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Preventive Health

Géraldine Bloy, Laetitia Moussard Philippon, Laurent Rigal
INTRODUCTION: Healthy behaviours become less common when descending the social ladder, which contributes to social inequalities in health. General practitioners (GPs) could have an impact on this general trend by providing preventive care counselling. We wanted to describe the social inequalities related to physical activity (PA) and the counselling given to patients, in order to improve our understanding of how inequalities can be produced at the doctor-patient relationship level. METHODS: Prev Quanti simultaneously examined social differences in the patients' level of PA and in the PA counselling provided by their GPs...
September 6, 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
[Introduction: Reduction of social inequalities in health has been one of the main political pillars of Regional Health Agencies in France since their creation in 2009. This paper presents a contextual analysis of the effects on social inequalities in health of a hospital-based health promotion and disease prevention programme in terms of overall health policy and scope.Methods: Qualitative analysis was used to describe the impact on social inequalities in health according to the classification proposed by Diderichsen et al. Carey’s framework was used to apply proportionate universalism in order to analyse its action on these inequalities, adopting a contextualised and holistic approach with regard to regional and national public policy. The results showed that the intervention focused on targeted actions, but may have broader applications. The intervention strategy shifts between closing the inequality gap and levelling up the social gradient. However, analysis of this type of intervention using the proportionate universalism framework may lead to a revised view of the effects of the intervention on social inequalities in health.Results: Implementing health-equity focused interventions remains a challenge for each institution, including Regional Health Agencies. However, research on hospital-based preventive interventions highlights contrasting results in terms of social gradient, depending on whether the intervention is considered in isolation or in its broader context.Discussion].
Marion Porcherie, Blanche Le Bihan-Youinou, Jeanine Pommier
INTRODUCTION: Reduction of social inequalities in health has been one of the main political pillars of Regional Health Agencies in France since their creation in 2009. This paper presents a contextual analysis of the effects on social inequalities in health of a hospital-based health promotion and disease prevention programme in terms of overall health policy and scope. METHODS: Qualitative analysis was used to describe the impact on social inequalities in health according to the classification proposed by Diderichsen et al...
September 6, 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
Bastien Affeltranger, Louise Potvin, Christine Ferron, Hélène Vandewalle, Alexandre Vallée
Although their design may feature a considerable amount of universalism, prevention strategies often produce results that are socially and/or spatially differentiated. This differentiation process can induce social or territorial gradients of access to and/or effectiveness of prevention and, in turn, worsen health inequalities. This process also accentuates the gap between the principles of certain public policies and their practical implementation, raising the question of the real benefit of these policies for beneficiaries...
September 6, 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
Anthony Jehn, Anna Zajacova
OBJECTIVES: Disability is a major concern for the health of midlife and older Canadians. Understanding disability trends is critical for detecting socio-economic and health precursors that could be amenable to policy interventions. The purpose of this study is to assess trends in rates of disability among Canadian adults age 40-64 and 65+. We also examine the impact of changing socio-demographic and health factors over time on the trends. METHODS: Data from the 2001-2014 Canadian Community Health Survey (CCHS), a repeated cross-sectional nationally representative study, are used to estimate age- and gender-stratified logistic regression models of disability as a function of the year of interview to assess trends...
December 13, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Stephanie Fischinger, Carolyn M Boudreau, Audrey L Butler, Hendrik Streeck, Galit Alter
Vaccines are among the most impactful public health interventions, preventing millions of new infections and deaths annually worldwide. However, emerging data suggest that vaccines may not protect all populations equally. Specifically, studies analyzing variation in vaccine-induced immunity have pointed to the critical impact of genetics, the environment, nutrition, the microbiome, and sex in influencing vaccine responsiveness. The significant contribution of sex to modulating vaccine-induced immunity has gained attention over the last years...
December 13, 2018: Seminars in Immunopathology
Motohiro Fujiwara, Naoko Kawamura, Tetsuo Okuno
Renal angiomyolipoma without local invasion is usually considered benign entity, however, it may extend into the renal vein or the inferior vena cava. Renal angiomyolipoma with venous extension should be treated; however, surgical complications such as iatrogenic pulmonary fat embolism remain a serious concern. We present a case of a 66-year-old Japanese woman without tuberous sclerosis in whom a right-sided renal tumor was incidentally detected on ultrasonography during a health check-up. Further evaluation showed that the tumor extended into the renal vein, and she was successfully treated using preoperative inferior vena cava filter placement and radical nephrectomy...
November 2018: Journal of Rural Medicine: JRM
Pedro R Pereira, Marta Guimarães, Tiago Morais, Sofia S Pereira, Mário Nora, Mariana P Monteiro
Background/Objetives: Obesity and obesity related co-morbidities are well-recognized risks for cardiovascular (CV) disease and mortality. Weight loss improves CV risk factors and the efficacy of bariatric surgery in decreasing CV mortality is now well-established. Our aim was to assess CV risk progression and occurrence of CV events in a cohort of patients that underwent Roux-en-Y gastric bypass (RYGB) for obesity treatment in a single academic public center. Subjects and Methods: Ten year CV risk was estimated using the Framingham Equation at baseline and 2 years after RYGB surgery in our patients cohort ( n = 260)...
2018: Frontiers in Endocrinology
Michael A Lindsey, Andrae Banks, Catherine F Cota, Marquisha Lawrence Scott, Sean Joe
The objective was to qualitatively examine the treatment effects of depression interventions on young, Black males (YBM) across treatment providers and settings via a review. Randomized controlled trials (RCTs) seeking to ameliorate depressive symptomology in Black males ages 12-29 were eligible for inclusion. After review of 627 abstracts and 212 full-text articles, 12 studies were selected. These RCTs were organized into five categories based on the intervention method. We isolated only one study that targeted YBM exclusively...
March 1, 2018: Research on Social Work Practice
Akhilanand Chaurasia, Gaurav Katheriya
Background: Injuries of the maxillofacial complex represent one of the most important health problems worldwide. At present, in developing India, due to poor traffic sense, maxillofacial trauma and fractures are most epidemiologic diseases. Mandible is the largest and strongest facial bone and it is the second most commonly fractured bone. Mandibular fractures can involve only one site or can often involve multiple anatomic sites simultaneously. Aims: The present study is aimed to know the age- and sex-related prevalence of parasymphyseal fracture, fracture of angle, condylar fracture, symphyseal fracture, and coronoid fracture of mandible in North Indian population...
July 2018: National Journal of Maxillofacial Surgery
Silvia A Purro, Mark A Farrow, Jacqueline Linehan, Tamsin Nazari, David X Thomas, Zhicheng Chen, David Mengel, Takashi Saito, Takaomi Saido, Peter Rudge, Sebastian Brandner, Dominic M Walsh, John Collinge
We previously reported1 the presence of amyloid-β protein (Aβ) deposits in individuals with Creutzfeldt-Jakob disease (CJD) who had been treated during childhood with human cadaveric pituitary-derived growth hormone (c-hGH) contaminated with prions. The marked deposition of parenchymal and vascular Aβ in these relatively young individuals with treatment-induced (iatrogenic) CJD (iCJD), in contrast to other prion-disease patients and population controls, allied with the ability of Alzheimer's disease brain homogenates to seed Aβ deposition in laboratory animals, led us to argue that the implicated c-hGH batches might have been contaminated with Aβ seeds as well as with prions...
December 13, 2018: Nature
Raul E Piña-Aguilar, Sheila A Simpson, Abdulrahman Alshatti, Angus Clarke, David Craufurd, Huw Dorkins, Karen Doye, Nayana Lahiri, Alison Lashwood, Colleen Lynch, Claire Miller, Sally Morton, Mary O'Driscoll, Oliver W Quarrell, Daniela Rae, Mark Strong, Charlotte Tomlinson, Peter Turnpenny, Zosia Miedzybrodzka
PURPOSE: There is little long-term, population-based data on uptake of prenatal diagnosis for Huntington disease (HD), a late-onset autosomal dominant neurodegenerative disorder, and the effect of the availability of preimplantation genetic diagnosis (PGD) on families' decisions about conventional prenatal diagnosis is not known. We report trends in prenatal diagnosis and preimplantation diagnosis for HD in the United Kingdom since services commenced. METHODS: Long-term UK-wide prospective case record-based service evaluation in 23 UK Regional Genetic Centres 1988-2015, and four UK PGD centers 2002-2015...
December 14, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Saroj Niraula, Zoann Nugent
Background: FDA approvals do not consider cost, but they set the tone for regulatory approvals worldwide, including in countries with universal healthcare where cost-effectiveness, utility, and adoption feasibility are considered rigorously. Methods: Data from the pan-Canadian Oncology Drug Review (pCODR), a national drug review system that makes evidence-based funding recommendations to Canada's provinces and territories, were collected. Our objectives were to assess (1) temporal trends in cost and efficacy of drugs reviewed, (2) correlations among magnitude of benefits, cost, and pCODR decisions, and (3) predictors of approvals...
December 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Tanner J Caverly, Rodney A Hayward, James F Burke
OBJECTIVE: To investigate the credibility of claims that general practitioners lack time for shared decision making and preventive care. DESIGN: Monte Carlo microsimulation study. SETTING: Primary care, United States. PARTICIPANTS: Sample of general practitioners (n=1000) representative of annual work hours and patient panel size (n=2000 patients) in the US, derived from the National Health and Nutrition Examination Survey...
December 13, 2018: BMJ: British Medical Journal
Arjan van der Tol, Norbert Lameire, Rachael L Morton, Wim Van Biesen, Raymond Vanholder
BACKGROUND AND OBJECTIVES: The prevalence of patients with ESKD who receive extracorporeal kidney replacement therapy is rising worldwide. We compared government reimbursement for hemodialysis and peritoneal dialysis worldwide, assessed the effect on the government health care budget, and discussed strategies to reduce the cost of kidney replacement therapy. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Cross-sectional global survey of nephrologists in 90 countries to assess reimbursement for dialysis, number of patients receiving hemodialysis and peritoneal dialysis, and measures to prevent development or progression of CKD, conducted online July to December of 2016...
December 13, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Tiba Delespierre, Loic Josseran
BACKGROUND: New nursing homes (NH) data warehouses fed from residents' medical records allow monitoring the health of elderly population on a daily basis. Elsewhere, syndromic surveillance has already shown that professional data can be used for public health (PH) surveillance but not during a long-term follow-up of the same cohort. OBJECTIVE: This study aimed to build and assess a national ecological NH PH surveillance system (SS). METHODS: Using a national network of 126 NH, we built a residents' cohort, extracted medical and personal data from their electronic health records, and transmitted them through the internet to a national server almost in real time...
December 13, 2018: JMIR Public Health and Surveillance
Yulin Hswen, John A Naslund, John S Brownstein, Jared B Hawkins
BACKGROUND: People with schizophrenia experience elevated risk of suicide. Mental health symptoms, including depression and anxiety, contribute to increased risk of suicide. Digital technology could support efforts to detect suicide risk and inform suicide prevention efforts. OBJECTIVE: This exploratory study examined the feasibility of monitoring online discussions about suicide among Twitter users who self-identify as having schizophrenia. METHODS: Posts containing the terms suicide or suicidal were collected from a sample of Twitter users who self-identify as having schizophrenia (N=203) and a random sample of control users (N=173) over a 200-day period...
December 13, 2018: JMIR Mental Health
Mohammad M Mojahedian, Mahdi Toroski, Khosro Keshavarz, Mahdi Aghili, Shahryar Zeyghami, Shekoufeh Nikfar
PURPOSE: Prostate cancer is the second most common cancer among men worldwide. In the past 10 years in Iran, prostate cancer has increased and become more common among hormone-related cancers. As the percentage of seniors in the population increases, the economic burden of this cancer will likely increase significantly. This study aims to estimate direct and indirect costs of treatment at different stages of prostate cancer in Iran. METHODS: This cross-sectional study was conducted on 263 patients diagnosed with prostate cancer who were referred to prostate treatment centers in 2016...
December 10, 2018: Clinical Therapeutics
Ian Litchfield, Laura L Jones, Naiem Moiemen, Nicole Andrews, Sheila Greenfield, Jonathan Mathers
INTRODUCTION: For severe burns patient care presents a considerable challenge, necessitating an integrated multi-disciplinary approach that utilises a range of treatments. The period of care post-discharge can be lengthy and complex, and include scar management, occupational and physiotherapies, psychological support, and further surgery. How successfully the patient negotiates this complex care regimen is critical to their long-term recovery and in doing so they would appear to employ approaches recognised as "self-management" in other chronic conditions...
December 10, 2018: Burns: Journal of the International Society for Burn Injuries
Fabrizio Veglia, Damiano Baldassarre, Ulf de Faire, Sudhir Kurl, Andries J Smit, Rainer Rauramaa, Philippe Giral, Mauro Amato, Alessandro Di Minno, Alessio Ravani, Beatrice Frigerio, Samuela Castelnuovo, Daniela Sansaro, Daniela Coggi, Alice Bonomi, Calogero C Tedesco, Elmo Mannarino, Steve E Humphries, Anders Hamsten, Elena Tremoli
BACKGROUND: The Mediterranean Diet (MD) is a model of healthy eating contributing to a favorable health status, but its clinical usefulness is still debated. The aim of this study was to relate the adherence to MD with the incidence of cardio/cerebro-vascular events (VEs) in north and south European participants of the IMPROVE study. METHODS: IMPROVE is an observational, longitudinal, prospective cohort study involving 3703 individuals from five European countries (Finland, Sweden, Netherlands, France and Italy)...
November 29, 2018: International Journal of Cardiology
LáShauntá M Glover, Alain G Bertoni, Sherita H Golden, Peter Baltrus, Yuan-I Min, Mercedes R Carnethon, Herman Taylor, Mario Sims
AIM: To examine the association of psychosocial resources with prevalent type 2 diabetes (T2D) in 5104 African American men and women. METHODS: Using data from the Jackson Heart Study (JHS), we evaluated the cross-sectional associations of four psychosocial resources (social support, optimism, religiosity, and social networks) with T2D [fasting glucose ≥126 mg/dL, or HbA1c ≥ 6.5%, or use of diabetic medication]. Multivariable Poisson regression estimated prevalence ratios (PR, 95% confidence interval-CI) of T2D by each psychosocial measure, adjusting for demographics, SES, waist circumference, health behaviors, and depressive symptoms...
November 22, 2018: Journal of Diabetes and its Complications
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