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The Pennsylvania Cancer Registry was used to contact breast cancer patients and, through them, their adult sisters and daughters. The sisters and daughters were counseled concerning their higher than average risks for breast cancer and their need for mammography and breast self-examination. Results showed a 9 percent increase in mammography and a 10 percent increase in breast self-examination rates for the counseled over control group. Costs were $49 per counseled sister or daughter indicating a need to increase cost effectiveness before implementation is practical. [ABSTRACT FROM AUTHOR]

Objectives. This report measured the effect of births at 22 weeks' gestation or earlier on infant mortality in Philadelphia, Pa. Methods. The proportion of live-born deliveries at 22 weeks or earlier was calculated. Overall and race-specific infant mortality was calculated after excluding live-born deliveries at 22 weeks' gestation or earlier. Results. Of all deliveries, 1.5% were at 22 weeks or earlier. Of these, 68% were stillborn and 32% were live-born. Large hospital-to-hospital variation in the proportion of live-born deliveries at 22 weeks' gestation or earlier was noted. When nonviable births were excluded, overall infant mortality decreased 40%. Conclusions. The development of a standardized birth certificate policy is needed and will facilitate comparisons of infant mortality across spatial boundaries and racial/ethnic groups. (Am J Public Health. 2000;90:1303-1306) [ABSTRACT FROM AUTHOR]

A pilot program based on the substitution of domiciliary care for traditional institutional care was established by the Commonwealth of Pennsylvania lo provide community-based care for individuals who could no longer live independently (aging, mentally retarded, mentally ill). To ascertain the cost saving potential of this program, 190 participants and a comparable pool of non-participants were followed for an average 10-month follow-up period. Within each subgroup, participants were disaggregated into two categories: those residing in a community setting at pretest, and those residing in an institutional setting. An analysis of medical care and social support service utilization profiles indicated that program savings exceeded program cost for five of the six study subsamples: the one exception was the mental retardation cohort residing in a community setting at pretest, Net savings were greatest for the three subsamples residing in an institutional setting at pretest. For all the subsamples, over 90 per cent of the program saving stemmed from a lower use of institutional placements. [ABSTRACT FROM AUTHOR]

A study of all 37 ambulance squads in two Pennsylvania counties (Lehigh and Northampton), an area known to be served largely by volunteer units, was carried out by personal on-site interviews in 1973. The objectives were to determine the structure and functions of the squads and to devise some preliminary estimates of effectiveness as a base for regional planning. Topics examined include population and geographic area served, numbers and training of personnel, vehicles, equipment, record keeping, finances, communications capabilities, and squad organization. The 34 volunteer squads were found to vary greatly in resources and sophistication. The rural squads in particular tended to be underfinanced, to have low call loads and a delayed response to calls. In some squads personnel were inadequate in numbers and training. The advantages and disadvantages of maintaining volunteer services in rural areas are discussed and some possible approaches to the problem of providing high-quality services in rural areas outlined. [ABSTRACT FROM AUTHOR]