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McDermott A. Inner Workings: Researchers race to develop in-home testing for COVID-19, a potential game changer. Proc Natl Acad Sci U S A 2020; 117:25956-25959. [PMID: 32999063 PMCID: PMC7584891 DOI: 10.1073/pnas.2019062117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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2
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Wei M, Ye M, Dong K, Dong R. Mass screening for neuroblastoma in infants. Discov Med 2020; 30:63-70. [PMID: 33382962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Neuroblastoma (NB) is the only pediatric tumor that is screened for nationwide by detecting the urinary levels of homovanillic acid and/or vanillylmandelic acid; however, whether NB screening reduces the mortality rate has not been established. This review compared the incidence and mortality rates among data from international mass screening for NB, as well as an analysis of differences in age of screening, detection methods, and diagnostic biomarkers. A well-designed trial exploring possible benefits and hazards is warranted prior to resuming mass screening for NB.
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Affiliation(s)
- Meng Wei
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Mujie Ye
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Kuiran Dong
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 201102, China
- Corresponding author
| | - Rui Dong
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 201102, China
- Corresponding author
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3
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Affiliation(s)
- David M Studdert
- From the Stanford University Schools of Law and Medicine, Stanford, CA (D.M.S.); and the Wake Forest Schools of Law and Medicine, Winston-Salem, NC (M.A.H.)
| | - Mark A Hall
- From the Stanford University Schools of Law and Medicine, Stanford, CA (D.M.S.); and the Wake Forest Schools of Law and Medicine, Winston-Salem, NC (M.A.H.)
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Odegard TN, Farris EA, Middleton AE, Oslund E, Rimrodt-Frierson S. Characteristics of Students Identified With Dyslexia Within the Context of State Legislation. J Learn Disabil 2020; 53:366-379. [PMID: 32338146 DOI: 10.1177/0022219420914551] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
All but seven U.S. states have laws that govern some aspects of dyslexia screening, intervention, or teacher training in public schools. However, in the three states that mandate child-level reporting, data indicate lower than expected rates of dyslexia identification when compared with commonly accepted dyslexia prevalence rates. To better understand this apparent mismatch, this study explores factors that might predict the school-assigned identification of individuals with dyslexia. Deidentified data on 7,947 second-grade students in 126 schools from one U.S. state included a universal screening measure of literacy skills indicative of dyslexia (i.e., reading and spelling), school-assigned dyslexia classification, and demographic characteristics. As expected, behavioral characteristics of dyslexia from universal screening were associated with school-assigned dyslexia classification. However, dyslexia classification was less likely for minority students and individuals attending schools with a higher percentage of minority students. Students who showed behavioral characteristics of dyslexia and attended schools with a higher proportion of other students with similar poor literacy skills were more likely not to receive a school-assigned dyslexia classification. The findings suggest systematic demographic differences in whether a student is identified with dyslexia by schools even when using universal screening.
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Affiliation(s)
| | | | | | - Eric Oslund
- Middle Tennessee State University, Murfreesboro, USA
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Abstract
PURPOSE OF REVIEW Machine learning (ML) is increasingly being studied for the screening, diagnosis, and management of diabetes and its complications. Although various models of ML have been developed, most have not led to practical solutions for real-world problems. There has been a disconnect between ML developers, regulatory bodies, health services researchers, clinicians, and patients in their efforts. Our aim is to review the current status of ML in various aspects of diabetes care and identify key challenges that must be overcome to leverage ML to its full potential. RECENT FINDINGS ML has led to impressive progress in development of automated insulin delivery systems and diabetic retinopathy screening tools. Compared with these, use of ML in other aspects of diabetes is still at an early stage. The Food & Drug Administration (FDA) is adopting some innovative models to help bring technologies to the market in an expeditious and safe manner. ML has great potential in managing diabetes and the future is in furthering the partnership of regulatory bodies with health service researchers, clinicians, developers, and patients to improve the outcomes of populations and individual patients with diabetes.
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Affiliation(s)
- David T Broome
- Department of Endocrinology, Diabetes & Metabolism, Cleveland Clinic Foundation, F-20 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - C Beau Hilton
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Neil Mehta
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, EC-40 9500 Euclid Ave, Cleveland, OH, 44195, USA.
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Cloete E, Gentles TL, Bloomfield FH. introduce nationwide pulse oximetry screening for the detection of critical congenital heart disease and other hypoxaemic conditions in the newborn. N Z Med J 2020; 133:111-117. [PMID: 31945047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The mortality risk for infants with critical congenital heart disease (CCHD) unrecognised at the time of birth is high. Pulse oximetry has been utilised as a screening tool for the detection of these anomalies in the newborn as the majority will have a degree of hypoxaemia. This screening strategy has a moderate sensitivity and excellent specificity for the detection of CCHD, and a low false-positive rate. Respiratory and infective diseases are responsible for a large number of positive test results. The early recognition of these diseases can also improve health outcomes. Different approaches have been taken to introduce screening, ranging from hospital-led initiatives to mandatory state-wide policies. A study conducted in New Zealand demonstrated that sector-led screening initiatives are unlikely to result in equitable outcomes. In this midwifery-led maternity setting a nationwide pulse oximetry screening programme with adequate human and material resources should be introduced.
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Affiliation(s)
- Elza Cloete
- Senior Research Fellow, Liggins Institute, University of Auckland, Auckland
| | - Thomas L Gentles
- Paediatric Cardiologist, Director Paediatric and Congenital Cardiac Service, Starship Children's Hospital, Auckland
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Miller VG. Falling short: When testing is mandated and follow-up is not. Nurs Forum 2020; 55:33-36. [PMID: 31432522 DOI: 10.1111/nuf.12378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/05/2019] [Accepted: 07/23/2019] [Indexed: 06/10/2023]
Abstract
In 1999, the Texas Legislature mandated acanthosis nigricans (AN) screening in primary schools in designated regions of the state through the passage of House Bill 1860 to identify children at risk for diabetes by identifying the skin condition AN. AN is related to insulin resistance, and, thus, is associated with type 2 diabetes (diabetes mellitus type 2 [DMT2]), a growing concern among school-aged children. Since 1999, millions of children have been screened and hundreds of thousands have been screened positive. No data are available about the effectiveness of the program in identifying DMT2 among the school-aged population because no follow-up is mandated. The current practice is to send a letter to the parents of the child who screens positive, advising the parents to take the child to a health care provider for further assessment. Hence, children within the state may have diabetes or are developing diabetes but have yet to be diagnosed. In light of the presence of a law mandating AN screening, mandating a follow-up to identify those who have diabetes or are developing the condition of diabetes can provide early intervention and decrease costs of care. It is not known why the follow-up of those who screen positive was not included in the initial legislation. It may have been due to the cost of the necessary blood tests that are used to assess an individual for diabetes. Related to this is the reality that blood tests are invasive procedures, whereas screening for a skin disorder is not, thereby possibly explaining the omission of mandated follow-up from the legislation .
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Affiliation(s)
- Virginia G Miller
- School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas
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Nyante SJ, Marsh MW, Benefield T, Earnhardt K, Lee SS, Henderson LM. Supplemental Breast Imaging Utilization After Breast Density Legislation in North Carolina. J Am Coll Radiol 2020; 17:6-14. [PMID: 31271735 PMCID: PMC6938553 DOI: 10.1016/j.jacr.2019.05.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/29/2019] [Accepted: 05/30/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Breast density notification laws are increasingly common but little is known of how they affect supplemental screening use. The aim of this study was to investigate supplemental screening before and after density notification in North Carolina, where notification has been required since 2014. METHODS Breast screening data from Carolina Mammography Registry participants aged 40 to 79 years with no personal histories of breast cancer or breast implants were evaluated. Supplemental screening was defined as a nondiagnostic digital breast tomosynthesis (DBT), whole-breast ultrasound, or breast MRI performed within 3 months of negative or benign results on screening mammography (2-D or DBT). Supplemental screening before (2012-2013) and after (2014-2016) the notification law was compared using logistic regression. RESULTS During the study period, 78,967 women underwent 145,279 index screening mammographic examinations. Supplemental screening use was similar before and after the notification law, regardless of breast density (dense breasts: adjusted odds ratio [aOR], 1.01; 95% confidence interval [CI], 0.58-1.75; nondense breasts: aOR, 0.63; 95% CI, 0.38-1.04). Although there was no change in supplemental screening, new use of any screening DBT from 2014 to 2016 was greater for women with dense breasts (versus nondense breasts; aOR, 1.15; 95% CI, 1.08-1.23). CONCLUSIONS Data suggest that supplemental screening use in North Carolina did not change after enactment of a breast density notification law, though the increase in new use of any screening DBT was greater for women with dense breasts. The short-term lack of change in supplemental screening should be considered as additional notification laws are developed.
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Affiliation(s)
- Sarah J Nyante
- Department of Radiology and the Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Mary W Marsh
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Thad Benefield
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn Earnhardt
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sheila S Lee
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Louise M Henderson
- Department of Radiology and the Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Jadavji T, Lang R, Gill MJ. Protecting the health of children moving to Canada. Lancet 2019; 394:1901-1902. [PMID: 31703957 DOI: 10.1016/s0140-6736(19)31913-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Taj Jadavji
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Raynell Lang
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M John Gill
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Southern Alberta HIV Clinic, Calgary, AB T2N 4N1, Canada.
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Ino H, Nakazawa E, Akabayashi A. Health and welfare in Japan. Lancet 2019; 394:1614-1615. [PMID: 31690440 DOI: 10.1016/s0140-6736(19)31805-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/10/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Hiroyasu Ino
- Department of Biomedical Ethics, Faculty of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Eisuke Nakazawa
- Department of Biomedical Ethics, Faculty of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Akira Akabayashi
- Department of Biomedical Ethics, Faculty of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; Division of Medical Ethics, New York University School of Medicine, New York, NY, USA.
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Stingl M, Knipper M, Hetzger B, Richards J, Yazgan B, Gallhofer B, Hanewald B. Assessing the special need for protection of vulnerable refugees: testing the applicability of a screening method (RHS-15) to detect traumatic disorders in a refugee sample in Germany. Ethn Health 2019; 24:897-908. [PMID: 29081242 DOI: 10.1080/13557858.2017.1379598] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 08/21/2017] [Indexed: 06/07/2023]
Abstract
Objectives: Although EU member states are obligated to take special account of the situation of particularly vulnerable refugees, appropriate and specific measures to detect affected asylum seekers are not yet available. This study tries to pave the way for the implementation of an adequate instrument which at the same time assesses these needs of suffering people whilst responding to the need for mental health assessments specifically designed for refugees. This was done by testing the implementation of a screening method (Refugee Health Screener RHS-15) for trauma related mental health problems in refugees. Design: Two refugee samples in Germany (differing in arrival time: 126 applicants for asylum residing in the initial reception center and 116 living in long term communal accommodations) were assessed with the culturally sensitive Refugee Health Screener (RHS-15) to detect the incidence of mental health problems amongst them. Test fairness, reasonableness, susceptibility, transparency, acceptance, external design, utility and economy of the instrument were examined to check the applicability of the RHS-15 standardization test. Results: The RHS-15 indicates a good practical feasibility as the examination of the focused psychometric characteristics suggests. It became apparent, that implementing a screening procedure depends on political, legal and medical context factors that need to be considered. 2/3 of the participants had a positive screening result, which needs further diagnostic clarification in a second step. Conclusion: The RHS-15 seems to be practicable, economical, and rapidly deployable for the widespread detection of traumatic disorders in refugees living in Europe. The tool proved useful to aid diagnostic assessments and provide treatment to individuals in need, however the time of examination (resp. the duration of staying in the target land) influences the results.
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Affiliation(s)
- Markus Stingl
- Centre for Psychiatry and Psychotherapy, Justus-Liebig-University , Giessen , Germany
| | - Michael Knipper
- Institute for the History of Medicine, Justus-Liebig-University , Giessen , Germany
| | - Björge Hetzger
- Centre for Psychiatry and Psychotherapy, Justus-Liebig-University , Giessen , Germany
| | - Jessica Richards
- Centre for Psychiatry and Psychotherapy, Justus-Liebig-University , Giessen , Germany
| | - Bülent Yazgan
- Centre for Psychiatry and Psychotherapy, Justus-Liebig-University , Giessen , Germany
| | - Bernd Gallhofer
- Centre for Psychiatry and Psychotherapy, Justus-Liebig-University , Giessen , Germany
| | - Bernd Hanewald
- Centre for Psychiatry and Psychotherapy, Justus-Liebig-University , Giessen , Germany
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Brown J, Soukas C, Lin JJ, Margolies L, Santiago-Rivas M, Jandorf L. Physician Knowledge, Attitudes, and Practices Regarding Breast Density. J Womens Health (Larchmt) 2019; 28:1193-1199. [PMID: 31063441 PMCID: PMC6743086 DOI: 10.1089/jwh.2018.7429] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Many states have enacted breast density laws, requiring that women be informed of their breast density status; however there is currently no consensus for screening guidelines or recommendations for women with dense breasts. The objective of this study is to access physician views about breast density and their practices for breast cancer screening of women with dense breasts in light of breast density laws. Materials and Methods: Setting: Academic medical centers, community and private practices mostly in New York City. Participants: Primary care providers (PCPs), radiologists and gynecologists. Procedure: We conducted the study through anonymous, self-administered surveys about physician knowledge, attitudes, and practices regarding screening of women with dense breasts. Bivariate and multivariate analyses were performed to assess differences between PCPs and specialists. Results: We received 155 responses of which 75% were female, 77% were attending-level physicians, 42% were PCPs, 28% were radiologists, 17% were gynecologists, and 9% other. Almost half of the respondents (48%) were unaware of breast density laws, and two-thirds (67%) felt they needed more education about breast density and supplemental screening. More than half of the respondents (62%) were unaware of the increased risk of breast cancer related to dense breasts. Compared to specialists, PCPs were less aware of their state's breast density laws (odds ratio [OR] 0.21; 95% confidence interval [CI] 0.09-0.50) and of the increased breast cancer risk for women with dense breasts (OR 0.23; 95% CI 0.09-0.60). Conclusion: Breast density laws have not translated into greater knowledge of breast density and recommendations for supplemental screening among PCPs.
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Affiliation(s)
- Jordonna Brown
- Graduate Program in Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Chloe Soukas
- Rutgers New Jersey Medical School, Newark, New Jersey
| | - Jenny J. Lin
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Laurie Margolies
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Marimer Santiago-Rivas
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lina Jandorf
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
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14
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15
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Hallek M, Bokemeyer C, Lüftner D, Weissinger F. Vorwort. Oncol Res Treat 2018; 41 Suppl 3:1. [PMID: 30056448 DOI: 10.1159/000491683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Affiliation(s)
- Evan M Bloch
- From the Johns Hopkins University School of Medicine (E.M.B., P.M.N., A.A.R.T., J.S.) and the Berman Institute of Bioethics, Johns Hopkins University (J.S.), Baltimore
| | - Paul M Ness
- From the Johns Hopkins University School of Medicine (E.M.B., P.M.N., A.A.R.T., J.S.) and the Berman Institute of Bioethics, Johns Hopkins University (J.S.), Baltimore
| | - Aaron A R Tobian
- From the Johns Hopkins University School of Medicine (E.M.B., P.M.N., A.A.R.T., J.S.) and the Berman Institute of Bioethics, Johns Hopkins University (J.S.), Baltimore
| | - Jeremy Sugarman
- From the Johns Hopkins University School of Medicine (E.M.B., P.M.N., A.A.R.T., J.S.) and the Berman Institute of Bioethics, Johns Hopkins University (J.S.), Baltimore
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Gracy D, Fabian A, Basch CH, Scigliano M, MacLean SA, MacKenzie RK, Redlener IE. Missed opportunities: Do states require screening of children for health conditions that interfere with learning? PLoS One 2018; 13:e0190254. [PMID: 29342147 PMCID: PMC5771574 DOI: 10.1371/journal.pone.0190254] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 12/10/2017] [Indexed: 11/30/2022] Open
Abstract
METHODS Investigators reviewed websites of state departments of health and education, and legislation for all 50 states and DC. For states with mandated screenings and a required form, investigators applied structured analysis to assess HBL inclusion. RESULTS No state mandated that schools require screening for all 7 HBLs. Less than half (49%) required comprehensive school health examinations and only 12 states plus DC required a specific form. Of these, 12 of the forms required documentation of vision screening, 11 of hearing screening, and 12 of dental screening. Ten forms asked about asthma and 9 required documentation of lead testing. Seven asked about general well-being, emotional problems, or mental health. None addressed hunger. When including states without comprehensive school health examination requirements, the most commonly required HBL screenings were for vision (80% of states; includes DC), hearing (75% of states; includes DC) and dental (24% of state; includes DC). CONCLUSION The lack of state mandated requirements for regular student health screening represents a missed opportunity to identify children with HBLs. Without state mandates, accompanying comprehensive forms, and protocols, children continue to be at risk of untreated health conditions that can undermine their success in school.
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Affiliation(s)
- Delaney Gracy
- Children’s Health Fund, New York, NY, United States of America
| | - Anupa Fabian
- Children’s Health Fund, New York, NY, United States of America
| | - Corey Hannah Basch
- Department of Public Health, William Paterson University, New York, NY, United States of America
| | - Maria Scigliano
- Children’s Health Fund, New York, NY, United States of America
| | - Sarah A. MacLean
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | | | - Irwin E. Redlener
- Children’s Health Fund, New York, NY, United States of America
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, United States of America
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Pashkov V, Noha P, Soloviov A. Screening and periodical medical examinations as important part of public health: problem of the legal implementation. Wiad Lek 2018; 71:893-896. [PMID: 30099431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Introduction: Public health is an important concept, which is continually being globalized and integrated into today's society. It helps to improve and prolong the quality of life of people and prevent the spread of epidemics and serious incurable diseases. The components of public health include protection, prevention, and promotion. Prevention, the measures taken to prevent disease as opposed to treatment consist of screening and periodical medical examinations. There are two types of screening- universal screening and case finding (individual screening). Universal screening and periodical medical examination are identical concepts; the terms dispensary and individual screening (case finding) have similar meanings and can be used interchangeably. These concepts and their importance are analyzed in this research. The aim: A research on the legal regulation of periodic health examinations and screening as a two systems, which provides the implementation of prevention within the public health. Analysis of foreign experience such countries as: Great Britain, USA, Austria, Germany, Australia, France, Italy and others. PATIENTS AND METHODS Materials and methods: The research based on: Ukrainian legislation, European Union's Law Acts, decisions of the ECHR, EU's member-states law, WHO Acts and Recommendations, scientific articles. The research is also based on general scientific and special research methods (such as dialectical, comparative, analytic, synthetic). RESULTS Review: In Europe (except Germany and Austria) is happening the transition from the system of mandatory periodical medical examination to new screening system. However, despite this, periodical medical examinations of Europeans held in connection with exist system health insurance (both voluntary and mandatory). CONCLUSION Conclusions: Screening and periodical medical examinations are two of the most important aspects of public health as they help to diagnose diseases at an early stage, even before showing any symptoms. Screening and periodical medical examinations ensures the safety and health of the entire population as opposed to certain individuals and therefore be mandatory procedure in today's society.
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Affiliation(s)
- Vitalii Pashkov
- Poltava Law Institute Of Yaroslav Mudriy National Law University, Poltava, Ukraine
| | - Petro Noha
- Poltava Law Institute Of Yaroslav Mudriy National Law University, Poltava, Ukraine
| | - Aleksey Soloviov
- National Medical Academy Of Postgraduate Education Named P.L.Shupyk, Kyiv, Ukraina
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Potter MT. Nurse-Led Initiatives to Implement Universal Screening for Perinatal Emotional Complications. Nurs Womens Health 2017; 21:452-461. [PMID: 29223209 DOI: 10.1016/j.nwh.2017.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/13/2017] [Indexed: 06/07/2023]
Abstract
Perinatal emotional complications are the most common pregnancy complications in the United States. This article reviews three recent studies that illustrate the prevalence of and risk factors for perinatal emotional complications and sheds light on the inconsistency of screening by health care providers in acute care and outpatient settings. Also presented is an example of nurse-led quality improvement initiatives aimed at implementing universal screening in a rural New England county, which resulted in 100% screening with the Edinburgh Postnatal Depression Scale across health care facilities within the community, as well as a system-wide change in the approach to identifying and treating perinatal emotional complications.
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Flanigan CA, Leung SYJ, Rowe KA, Levey WK, King A, Sommer JN, Morne JE, Zucker HA. Evaluation of the Impact of Mandating Health Care Providers to Offer Hepatitis C Virus Screening to All Persons Born During 1945-1965 - New York, 2014. MMWR Morb Mortal Wkly Rep 2017; 66:1023-1026. [PMID: 28957037 PMCID: PMC5657676 DOI: 10.15585/mmwr.mm6638a3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Approximately 75% of all hepatitis C virus (HCV) infections in the United States and 73% of HCV-associated mortality occur in persons born during 1945-1965, placing this birth cohort at increased risk for liver cancer and other HCV-related liver disease (1). In the United States, an estimated 2.7 million persons are living with HCV infection, and it is estimated that up to 75% of these persons do not know their status. Since 2012, CDC has recommended that persons born during 1945-1965 receive one-time HCV testing. To increase the number of persons tested for HCV and to ensure timely diagnosis and linkage to care, in 2014, New York enacted a hepatitis C testing law that requires health care providers to offer HCV antibody screening to all persons born during 1945-1965 who are receiving services in primary care settings or as hospital inpatients, and to refer persons with positive HCV antibody tests for follow-up health care, including an HCV diagnostic test (i.e., HCV RNA).* The New York State Department of Health (NYSDOH) used survey data from clinical laboratories and Medicaid claims and encounter data, and state and New York City (NYC) HCV surveillance data to assess the number of persons tested for HCV and number of persons with newly diagnosed HCV infections who were linked to care. During the first year of the HCV law implementation, there was a 51% increase in specimens submitted for HCV testing to surveyed clinical laboratories; testing rates among active Medicaid clients increased 52%, and linkage to care among persons with newly diagnosed HCV infection increased approximately 40% in New York and 11% in NYC. These findings highlight the potential for state laws to promote HCV testing and the utility of HCV surveillance and Medicaid claims data to monitor the quality of HCV testing and linkage to care for HCV-infected persons.
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Affiliation(s)
| | - Semmie Kim
- Correctional Health Services, New York, NY 10041, USA
| | - Homer Venters
- Correctional Health Services, New York, NY 10041, USA.
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Chen DJ, Yao JD. Comparison of turnaround time and total cost of HIV testing before and after implementation of the 2014 CDC/APHL Laboratory Testing Algorithm for diagnosis of HIV infection. J Clin Virol 2017; 91:69-72. [PMID: 28461133 DOI: 10.1016/j.jcv.2017.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 03/08/2017] [Accepted: 04/03/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Updated recommendations for HIV diagnostic laboratory testing published by the Centers for Disease Control and Prevention and the Association of Public Health Laboratories incorporate 4th generation HIV immunoassays, which are capable of identifying HIV infection prior to seroconversion. OBJECTIVES The purpose of this study was to compare turnaround time and cost between 3rd and 4th generation HIV immunoassay-based testing algorithms for initially reactive results. STUDY DESIGN The clinical microbiology laboratory database at Mayo Clinic, Rochester, MN was queried for 3rd generation (from November 2012 to May 2014) and 4th generation (from May 2014 to November 2015) HIV immunoassay results. All results from downstream supplemental testing were recorded. Turnaround time (defined as the time of initial sample receipt in the laboratory to the time the final supplemental test in the algorithm was resulted) and cost (based on 2016 Medicare reimbursement rates) were assessed. RESULTS A total of 76,454 and 78,998 initial tests were performed during the study period using the 3rd generation and 4th generation HIV immunoassays, respectively. There were 516 (0.7%) and 581 (0.7%) total initially reactive results, respectively. Of these, 304 (58.9%) and 457 (78.7%) were positive by supplemental testing. There were 10 (0.01%) cases of acute HIV infection identified with the 4th generation algorithm. The most frequent tests performed to confirm an HIV-positive case using the 3rd generation algorithm, which were reactive initial immunoassay and positive HIV-1 Western blot, took a median time of 1.1 days to complete at a cost of $45.00. In contrast, the most frequent tests performed to confirm an HIV-positive case using the 4th generation algorithm, which included a reactive initial immunoassay and positive HIV-1/-2 antibody differentiation immunoassay for HIV-1, took a median time of 0.4 days and cost $63.25. Overall median turnaround time was 2.2 and 1.5 days, and overall median cost was $63.90 and $72.50 for 3rd and 4th generation algorithms, respectively. CONCLUSIONS Both 3rd and 4th generation HIV immunoassays had similar total numbers of tests performed and positivity rates during the study period. A greater proportion of reactive 4th generation immunoassays were confirmed to be positive, and the 4th generation algorithm identified several cases of acute HIV infection that would have been missed by the 3rd generation algorithm. The 4th generation algorithm had a more rapid turnaround time but higher cost for confirmed positive HIV infections and overall, compared to the 3rd generation algorithm.
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Affiliation(s)
- Derrick J Chen
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
| | - Joseph D Yao
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
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Abstract
Australian immigration detention has received persistent criticism since its introduction almost 25 years ago. With the recent introduction of offshore processing, these criticisms have intensified. Riots, violence, self-harm, abuse and devastating mental health outcomes are all now well documented, along with a number of deaths. Clinicians have played a central role working in these environments, faced with the overarching issue of delivering healthcare while facilitating an abusive and harmful system. Since the re-introduction of offshore processing a number of authors have begun to discuss the possibility of a boycott. While taking such action may lead to change, further discussion is needed, not only in relation to the impact of a boycott, but whether it is possible for clinicians to engage with this system in more productive, ethical ways. This article utilises a framework proposed by Lepora and Goodin (On complicity and compromise, Oxford University Press, Oxford, 2013) that provides a structured approach to examine complicity and seeks to explore how clinicians have engaged with Australian immigration detention and ultimately whether they should continue to do so.
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Affiliation(s)
- Ryan Essex
- The Centre for Values, Ethics and the Law in Medicine, The University of Sydney, School of Public Health, Medical Foundation Building K25, Sydney, NSW, 2006, Australia.
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Heil D. Addressing Inadequate Federal Legislation Concerning Viral Disasters: A Hard Look at the Emergency Treatment and Active Labor Act. J Leg Med 2017; 37:167-174. [PMID: 28910228 DOI: 10.1080/01947648.2017.1303355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Sefty H, Klivitsky A, Bromberg M, Dichtiar R, Ami MB, Shohat T, Glatman-Freedman A. Factors associated with choice of approach for Group B streptococcus screening. Isr J Health Policy Res 2016; 5:42. [PMID: 27879969 PMCID: PMC5109778 DOI: 10.1186/s13584-016-0103-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 08/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The crude rate of early-onset Group B streptococcus disease (EOGBS) in Israel has been consistently under 0.5 for 1000 live births for the past 8 years. The Israeli Ministry of Health has adapted the risk factor based approach for preventing EOGBS and universal bacteriological screening for GBS is not recommended. In spite of this policy, there are indications that many pregnant women in Israel undergo bacteriological screening for GBS. The objective of this study is to assess the rate and characteristics of pregnant women who undergo screening for group B streptococcus (GBS) colonization in Israel. METHODS Survey of expectant mothers who came to give birth in 29 delivery rooms throughout Israel during the month of July 2012 regarding GBS screening practice and demographics. RESULTS A total of 2968 pregnant women participated in the assessment. Among them, 935 women (31.5 %) had been tested for GBS colonization. About 90 % of those women had no risk factors, only 542 women (60 %) underwent testing during the recommended gestational timing (35-37 weeks) and 23 % of the tested women reported being GBS carriers. GBS screening as part of the routine pregnancy follow- up was associated with: residence district, intermediate or high socioeconomic rank, being a member of certain health maintenance organization and being Jewish. Characteristics found to be significantly associated with being a GBS carrier were: low socioeconomic rank, and having a risk factor for GBS infection. CONCLUSIONS A substantial number of pregnant women in Israel undergo screening for GBS colonization despite the national policy against universal screening. While GBS colonization was more prevalent in women of lower socioeconomic status, screening is done more often in those of higher socioeconomic status, suggesting unnecessary monetary expenses.
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Affiliation(s)
- H. Sefty
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Israel
- The Israel Center for Disease Control, Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, 52621 Israel
| | - A. Klivitsky
- Pediatric Infectious Disease unit, E.Wolfson Medical Center, Holon, Israel
| | - M. Bromberg
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Israel
| | - R. Dichtiar
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Israel
| | - M. Ben Ami
- Department of Obstetrics and Gynecology, Poriya Medical Center, Tiberias, Israel
- School of Medicine, Bar Ilan University, Ramat Gan, Israel
| | - T. Shohat
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Israel
- School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A. Glatman-Freedman
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Israel
- Departments of Pediatrics and Family and Community Medicine, New York Medical College, Valhalla, NY USA
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Paulke A, Wunder C, Toennes SW. Field study to detect illicit and medicinal drugs in car drivers in Southern and Western Hesse. Arch Kriminol 2016; 238:173-187. [PMID: 29465866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In the present study, immunochemical tests (Mahsan DrugInspector, DOA4, DOA8, DOA10, Protzek) as well as the detection rate of police checks were evaluated. Urine and blood samples of suspected car drivers were analysed by chromatography-mass spectrometry. Additionally, anonymised urine samples were analysed on a voluntary basis in cases where no legal proceedings were initiated. Toxicological analyses (total unknown screening) were performed using gas chromatography-mass spectrometry (GC-MS) after hydrolysis, acidic and alkaline extraction and derivatization. A data base for screening 9000 substance entries was applied. In addition, urine samples were analysed using liquid chromatography/ time-of-flight mass spectrometry (HPLC-ToF-MS) to screen psychiatric and narcotic drugs. In total, samples of 154 suspects were analysed, of these, 46 samples for no actual reason. In 5 of the latter samples, forensically relevant substances were detected; in two cases the consumption of illicit drugs, i. e. cannabis and methamphetamine, was proved. Of the 154 suspects, 108 were charged with driving under the influence of drugs; in samples of 103 of these cases, illicit drugs were found. Immunochemical pretesting showed posi- tive results in 97 of the 108 cases; in 6 samples, psychiatric drugs (citalopram, doxepin, promethazine, mirtazapine, fluoxetine, venlafaxine) were later identified, which are not detectable by ordinary pretesting systems. Police officers successfully identified 95.4 % of the suspects as drug consumers, which is an excellent result. In practice, pretesting of urine samples using immunochemical techniques proved to be very reliable. The Protzek system in particular corresponded well with the results of the chromatographic analyses. In conclusion, systematic chromatographic-mass spectrometric analysis of urine samples of suspects is recommended to identify car drivers consuming illicit drugs and to obtain data usable in legal proceedings (e. g. suspending of the driving license), which is not always possible when using blood samples in cases of drugs consumed some time ago.
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Measuring the Effect of Breast Density Legislation on a State's Patients. Radiol Technol 2016; 88:189CT-92CT. [PMID: 27837145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Hoffman R, Hirdes J, Brown GP, Dubin JA, Barbaree H. The use of a brief mental health screener to enhance the ability of police officers to identify persons with serious mental disorders. Int J Law Psychiatry 2016; 47:28-35. [PMID: 27044526 DOI: 10.1016/j.ijlp.2016.02.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Police agencies in Canada and elsewhere have received much criticism over how they respond to persons with serious mental disorders. The adequacy of training provided to police officers on mental health issues and in particular on recognizing indicators of serious mental disorders has been a major concern. This paper describes the process that led to the development of a new brief mental health screener (interRAI Brief Mental Health Screener, BMHS) designed to assist police officers to better identify persons with serious mental disorders. The interRAI BMHS was developed in collaboration with interRAI, an international, not-for-profit consortium of researchers. The government of Ontario had previously partnered with interRAI to develop and implement the Resident Assessment Instrument for Mental Health (RAI-MH), the assessment system mandated for use on all persons admitted into inpatient psychiatric care in the province. Core items on the interRAI BMHS were obtained through analysis (N=41,019) of RAI-MH data together with input from representatives from health care, police services, and patient groups. Two police services in southwestern Ontario completed forms (N=235) on persons thought to have a mental disorder. Patient records were later accessed to determine patient disposition. The use of summary and inferential statistics revealed that the variables significantly associated with being taken to hospital by police included performing a self-injurious act in the past 30days, and others being concerned over the person's risk for self-injury. Variables significantly associated with being admitted included abnormal thought process, delusions, and hallucinations. The results of the study indicate that the 14-variable algorithm used to construct the interRAI BMHS is a good predictor of who was most likely to be taken to hospital by police officers and who was most likely to be admitted. The instrument is an effective means of capturing and standardizing police officer observations enabling them to provide more and better quality information to emergency department (ED) staff. Teaching police officers to use the form constitutes enhanced training on major indicators of serious mental disorders. Further, given that items on the interRAI BMHS are written in the language of the health system, language acts as common currency between police officers and ED staff laying the foundation for a more collaborative approach between the systems.
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Affiliation(s)
- Ron Hoffman
- Ministry of Community Safety and Correctional Services, Ontario Police College, 10716 Hacienda Road, Aylmer, Ontario N5H 2T2, Canada; Faculty of Applied and Professional Studies, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L, Canada.
| | - John Hirdes
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Gregory P Brown
- Faculty of Applied and Professional Studies, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L7, Canada
| | - Joel A Dubin
- Department of Statistics and Actuarial Science, School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Howard Barbaree
- Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R, Canada; Waypoint Centre for Mental Health Care, 500 Church Street, Penetanguishene, Ontario L9M 1G3, Canada
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Jewett A, Bell T, Cohen NJ, Buckley K, Leino V, Even S, Beavers S, Brown C, Marano N. US college and university student health screening requirements for tuberculosis and vaccine-preventable diseases, 2012. J Am Coll Health 2016; 64:409-15. [PMID: 26730492 PMCID: PMC4879121 DOI: 10.1080/07448481.2015.1117465] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the US college student health screening requirements among US resident and international students for tuberculosis (TB) and vaccine-preventable diseases (VPDs) as they relate to the American College Health Association (ACHA) guidelines. Methods/Participants: In April 2012, US college health administrators (N = 2,858) were sent online surveys to assess their respective school's TB screening and immunization requirements. RESULTS Surveys were completed by 308 (11%) schools. Most schools were aware of the ACHA immunization (78%) and TB screening (76%) guidelines. Schools reported having policies related to immunization screening (80.4%), immunization compliance (93%), TB screening (55%), and TB compliance (87%). CONCLUSION Most colleges were following ACHA guidelines. However, there are opportunities for improvement to fully utilize the recommendations and prevent outbreaks of communicable diseases among students in colleges.
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Affiliation(s)
- A. Jewett
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
| | - T Bell
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
- Council of State and Territorial Epidemiologists, Atlanta, GA
| | - NJ. Cohen
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
| | - K. Buckley
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
| | - V. Leino
- American College of Health Association, Hanover, MD
| | - S. Even
- American College of Health Association, Hanover, MD
| | - S. Beavers
- Centers for Disease Control and Prevention, Division of Tuberculosis Elimination, Atlanta, GA
| | - C. Brown
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
| | - N. Marano
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
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Greacen T, Kersaudy-Rahib D, Le Gall JM, Lydié N, Ghosn J, Champenois K. Comparing the Information and Support Needs of Different Population Groups in Preparation for 2015 Government Approval for HIV Self-testing in France. PLoS One 2016; 11:e0152567. [PMID: 27031234 PMCID: PMC4816498 DOI: 10.1371/journal.pone.0152567] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 03/16/2016] [Indexed: 12/02/2022] Open
Abstract
CONTEXT HIV self-tests are currently being introduced in France with the aim of promoting screening both for the general population and for high-risk populations. OBJECTIVE The current study aimed to identify and compare the information and support needs of the different target population groups. METHODS The Delphi process was used to synthesize expert opinions for each population group. Experts were chosen for their experience and expertise in the area of HIV and HIV screening for each population. Each group developed recommendations for a specific population: six high HIV prevalence populations (men who have sex with men; transgender people; substance users; migrants from sub-Saharan Africa; French West Indies; French Guiana) and two low prevalence populations (the general population; people under 25). Each group included expertise from four areas: research, screening and care, policy-making, and community groups. RESULTS A final total of 263 recommendations were grouped into eight main themes: Communicating at both national and community levels about self-test arrival (24% of all recommendations); Providing information adapted to the different community groups' needs (23%); Providing counselling on self-test use and access to care (15%); Making self-tests available to all in terms of accessibility and cost (13%); Preparing community healthcare and screening systems for the arrival of the self-test (11%); Approving only high quality self-tests (6%); Defending self-test users' legal rights (5%); Evaluating self-test use (3%). Although a large number of recommendations were common to several groups of experts, the study highlighted a certain number of recommendations specific to each different population group, particularly with regard to information content and access both to information and to the self-tests themselves. CONCLUSION Results from the current study should make a significant contribution to policy decisions concerning catering for the specific access, information and support needs of different potential HIV self-test user groups in France.
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Affiliation(s)
- Tim Greacen
- Laboratoire de recherche, EPS Maison Blanche, Paris, France
| | | | | | | | - Jade Ghosn
- AP-HP, UF de Thérapeutique en Immuno-Infectiologie, Hôpital Hôtel-Dieu, Paris, France
- Université Paris Descartes, EA7327, Faculté de Médecine site Necker, Paris, France
| | - Karen Champenois
- Laboratoire de recherche, EPS Maison Blanche, Paris, France
- Inserm U1018, CESP-4: Epidémiologie du VIH et des IST, Le Kremlin Bicêtre, France
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Hamman MK, Kapinos KA. Colorectal Cancer Screening and State Health Insurance Mandates. Health Econ 2016; 25:178-191. [PMID: 25521438 DOI: 10.1002/hec.3132] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Revised: 10/17/2014] [Accepted: 11/05/2014] [Indexed: 06/04/2023]
Abstract
Colorectal cancer (CRC) is the third most deadly cancer in the USA. CRC screening is the most effective way to prevent CRC death, but compliance with recommended screenings is very low. In this study, we investigate whether CRC screening behavior changed under state mandated private insurance coverage of CRC screening in a sample of insured adults from the 1997 to 2008 Behavioral Risk Factor Surveillance Survey (BRFSS). We present difference-in-difference-in-differences (DDD) estimates that compare insured individuals age 51 to 64 to Medicare age-eligible individuals (ages 66 to 75) in mandate and non-mandate states over time. Our DDD estimates suggest endoscopic screening among men increased by 2 to 3 percentage points under mandated coverage among 51 to 64 year olds relative to their Medicare age-eligible counterparts. We find no clear evidence of changes in screening behavior among women. DD estimates suggest no evidence of a mandate effect on either type of CRC screening for men or women.
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Affiliation(s)
- Mary K Hamman
- Department of Economics, University of Wisconsin, La Crosse, La Crosse, WI, USA
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Green D, Webb S. Rubella screening cessation. Midwives 2016; 19:62-64. [PMID: 27290870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Krause V. Policy recommendation: latent tuberculosis infection screening and treatment in children in immigration detention. Commun Dis Intell (2018) 2015; 39:E597-E598. [PMID: 26779733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Vicki Krause
- Director, Centre for Disease Control, Department of Health, Northern Territory Government, Ground Floor, Building 4, Royal Darwin Hospital, Tiwi, Northern Territory
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Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). Intimate Partner Violence. Nurs Womens Health 2015; 19:455-8. [PMID: 26460920 DOI: 10.1111/1751-486X.12241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Abstract
BACKGROUND The Centers for Disease Control and Prevention (CDC) estimates that 156,300 (95% CI 144,100-165,900) Americans living with HIV in 2012 were unaware of their infection. To increase knowledge of HIV status, CDC guidelines seek to make HIV screening a routine part of medical care. This paper examines how routinely California primary care providers test for HIV and how providers' knowledge of California's streamlined testing requirements, use of sexual histories, and having an electronic medical record prompt for HIV testing, relate to test offers. METHODS We surveyed all ten California health plans offered under health reform's Insurance Exchange (response rate = 50%) and 322 primary care providers to those plans (response rate = 19%) to assess use of HIV screening and risk assessments. RESULTS Only 31.7% of 60 responding providers reported offering HIV tests to all or most new enrollees and only 8.8% offered an HIV test of blood samples all or most of the time despite the California law requiring that providers offer HIV testing of blood samples in primary care settings. Twenty-eight of the 60 providers (46.6%) were unaware that California had reduced barriers to HIV screening by eliminating the requirement for written informed consent and pre-test counseling. HIV screening of new enrollees all or most of the time was reported by 53.1% of the well-informed providers, but only 7.1% of the less informed providers, a difference of 46 percentage points (95% CI: 21.0%-66.5%). Providers who routinely obtained sexual histories were 29 percentage points (95% CI: 0.2%-54.9%) more likely to screen for HIV all or most of the time than those who did not ask sexual histories. CONCLUSION Changing HIV screening requirements is important, but not sufficient to make HIV testing a routine part of medical care. Provider education to increase knowledge about the changed HIV testing requirements could positively impact testing rates.
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Affiliation(s)
- Arleen A. Leibowitz
- Department of Public Policy, UCLA Luskin School of Public Affairs, Box 951656, Los Angeles, CA, 90095–1656, United States of America
- * E-mail:
| | - Agustin T. Garcia-Aguilar
- Department of Public Policy, UCLA Luskin School of Public Affairs, Box 951656, Los Angeles, CA, 90095–1656, United States of America
- AIDS Project Los Angeles, 611 South Kingsley Drive, Los Angeles, CA 90005, United States of America
| | - Kevin Farrell
- Department of Public Policy, UCLA Luskin School of Public Affairs, Box 951656, Los Angeles, CA, 90095–1656, United States of America
- AIDS Project Los Angeles, 611 South Kingsley Drive, Los Angeles, CA 90005, United States of America
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Chenot JF, Schumacher B. ["No evidence that the benefits outweight the damage"]. MMW Fortschr Med 2015; 157:8. [PMID: 26012796 DOI: 10.1007/s15006-015-3052-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Abstract
In the March issue of the journal, the Joint SHEA and APIC Task Force indicates that the Society for Healthcare Epidemiology of America (SHEA) and the Association for Professionals in Infection Control and Epidemiology (APIC) support the use of active detection and isolation (ADI) for controlling nosocomial infections due to methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) “in appropriate circumstances, as recommended in previously published guidelines”1(p250) (those published by SHEA and the Healthcare Infection Control Practices Advisory Committee [HICPAC]), but that SHEA and APIC oppose the use of legislation for mandating any infection control approach, including this one as tried in 2006 in Illinois and Maryland.
Both supporters and opponents of controlling MRSA and VRE with ADI probably will agree that legislation is not the optimal way to control nosocomial infections in general, but this position statement undoubtedly will please the latter more than it does the former because the SHEA/APIC Task Force argues that ADI is not ready for routine use throughout all healthcare facilities, directly opposing the position of the original SHEA guideline. As an author of that SHEA guideline, I would like to comment. First, the new position seems politically correct (since most infection control professionals have not yet bothered using ADI to control MRSA and VRE), but many of the planks of the SHEA/APIC Task Force position statement are misleading.
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Affiliation(s)
- Barry M Farr
- University of Virginia Health System, Charlottesville, VA 22908, USA.
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Fraser V, Murphy D, Brennan PJ, Frain J, Arias KM, Perl TM. Politically Incorrect: Legislation Must Not Mandate Specific Healthcare Epidemiology and Infection Prevention and Control Practices. Infect Control Hosp Epidemiol 2015; 28:594-5. [PMID: 17464921 DOI: 10.1086/518681] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Accepted: 04/05/2007] [Indexed: 11/03/2022]
Abstract
In this issue of the journal, Dr. Farr offers his perspective on the recent position statement from the Joint SHEA and APIC Task Force regarding legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The position statement specifically addresses the issue of whether the use of MRSA and VRE surveillance cultures in healthcare settings should be mandated by legislation. It does not attempt to address whether or not, when, or for whom active surveillance cultures should be performed. A broad range of experts and the Boards of Directors of the Society for Healthcare Epidemiology (SHEA) and the Association of Professionals in Infection Control (APIC) reviewed this position statement, which summarizes the effectiveness of active surveillance culturing as it pertains to potential legislation. Both Boards agree the position statement represents a well-reasoned, systematic, and fair review of the literature. Of course, no single document, group, or individual should ever be viewed as having the final word on this or any subject. Thoughtful debate regarding the scientific evidence, when conducted in a professional and constructive manner, is a critical and necessary step in the translation of research and clinical observations into bedside practices. Such debate should also lead to a research agenda that will help fill gaps in knowledge that become apparent in the discussion.
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Affiliation(s)
- Victoria Fraser
- Society for Healthcare Epidemiology, Washington University School of Medicine, St. Louis, Missouri, USA
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West JC. Hospital must be able to produce screening protocols to avoid EMTALA Liability. Blake v. Main Line Hospitals, Inc. , Civil Action No. 12–3456 (E.D. Penn. April 3, 2014). J Healthc Risk Manag 2015; 34:48-49. [PMID: 26076501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Hanson K. Treating hepatitis C. NCSL Legisbrief 2014; 22:1-2. [PMID: 25514812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
(1) New treatments for hepatitis C are curing more people than before. (2) Baby boomers make up an estimated 75 percent of all cases of hepatitis C. (3) Medicare and some insurance plans cover screening for hepatitis C as a preventive service without a copayment.
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Goodwin JS, Jaramillo E, Yang L, Kuo YF, Tan A. Is anyone listening? Variation in PSA screening among providers for men 75+ before and after United States Preventive Services Task Force recommendations against it: a retrospective cohort study. PLoS One 2014; 9:e107352. [PMID: 25208250 PMCID: PMC4160253 DOI: 10.1371/journal.pone.0107352] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/13/2014] [Indexed: 11/19/2022] Open
Abstract
Background In 2008, the United States Preventive Services Task Force recommended against prostate specific antigen (PSA) testing for cancer screening in men age 75+. Purpose To assess PSA screening by primary care physicians (PCPs) before and after recommendations. Methods In 2013, this retrospective cohort study analyzed PCPs in Texas with 20+ male patients aged 75+ in both 2007 and 2010, with Parts A and B Medicare. The main outcome was percent of PCP’s male patients 75+ who received PSA testing ordered by the PCP in 2007 and 2010, with no recent symptoms suggestive of prostate cancer. Results In both 2007 and 2010, 1,083 PCPs cared for at least 20 men aged 75 or older. The rate of PSA screening ordered by PCPs was 33.2% in 2007 and 30.6% in 2010. In multilevel analyses controlling for patient characteristics, the variation in PSA screening attributable to the PCP (intraclass correlation coefficient) increased from 23% in 2007 to 26% in 2010, p<0.001. Men with PCPs older than age 60 had 9% lower odds (95% CI, 1–17%) in 2010 compared to 2007 of receiving a PSA test, vs. a 4% increase (95% CI, 4% decrease to 12% increase) in men with PCPs aged 50 or younger. Patients with Board Certified PCPs had a 12% lower odds (95% CI, 8% to 16%) from 2007 to 2010, vs. 2% increase (95% CI 11% decrease to 18% increase) in men with PCPs without board certification. Conclusions The USPSTF recommendation did not increase consensus among PCPs regarding PSA screening of older men.
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Affiliation(s)
- James S. Goodwin
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, United States of America
- The Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- The Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, United States of America
- * E-mail:
| | - Elizabeth Jaramillo
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, United States of America
- The Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Liu Yang
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Yong-Fang Kuo
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, United States of America
- The Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Alai Tan
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, United States of America
- The Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, United States of America
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Rhodes DJ, Conners AL. Breast density legislation. Implications for patients and primary care providers. Minn Med 2014; 97:43-48. [PMID: 25158436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Minnesota recently became the 16th state to require facilities that perform mammograms to notify patients if they are found to have dense or extremely dense breasts, as this may make it more difficult to detect a cancer or put them at increased risk for cancer. This article outlines the new law and describes the classification system for breast density, the implications for breast density on screening mammography, and the relationship between breast density and cancer. It also provides guidance for patients who have dense breast tissue regarding supplementary screening.
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Hall A, Chowdhury S, Hallowell N, Pashayan N, Dent T, Pharoah P, Burton H. Implementing risk-stratified screening for common cancers: a review of potential ethical, legal and social issues. J Public Health (Oxf) 2014; 36:285-91. [PMID: 23986542 PMCID: PMC4041100 DOI: 10.1093/pubmed/fdt078] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The identification of common genetic variants associated with common cancers including breast, prostate and ovarian cancers would allow population stratification by genotype to effectively target screening and treatment. As scientific, clinical and economic evidence mounts there will be increasing pressure for risk-stratified screening programmes to be implemented. METHODS This paper reviews some of the main ethical, legal and social issues (ELSI) raised by the introduction of genotyping into risk-stratified screening programmes, in terms of Beauchamp and Childress's four principles of biomedical ethics--respect for autonomy, non-maleficence, beneficence and justice. Two alternative approaches to data collection, storage, communication and consent are used to exemplify the ELSI issues that are likely to be raised. RESULTS Ultimately, the provision of risk-stratified screening using genotyping raises fundamental questions about respective roles of individuals, healthcare providers and the state in organizing or mandating such programmes, and the principles, which underpin their provision, particularly the requirement for distributive justice. CONCLUSIONS The scope and breadth of these issues suggest that ELSI relating to risk-stratified screening will become increasingly important for policy-makers, healthcare professionals and a wide diversity of stakeholders.
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Affiliation(s)
- A.E. Hall
- PHG Foundation (Foundation for Genomics and Population Health), 2 Worts Causeway, Cambridge CB1 8RN, UK
| | - S. Chowdhury
- PHG Foundation (Foundation for Genomics and Population Health), 2 Worts Causeway, Cambridge CB1 8RN, UK
| | - N. Hallowell
- PHG Foundation (Foundation for Genomics and Population Health), 2 Worts Causeway, Cambridge CB1 8RN, UK
| | - N. Pashayan
- UCL Department of Applied Health Research, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - T. Dent
- PHG Foundation (Foundation for Genomics and Population Health), 2 Worts Causeway, Cambridge CB1 8RN, UK
| | - P. Pharoah
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, University Forvie Site, Robinson Way, Cambridge CB2 OSR, UK
- Department of Oncology, University of Cambridge, Cambridge CB2 2QQ, UK
| | - H. Burton
- PHG Foundation (Foundation for Genomics and Population Health), 2 Worts Causeway, Cambridge CB1 8RN, UK
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Affiliation(s)
- Annekathryn Goodman
- Department of Obstetrics and Gynecology, Divisions of Gynecologic Oncology and Women's Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Obstetrics and Gynecology, Division of Global Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Oral cancer protocol essential as legal cases rise. J Calif Dent Assoc 2014; 42:190, 193. [PMID: 25080726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Plunkett L. Dentists, vaccines and disease detection. N Y State Dent J 2014; 80:6-8. [PMID: 24851384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Abstract
The controversial recent recommendation by the United States Preventive Services Task Force (USPSTF) against prostate-specific antigen (PSA) screening for early-stage prostate cancer has caused much debate. Whereas USPSTF recommendations against routine screening mammography in younger women resulted in fierce public outcry and eventual alteration in the language of the recommendation, the same public and political response has not been seen with PSA screening for prostate cancer. It is of paramount importance to ensure improved efficiency and transparency of the USPSTF recommendation process, and resolution of concerns with the current USPSTF recommendation against PSA screening for all ages.
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Affiliation(s)
- Samuel D Kaffenberger
- Department of Urologic Surgery, Vanderbilt University, 2525 West End Avenue, Nashville, TN, USA
| | - David F Penson
- Department of Urologic Surgery, VA Tennessee Valley Geriatric Research, Education, and Clinical Center (GRECC), Vanderbilt University, 2525 West End Avenue, Nashville, TN, USA; Center for Surgical Quality and Outcomes Research, Vanderbilt University, 2525 West End Avenue, Suite 1200, Nashville, TN 37203-1738, USA.
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Pankova VB. [The new regulations for diagnostics of occupational hearing impairment]. Vestn Otorinolaringol 2014:44-48. [PMID: 24781171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The author presents information about the new regulations for diagnostics of occupational hearing impairment included in the technical documentation of the Russian Ministry of Health and Social Development and Ministry of Health governing provision of medical assistance to the subjects suffering from occupational hearing impairment and establishing the new rules for the compulsory prophylactic examination (preliminary and periodic) of the candidates for employment in the noisy environment. In addition, the newly-established criteria for the estimation of hearing impairment and occupational fitness of the subjects presenting with this condition are considered. The advantages of the new regulations are discussed along with their drawbacks that require further correction.
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Lawrence RH, Shah GH. Athletes' perceptions of National Collegiate Athletic Association-mandated sickle cell trait screening: insight for academic institutions and college health professionals. J Am Coll Health 2014; 62:343-350. [PMID: 24628029 DOI: 10.1080/07448481.2014.902840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The study objective was to explore athletes' perspectives of National Collegiate Athletic Association (NCAA)-mandated sickle cell trait (SCT)-screening policy by examining race- and gender-related differences in athletes' perceptions regarding risk of having SCT and concern about loss of playing time. PARTICIPANTS Participants were 259 athletes at a southeastern United States campus during April-August of 2010. METHODS Athletes completed a 21-question survey. RESULTS The majority of athletes (81.7%) perceived that they would have a high level of concern if found to carry the SCT. African Americans were 9.07 times more likely than Caucasians to perceive risk of having the SCT. The majority of athletes disagreed (38.4%) or did not know (50.8%) if they would lose playing time related to carrying the SCT. CONCLUSION Campus health professionals must be aware of athletes' perspectives on NCAA's SCT screening so that athletes are not unnecessarily subjected to stress or harm.
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Affiliation(s)
- Raymona H Lawrence
- a Jiann Ping Hsu College of Public Health, Georgia Southern University , Statesboro , Georgia
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