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Lund NLT, Petersen AS, Fronczek R, Tfelt-Hansen J, Belin AC, Meisingset T, Tronvik E, Steinberg A, Gaul C, Jensen RH. Current treatment options for cluster headache: limitations and the unmet need for better and specific treatments-a consensus article. J Headache Pain 2023; 24:121. [PMID: 37667192 PMCID: PMC10476341 DOI: 10.1186/s10194-023-01660-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023] Open
Abstract
AIM Treatment for cluster headache is currently based on a trial-and-error approach. The available preventive treatment is unspecific and based on few and small studies not adhering to modern standards. Therefore, the authors collaborated to discuss acute and preventive treatment in cluster headache, addressing the unmet need of safe and tolerable preventive medication from the perspectives of people with cluster headache and society, headache specialist and cardiologist. FINDINGS The impact of cluster headache on personal life is substantial. Mean annual direct and indirect costs of cluster headache are more than 11,000 Euros per patient. For acute treatment, the main problems are treatment response, availability, costs and, for triptans, contraindications and the maximum use allowed. Intermediate treatment with steroids and greater occipital nerve blocks are effective but cannot be used continuously. Preventive treatment is sparsely studied and overall limited by relatively low efficacy and side effects. Neurostimulation is a relevant option for treatment-refractory chronic patients. From a cardiologist's perspective use of verapamil and triptans may be worrisome and regular follow-up is essential when using verapamil and lithium. CONCLUSION We find that there is a great and unmet need to pursue novel and targeted preventive modalities to suppress the horrific pain attacks for people with cluster headache.
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Affiliation(s)
- Nunu Laura Timotheussen Lund
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark.
- Department of Neurology, Sjællands Universitetshospital Roskilde, Roskilde, Denmark.
| | - Anja Sofie Petersen
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark
| | - Rolf Fronczek
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
- Stichting Epilepsie Instellingen Nederlands (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
| | - Jacob Tfelt-Hansen
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Forensic Medicine, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Andrea Carmine Belin
- Centre for Cluster Headache, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tore Meisingset
- Norwegian Advisory Unit On Headaches, St. Olav University Hospital, Trondheim, Norway
- NorHEAD, Norwegian Headache Research Centre, NTNU, Trondheim, Norway
| | - Erling Tronvik
- Norwegian Advisory Unit On Headaches, St. Olav University Hospital, Trondheim, Norway
- NorHEAD, Norwegian Headache Research Centre, NTNU, Trondheim, Norway
| | - Anna Steinberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Charly Gaul
- Charly Gaul, Headache Center, Frankfurt, Germany
| | - Rigmor Højland Jensen
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Valdemar Hansens Vej 5, 2600, Glostrup, Denmark
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Abstract
BACKGROUND There were large differences across subgroups of adults in preventive services utilization before 2010. The Affordable Care Act had numerous provisions aimed at increasing utilization as well as at reducing disparities. OBJECTIVE This study examines whether preventive services utilization changed over time, across subgroups of adults defined by race/ethnicity, insurance coverage, poverty status, Census region, and urbanicity. METHODS Data from the Medical Expenditure Panel Survey Household Component are used to examine service utilization before the passage of the Affordable Care Act (2008/2009), after the implementation of the preventive services mandate and the dependent coverage provision (2012/2013), and after Medicaid expansions (2015/2016). Four preventive services are examined for adults aged 19-64-general checkups, blood cholesterol screening, mammograms, and colorectal cancer screening. Multivariate logistic regression models are used to predict preventive services utilization of adult subgroups in each time period, and to examine how differences across subgroups changed between 2008/2009 and 2015/2016. RESULTS There were modest increases in utilization between 2008/2009 and 2015/2016 for blood cholesterol and colorectal cancer screenings. For 3 of 4 preventive services, differences between the Northeast and the Midwest regions narrowed. However, large gaps in utilization across income groups and between those with and without coverage persisted. Disparities across racial/ethnic groups in general checkups persisted over time as well. CONCLUSION While some differences have narrowed, large gaps in preventive service utilization across population subgroups remain.
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Affiliation(s)
- Salam Abdus
- Agency for Healthcare Research and Quality, Department of Health and Human Services, Center for Financing, Access, and Cost Trends, Division of Research and Modeling, Rockville, MD
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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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4
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Abstract
Failures in preparation and response led to a worsened crisis.
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5
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Affiliation(s)
- Christian Gerber
- Department of Orthopaedics, Balgrist University Hospital, Zürich, Switzerland
- ResOrtho Foundation, Zürich, Switzerland
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6
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O'Neill S. Update on technologies, medicines and treatments. Diabet Med 2021; 38:e14516. [PMID: 33421214 DOI: 10.1111/dme.14516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Greiner GG, Emmert-Fees KMF, Becker J, Rathmann W, Thorand B, Peters A, Quante AS, Schwettmann L, Laxy M. Toward targeted prevention: risk factors for prediabetes defined by impaired fasting glucose, impaired glucose tolerance and increased HbA1c in the population-based KORA study from Germany. Acta Diabetol 2020; 57:1481-1491. [PMID: 32748175 PMCID: PMC7591423 DOI: 10.1007/s00592-020-01573-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022]
Abstract
AIMS To identify socioeconomic, behavioral and clinical factors that are associated with prediabetes according to different prediabetes definition criteria. METHODS Analyses use pooled data of the population-based Cooperative Health Research in the Region of Augsburg (KORA) studies (n = 5312 observations aged ≥ 38 years without diabetes). Prediabetes was defined through either impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or elevated HbA1c according to thresholds of the American Diabetes Association. Explanatory variables were regressed on prediabetes using generalized estimating equations. RESULTS Mean age was 58.4 years; 50% had prediabetes (33% had IFG, 16% IGT, and 26% elevated HbA1c, 10% fulfilled all three criteria). Age, obesity, hypertension, low education, unemployment, statutory health insurance, urban residence and physical inactivity were associated with prediabetes. Male sex was a stronger risk factor for IFG (OR = 2.5; 95%-CI: 2.2-2.9) than for IGT or elevated HbA1c, and being unemployed was a stronger risk factor for IGT (OR = 3.2 95%-CI: 2.6-4.0) than for IFG or elevated HbA1c. CONCLUSIONS The overlap of people with IFG, IGT and elevated HbA1c is small, and some factors are associated with only one criterion. Knowledge on sociodemographic and socioeconomic risk factors can be used to effectively target interventions to people at high risk for type 2 diabetes.
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Affiliation(s)
- Gregory G Greiner
- Institute for Health Services Research and Health Economics, German Diabetes Center, Auf'm Hennekamp 65, 40225, Duesseldorf, Germany.
- Medical Faculty, Centre for Health and Society, Institute for Health Services Research and Health Economics, Heinrich Heine University, Moorenstr. 5, 40225, Duesseldorf, Germany.
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
| | - Karl M F Emmert-Fees
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Jana Becker
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Wolfgang Rathmann
- Institute for Biometry and Epidemiology, German Diabetes Center, Auf'm Hennekamp 65, 40225, Duesseldorf, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764, Munich-Neuherberg, Germany
| | - Barbara Thorand
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764, Munich-Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Annette Peters
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764, Munich-Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Anne S Quante
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Department of Gynecology and Obstetrics, Klinikum Rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Lars Schwettmann
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Department of Economics, Martin Luther University Halle-Wittenberg, 06099, Halle (Saale), Germany
| | - Michael Laxy
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- German Centre for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764, Munich-Neuherberg, Germany
- Global Diabetes Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA, 30322, USA
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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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Abstract
PURPOSE OF REVIEW To give an update on the latest developments regarding rare adverse effects of bisphosphonate therapy. RECENT FINDINGS Recent studies covering osteonecrosis of the jaw (ONJ) and atypical femoral fractures (AFFs) provided several updates to the literature. Identification of ONJ in large population databases is a challenge but based on one systematic review, the ICD-10 diagnosis code K10.2 (inflammatory conditions of the jaw) seems to be the most commonly used code for this condition. Duration of bisphosphonate therapy was determined to be an important predictor of AFFs. Appropriate duration of therapy followed by a timely drug holiday was shown to be the best strategy for improving bone mineral density and reducing fracture risk, while minimizing risk of rare adverse effects of therapy. The utility of bone turnover markers as a monitoring tool during drug holidays needs to be further investigated. SUMMARY ONJ and AFFs are two of the rare adverse effects associated with bisphosphonate therapy. Population-level trends of bisphosphonate use suggest a decline in prescriptions, pointing to broad fears of these side effects. Careful patient evaluation, duration of bisphosphonate therapy, and use of drug holidays can help limit any risk associated with therapy.
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Affiliation(s)
- Zubair Ilyas
- Loyola University Medical Center, Maywood, Illinois, USA
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Brucker MC. Weaving All the Threads to Prevent Maternal Mortality. Nurs Womens Health 2019; 23:373-374. [PMID: 31449785 DOI: 10.1016/j.nwh.2019.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The etiology of maternal mortality is multifactorial and requires a concerted and comprehensive effort to address the problem.
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Abstract
On our 15th anniversary, the PLOS Medicine editors discuss progress in open access, medical publishing and the journal's mission over the years.
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Affiliation(s)
- The PLOS Medicine Editors
- Public Library of Science, San Francisco, California, United States of America and Cambridge, United Kingdom
- * E-mail:
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12
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Korea Health Rights Working Group. Statement on Health Rights in the New Constitution. J Prev Med Public Health 2019; 52:145-146. [PMID: 31163948 PMCID: PMC6549010 DOI: 10.3961/jpmph.19.051] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
Prevention is an attractive idea to policymakers in theory, particularly in health where the burden of spending and care is increasingly taken up by complex and chronic conditions associated with lifestyle choices. However, prevention in general, and preventive health in particular, has proven hard to implement in practice. In this paper, we look to one tangible legacy of the recent rise of the prevention agenda: agencies with responsibility for preventive health policy. We ask how this form of institutionalizing preventive health happens in practice, and what consequences it has for the advancement of the prevention agenda. We draw on qualitative data to compare the trajectories of newly formed agencies in Australia, New Zealand and England. We find that building and maintaining legitimacy for such agencies may come at the expense of quick progress or radical action in service of the prevention agenda.
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Affiliation(s)
- John Boswell
- University of Southampton, Building 58 Highfield Campus, So17 1BJ, United Kingdom.
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14
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Geiger CK, Kranz AM, Dick AW, Duffy E, Sorbero M, Stein BD. Delivery of Preventive Oral Health Services by Rurality: A Cross-Sectional Analysis. J Rural Health 2019; 35:3-11. [PMID: 30537073 PMCID: PMC6298795 DOI: 10.1111/jrh.12340] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 08/15/2018] [Revised: 10/10/2018] [Accepted: 10/30/2018] [Indexed: 12/01/2022]
Abstract
PURPOSE Integrating oral health care into primary care has been promoted as a strategy to increase delivery of preventive oral health services (POHS) to young children, particularly in rural areas where few dentists practice. Using a multistate sample of Medicaid claims, we examined a child's odds of receiving POHS in a medical office by county rurality. METHODS We used 2012-2014 Medicaid Analytic extract claims data for 6,275,456 children younger than 6 years in 39 states that allowed Medicaid payment for POHS in medical offices. We used county-level characteristics from the Area Health Resources Files, including a 3-level measure of county rurality. We used logistic regression to estimate a child's odds of receiving POHS in a medical office by county rurality, while controlling for other patient and county characteristics. FINDINGS POHS in medical offices were received by 7.8% of children. Rates of POHS in medical offices were higher in metropolitan (metro) counties (8.4%) than nonmetro adjacent to metro (5.8%) and nonmetro not adjacent to metro (4.3%). In adjusted analysis, children living in nonmetro not adjacent to metro (OR = 0.79, 95% CI: 0.64-0.99) and adjacent to metro counties (OR = 0.70, 95% CI: 0.59-0.82) were significantly less likely to receive POHS in medical offices than children living in metro counties. CONCLUSIONS In this study of POHS in medical offices among young Medicaid-enrolled children, we found POHS rates were lowest in nonmetro counties. Given barriers to dental care in rural areas, states should take additional steps beyond allowing Medicaid reimbursement to increase delivery of POHS in medical offices.
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Affiliation(s)
- Caroline K. Geiger
- RAND Corporation Pittsburgh, Pittsburgh, Pennsylvania
- Harvard University Graduate School of Arts and Sciences, Cambridge, Massachusetts
| | | | | | - Erin Duffy
- Pardee RAND Graduate School, Santa Monica, California
| | - Mark Sorbero
- RAND Corporation Pittsburgh, Pittsburgh, Pennsylvania
| | - Bradley D. Stein
- RAND Corporation Pittsburgh, Pittsburgh, Pennsylvania
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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15
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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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Lucivero F, Jongsma KR. A mobile revolution for healthcare? Setting the agenda for bioethics. J Med Ethics 2018; 44:685-689. [PMID: 29907579 PMCID: PMC6173811 DOI: 10.1136/medethics-2017-104741] [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] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 05/17/2018] [Accepted: 05/30/2018] [Indexed: 05/20/2023]
Abstract
Mobile health (mHealth) is rapidly being implemented and changing our ways of doing, understanding and organising healthcare. mHealth includes wearable devices as well as apps that track fitness, offer wellness programmes or provide tools to manage chronic conditions. According to industry and policy makers, these systems offer efficient and cost-effective solutions for disease prevention and self-management. While this development raises many ethically relevant questions, so far mHealth has received only little attention in medical ethics. This paper provides an overview of bioethical issues raised by mHealth and aims to draw scholarly attention to the ethical significance of its promises and challenges. We show that the overly positive promises of mHealth need to be nuanced and their desirability critically assessed. Finally, we offer suggestions to bioethicists to engage with this emerging trend in healthcare to develop mHealth to its best potential in a morally sound way.
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Affiliation(s)
- Federica Lucivero
- Ethox Centre, Wellcome Centre for Ethics and Humanities, Big Data Institute, University of Oxford, Oxford, UK
| | - Karin R Jongsma
- Julius Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Abstract
Very recently one of the largest type 1 diabetes prevention trials using daily administration of oral insulin or placebo was completed. After 9 years of study enrollment and follow-up, the randomized controlled trial failed to delay the onset of clinical type 1 diabetes, which was the primary end point. The unfortunate outcome follows the previous large-scale trial, the Diabetes Prevention Trial-Type 1 (DPT-1), which again failed to delay diabetes onset with oral insulin or low-dose subcutaneous insulin injections in a randomized controlled trial with relatives at risk for type 1 diabetes. These sobering results raise the important question, "Where does the type 1 diabetes prevention field move next?" In this Perspective, we advocate for a paradigm shift in which smaller mechanistic trials are conducted to define immune mechanisms and potentially identify treatment responders. The stage is set for these interventions in individuals at risk for type 1 diabetes as Type 1 Diabetes TrialNet has identified thousands of relatives with islet autoantibodies and general population screening for type 1 diabetes risk is under way. Mechanistic trials will allow for better trial design and patient selection based upon molecular markers prior to large randomized controlled trials, moving toward a personalized medicine approach for the prevention of type 1 diabetes.
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Affiliation(s)
- Aaron W Michels
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A Gottlieb
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
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Greenbaum CJ, Speake C, Krischer J, Buckner J, Gottlieb PA, Schatz DA, Herold KC, Atkinson MA. Strength in Numbers: Opportunities for Enhancing the Development of Effective Treatments for Type 1 Diabetes-The TrialNet Experience. Diabetes 2018; 67:1216-1225. [PMID: 29769238 PMCID: PMC6014559 DOI: 10.2337/db18-0065] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/20/2018] [Indexed: 12/12/2022]
Abstract
The early to mid-1980s were an inflection point in the history of type 1 diabetes research. Two landmark events occurred: the initiation of immune-based interventions seeking to prevent type 1 diabetes and the presentation of an innovative model describing the disorder's natural history. Both formed the basis for hundreds of subsequent studies designed to achieve a dramatic therapeutic goal-a means to prevent and/or reverse type 1 diabetes. However, the need to screen large numbers of individuals and prospectively monitor them using immunologic and metabolic tests for extended periods of time suggested such efforts would require a large collaborative network. Hence, the National Institutes of Health formed the landmark Diabetes Prevention Trial-Type 1 (DPT-1) in the mid-1990s, an effort that led to Type 1 Diabetes TrialNet. TrialNet studies have helped identify novel biomarkers; delineate type 1 diabetes progression, resulting in identification of highly predictable stages defined by the accumulation of autoantibodies (stage 1), dysglycemia (stage 2), and disease meeting clinical criteria for diagnosis (stage 3); and oversee numerous clinical trials aimed at preventing disease progression. Such efforts pave the way for stage-specific intervention trials with improved hope that a means to effectively disrupt the disorder's development will be identified.
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Affiliation(s)
- Carla J Greenbaum
- Clinical Research Center, Diabetes Research Program, Benaroya Research Institute at Virginia Mason, Seattle, WA
| | - Cate Speake
- Clinical Research Center, Diabetes Research Program, Benaroya Research Institute at Virginia Mason, Seattle, WA
| | - Jeffrey Krischer
- Diabetes Center and Pediatric Epidemiology Center, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Jane Buckner
- Clinical Research Center, Diabetes Research Program, Benaroya Research Institute at Virginia Mason, Seattle, WA
| | - Peter A Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Desmond A Schatz
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL
| | - Kevan C Herold
- Departments of Immunobiology and Internal Medicine, Yale University, New Haven, CT
| | - Mark A Atkinson
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL
- Department of Pathology, College of Medicine, University of Florida, Gainesville, FL
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Biggeri A. [Four years of Epichange: first evaluation]. Epidemiol Prev 2018; 42:12-14. [PMID: 29506356 DOI: 10.19191/ep18.1.p012.010] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Annibale Biggeri
- Dipartimento di statistica, informatica, applicazioni "G. Parenti", Università di Firenze.
- Società per l'epidemiologia e la prevenzione "Giulio A. Maccacaro", impresa sociale srl, Milano
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20
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Faggiano F, Ferrante G. [The place of prevention]. Epidemiol Prev 2018; 42:100-101. [PMID: 29506376 DOI: 10.19191/ep18.1.p100.029] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Fabrizio Faggiano
- Osservatorio epidemiologico, ASL Vercelli.
- Dipartimento di medicina traslazionale, Università del Piemonte orientale, Novara
| | - Gianluigi Ferrante
- Centro nazionale di ricerca e valutazione preclinica e clinica dei farmaci, Istituto superiore di sanità, Roma
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Affiliation(s)
- Anne Papas
- Ifsi Pitié-Salpêtrière, 47, boulevard de l'Hôpital, 75013 Paris, France.
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22
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Emenaker NJ, Vargas AJ. Nutrition and Cancer Research: Resources for the Nutrition and Dietetics Practitioner. J Acad Nutr Diet 2018; 118:550-554. [PMID: 29289548 DOI: 10.1016/j.jand.2017.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/13/2017] [Indexed: 11/17/2022]
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Abstract
PURPOSE OF REVIEW The aim of this study is to summarize monitoring, prevention and treatment options of glucocorticoid-induced osteoporosis for patients on chronic glucocorticoid therapy. RECENT FINDINGS Recent meta-analyses highlight the efficacy of bisphosphonate use in improving bone mineral density and in reducing vertebral fractures in the setting of long-term glucocorticoid use. A new study has now shown that alendronate also reduces the risk of hip fracture in glucocorticoid use. Emerging data indicate that teriparatide and denosumab also reduce the risk of osteoporotic fracture in glucocorticoid-induced osteoporosis. SUMMARY Glucocorticoid use is a leading cause of secondary osteoporosis; however, patients at risk of glucocorticoid-induced osteoporosis are often not evaluated or treated in a timely manner. Patients on a dose equivalent of 2.5 mg prednisone or greater for 3 months or longer duration should have their fracture risk assessed. Those at moderate or high risk should start bisphosphonate therapy, or if contraindicated, a second-line agent such as teriparatide or denosumab.
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Affiliation(s)
- Emory Hsu
- Emory University School of Medicine, Atlanta, Georgia, USA
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24
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Cislaghi C. [Restarting with prevention?]. Epidemiol Prev 2017; 41:220. [PMID: 29119747 DOI: 10.19191/ep17.5-6.p220.072] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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25
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Neves-E-Castro M. The only best way to care for climacteric women. Gynecol Endocrinol 2017; 33:501-502. [PMID: 28368212 DOI: 10.1080/09513590.2017.1302422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Narimatsu H. Gene-Environment Interactions in Preventive Medicine: Current Status and Expectations for the Future. Int J Mol Sci 2017; 18:ijms18020302. [PMID: 28146085 PMCID: PMC5343838 DOI: 10.3390/ijms18020302] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 01/12/2017] [Accepted: 01/26/2017] [Indexed: 11/16/2022] Open
Abstract
The progression of many common disorders involves a complex interplay of multiple factors, including numerous different genes and environmental factors. Gene-environmental cohort studies focus on the identification of risk factors that cannot be discovered by conventional epidemiological methodologies. Such epidemiological methodologies preclude precise predictions, because the exact risk factors can be revealed only after detailed analyses of the interactions among multiple factors, that is, between genes and environmental factors. To date, these cohort studies have reported some promising results. However, the findings do not yet have sufficient clinical significance for the development of precise, personalized preventive medicine. Especially, some promising preliminary studies have been conducted in terms of the prevention of obesity. Large-scale validation studies of those preliminary studies, using a prospective cohort design and long follow-ups, will produce useful and practical evidence for the development of preventive medicine in the future.
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Affiliation(s)
- Hiroto Narimatsu
- Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama 241-8515, Japan.
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Parackal S. Dietary Transition in the South Asian Diaspora: Implications for Diabetes Prevention Strategies. Curr Diabetes Rev 2017; 13:482-487. [PMID: 27586360 DOI: 10.2174/1573399812666160901094741] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 12/30/2015] [Revised: 02/10/2016] [Accepted: 03/05/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND South Asians (SA) have a four to five fold higher risk for type 2 diabetes mellitus (T2DM) in comparison to other Asian migrant groups. Dietary patterns have been attributed as an important independent modifiable risk factor. OBJECTIVE The aim of this review is to document the dietary patterns of SA migrants in Western countries and to summarize the evidence for the association of dietary patterns with T2DM and its predisposing factors. METHODS Using key search words articles from 1990 onwards were sourced from MEDLINE Pro- Quest and PubMed (not MEDLINE) databases for this narrative review. RESULTS A significant shift in meal pattern with frequent dining out and eating fast foods, traditional festival foods and Western desserts and snacks was common among SA. Consumption of potatoes, dairy, oil, meat and fish increased and beans, lentils, fruits and vegetables decreased post-migration. "Animal protein" and "fried snacks, sweets and high-fat dairy" were associated with greater insulin resistance and lower HDL cholesterol. A "mixed" dietary pattern was associated with obesity and hypertension and a "western" dietary pattern was associated with overall risk for Metabolic Syndrome. A 70% increase in the odds of diabetes per standard deviation in gram of protein intake was also observed. CONCLUSION Dietary patterns pave the way to develop diabetes and other obesity related diseases among SA as duration of residence increases. The first five years since migration maybe a window of opportunity to provide targeted interventions to ensure maintenance of healthy dietary habits.
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Affiliation(s)
- Sherly Parackal
- Preventive and Social Medicine, Dunedin School of Medicine, Faculty of Health Science, University of Otago. New Zealand
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29
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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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Daldrup-Link HE, Sammet C, Hernanz-Schulman M, Barsness KA, Cahill AM, Chung E, Doria AS, Darge K, Krishnamurthy R, Lungren MP, Moore S, Olivieri L, Panigrahy A, Towbin AJ, Trout A, Voss S. White Paper on P4 Concepts for Pediatric Imaging. J Am Coll Radiol 2016; 13:590-597.e2. [PMID: 26850380 DOI: 10.1016/j.jacr.2015.10.028] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 10/20/2015] [Accepted: 10/21/2015] [Indexed: 12/21/2022]
Abstract
Over the past decade, innovations in the field of pediatric imaging have been based largely on single-center and retrospective studies, which provided limited advances for the benefit of pediatric patients. To identify opportunities for potential "quantum-leap" progress in the field of pediatric imaging, the ACR-Pediatric Imaging Research (PIR) Committee has identified high-impact research directions related to the P4 concept of predictive, preventive, personalized, and participatory diagnosis and intervention. Input from 237 members of the Society for Pediatric Radiology was clustered around 10 priority areas, which are discussed in this article. Needs within each priority area have been analyzed in detail by ACR-PIR experts on these topics. By facilitating work in these priority areas, we hope to revolutionize the care of children by shifting our efforts from unilateral reaction to clinical symptoms, to interactive maintenance of child health.
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Affiliation(s)
- Heike E Daldrup-Link
- Lucile Packard Children's Hospital, Stanford School of Medicine, Palo Alto, California.
| | - Christina Sammet
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | | | | | | | - Ellen Chung
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Kassa Darge
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Matthew P Lungren
- Lucile Packard Children's Hospital, Stanford School of Medicine, Palo Alto, California
| | - Sheila Moore
- Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | | | - Andrew Trout
- Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Stephan Voss
- Children's Hospital of Boston, Boston, Massachusetts
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31
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Fewtrell MS, Haschke F, Prescott SL. Preface. Nestle Nutr Inst Workshop Ser 2016; 85:VII-IX. [PMID: 27556125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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32
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Bokarev IN, Kondrat'eva TB. [New anticoagulants in clinical practice. Effectiveness and problems]. Klin Med (Mosk) 2016; 94:383-387. [PMID: 30289652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We analyze the effectiveness of new oral anticoagulants and antivitamins K for the treatment of patients with venous problems, atrial fibrillation, and acute coronary syndrome with reference to advantages of this therapy and methods of prevention of complications of these conditions.
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Stussman BJ, Black LI, Barnes PM, Clarke TC, Nahin RL. Wellness-related Use of Common Complementary Health Approaches Among Adults: United States, 2012. Natl Health Stat Report 2015:1-12. [PMID: 26556396] [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: 06/05/2023]
Abstract
OBJECTIVE This report presents national estimates of selected wellness-related reasons for the use of natural product supplements, yoga, and spinal manipulation among U.S. adults in 2012. Self-reported perceived health outcomes were also examined. METHODS Data from 34,252 adults aged 18 and over collected as part of the 2012 National Health Interview Survey were analyzed for this report. In particular, whether adults who used selected complementary health approaches did so to treat a specific health condition or for any of five wellness-related reasons was examined, as well as whether these adults perceived that this use led to any of nine health-related outcomes. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adults population. RESULTS Users of natural product supplements and yoga were more likely to have reported using the approach for a wellness reason than for treatment of a specific health condition, whereas more spinal manipulation users reported using it for treatment rather than for wellness. The most common wellness-related reason reported by user of each of the three approaches was for "general wellness or disease prevention." The majority of users of all three health approaches reported that they perceived this use improved their overall health and made them feel better. Yoga users perceived higher rates of all of the self-reported wellness-related health outcomes than users of natural product supplements or spinal manipulation.
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Sykut-Cegielska J, Bożkowa K. WHY THE RARE DISEASES BECOME TO BE A CHALLENGE FOR MEDICINE OF TODAY? Dev Period Med 2015; 19:401-402. [PMID: 27030832] [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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35
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Zhao Y. [Biological safety of nanomaterials: the opportunity and challenge of preventive medicine]. Zhonghua Yu Fang Yi Xue Za Zhi 2015; 49:761-765. [PMID: 26733131] [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: 06/05/2023]
Abstract
Nanotechnology, as a newly arisen technology, does not only benefit people, but also become one of the inevitable threats to public health due to the widely application of nanomaterials. The safety evaluation of nanomaterials has become one of the hottest research topics in the 21st century, which provides opportunities and challenges in the field of preventive medicine once in a blue moon. Although the history of development in the safety assessment of nanomaterials is just over twenty years, the achievements could not be underestimated. This paper summarized the research of nano biological, predicted the directions for future research, and proposed several recommendations, based on which, we hope it can promote the sustainable development safety in China.
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Affiliation(s)
- Yuliang Zhao
- National Center for Nanoscience and Technology of China, Beijing 100190, China;
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36
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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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37
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Sprinks J. What the chancellor's cuts today mean for public health tomorrow. Nurs Stand 2015; 29:12-13. [PMID: 26080958 DOI: 10.7748/ns.29.42.12.s13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
England's health service is grappling with an ageing population coupled with a desire for people to live well for longer. In its attempts to address such pressures on NHS resources, the government wants people to take control of their own health and to focus more on preventive measures.
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Abstract
Illness prevention is a priority for the NHS Mandate and the Five Year Forward View, and offers a means to maintain sustainable health and social care services in the context of an ageing population and the growth of behaviour-related illness. The National Institute for Health and Care Excellence guidance recommends a structured approach to embedding behaviour change interventions into clinical care, and effective implementation requires organisational support. This article describes how nurse leaders, managers and commissioners can ensure this implementation through setting objectives for staff, training and development, as well as supporting staff to adopt healthier lifestyles.
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Ilnitski AN, Prashchayeu KI, Trofimova SV, Birjukova IV. [Preventive geriatrics vs anti-aging medicine]. Adv Gerontol 2015; 28:589-593. [PMID: 28509502] [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
The article presents the main modern ideas of the new interdisciplinary direction at the junction of aesthetic medicine, geriatrics and valeology - preventive geriatrics, or the anti-aging medicine. Describes its purpose, namely effective individual programs of prevention of the development and progression of chronic diseases and age-related conditions; the overview of the diagnostic methods used in preventive geriatrics, individualized prevention programs with proven efficacy is given. Substantiates the importance of preventive geriatrics (anti-aging medicine) as a discipline with its own scientific methodological tools, points of application, and presents prospects of scientific study.
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Affiliation(s)
- A N Ilnitski
- Institute of cvalification improvement of Federal medico-biological agency, Moscow, 125371, Russian Federation;
| | - K I Prashchayeu
- Research Medical Center «Gerontology», Khimki, Moscow region, 126000, Russian Federation
| | - S V Trofimova
- Saint-Petersburg Institute of Bioregulation and Gerontology, Saint-Petersburg, 197110, Russian Federation
| | - I V Birjukova
- Saint-Petersburg Institute of Bioregulation and Gerontology, Saint-Petersburg, 197110, Russian Federation
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40
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Project aims to halve preventable stillbirths by 2020. Pract Midwife 2014; 17:8. [PMID: 25597128] [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: 06/04/2023]
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Nelken-Bestvina D, Kurc-Bionda A, Vojvodić Z, Babić I, Pavleković G, Sošić Z. Trends in preventive activities for the adult population in family medicine in Croatia: 1995-2012. Coll Antropol 2014; 38 Suppl 2:61-66. [PMID: 25643529] [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
A few preventive activities were recorded in Croatian family medicine (FM) from 1995 until 2003, and then in 2004, additional fee-for-service reimbursement for general check-ups for people aged 45 to 65 years was introduced. The aim of this study was to investigate the trends in preventive activities before and after the introduction of those measures by using the Croatian Health Service Yearbooks for 1995-2012 as the main database. Data on the number of preventive, general, and total number of check-ups were collected. The results showed that the total number of check-ups registered in FM was low, suggesting that the additional reimbursement did not bring any improvements. In fact, the trend in the number decreased after 2004. These results are not unexpected because of the ineffectiveness of general check-ups as indicated in the literature. General check-ups should be replaced by targeted preventive interventions with evidence-based effectiveness.
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Abstract
In response to growing interest in economic analyses of prevention efforts, a diverse group of prevention researchers, economists, and policy analysts convened a scientific panel, on "Research Priorities in Economic Analysis of Prevention" at the 19th annual conference of the Society for Prevention Research. The panel articulated four priorities that, if followed in future research, would make economic analyses of prevention efforts easier to compare and more relevant to policymakers and community stakeholders. These priorities are: (1) increased standardization of evaluation methods, (2) improved economic valuation of common prevention outcomes, (3) expanded efforts to maximize evaluation generalizability and impact as well as (4) enhanced transparency and communicability of economic evaluations. In this paper, we define three types of economic analyses in prevention, provide context and rationale for these four priorities as well as related sub-priorities, and discuss the challenges inherent in meeting them.
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Affiliation(s)
- D Max Crowley
- Center for Child and Family Policy, Duke University, Durham, NC, USA,
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Bendeković Z, Simić D, Gladović A, Kovačić L. Changes in the organizational structure of public health nurse service in the Republic of Croatia 1995 to 2012. Coll Antropol 2014; 38 Suppl 2:85-89. [PMID: 25643533] [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
Since 1996, after the privatization of primary health care, public health nurse (PHN) in Croatia remained employed within the health center, mainly responsible for the preventive care of the inhabitants from defined catchment's area. Before that time they were part of general practice teams. The main aim of the study was to investigate what are the trends in the organizational structure of PHN service in Croatia, from 1995-2012. The main source was the Croatian Health Service Yearbooks. The obtained results shows that they are college educated and mostly in full-time jobs. The important findings are the lack of nurses and theirs regional differences. In highly demanding societies, with growing numbers of elderly, mental, social and economic problems, it will be worthy to consider the lower standard then 5 100 inhabitants per one PHN. Also, it should be taken into account to invest into the lowering of regional disparities.
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Iakovleva TV, Baranov AA, Ivanova AA, Al'bitskii VI. [The organizational principles and technologies of prevention of the XXI century]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2014:3-9. [PMID: 25799742] [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
The article considers organizational principles, technologies and criteria of effectiveness of actual preventive activities considering indicators of health condition of children and adolescents. The structures participating in implementation of general and specific prevention among children and adolescents are presented. The structures' functions are enumerated concerning development of succession and unity of preventive environment. The particular attention is paid to development of informational and telecommunication technologies in the fields of health care legal support of health care of children and adolescents, manpower development in area of preventive pediatrics.
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Ponomarenko VA, Vorona AA. [Suppositions for development of preventive military air medicine]. Voen Med Zh 2014; 335:55-59. [PMID: 25532313] [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
It is shown that on the basis of scientific concepts for regenerative medicine and organizational principles of prevention as a result of the research were revealed fundamental laws of life of the organism in an unusual environment. It is concluded that the need to integrate the methodology of research and testing aircraft and medical equipment on a single scientific basis. This will enable more productive use of research results in the field of ergonomics, ecology, and computer science in order to preserve the life and health of military personnel and maintain their combat capability.
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Rakhmanin YA, Mikhaylova RI. [Environment and health: priorities for preventive medicine]. Gig Sanit 2014:5-10. [PMID: 25831920] [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
Contemporary environmental factors influencing the formation of the environment and public health have been analyzed The increasing chemical pollution of the environment (air water, soil, living environment), and the intensification of the impact of physical factors in the first place, "electromagnetic smog" associated with the widespread use of appliances and computer equipment, cellular threaten public health have been shown. In this connection, there were determined priorities and main directions of research in the platform "Preventive Environment", approved by Ministry of Health of Russia, which is based on the concept of the factor prevention of noninfectious diseases.
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Abstract
The possibility for one generation to eradicate a disease is very motivating. It is also very difficult. The many failed eradication attempts outnumber the one current success (smallpox), although two eradication campaigns for polio and Guinea worm are tantalisingly close to their goals. The early stages of a well-planned eradication campaign generally go well; it is the last stage where technical, biological, social and political problems occur. This paper considers the opportunities and pitfalls in planning for eradication of a disease.
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Buchtiyrov IV, Denisov EI, Eryomin AL. [Bases of information hygiene: concepts and problems of innovations]. Gig Sanit 2014:5-9. [PMID: 25842485] [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
The rising flow of information affects the health and affords ground for strengthening measures of hygienists. There is considered the place of information hygiene in preventive medicine. There are discussed physical and hygienic aspects of measurement and evaluation of information, there are considered some of their negative consequences. International and local regulations and guidance documents in this area are presented. In the light of the strategy of innovative development of Russia there are considered hygienic aspects of innovation and the improvement of hygienic standards.
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Halban PA, Polonsky KS, Bowden DW, Hawkins MA, Ling C, Mather KJ, Powers AC, Rhodes CJ, Sussel L, Weir GC. β-cell failure in type 2 diabetes: postulated mechanisms and prospects for prevention and treatment. J Clin Endocrinol Metab 2014; 99:1983-92. [PMID: 24712577 PMCID: PMC5393482 DOI: 10.1210/jc.2014-1425] [Citation(s) in RCA: 143] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This article examines the foundation of β-cell failure in type 2 diabetes (T2D) and suggests areas for future research on the underlying mechanisms that may lead to improved prevention and treatment. RESEARCH DESIGN AND METHODS A group of experts participated in a conference on 14-16 October 2013 cosponsored by the Endocrine Society and the American Diabetes Association. A writing group prepared this summary and recommendations. RESULTS The writing group based this article on conference presentations, discussion, and debate. Topics covered include genetic predisposition, foundations of β-cell failure, natural history of β-cell failure, and impact of therapeutic interventions. CONCLUSIONS β-Cell failure is central to the development and progression of T2D. It antedates and predicts diabetes onset and progression, is in part genetically determined, and often can be identified with accuracy even though current tests are cumbersome and not well standardized. Multiple pathways underlie decreased β-cell function and mass, some of which may be shared and may also be a consequence of processes that initially caused dysfunction. Goals for future research include to 1) impact the natural history of β-cell failure; 2) identify and characterize genetic loci for T2D; 3) target β-cell signaling, metabolic, and genetic pathways to improve function/mass; 4) develop alternative sources of β-cells for cell-based therapy; 5) focus on metabolic environment to provide indirect benefit to β-cells; 6) improve understanding of the physiology of responses to bypass surgery; and 7) identify circulating factors and neuronal circuits underlying the axis of communication between the brain and β-cells.
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Valsecchi M. [Reducing inequality by improving preventing measures]. Ann Ig 2014; 26:29-38. [PMID: 25486690] [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
Terms of inequalities issue in health service are defined and the consolidated scientific acquisitions are recalled. Three prioritary areas of action are defined and described, that Prevention Departments are suggested to activate through focused programs in order to reduce specific inequalities. First area of action: includes three types of vital interventions: vaccinations, contrasting of tuberculosis infection and oncological screening that have to be granted to specific disadvantaged groups of population as Rom communities, immigrant women, prisoners e psychiatric patients. Second area of action: actions on focused urban planning aiming to improve conditions of social housing (with a special focus on thermal insulation, minimal distances to be kept towards streets of havy traffic), increase of increase of urban green spaces enjoyed by the population and contrasting degradation of housing (with particular attention to poisoning by carbon monoxide). Third area of action: actions contrasting cardiovascular diseases, that is the leading cause of death and inequalities in health for the working class population. A coordinated intervention directly in the workplace is proposed, where a particularly high percentage of individuals exposed to specific risk factors is present.
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