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Biomedical subjects

Richard C Wender

Publications and source records attributed to Richard C Wender.

14 recordsLinked to original sources

A midpoint assessment of the American Cancer Society challenge goal to halve the U.S. cancer mortality rates between the years 1990 and 2015.

BACKGROUND: The American Cancer Society has challenged the U.S. to reduce cancer mortality rates 50% over the 25 years from 1990 to 2015. The current report is an analysis and commentary on progress toward that goal through 2002, the midpoint of the challenge period. METHODS: Cancer mortality rates were examined from 1990 through 2002, and projections to the Year 2015 were made. Cancer deaths that were prevented or deferred by the declining death rates were expressed as the difference between the observed and projected numbers of deaths and the numbers that would have been observed over that period had the 1990 death rates persisted. RESULTS: Since 1990, cancer mortality rates have been declining in the U.S. by approximately 1% per year. Trends especially have been favorable for cancers of the breast, prostate, and colorectum and for lung cancer among men. Should this rate of decline continue over the coming decade, death rates from cancer will be approximately 23% lower in the Year 2015 than they were in 1990, and approximately 1.8 million deaths from cancer will have been prevented or deferred. CONCLUSIONS: At this midpoint of the 25-year challenge period, it appears that fully reaching the goal will require substantial breakthroughs in cancer early detection and/or in cancer therapy. Between now and 2015, however, many more cancer deaths can be averted by concerted action to control tobacco and obesity, by redoubling efforts in mammography and colorectal screening, and by enacting policies to close gaps in access to cancer detection and treatment services.

Adult↗

Men's health.

Explore the source record for details and available documents.

Health Behavior↗

Management of epilepsy in adults. Diagnosis guidelines.

In this first of two articles on new epilepsy guidelines for primary care physicians, the authors present detailed algorithms for the diagnosis and classification of seizure disorders in adults. They discuss the differentiation between generalized and partial seizures and stress that accurate identification is especially important because the type of seizure determines the appropriate treatment. The second article (page 29) looks at the treatment portion of the new guidelines.

Adolescent↗

Management of epilepsy in adults. Treatment guidelines.

In this second of two articles on new epilepsy guidelines for primary care physicians, the authors discuss which treatments are the most effective in adults with this disease. They describe the antiepileptic drugs that are currently approved and elucidate the differences between established and newer options. Detailed algorithms cover pharmacotherapy, follow-up, and ongoing maintenance.

Adult↗

Do physicians in Delaware follow national guidelines for tobacco counseling?

BACKGROUND: Despite national guidelines, studies across the country have shown that many physicians do not regularly engage in tobacco cessation behaviors such as assisting their patients with quitting. This survey study examined tobacco cessation behaviors among physicians in Delaware as part of the state's tobacco control program called Plan for a Tobacco-Free Delaware. METHODS: A self-administered questionnaire was mailed to all Delaware physicians in primary care and specialties that manage tobacco-related illnesses (cardiology, pulmonology, and allergy) in May of 2002 (n=890). RESULTS: Of the 156 survey respondents, most physicians reported regularly asking their adolescent patients (57.3%) and their adult patients (65.4%) about smoking and advising their smoking patients to quit (84%). Most physicians do not regularly assist patients in quitting (17.6%) or arrange follow-up (28.1%). Also, most physicians do not regularly prescribe nicotine replacement (12.9%) or bupropion (10.7%), nor do they regularly give written materials to help in quitting (16.3%) or refer patients to smoking cessation programs (14.7%). CONCLUSIONS: While most physicians in Delaware ask their patients about smoking and advise them to quit, most physicians do not adequately assist their smoking patients in accordance with national guidelines. Reasons include lack of time, lack of quick and easy tools to help patients quit, and inadequate reimbursement for physicians' tobacco cessation activities and medications. This article suggests ways that the state can assist physicians with tobacco cessation that can be incorporated into the Plan for a Tobacco-Free Delaware. In particular, ensuring adequate and universal reimbursement for physician visits related to tobacco cessation, for tobacco cessation programs, and for tobacco cessation medications is essential to increasing physician involvement in tobacco cessation activities.

Adult↗

Cancer screening.

Table 3 provides a summary of key recommendations for each cancer site discussed in this chapter. One of the unifying principles of cancer screening is that every clinician or group practice needs to define an explicit screening policy. Resources must then be devoted to implementing this policy, evaluating adherence, and improving performance.

Adult↗

Barriers to screening for colorectal cancer.

Rapidly growing interest in colon cancer screening is a crucial first step to identifying and reducing many of the barriers that impede population screening for this common disease. Promoting screening demands health care policy change to increase the percentage of Americans with insurance coverage that includes a colon cancer screening benefit. A systematic approach to screening with invitations that come from a clinician are likely to be the most effective way to prompt more individuals to be screened. Awareness campaigns and patient educational aids, including decision tools, implemented in multiple sites, such as worksites, community centers, health care systems, and physician offices, increase the percent of eligible Americans who understand their personal risk, the need for screening, and the options available to them.

Barium Sulfate↗

NIH funding in family medicine: an analysis of 2003 awards.

PURPOSE: We wanted to analyze National Institutes of Health (NIH) awards to departments of family medicine. METHODS: We obtained the list of NIH awards to departments of family medicine in 2003, and collected additional information from the Internet regarding each principal investigator (PI), including whether he or she worked primarily in a core (central) organizational component within a family medicine department. RESULTS: One hundred forty-nine NIH awards were granted to 45 departments of family medicine, for a total of 60,085,000 dollars. Of 146 awards with a designated PI, approximately two thirds of awards (89, 61%) and awarded dollars (39,850,000 dollars, 70%) went to PIs who were either not full-time family medicine faculty primarily working in family medicine departments, or they were not working in core family medicine organizational components. Few awards to physician PIs in these non-core areas were to family physicians (4 of 37, 11%), whereas most awards to physician PIs in core family medicine areas went to family physicians (40 of 45, 89%). In contrast, most K awards (research career programs) went to PIs in core areas (19 of 23, 83%), and most to family physicians (17 of 23, 74%). Nationally, only 17 R01 awards (research project, traditional) went to family physicians. CONCLUSIONS: Most NIH awards to family medicine departments went to PIs in noncore organizational components, where most physician PIs were not family physicians. Family medicine departments interested in increasing NIH funding may want to consider 4 models that appear to exist: individual faculty in core departmental components, K awards, core faculty also working in university-wide organizational components that provide research infrastructure, and integrating noncore administrative components into the department.

Awards and Prizes↗