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Grynin VM, Avetisyan AY, Reshetnikov VA. [The criterion mode of evaluating functioning of stomatologic polyclinic]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2022; 30:288-291. [PMID: 35439391 DOI: 10.32687/0869-866x-2022-30-2-288-291] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
To improve quality and efficiency of primary health care and to strengthen its preventive directivity is possible through health care modernization including implementation of management technologies, development of database for evaluation and control. The purpose of the study is to develop method of evaluating activity of stomatologic clinic. The methodology was based on concepts of "functional systems" and "decision making". The listing of informative criteria was based on data analysis of functioning of stomatologic service of the Chechen Republic in 2002-2016 and results of sociological survey of stomatologists (n=181), health care administrators in stomatology (n=45), paramedics (n=220) and patients (n=359). The experts (n=13) developed required number of criteria and their gradation. The algorithm of evaluating activity of stomatologic clinic was developed using systematic approach. The listing of 52 criteria and their 10 blocks were established. The experts established coefficients of significance of criteria (0.0084-0.0781; ≥0.0224 - more significant, <0.0224 - less significant). Three levels were determined for each criterion (according principle of minimization) that became a basis for calculation of integrated indicator of efficiency of functioning of stomatologic polyclinic. The expanded methodological approaches ensure comparartivity of estimates of stomatologic polyclinic in various time periods. The health care authorities have opportunity to objectify analysis of functioning of a number of polyclinics in different periods.
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Affiliation(s)
- V M Grynin
- The Federal State Autonomous Educational Institution of Higher Education "The I. M. Sechenov First Moscow State Medical University" (Sechenov University) of Minzdrav of Russia, 119991, Moscow, Russia
| | - A Yu Avetisyan
- The Federal State Autonomous Educational Institution of Higher Education "The I. M. Sechenov First Moscow State Medical University" (Sechenov University) of Minzdrav of Russia, 119991, Moscow, Russia,
| | - V A Reshetnikov
- The Federal State Autonomous Educational Institution of Higher Education "The I. M. Sechenov First Moscow State Medical University" (Sechenov University) of Minzdrav of Russia, 119991, Moscow, Russia
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Stangl AL, Pliakas T, Izazola-Licea JA, Ayala G, Beattie TS, Ferguson L, Orza L, Mathur S, Pulerwitz J, Iovita A, Bendaud V. Removing the societal and legal impediments to the HIV response: An evidence-based framework for 2025 and beyond. PLoS One 2022; 17:e0264249. [PMID: 35192663 PMCID: PMC8863250 DOI: 10.1371/journal.pone.0264249] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 12/18/2020] [Accepted: 02/07/2022] [Indexed: 02/04/2023] Open
Abstract
Societal and legal impediments inhibit quality HIV prevention, care, treatment and support services and need to be removed. The political declaration adopted by UN member countries at the high-level meeting on HIV and AIDS in June 2021, included new societal enabler global targets for achievement by 2025 that will address this gap. Our paper describes how and why UNAIDS arrived at the societal enabler targets adopted. We conducted a scoping review and led a participatory process between January 2019 and June 2020 to develop an evidence-based framework for action, propose global societal enabler targets, and identify indicators for monitoring progress. A re-envisioned framework called the '3 S's of the HIV response: Society, Systems and Services' was defined. In the framework, societal enablers enhance the effectiveness of HIV programmes by removing impediments to service availability, access and uptake at the societal level, while service and system enablers improve efficiencies in and expand the reach of HIV services and systems. Investments in societal enabling approaches that remove legal barriers, shift harmful social and gender norms, reduce inequalities and improve institutional and community structures are needed to progressively realize four overarching societal enablers, the first three of which fall within the purview of the HIV sector: (i) societies with supportive legal environments and access to justice, (ii) gender equal societies, (iii) societies free from stigma and discrimination, and (iv) co-action across development sectors to reduce exclusion and poverty. Three top-line and 15 detailed targets were recommended for monitoring progress towards their achievement. The clear articulation of societal enablers in the re-envisioned framework should have a substantial impact on improving the effectiveness of core HIV programmes if implemented. Together with the new global targets, the framework will also galvanize advocacy to scale up societal enabling approaches with proven impact on HIV outcomes.
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Affiliation(s)
- Anne L. Stangl
- Hera Solutions, Baltimore, MD, United States of America
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Triantafyllos Pliakas
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Impact Epilysis, Thessaloniki, Greece
| | | | - George Ayala
- Alameda County Public Health Department, Oakland, CA, United States of America
- MPact Global Action for Gay Men’s Health and Rights, Oakland, CA, United States of America
| | - Tara S. Beattie
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Laura Ferguson
- Institute on Inequalities in Global Health, University of Southern California, Los Angeles, CA, United States of America
| | - Luisa Orza
- Frontline AIDS, Brighton, United Kingdom
| | - Sanyukta Mathur
- Population Council, Washington, DC, United States of America
| | - Julie Pulerwitz
- Population Council, Washington, DC, United States of America
| | | | - Victoria Bendaud
- Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
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Ritzwoller DP, Meza R, Carroll NM, Blum-Barnett E, Burnett-Hartman AN, Greenlee RT, Honda SA, Neslund-Dudas C, Rendle KA, Vachani A. Evaluation of Population-Level Changes Associated With the 2021 US Preventive Services Task Force Lung Cancer Screening Recommendations in Community-Based Health Care Systems. JAMA Netw Open 2021; 4:e2128176. [PMID: 34636916 PMCID: PMC8511972 DOI: 10.1001/jamanetworkopen.2021.28176] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE The US Preventive Services Task Force (USPSTF) released updated lung cancer screening recommendations in 2021, lowering the screening age from 55 to 50 years and smoking history from 30 to 20 pack-years. These changes are expected to expand screening access to women and racial and ethnic minority groups. OBJECTIVE To estimate the population-level changes associated with the 2021 USPSTF expansion of lung cancer screening eligibility by sex, race and ethnicity, sociodemographic factors, and comorbidities in 5 community-based health care systems. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed data of patients who received care from any of 5 community-based health care systems (which are members of the Population-based Research to Optimize the Screening Process Lung Consortium, a collaboration that conducts research to better understand how to improve the cancer screening processes in community health care settings) from January 1, 2010, through September 30, 2019. Individuals who had complete smoking history and were engaged with the health care system for 12 or more continuous months were included. Those who had never smoked or who had unknown smoking history were excluded. EXPOSURES Electronic health record-derived age, sex, race and ethnicity, socioeconomic status (SES), comorbidities, and smoking history. MAIN OUTCOMES AND MEASURES Differences in the proportion of the newly eligible population by age, sex, race and ethnicity, Charlson Comorbidity Index, chronic obstructive pulmonary disease diagnosis, and SES as well as lung cancer diagnoses under the 2013 recommendations vs the expected cases under the 2021 recommendations were evaluated using χ2 tests. RESULTS As of September 2019, there were 341 163 individuals aged 50 to 80 years who currently or previously smoked. Among these, 34 528 had electronic health record data that captured pack-year and quit-date information and were eligible for lung cancer screening according to the 2013 USPSTF recommendations. The 2021 USPSTF recommendations expanded screening eligibility to 18 533 individuals, representing a 53.7% increase. Compared with the 2013 cohort, the newly eligible 2021 population included 5833 individuals (31.5%) aged 50 to 54 years, a larger proportion of women (52.0% [n = 9631]), and more racial or ethnic minority groups. The relative increases in the proportion of newly eligible individuals were 60.6% for Asian, Native Hawaiian, or Pacific Islander; 67.4% for Hispanic; 69.7% for non-Hispanic Black; and 49.0% for non-Hispanic White groups. The relative increase for women was 13.8% higher than for men (61.2% vs 47.4%), and those with a lower comorbidity burden and lower SES had higher relative increases (eg, 68.7% for a Charlson Comorbidity Index score of 0; 61.1% for lowest SES). The 2021 recommendations were associated with an estimated 30% increase in incident lung cancer diagnoses compared with the 2013 recommendations. CONCLUSIONS AND RELEVANCE This cohort study suggests that, in diverse health care systems, adopting the 2021 USPSTF recommendations will increase the number of women, racial and ethnic minority groups, and individuals with lower SES who are eligible for lung cancer screening, thus helping to minimize the barriers to screening access for individuals with high risk for lung cancer.
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Affiliation(s)
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, Ann Arbor
| | - Nikki M. Carroll
- Institute for Health Research, Kaiser Permanente Colorado, Aurora
| | | | | | | | - Stacey A. Honda
- Center for Integrated Healthcare Research, Kaiser Permanente Hawaii, Oahu
| | | | | | - Anil Vachani
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Abstract
Failures in preparation and response led to a worsened crisis.
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Sidhar K, Hammer E. How to help runners steer clear of injury. J Fam Pract 2021; 70:182-188. [PMID: 34339361 DOI: 10.12788/jfp.0183] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Assess risk factors, then work to address modifiable ones, such as wearing the right running shoes and building up slowly. Don't let overweight or OA dampen enthusiasm.
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Affiliation(s)
- Kartik Sidhar
- Department of Family Medicine and Community Health (Drs. Sidhar and Hammer) and Department of Orthopedics and Rehabilitation (Dr. Hammer), University of Wisconsin School of Medicine and Public Health, Madison
| | - Erin Hammer
- Department of Family Medicine and Community Health (Drs. Sidhar and Hammer) and Department of Orthopedics and Rehabilitation (Dr. Hammer), University of Wisconsin School of Medicine and Public Health, Madison
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Campos-Outcalt D. A review of the latest USPSTF recommendations. J Fam Pract 2021; 70:189-204. [PMID: 34339362 DOI: 10.12788/jfp.0184] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Task Force has expanded the age range for screening for hepatitis C virus infection in adolescents and adults, and now endorses behavioral counseling for all adults with any CVD risk factors.
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Basu A, Gandhay VJ. Quality-Adjusted Life-Year Losses Averted With Every COVID-19 Infection Prevented in the United States. Value Health 2021; 24:632-640. [PMID: 33933231 PMCID: PMC7938736 DOI: 10.1016/j.jval.2020.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/02/2020] [Accepted: 11/20/2020] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To estimate the overall quality-adjusted life-years (QALYs) gained by averting 1 coronavirus disease 2019 (COVID-19) infection over the duration of the pandemic. METHODS A cohort-based probabilistic simulation model, informed by the latest epidemiological estimates on COVID-19 in the United States provided by the Centers for Disease Control and Prevention and literature review. Heterogeneity of parameter values across age group was accounted for. The main outcome studied was QALYs for the infected patient, patient's family members, and the contagion effect of the infected patient over the duration of the pandemic. RESULTS Averting a COVID-19 infection in a representative US resident will generate an additional 0.061 (0.016-0.129) QALYs (for the patient: 0.055, 95% confidence interval [CI] 0.014-0.115; for the patient's family members: 0.006, 95% CI 0.002-0.015). Accounting for the contagion effect of this infection, and assuming that an effective vaccine will be available in 3 months, the total QALYs gains from averting 1 single infection is 1.51 (95% CI 0.28-4.37) accrued to patients and their family members affected by the index infection and its sequelae. These results were robust to most parameter values and were most influenced by effective reproduction number, probability of death outside the hospital, the time-varying hazard rates of hospitalization, and death in critical care. CONCLUSION Our findings suggest that the health benefits of averting 1 COVID-19 infection in the United States are substantial. Efforts to curb infections must weigh the costs against these benefits.
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Affiliation(s)
- Anirban Basu
- The CHOICE Institute, School of Pharmacy, University of Washington, Seattle, WA, USA.
| | - Varun J Gandhay
- Department of Economics, University of California, San Diego, CA, USA
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Pluchino A, Biondo AE, Giuffrida N, Inturri G, Latora V, Le Moli R, Rapisarda A, Russo G, Zappalà C. A novel methodology for epidemic risk assessment of COVID-19 outbreak. Sci Rep 2021; 11:5304. [PMID: 33674627 PMCID: PMC7935987 DOI: 10.1038/s41598-021-82310-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [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] [Received: 05/06/2020] [Accepted: 01/19/2021] [Indexed: 12/24/2022] Open
Abstract
We propose a novel data-driven framework for assessing the a-priori epidemic risk of a geographical area and for identifying high-risk areas within a country. Our risk index is evaluated as a function of three different components: the hazard of the disease, the exposure of the area and the vulnerability of its inhabitants. As an application, we discuss the case of COVID-19 outbreak in Italy. We characterize each of the twenty Italian regions by using available historical data on air pollution, human mobility, winter temperature, housing concentration, health care density, population size and age. We find that the epidemic risk is higher in some of the Northern regions with respect to Central and Southern Italy. The corresponding risk index shows correlations with the available official data on the number of infected individuals, patients in intensive care and deceased patients, and can help explaining why regions such as Lombardia, Emilia-Romagna, Piemonte and Veneto have suffered much more than the rest of the country. Although the COVID-19 outbreak started in both North (Lombardia) and Central Italy (Lazio) almost at the same time, when the first cases were officially certified at the beginning of 2020, the disease has spread faster and with heavier consequences in regions with higher epidemic risk. Our framework can be extended and tested on other epidemic data, such as those on seasonal flu, and applied to other countries. We also present a policy model connected with our methodology, which might help policy-makers to take informed decisions.
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Affiliation(s)
- A Pluchino
- Dipartimento di Fisica e Astronomia "Ettore Majorana", INFN Sezione di Catania, Università di Catania, Catania, Italy.
| | - A E Biondo
- Dipartimento di Economia e Impresa, Università di Catania, Catania, Italy
| | - N Giuffrida
- Dipartimento di Ingegneria Civile e Architettura, Università di Catania, Catania, Italy
| | - G Inturri
- Dipartimento di Ingegneria Elettrica Elettronica e Informatica, Università di Catania, Catania, Italy
| | - V Latora
- Dipartimento di Fisica e Astronomia "Ettore Majorana", INFN Sezione di Catania, Università di Catania, Catania, Italy
- Complexity Science Hub Vienna, Vienna, Austria
- School of Mathematical Sciences, Queen Mary University of London, London, E1 4NS, UK
- The Alan Turing Institute, The British Library, London, NW1 2DB, UK
| | - R Le Moli
- Dipartimento di Medicina Clinica e Sperimentale - UO di Endocrinologia - Ospedale Garibaldi Nesima, Università di Catania, Catania, Italy
| | - A Rapisarda
- Dipartimento di Fisica e Astronomia "Ettore Majorana", INFN Sezione di Catania, Università di Catania, Catania, Italy
- Complexity Science Hub Vienna, Vienna, Austria
| | - G Russo
- Dipartimento di Matematica e Informatica, Università di Catania, Catania, Italy
| | - C Zappalà
- Dipartimento di Fisica e Astronomia "Ettore Majorana", INFN Sezione di Catania, Università di Catania, Catania, Italy
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Bala R, Srivastava A, Ningthoujam GD, Potsangbam T, Oinam A, Anal CL. An Observational Study in Manipur State, India on Preventive Behavior Influenced by Social Media During the COVID-19 Pandemic Mediated by Cyberchondria and Information Overload. J Prev Med Public Health 2021; 54:22-30. [PMID: 33618496 PMCID: PMC7939751 DOI: 10.3961/jpmph.20.465] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/23/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency posing unprecedented challenges for health authorities. Social media may serve as an effective platform to disseminate health-related information. This study aimed to assess the extent of social media use, its impact on preventive behavior, and negative health effects such as cyberchondria and information overload. METHODS A cross-sectional observational study was conducted between June 10, 2020 and August 9, 2020 among people visiting the outpatient department of the authors' institution, and participants were also recruited during field visits for an awareness drive. Questions were developed on preventive behavior, and the Short Cyberchondria Scale and instruments dealing with information overload and perceived vulnerability were used. RESULTS The study recruited 767 participants with a mean age of about 45 years. Most of the participants (>90%) engaged in preventive behaviors, which were influenced by the extent of information received through social media platforms (β=3.297; p<0.001) and awareness of infection when a family member tested positive (β=29.082; p<0.001) or a neighbor tested positive (β=27.964; p<0.001). The majority (63.0%) of individuals often searched for COVID-19 related news on social media platforms. The mean±standard deviation scores for cyberchondria and information overload were 9.09±4.05 and 8.69±2.56, respectively. Significant and moderately strong correlations were found between cyberchondria, information overload, and perceived vulnerability to COVID-19. CONCLUSIONS This study provides evidence that the use of social media as an information- seeking platform altered preventive behavior. However, excessive and misleading information resulted in cyberchondria and information overload.
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Affiliation(s)
- Renu Bala
- Regional Research Institute for Homoeopathy, Imphal, India
| | | | | | | | - Amita Oinam
- Regional Research Institute for Homoeopathy, Imphal, India
| | - Ch Lily Anal
- Regional Research Institute for Homoeopathy, Imphal, India
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Affiliation(s)
- Daniel M Horn
- From the Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Jennifer S Haas
- From the Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
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11
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Screening for Bacterial Vaginosis in Pregnant Persons to Prevent Preterm Delivery: Recommendation Statement. Am Fam Physician 2020; 102:105-9. [PMID: 32667170] [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: 06/11/2023]
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12
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Abstract
IMPORTANCE Primary care physicians have limited time to discuss preventive care, but it is unknown how they prioritize recommended services. OBJECTIVE To understand primary care physicians' prioritization of preventive services. DESIGN, SETTING, AND PARTICIPANTS This online survey was administered to primary care physicians in a large health care system from March 17 to May 12, 2017. Physicians were asked whether they prioritize preventive services and which factors contribute to their choice (5-point Likert scale). Results were analyzed from July 8, 2017, to September 19, 2019. EXPOSURES A 2 × 2 factorial design of 2 hypothetical patients: (1) a 50-year-old white woman with hypertension, type 2 diabetes, hyperlipidemia, obesity, a 30-pack-year history of smoking, and a family history of breast cancer; and (2) a 45-year-old black man with hypertension, hyperlipidemia, obesity, a 30-pack-year history of smoking, and a family history of colorectal cancer. Two visit lengths (40 minutes vs 20 minutes) were given. Each patient was eligible for at least 11 preventive services. MAIN OUTCOMES AND MEASURES Physicians rated their likelihood of discussing each service during the visit and reported their top 3 priorities for patients 1 and 2. Physician choices were compared with the preventive services most likely to improve life expectancy, using a previously published mathematical model. RESULTS Of 241 physicians, 137 responded (57%), of whom 74 (54%) were female and 85 (62%) were younger than 50 years. Physicians agreed they prioritized preventive services (mean score, 4.27 [95% CI, 4.12-4.42] of 5.00), mostly by ability to improve quality (4.56 [95% CI, 4.44-4.68] of 5.00) or length (4.53 [95% CI, 4.40-4.66] of 5.00) of life. Physicians reported more prioritization in the 20- vs 40-minute visit, indicating that they were likely to discuss fewer services during the shorter visit (median, 5 [interquartile range {IQR}, 3-8] vs 11 [IQR, 9-13] preventive services for patient 1, and 4 [IQR, 3-6] vs 9 [IQR, 8-11] for patient 2). Physicians reported similar top 3 priorities for both patients: smoking cessation, hypertension control, and glycemic control for patient 1 and smoking cessation, hypertension control, and colorectal cancer screening for patient 2. Physicians' top 3 priorities did not usually include diet and exercise or weight loss (ranked in their top 3 recommendations for either patient by only 48 physicians [35%]), although these were among the 3 preventive services most likely to improve life expectancy based on the mathematical model. CONCLUSIONS AND RELEVANCE In this survey study, physicians prioritized preventive services under time constraints, but priorities did not vary across patients. Physicians did not prioritize lifestyle interventions despite large potential benefits. Future research should consider whether physicians and patients would benefit from guidance on preventive care priorities.
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Affiliation(s)
- Jessica J. Zhang
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Michael B. Rothberg
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
- Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Anita D. Misra-Hebert
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
- Medicine Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | | | - Glen B. Taksler
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
- Medicine Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
- Center for Health Care Research and Policy, Case Western Reserve University and MetroHealth Medical Center, Cleveland, Ohio
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13
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Campos-Outcalt D. USPSTF round-up. J Fam Pract 2020; 69:201-204. [PMID: 32437486] [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: 06/11/2023]
Abstract
The Task Force now recommends that physicians take steps to prevent perinatal depression and has modified its recommendation on lead screening.
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14
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van den Bemt BJF. [Better compliance with therapy in preventative medication use]. Ned Tijdschr Geneeskd 2020; 164:D4206. [PMID: 32324350] [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: 06/11/2023]
Abstract
Prescription of medication is one of the most common medical interventions. Just half of patients use a prescribed preventative medication in accordance with the doctor's instructions; this leads to a smaller effect from the medication, side effects and higher care costs. Therapy-non-compliant patients are hardly recognisable on the basis of clinical, demographic or medication-related characteristics. The prescriber can make use of pharmacist data, questionnaires, or technical aids, or broach the subject with the patient to discover whether or not the patient is therapy-compliant. Reasons for non-compliance with therapy can be roughly divided into unintentional or practical reasons and intentional reasons. Tailored intervention can be offered on the basis of the underlying reasons.
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Affiliation(s)
- B J F van den Bemt
- Sint Maartenskliniek, afd. Farmacie, Nijmegen: prof.dr. B.J.F. van den Bemt, apotheker-klinisch farmacoloog (tevens: Radboudumc, Apotheek)
- Contact: B.J.F. van den Bemt
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Al Mutair A, Ambani Z, Al Obaidan F, Al Salman K, Alhassan H, Al Mutairi A. The effectiveness of pressure ulcer prevention programme: A comparative study. Int Wound J 2020; 17:214-219. [PMID: 31696665 PMCID: PMC7948995 DOI: 10.1111/iwj.13259] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/25/2019] [Revised: 09/04/2019] [Accepted: 10/17/2019] [Indexed: 12/01/2022] Open
Abstract
Hospital-acquired pressure ulcers (HAPUs) affect patients during hospitalisation, putting patients at risk for further complications. HAPU is one of the hospital quality indicators that require quality initiatives or programmes to minimise its occurrence and consequences. The aim of this study was to assess the effectiveness of a developed quality improvement programme in preventing HAPUs. This is a retrospective comparative study, which tracked the outcomes of pressure ulcer prevention programme (PUPP) for 5 years from 2014 to 2018. Data from 50 441 patients were collected from different units in a tertiary hospital in the eastern region of Saudi Arabia. The programme focused on building a wound care team; providing education to hospital staff, patients, and their families; and continuous data monitoring, in addition to follow-up visits after discharge. Implementation of the programme was successful showing a statistically significant reduction of HAPUs from 0.20% in 2014 to 0.06% in 2018 (P value <.001). The PUPP was effective in reducing the percentage of pressure ulcer cases. The programme can be extended and implemented in other hospitals.
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Affiliation(s)
- Abbas Al Mutair
- Research CenterDr Sulaiman Al Habib Medical GroupRiyadhSaudi Arabia
- School of NursingWollongong UniversityAustralia
- College of MedicineAlfaisal UniversityRiyadhSaudi Arabia
| | - Zainab Ambani
- College of NursingKing Saud bin Abdulaziz University for Health SciencesAl AhsaSaudi Arabia
| | | | - Khulud Al Salman
- Nursing DepartmentAl Jaber Hospital for eye, Ear, Nose and Throat, Ministry of HealthSaudi Arabia
| | | | - Alya Al Mutairi
- Faculty of Science, Department of MathematicsTaibah UniversitySaudi Arabia
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Abstract
PURPOSE OF REVIEW This article summarizes the risk factors for atypical femur fractures (AFF), discusses current and emerging imaging modalities for early identification of AFF, and offers recommendations for prevention and management of AFFs based on the current concepts. RECENT FINDINGS Antiresorptive therapies are widely recommended for prevention and treatment of osteoporosis. Despite their well established effectiveness to reduce fracture risk, emerging concerns related to potential adverse effects have led to a substantial decline in the use of bisphosphonates. Although, the pathogenesis of AFF has not yet been elucidated, the bulk of evidence supports that the well known therapeutic benefits of bisphosphonate far outweigh the relatively low risk of AFFs. Recommendations for early identification of patients at risk for AFF using radiographic imaging have been established. Consensus on the management of AFF and osteoporosis in patients with AFF needs to be formulated. SUMMARY AFF is a rare event associated with long-term bisphosphonate therapy, which represents an apparent paradox in the management of osteoporosis. Improved understanding of pathogenetic mechanisms will be helpful in further refining of screening guidelines and standardization of management and treatment strategies.
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Affiliation(s)
- Vidita Divan
- Metabolic Bone Disease Center, State University of New York Upstate Medical University, Syracuse, New York
| | - Sudhaker D Rao
- Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, Michigan, USA
| | - Ruban Dhaliwal
- Metabolic Bone Disease Center, State University of New York Upstate Medical University, Syracuse, New York
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Kalra S, Kumar A. Quinary prevention: Defined and conceptualized. J PAK MED ASSOC 2019; 69:1765-11766. [PMID: 31853099] [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: 06/10/2023]
Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
| | - Arun Kumar
- Department of Community Medicine, SHKM Government Medical College, Mewat, India
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Pérez Galende E, Ruiz Álvarez M, Tejedor Romero L, Fernández-Braso Arranz AM, Vinuesa Sebastián M, Villagrasa Ferrer JR. [Compliance evaluation of "do not do" recommendations of the Spanish Society of Preventive Medicine and public health]. Rev Esp Salud Publica 2019; 93:e201911089. [PMID: 31776324] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 08/21/2019] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE The reduction of unnecessary health interventions determines good care quality. The objective of this work was to evaluate the compliance of the "do not do" recommendations proposed by the Spanish Society of Preventive Medicine, Public Health and Hygiene. METHODS Prospective, observational, descriptive study of patients admitted to the La Princesa University Hospital between December 2018 and January 2019. The compliance of each recommendation in different patients was analyzed. The quantitative variables are expressed as means and standard deviation and the qualitative values as percentages and confidence interval. RESULTS In Recommendation 1 (R1: "Do not remove hair systematically"), 231 interventions were studied and the compliance was of 100% (95% CI: 98.27-100). In Recommendation 2 (R2: "Do not maintain antibiotics for more than 48 hours, unless evidence of infection"), 201 interventions were studied and the compliance was of 93.53% (95% CI: 90.09-96.91). In Recommendation 3 (R3: "Do not analyze C. difficile toxin in asymptomatic patients"), 200 determinations were studied and the compliance was of 93.5% (95% CI: 90.08-96.92). In Recommendation 4 (R4: "Do not do routine nasal decolonization"), 167 interventions were recruited and the compliance was of 100% (95% CI: 97.6-100). In Recommendation 5 (R5: "Do not perform routine replacement of peripheral venous catheter every 72-96 hours"), 153 patients were studied in compliance with the recommendation of 98.04% (95% CI: 94.12-99.35). CONCLUSIONS A 100% compliance was found in Recommendations 1 and 4. There is an opportunity of improvement in the recommendations R2, R3 and R5.
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Affiliation(s)
- Elena Pérez Galende
- Servicio de Medicina Preventiva y Salud Pública. Hospital Universitario de La Princesa. Madrid. España
| | - Miguel Ruiz Álvarez
- Servicio de Medicina Preventiva y Salud Pública. Hospital Universitario de La Princesa. Madrid. España
| | - Laura Tejedor Romero
- Servicio de Medicina Preventiva y Salud Pública. Hospital Universitario de La Princesa. Madrid. España
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Vargas AJ, Schully SD, Villani J, Ganoza Caballero L, Murray DM. Assessment of Prevention Research Measuring Leading Risk Factors and Causes of Mortality and Disability Supported by the US National Institutes of Health. JAMA Netw Open 2019; 2:e1914718. [PMID: 31702797 PMCID: PMC6902772 DOI: 10.1001/jamanetworkopen.2019.14718] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE No studies to date have examined support by the National Institutes of Health (NIH) for primary and secondary prevention research in humans and related methods research that measures the leading risk factors or causes of death or disability as outcomes or exposures. OBJECTIVE To characterize NIH support for such research. DESIGN AND SETTING This serial cross-sectional study randomly sampled NIH grants and cooperative agreements funded during fiscal years 2012 through 2017. For awards with multiple subprojects, each was treated as a separate project. Study characteristics, outcomes, and exposures were coded from October 2015 through February 2019. Analyses weighted to reflect the sampling scheme were completed in March through June 2019. Using 2017 data from the Centers for Disease Control and Prevention and 2016 data from the Global Burden of Disease project, the leading risk factors and causes of death and disability in the United States were identified. MAIN OUTCOMES AND MEASURES The main outcome was the percentage of the NIH prevention research portfolio measuring a leading risk factor or cause of death or disability as an outcome or exposure. RESULTS A total of 11 082 research projects were coded. Only 25.9% (95% CI, 24.0%-27.8%) of prevention research projects measured a leading cause of death as an outcome or exposure, although these leading causes were associated with 74.0% of US mortality. Only 34.0% (95% CI, 32.2%-35.9%) measured a leading risk factor for death, although these risk factors were associated with 57.3% of mortality. Only 31.4% (95% CI, 29.6%-33.3%) measured a leading risk factor for disability-adjusted life-years lost, although these risk factors were associated with 42.1% of disability-adjusted life-years lost. Relatively few projects included a randomized clinical trial (24.6%; 95% CI, 22.5%-26.9%) or involved more than 1 leading cause (3.3%; 95% CI, 2.6%-4.1%) or risk factor (8.8%; 95% CI, 7.9%-9.8%). CONCLUSIONS AND RELEVANCE In this cross-sectional study, the leading risk factors and causes of death and disability were underrepresented in the NIH prevention research portfolio relative to their burden. Because so much is already known about these risk factors and causes, and because randomized interventions play such a vital role in the development of clinical and public health guidelines, it appears that greater attention should be given to develop and test interventions that address these risk factors and causes, addressing multiple risk factors or causes when possible.
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Affiliation(s)
- Ashley J. Vargas
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
| | - Sheri D. Schully
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
| | - Jennifer Villani
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
| | - Luis Ganoza Caballero
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
- Scientific Consulting Group, Inc, Gaithersburg, Maryland
| | - David M. Murray
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
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Nacef T, Baccar MA, Zouari B. Antituberculous fight in the Maghreb: the balance sheet. Tunis Med 2018; 96:584-589. [PMID: 30746650] [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: 06/09/2023]
Abstract
The fight against tuberculosis remains a priority for world leaders: a re-emerging disease in developed countries, endemic elsewhere, it was declared in 1993, as a "world emergency" by the World Health Organization (WHO). The aim of programs is to prevent infection from spreading and perpetuating; the recommended strategies were the subject of common consent by expert committees convened by international agencies, primarily the WHO. As a result, programs of the Maghreb countries have great similarities. Though the regression in cases's number, especially primary and post-primary forms, as well as extensive, deleterious pulmonary tuberculosis in adults, the endemic persists. The proportion of extra-pulmonary tuberculosis (PET) is high. Control of "contacts" would be lacking or delayed in almost half of the cases. The cover by an effective treatment of these cases in Libya and in Mauritania stays below the required 85 %. Taken as a whole, the constituent countries of the Maghreb entity count approximately 78 000 tuberculosis patients for a population close to 100 million inhabitants, with an incidence rate of 76 for 100 000. Reducing the incidence of tuberculosis by 90 % and the mortality by 95%, to ensure that by the end of 2035 tuberculosis is no longer a public health problem is a goal within the reach of Maghreb countries. It can be postulated that by this deadline, the conditions for success will be met.
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Bannour I, Briki R, Zrairi F, Zahmoul T, Hamchi H, Kammoun Belajouza S, Hidar S, Ben Fatma L, Boughizane S, Mokni M. Breast cancer in the Maghreb : epidemiology and control strategies. Review. Tunis Med 2018; 96:658-664. [PMID: 30746658] [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: 06/09/2023]
Abstract
Breast cancer is the most common cancer diagnosed in women in the Maghreb and around the world. It's the most common cause of cancer deaths. It represents a major public health problem because of its frequency, morbidity and mortality that it generates as well as the cost of the therapies used. Epidemiological data are similar in the 3 countries of the Maghreb (Tunisia, Morocco, and Algeria). Currently, the incidence of breast cancer is lower than in developed countries, but is increasing steadily, and projections for the coming years predict that rates will be closer to the European ones. The diagnosis is often done at advanced stages compromising the prognosis of the patients. Strategies to combat this cancer remain insufficient and further efforts are needed to improve the situation.
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Yazghich I, Berraho M. Cervical cancer in the Maghreb country (Morocco - Algeria - Tunisia) : epidemiological, clinical profile and control policy. Tunis Med 2018; 96:647-657. [PMID: 30746657] [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: 06/09/2023]
Abstract
INTRODUCTION Cervical cancer is a public health problem in the Maghreb countries with high mortality and socio-economic impact. The objective of this subject is exposed the epidemiological profile, programs of prevention and the support of cervical cancer in Maghreb (Morocco, Tunisia and Algeria). METHODS To implement this work, we carried out research on morbidity and mortality; cancer plans for Maghreb countries (Morocco, Algeria and Tunisia); cervical cancer surveillance for each country; the prevention programs of cervical cancer including vaccination, screening, information campaigns, awareness and education; and research conducted in Morocco, Algeria and Tunisia. We interviewed databases (Pubmed, Sciences Direct etc.), ministerial website, World Health Organization website, foundations website and centers of cancer research. RESULTS The cervical cancer (CC) is diagnosed at advanced stages. The majority of patients are in advanced stages (stage II, III and IV). Regarding the histological profile squamous cell carcinoma is predominant. HPV 16 and HPV 18 single or multiple infection are by far the most common types of HPV associated with CCU in the Maghreb countries concerning the microbiological profile. All three countries have set up a cancer plans to prevent and control this disease and these impacts. Among the strong points of health policy in cancerology, in all three countries, we raised the existence of a cancer registry for monitoring and evolution of disease. Regarding the prevention of CC, in the three Maghreb countries, there is no primary prevention program (HPV vaccine and the struggle against risk factors), much deficiencies about secondary and tertiary prevention. CONCLUSION To win the fight against the CC, the Maghreb countries are called to strengthen the health system globally, to consolidate the national policy and the national guidelines to fight against the CC and to allocate the financial and technical resources to support the implementation policy and guidelines to make services accessible and affordable for women and girls.
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Alemu G, Aschalew Z, Zerihun E. Burden of intestinal helminths and associated factors three years after initiation of mass drug administration in Arbaminch Zuria district, Southern Ethiopia. BMC Infect Dis 2018; 18:435. [PMID: 30157789 PMCID: PMC6114701 DOI: 10.1186/s12879-018-3330-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 03/22/2018] [Accepted: 08/15/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Epidemiological information on the burden of various parasitic infections and associated factors in different localities is indispensable to develop appropriate control and prevention measures as well as to monitor and evaluate existing programs. Hence the aim of the present study was to assess the prevalence and associated factors of intestinal helminths among school age children in Arbaminch Zuria district, Southern Ethiopia. METHODS A community based cross-sectional study was conducted by recruiting 391 primary school age children. Participants were selected using simple random sampling technique. Pre-tested structured questionnaire was used to collect data about socio-demographic characteristics and perceived factors associated with intestinal parasitosis. Stool microscopic examination was done following standard protocol. Data were analyzed using Statistical Package for Social Science version 22. RESULTS Among 391 children participated, 181 (46.3%; 95% CI: 41.9-51.5) were infected with intestinal helminths. The magnitudes of single and double infections were 40.2% and 6.1% respectively. Seven helminths were detected among which Ascaris lumbricoides was with the highest frequency (56, 14.3%) followed by hookworms (55, 14.1%). Not washing fruits and vegetables before consumption (AOR = 2.16; 95%CI: 1.10-4.25, p = 0.026) and habit of swimming (AOR = 1.17; 95%CI: 1.03-1.95, p = 0.045) were significantly associated with helminthic infection. CONCLUSION High prevalence of intestinal helminthic infections among school age children demands integration of deworming with water, hygiene and sanitation as well as consistent health education.
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Affiliation(s)
- Getaneh Alemu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zeleke Aschalew
- Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Eshetu Zerihun
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Weihrauch-Blüher S, Kromeyer-Hauschild K, Graf C, Widhalm K, Korsten-Reck U, Jödicke B, Markert J, Müller MJ, Moss A, Wabitsch M, Wiegand S. Current Guidelines for Obesity Prevention in Childhood and Adolescence. Obes Facts 2018; 11:263-276. [PMID: 29969778 PMCID: PMC6103347 DOI: 10.1159/000486512] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/21/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Current guidelines for prevention of obesity in childhood and adolescence are discussed. METHODS A literature search was performed in Medline via PubMed, and appropriate studies were analyzed. RESULTS Programs to prevent childhood obesity have so far remained mainly school-based and effects have been limited. Analyses by age group show that prevention programs have the best results in younger children (<12 years). Evidence-based recommendations for pre-school- and early school-aged children indicate the need for interventions that address parents and teachers alike. During adolescence, school-based interventions proved most effective when adolescents were addressed directly. To date, obesity prevention programs have mainly focused on behavior-oriented prevention. Recommendations for community- or environment-based prevention have been suggested by the German Alliance of Noncommunicable Diseases and include a minimum of 1 h of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory standards for meals at kindergartens and schools as well as a ban on unhealthy food advertisement aimed at children. CONCLUSION Behavior-oriented prevention programs showed only limited long-term effects. Certain groups at risk for the development of obesity are not reached effectively by current programs. Although universally valid conclusions cannot be drawn given the heterogeneity of available studies, clearly combining behavior-based programs with community-based prevention to counteract an 'obesogenic environment' is crucial for sustainable success of future obesity prevention programs.
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Affiliation(s)
- Susann Weihrauch-Blüher
- IFB AdiposityDiseases; Leipzig University Medical Center, University of Leipzig, Leipzig, Germany
- Department of Pediatrics I / Pediatric Endocrinology and Diabetology, University Hospital of Halle/Saale, Halle/Saale, Germany
| | - Kartin Kromeyer-Hauschild
- Institute of Human Genetics, Jena University Medical Center, Friedrich-Schiller-University of Jena, Jena, Germany
| | - Christine Graf
- Institute of Movement and Neuroscience, German Sport University of Cologne, Cologne, Germany
| | - Kurt Widhalm
- Department Of Clinical Nutrition and Prevention, Children's Hospital, University Hospital of Vienna, Vienna, Austria
| | - Ulrike Korsten-Reck
- Department of Rehabilitative and Preventive Sports Medicine, University Medical Center Freiburg, Freiburg i.Br., Germany
| | - Birgit Jödicke
- Department of Pediatric Endocrinology and Diabetology and Center for Social-Pediatric Care, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jana Markert
- IFB AdiposityDiseases; Leipzig University Medical Center, University of Leipzig, Leipzig, Germany
- Institute of Special and Inclusive Education, University of Leipzig, Leipzig, Germany
| | - Manfred James Müller
- Institute for Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
- Department of Pediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Anja Moss
- Department of Pediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Martin Wabitsch
- Department of Pediatric Endocrinology and Diabetology, Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Susanna Wiegand
- Department of Pediatric Endocrinology and Diabetology and Center for Social-Pediatric Care, Charité Universitätsmedizin Berlin, Berlin, Germany
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Baird DC, Meyers GJ, Hu JS. Testicular Cancer: Diagnosis and Treatment. Am Fam Physician 2018; 97:261-268. [PMID: 29671528] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Testicular cancer is the most common solid tumor among males 15 to 34 years of age, with an estimated 8,850 new cases and 410 deaths during 2017 in the United States. With effective treatment, the overall five-year survival rate is 97%. Risk factors for testicular cancer include undescended testis (cryptorchidism), personal or family history of testicular cancer, age, ethnicity, and infertility. The U.S. Preventive Services Task Force recommends against routine screening in asymptomatic men. Men with symptoms should receive a complete history and physical examination. Scrotal ultrasonography is the preferred initial imaging study. If a solid intratesticular mass is discovered, orchiectomy is both diagnostic and therapeutic. Staging through chest radiography, chemistry panel, liver function tests, and tumor markers guides treatment. Active surveillance, chemotherapy, retroperitoneal lymph node dissection, and radiation therapy are treatment options following orchiectomy. For patients desiring future fertility, sperm banking should be discussed early in the course of treatment. Family physicians often play a role in the care of cancer survivors and should be familiar with monitoring for recurrence and future complications, including secondary malignant neoplasms, cardiovascular risk, and infertility and subfertility.
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Affiliation(s)
- Drew C Baird
- Carl R. Darnall Army Medical Center, Fort Hood, TX, USA
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Barreto TW, Lin KW. Clostridium difficile Infection: Prevention and Treatment. Am Fam Physician 2018; 97:196-199. [PMID: 29431975] [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: 06/08/2023]
Affiliation(s)
- Tyler W Barreto
- University of Texas Health San Antonio, San Antonio, TX, USA
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Loftus J, Allen EM, Call KT, Everson-Rose SA. Rural-Urban Differences in Access to Preventive Health Care Among Publicly Insured Minnesotans. J Rural Health 2018; 34 Suppl 1:s48-s55. [PMID: 28295584 PMCID: PMC6069955 DOI: 10.1111/jrh.12235] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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] [Received: 09/23/2016] [Revised: 12/20/2016] [Accepted: 01/30/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Reduced access to care and barriers have been shown in rural populations and in publicly insured populations. Barriers limiting health care access in publicly insured populations living in rural areas are not understood. This study investigates rural-urban differences in system-, provider-, and individual-level barriers and access to preventive care among adults and children enrolled in a public insurance program in Minnesota. METHODS This was a secondary analysis of a 2008 statewide, cross-sectional survey of publicly insured adults and children (n = 4,388) investigating barriers associated with low utilization of preventive care. Sampling was stratified with oversampling of racial/ethnic minorities. RESULTS Rural enrollees were more likely to report no past year preventive care compared to urban enrollees. However, this difference was no longer statistically significant after controlling for demographic and socioeconomic factors (OR: 1.37, 95% CI: 1.00-1.88). Provider- and system-level barriers associated with low use of preventive care among rural enrollees included discrimination based on public insurance status (OR: 2.26, 95% CI: 1.34-2.38), cost of care concerns (OR: 1.72, 95% CI: 1.03-2.89) and uncertainty about care being covered by insurance (OR: 1.70, 95% CI: 1.01-2.85). These and additional provider-level barriers were also identified among urban enrollees. CONCLUSIONS Discrimination, cost of care, and uncertainty about insurance coverage inhibit access in both the rural and urban samples. These barriers are worthy targets of interventions for publicly insured populations regardless of residence. Future studies should investigate additional factors associated with access disparities based on rural-urban residence.
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Affiliation(s)
- John Loftus
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Elizabeth M Allen
- Department of Public Health, St. Catherine University, St. Paul, Minnesota
| | - Kathleen Thiede Call
- School of Public Health, Division of Health Policy & Management, and SHADAC, University of Minnesota, Minneapolis, Minnesota
| | - Susan A Everson-Rose
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota
- Department of Medicine, and Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota
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Adolescent Oral Health Care. Pediatr Dent 2017; 39:213-20. [PMID: 29179360] [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: 06/07/2023]
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Kalra S, Lauritzen T, Sharmanov T, Akanov Z, Al Awadi F, Das AK, Espinosa López C, Medea G, Oh P, Samoilova Y, Shestakova M, Netto P, Cos X, Farghaly M, Du X. Alma-Ata to Berlin: diabetes prevention and treatment to achieve healthy living. Diabet Med 2017; 34:1169-1170. [PMID: 28477409 DOI: 10.1111/dme.13374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Indexed: 11/28/2022]
Affiliation(s)
- S Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
| | - T Lauritzen
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - T Sharmanov
- Kazakh Academy of Nutrition, Almaty, Kazakhstan
- Academy of Preventive Medicine, Almaty, Kazakhstan
| | - Z Akanov
- Kazakh National Medical University, Almaty, Kazakhstan
| | - F Al Awadi
- Department of Endocrinology, Dubai Hospital, Dubai, UAE
| | - A K Das
- Department of Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - C Espinosa López
- Directorate of Epidemiology, Ministry of Health, Mexico City, Mexico
| | - G Medea
- Italian College of General Practitioners, Florence, Italy
| | - P Oh
- University Health Network, Toronto, Canada
| | - Y Samoilova
- Siberian State Medical University, Tomsk, Moscow, Russia
| | - M Shestakova
- Endocrinology Research Centre, Diabetes Institute, Moscow, Russia
| | - P Netto
- Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - X Cos
- Primary Care Diabetes Europe (PCDE), Spain
| | | | - X Du
- Peking Union Medical College, Beijing, China
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Affiliation(s)
- Daniel Maroudy
- 21, chemin de Quincangrogne, 77400 Lagny-sur-Marne, France.
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Knight DA, Jarrett D. Preventive Health Care for Women Who Have Sex with Women. Am Fam Physician 2017; 95:314-321. [PMID: 28290645] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Despite recent shifts in societal attitudes toward same-sex relationships, women who have sex with women face a variety of barriers to optimal health, including a history of negatively perceived interactions in clinical settings that lead them to delay or avoid health care. Women who have sex with women may be at disproportionate risk of obesity, tobacco use, substance use, mental health issues, intimate partner violence, sexually transmitted infections, and some cancers. Disparities can exist throughout the lifetime. Lesbian and bisexual adolescents are vulnerable to bullying, family rejection, and risky sexual behavior that may lead to sexually transmitted infections or unintended pregnancy. Sexual minority stress, which is a response to stigmatization, prejudice, and internalized homophobia, contributes to many of these conditions. Family physicians should foster trust and communication to provide a nonjudgmental, welcoming environment supportive of culturally competent health care and optimal outcomes. When indicated, clinicians should refer women who have sex with women to culturally sensitive community resources and legal advisors for assistance with medical decision making, hospital visitation, conception, and legal recognition of nonbiologic parents.
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Affiliation(s)
- Daniel A Knight
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Diane Jarrett
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Haebler J, Casey T. Nurses Lead in Fighting Opioid Crisis. Ala Nurse 2017; 44:19. [PMID: 29791091] [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: 06/08/2023]
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Al-Hablani B. The Use of Automated SNOMED CT Clinical Coding in Clinical Decision Support Systems for Preventive Care. Perspect Health Inf Manag 2017; 14:1f. [PMID: 28566995 PMCID: PMC5430114] [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: 06/07/2023]
Abstract
OBJECTIVE The objective of this study is to discuss and analyze the use of automated SNOMED CT clinical coding in clinical decision support systems (CDSSs) for preventive care. The central question that this study seeks to answer is whether the utilization of SNOMED CT in CDSSs can improve preventive care. METHOD PubMed, Google Scholar, and Cochrane Library were searched for articles published in English between 2001 and 2012 on SNOMED CT, CDSS, and preventive care. OUTCOME MEASURES Outcome measures were the sensitivity or specificity of SNOMED CT coded data and the positive predictive value or negative predictive value of SNOMED CT coded data. Additionally, we documented the publication year, research question, study design, results, and conclusions of these studies. RESULTS The reviewed studies suggested that SNOMED CT successfully represents clinical terms and negated clinical terms. CONCLUSION The use of SNOMED CT in CDSS can be considered to provide an answer to the problem of medical errors as well as for preventive care in general. Enhancement of the modifiers and synonyms found in SNOMED CT will be necessary to improve the expected outcome of the integration of SNOMED CT with CDSS. Moreover, the application of the tree-augmented naïve (TAN) Bayesian network method can be considered the best technique to search SNOMED CT data and, consequently, to help improve preventive health services.
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Affiliation(s)
- Bader Al-Hablani
- King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia
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Norris SA, Daar A, Balasubramanian D, Byass P, Kimani-Murage E, Macnab A, Pauw C, Singhal A, Yajnik C, Akazili J, Levitt N, Maatoug J, Mkhwanazi N, Moore SE, Nyirenda M, Pulliam JRC, Rochat T, Said-Mohamed R, Seedat S, Sobngwi E, Tomlinson M, Toska E, van Schalkwyk C. Understanding and acting on the developmental origins of health and disease in Africa would improve health across generations. Glob Health Action 2017; 10:1334985. [PMID: 28715931 PMCID: PMC5533158 DOI: 10.1080/16549716.2017.1334985] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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] [Received: 10/10/2016] [Accepted: 03/10/2017] [Indexed: 01/09/2023] Open
Abstract
Data from many high- and low- or middle-income countries have linked exposures during key developmental periods (in particular pregnancy and infancy) to later health and disease. Africa faces substantial challenges with persisting infectious disease and now burgeoning non-communicable disease.This paper opens the debate to the value of strengthening the developmental origins of health and disease (DOHaD) research focus in Africa to tackle critical public health challenges across the life-course. We argue that the application of DOHaD science in Africa to advance life-course prevention programmes can aid the achievement of the Sustainable Development Goals, and assist in improving health across generations. To increase DOHaD research and its application in Africa, we need to mobilise multisectoral partners, utilise existing data and expertise on the continent, and foster a new generation of young African scientists engrossed in DOHaD.
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Affiliation(s)
- Shane A. Norris
- Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, South Africa
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Abdallah Daar
- Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, South Africa
- Dalla Lana School of Public Health and Department of Surgery, University of Toronto, Toronto, Canada
| | - Dorairajan Balasubramanian
- Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, South Africa
- L V Prasad Eye Institute, Hyderabad, India
| | - Peter Byass
- Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, South Africa
- Department of Public Health and Clinical Medicine, Umeå University, Umea, Sweden
| | - Elizabeth Kimani-Murage
- Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, South Africa
- African Population and Health Research Center, Kenya
| | - Andrew Macnab
- Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, South Africa
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Christoff Pauw
- Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, South Africa
| | - Atul Singhal
- Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, South Africa
- Institute of Child Health, University College London, London, UK
| | - Chittaranjan Yajnik
- Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, South Africa
- King Edward Memorial Hospital Research Centre, Pune, India
| | | | - Naomi Levitt
- Department of Diabetic Medicine and Endocrinology, University of Cape Town, Cape Town, South Africa
| | - Jihene Maatoug
- Department of Epidemiology, Hospital Farhat Hached, Sousse, Tunisia
| | - Nolwazi Mkhwanazi
- Department of Anthropology, University of the Witwatersrand, Johannesburg, South Africa
| | - Sophie E. Moore
- Division of Women’s Health, King’s College London, London, UK
| | | | - Juliet R. C. Pulliam
- DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), University of Stellenbosch, Stellenbosch, South Africa
| | - Tamsen Rochat
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Human and Social Development Research Programme, Human Sciences Research Council, Durban, South Africa
| | - Rihlat Said-Mohamed
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Eugene Sobngwi
- Department of Applied Epidemiology, University of Yaoundé, Yaounde, Cameroon
| | - Mark Tomlinson
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Elona Toska
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Cari van Schalkwyk
- DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), University of Stellenbosch, Stellenbosch, South Africa
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Fazio SB, Demasi M, Farren E, Frankl S, Gottlieb B, Hoy J, Johnson A, Kasper J, Lee P, McCarthy C, Miller K, Morris J, O'Hare K, Rosales R, Simmons L, Smith B, Treadway K, Goodell K, Ogur B. Blueprint for an Undergraduate Primary Care Curriculum. Acad Med 2016; 91:1628-1637. [PMID: 27415445 DOI: 10.1097/acm.0000000000001302] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In light of the increasing demand for primary care services and the changing scope of health care, it is important to consider how the principles of primary care are taught in medical school. While the majority of schools have increased students' exposure to primary care, they have not developed a standardized primary care curriculum for undergraduate medical education. In 2013, the authors convened a group of educators from primary care internal medicine, pediatrics, family medicine, and medicine-pediatrics, as well as five medical students to create a blueprint for a primary care curriculum that could be integrated into a longitudinal primary care experience spanning undergraduate medical education and delivered to all students regardless of their eventual career choice.The authors organized this blueprint into three domains: care management, specific areas of content expertise, and understanding the role of primary care in the health care system. Within each domain, they described specific curriculum content, including longitudinality, generalism, central responsibility for managing care, therapeutic alliance/communication, approach to acute and chronic care, wellness and prevention, mental and behavioral health, systems improvement, interprofessional training, and population health, as well as competencies that all medical students should attain by graduation.The proposed curriculum incorporates important core features of doctoring, which are often affirmed by all disciplines but owned by none. The authors argue that primary care educators are natural stewards of this curriculum content and can ensure that it complements and strengthens all aspects of undergraduate medical education.
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Affiliation(s)
- Sara B Fazio
- S.B. Fazio is associate professor, Department of Internal Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts. M. Demasi is instructor of population health (family medicine), Cambridge Health Alliance, and Harvard Medical School, Boston, Massachusetts. E. Farren is education program director, Center for Primary Care, Harvard Medical School, Boston, Massachusetts. S. Frankl is assistant professor, Department of Internal Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts. B. Gottlieb is associate professor, Department of Internal Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts. J. Hoy is resident physician, Department of Internal Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts. A. Johnson is resident physician, Department of Internal Medicine, University of California, San Francisco, School of Medicine, San Francisco, California. J. Kasper is instructor, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. P. Lee is assistant professor, Department of Internal Medicine, Cambridge Health Alliance, and Harvard Medical School, Boston, Massachusetts. C. McCarthy is assistant professor, Department of Pediatrics, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts. K. Miller is assistant professor of population medicine (family medicine), Cambridge Health Alliance, and Harvard Medical School, Boston, Massachusetts. J. Morris is resident physician, Department of Family & Community Medicine, University of California, San Francisco, School of Medicine, San Francisco, California. K. O'Hare is assistant professor, Department of Internal Medicine, Brigham and Women's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. R. Rosales is a medical student, Harvard Medical School, Boston, Massachusetts. L. Simmons is assistant professor, Department of Internal Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts. B. Smith is resident physician, Fort Collins Family Medicine Residency, Fort Collins, Colorado. K. Treadway is associate professor, Department of Internal Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts. K. Goodell is director for innovation in medical education (family medicine), Center for Primary Care, Harvard Medical School, Boston, Massachusetts. B. Ogur is associate professor of medicine, Department of Internal Medicine, Cambridge Health Alliance, and Harvard Medical School, Boston, Massachusetts
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Brown M, Jacobstein D, Yoon IS, Anthony B, Bullock K. Systemwide Initiative Documents Robust Health Screening for Adults With Intellectual Disability. Intellect Dev Disabil 2016; 54:354-365. [PMID: 27673736 DOI: 10.1352/1934-9556-54.5.354] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
It is well documented that adults with intellectual disability (ID) experience higher rates of a series of health conditions compared to their peers without disability. These health conditions include cardiovascular disease, obesity, diabetes, gastrointestinal disorders, and psychiatric and behavioral disorders. With life expectancy approximating the general population, adults with ID are also now experiencing health conditions related to aging, further increasing their risk for diminished function and well-being. This increased morbidity poses new challenges in geriatric healthcare planning for this population. Relatively simple health prevention practices, such as the implementation of a health screening tool, can substantially increase disease detection and clinical activities directed toward improved health outcomes for people with ID. This study examines data collected from the District of Columbia Developmental Disabilities Administration's (DC DDA's) health screening component of its Health and Wellness Standards. Findings are presented, along with recommendations and implications for improving preventive health screening practices in the ID population.
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Affiliation(s)
- Marisa Brown
- Marisa Brown, Diane Jacobstein, and Irene Seyoung Yoon, Georgetown University Center for Child and Human Development, University Center for Excellence in Developmental Disabilities; Bruno Anthony, Georgetown University Center for Child and Human Development; and Kim Bullock, Georgetown University, Department of Family Medicine
| | - Diane Jacobstein
- Marisa Brown, Diane Jacobstein, and Irene Seyoung Yoon, Georgetown University Center for Child and Human Development, University Center for Excellence in Developmental Disabilities; Bruno Anthony, Georgetown University Center for Child and Human Development; and Kim Bullock, Georgetown University, Department of Family Medicine
| | - Irene Seyoung Yoon
- Marisa Brown, Diane Jacobstein, and Irene Seyoung Yoon, Georgetown University Center for Child and Human Development, University Center for Excellence in Developmental Disabilities; Bruno Anthony, Georgetown University Center for Child and Human Development; and Kim Bullock, Georgetown University, Department of Family Medicine
| | - Bruno Anthony
- Marisa Brown, Diane Jacobstein, and Irene Seyoung Yoon, Georgetown University Center for Child and Human Development, University Center for Excellence in Developmental Disabilities; Bruno Anthony, Georgetown University Center for Child and Human Development; and Kim Bullock, Georgetown University, Department of Family Medicine
| | - Kim Bullock
- Marisa Brown, Diane Jacobstein, and Irene Seyoung Yoon, Georgetown University Center for Child and Human Development, University Center for Excellence in Developmental Disabilities; Bruno Anthony, Georgetown University Center for Child and Human Development; and Kim Bullock, Georgetown University, Department of Family Medicine
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Duncan D. Stop the spread: prevention and reduction of influenza among older individuals. Br J Community Nurs 2016; 21:446-450. [PMID: 27594059 DOI: 10.12968/bjcn.2016.21.9.446] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Debbie Duncan
- Senior Lecturer in Adult Nursing, Bucks New University, UK
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Hennessey JV, Garber JR, Woeber KA, Cobin R, Klein I. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON THYROID DYSFUNCTION CASE FINDING. Endocr Pract 2016; 22:262-70. [PMID: 26848631 DOI: 10.4158/ep151038.ps] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Hypothyroidism and hyperthyroidism can be readily diagnosed and can be treated in a safe, cost-effective manner. Professional organizations have given guidance on how and when to employ thyroid-stimulating hormone testing for the detection of thyroid dysfunction. Most recently, the United States Preventive Services Task Force did not endorse screening for thyroid dysfunction based on a lack of proven benefit and potential harm of treating those with thyroid dysfunction, which is mostly subclinical disease. The American Association of Clinical Endocrinologists (AACE) is concerned that this may discourage physicians from testing for thyroid dysfunction when clinically appropriate. Given the lack of specificity of thyroid-associated symptoms, the appropriate diagnosis of thyroid disease requires biochemical confirmation. The Thyroid Scientific Committee of the AACE has produced this White Paper to highlight the important difference between screening and case-based testing in the practice of clinical medicine. We recommend that thyroid dysfunction should be frequently considered as a potential etiology for many of the nonspecific complaints that physicians face daily. The application and success of safe and effective interventions are dependent on an accurate diagnosis. We, therefore, advocate for an aggressive case-finding approach, based on identifying those persons most likely to have thyroid disease that will benefit from its treatment.
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Campos-Outcalt D. USPSTF update: Screening for abnormal blood glucose, diabetes. J Fam Pract 2016; 65:481-483. [PMID: 27565101] [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: 06/06/2023]
Abstract
Screen all adults, ages 40 to 70 years, who are overweight or obese. Consider screening younger patients who have specific personal or family risk factors.
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Finocchario-Kessler S, Wexler C, Maloba M, Mabachi N, Ndikum-Moffor F, Bukusi E. Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective. BMC Womens Health 2016; 16:29. [PMID: 27259656 PMCID: PMC4893293 DOI: 10.1186/s12905-016-0306-6] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [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] [Received: 11/21/2015] [Accepted: 05/21/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Women living in Africa experience the highest burden of cervical cancer. Research and investment to improve vaccination, screening, and treatment efforts are critically needed. We systematically reviewed and characterized recent research within a broader public health framework to organize and assess the range of cervical cancer research in Africa. METHODS We searched online databases and the Internet for published articles and cervical cancer reports in African countries. Inclusion criteria included publication between 2004 and 2014, cervical cancer-related content pertinent to one of the four public health categories (primary, secondary, tertiary prevention or quality of life), and conducted in or specifically relevant to countries or regions within the African continent. The study design, geographic region/country, focus of research, and key findings were documented for each eligible article and summarized to illustrate the weight and research coverage in each area. Publications with more than one focus (e.g. secondary and tertiary prevention) were categorized by the primary emphasis of the paper. Research specific to HIV-infected women or focused on feasibility issues was delineated within each of the four public health categories. RESULTS A total of 380 research articles/reports were included. The majority (54.6 %) of cervical cancer research in Africa focused on secondary prevention (i.e., screening). The number of publication focusing on primary prevention (23.4 %), particularly HPV vaccination, increased significantly in the past decade. Research regarding the treatment of precancerous lesions and invasive cervical cancer is emerging (17.6 %), but infrastructure and feasibility challenges in many countries have impeded efforts to provide and evaluate treatment. Studies assessing aspects of quality of life among women living with cervical cancer are severely limited (4.1 %). Across all categories, 11.3 % of publications focused on cervical cancer among HIV-infected women, while 17.1 % focused on aspects of feasibility for cervical cancer control efforts. CONCLUSIONS Cervical cancer research in African countries has increased steadily over the past decade, but more is needed. Tertiary prevention (i.e. treatment of disease with effective medicine) and quality of life of cervical cancer survivors are two severely under-researched areas. Similarly, there are several countries in Africa with little to no research ever conducted on cervical cancer.
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Affiliation(s)
| | - Catherine Wexler
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, USA
| | - May Maloba
- Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya
| | - Natabhona Mabachi
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, USA
| | - Florence Ndikum-Moffor
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, USA
| | - Elizabeth Bukusi
- Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
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Swenson PF, Ebell MH. Introducing a One-page Adult Preventive Health Care Schedule: USPSTF Recommendations at a Glance. Am Fam Physician 2016; 93:738-740. [PMID: 27175949] [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)
| | - Mark H Ebell
- University of Georgia College of Public Health, Athens, GA, USA
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Sinclair LB, Taft KE, Sloan ML, Stevens AC, Krahn GL. Tools for improving clinical preventive services receipt among women with disabilities of childbearing ages and beyond. Matern Child Health J 2016; 19:1189-201. [PMID: 25359095 DOI: 10.1007/s10995-014-1627-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Efforts to improve clinical preventive services (CPS) receipt among women with disabilities are poorly understood and not widely disseminated. The reported results represent a 2-year, Centers for Disease Control and Prevention and Association of Maternal and Child Health Programs partnership to develop a central resource for existing tools that are of potential use to maternal and child health practitioners who work with women with disabilities. Steps included contacting experts in the fields of disability and women's health, searching the Internet to locate examples of existing tools that may facilitate CPS receipt, convening key stakeholders from state and community-based programs to determine their potential use of the tools, and developing an online Toolbox. Nine examples of existing tools were located. The tools focused on facilitating use of the CPS guidelines, monitoring CPS receipt among women with disabilities, improving the accessibility of communities and local transportation, and training clinicians and women with disabilities. Stakeholders affirmed the relevance of these tools to their work and encouraged developing a Toolbox. The Toolbox, launched in May 2013, provides information and links to existing tools and accepts feedback and proposals for additional tools. This Toolbox offers central access to existing tools. Maternal and child health stakeholders and other service providers can better locate, adopt and implement existing tools to facilitate CPS receipt among adolescent girls with disabilities who are transitioning into adult care as well as women with disabilities of childbearing ages and beyond.
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Affiliation(s)
- Lisa B Sinclair
- Disability and Health Branch, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, E-88, Atlanta, GA, 30333, USA,
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Durbin J, Selick A, Casson I, Green L, Spassiani N, Perry A, Lunsky Y. Evaluating the Implementation of Health Checks for Adults With Intellectual and Developmental Disabilities in Primary Care: The Importance of Organizational Context. Intellect Dev Disabil 2016; 54:136-150. [PMID: 27028255 DOI: 10.1352/1934-9556-54.2.136] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Compared to other adults, those with intellectual and developmental disabilities have more health issues, yet are less likely to receive preventative care. One strategy that has shown success in increasing prevention activities and early detection of illness is the periodic comprehensive health assessment (the health check). Effectively moving evidence into practice is a complex process that often receives inadequate attention. This qualitative study evaluates the implementation of the health check at two primary-care clinics in Ontario, Canada, and the influence of the clinic context on implementation decisions. Each clinic implemented the same core components; however, due to contextual differences, some components were operationalized differently. Adapting to the setting context is important to ensuring successful and sustainable implementation.
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Affiliation(s)
- Janet Durbin
- Janet Durbin and Avra Selick, Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada
| | - Avra Selick
- Janet Durbin and Avra Selick, Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada
| | - Ian Casson
- Ian Casson, Queen's University, Kingston, Ontario, Canada
| | - Laurie Green
- Laurie Green, St Michael's Hospital, University of Toronto, Ontario, Canada
| | - Natasha Spassiani
- Natasha Spassiani, Andrea Perry, and Yona Lunsky, Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada
| | - Andrea Perry
- Natasha Spassiani, Andrea Perry, and Yona Lunsky, Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada
| | - Yona Lunsky
- Natasha Spassiani, Andrea Perry, and Yona Lunsky, Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada
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American Nurses Association Makes New Recommendation that All Nurses Should be Immunized Against Vaccine-Preventable Diseases. Ala Nurse 2015; 42:16. [PMID: 26749946] [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: 06/05/2023]
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Fox CS, Golden SH, Anderson C, Bray GA, Burke LE, de Boer IH, Deedwania P, Eckel RH, Ershow AG, Fradkin J, Inzucchi SE, Kosiborod M, Nelson RG, Patel MJ, Pignone M, Quinn L, Schauer PR, Selvin E, Vafiadis DK. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Diabetes Care 2015; 38:1777-803. [PMID: 26246459 PMCID: PMC4876675 DOI: 10.2337/dci15-0012] [Citation(s) in RCA: 283] [Impact Index Per Article: 31.4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus.
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Hendrickson CD, Comi RJ. ON THE EDGE OF DISEASE. Endocr Pract 2015; 21:1303-5. [PMID: 26247113 DOI: 10.4158/ep15861.co] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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48
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Printz C. ACS report: Progress lags in some cancer control efforts. Cancer 2015. [PMID: 26198789 DOI: 10.1002/cncr.29557] [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: 11/09/2022]
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Makarem N, Lin Y, Bandera EV, Jacques PF, Parekh N. Concordance with World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines for cancer prevention and obesity-related cancer risk in the Framingham Offspring cohort (1991-2008). Cancer Causes Control 2015; 26:277-286. [PMID: 25559553 DOI: 10.1007/s10552-014-0509-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 12/04/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE This prospective cohort study evaluates associations between healthful behaviors consistent with WCRF/AICR cancer prevention guidelines and obesity-related cancer risk, as a third of cancers are estimated to be preventable. METHODS The study sample consisted of adults from the Framingham Offspring cohort (n = 2,983). From 1991 to 2008, 480 incident doctor-diagnosed obesity-related cancers were identified. Data on diet, measured by a food frequency questionnaire, anthropometric measures, and self-reported physical activity, collected in 1991 was used to construct a 7-component score based on recommendations for body fatness, physical activity, foods that promote weight gain, plant foods, animal foods, alcohol, and food preservation, processing, and preparation. Multivariable Cox regression models were used to estimate associations between the computed score, its components, and subcomponents in relation to obesity-related cancer risk. RESULTS The overall score was not associated with obesity-related cancer risk after adjusting for age, sex, smoking, energy, and preexisting conditions (HR 0.94, 95 % CI 0.86-1.02). When score components were evaluated separately, for every unit increment in the alcohol score, there was 29 % lower risk of obesity-related cancers (HR 0.71, 95 % CI 0.51-0.99) and 49-71 % reduced risk of breast, prostate, and colorectal cancers. Every unit increment in the subcomponent score for non-starchy plant foods (fruits, vegetables, and legumes) among participants who consume starchy vegetables was associated with 66 % reduced risk of colorectal cancer (HR 0.44, 95 % CI 0.22-0.88). CONCLUSIONS Lower alcohol consumption and a plant-based diet consistent with the cancer prevention guidelines were associated with reduced risk of obesity-related cancers in this population.
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Affiliation(s)
- Nour Makarem
- Department of Nutrition, Food Studies and Public Health Steinhardt School, New York University, 411 LaFayette Street, 5th Floor, Room 542, New York, NY, 10003, USA
| | - Yong Lin
- Rutgers School of Public Health, Rutgers The State University of New Jersey, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903-2681, USA
| | - Elisa V Bandera
- Rutgers School of Public Health, Rutgers The State University of New Jersey, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903-2681, USA
| | - Paul F Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging, Friedman School of Nutrition Science and Policy, Tufts University, 711 Washington Street, Boston, MA, 02111, USA
| | - Niyati Parekh
- Department of Nutrition, Food Studies and Public Health Steinhardt School, New York University, 411 LaFayette Street, 5th Floor, Room 542, New York, NY, 10003, USA.
- Department of Population Health, NYU Langone School of Medicine, 227 East 30th Street, 7th Floor, New York, NY, 10016, USA.
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Tiendrebéogo J, Koiné Drabo M, Saizonou J, Soglohoun CT, Paraiso NM, Sié A, Ouédraogo LT, Makoutodé M. [Factors associated with the poor coverage of Intermittent Preventive Treatment in pregnant women in the Pobè-Adja-Ouèrè-Kétou health zone in Benin]. Sante Publique 2015; 27:99-106. [PMID: 26164960] [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
World Health Organization estimates indicate 216 million malaria episodes in 2010, including 81% in the African region. One of the recommended means of prevention in pregnant women is intermittent preventive treatment, until 2012, two doses of sulfadoxine/pyrimethamine or three doesfor a woman living with HIV In the Pobè-Adja-Ouèrè-Kétou health zone of Benin, coverage ofintermittent preventive treatment remains low (49% against a forecast of 80%) several years after implementation of this strategy. We conducted a cross-sectional study in June and July 2012 to identify factors associated with low intermittent preventive treatment coverage in this area. A total of 339 women were interviewed and 48% ofthem received less than two doses of sulfadoxine pyrimethamine during their prenatal consultations. The variables associated with low intermittent preventive treatment coverage were low antenatal care coverage (p < 0.001) and a prenatal consultation in the private sector (p = 0.039). In the light of our results, actions must be taken by this health zone to encourage women to complete the four visits during pregnancy.
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