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Population Coverage (population + coverage)
Selected AbstractsScreening for the 21st century: learning from the pastCYTOPATHOLOGY, Issue 1 2000A. E. Raffle Introduction In 1986 I took on the public health responsibility for the cervical screening service in Avon. Like many others, I understood screening to be a simple, highly effective, and inexpensive way of stopping people getting cancer. The only problem so far as I was aware was in making sure those most at risk took up the opportunity to be screened. The more involved I became with screening, however, the more I was obliged to modify this view. In summary, I was confronted with two problems. The Avon cervical screening service,thanks to contributions from many individuals over the previous two decades,was already well organized and population coverage was already high. Why then were women still dying from cancer of the cervix? Why also was there a substantial and rising number of women requiring colposcopic investigation for screen-detected abnormality when, according to screening theory, the ,prevalence' pool should have been cleared and the rate of newly detected ,incident' abnormalities should equate to the incidence of serious disease? [source] Case studies of tobacco dependence treatment in Brazil, England, India, South Africa and UruguayADDICTION, Issue 10 2010Martin Raw ABSTRACT Aims The aims of this study are to describe the tobacco dependence treatment systems in five countries at different stages of development of their systems, and from different income levels and regions of the world, and to draw some lessons from their experiences that might be useful to other countries. Methods and data sourses Data were drawn from an earlier survey of treatment services led by M.R. and A.M., from Party reports to the Secretariat of the Framework Convention on Tobacco Control, and from correspondents in the five countries. These data were entered onto a standard template by the authors, discussed with the correspondents to ensure they were accurate and to help us interpret them, and then the templates were used as a basis to write prose descriptions of the countries' treatment systems, with additional summary data presented in tables. Results Two of the middle-income countries have based their treatment on specialist support and both consequently have very low population coverage for treatment. Two countries have integrated broad-reach approaches, such as brief advice with intensive specialist support; these countries are focusing currently upon monitoring performance and guaranteeing quality. Cost is a significant barrier to improving treatment coverage and highlights the importance of using existing infrastucture as much as possible. Conclusions Perhaps not surprisingly the greatest challenges appear to be faced by large, lower-income countries that have prioritized more intensive but low-reach approaches to treatment, rather than developing basic infrastructure, including brief advice in primary care and quitlines. [source] Trends in childhood acute lymphoblastic leukemia in Western Australia, 1960,2006INTERNATIONAL JOURNAL OF CANCER, Issue 5 2008Elizabeth Milne Abstract Increases in the incidence of childhood acute lymphoblastic leukemia (ALL) have been reported in some countries, while other reports from similar geographical regions have indicated stable rates. The reasons for the discrepancies have been debated in the literature, with the focus on whether the observed increases are "real" or an artifact resulting from improvements in diagnosis, case ascertainment and population coverage over time. We used population-based data from Western Australia to investigate trends in the incidence of childhood ALL between 1960 and 2006. Age-standardized incidence rates (ASRs) and rate ratios (indicating annual percent change) were estimated using Poisson regression. Between 1960 and 2006, the ASR was 3.7 per 100,000 person-years, with an annual percent increase of 0.40% (95% CI: ,0.20, 1.00). Between 1982 and 2006, the ASR was 3.8, with an annual percent increase of 0.80% (95% CI = ,0.70 to 2.30). This increased to 1.42% (95% CI: ,0.30, 3.0) when a sensitivity analysis was undertaken to assess the effect of excluding the final 2 years of data. Annual increases of 3.7% (95% CI: ,0.50, 8.00) among children aged 5,14 years, and of 3.10% (95% CI: 0.50, 5.70) in girls, were observed for this latter period. These results were supported by national Australian incidence data available for 1982,2003. There may have been a small increase in the incidence of ALL since 1982 among girls and older children, but an overall increase appears unlikely. No impact of folate supplementation or fortification is apparent. © 2007 Wiley-Liss, Inc. [source] Low Public Expenditures on Social Welfare: Do East Asian Countries have a Secret?INTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 1 2000David Jacobs This paper explores the sources of low public expenditures on social welfare in Japan, Korea, Taiwan, Hong Kong and Singapore. Six factors are analysed based on aggregate data: the public/private mix of welfare programmes, the age structure, the maturity of old-age pension schemes, the population coverage of social security, the relative generosity of social security and the role of enterprises and families as alternative providers of welfare. The evidence allows putting some conventional statements about the virtues of East Asian welfare states into questions. Public expenditures on welfare are bound to rise a lot in Japan, Korea and Taiwan, while the level of protection in Hong Kong and Singapore is well below the standards of Western countries. [source] Case ascertainment and estimated incidence of drug-induced long-QT syndrome: study in Southwest FranceBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 3 2008Mariam Molokhia WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT , Drug-induced long-QT syndrome (LQTS) is a potentially fatal condition that has led to a number of postmarketing withdrawals in recent years. , However, many cases may not survive long enough to reach hospital, and only a small proportion are reported to pharmacovigilance agencies. , The extent to which genetic determinants of susceptibility to LQTS are specific to particular drugs, or common to several classes of drug, remains to be determined. WHAT THIS STUDY ADDS , We estimated population prevalence of drug-induced LQTS in the Midi-Pyrenees region, southwest France, using five different institutions and assessed feasibility of tracing potential cases (in addition to pharmacovigilance data), using hospital data and rigorous case definition. , These methods can be adapted to a wider region, used to augment pharmacovigilance reporting, and offer researchers the opportunity to study genetic susceptibility to drug-induced LQTS. AIMS The aim of this study was to investigate the incidence and reporting rate of drug-induced long-QT syndrome (LQTS) in France [defined by evidence of torsades de pointes (TdP), QT prolongation and exposure to a relevant drug] and to assess feasibility of case collection for drug-induced LQTS. METHODS A retrospective population-based study was carried out in Southwest France in five institutions: three main hospitals, one private clinic and one cardiac emergency unit, searched from 1 January 1999 to 1 January 2005 (population coverage of 614 000). The study population consisted of 861 cases with International Classification of Diseases-10 diagnostic codes for ventricular tachycardia (I147.2), ventricular fibrillation (I149.0) and sudden cardiac death (I146.1) from hospital discharge summaries, supplemented by cases reported to national or regional pharmacovigilance systems, and voluntary reporting by physicians, validated according to internationally defined criteria for drug-induced LQTS. RESULTS Of 861 patients coded with arrhythmias or sudden cardiac death, there were 40 confirmed surviving acquired cases of drug-induced LQTS. We estimated that the incidence of those who survive to reach hospital drug-induced LQTS is approximately 10.9 per million annually in France (95% confidence interval 7.8, 14.8). CONCLUSIONS Many cases of drug-induced LQTS may not survive before they reach hospital, as the reporting rate for drug-induced LQTS identified through the cardiology records and also reported to pharmacovigilance systems for the Midi-Pyrenees area is 3/40 (7.5%). Using the methods outlined it is possible to assemble cases to study genetic susceptibility to drug-induced LQTS and adapt these methods more widely. [source] | ||||||||||