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The universal newborn hearing screening in Brazil: From identification to intervention

BEVILACQUA, Maria Cecilia; ALVARENGA, Katia de Freitas; COSTA, Orozimbo Alves; MORET, Adriane Lima Mortari
Fonte: ELSEVIER IRELAND LTD Publicador: ELSEVIER IRELAND LTD
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.39%
Objective: The objective of the study is to investigate the results of the newborn hearing screening program carried out in a Public Hospital in Brazil, in the first 3 years regarding: (1) the prevalence of hearing impairment; (2) the influence of the universal hearing screening program on the age at which the diagnosis of hearing loss is defined; (3) the cost effectiveness of the program; (4) the outcomes, in terms of the age in which the hearing rehabilitation started. Methods: A descriptive study of the first 3 years after starting the universal newborn hearing screening in a Public Hospital of Bauru, Sao Paulo state, Brazil. The screening method consists of a two-stage screening approach with transient otoacoustic emissions (TOAE), conducted by an audiologist. If the outcome in the second-stage screening is REFER, the infant is submitted to diagnostic follow-up testing and intervention at the Audiology and Speech Pathology Clinic at the University of Sao Paulo, campus of Bauru. The evaluation of the costs of the universal newborn hearing screening program per each screened newborn (around 4000/year) was done based on a proposal by the National Center for Hearing Assessment and Management, of the Utah State University, United States of America. Results: 11...

Triagem nutricional em adultos hospitalizados; Nutritional screening in inpatients

Beghetto, Mariur Gomes; Manna, Bibiana Borges; Candal, Andréia; Mello, Elza Daniel de; Polanczyk, Carisi Anne
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
POR
Relevância na Pesquisa
36.39%
Em hospitais, o objetivo de um procedimento de triagem nutricional é identificar indivíduos desnutridos ou em risco de desnutrição, possibilitando intervenção nutricional precoce e melhor alocação de recursos. Diferentes métodos são apresentados na literatura para esta finalidade: Malnutrition Screening Tool, Short Nutritional Assessment Questionnaire, Nutritional Risk Index, Nutrition Risk Score, Nutritional Risk Screening, Mini Nutritional Assessment, Malnutrition Universal Screening Tool, Nutritional Screening Tool, Nutritional Screening Equation. No entanto, o emprego de muitos destes instrumentos está limitado pela inadequada metodologia empregada na derivação e/ou validação, pela seleção de grupos específicos de pacientes, pela pouca praticidade ou por necessidade de um especialista para seu emprego. Na ausência de um padrão de referência para emitir o diagnóstico nutricional, desfechos clínicos relevantes devem balizar a derivação e a validação de novos instrumentos. Este trabalho descreve os instrumentos de triagem nutricional acima referidos e apresenta considerações quanto ao seu emprego para adultos hospitalizados não selecionados.; In hospitals, the aim of a nutritional screening procedure is to identify malnourished individuals or those at risk of malnutrition...

Screening de deglutição na fase aguda do acidente vascular cerebral : uma análise dos preditores clínicos da disfagia; Swallowing screening in acute stroke : an analysis of the clinical predictor of dysphagia

Mariana Mendes Bahia
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
PT
Relevância na Pesquisa
36.41%
O Acidente Vascular Cerebral (AVC) é a principal causa de morbi-mortalidade no Brasil, tendo a disfagia como uma importante sequela. A disfagia é responsável por complicações como pneumonia, desnutrição e desidratação. Atualmente, o screening é a forma de avaliação mais difundida para identificar de maneira rápida os pacientes com risco de disfagia na fase aguda do AVC. O objetivo da pesquisa é identificar a presença de disfagia orofaríngea na fase aguda do AVC, determinando sua frequência, relação com a gravidade do AVC e seus preditores, a partir da proposta de um screening. Trata-se de estudo de corte transversal e de abordagem quantitativa, aprovado pelo CEP, envolvendo a avaliação da deglutição nas primeiras 72 horas do AVC. Foram incluídos pacientes consecutivos admitidos na Unidade de Emergência Referenciada de um hospital terciário do Estado de São Paulo entre abril/2012 e agosto/2013, com presença de AVC único em qualquer topografia cerebral, sendo o diagnóstico de AVC determinado por avaliação neurológica e confirmado por TC e/ou RM de crânio. Foram excluídos pacientes cujo AVC havia ocorrido há mais de 72 horas, com evidência de AVC prévio, com história de doenças neurológicas ou psiquiátricas...

Screening for Gastric Cancer: The Usefulness of Endoscopy

Choi, Kui Son; Suh, Mina
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.39%
Gastric cancer screening is common in countries with high prevalence rates of gastric cancer. However, data supporting the effectiveness of gastric cancer screening are lacking. Thus, the aim of this review was to examine the current evidence on gastric cancer screening. Herein, we reviewed radiographic and endoscopic tests as methods of gastric cancer screening. Previous cohort studies and case-control studies have demonstrated reduced gastric cancer mortality in study populations that had undergone gastric cancer screening with radiographic tests. Recently, a case-control study in Japan reported a 30% reduction in gastric cancer mortality when screening was undertaken via endoscopy. Also, endoscopic screening for gastric cancer exhibited higher sensitivity and specificity than radiographic screening. Moreover, most cost-effectiveness analyses on the best strategy for detecting early gastric cancer have generally concluded that endoscopy is more cost-effective than radiographic testing. Although data on the impact of endoscopy screening programs on gastric cancer mortality are limited, recent study results suggest that gastric cancer screening by endoscopy in average-risk populations performs better than radiography screening. Further evaluation of the impact of these screening methods should take into account cost and any associated reduction in gastric cancer mortality.

Unifying Screening Processes Within the PROSPR Consortium: A Conceptual Model for Breast, Cervical, and Colorectal Cancer Screening

Beaber, Elisabeth F.; Kim, Jane J.; Schapira, Marilyn M.; Tosteson, Anna N. A.; Zauber, Ann G.; Geiger, Ann M.; Kamineni, Aruna; Weaver, Donald L.; Tiro, Jasmin A.; on behalf of the Population-based Research Optimizing Screening through Personalized Regim
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica Formato: text/html
EN
Relevância na Pesquisa
36.39%
General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. We present a trans-organ conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based on clinical guidelines and protocols; the model concepts could be expanded to other organ sites. The model covers four types of care in the screening process: risk assessment, detection, diagnosis, and treatment. Interfaces between different provider teams (eg, primary care and specialty care), including communication and transfer of responsibility, may occur when transitioning between types of care. Our model highlights across each organ site similarities and differences in steps, interfaces, and transitions in the screening process and documents the conclusion of a screening episode. This model was developed within the National Cancer Institute–funded consortium Population-based Research Optimizing Screening through Personalized Regimens (PROSPR). PROSPR aims to optimize the screening process for breast...

Cost-effectiveness of alternative blood-screening strategies for West Nile virus in the United States

Korves, Caroline T; Goldie, Sue J.; Murray, Megan Blanche
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
36.41%
Background: West Nile virus (WNV) is endemic in the US, varying seasonally and by geographic region. WNV can be transmitted by blood transfusion, and mandatory screening of blood for WNV was recently introduced throughout the US. Guidelines for selecting cost-effective strategies for screening blood for WNV do not exist. Methods and Findings: We conducted a cost-effectiveness analysis for screening blood for WNV using a computer-based mathematical model, and using data from prospective studies, retrospective studies, and published literature. For three geographic areas with varying WNV-transmission intensity and length of transmission season, the model was used to estimate lifetime costs, quality-adjusted life expectancy, and incremental cost-effectiveness ratios associated with alternative screening strategies in a target population of blood-transfusion recipients. We compared the status quo (baseline screening using a donor questionnaire) to several strategies which differed by nucleic acid testing of either pooled or individual samples, universal versus targeted screening of donations designated for immunocompromised patients, and seasonal versus year-long screening. In low-transmission areas with short WNV seasons, screening by questionnaire alone was the most cost-effective strategy. In areas with high levels of WNV transmission...

Influence of providers and nurses on completion of non-targeted HIV screening in an urgent care setting

Bender Ignacio, Rachel A; Chu, Jacqueline; Power, Melinda C; Douaiher, Jeffrey; Lane, Jordan D; Collins, Jeffrey P; Stone, Valerie E
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
36.39%
Introduction: Despite recommendations by the Centers for Disease Control (CDC) that all adults be offered non-targeted HIV screening in all care settings, screening in acute-care settings remains unacceptably low. We performed an observational study to evaluate an HIV screening pilot in an academic-community partnership health center urgent care clinic. Methods: We collected visit data via encounter forms and demographic and laboratory data from electronic medical records. A post-pilot survey of perceptions of HIV screening was administered to providers and nurses. Multivariable analysis was used to identify factors associated with completion of testing. Results: Visit provider and triage nurse were highly associated with both acceptance of screening and completion of testing, as were younger age, male gender, and race/ethnicity. 23.5% of patients completed tests, although 36.0% requested screening; time constraints as well as risk perceptions by both the provider and patient were cited as limiting completion of screening. Post-pilot surveys showed mixed support for ongoing HIV screening in this setting by providers and little support by nurses. Conclusions: Visit provider and triage nurse were strongly associated with acceptance of testing...

Efficiency of alternative policy options for screening for developmental dysplasia of the hip in the United Kingdom

Brown, J.; Dezateux, C.; Karnon, J.; Parnaby, A.; Arthur, R.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2003 EN
Relevância na Pesquisa
36.4%
Aims: To assess, using a decision model, the efficiency of ultrasound based and clinical screening strategies for developmental dysplasia of the hip. Methods: The additional cost per additional favourable outcome was compared for the following strategies: clinical screening alone using the Ortolani and Barlow tests; addition of static and dynamic ultrasound examination of the hips of all infants (universal ultrasound) or restricted to infants with defined risk factors (selective ultrasound); "no screening" (that is, clinical diagnosis only). Results: Ultrasound based screening strategies are predicted to be more effective but more costly than clinical screening or no screening. Estimated total costs per 100 000 live births are approximately £4 million for universal ultrasound, £3 million for selective ultrasound, £1 million for clinical screening alone, and £0.4 million for no screening. The relative efficiency of selective ultrasound and clinical screening is poorly differentiated, and depends on how infants are selected for ultrasound as well as the expertise of clinical screening examiners. If training costs less than £20 per child screened, clinical screening alone would be more efficient than selective ultrasound. Relative to no screening...

Cost-effectiveness of screening high-risk HIV-positive men who have sex with men (MSM) and HIV-positive women for anal cancer

Czoski-Murray, C.; Karnon, J.; Jones, R.; Smith, K.; Kinghorn, G.
Fonte: National Coordinating Centre for Health Technology Assessment Publicador: National Coordinating Centre for Health Technology Assessment
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
36.41%
BACKGROUND: Anal cancer is uncommon and predominantly a disease of the elderly. The human papillomavirus (HPV) has been implicated as a causal agent, and HPV infection is usually transmitted sexually. Individuals who are human immunodeficiency virus (HIV)-positive are particularly vulnerable to HPV infections, and increasing numbers from this population present with anal cancer. OBJECTIVE: To estimate the cost-effectiveness of screening for anal cancer in the high-risk HIV-positive population [in particular, men who have sex with men (MSM), who have been identified as being at greater risk of the disease] by developing a model that incorporates the national screening guidelines criteria. DATA SOURCES: A comprehensive literature search was undertaken in January 2006 (updated in November 2006). The following electronic bibliographic databases were searched: Applied Social Sciences Index and Abstracts (ASSIA), BIOSIS previews (Biological Abstracts), British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, NHS Database of Abstracts of Reviews of Effects (DARE)...

Breast screening and breast cancer survival in Aboriginal and Torres Strait Islander women of Australia

Roder, D.; Webster, F.; Zorbas, H.; Sinclair, S.; Aitken, J.; Culjak, G.; Elston, J.; Epping, Y.; Farrugia, H.; Grayson, N.; Guthridge, S.; Halliday, L.; Muller, J.; Pridmore, V.; Threlfall, T.; Tyzack, C.; Venn, A.; Ward, G.; Williamson, L.; Wylie, L.
Fonte: Asian Pacific Organization for Cancer Prevention Publicador: Asian Pacific Organization for Cancer Prevention
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
36.4%
Aboriginal and Torres Strait Islander people comprise about 2.5% of the Australian population. Cancer registry data indicate that their breast cancer survivals are lower than for other women but the completeness and accuracy of Indigenous descriptors on registries are uncertain. We followed women receiving mammography screening in BreastScreen to determine differences in screening experiences and survivals from breast cancer by Aboriginal and Torres Strait Islander status, as recorded by BreastScreen. This status is self-reported and used in BreastScreen accreditation, and is considered to be more accurate. The study included breast cancers diagnosed during the period of screening and after leaving the screening program. Design: Least square regression models were used to compare screening experiences and outcomes adjusted for age, geographic remoteness, socio-economic disadvantage, screening period and round during 1996-2005. Survival of breast cancer patients from all causes and from breast cancer specifically was compared for the 1991-2006 diagnostic period using linked cancer-registry data. Cox proportional hazards regression was used to adjust for socio-demographic differences, screening period, and where available, tumour size...

Quantifying breast cancer over-diagnosis in an organised mammography screening program.

Beckmann, Kerrilyn Rose
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2014
Relevância na Pesquisa
36.45%
Mammography screening is effective in reducing breast cancer (BC) mortality; however there are widespread concerns that it may also lead to over-diagnosis, i.e. the detection of BC that would not have emerged clinically in a woman’s lifetime had she not participated in screening. The extent of over-diagnosis due to mammography is contested, with published estimates varying from 0% to 54%. The principal aim of this research is to quantify the level of over-diagnosis of BC associated with population-based mammography screening in South Australia (SA). The following questions are addressed: (1) Have BC incidence rates increased following the introduction of screening in SA and is the increase greater than expected based on projections of pre-screening trends?, (2) Has the prevalence of key breast cancer risk factors also increased?, (3) To what extent does hormone replacement therapy (HRT) use affect breast cancer risk and screening outcomes?, (4) Are there any differences in the underlying risk of BC among screening participants and non-participants?, and the central question (5) What is the level of over-diagnosis due to organised mammography screening in SA? Questions 2-4 relate to the potential for estimates of over-diagnosis to be confounded by risk factor differences/temporal changes. A review of previous studies of over-diagnosis due to mammography screening is included...

Bestimmung von Referenzwerten für krankheitsrelevante Aminosäurenkonzentrationen im Trockenblut mittels Tandem-Massenspektrometrie in einem Normalkollektiv gesunder Neugeborener; Reference values on screening relevant amino acids in healthy newborns measured by tandem mass spectrometry

Morgenthaler, Janine
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
DE_DE
Relevância na Pesquisa
36.4%
Durch den Einsatz der Tandem-Massenspektrometrie (TMS) im Neugeborenen-Screening ergibt sich die Möglichkeit, das Screening auf metabolische Erkrankungen unter anderem im Bereich des Aminosäurenstoffwechsels zu erweitern. Eine frühzeitige, präsymptomatische Diagnose und Therapie dieser Erkrankungen soll den Behandlungserfolg verbessern und vor allem irreversible Schäden der geistigen Entwicklung und lebensbedrohliche Entgleisungen des Stoffwechsels verhindern. Bislang gibt es noch keine Referenzwerte von quantitativ mittels TMS gemessenen Konzentrationen krankheitsrelevanter Aminosäuren in einem Normalkollektiv gesunder, reifer Neugeborener und deren Abhängigkeit von Alter, Gestationsalter, Geschlecht, Geburtsgewicht, Gewichtsverlust und Ernährung. Die vorliegende Arbeit hatte zum Ziel, die Einflüsse dieser Faktoren auf die Aminosäurenkonzentrationen gesunder Neugeborener zu untersuchen und Referenzwerte für ein gesundes Kollektiv zu erstellen. Weiterhin wurden die Konzentrationen von Phenylalanin (Phe) und Tyrosin (Tyr) und damit des Phe/Tyr-Quotienten in den ersten 48 Lebensstunden von 6 Patienten mit Risiko für Phenylketonurie (PKU) bestimmt, um Aufschluß über den frühest möglichen Zeitpunkt der Diagnosestellung PKU mittels TMS zu gewinnen. Es wurden prospektiv 2159 Neugeborene untersucht...

Evaluation der Intervallkarzinome aus der Screening-Region Neckar-Alb vom 23.01.2008 bis 23.01.2011; Evaluation of the interval cancers from the screening area Neckar-Alb from 23.01.2008 to 23.01.2011

Stub, Sabine
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
DE_DE
Relevância na Pesquisa
36.45%
Intervallkarzinome sind Karzinome, die zwischen zwei Screening-Untersuchungen auftreten und auf der Vor-Mammographie entweder gar nicht sichtbar waren (no signs), retrospektiv mammographisch geringe Anzeichen aufwiesen (minimal signs) oder fälschlich als negativ befundet wurden (missed cancer). Die aufgetretenen Intervallkarzinome der ersten Screening-Runde aus dem Mammographie-Screening-Programm der Region Neckar-Alb wurden auf ihre Charakteristika untersucht und mit den im Screening entdeckten Karzinomen verglichen. Es wurde der Fragestellung nachgegangen, ob eine differierende Parenchymdichte zwischen der Intervallkarzinomgruppe und der Screening-Karzinomgruppe existiert. Es wurde geprüft, ob die europäischen Leitlinien eingehalten wurden und ob Intervallkarzinome als Qualitätsparameter zur Bewertung der Leistungsfähigkeit einer Screening-Einheit aussagekräftig sind. Abschließend wurden die Ergebnisse des Review-Prozesses der Intervallkarzinome evaluiert. Patientinnen, Material und Methode: Grundlage für diese Arbeit stellen die 70102 durchgeführten Mammographie-Untersuchungen, die 560 Screening-Karzinome, sowie die 49 Intervall-karzinome dar, die vom 23.01.2008 bis zum 23.01.2011 und bis zum Datenstand vom 01.03.2011 ermittelt wurden. Ergebnisse: Im Vergleich zu den Screening-Karzinomen gab bei den Intervallkarzinomen deutlich mehr invasive Karzinome...

A review and critique of modelling in prioritising and designing screening programmes

Karnon, J.; Goyder, E.; Tappenden, P.; McPhie, S.; Towers, I.; Brazier, J.; Madan, J.
Fonte: National Coordinating Centre for Health Technology Assessment Publicador: National Coordinating Centre for Health Technology Assessment
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
Relevância na Pesquisa
36.45%
OBJECTIVES: To undertake a structured review and critical appraisal of methods for the model-based cost-utility analysis of screening programmes. Also to develop guidelines and an assessment checklist of good practice in the development of screening models. DATA SOURCES: Major electronic databases of healthcare and operational research literatures were searched up to June 2003. REVIEW METHODS: Searches of the literature were undertaken to identify applied and methodological studies of economic evaluations of healthcare screening programmes. All applied screening models were also reviewed in three broad disease areas (cancer, cardiovascular disease and diabetes), as well as antenatal screening. A second-level review focused on particular aspects of the modelling process through case study assessments of screening models for three specific disease areas (colorectal cancer, abdominal aortic aneurysms and antenatal screening for haemoglobinopathies). A separate literature review of studies reporting the utility effects of screening was also undertaken. Guidelines and an assessment checklist for good practice for screening modelling were developed. RESULTS: Few relevant methodological studies were identified, and no studies reporting direct empirical comparisons of alternative methodologies were retrieved. From the review of disease-based screening models...

A preliminary model-based assessment of the cost-utility of a screening programme for early age-related macular degeneration

Karnon, J.; Czoski-Murray, C.; Smith, K.; Brand, C.; Chakravarthy, U.; Davis, S.; Bansback, N.; Beverley, C.; Bird, A.; Harding, S.; Chisholm, I.; Yang, Y.
Fonte: National Coordinating Centre for Health Technology Assessment Publicador: National Coordinating Centre for Health Technology Assessment
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
36.4%
OBJECTIVES: To estimate the cost-effectiveness of screening for age-related macular degeneration (AMD) by developing a decision analytic model that incorporated and assessed all of the National Screening Committee criteria. A further objective was to identify the major areas of uncertainty in the model, and so inform future research priorities in this disease area. DATA SOURCES: Major databases were searched in March 2004 and updated in January 2005. REVIEW METHODS: Systematic literature reviews covered the epidemiology and natural history of AMD, the screening and treatment effectiveness and health-related quality of life relating to AMD. A hybrid cohort-individual sampling model was implemented to describe the range of pathways between the incidence of age-related maculopathy (ARM) and death via clinical presentation and treatment at different stages of the disease. As significant shortfalls in the data available from the literature were apparent, so a range of primary data sources were also used to populate the model. To obtain estimates for the value of parameters deemed to be within an expert's remit, data describing some parameters were elicited from relevant experts. The data identified informed probability distributions describing the uncertainty around the model parameters. To incorporate joint parameter uncertainty (i.e. correlations between parameters)...

Hierarchical screening for multiple mental disorders

Batterham, Philip J.; Calear, Alison L.; Sunderland, Matthew; Carragher, Natacha; Christensen, Helen; Mackinnon, Andrew J.
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica Formato: 8 pages
Relevância na Pesquisa
36.4%
Background: There is a need for brief, accurate screening when assessing multiple mental disorders. Two-stage hierarchical screening, consisting of brief pre-screening followed by a battery of disorder-specific scales for those who meet diagnostic criteria, may increase the efficiency of screening without sacrificing precision. This study tested whether more efficient screening could be gained using two-stage hierarchical screening than by administering multiple separate tests. Method: Two Australian adult samples (N=1990) with high rates of psychopathology were recruited using Facebook advertising to examine four methods of hierarchical screening for four mental disorders: major depressive disorder, generalised anxiety disorder, panic disorder and social phobia. Results: Using K6 scores to determine whether full screening was required did not increase screening efficiency. However, pre-screening based on two decision tree approaches or item gating led to considerable reductions in the mean number of items presented per disorder screened, with estimated item reductions of up to 54%. The sensitivity of these hierarchical methods approached 100% relative to the full screening battery. Limitations: Further testing of the hierarchical screening approach based on clinical criteria and in other samples is warranted. Conclusions: The results demonstrate that a two-phase hierarchical approach to screening multiple mental disorders leads to considerable increases efficiency gains without reducing accuracy. Screening programs should take advantage of prescreeners based on gating items or decision trees to reduce the burden on respondents. (C) 2013 Elsevier B.V. All rights reserved.

DETERMINANTS OF CERVICAL CANCER SCREENING IN THE KILIMANJARO REGION OF TANZANIA

Skrastins, EMILY F E
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
36.4%
Background: Cervical cancer is a leading cause of death in Tanzanian women, with annual age-standardized mortality of 38 per 100,000. While organized screening programs have minimized cervical cancer rates in the developed world, a national prevention program has not yet been instituted in Tanzania. Though screening is available at clinics in the Kilimanjaro region, uptake of these services is reported to be low. The objectives of this thesis were: 1) to describe the knowledge, attitudes and practices of cervical cancer screening in rural and urban Kilimanjaro women, 2) to determine the main barriers preventing women from being screened, and 3) to identify important determinants of screening status and screening acceptability in the population. Methods: A cross-sectional survey was administered to 312 rural and 280 urban women in the region over June-July 2012. The sample was obtained through a multistage random sampling strategy. Descriptive statistics were performed to address Objectives 1 and 2, while multivariate logistic regression models were created using generalized estimating equations to address Objective 3. Results: Awareness of cervical cancer in the sample was high, but women had less knowledge of screening tests for the disease. The proportion of ever-screened women was significantly lower in the rural (4%) than in the urban (8%) sample. The most common barrier in never-screened women was not knowing that screening existed...

A study of producing smoother gradients in the flexographic process on oriented polypropylene with UV ink by varying screening techniques, gradient lengths and the surrounding

Boonprasit, Wimonrat
Fonte: Rochester Instituto de Tecnologia Publicador: Rochester Instituto de Tecnologia
Tipo: Tese de Doutorado Formato: 1910552 bytes; application/pdf
EN_US
Relevância na Pesquisa
36.42%
Printers find that producing smooth gradients in the highlight area is a great challenge for flexographic printing. Screening technology vendors claim that hybrid screening technologies produce smoother gradients and enhance reproducible dots in the highlight areas. This study was designed to investigate if hybrid screening technologies can achieve better gradient results than other screening technologies—conventional screening and FM screening—with the flexographic process. A single test form was printed on oriented polypropylene with UV ink, as these are common materials used in flexible packaging. The first objective was to see how different pressure settings impact tone reproduction of each screening technique. There were three pressure settings—kiss impression, moderate pressure and high pressure. Tone reproduction curves of all three screening techniques were evaluated to see the change due to the different pressure settings. The results show that FM screening had a high sensitivity to change in pressure, while AM and hybrid screenings were more forgiving to variations in pressure settings. In the highlight areas, hybrid screening is the least sensitive to changes in pressure. The second objective was to study whether smoother gradients can be produced by altering three variables: screening techniques...

A comparison study of concentric screening versus conventional AM screening and FM screening in offset printing

Carvajal, Eugenio
Fonte: Rochester Instituto de Tecnologia Publicador: Rochester Instituto de Tecnologia
Tipo: Tese de Doutorado
EN_US
Relevância na Pesquisa
36.4%
A new screening technology from Artwork Systems, Concentric screening, was evaluated against conventional AM and FM Staccato screening. The main feature of Concentric screening is to have very small concentric white circles inside AM halftone dots. Test targets were used in order to get information about different aspects of screening, such as: sensitivity to changes in ink film thickness; color gamut size, particularly for pastel colors; and detail rendering. A comparison was made between AM, FM, and Concentric screening. The results indicate that Concentric tints are more resistant to ink variation than conventional AM screening. Thus, the dot gain stability behavior was closer to FM Screening than to AM screening when ink levels are increased. Regarding color gamut, although there were differences in the expected direction, conclusions are uncertain because of inking variability between the press runs. However, micro-photographs from tints indicate that high resolution screens (FM and Concentric) have a thinner layer of ink on the dots when compared to AM screening. This results in improved color saturation and insensitivity to inking changes. Finally, in terms of contrast and resolution, results show no visually significant differences between the different screenings.

Effective screening programmes for cervical cancer in low- and middle-income developing countries

Sankaranarayanan,Rengaswamy; Budukh,Atul Madhukar; Rajkumar,Rajamanickam
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 EN
Relevância na Pesquisa
36.4%
Cervical cancer is an important public health problem among adult women in developing countries in South and Central America, sub-Saharan Africa, and south and south-east Asia. Frequently repeated cytology screening programmes -- either organized or opportunistic -- have led to a large decline in cervical cancer incidence and mortality in developed countries. In contrast, cervical cancer remains largely uncontrolled in high-risk developing countries because of ineffective or no screening. This article briefly reviews the experience from existing screening and research initiatives in developing countries. Substantial costs are involved in providing the infrastructure, manpower, consumables, follow-up and surveillance for both organized and opportunistic screening programmes for cervical cancer. Owing to their limited health care resources, developing countries cannot afford the models of frequently repeated screening of women over a wide age range that are used in developed countries. Many low-income developing countries, including most in sub-Saharan Africa, have neither the resources nor the capacity for their health services to organize and sustain any kind of screening programme. Middle-income developing countries, which currently provide inefficient screening...