesota and Georgia and 7.1% in those ≥ 6 years of age. The SVIM program variation was more cost beneficial than VO. While the up-front costs of SVIM were higher than VO ($154,084 vs. $73,758; n=58,538 refugees), the SVIM proposal displayed a positive net benefit, ranging from $24 million to $130 million after only 5 years since program initiation, depending on domestic post-arrival screening rates in the VO proposal. Conclusions Chronic HBV infection remains an important health problem in refugees resettling to the United States. An overseas screening policy for chronic HBV infection is more cost-beneficial than a ‘Vaccination only’ policy. The major benefit drivers for the screening policy are earlier medical management of chronic HBV infection and averted lost societal contributions from premature death. PMID:25595868

  11. A Clinical Study on a 5 Decades Tuberculosis Screening Program Based on Chest Radiography(CXR)

    International Nuclear Information System (INIS)

    Kim, Ham Gyun

    2009-01-01

    This study analyzed decade-based statistic data which had been collected from the reports of annual radiographic pulmonary tuberculosis screening program initiated by the Korean National Tuberculosis Association (KNTA) for last 5 decades (from 1956 to 2005). We analyzed only the content of annual statistic report to preserve the characteristic of statistic data and the contents of original copy by focusing on the analysis of tuberculosis cases where age and sex were excluded. The results of the disease-based analysis on the tuberculosis cases from cumulative subjects of chest radiography (CXR) from 1956 to 2005 are summarized as follows. 1. The cumulative number of subjects who were examined under annual chest radiography over last 5 decades totaled 54,938,875 persons. 2. The cumulative number of pulmonary tuberculosis cases during same period totaled 958,251 persons (1.74%). 3. The cumulative number of subjects treated during same period totaled 465,082 persons (0.85%). 4. The cumulative number of mild pulmonary tuberculosis cases during same period totaled 229,615 persons (0.42%). 5. The cumulative number of moderate pulmonary tuberculosis cases during same period totaled 144,247 persons (0.26%). 6. The cumulative number of severe pulmonary tuberculosis cases during same period totaled 74,066 persons (0.13%). 7. The cumulative number of exudative pleurisy cases during same period totaled 17,154 persons (0.03%). 8. The cumulative number of subjects under monitoring during same period totaled 493,169 persons (0.90%). 9. The cumulative number of uncertain activity cases during same period totaled 78,214 persons (0.14%). 10. The cumulative number of pseudo-pulmonary tuberculosis cases during same period totaled 272,349 persons (0.50%).

  12. Achieving public and global health competencies: A teaching case study of Botswana's cervical cancer screening program.

    Science.gov (United States)

    Okatch, Harriet; Sowicz, Timothy Joseph; Teng, Helen; Ramogola-Masire, Doreen; Buttenheim, Alison M

    2018-02-09

    To design and implement a case study on the cervical cancer screening program in Botswana to teach public and global health competencies to undergraduate nursing students. The case study was developed following a review of the literature on the epidemiology and health policies of cervical cancer in Botswana, and an interview with an obstetrician/gynecologist engaged in both clinical practice and research in Botswana. The case study has been implemented over seven semesters to students enrolled in the Nursing in the Community course at the University of Pennsylvania. Approximately 75-100 students are enrolled each semester. Student's perceptions of epidemiologic skills gained and group functioning. Students responded to an open-ended question about lessons learned and offered suggestions to improve the learning experience. Faculty assessment of student deliverables demonstrated that students achieved the learning objectives and mastered necessary competencies. More than 70% (n = 69) of the students indicated that they acquired relevant skills at greater than a satisfactory level. Generally, students had great experiences working in groups measured across five dimensions: engagement/contribution, creativity/resilience, on task/works independently, social interaction/communication, and preparedness. However, isolated cases of poor group functioning were reported for engagement/contribution, and creativity/resilience. The case study, which has been revised with respect to length, content and group processes, has been valuable in educating undergraduate nursing students in a more engaging way that mimics real life public health nursing scenarios. Students achieved both public and global health competencies through participation in the case study. © 2018 Wiley Periodicals, Inc.

  13. Results of the FIT-based National Colorectal Cancer Screening Program in Slovenia.

    Science.gov (United States)

    Tepeš, Bojan; Bracko, Matej; Novak Mlakar, Dominika; Stefanovic, Milan; Stabuc, Borut; Frkovic Grazio, Snjezana; Maucec Zakotnik, Jozica

    2017-07-01

    Colorectal cancer (CRC) is one of the most common malignancies in the western world. We aimed to assess the first round of fecal immunochemical test (FIT)-based National CRC screening program (NCSP). In the NCSP conducted in Slovenia, a FIT and colonoscopy for those tested positive was used. The NCSP central unit sent 536,709 invitations to Slovenian residents age 50 to 69 years old between 2009 and 2011. The adherence rate was 56.9% (303,343 participants). FIT was positive in 6.2% (15,310) of the participants (men, 7.8%; women, 5.0%; P<0.01). A total of 13,919 unsedated colonoscopies were performed with the cecal intubation rate of 97.8%. The overall adenoma detection rate was 51.3% [95% confidence interval (CI), 50.5%-52.1%] of which 61.0% (95% CI, 59.9%-62.1%) was in men, and 39.1% (95% CI, 37.8%-40.3%) in women (P<0.01). The mean number of adenoma per positive colonoscopy was 1.94 (95% CI, 1.90-1.97). Adenoma, advanced adenoma, or cancer were found in 7732 (55.5%) colonoscopies. A total of 862 (6.2%) CRC cases were found. Only 161 (18.7%) carcinomas were situated in the right colon. A total of 597 (70.2%) patients with cancer were in the early clinical stages (N, negative; 194 22.8%) of all cancers were cured with only endoscopic resection. In the NCSP, CRC was found in 6.2% of those participants attending colonoscopy, with 81.3% of carcinomas found in the left colon. A localized clinical stage was found in 70.2% participants. In 22.8% of CRC patients, cancer was cured with endoscopic resection only.

  14. Parent-completed developmental screening in premature children: a valid tool for follow-up programs.

    Directory of Open Access Journals (Sweden)

    Cyril Flamant

    Full Text Available Our goals were to (1 validate the parental Ages and Stages Questionnaires (ASQ as a screening tool for psychomotor development among a cohort of ex-premature infants reaching 2 years, and (2 analyse the influence of parental socio-economic status and maternal education on the efficacy of the questionnaire. A regional population of 703 very preterm infants (<35 weeks gestational age born between 2003 and 2006 were evaluated at 2 years by their parents who completed the ASQ, by a pediatric clinical examination, and by the revised Brunet Lezine psychometric test with establishment of a DQ score. Detailed information regarding parental socio-economic status was available for 419 infants. At 2 years corrected age, 630 infants (89.6% had an optimal neuromotor examination. Overall ASQ scores for predicting a DQ score ≤85 produced an area under the receiver operator curve value of 0.85 (95% Confidence Interval:0.82-0.87. An ASQ cut-off score of ≤220 had optimal discriminatory power for identifying a DQ score ≤85 with a sensitivity of 0.85 (95%CI:0.75-0.91, a specificity of 0.72 (95%CI:0.69-0.75, a positive likelihood ratio of 3, and a negative likelihood ratio of 0.21. The median value for ASQ was not significantly associated with socio-economic level or maternal education. ASQ is an easy and reliable tool regardless of the socio-economic status of the family to predict normal neurologic outcome in ex-premature infants at 2 years of age. ASQ may be beneficial with a low-cost impact to some follow-up programs, and helps to establish a genuine sense of parental involvement.

  15. The Sensitivity, Specificity and Predictive Values of Snellen Chart Compared to the Diagnostic Test in Amblyopia Screening Program in Iran

    Directory of Open Access Journals (Sweden)

    Fatemeh Rivakani

    2015-12-01

    Full Text Available Introduction Amblyopia is a leading cause of visual impairment in both childhood and adult populations. Our aim in this study was to assess the epidemiological characteristics of the amblyopia screening program in Iran. Materials and Methods A cross-sectional study was done on a randomly selected sample of 4,636 Iranian children who were referred to screening program in 2013 were participated in validity study, too. From each provinces the major city were selected. Screening and diagnostic tests were done by instructors in first stage and optometrists in second stage, respectively. Finally data were analyzed by Stata version 13. Results The sensitivity was ranged from 74% to 100% among the various provinces such that Fars and Ardabil province had maximum and minimum values, respectively. The pattern of specificity was differ and ranged 44% to 84% among the provinces; Hormozgan and Fars had maximum and minimum values, respectively. The positive predictive value was also ranged from 35% to %81 which was assigned to Khuzestan and Ardabil provinces, respectively. The range of Negative Predictive value was 61% to 100% which was belonged to Ardabil and Fars provinces. Conclusion The total sensitivity (89% and negative predictive values (93% of screening test among children aged 3-6 years is acceptable, but only 51% of children refereed to second stage are true positive and this imposes considerable cost to health system.

  16. Development of a Program to train Physician Extenders to Perform Transnasal Esophagoscopy and Screen for Barrett’s Esophagus’

    Science.gov (United States)

    Alashkar, Bronia; Faulx, Ashley L.; Hepner, Ashley; Pulice, Richard; Vemana, Srikrishna; Greer, Katarina B.; Isenberg, Gerard A.; Falck-Ytter, Yngve; Chak, Amitabh

    2013-01-01

    Background & Aims Screening for Barrett’s esophagus (BE) and esophageal adenocarcinoma is not recommended because it was not found to be cost effective. However, physician extenders (PEs) are able to perforn unsedated procedures—their involvement might reduce the costs of BE screening. We examined the feasibility of training PEs to independently perform transnasal esophagoscopy (TNE) and screen patients for Barrett’s esophagus, and measured their learning curve. Methods Two PEs at a Veterans Administration (VA) medical center underwent a structured didactic training program and observed nasopharyngoscopies before performing TNE under the supervision of attending endoscopists. Individual technical and cognitive components of TNE were rated on a 9-point structured scale. Learning curves were constructed using cumulative summation. Once the PEs were judged to be technically competent, each PE performed 10 independent videotaped TNEs, which were graded. Results Both PEs identified anatomic landmarks after 18 consecutive procedures. PEs 1 and 2 performed satisfactory nasal intubations after 20 and 25 procedures and esophageal intubations after 29 and 35 procedures, respectively. They acquired overall competence after supervised training on 43 and 47 procedures, respectively. Conclusions We developed a program at a VA medical center to train PEs to perform TNE to screen for BE. The PEs were able to perform TNE and recognize esophageal landmarks independently after a modest number of supervised procedures. PMID:24161352

  17. Identifying Non-Duchenne Muscular Dystrophy-Positive and False Negative Results in Prior Duchenne Muscular Dystrophy Newborn Screening Programs: A Review.

    Science.gov (United States)

    Gatheridge, Michele A; Kwon, Jennifer M; Mendell, Jerry M; Scheuerbrandt, Günter; Moat, Stuart J; Eyskens, François; Rockman-Greenberg, Cheryl; Drousiotou, Anthi; Griggs, Robert C

    2016-01-01

    Duchenne muscular dystrophy (DMD) is a candidate for the recommended universal screening panel based on evidence that early corticosteroid treatment improves outcomes and on new genetic therapies that require early diagnosis for effectiveness. Elevated creatine kinase levels in the neonatal period are the initial screening marker in DMD newborn screening programs but is found in inherited muscle disorders other than DMD. Data are needed to inform protocols for future screening and follow-up testing and care in these patients. To review non-DMD muscle disorders identified by prior DMD screening programs and to investigate whether these programs failed to identify patients later diagnosed as having DMD (false-negative findings). Since 1975, 10 DMD newborn screening programs have provided opportunities to study screening protocols, outcomes, and parental responses. These programs used elevated creatine kinase levels in dried blood spots for the initial screening, with the diagnosis of DMD based on findings of clinical follow-up, muscle biopsy, or direct mutational testing of the DMD gene. Literature regarding these prior programs was reviewed in PubMed, and the programs were discussed directly with the directors when possible to identify diagnoses of non-DMD disorders and false negative results from 1975 to July 12, 2015. Data were collected from screening programs, which were active between 1975 and December 2011. Data were analyzed from March 26, 2015, to August 24, 2015. The 10 screening programs screened more than 1.8 million newborns between 1975 and 2011, and 344 were diagnosed with DMD. Of those screened, the majority were boys. Across all programs, 80 patients had positive results for non-DMD disorders, including Becker muscular dystrophy and forms of limb-girdle and congenital muscular dystrophies, and 21 patients had false-negative findings for DMD. Screening for DMD will result in identification of other muscle diseases. Future screening protocols should

  18. Screening women for cervical cancer carcinoma with a HPV mRNA test: first results from the Venice pilot program.

    Science.gov (United States)

    Maggino, Tiziano; Sciarrone, Rocco; Murer, Bruno; Dei Rossi, Maria Rosa; Fedato, Chiara; Maran, Michela; Lorio, Melania; Soldà, Marika; Zago, Fiorella; Giorgi Rossi, Paolo; Zorzi, Manuel

    2016-08-23

    HPV DNA-based screening is more effective than a Pap test in preventing cervical cancer, but the test is less specific. New HPV tests have been proposed for primary screening. The HPV mRNA test showed a similar or slightly lower sensitivity than the HPV DNA tests but with a higher specificity. We report the results of an organised HPV mRNA-based screening pilot program in Venice, Italy. From October 2011 to May 2014, women aged 25-64 years were invited to undergo a HPV mRNA test (Aptima). Those testing positive underwent cytological triage. Women with positive cytology were referred to colposcopy, whereas those with negative cytology were referred to repeat the HPV mRNA test 1 year later. The results of the HPV mRNA test program were compared with both the local historical cytology-based program and with four neighbouring DNA HPV-based pilot projects. Overall, 23 211 women underwent a HPV mRNA test. The age-standardised positivity rate was 7.0%, higher than in HPV DNA programs (6.8%; relative rate (RR) 1.11, 95% confidence interval (CI) 1.05-1.17). The total colposcopy referral was 5.1%, double than with cytology (2.6%; RR 2.02, 95% CI 1.82-2.25) but similar to the HPV DNA programs (4.8%; RR 1.02; 95% CI 0.96-1.08). The cervical intraepithelial neoplasia grade 2+ detection rate with HPV mRNA was greater than in the HPV DNA programs at baseline (RR 1.50; 95% CI 1.19-1.88) and not significantly lower at the 1-year repeat (RR 0.70; 95% CI 0.40-1.16). The overall RR was 1.29 (95% CI 1.05-1.59), which was much higher than with cytology (detection rate 5.5‰ vs 2.1‰; RR 2.50, 95% CI 1.76-3.62). A screening programme based on the HPV mRNA obtained results similar to those observed with the HPV DNA test. In routine screening programmes, even a limited increase in HPV prevalence may conceal the advantage represented by the higher specificity of HPV mRNA.

  19. AD-SISCOLO: a decision-support tool to aid the management of a cervical cancer screening program

    Directory of Open Access Journals (Sweden)

    Sulafa Yacoub Mohammed Ahmed

    2018-02-01

    Full Text Available AbstractIntroduction: This paper aims to develop a data warehouse (AD-SISCOLO in order to support the management of the cervical cancer screening program in the municipality of Rio de Janeiro/Brazil. As a part of the management process, the program managers of the municipality perform tedious manual work in order to calculate a series of performance indicators and then take decisions based on them. Methods AD-SISCOLO was implemented using the Pentaho BI Suite Business Intelligence Platform and the MySQL database management system. The indicators to be calculated and visualized in the tool were based on the municipal data of the cytopathology and histopathology tests from January 2012 until December 2014, which was obtained from the Information System of Cervical Cancer (SISCOLO after a record linkage process. The follow-up indicators were based on a simplified version of the Brazilian guidelines for the cervical cancer screening. Results AD-SISCOLO allows the visualization of a set of test-based and follow-up indicators from different views and dimensions, which enable managers to monitor all the phases of the screening process and to identify the process’ failures. Conclusions Compared with the current available environments in Brazil, AD-SISCOLO is unique in its visualization of the follow-up indicators of groups of women, according to their test results and age. Thereby it provides presentation flexibility to suit the program manager's needs.

  20. Assessment of the routine, occupation-based gonorrhea and syphilis screening program in Moscow, Russia: an analysis of sexually transmitted infection prevalence and cost-effectiveness.

    Science.gov (United States)

    Kourbatova, Ekaterina V; Akovbyan, Vagan A; Chesson, Harrell W; Lytkina, Irina N; Dmitriev, Georgyi A; Tikhonova, Lilia I; Koubanova, Anna A; Petukhova, Irina I; Latypova, Munira F; Aboymova, Olga A; Lewis, Joel S; Ryan, Caroline A; Shakarishvili, Anna

    2008-05-01

    In the Russian Federation, large sectors of the population regularly undergo mandatory occupational screening for sexually transmitted infections (STIs). Objectives of our study were to determine the prevalence of syphilis and gonorrhea in the screened occupational groups in Moscow and to conduct a cost-effectiveness evaluation of the occupational screening program. Serum samples from 4 main occupational groups (food handlers and other food industry workers, market salespersons, education and health care providers, and hotel and other public utility workers) were tested for syphilis and gonorrhea. We conducted a cost-effectiveness analysis (in 2003 rubles) of the screening program using decision analysis models. In the total sample of 1000 study participants, overall prevalence for syphilis was 1.2% with the highest rate in market salespersons (4.4%) and for gonorrhea 0.3%. The incremental cost per case of STI treated was 8409 rubles ($252) for syphilis screening (compared with no screening) with higher incremental costs associated with expanding the program to include gonorrhea screening. The relatively low STI prevalence in the screened groups and the poor performance of the diagnostic tests used were important factors in the estimated cost-effectiveness of occupation-based screening. Modifications to occupation-based screening, including an increased focus on higher risk population and the adoption of more current diagnostic technologies, could help to use prevention resources more effectively.

  1. [Screening program for cervical cancer: public policies and experiences of actors who implement the program in the state of Veracruz, Mexico].

    Science.gov (United States)

    González, Zuanilda Mendoza

    2017-01-01

    The aim of this article is to analyze the way in which the Screening Program for Cervical Cancer is carried out in a dysplasia clinic and related health centers in the state of Veracruz, through the representations and practices of the social actors who implement the program. In order to do so, in-depth interviews and observations of the practices of health service providers were carried out during different periods over the course of three years, from 2009 to 2011. Through the information obtained, the article explores the difficulties, achievements and results of this program as part of a public policy. Although a priority of public health policy is to see the whole population benefit from preventive and curative health care services, evidence shows that marginalized populations are not benefitted by such programs; such information does not however seem to permeate popular and medical knowledge.

  2. A Call to Include Severe Combined Immunodeficiency in Newborn Screening Program

    OpenAIRE

    Raz Somech; Amos Etzioni

    2014-01-01

    Quantification of the T cell receptor excision circles (TRECs) has recently emerged as a useful non-invasive clinical and research tool to investigate thymic activity. It allows the identification of T cell production by the thymus. Quantification of TREC copies has recently been implemented as the preferred test to screen neonates with severe combined immunodeficiency (SCID) or significant lymphopenia. Neonatal genetic screening for SCID is highly important in countries with high rates of co...

  3. Straddle carrier radiation portal monitoring

    Science.gov (United States)

    Andersen, Eric S.; Samuel, Todd J.; Mullen, O. Dennis

    2005-05-01

    U.S. Customs and Border Protection (CBP) is the primary enforcement agency protecting the nation"s ports of entry. CBP is enhancing its capability to interdict the illicit import of nuclear and radiological materials and devices that may be used by terrorists. Pacific Northwest National Laboratory (PNNL) is providing scientific and technical support to CBP in their goal to enable rapid deployment of nuclear and radiation detection systems at U. S. ports of entry to monitor 100% of the incoming international traffic and cargo while not adversely impacting the operations or throughput of the ports. The U.S. ports of entry include the following vectors: land border crossings, seaports, airports, rail crossings, and mail and express consignment courier facilities. U.S. Customs and Border Protection (CBP) determined that a screening solution was needed for Seaport cargo containers being transported by Straddle Carriers (straddle carriers). A stationary Radiation Portal Monitor (RPM) for Straddle Carriers (SCRPM) is needed so that cargo containers can be scanned while in transit under a Straddle Carrier. The Straddle Carrier Portal operational impacts were minimized by conducting a time-motion study at the Port, and adaptation of a Remotely Operated RPM (RO-RPM) booth concept that uses logical lighting schemes for traffic control, cameras, Optical Character Recognition, and wireless technology.

  4. Estimation of Pap-test coverage in an area with an organised screening program: challenges for survey methods

    Directory of Open Access Journals (Sweden)

    Raggi Patrizio

    2006-03-01

    Full Text Available Abstract Background The cytological screening programme of Viterbo has completed the second round of invitations to the entire target population (age 25–64. From a public health perspective, it is important to know the Pap-test coverage rate and the use of opportunistic screening. The most commonly used study design is the survey, but the validity of self-reports and the assumptions made about non respondents are often questioned. Methods From the target population, 940 women were sampled, and responded to a telephone interview about Pap-test utilisation. The answers were compared with the screening program registry; comparing the dates of Pap-tests reported by both sources. Sensitivity analyses were performed for coverage over a 36-month period, according to various assumptions regarding non respondents. Results The response rate was 68%. The coverage over 36 months was 86.4% if we assume that non respondents had the same coverage as respondents, 66% if we assume they were not covered at all, and 74.6% if we adjust for screening compliance in the non respondents. The sensitivity and specificity of the question, "have you ever had a Pap test with the screening programme" were 84.5% and 82.2% respectively. The test dates reported in the interview tended to be more recent than those reported in the registry, but 68% were within 12 months of each other. Conclusion Surveys are useful tools to understand the effectiveness of a screening programme and women's self-report was sufficiently reliable in our setting, but the coverage estimates were strongly influenced by the assumptions we made regarding non respondents.

  5. Informed Choice in the German Mammography Screening Program by Education and Migrant Status: Survey among First-Time Invitees.

    Directory of Open Access Journals (Sweden)

    Eva-Maria Berens

    Full Text Available Breast cancer is the most prevalent cancer among women and mammography screening programs are seen as a key strategy to reduce breast cancer mortality. In Germany, women are invited to the population-based mammography screening program between ages 50 to 69. It is still discussed whether the benefits of mammography screening outweigh its harms. Therefore, the concept of informed choice comprising knowledge, attitude and intention has gained importance. The objective of this observational study was to assess the proportion of informed choices among women invited to the German mammography screening program for the first time. A representative sample of 17,349 women aged 50 years from a sub-region of North Rhine Westphalia was invited to participate in a postal survey. Turkish immigrant women were oversampled. The effects of education level and migration status on informed choice and its components were assessed. 5,847 (33.7% women responded to the postal questionnaire of which 4,113 were used for analyses. 31.5% of the women had sufficient knowledge. The proportion of sufficient knowledge was lower among immigrants and among women with low education levels. The proportion of women making informed choices was low (27.1%, with similar associations with education level and migration status. Women of low (OR 2.75; 95% CI 2.18-3.46 and medium education level (OR 1.49; 95% CI 1.27-1.75 were more likely to make an uninformed choice than women of high education level. Turkish immigrant women had the greatest odds for making an uninformed choice (OR 5.30, 95% CI 1.92-14.66 compared to non-immigrant women. Other immigrant women only had slightly greater odds for making an uninformed choice than non-immigrant women. As immigrant populations and women with low education level have been shown to have poor knowledge, they need special attention in measures to increase knowledge and thus informed choices.

  6. Effects of a health education and telephone counseling program on patients with a positive fecal occult blood test result for colorectal cancer screening: A randomized controlled trial.

    Science.gov (United States)

    Chiu, Hui-Chuan; Hung, Hsin-Yuan; Lin, Hsiu-Chen; Chen, Shu-Ching

    2017-10-01

    Our purpose was to evaluate the effects of a health education and telephone counseling program on knowledge and attitudes about colorectal cancer and screening and the psychological impact of positive screening results. A randomized controlled trial was conducted with 2 groups using a pretest and posttest measures design. Patients with positive colorectal cancer screening results were selected and randomly assigned to an experimental (n = 51) or control (n = 51) group. Subjects in the experimental group received a health education and telephone counseling program, while the control group received routine care only. Patients were assessed pretest before intervention (first visit to the outpatient) and posttest at 4 weeks after intervention (4 weeks after first visit to the outpatient). Patients in the experimental group had a significantly better level of knowledge about colorectal cancer and the psychological impact of a positive screening result than did the control group. Analysis of covariance revealed that the health education and telephone counseling program had a significant main effect on colorectal cancer knowledge. A health education and telephone counseling program can improve knowledge about colorectal cancer and about the psychological impact in patients with positive colorectal cancer screening results. The health education and telephone counseling program is an easy, simple, and convenient method of improving knowledge, improving attitudes, and alleviating psychological distress in patients with positive colorectal cancer screening results, and this program can be expanded to other types of cancer screening. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Reduction in advanced breast cancer after introduction of a mammography screening program in Tyrol/Austria.

    Science.gov (United States)

    Oberaigner, W; Geiger-Gritsch, Sabine; Edlinger, M; Daniaux, M; Knapp, R; Hubalek, M; Siebert, U; Marth, C; Buchberger, W

    2017-06-01

    We analysed all female breast cancer (BC) cases in Tyrol/Austria regarding the shift in cancer characteristics, especially the shift in advanced BC, for the group exposed to screening as compared to the group unexposed to screening. The analysis was based on all BC cases diagnosed in women aged 40-69 years, resident in Tyrol, and diagnosed between 2009 and 2013. The data were linked to the Tyrolean mammography screening programme database to classify BC cases as "exposed to screening" or "unexposed to screening". Age-adjusted relative risks (RR) were estimated by relating the exposed to the unexposed group. In a total of about 145,000 women aged 40-69 years living in Tyrol during the study period, 1475 invasive BC cases were registered. We estimated an age-adjusted relative risk (RR) for tumour size ≥ 21 mm of 0.72 (95% confidence interval (CI) 0.60 to 0.86), for metastatic BC of 0.27 (95% CI 0.17 to 0.46) and for advanced BC of 0.83 (95% CI 0.71 to 0.96), each comparing those exposed to those unexposed to screening, respectively. In our population-based registry analysis we observed that participation in the mammography screening programme in Tyrol is associated with a 28% decrease in risk for BC cases with tumour size ≥ 21 mm and a 17% decrease in risk for advanced BC. We therefore expect the Tyrolean mammography programme to show a reduction in BC mortality. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Low Rates of Retention Into Hepatocellular Carcinoma (HCC) Surveillance Program After Initial HCC Screening.

    Science.gov (United States)

    Robinson, Ann; Tavakoli, Hesam; Cheung, Ramsey; Liu, Benny; Bhuket, Taft; Wong, Robert J

    2018-04-06

    To evaluate rates and predictors of retention into hepatocellular carcinoma (HCC) surveillance beyond initial screening among underserved cirrhosis patients. Although initial HCC screening among cirrhosis patients remains low, few studies have evaluated retention to HCC surveillance beyond initial screening. We retrospectively evaluated all consecutive adults with cirrhosis from 2014 to 2017 at a single underserved safety net hospital system to determine rates of HCC surveillance at 6 months and at 1 year beyond initial screening. Rates of HCC surveillance was stratified by sex, race/ethnicity, and etiology of liver disease. Multivariate Cox proportional hazards models evaluated predictors of retention into HCC surveillance. Among 235 cirrhosis patients [hepatitis C virus: 35.7%, hepatitis B virus (HBV): 15.7%, alcoholic cirrhosis: 36.2%, nonalcoholic steatohepatitis (NASH): 8.1%], mean age of cirrhosis diagnosis was 54.2±8.9 years. Overall, 74.8% received initial screening within 1 year of cirrhosis diagnosis. Among those who completed initial screening, 47.6% [95% confidence interval (CI), 41.4-54.2) received second surveillance within 1 year. On multivariate analyses, patients with NASH and HBV were significantly more likely to receive second HCC surveillance compared with hepatitis C virus, HBV (hazard ratio, 2.32; 95% CI, 1.18-4.56; P=0.014) and NASH (hazard ratio, 2.49; 95% CI, 1.22-5.11; P=0.012). No sex or race-specific/ethnicity-specific differences in HCC surveillance retention were observed. Although overall rates of initial HCC screening among cirrhosis patients is nearly 75%, retention into continued HCC surveillance is poor, with less than half of patients undergoing subsequent HCC surveillance. Cirrhosis patients with HBV and NASH were more likely to be retained into HCC surveillance.

  9. Budget impact analysis of switching to digital mammography in a population-based breast cancer screening program: a discrete event simulation model.

    Science.gov (United States)

    Comas, Mercè; Arrospide, Arantzazu; Mar, Javier; Sala, Maria; Vilaprinyó, Ester; Hernández, Cristina; Cots, Francesc; Martínez, Juan; Castells, Xavier

    2014-01-01

    To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs.

  10. Budget impact analysis of switching to digital mammography in a population-based breast cancer screening program: a discrete event simulation model.

    Directory of Open Access Journals (Sweden)

    Mercè Comas

    Full Text Available OBJECTIVE: To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. METHODS: A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. RESULTS: Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567 in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638 in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. CONCLUSIONS: Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs.

  11. Community-Academic Partnership to implement a Breast and Cervical Cancer screening education program in Puerto Rico

    Science.gov (United States)

    Colón-López, Vivian; González, Daisy; Vélez, Camille; Fernández-Espada, Natalie; Soler, Alana Feldman; Escobar, Kelly Ayala; Ayala-Marín, Alelí M.; Soto-Salgado, Marievelisse; Calo, William A.; Aragón, Angela Pattatucci; Rivera-Díaz, Marinilda; Fernández, María E.

    2018-01-01

    Objective To describe how a community-academic partnership between Taller Salud Inc., a community-based organization, and the Puerto Rico Community Cancer Control Outreach Program of the University of Puerto Rico was crucial in the adaptation and implementation of Cultivando La Salud (CLS), an evidence-based educational outreach program designed to increase breast and cervical cancer screening among Hispanic women living in Puerto Rico. This collaboration facilitated the review and adaptation of the CLS intervention to improve cultural appropriateness, relevance, and acceptability for Puerto Rican women. Methods A total of 25 interviewers and 12 Lay Health Workers (LHWs) were recruited and trained to deliver the program. The interviewers recruited women who were non-adherent to recommended screening guidelines for both breast and cervical cancer. LHWs then provided one-on-one education using the adapted CLS materials. Results A total of 444 women were recruited and 48% of them were educated through this collaborative effort. Conclusions Our main accomplishment was establishing the academic-community partnership to implement the CLS program. Nevertheless, in order to promote better collaborations with our community partners, it is important to carefully delineate and establish clear roles and shared responsibilities for each partner for the successful execution of research activities, taking into consideration the community’s needs. PMID:29220062

  12. Community-Academic Partnership to Implement a Breast and Cervical Cancer Screening Education Program in Puerto Rico.

    Science.gov (United States)

    Colón-López, Vivian; González, Daisy; Vélez, Camille; Fernández-Espada, Natalie; Feldman-Soler, Alana; Ayala-Escobar, Kelly; Ayala-Marín, Alelí M; Soto-Salgado, Marievelisse; Calo, William A; Pattatucci-Aragón, Angela; Rivera-Díaz, Marinilda; Fernández, María E

    2017-12-01

    To describe how a community-academic partnership between Taller Salud Inc., a community-based organization, and the Puerto Rico Community Cancer Control Outreach Program of the University of Puerto Rico was crucial in the adaptation and implementation of Cultivando La Salud (CLS), an evidencebased educational outreach program designed to increase breast and cervical cancer screening among Hispanic women living in Puerto Rico. This collaboration facilitated the review and adaptation of the CLS intervention to improve cultural appropriateness, relevance, and acceptability for Puerto Rican women. A total of 25 interviewers and 12 Lay Health Workers (LHWs) were recruited and trained to deliver the program. The interviewers recruited women who were non-adherent to recommended screening guidelines for both breast and cervical cancer. LHWs then provided one-on-one education using the adapted CLS materials. A total of 444 women were recruited and 48% of them were educated through this collaborative effort. Our main accomplishment was establishing the academic-community partnership to implement the CLS program. Nevertheless, in order to promote better collaborations with our community partners, it is important to carefully delineate and establish clear roles and shared responsibilities for each partner for the successful execution of research activities, taking into consideration the community's needs.

  13. Sociodemographic characteristics of nonparticipants in the Danish colorectal cancer screening program: a nationwide cross-sectional study

    DEFF Research Database (Denmark)

    Larsen, Mette Bach; Mikkelsen, Ellen Margrethe; Rasmussen, Morten

    2017-01-01

    INTRODUCTION: Fecal occult blood tests are recommended for colorectal cancer (CRC) screening in Europe. Recently, the fecal immunochemical test (FIT) has come into use. Sociodemographic differences between participants and nonparticipants may be less pronounced when using FIT as there are no prec......INTRODUCTION: Fecal occult blood tests are recommended for colorectal cancer (CRC) screening in Europe. Recently, the fecal immunochemical test (FIT) has come into use. Sociodemographic differences between participants and nonparticipants may be less pronounced when using FIT...... as there are no preceding dietary restrictions and only one specimen is required. The aim of this study was to examine the associations between sociodemographic characteristics and nonparticipation for both genders, with special emphasis on those who actively unsubscribe from the program. METHODS: The study was a national......, register-based, cross-sectional study among men and women randomized to be invited to participate in the prevalence round of the Danish CRC screening program between March 1 and December 31, 2014. Prevalence ratios (PRs) were used to quantify the association between sociodemographic characteristics...

  14. A Novel Approach to Realizing Routine HIV Screening and Enhancing Linkage to Care in the United States: Protocol of the FOCUS Program and Early Results

    Science.gov (United States)

    Sullivan, Patrick S; Rothman, Richard E; Brown, Emily H; Fitzpatrick, Lisa K; Wood, Angela F; Hernandez, Paloma I; Nunn, Amy S; Serota, Martin L; Moreno-Walton, Lisa

    2014-01-01

    Background The United States health care system remains far from implementing the Centers for Disease Control and Prevention's recommendation of routine human immunodeficiency virus (HIV) screening as part of health care for adults. Although consensus for the importance of screening has grown, innovations in implementing routine screening are still lacking. HIV on the Frontlines of Communities in the United States (FOCUS) was launched in 2010 to provide an environment for testing innovative approaches to routine HIV screening and linkage to care. Objective The strategy of the FOCUS program was to develop models that maximize the use of information systems, fully integrate HIV screening into clinical practice, transform basic perceptions about routine HIV screening, and capitalize on emerging technologies in health care settings and laboratories. Methods In 10 of the most highly impacted cities, the FOCUS program supports 153 partnerships to increase routine HIV screening in clinical and community settings. Results From program launch in 2010 through October 2013, the partnerships have resulted in a total of 799,573 HIV tests and 0.68% (5425/799,573) tested positive. Conclusions The FOCUS program is a unique model that will identify best practices for HIV screening and linkage to care. PMID:25093431

  15. A Cost-Effectiveness Analysis of a Pilot Neonatal Screening Program for Sickle Cell Anemia in the Republic of Angola.

    Science.gov (United States)

    McGann, Patrick T; Grosse, Scott D; Santos, Brigida; de Oliveira, Vysolela; Bernardino, Luis; Kassebaum, Nicholas J; Ware, Russell E; Airewele, Gladstone E

    2015-12-01

    To assess the cost-effectiveness of a pilot newborn screening (NBS) and treatment program for sickle cell anemia (SCA) in Luanda, Angola. In July 2011, a pilot NBS and treatment program was implemented in Luanda, Angola. Infants identified with SCA were enrolled in a specialized SCA clinic in which they received preventive care and sickle cell education. In this analysis, the World Health Organization (WHO) and generalized cost-effectiveness analysis methods were used to estimate gross intervention costs of the NBS and treatment program. To determine healthy life-years (HLYs) gained by screening and treatment, we assumed NBS reduced mortality to that of the Angolan population during the first 5 years based upon WHO and Global Burden of Diseases Study 2010 estimates, but provided no significant survival benefit for children who survive through age 5 years. A secondary sensitivity analysis with more conservative estimates of mortality benefits also was performed. The costs of downstream medical costs, including acute care, were not included. Based upon the costs of screening 36,453 infants and treating the 236 infants with SCA followed after NBS in the pilot project, NBS and treatment program is projected to result in the gain of 452-1105 HLYs, depending upon the discounting rate and survival assumptions used. The corresponding estimated cost per HLY gained is $1380-$3565, less than the gross domestic product per capita in Angola. These data demonstrate that NBS and treatment for SCA appear to be highly cost-effective across all scenarios for Angola by the WHO criteria. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Population-based screening for breast and ovarian cancer risk due to BRCA1 and BRCA2.

    Science.gov (United States)

    Gabai-Kapara, Efrat; Lahad, Amnon; Kaufman, Bella; Friedman, Eitan; Segev, Shlomo; Renbaum, Paul; Beeri, Rachel; Gal, Moran; Grinshpun-Cohen, Julia; Djemal, Karen; Mandell, Jessica B; Lee, Ming K; Beller, Uziel; Catane, Raphael; King, Mary-Claire; Levy-Lahad, Ephrat

    2014-09-30

    In the Ashkenazi Jewish (AJ) population of Israel, 11% of breast cancer and 40% of ovarian cancer are due to three inherited founder mutations in the cancer predisposition genes BRCA1 and BRCA2. For carriers of these mutations, risk-reducing salpingo-oophorectomy significantly reduces morbidity and mortality. Population screening for these mutations among AJ women may be justifiable if accurate estimates of cancer risk for mutation carriers can be obtained. We therefore undertook to determine risks of breast and ovarian cancer for BRCA1 and BRCA2 mutation carriers ascertained irrespective of personal or family history of cancer. Families harboring mutations in BRCA1 or BRCA2 were ascertained by identifying mutation carriers among healthy AJ males recruited from health screening centers and outpatient clinics. Female relatives of the carriers were then enrolled and genotyped. Among the female relatives with BRCA1 or BRCA2 mutations, cumulative risk of developing either breast or ovarian cancer by age 60 and 80, respectively, were 0.60 (± 0.07) and 0.83 (± 0.07) for BRCA1 carriers and 0.33 (± 0.09) and 0.76 (± 0.13) for BRCA2 carriers. Risks were higher in recent vs. earlier birth cohorts (P = 0.006). High cancer risks in BRCA1 or BRCA2 mutation carriers identified through healthy males provide an evidence base for initiating a general screening program in the AJ population. General screening would identify many carriers who are not evaluated by genetic testing based on family history criteria. Such a program could serve as a model to investigate implementation and outcomes of population screening for genetic predisposition to cancer in other populations.

  17. Two distinct groups of non-attenders in an organized mammography screening program

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    2001-01-01

    on personal first round invitations, with 89% attendance rate. PARTICIPANTS: Four hundred thirty six women with both pre-screening response to socioeconomic and psychosocial measures, and post-screening response reporting reasons of non-attendance. MAIN RESULTS: Most common single reason for non......, more socially isolated, depressed and anxious than ELSE. Level of depression among REAL was clearly higher (10.80) than the mean value (7.91, SD = 7.28) of the age group, and was also slightly above the cut-off score of 10 indicating mild or moderate depression. Trait anxiety was also markedly higher...

  18. Development of a PCR assay suitable for Campylobacter spp. mass screening programs in broiler production

    DEFF Research Database (Denmark)

    Bang, Dang Duong; Pedersen, Karl; Madsen, Mogens

    2001-01-01

    culture techniques since 1998. However, using conventional culture methods is time consuming and laborious, and therefore a Polymerase Chain Reaction (PCR) Campylobacter detection assay suitable for mass screening of cloacal swab samples from broilers was developed. By comparing the PCR detection...... with conventional culture methods, significantly more samples were found positive for Campylobacter with the PCR method. The PCR method is rapid, sensitive and suitable for mass screening for Campylobacter in poultry. Using this PCR method Campylobacter can be detected within 15 h. Notably, the method can...... be applied to detect Campylobacter directly from chicken feces at the species level....

  19. Screening, brief intervention, and referral to treatment: overview of and student satisfaction with an undergraduate addiction training program for nurses.

    Science.gov (United States)

    Mitchell, Ann M; Puskar, Kathryn; Hagle, Holly; Gotham, Heather J; Talcott, Kimberly S; Terhorst, Lauren; Fioravanti, Marie; Kane, Irene; Hulsey, Eric; Luongo, Peter; Burns, Helen K

    2013-10-01

    Preparing nursing students to apply an evidence-based screening and brief intervention approach with patients has the potential to reduce patients' risky alcohol and drug use. Responding to Mollica, Hyman, and Mann's article published in 2011, the current article describes implementation results of an Addiction Training for Nurses program of Screening, Brief Intervention, and Referral to Treatment (SBIRT) embedded within an undergraduate nursing curriculum. Results reveal that students in other schools of nursing would benefit from similar, significant training on substance use disorders and SBIRT. Training satisfaction surveys (N = 488) indicate students were satisfied with the quality of the training experience. More than 90% of students strongly agreed or agreed that the training was relevant to their nursing careers and would help their patients. Additional clinical practice and skill development may increase students' reported effectiveness in working with the topic area of substance use and SBIRT. Copyright 2013, SLACK Incorporated.

  20. How to offer culturally relevant type 2 diabetes screening: lessons learned from the South asian diabetes prevention program.

    Science.gov (United States)

    van Draanen, Jenna; Shafique, Ammara; Farissi, Aziz; Wickramanayake, Dilani; Kuttaiya, Sheela; Oza, Shobha; Stephens, Neil

    2014-10-01

    The literature on diabetes mellitus in the South Asian population clearly states the high-risk status of this group, yet there is a lack of effective models of culturally relevant, community-based screening and education programs for such a group. The South Asian Diabetes Prevention Program (SADPP) was developed to enhance equitable access to diabetes prevention resources for the South Asian communities in Toronto by offering language-specific and culturally relevant services. The SADPP model works through 3 participant education sessions plus an additional attachment and enrolment component. The screening tool that SADPP uses to provide participants with their individual risk score at the first education session is derived from the multiculturally validated Canadian Diabetes Risk Assessment Questionnaire (CANRISK), which has been modified to reflect the distinctive characteristics of the South Asian population. After analyzing the risk scores, 32% of participants were at increased risk, 40% were at high risk, 21% were at very high risk and only 7% were found to be at low risk of diabetes development. Evaluations of the program conducted in 2010 and 2013 revealed that the program is achieving its objectives and that participants increase their knowledge and self-efficacy related to diabetes prevention after program participation. Participants reported that the presentation from the nurse and dietitian, the question-and-answer time, the healthy eating demonstration, the multiple languages of delivery and the convenient location were especially beneficial. Those working in the field are encouraged to adapt this model and to contribute to the development of culturally relevant, community-driven diabetes prevention programs. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  1. Implementation and Evaluation of a Large-Scale Teleretinal Diabetic Retinopathy Screening Program in the Los Angeles County Department of Health Services.

    Science.gov (United States)

    Daskivich, Lauren P; Vasquez, Carolina; Martinez, Carlos; Tseng, Chi-Hong; Mangione, Carol M

    2017-05-01

    Diabetic retinopathy (DR) is the leading cause of blindness in adults of working age in the United States. In the Los Angeles County safety net, a nonvertically integrated system serving underinsured and uninsured patients, the prevalence of DR is approximately 50%, and owing to limited specialty care resources, the average wait times for screening for DR have been 8 months or more. To determine whether a primary care-based teleretinal DR screening (TDRS) program reduces wait times for screening and improves timeliness of needed care in the Los Angeles County safety net. Quasi-experimental, pretest-posttest evaluation of exposure to primary care-based TDRS at 5 of 15 Los Angeles County Department of Health Services safety net clinics from September 1, 2013, to December 31, 2015, with a subgroup analysis of random samples of 600 patients before and after the intervention (1200 total). Primary care clinic-based teleretinal screening for DR. Annual rates of screening for DR before and after implementation of the TDRS program across the 5 clinics, time to screening for DR in a random sample of patients from these clinics, and a description of the larger framework of program implementation. Among the 21 222 patients who underwent the screening (12 790 female, 8084 male, and 348 other gender or not specified; mean [SD] age, 57.4 [9.6] years), the median time to screening for DR decreased from 158 days (interquartile range, 68-324 days) before the intervention to 17 days (interquartile range, 8-50 days) after initiation of the program (P screening rates for DR increased from 5942 of 14 633 patients (40.6%) before implementation to 7470 of 13 133 patients (56.9%) after initiation of the program at all 15 targeted clinics (odds ratio, 1.9; 95% CI, 1.3-2.9; P = .002). Of the 21 222 patients who were screened, 14 595 (68.8%) did not require referral to an eye care professional, 4160 (19.6%) were referred for treatment or monitoring of DR, and 2461 (11

  2. Risk- and cost-benefit analyses of breast screening programs derived from absorbed dose measurements in the Netherlands

    International Nuclear Information System (INIS)

    Zuur, C.; Broerse, J.J.

    1985-01-01

    Risk- and cost benefit analyses for breast screening programs are being performed, employing the risk-factors for induction of breast cancer from six extensive follow-up studies. For women of the age group above 35 years and for a risk period of 30 years after a 10-year latency period, a factor of extra cases of 20 x 10 -6 mGy -1 can be estimated. Measurements are being performed in Dutch hospitals to determine the mean absorbed tissue dose. These doses vary from 0.6 to 4.4 mGy per radiography. For a dose of 1 mGy per radiograph and yearly screening of women between 35 and 75 years, the risk of radiogenic breast cancer is about 1% of the natural incidence (85,000 per 10 6 women) in this group. A recommended frequency of screening has to be based on medical, social and financial considerations. The gain in woman years and in completely cured women is being estimated for screening with intervals of 12 instead of 24 months. The medical and social benefit is 1,520 years life-time and 69 more cases completely cured per 1,000 breast cancer patients. The financial profit of a completely cured instead of an ultimately fatal cancer can be roughly estimated at 55,000 guilders. In addition the costs per gained woman-year are about 5,000 guilders. In consequence, the extra costs of annual additional rounds of mammographic screening are balanced by the benefit. (Auth.)

  3. Implementing Universal Maternal Depression Screening in Home Visiting Programs: A Pragmatic Overview

    Science.gov (United States)

    Segre, Lisa S.; Taylor, Darby

    2014-01-01

    Maternal depression, although prevalent in low-income women, is not an inevitable consequence of poverty. Nevertheless, depression is a double burden for impoverished women: compromising infant development and diminishing mothers' ability to benefit from or effectively use home visiting services. Without universal screening, depression is often…

  4. Early Education Screening Test Battery of Basic Skills Development: Criteria for Personalizing Programs.

    Science.gov (United States)

    University City School District, MO.

    The development and content of the Early Education Screening Test Battery are described elsewhere (TM 000 184). This report provides norms for the Gross Motor Test (GMO), Visual-Motor Integration (VMI), four scales of the Illinois Test of Psycholinguistic Abilities (ITPA), Peabody Picture Vocabulary Test (PPVT), and the Behavior Rating Scale…

  5. Implementation of a vision-screening program in rural northeastern United States

    Directory of Open Access Journals (Sweden)

    Tsui E

    2015-10-01

    Full Text Available Edmund Tsui,1,2 Andrew N Siedlecki,3 Jie Deng,3 Margaret C Pollard,3 Sandolsam Cha,3 Susan M Pepin,4 Erin M Salcone4 1Department of Surgery, Dartmouth–Hitchcock Medical Center, Lebanon, NH, 2Department of Ophthalmology, New York University School of Medicine, New York, NY, 3Geisel School of Medicine at Dartmouth, Hanover, NH, 4Section of Ophthalmology, Dartmouth–Hitchcock Medical Center, Lebanon, NH, USA Background: Rural populations comprise almost 20% of the US population and face unique barriers in receiving health care. We describe the implementation of a medical student-run free vision-screening clinic as a strategy to overcome barriers in accessing eye care in New Hampshire and Vermont.Methods: Medical students were trained by an ophthalmologist to administer screening eye examinations. Patients from New Hampshire and Vermont were enrolled through a free community clinic. Screening included a questionnaire, distance and near visual acuity, extraocular movements, confrontational visual fields, and Amsler grid. Patients who met predetermined screening criteria were referred to an ophthalmologist or optometrist for further evaluation. Data including patient demographics, appointment attendance, level of education, and diagnoses were recorded and analyzed.Results: Of 103 patients (mean age of 45.5±12.3 years, 63% female, 74/103 (72% were referred for further evaluation, and 66/74 (89% attended their referral appointments. Abnormal ophthalmologic examination findings were observed in 58/66 (88% patients who attended their referral appointment. Uncorrected refractive error was the most common primary diagnosis in 38% of referred patients. Other diagnoses included glaucoma suspect (21%, retinal diseases (8%, amblyopia (8%, cataract (6%, others (6%, and normal examination (12%. Of the 8/74 (11% referred patients who did not attend their appointments, reasons included patient cancellation of appointment, work conflicts, or forgetfulness

  6. Do the Results of the Process Indicators in the Norwegian Breast Cancer Screening Program Predict Future Mortality Reduction from Breast Cancer?

    International Nuclear Information System (INIS)

    Hofvind, Solveig; Wang, Hege; Thoresen, Steinar

    2004-01-01

    Continuous emphases of quality control are required to achieve reduction in mortality from breast cancer as a consequence of breast cancer screening. Results of the process indicators in the first 6 years in 4 counties in the Norwegian Breast Cancer Screening Program are evaluated and will be presented. Data from women who had their initial (n=173?402) and subsequent (n=220?058) screening provide the basis for the analysis. The breast cancer detection ratio was 3.2 the expected incidence (based on the incidence before the screening started, 1991-1995) among the initially screened women, decreasing to 2.3 among the subsequently screened. The ratio of interval cancer among the initially screened was 0.25 and 0.72 of the expected incidence, 0-12 and 13-23 months after screening, respectively. For those subsequently screened the proportions were 0.22 and 0.64, respectively. More than 50% of the invasive tumors were less than 15 mm in size, and more than 75% were lymph node negative, among both the initially and subsequently screened. The process indicators achieved in the NBCSP are promising as regards future mortality reduction. The incidence of interval cancer 13-24 months after screening is higher than recommended in the European guidelines

  7. Single reading with computer-aided detection performed by selected radiologists in a breast cancer screening program

    Energy Technology Data Exchange (ETDEWEB)

    Bargalló, Xavier, E-mail: xbarga@clinic.cat [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain); Santamaría, Gorane; Amo, Montse del; Arguis, Pedro [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain); Ríos, José [Biostatistics and Data Management Core Facility, IDIBAPS, (Hospital Clinic) C/ Mallorca, 183. Floor -1. Office #60. 08036 Barcelona (Spain); Grau, Jaume [Preventive Medicine and Epidemiology Unit, Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain); Burrel, Marta; Cores, Enrique; Velasco, Martín [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain)

    2014-11-15

    Highlights: • 1-The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD. • 2-The cancer detection rate improved at the cost of increasing recall rate. • 3-CAD, used by breast radiologists, did not help to detect more cancers. - Abstract: Objectives: To assess the impact of shifting from a standard double reading plus arbitration protocol to a single reading by experienced radiologists assisted by computer-aided detection (CAD) in a breast cancer screening program. Methods: This was a prospective study approved by the ethics committee. Data from 21,321 consecutive screening mammograms in incident rounds (2010–2012) were read following a single reading plus CAD protocol and compared with data from 47,462 consecutive screening mammograms in incident rounds (2004–2010) that were interpreted following a double reading plus arbitration protocol. For the single reading, radiologists were selected on the basis of the appraisement of their previous performance. Results: Period 2010–2012 vs. period 2004–2010: Cancer detection rate (CDR): 6.1‰ (95% confidence interval: 5.1–7.2) vs. 5.25‰; Recall rate (RR): 7.02% (95% confidence interval: 6.7–7.4) vs. 7.24% (selected readers before arbitration) and vs. 3.94 (all readers after arbitration); Predictive positive value of recall: 8.69% vs. 13.32%. Average size of invasive cancers: 14.6 ± 9.5 mm vs. 14.3 ± 9.5 mm. Stage: 0 (22.3/26.1%); I (59.2/50.8%); II (19.2/17.1%); III (3.1/3.3%); IV (0/1.9%). Specialized breast radiologists performed better than general radiologists. Conclusions: The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD, at the cost of a moderate increase of the recall rate mainly related to the lack of arbitration.

  8. Screening for Fall Risks in the Emergency Department: A Novel Nursing-Driven Program

    Directory of Open Access Journals (Sweden)

    Jill M. Huded

    2015-12-01

    Full Text Available Introduction: Seniors represent the fasting growing population in the U.S., accounting for 20.3 million visits to emergency departments (EDs annually. The ED visit can provide an opportunity for identifying seniors at high risk of falls. We sought to incorporate the Timed Up & Go Test (TUGT, a commonly used falls screening tool, into the ED encounter to identify seniors at high fall risk and prompt interventions through a geriatric nurse liaison (GNL model. Methods: Patients aged 65 and older presenting to an urban ED were evaluated by a team of ED nurses trained in care coordination and geriatric assessment skills. They performed fall risk screening with the TUGT. Patients with abnormal TUGT results could then be referred to physical therapy (PT, social work or home health as determined by the GNL. Results: Gait assessment with the TUGT was performed on 443 elderly patients between 4/1/13 and 5/31/14. A prior fall was reported in 37% of patients in the previous six months. Of those screened with the TUGT, 368 patients experienced a positive result. Interventions for positive results included ED-based PT (n=63, 17.1%, outpatient PT referrals (n=56, 12.2% and social work consultation (n=162, 44%. Conclusion: The ED visit may provide an opportunity for older adults to be screened for fall risk. Our results show ED nurses can conduct the TUGT, a validated and time efficient screen, and place appropriate referrals based on assessment results. Identifying and intervening on high fall risk patients who visit the ED has the potential to improve the trajectory of functional decline in our elderly population.

  9. Massachusetts Beryllium Screening Program for Former Workers of Wyman-Gordon, Norton Abrasives, and MIT/Nuclear Metals

    Energy Technology Data Exchange (ETDEWEB)

    Pepper, L. D.

    2008-05-21

    The overall objective of this project was to provide medical screening to former workers of Wyman-Gordon Company, Norton Abrasives, and MIT/Nuclear Metals (NMI) in order to prevent and minimize the health impact of diseases caused by site related workplace exposures to beryllium. The program was developed in response to a request by the U.S. Department of Energy (DOE) that had been authorized by Congress in Section 3162 of the 1993 Defense Authorization Act, urging the DOE to carry out a program for the identification and ongoing evaluation of current and former DOE employees who are subjected to significant health risks during such employment." This program, funded by the DOE, was an amendment to the medical surveillance program for former DOE workers at the Nevada Test Site (NTS). This program's scope included workers who had worked for organizations that provided beryllium products or materials to the DOE as part of their nuclear weapons program. These organizations have been identified as Beryllium Vendors.

  10. A Case-Control Study to Estimate the Impact of the Icelandic Population-Based Mammography Screening Program on Breast Cancer Death

    Energy Technology Data Exchange (ETDEWEB)

    Gabe, R.; Tryggvadottir, L.; Sigfusson, B.F.; Olafsdottir, G.H.; Sigurarsson , K. [Icelandic Cancer Society (Krabbameinsfelag Islands), Reykjavik (Iceland); Duffy, S.W. [Cancer Research UK, Centre for Epidemiology, Mathematics and Stati stics, Wolfson Inst. of Preventive Medicine, London (United Kingdom)

    2007-11-15

    Background: The Icelandic breast cancer screening program, initiated November 1987 in Reykjavik and covering the whole country from December 1989, comprises biennial invitation to mammography for women aged 40-69 years old. Purpose: To estimate the impact of mammography service screening in Iceland on deaths from breast cancer. Material and Methods: Cases were deaths from breast cancer from 1990 onwards in women aged 40 and over at diagnosis, during the period November 1987 to December 31, 2002. Age- and screening-area-matched, population-based controls were women who had also been invited to screening but were alive at the time their case died. Results: Using conditional logistic regression on the data from 226 cases and 902 controls, the odds ratio for the risk of death from breast cancer in those attending at least one screen compared to those never screened was 0.59 (95% CI 0.41-0.84). After adjustment for healthy-volunteer bias and screening-opportunity bias, the odds ratio was 0.65 (95% CI 0.39-1.09). Conclusion: These results indicate a 35-40% reduction in breast cancer deaths by attending the Icelandic breast cancer screening program. These results are consistent with the overall evidence from other observational evaluations of mammography-based programs.

  11. A Case-Control Study to Estimate the Impact of the Icelandic Population-Based Mammography Screening Program on Breast Cancer Death

    International Nuclear Information System (INIS)

    Gabe, R.; Tryggvadottir, L.; Sigfusson, B.F.; Olafsdottir, G.H.; Sigurarsson, K.; Duffy, S.W.

    2007-01-01

    Background: The Icelandic breast cancer screening program, initiated November 1987 in Reykjavik and covering the whole country from December 1989, comprises biennial invitation to mammography for women aged 40-69 years old. Purpose: To estimate the impact of mammography service screening in Iceland on deaths from breast cancer. Material and Methods: Cases were deaths from breast cancer from 1990 onwards in women aged 40 and over at diagnosis, during the period November 1987 to December 31, 2002. Age- and screening-area-matched, population-based controls were women who had also been invited to screening but were alive at the time their case died. Results: Using conditional logistic regression on the data from 226 cases and 902 controls, the odds ratio for the risk of death from breast cancer in those attending at least one screen compared to those never screened was 0.59 (95% CI 0.41-0.84). After adjustment for healthy-volunteer bias and screening-opportunity bias, the odds ratio was 0.65 (95% CI 0.39-1.09). Conclusion: These results indicate a 35-40% reduction in breast cancer deaths by attending the Icelandic breast cancer screening program. These results are consistent with the overall evidence from other observational evaluations of mammography-based programs

  12. Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervical screening in an organized screening program: a cross-sectional study of 12,058 Norwegian women

    Science.gov (United States)

    2011-01-01

    Background Cervical cancer incidence and mortality may be reduced by organized screening. Participant compliance with the attendance recommendations of the screening program is necessary to achieve this. Knowledge about the predictors of compliance is needed in order to enhance screening attendance. Methods The Norwegian Co-ordinated Cervical Cancer Screening Program (NCCSP) registers all cervix cytology diagnoses in Norway and individually reminds women who have no registered smear for the past three years to make an appointment for screening. In the present study, a questionnaire on lifestyle and health was administered to a random sample of Norwegian women. The response rate was 68%. To address the predictors of screening attendance for the 12,058 women aged 25-45 who were eligible for this study, individual questionnaire data was linked to the cytology registry of the NCCSP. We distinguished between non-attendees, opportunistic attendees and reminded attendees to screening for a period of four years. Predictors of non-attendance versus attendance and reminded versus opportunistic attendance were established by multivariate logistic regression. Results Women who attended screening were more likely than non-attendees to report that they were aware of the recommended screening interval, a history of sexually transmitted infections and a history of hormonal contraceptive and condom use. Attendance was also positively associated with being married/cohabiting, being a non-smoker and giving birth. Women who attended after being reminded were more likely than opportunistic attendees to be aware of cervical cancer and the recommended screening interval, but less likely to report a history of sexually transmitted infections and hormonal contraceptive use. Moreover, the likelihood of reminded attendance increased with age. Educational level did not significantly affect the women's attendance status in the fully adjusted models. Conclusions The likelihood of attendance in

  13. An adverse event in a well-established cervical cancer screening program: an observational study of 19,000 females unsubscribed to the program

    DEFF Research Database (Denmark)

    Larsen, Mette Bach; Svanholm, Hans; Andersen, Berit

    2016-01-01

    or reminders as recommended by the health authorities. The study aims to report the essence of this adverse event and describe the outcomes of reestablishing invitations in terms of participation rates and screening results. Furthermore, patient compensations to affected females diagnosed with cervical cancer...... and coverage in the mass media was reported. Methods: An observational study based on information from the Danish Pathology Databank, the Department of Public Health Programs, and Infomedia (a Danish database of media coverage) was carried out. Results: A total of 19,106 females were affected. Of those still...... ranked alongside other adverse events in the health care system if cancer diagnoses were delayed....

  14. Improving NASA's technology transfer process through increased screening and evaluation in the information dissemination program

    Science.gov (United States)

    Laepple, H.

    1979-01-01

    The current status of NASA's technology transfer system can be improved if the technology transfer process is better understood. This understanding will only be gained if a detailed knowledge about factors generally influencing technology transfer is developed, and particularly those factors affecting technology transfer from government R and D agencies to industry. Secondary utilization of aerospace technology is made more difficult because it depends on a transfer process which crosses established organizational lines of authority and which is outside well understood patterns of technical applications. In the absence of a sound theory about technology transfer and because of the limited capability of government agencies to explore industry's needs, a team approach to screening and evaluation of NASA generated technologies is proposed which calls for NASA, and other organizations of the private and public sectors which influence the transfer of NASA generated technology, to participate in a screening and evaluation process to determine the commercial feasibility of a wide range of technical applications.

  15. Evaluation of culture media for the production of secondary metabolites in a natural products screening program.

    Science.gov (United States)

    Vandermolen, Karen M; Raja, Huzefa A; El-Elimat, Tamam; Oberlies, Nicholas H

    2013-12-17

    Variation in the growing environment can have significant impacts on the quantity and diversity of fungal secondary metabolites. In the industrial setting, optimization of growing conditions can lead to significantly increased production of a compound of interest. Such optimization becomes challenging in a drug-discovery screening situation, as the ideal conditions for one organism may induce poor metabolic diversity for a different organism. Here, the impact of different media types, including six liquid media and five solid media, on the secondary metabolite production of three fungal strains was examined in the context of the drug-discovery screening process. The relative production of marker compounds was used to evaluate the usefulness and reliability of each medium for the purpose of producing secondary metabolites.

  16. A Call to Include Severe Combined Immunodeficiency in Newborn Screening Program

    Directory of Open Access Journals (Sweden)

    Raz Somech

    2014-01-01

    Full Text Available Quantification of the T cell receptor excision circles (TRECs has recently emerged as a useful non-invasive clinical and research tool to investigate thymic activity. It allows the identification of T cell production by the thymus. Quantification of TREC copies has recently been implemented as the preferred test to screen neonates with severe combined immunodeficiency (SCID or significant lymphopenia. Neonatal genetic screening for SCID is highly important in countries with high rates of consanguinous marriages, such as Israel, and can be used for early diagnosis, enabling prompt therapeutic intervention that will save lives and improve the outcome of these patients. TREC measurement is also applicable in clinical settings where T cell immunity is involved, including any T cell immunodeficiencies, HIV infection, the aging process, autoimmune diseases, and immune reconstitution after bone marrow transplantation.

  17. Changes in detection of retinopathy in type 2 diabetes in the first 4 years of a population-based diabetic eye screening program: retrospective cohort study.

    Science.gov (United States)

    Forster, Alice S; Forbes, Angus; Dodhia, Hiten; Connor, Clare; Du Chemin, Alain; Sivaprasad, Sobha; Mann, Samantha; Gulliford, Martin C

    2013-09-01

    Annual diabetic eye screening has been implemented in England since 2008. This study aimed to estimate changes in the detection of retinopathy in the first 4 years of the program. Participants included 32,340 patients with type 2 diabetes resident in three London boroughs with one or more screening records between 2008 and 2011. Data for 87,570 digital images from 2008 to 2011 were analyzed. Frequency of sight-threatening diabetic retinopathy (STDR) was estimated by year of screen for first screens and for subsequent screens according to retinopathy status at first screen. Among 16,621 first-ever screens, the frequency of STDR was 7.1% in 2008, declining to 6.4% in 2011 (P = 0.087). The proportion with a duration of diabetes of screen increased from 18.7% in 2008 to 48.6% in 2011. Second or later screens were received by 26,308 participants. In participants with mild nonproliferative retinopathy at first screen, the proportion with STDR at second or later screen declined from 21.6% in 2008 to 8.4% in 2011 (annual change -2.2% [95% CI -3.3 to -1.0], P screen, STDR declined from 9.2% in 2008 to 3.2% in 2011 (annual change -1.8% [-2.0 to -1.7], P eye screening, patients at lower risk of STDR contribute an increasing proportion to the eligible population, and the proportion detected with STDR at second or subsequent screening rounds declines rapidly.

  18. Changes in Detection of Retinopathy in Type 2 Diabetes in the First 4 Years of a Population-Based Diabetic Eye Screening Program

    Science.gov (United States)

    Forster, Alice S.; Forbes, Angus; Dodhia, Hiten; Connor, Clare; Du Chemin, Alain; Sivaprasad, Sobha; Mann, Samantha; Gulliford, Martin C.

    2013-01-01

    OBJECTIVE Annual diabetic eye screening has been implemented in England since 2008. This study aimed to estimate changes in the detection of retinopathy in the first 4 years of the program. RESEARCH DESIGN AND METHODS Participants included 32,340 patients with type 2 diabetes resident in three London boroughs with one or more screening records between 2008 and 2011. Data for 87,570 digital images from 2008 to 2011 were analyzed. Frequency of sight-threatening diabetic retinopathy (STDR) was estimated by year of screen for first screens and for subsequent screens according to retinopathy status at first screen. RESULTS Among 16,621 first-ever screens, the frequency of STDR was 7.1% in 2008, declining to 6.4% in 2011 (P = 0.087). The proportion with a duration of diabetes of <1 year at first screen increased from 18.7% in 2008 to 48.6% in 2011. Second or later screens were received by 26,308 participants. In participants with mild nonproliferative retinopathy at first screen, the proportion with STDR at second or later screen declined from 21.6% in 2008 to 8.4% in 2011 (annual change −2.2% [95% CI −3.3 to −1.0], P < 0.001). In participants with no retinopathy at first screen, STDR declined from 9.2% in 2008 to 3.2% in 2011 (annual change −1.8% [−2.0 to −1.7], P < 0.001). Declining trends were similar in sociodemographic subgroups. CONCLUSIONS After the inception of population-based diabetic eye screening, patients at lower risk of STDR contribute an increasing proportion to the eligible population, and the proportion detected with STDR at second or subsequent screening rounds declines rapidly. PMID:23620476

  19. Effectiveness of Bacterial Vaginosis Screening Program in Routine Prenatal Care and Its Effect on Decrease of Preterm Labor

    Directory of Open Access Journals (Sweden)

    Mehrnaz Mashoufi

    2012-09-01

    Full Text Available Background & Objectives : Bacterial vaginosis is a condition which is determined by changes in microbial ecosystem of vagina and is considered as a preventable risk factor for preterm delivery. This study was conducted to assess the effectiveness of bacterial vaginosis screening program in routine prenatal care and its effect on decreasing preterm labor.   Methods: This clinical trial study was conducted on 474 pregnant women at gestational stage between 2007 and 2008. The participants were randomly divided into 2 groups: intervention group and control group. Screening was performed in intervention group with Amsel's criteria (3 of 4 needed for diagnosis. Positive cases were given clindamycin cream (2% for one week. The outcome of the delivery was assessed in both groups afterward. Data were analyzed by SPSS11 software using descriptive statistics.   Results: There was no significant difference between two groups regarding pregnancy rank, wanted and unwanted pregnancy, insufficient weight gain, mother vaccination and complication of pregnancy. Bacterial vaginosis was observed in 17 out of 216 (8% in the intervention group and then treated. Prevalence of preterm delivery in the intervention and control groups were 3 (1.4% and 12 (4.7%, respectively. The relative risk was protective (RR: 0.3, DR: 0.033, NNT: 30.   Conclusion: Screening and treatment of bacterial vaginosis in pregnant women could significantly decrease the rate of preterm delivery.

  20. UsefuIIness of upper gastrointestinal series using indirect radiography in mass screening program for gastric cancer

    International Nuclear Information System (INIS)

    Kim, Min Jeong; Ha, Hyun Kwon; Kim, Kyoung Won; Lee, Jeong Kyong; Chin, Soo Yil

    2004-01-01

    To compare the image quality of UGIS (upper gastrointestinal series) obtained by direct radiography with that of UGIS obtained by indirect radiography in a mass screening program for gastric cancer, and to assess the validity of UGIS by indirect radiography. A total of 994 persons participated in a mass screening test for gastric cancer between March 2003 and April 2003 at the Korea Association of Health Promotion (KAHP). Of these 994 persons, 494 underwent UGIS by direct radiography, while the remaining 500 underwent UGIS by indirect radiography (i.e. photofluorography using a mirror camera and a 100 mm-roll film). We compared the image quality of UGIS obtained by direct and indirect radiography with, in each case, the image quality being graded as 'excellent', 'good', 'fair', 'poor', or 'very poor'. The image quality of UGIS by both direct and indirect radiography was similar: most images in both groups were rated as either 'excellent','good', or 'fair', while the incidences of poorly rated images were similar in both cases (5% versus 6%, respectively); and there were no images rated as 'very poor', in either case. For certain sites of the stomach, the image quality of UGIS by direct radiography was superior to that of UGIS by indirect radiography, namely at the cardia (p 0.05). There was no significant difference in the image quality between UGIS by indirect and direct radiography. Therefore, UGIS by indirect radiography may be used as a method of mass screening for gastric cancer

  1. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach

    Science.gov (United States)

    Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent’s residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40–74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8–112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60–78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0–340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40–240.00). Higher travel impedance was noted

  2. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach.

    Science.gov (United States)

    Mahmud, Aidalina; Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who

  3. Scoliosis detection, patient characteristics, referral patterns and treatment in the absence of a screening program in Norway

    Science.gov (United States)

    2012-01-01

    Background Early diagnosis of idiopathic scoliosis allows for observation and timely initiation of brace treatment in order to halt progression. School scoliosis screening programs were abolished in Norway in 1994 for lack of evidence that the programs improved outcome and for the costs involved. The consequences of this decision are discussed. Objectives To describe the detection, patient characteristics, referral patterns and treatment of idiopathic scoliosis at a scoliosis clinic during the period 2003–2011, when there was no screening and to compare treatment modalities to the period 1976–1988 when screening was performed. Methods Patient demographics, age at detection, family history, clinical and radiological charts of consecutive patients referred for scoliosis evaluation during the period 2003–2011, were prospectively registered. Patients were recruited from a catchment area of about 500000 teenagers. Maturity was estimated according to Risser sign and menarcheal status. Severity of pain was recorded by a verbal 5-point scale from no pain to pain at all times. Physical and neurological examinations were conducted. The detector and patient characteristics were recorded. Referral patterns of orthopedic surgeons at local hospitals and other health care providers were recorded. Patient data was obtained by spine surgeons. Treatment modalities in the current period were compared to the period 1976–1988. Results We registered 752 patients with late onset juvenile and adolescent idiopathic scoliosis from 2003–2011. There were 644 (86%) girls and 108 (14%) boys. Mean age at detection was 14.6 (7–19) years. Sixty percent had Risser sign ≥ 3, whilst 74% were post menarche with a mean age at menarche of 13.2 years. Thirty-one percent had a family history of scoliosis. The mean major curve at first consultation at our clinic was 38° (10°-95°). About 40% had a major curve >40°. Seventy-one percent were detected by patients, close relatives, and friends

  4. Scoliosis detection, patient characteristics, referral patterns and treatment in the absence of a screening program in Norway

    Directory of Open Access Journals (Sweden)

    Adobor Raphael

    2012-10-01

    Full Text Available Abstract Background Early diagnosis of idiopathic scoliosis allows for observation and timely initiation of brace treatment in order to halt progression. School scoliosis screening programs were abolished in Norway in 1994 for lack of evidence that the programs improved outcome and for the costs involved. The consequences of this decision are discussed. Objectives To describe the detection, patient characteristics, referral patterns and treatment of idiopathic scoliosis at a scoliosis clinic during the period 2003–2011, when there was no screening and to compare treatment modalities to the period 1976–1988 when screening was performed. Methods Patient demographics, age at detection, family history, clinical and radiological charts of consecutive patients referred for scoliosis evaluation during the period 2003–2011, were prospectively registered. Patients were recruited from a catchment area of about 500000 teenagers. Maturity was estimated according to Risser sign and menarcheal status. Severity of pain was recorded by a verbal 5-point scale from no pain to pain at all times. Physical and neurological examinations were conducted. The detector and patient characteristics were recorded. Referral patterns of orthopedic surgeons at local hospitals and other health care providers were recorded. Patient data was obtained by spine surgeons. Treatment modalities in the current period were compared to the period 1976–1988. Results We registered 752 patients with late onset juvenile and adolescent idiopathic scoliosis from 2003–2011. There were 644 (86% girls and 108 (14% boys. Mean age at detection was 14.6 (7–19 years. Sixty percent had Risser sign ≥ 3, whilst 74% were post menarche with a mean age at menarche of 13.2 years. Thirty-one percent had a family history of scoliosis. The mean major curve at first consultation at our clinic was 38° (10°-95°. About 40% had a major curve >40°. Seventy-one percent were detected by patients

  5. Screening for illicit heroin use in patients in a heroin-assisted treatment program

    NARCIS (Netherlands)

    Rook, Elisabeth J.; Huitema, Alwin D. R.; van den Brink, Wim; Hillebrand, Michel J. X.; van Ree, Jan M.; Beijnen, Jos H.

    2006-01-01

    The aim of this study was to investigate the use of illicit heroin among patients in a heroin-assisted treatment program. In this program, pharmaceutical-grade heroin was administered to heroin-addicted patients. Monitoring of illicit heroin use was considered important for the evaluation of this

  6. Workplace Training Programs: Instruments for Human Capital Improvements or Screening Devices?

    Science.gov (United States)

    Brunetti, Irene; Corsini, Lorenzo

    2017-01-01

    Purpose: The purpose of this paper is to analyse the effect of an Italian training program on the re-employment probability of young unemployed workers. The program consists exclusively of workplace training and is coordinated by employment centers, even if it is fully implemented by firms. Design/Methodology/Approach: The authors develop a…

  7. Breast cancer knowledge, attitudes, and screening behaviors among African American women: the Black cosmetologists promoting health program

    Directory of Open Access Journals (Sweden)

    Weldon Rai-nesha

    2007-04-01

    demonstrated a lack of basic knowledge about breast cancer. The Health Belief Model postulates that access to such information is an essential element in the progression toward engaging in screening behaviors. Conclusion Data from this study reflect a continuing need for increased breast cancer education for African American women. In light of the considerable mainstream information available related to breast cancer, these data reinforce the need for more breast cancer education programs that are clearly intended to attract the attention of African American women.

  8. Bacterial Carriers for Glioblastoma Therapy

    Directory of Open Access Journals (Sweden)

    Nalini Mehta

    2017-03-01

    Full Text Available Treatment of aggressive glioblastoma brain tumors is challenging, largely due to diffusion barriers preventing efficient drug dosing to tumors. To overcome these barriers, bacterial carriers that are actively motile and programmed to migrate and localize to tumor zones were designed. These carriers can induce apoptosis via hypoxia-controlled expression of a tumor suppressor protein p53 and a pro-apoptotic drug, Azurin. In a xenograft model of human glioblastoma in rats, bacterial carrier therapy conferred a significant survival benefit with 19% overall long-term survival of >100 days in treated animals relative to a median survival of 26 days in control untreated animals. Histological and proteomic analyses were performed to elucidate the safety and efficacy of these carriers, showing an absence of systemic toxicity and a restored neural environment in treated responders. In the treated non-responders, proteomic analysis revealed competing mechanisms of pro-apoptotic and drug-resistant activity. This bacterial carrier opens a versatile avenue to overcome diffusion barriers in glioblastoma by virtue of its active motility in extracellular space and can lead to tailored therapies via tumor-specific expression of tumoricidal proteins.

  9. Injury patterns in elite preprofessional ballet dancers and the utility of screening programs to identify risk characteristics.

    Science.gov (United States)

    Gamboa, Jennifer M; Roberts, Leigh A; Maring, Joyce; Fergus, Andrea

    2008-03-01

    Retrospective descriptive cohort study. To describe the distribution and rate of injuries in elite adolescent ballet dancers, and to examine the utility of screening data to distinguish between injured and noninjured dancers. Adolescent dancers account for most ballet injuries. Limited information exists, however, regarding the distribution of, rate of, and risk factors for, adolescent dance injuries. Two hundred four dancers (age, 9-20 years) were screened over 5 years. Screening data were collected at the beginning and injury data were collected at the end of each training year. Descriptive statistics were used to characterize distribution and rate of injuries. Inference statistics were used to examine differences between injured and noninjured dancers. Fifty-three percent of injuries occurred in the foot/ankle, 21.6% in the hip, 16.1% in the knee, and 9.4% in the back. Thirty-two to fifty-one percent of the dancers were injured each year, and, over the 5 years, there were 1.09 injuries per 1000 athletic exposures, and 0.77 injuries per 1000 hours of dance. Significant differences between injured and noninjured dancers were limited to current disability scores (P = .007), history of low back pain (P = .017), right foot pronation (P = .005), insufficient right-ankle plantar flexion (P = .037), and lower extremity strength (P = .045). Distribution of injuries was similar to that of other studies. Injury rates were lower than most reported rates, except when expressed per 1000 hours of dance. Few differences were found between injured and noninjured dancers. These findings should be considered when designing and implementing screening programs.

  10. Cervical cancer screening of underserved women in the United States: results from the National Breast and Cervical Cancer Early Detection Program, 1997-2012.

    Science.gov (United States)

    Tangka, Florence K L; Howard, David H; Royalty, Janet; Dalzell, Lucinda P; Miller, Jacqueline; O'Hara, Brett J; Sabatino, Susan A; Joseph, Kristy; Kenney, Kristy; Guy, Gery P; Hall, Ingrid J

    2015-05-01

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screens to low-income, uninsured, and underinsured women. We describe the number and proportion of women eligible for cervical cancer screening services and the proportion of eligible women screened over the period 1997-2012. Low-income, uninsured, and underinsured women aged 18-64 years who have not had a hysterectomy are eligible for cervical cancer screening through the NBCCEDP. We estimated the number of low-income, uninsured women using data from the US Census Bureau. We adjusted our estimates for hysterectomy status using the National Health Interview Survey and the Behavioral Risk Factor Surveillance System. We used data from the NBCCEDP to describe the number of women receiving NBCCEDP-funded screening and calculated the proportion of eligible women who received screening through the NBCCEDP at the national level (by age group, race/ethnicity) and at the state level by age group. We used the Medical Expenditure Panel Survey to estimate the proportion of NBCCEDP-eligible women who were screened outside the NBCCEDP and the proportion that are not screened. We estimate that in 2010-2012, 705,970 women aged 18-64 years, 6.5 % (705,970 of 9.8 million) of the eligible population, received NBCCEDP-funded Pap tests. We estimate that 60.2 % of eligible women aged 18-64 years were screened outside the NBCCEDP and 33.3 % were not screened. The NBCCEDP provided 623,603 screens to women aged 40-64 years, an estimated 16.5 % of the eligible population, and 83,660 screens to women aged 18-39 years, representing an estimated 1.2 % of the eligible population. The estimated proportions of eligible women screened in each state ranged from 1.5 to 32.7 % and 5 % to 73.2 % among the 18-64 and 40-64 years age groups, respectively. Changes in the proportion of eligible women screened over the study period were nonsignificant. Although the program provided cervical

  11. Socio-demographic factors drive regional differences in participation in the National Bowel Cancer Screening Program - An ecological analysis.

    Science.gov (United States)

    Sun, Jiandong; March, Sonja; Ireland, Michael J; Crawford-Williams, Fiona; Goodwin, Belinda; Hyde, Melissa K; Chambers, Suzanne K; Aitken, Joanne F; Dunn, Jeff

    2018-02-01

    To examine if geographic variations in the participation rates in the National Bowel Cancer Screening Program (NBCSP) are related to population-level socio-demographic characteristics. Data reflecting participation in the NBCSP for 504 Local Government Areas (LGAs) between July 2011 and June 2013 were extracted from the Social Health Atlas of Australia. Logistic regression models were used to examine independent associations (odds ratios [ORs]) between participation, Remoteness Area (RA) and selected socio-demographic variables. Compared to the participation rate for major cities (33.4%), participation was significantly higher in inner regional areas (36.5%, OR=1.15), but was much lower in remote (27.9%, OR=0.77) or very remote areas (25.0%, OR=0.65). When controlling for study period, gender, proportion of persons aged 65 years and older, Indigenous status, cultural background and socioeconomic status, significantly higher rates were observed in all non-metropolitan areas than in major cities. Indigenous status was strongly related to the poorer participation in remote areas. Socio-demographic characteristics, particularly Indigenous status, cultural background and population ageing, seem to be more important drivers of regional disparities in NBCSP participation than geographic remoteness. Implications for public health: This study provides important evidence to understand the regional disparities in participating in the national screening program. © 2017 The Authors.

  12. The effectiveness of an obstructive sleep apnea screening and treatment program in patients with type 2 diabetes.

    Science.gov (United States)

    Donovan, Lucas M; Rueschman, Michael; Weng, Jia; Basu, Nisha; Dudley, Katherine A; Bakker, Jessie P; Wang, Rui; Bertisch, Suzanne M; Patel, Sanjay R

    2017-12-01

    As recommended by current guidelines, we tested the acceptability and impact of screening patients with type 2 diabetes for obstructive sleep apnea (OSA). In a large urban primary care practice, we instituted a telephone-based OSA screening program using a validated tool (STOP-BANG) in patients with type 2 diabetes. Patients identified as high risk were referred for diagnostic sleep testing, and those diagnosed with OSA were offered positive airway pressure (PAP) therapy. We evaluated the impact of PAP on sleep-related symptoms, glycemic control, and hospitalization rates. We identified 738 of 818 (90.1%) patients with type 2 diabetes as high risk for OSA. Only 29.2% (n = 213) of high risk patients were willing to undergo diagnostic sleep testing. The prevalence of OSA was 90.6% in this group, but only 66.0% of those with OSA initiated PAP. Patients with higher burden of sleep symptoms were more likely to pursue testing and initiate therapy. PAP use was associated with reduced sleep-related symptoms (mean Epworth sleepiness scale score declined from 8.8 to 7.3, p < .001), but did not impact hemoglobin A1c levels at one year (7.7-7.9%, p = .12). Changes in glycemic control and hospitalization rates did not differ from comparator groups. Despite a high prevalence of OSA, willingness to pursue diagnostic testing and treatment was low in an unselected type 2 diabetes population. Furthermore, glycemic control did not improve. Future screening programs should focus on patients with substantial sleep related symptoms as this group is most likely to derive benefit from treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Comparative study of RetCamRetCam II vs. binocular ophthalmoscopy in a screening program for retinopathy of prematurity.

    Science.gov (United States)

    Tejada-Palacios, P; Zarratea, L; Moral, M; de la Cruz-Bértolo, J

    2015-08-01

    To determine the performance of RetCam vs. binocular ophthalmoscopy (BIO) in a screening program for retinopathy of prematurity (ROP). Observational comparative study with prospective data collection. Examinations with RetCam (n=169) were performed on 83 infants included in a screening program for ROP and stored for analysis at a later stage. An experienced ophthalmologist examined the ocular fundus with binocular indirect ophthalmoscopy (BIO). The RetCam images were assessed for the presence of ROP, zone, grade, and presence of plus disease. RetCam and BIO data were compared by visually to estimate sensitivity, specificity, positive (VPP) and negative (VPN) predictive values. ROP disease was detected in 108 eyes with BIO, and in 74 with RetCam. Out of 306 eyes examined with RetCam, false negative results were found in 34 eyes, with no false positives. Sensitivity of RetCam exam vs. BIO was 0.68, and specificity was 0.99. Positive predictive value was 0.93 and negative predictive value was 0.85. All 34 ROP cases not detected with RetCam were in zone III or outer zone II. They were all mild and regressed spontaneously. No threshold ROP was missed with RetCam. Binocular indirect ophthalmoscopy is the reference method for the diagnosis of ROP. RetCam may be used as an alternative for ROP screening. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  14. Referring Patients to Nurses: Outcomes and Evaluation of a Nurse Flexible Sigmoidoscopy Training Program for Colorectal Cancer Screening

    Directory of Open Access Journals (Sweden)

    Mark J Dobrow

    2007-01-01

    Full Text Available Colorectal cancer is a significant health burden. Several screening options exist that can detect colorectal cancer at an early stage, leading to a more favourable prognosis. However, despite years of knowledge on best practice, screening rates are still very low in Canada, particularly in Ontario. The present paper reports on efforts to increase the flexible sigmoidoscopy screening capacity in Ontario by training nurses to perform this traditionally physician-performed procedure. Drawing on American, British and local experience, a professional regulatory framework was established, and training curriculum and assessment criteria were developed. Training was initiated at Princess Margaret Hospital and Sunnybrook and Women’s College Health Sciences Centre in Toronto, Ontario. (During the study, Sunnybrook and Women’s College Health Sciences Centre was deamalgamated into two separate hospitals: Women’s College Hospital and Sunnybrook Health Sciences Centre. Six registered nurses participated in didactic, simulator and practical training. These nurses performed a total of 77 procedures in patients, 23 of whom had polyps detected and biopsied. Eight patients were advised to undergo colonoscopy because they had one or more neoplastic polyps. To date, six of these eight patients have undergone colonoscopy, one patient has moved out of the province and another patient is awaiting the procedure. Classifying the six patients according to the most advanced polyp histology, one patient had a negative colonoscopy (no polyps found, one patient’s polyps were hyperplastic, one had a tubular adenoma, two had advanced neoplasia (tubulovillous adenomas and one had adenocarcinoma. All these lesions were excised completely at colonoscopy. Overall, many difficulties were anticipated and addressed in the development of the training program; ultimately, the project was affected most directly by challenges in encouraging family physicians to refer patients to

  15. Cardiac pre-competiton screening in Swiss athletes. Current situation in competitive athletes and short-time assessment of an exemplary local screening program.

    Science.gov (United States)

    Schmied, Christian; Notz, Sara; Cribari, Marco; Gähwiler, Roman; Keller, Dagmar I; Lüscher, Thomas F

    2012-05-31

    In Switzerland, screening concepts for the prevention of sports-associated sudden cardiac death are still insufficiently established in the large group of competitive athletes who are not integrated in an Olympic- or other high-level squad. The aim of the present study was to objectively determine the current situation in this particular group of athletes concerning cardiac pre-competition screening and define specific features of an "ideal" Swiss screening concept. Based on these data, the feasibility and validity was tested by the implementation of an exemplary local screening programme. A standardised questionnaire was completed by 1,047 competitive athletes of different ages and gender. The individual, sports-specific profile of an athlete and furthermore, the personal attitude towards and the vision of a "perfect" cardiac screening were assessed. Based on the results, an exemplary local screening programme for competitive athletes was implemented at the "Academic Sports Association Zurich" (ASVZ) in Zurich, Switzerland and evaluated 1 year after its introduction. Only 9% of the 1,047 interviewed competitive athletes (aged 13 to 64 years; median age 22 years, SD = 5.87) had previously undergone a cardiac screening. Only 47% of the interviewed competitive athletes expressed their interest to undergo a cardiac screening at all. Male and older athletes showed a significantly higher acceptance rate for the screening programme than women and younger athletes. All athletes accepted to bear the expenses for the baseline screening programme, adapted to international standards (minimal accepted fee of 60 Swiss Francs). Almost half of the athletes (49.2%) preferred easy accessibility to a sports cardiologist (max. distance of 10 kilometres). The exemplary local screening programme proved to be feasible and successful. However, only 30% of the 102 screened individuals were female and most of the athletes (80%) who made use of the screening had a specific concern or

  16. Screening for caries in targeted schools in the Blue Mountains and Hawkesbury districts, New South Wales, Australia: an evaluation of the School Assessment Program.

    Science.gov (United States)

    Chong, Gabriel Tse Feng; Evans, Robin Wendell; Dennison, Peter John

    2011-11-01

      To determine if the school dental screening program in New South Wales, the School Assessment Program, achieved its aim of being the key entry point for high-risk children to receive care.   A secondary analysis was conducted on epidemiological data gathered in 16 primary schools in New South Wales (10 for the School Assessment Program and six for the non-School Assessment Program) in 2003. The validity of the School Assessment Program targeting criteria in identifying high-risk schools was determined. Post-screening treatment outcomes were evaluated from the assessment of treatment ratios.   There were negligible differences in the caries experience and proportions of high-risk children, irrespective of their School Assessment Program status. Sensitivity and specificity values were approximately 60% and 40%, respectively, using various case definitions of high risk applied to both children and schools. Deciduous dentition treatment ratios for School Assessment Program and non-School Assessment Program children with decayed, missing, and filled teeth (dmft) ≥1 ranged from 0.48 to 0.79 and from 0.47 to 0.73, respectively. Respective permanent dentition treatment ratios for School Assessment Program and non-School Assessment Program children with Decayed, Missing, and Filled Teeth (DMFT) ≥1 were 0.49-0.82 and 0.64-1.08.   The School Assessment Program failed to identify schools with high caries-risk children or confer post-screening caries treatment benefits. © 2011 Blackwell Publishing Asia Pty Ltd.

  17. A Comprehensive Review of School-Based Body Mass Index Screening Programs and Their Implications for School Health: Do the Controversies Accurately Reflect the Research?

    Science.gov (United States)

    Ruggieri, Dominique G.; Bass, Sarah B.

    2015-01-01

    Background: Whereas legislation for body mass index (BMI) surveillance and screening programs has passed in 25 states, the programs are often subject to ethical debates about confidentiality and privacy, school-to-parent communication, and safety and self-esteem issues for students. Despite this debate, no comprehensive analysis has been completed…

  18. Organizational leadership, health risk screening, individually tailored programs, and supportive workplace culture might reduce presenteeism

    NARCIS (Netherlands)

    E. Steultjens; E. Baker; N. Aas; W. Randi

    2012-01-01

    To determine if Workplace Health Promotion programs (WHPs) are effective in improving presenteeism. The secondary objective was to identify characteristics of successful programmes and potential risk factors for presenteeism. The Cochrane Library, Medline and other electronic databases were searched

  19. Multi-image screening technique applied to a general orientation training program

    International Nuclear Information System (INIS)

    Hajek, B.K.; Campbell, T.O.; Evans, A.D.; Hickey, J.M.

    1979-01-01

    A general orientation and training program is a prerequisite for personnel to have unescorted access to various site locations at a nuclear power plant. A new general orientation and training program is being developed for the Toledo Edison Company to be used at the Davis-Besse Nuclear Power Station. The program is presented in a multi-image and stereo sound format that has the unique capability to present the magnitude and scale of the plant, to arouse and maintain the interest of the viewer, and to instill in him a feeling of importance and pride about his job. Satisfactory completion of the program by individuals is assessed and certified by a machine scored test that is administered as an integral part of the presentation

  20. Experience with a mobile whole body counting screening program at Ontario Hydro

    International Nuclear Information System (INIS)

    Wong, K.Y.

    1976-01-01

    A whole-body counting program using a trailer-mounted counter has been in service in Ontario Hydro since 1972 to monitor routinely internal uptakes of radionuclides by nuclear station employees. The philosophy and objectives of the program are discussed; equipment and calibration procedures are described, and experience over the past two and a half years is reviewed. The procedures to minimize the effects of external contamination, a problem commonly encountered in whole-body counting, are described. (auth)

  1. Risk estimation and value-of-information analysis for three proposed genetic screening programs for chronic beryllium disease prevention

    Energy Technology Data Exchange (ETDEWEB)

    Bartell, S.M.; Ponce, R.A.; Takaro, T.K.; Zerbe, R.O.; Omenn, G.S.; Faustman, E.M.

    2000-02-01

    Genetic differences (polymorphisms) among members of a population are thought to influence susceptibility to various environmental exposures. In practice, however, this information is rarely incorporated into quantitative risk assessment and risk management. The authors describe an analytic framework for predicting the risk reduction and value-of-information (VOI) resulting from specific risk management applications of genetic biomarkers, and they apply the framework to the example of occupational chronic beryllium disease (CBD), an immune-mediated pulmonary granulomatous disease. One described Human Leukocyte Antigen gene variant, HLA-DP{beta}1*0201, contains a substitution of glutamate for lysine at position 69 that appears to have high sensitivity ({approximately}94%) but low specificity ({approximately}70%) with respect to CBD among individuals occupationally exposed to respirable beryllium. The expected postintervention CBD prevalence rates for using the genetic variant (1) as a required job placement screen, (2) as a medical screen for semiannual in place of annual lymphocyte proliferation testing, or (3) as a voluntary job placement screen are 0.08%, 0.8%, and 0.6%, respectively, in a hypothetical cohort with 1% baseline CBD prevalence. VOI analysis is used to examine the reduction in total social cost, calculated as the net value of disease reduction and financial expenditures, expected for proposed CBD intervention programs based on the genetic susceptibility test. For the example cohort the expected net VOI per beryllium worker for genetically based testing and intervention is $13,000, $1,800, and $5,100, respectively, based on a health valuation of $1.45 million per CBD case avoided. VOI results for alternative CBD valuations are also presented. Despite large parameter uncertainty, probabilistic analysis predicts generally positive utility for each of the three evaluated programs when avoidance of a CBD case is valued at $1 million or higher. Although

  2. [Alcohol related problem in the workplace: trial of a screening and brief intervention program for risky drinking in the workplace, via the Internet].

    Science.gov (United States)

    Kawaguchi, Kaoru; Shimizu, Yukiko; Izumi, Tomoko; Ochiai, Hiroko; Yoshimoto, Hisashi; Ino, Aro; Ochiai, Masahiro

    2014-12-01

    This report describes the effect of a screening and brief intervention via the Internet (6-month Total health Management Program: TMP, a kind of life evolution program), for improvement of alcohol related problem in the workplace. At a certain company, 2,096 employees were screened.using AUDIT-C and CAGE via the Internet (electronic screening). From those screened, 17 risky drinkers were picked up. The classification of "risky drinker" was determined based on employees scoring over six points on AUDIT-C and over two points on_ AGE. These employees were then called to one-day practical seminar program (including the program of food education, music therapy, aro-atherapy, body conditioning etc.). After which, during 6 months, they were followed up via e-mail every month. After the 6-month follow up, their results of AUDIT-C were significantly decreased. Additionally, aside from the frequency of drinking at bedtime, maximum alcohol consumption per day was also significantly decreased. The Visual Analogue Scale for anxiety captured the initial screen and then again after follow-up was reduced significantly. Moreover, quality-of-life index for sleep and dinner were both significantly improved as well..These results suggest that the SBI (screening and brief intervention: TMP) is effective for reducing drinking behavior, can be used to effectively elevate quality of life.

  3. Toxicological benchmarks for screening potential contaminants of concern for effects on terrestrial plants. Environmental Restoration Program

    Energy Technology Data Exchange (ETDEWEB)

    Suter, G.W. II; Will, M.E.; Evans, C.

    1993-09-01

    One of the initial stages in ecological risk assessment for hazardous waste sites is the screening of contaminants to determine which of them are worthy of further consideration as ``contaminants of potential concern.`` This process is termed ``contaminant screening.`` It is performed by comparing measured ambient concentrations of chemicals to benchmark concentrations. Currently, no standard benchmark concentrations exist for assessing contaminants in soil with respect to their toxicity to plants. This report presents a standard method for deriving benchmarks for this purpose (phytotoxicity benchmarks), a set of data concerning effects of chemicals in soil or soil solution on plants, and a set of phytotoxicity benchmarks for 34 chemicals potentially associated with US Department of Energy (DOE) sites. Chemicals that are found in soil at concentrations exceeding both the phytotoxicity benchmark and the background concentration for the soil type should be considered contaminants of potential concern. The purpose of this report is to present plant toxicity data and discuss their utility as benchmarks for determining the hazard to terrestrial plants caused by contaminants in soil. Benchmarks are provided for soils and solutions.

  4. Methods for external event screening quantification: Risk Methods Integration and Evaluation Program (RMIEP) methods development

    International Nuclear Information System (INIS)

    Ravindra, M.K.; Banon, H.

    1992-07-01

    In this report, the scoping quantification procedures for external events in probabilistic risk assessments of nuclear power plants are described. External event analysis in a PRA has three important goals; (1) the analysis should be complete in that all events are considered; (2) by following some selected screening criteria, the more significant events are identified for detailed analysis; (3) the selected events are analyzed in depth by taking into account the unique features of the events: hazard, fragility of structures and equipment, external-event initiated accident sequences, etc. Based on the above goals, external event analysis may be considered as a three-stage process: Stage I: Identification and Initial Screening of External Events; Stage II: Bounding Analysis; Stage III: Detailed Risk Analysis. In the present report, first, a review of published PRAs is given to focus on the significance and treatment of external events in full-scope PRAs. Except for seismic, flooding, fire, and extreme wind events, the contributions of other external events to plant risk have been found to be negligible. Second, scoping methods for external events not covered in detail in the NRC's PRA Procedures Guide are provided. For this purpose, bounding analyses for transportation accidents, extreme winds and tornadoes, aircraft impacts, turbine missiles, and chemical release are described

  5. Estimating Development Cost of an Interactive Website Based Cancer Screening Promotion Program

    Science.gov (United States)

    Lairson, David R.; Chung, Tong Han; Smith, Lisa G.; Springston, Jeffrey K.; Champion, Victoria L.

    2015-01-01

    Objectives The aim of this study was to estimate the initial development costs for an innovative talk show format tailored intervention delivered via the interactive web, for increasing cancer screening in women 50 to 75 who were non-adherent to screening guidelines for colorectal cancer and/or breast cancer. Methods The cost of the intervention development was estimated from a societal perspective. Micro costing methods plus vendor contract costs were used to estimate cost. Staff logs were used to track personnel time. Non-personnel costs include all additional resources used to produce the intervention. Results Development cost of the interactive web based intervention was $.39 million, of which 77% was direct cost. About 98% of the cost was incurred in personnel time cost, contract cost and overhead cost. Conclusions The new web-based disease prevention medium required substantial investment in health promotion and media specialist time. The development cost was primarily driven by the high level of human capital required. The cost of intervention development is important information for assessing and planning future public and private investments in web-based health promotion interventions. PMID:25749548

  6. Breast cancer screening, outside the population-screening program, of women from breast cancer families without proven BRCA1/BRCA2 mutations : a simulation study

    NARCIS (Netherlands)

    Jacobi, C.E.; Nagelkerke, N.J.D.; van Houwelingen, J.C.; de Bock, G.H.

    Purpose: We assessed the cost-effectiveness of mammography screening for women under the age of 50, from breast cancer families without proven BRCA1./BRCA2 mutations, because current criteria for screening healthy women from breast cancer families are not evidence-based. Methods: We did simulation

  7. Breast cancer screening, outside the population-screening program, of women from breast cancer families without proven BRCA1/BRCA2 mutations: a simulation study

    NARCIS (Netherlands)

    Jacobi, C.E.; Nagelkerke, N.J.D.; van Houwelingen, J.C.; de Bock, Truuske

    2006-01-01

    Purpose: We assessed the cost-effectiveness of mammography screening for women under the age of 50, from breast cancer families without proven BRCA1./BRCA2 mutations, because current criteria for screening healthy women from breast cancer families are not evidence-based. Methods: We did simulation

  8. Conductive hearing loss and middle ear pathology in young infants referred through a newborn universal hearing screening program in Australia.

    Science.gov (United States)

    Aithal, Sreedevi; Aithal, Venkatesh; Kei, Joseph; Driscoll, Carlie

    2012-10-01

    Although newborn hearing screening programs have been introduced in most states in Australia, the prevalence of conductive hearing loss and middle ear pathology in the infants referred through these programs is not known. This study was designed to (1) evaluate the prevalence of conductive hearing loss and middle ear pathology in infants referred by a newborn hearing screening program in north Queensland, (2) compare prevalence rates of conductive hearing loss and middle ear pathology in indigenous and nonindigenous infants, and (3) review the outcomes of those infants diagnosed with conductive hearing loss and middle ear pathology. Retrospective chart review of infants referred to the Audiology Department of The Townsville Hospital was conducted. Chart review of 234 infants referred for one or both ears from a newborn hearing screening program in north Queensland was conducted. A total of 211 infants attended the diagnostic appointment. Review appointments to monitor hearing status were completed for 46 infants with middle ear pathology or conductive hearing loss. Diagnosis of hearing impairment was made using an age-appropriate battery of audiological tests. Results were analyzed for both initial and review appointments. Mean age at initial diagnostic assessment was 47.5 days (SD = 31.3). Of the 69 infants with middle ear pathology during initial diagnostic assessment, 18 had middle ear pathology with normal hearing, 47 had conductive hearing loss, and 4 had mixed hearing loss. Prevalence of conductive hearing loss in the newborns was 2.97 per 1,000 while prevalence of middle ear pathology (with or without conductive hearing loss) was 4.36 per 1,000. Indigenous Australians or Aboriginal and Torres Strait Islander (ATSI) infants had a significantly higher prevalence of conductive hearing loss and middle ear pathology than non-ATSI infants (35.19 and 44.45% vs 17.83 and 28.66%, respectively). ATSI infants also showed poor resolution of conductive hearing loss

  9. Access to Adequate Healthcare for Hmong Women: A Patient Navigation Program to Increase Pap Test Screening

    Directory of Open Access Journals (Sweden)

    Moon S. Chen, Jr

    2010-01-01

    Full Text Available This paper describes the development and implementation of a Hmong Cervical Cancer Intervention Program utilizing a patient navigation model to raise cervical cancer awareness for Hmong women through educational workshops and to assist Hmong women in obtaining a Pap test. Out of 402 women who participated in a baseline survey, the Patient Navigation Program was able to enroll 109 participants who had not had a Pap test in the past 3 years and had never had a Pap test. Through utilization of outreach, an awareness campaign and patient navigation support, at least 38 percent of 109 participants obtained a Pap test. Overall, 21 workshops and 43 outreach activities were conducted by the Hmong Women’s Heritage Association, leading to 63 percent of those enrolled in the Patient Navigation Program who could be contacted to obtain a Pap test.

  10. Comparison of adherence to chlamydia screening guidelines among Title X providers and non-Title X providers in the California Family Planning, Access, Care, and Treatment Program.

    Science.gov (United States)

    Chow, Joan M; de Bocanegra, Heike Thiel; Hulett, Denis; Park, Hye-Youn; Darney, Philip

    2012-08-01

    Annual chlamydia screening is recommended for adolescent and young adult females and targeted screening is recommended for women ≥26 years based on risk. Although screening levels have increased over time, adherence to these guidelines varies, with high levels of adherence among Title X family planning providers. However, previous studies of provider variation in screening rates have not adjusted for differences in clinic and client population characteristics. Administrative claims from the California Family Planning, Access, Care, and Treatment (Family PACT) program were used to (1) examine clinic and client sociodemographic characteristics by provider group-Title X-funded public sector, non-Title X public sector, and private sector providers, and (2) estimate age-specific screening and differences in rates by provider group during 2009. Among 833 providers, Title X providers were more likely than non-Title X public sector providers and private sector providers to serve a higher client volume, a higher proportion of clients aged ≤25 years, and a higher proportion of African American clients. Non-Title X public providers were more likely to be located in rural areas, compared with Title X grantees and private sector providers. Title X providers had the largest absolute difference in screening rates for young females vs. older females (10.9%). Unadjusted screening rates for young clients were lower among non-Title X public sector providers (54%) compared with private sector and Title X providers (64% each). After controlling for provider group, urban location, client volume, and percent African American, private sector providers had higher screening rates than Title X and non-Title X public providers. Screening rates for females were higher among private providers compared with Title X and non-Title X public providers. However, only Title X providers were more likely to adhere to screening guidelines through high screening rates for young females and low

  11. Simulation of reduced breast cancer mortality in breast cancer screening programs; Simulacion de la reduccion de mortalidad por cancer de mama en programas de cribado mamografico

    Energy Technology Data Exchange (ETDEWEB)

    Zamora, L. I.; Forastero, C.; Guirado, D.; Lallena, A. M.

    2011-07-01

    The breast cancer screening programs are an essential tool in the fight against breast cancer. Currently, many questions concerning the setup of these programs are open, namely: age range of women who undergo the same, frequency of mammography, ... The effectiveness of a program should be evaluated in terms of mortality reduction is its systematic implementation in the population. In this sense, we performed Monte Carlo simulations to assess that these reductions.

  12. Assessing the accuracy and feasibility of a refractive error screening program conducted by school teachers in pre-primary and primary schools in Thailand.

    Science.gov (United States)

    Teerawattananon, Kanlaya; Myint, Chaw-Yin; Wongkittirux, Kwanjai; Teerawattananon, Yot; Chinkulkitnivat, Bunyong; Orprayoon, Surapong; Kusakul, Suwat; Tengtrisorn, Supaporn; Jenchitr, Watanee

    2014-01-01

    As part of the development of a system for the screening of refractive error in Thai children, this study describes the accuracy and feasibility of establishing a program conducted by teachers. To assess the accuracy and feasibility of screening by teachers. A cross-sectional descriptive and analytical study was conducted in 17 schools in four provinces representing four geographic regions in Thailand. A two-staged cluster sampling was employed to compare the detection rate of refractive error among eligible students between trained teachers and health professionals. Serial focus group discussions were held for teachers and parents in order to understand their attitude towards refractive error screening at schools and the potential success factors and barriers. The detection rate of refractive error screening by teachers among pre-primary school children is relatively low (21%) for mild visual impairment but higher for moderate visual impairment (44%). The detection rate for primary school children is high for both levels of visual impairment (52% for mild and 74% for moderate). The focus group discussions reveal that both teachers and parents would benefit from further education regarding refractive errors and that the vast majority of teachers are willing to conduct a school-based screening program. Refractive error screening by health professionals in pre-primary and primary school children is not currently implemented in Thailand due to resource limitations. However, evidence suggests that a refractive error screening program conducted in schools by teachers in the country is reasonable and feasible because the detection and treatment of refractive error in very young generations is important and the screening program can be implemented and conducted with relatively low costs.

  13. Assessing the accuracy and feasibility of a refractive error screening program conducted by school teachers in pre-primary and primary schools in Thailand.

    Directory of Open Access Journals (Sweden)

    Kanlaya Teerawattananon

    Full Text Available As part of the development of a system for the screening of refractive error in Thai children, this study describes the accuracy and feasibility of establishing a program conducted by teachers.To assess the accuracy and feasibility of screening by teachers.A cross-sectional descriptive and analytical study was conducted in 17 schools in four provinces representing four geographic regions in Thailand. A two-staged cluster sampling was employed to compare the detection rate of refractive error among eligible students between trained teachers and health professionals. Serial focus group discussions were held for teachers and parents in order to understand their attitude towards refractive error screening at schools and the potential success factors and barriers.The detection rate of refractive error screening by teachers among pre-primary school children is relatively low (21% for mild visual impairment but higher for moderate visual impairment (44%. The detection rate for primary school children is high for both levels of visual impairment (52% for mild and 74% for moderate. The focus group discussions reveal that both teachers and parents would benefit from further education regarding refractive errors and that the vast majority of teachers are willing to conduct a school-based screening program.Refractive error screening by health professionals in pre-primary and primary school children is not currently implemented in Thailand due to resource limitations. However, evidence suggests that a refractive error screening program conducted in schools by teachers in the country is reasonable and feasible because the detection and treatment of refractive error in very young generations is important and the screening program can be implemented and conducted with relatively low costs.

  14. The effect of an intervention program on functional movement screen test scores in mixed martial arts athletes.

    Science.gov (United States)

    Bodden, Jamie G; Needham, Robert A; Chockalingam, Nachiappan

    2015-01-01

    This study assessed the basic fundamental movements of mixed martial arts (MMA) athletes using the functional movement screen (FMS) assessment and determined if an intervention program was successful at improving results. Participants were placed into 1 of the 2 groups: intervention and control groups. The intervention group was required to complete a corrective exercise program 4 times per week, and all participants were asked to continue their usual MMA training routine. A mid-intervention FMS test was included to examine if successful results were noticed sooner than the 8-week period. Results highlighted differences in FMS test scores between the control group and intervention group (p = 0.006). Post hoc testing revealed a significant increase in the FMS score of the intervention group between weeks 0 and 8 (p = 0.00) and weeks 0 and 4 (p = 0.00) and no significant increase between weeks 4 and 8 (p = 1.00). A χ analysis revealed that the intervention group participants were more likely to have an FMS score >14 than participants in the control group at week 4 (χ = 7.29, p < 0.01) and week 8 (χ = 5.2, p ≤ 0.05). Finally, a greater number of participants in the intervention group were free from asymmetry at week 4 and week 8 compared with the initial test period. The results of the study suggested that a 4-week intervention program was sufficient at improving FMS scores. Most if not all, the movements covered on the FMS relate to many aspects of MMA training. The knowledge that the FMS can identify movement dysfunctions and, furthermore, the fact that the issues can be improved through a standardized intervention program could be advantageous to MMA coaches, thus, providing the opportunity to adapt and implement new additions to training programs.

  15. A Japanese Stress Check Program screening tool predicts employee long-term sickness absence: a prospective study.

    Science.gov (United States)

    Tsutsumi, Akizumi; Shimazu, Akihito; Eguchi, Hisashi; Inoue, Akiomi; Kawakami, Norito

    2018-01-25

    On December 1, 2015, the Japanese government launched the Stress Check Program, a new occupational health policy to screen employees for high psychosocial stress in the workplace. As only weak evidence exists for the effectiveness of the program, we sought to estimate the risk of stress-associated long-term sickness absence as defined in the program manual. Participants were 7356 male and 7362 female employees in a financial service company who completed the Brief Job Stress Questionnaire (BJSQ). We followed them for 1 year and used company records to identify employees with sickness absence of 1 month or longer. We defined high-risk employees using the BJSQ and criteria recommended by the program manual. We used the Cox proportional regression model to evaluate the prospective association between stress and long-term sickness absence. During the follow-up period, we identified 34 male and 35 female employees who took long-term sickness absence. After adjustment for age, length of service, job type, position, and post-examination interview, hazard ratios (95% confidence intervals) for incident long-term sickness absence in high-stress employees were 6.59 (3.04-14.25) for men and 2.77 (1.32-5.83) for women. The corresponding population attributable risks for high stress were 23.8% (10.3-42.6) for men and 21.0% (4.6-42.1) for women. During the 1-year follow-up, employees identified as high stress (as defined by the Stress Check Program manual) had significantly elevated risks for long-term sickness absence.

  16. Is breast compression associated with breast cancer detection and other early performance measures in a population-based breast cancer screening program?

    Science.gov (United States)

    Moshina, Nataliia; Sebuødegård, Sofie; Hofvind, Solveig

    2017-06-01

    We aimed to investigate early performance measures in a population-based breast cancer screening program stratified by compression force and pressure at the time of mammographic screening examination. Early performance measures included recall rate, rates of screen-de