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At least 1,081 records · Page 60Linked to original sources
PubMed2006

The reasons of general practitioners for promoting colorectal cancer mass screening in France.

Implementation of colorectal cancer (CRC) mass screening is a public health priority. Obtaining the involvement of general practitioners (GPs) is crucial for ensuring participation by the general public. This study elicited GPs' reasons for promoting CRC screening. The method used was discrete choice modeling. Questionnaires with a set of pairs of hypothetical screening scenarios were sent to 700 GPs. Factors influencing GPs' screening practice were found to be: the effectiveness of the screening program, the proportion of false negatives and false positives, and their remuneration. Hence improving screening test sensitivity and setting up specific remuneration for conducting screening would help to increase GPs' participation in CRC screening in France.

Adult↗
PubMed2025

Polygenic risk scores in the clinic: Health-system leaders and primary care providers weigh in.

PURPOSE: The fourth phase of the Electronic Medical Records and Genome Network is testing the return of 10 polygenic risk scores (PRS) across multiple clinics. Understanding the perspectives of health-system leaders and frontline clinicians can inform plans for implementation of PRS. METHODS: A total of 15 health-system leaders and 20 primary care providers took part in semistructured interviews. A descriptive thematic analysis was performed. RESULTS: Interviewees generally perceived PRS to have limited clinical utility, although they saw value in the potential to identify and act upon risks that are not otherwise detectable. Perceived potential drawbacks included negative psycho-emotional effects on patients, unnecessary follow-up, distracting from population health priorities, opportunity costs, and medicolegal liability. Implementation considerations included increased encounter time and the need for clinical practice guidelines, provider training, care coordination, and point-of-care resources. CONCLUSION: Participants generally expressed favorable views of precision medicine and also identified potential challenges to introducing PRS in clinical care. Implementation will require careful assessment of clinical utility vs usual care; ensuring that the benefit to be realized merits the time and resources required to interpret, return, and act on results and developing guidelines and other decision-making supports for providers and patients.

Humans↗
PubMed2004

The end of the disease era.

The time has come to abandon disease as the focus of medical care. The changed spectrum of health, the complex interplay of biological and nonbiological factors, the aging population, and the interindividual variability in health priorities render medical care that is centered on the diagnosis and treatment of individual diseases at best out of date and at worst harmful. A primary focus on disease may inadvertently lead to undertreatment, overtreatment, or mistreatment. The numerous strategies that have evolved to address the limitations of the disease model, although laudable, are offered only to a select subset of persons and often further fragment care. Clinical decision making for all patients should be predicated on the attainment of individual goals and the identification and treatment of all modifiable biological and nonbiological factors, rather than solely on the diagnosis, treatment, or prevention of individual diseases. Anticipated arguments against a more integrated and individualized approach range from concerns about medicalization of life problems to "this is nothing new" and "resources would be better spent determining the underlying biological mechanisms." The perception that the disease model is "truth" rather than a previously useful model will be a barrier as well. Notwithstanding these barriers, medical care must evolve to meet the health care needs of patients in the 21st century.

Delivery of Health Care↗
PubMed2006

The illness trajectory of elderly cancer patients across cultures: SIOG position paper.

BACKGROUND: Due to the aging of the population, cancer has become a health priority worldwide. While the number of elderly cancer patients is rapidly increasing, many barriers still exist to their effective management. Compared with their younger counterparts, the elderly are less likely to receive optimal medical, psychological and spiritual treatment provided in a culturally competent manner. DESIGN: The scanty literature on cultural competence in elderly cancer patients has been reviewed. Additional material has been selected based on the authors' clinical research in medical oncology and psycho-oncology, and on their scholarly work in anthropology and bioethics. RESULTS: The aging process is a synergistic product of biological, behavioral and social issues within a cultural context. Knowledge about how older people understand, perceive and experience their illness trajectory and make choices is essential to the planning and delivering of effective cancer care. CONCLUSION: This position paper of the SIOG Task Force on Cultural Competence in the Elderly creates awareness of the influence of culture in geriatric oncology. Negotiating cross-cultural issues in geriatric oncology helps managing possible conflicts between patients, families and physicians over differing health care values, beliefs, or practices. Possible areas of future scholarly investigation and clinical research are identified.

Aged↗
PubMedDate not supplied

Public-private partnership models in France and in Europe.

The workshop entitled "Public-Private partnerships models in Europe-- comparison between France and European countries" brought together representatives of academia and industry, of national or European health research programs, of regional or national public-private partnership (PPP) initiatives, and of biotechnology with the following objectives: sharing a common vision on the needs, expectations and challenges of public-private partnership, based on the analysis of actual and original cases, and of new initiatives on public-private partnership, drawing conclusions and identifying key success factors, identifying trails for progress and drawing recommendations. The major event in this field is a European public-private partnership initiative between pharmaceutical industry (European Federation of Pharmaceultical Industry and Associations, EFPIA) and the European Commission (DG Research--health priority) resulting in the European Technology Platform project "Innovative Medicines Initiative" (IMI). Its architecture is based on the identification of the main bottlenecks to the development of innovative treatments (predictive pharmacology and toxicology, identification and validation of biomarkers, patients' recruitment, risk evaluation, and cooperation with the regulatory authorities). Simultaneously, initiatives both at the national and regional levels also foster PPP in the therapeutic field. Regional competitivity clusters acting in the biomedical sector, and national PPP calls such as the ANR (National Research Agency) RIB (Research and Innovation in Biotechnology) call are incentives for PPP projects. These regional and national PPP levels help public and private partners to further build consortia able to compete for EU-level calls, thus acting as incubators for EU PPP projects. In spite of incentives and of the regional and national structuring of PPP, weaknesses in the French system are linked to its fragmentation--multiple transfer agencies, multiple research organisations (operator or funding agency)--making contracts more difficult. This requires a simplified organisation, with a single referent per area (health, technology...). Improvement may also result from adaptation in the carreer, recruitment and mobility, from support to scientists in the management of projects, and from consistent support (without maintaining them artificially alive) to emerging companies from concept through clinical development. Pathways have been proposed to improve the efficiency of clinical research in France and Europe, involving the public hospital sector, and this requires the connection of disease-oriented networks and integrated infrastructures in Europe. As stated in the IMI strategic research agenda on efficacy, the quality of public infrastructures in Europe will be a key factor for its competitiveness and attractiveness for both academic and industry projects.

Drug Industry↗
PubMed1991

Infection control: the premier quality assessment program in United States hospitals.

The three decennial international meetings of the Centers for Disease Control have reaffirmed the national health priority for prevention of nosocomial infections. Moreover, the past 20 years have seen the institutionalization of the infection control practitioner and hospital epidemiologist. The epidemiologic activities of these two groups have included access to medical care, identification of risk factors, and both prevention and control of adverse nosocomial events. As such, they represent experience with issues commonly referred to as quality of care. It is argued that infection control not only is now but has been from its inception the premier quality assessment program in the United States. Moreover, it is the only activity in quality assessment that has been shown to be efficacious.

Cross Infection↗
PubMed2006

Knowledge, attitude and perception of adults on childhood hypertension in a rural community in Nigeria.

BACKGROUND: Childhood hypertension is less common and not readily recognised compared to adult hypertension. It is being missed because of lack of routine blood pressure measurements in some health facilities in the developing countries. This setback is likely to affect the knowledge, attitude and perception of parents and caregivers to the disease. OBJECTIVE: To assess the knowledge, attitude and perception of childhood hypertension by adult respondents in a rural community in Nigeria. METHOD: The study was carried out with the aid of pre-tested questionnaires, which sought information on wide ranging issues bothering on knowledge, attitude and perception of childhood hypertension. RESULTS: Fifty-four 54/62 (89%) knew that hypertension implied high blood pressure. Fifty-eight 58/61(95%) also indicated that hypertension is detected by measuring the blood pressure. However 37/60 (62%) respondents did not think that childhood hypertension exist, while 53/59 (90%) respondents were not aware of any child diagnosed with hypertension. All our 62 respondents claimed to have seen 9 children with hypertension compared to 81 adults some of whom were related to them. CONCLUSIONS: We conclude that there is still a low awareness about the existence of childhood hypertension by the rural populace. While this problem is not a priority health problem in the community, an increased awareness of it is crucial the successful management of any child that develops it. Periodic community survey for childhood hypertension and mandatory routine blood pressure measurement in all children presenting for consultation is suggested.

Adolescent↗
PubMed2004

Child motor vehicle occupant and pedestrian casualties before and after enactment of child restraint seats legislation in Japan.

PROBLEM: Prevention of injuries to child passengers is a significant public health priority, as motor vehicle-related injuries remain a leading cause of death for children in Japan. The purpose of compulsory child restraint seats legislation in April 2000 was to reduce the number of child passengers killed or injured in motor vehicle crashes. METHODS: The objectives of this preliminary evaluation are to measure the effectiveness, benefits and usage of safety seats for child passengers aged 1-5 years by analysing the child casualty data for the period of 1997--2002. Population and vehicle miles travelled based injury and fatality rates were used to compare before and after legislation trends in child casualties. RESULTS: Despite overall increases in the use of child restraint seats (as observed by different national surveys), overall casualty rates in motor vehicle occupants in the 1-5 year age group did not change (fatalities and serious injuries) or even increased (minor injuries). CONCLUSIONS: Casualties among restrained children have not decreased since the law came to effect in the year 2000, perhaps because of incorrect usage of the seats. Given that exposure to crash environments is increasing, traffic safety advocates and public health community need to be aware of the importance of child restraints as a means of reducing the likelihood of injury. It is necessary to implement effective community-based child safety seat campaigns to disseminate the information on appropriate restraint use and to increase efforts to enforce the existing legislation.

Accidents, Traffic↗
PubMed2002

Neural and behavioral substrates of mood and mood regulation.

A review of behavioral and neurobiological data on mood and mood regulation as they pertain to an understanding of mood disorders is presented. Four approaches are considered: 1) behavioral and cognitive; 2) neurobiological; 3) computational; and 4) developmental. Within each of these four sections, we summarize the current status of the field and present our vision for the future, including particular challenges and opportunities. We conclude with a series of specific recommendations for National Institute of Mental Health priorities. Recommendations are presented for the behavioral domain, the neural domain, the domain of behavioral-neural interaction, for training, and for dissemination. It is in the domain of behavioral-neural interaction, in particular, that new research is required that brings together traditions that have developed relatively independently. Training interdisciplinary clinical scientists who meaningfully draw upon both behavioral and neuroscientific literatures and methods is critically required for the realization of these goals.

Affect↗
PubMed1994

Public knowledge about passive smoking: results from a survey in the Australian Capital Territory.

Spreading public knowledge about the health consequences of passive smoking is now a major health priority. Using data from a random sample of Australian Capital Territory residents conducted in November-December 1991, this paper examines the level of general and specific knowledge that individuals possess about passive smoking. While 87% of the sample gave an accurate definition of passive smoking, the 13% who did not were distinguished by lack of educational qualifications and by employment outside the government sector. A similar proportion did not see any illnesses being associated with passive smoking, and this group was significantly more likely to consist of current smokers. Employment status emerged as a factor influencing specific knowledge of passive smoking, highlighting the importance of continued moves to restrict smoking within the workplace.

Adolescent↗
PubMedDate not supplied

[Cigarette smoking habit among 8th graders in different Italian regions. Collaborative Group S.I.D.R.I.A. (Italian Studies on Respiratory Disorders in Childhood and the Environment)].

Smoking is still one of the greatest causes of premature death in the world. Preventing young people from beginning to smoke is a major public health priority. This paper describes smoking prevalence among eight graders in different geographical Italian areas, and the associations between smoking habit and behavioural risk factors. Data come from S.I.D.R.I.A.--Italian Studies on Respiratory Disorders in Childhood and the Environment--a collaborative research project which involved 21,846 eight graders living in ten different areas of Northern and Central Italy. Information was provided by both adolescents and parents through ad hoc questionnaires. The response rate was very high (96% for students and 94% for parents). Overall smoking prevalence is 8.8% (95% CI = 7.9-9.7); the prevalence rate is 10.5% and 6.9%, respectively for males and females. Current smoking (> 1 cigarettes/week) prevalence, 5.1% (6.1% males-4.0% females), is higher then occasional smoking prevalence (< 4 cigarettes/month), 3.7% (4.4% males-2.9% females). Father's education, household crowding and residence area are associated with students smoking habit. Behavioural variables associated with smoking among students are: parental smoking (OR = 2.11), others smoking in the household (OR = 1.84) and the hours spent in public places with smokers (> 7 hours/week) (OR = 12.6). These results suggest the need of taking into account the family and social environment in programming health educational activities aimed at reducing smoking among adolescents.

Adolescent↗
PubMed1999

Occurrence of chronic diseases and their impact on physical disability over the whole spectrum of aging: from 65 to over 100 years of age.

The aging of the Italian population is an emerging public health priority. In 2025 Italy is expected to have the highest world median age with nearly half of the population over 50 years old. To avoid an unbearable burden of disease and disability on future generations, we must identify areas for intensive disease and disability prevention programs. Preliminary results from the PRO.V.A study show that disability is associated with conditions that are potentially preventable as chronic diseases and falls or are treatable as chronic pains. Moreover, it is of extreme interest to identify and understand biological and environmental secrets of successful aging as the AKEA study tries to do and the ways of overcoming disabilities in the extreme limits of life more and more possible to reach.

Aged↗
PubMed2026

Association between fruit and vegetable intake and risk of depression: A systematic review and meta-analysis of prospective cohort studies.

Depression is a leading cause of global disability, and identifying modifiable lifestyle factors is a public health priority. We conducted a systematic review and dose-response meta-analysis of prospective cohort studies examining the association between fruit and vegetable intake and incident depression. PubMed, Web of Science, Scopus, Embase, and Google Scholar were searched through November 2025. Data on study characteristics, dietary assessment, outcomes, effect estimates, and covariates were independently extracted by two reviewers. Random-effects models were used to calculate pooled relative risks (RRs), and linear and non-linear dose-response relationships were assessed. Heterogeneity was evaluated using I2, and evidence certainty was rated with GRADE. Thirteen cohorts with 385,449 participants and 26,592 depression cases were included. Highest versus lowest combined fruit and vegetable intake was associated with a 37% lower risk of depression (RR: 0.63; 95% CI: 0.50, 0.80). Each 200&#xa0;g/day increase corresponded to a 16% risk reduction (RR: 0.84; 95% CI: 0.74-0.94). Separate analyses showed that fruit and vegetable intake reduced depression risk by 16% and 12%, respectively, with a non-linear dose-response for vegetables. These findings indicate that higher consumption of fruits and vegetables is associated with lower depression risk, supporting dietary strategies as a potential approach for mental health prevention. However, given the observational nature of the included studies, these results should be interpreted with caution, as residual confounding may partially account for the observed associations. Registration: This study was registered at PROSPERO (CRD420261279998).

Humans↗
PubMed2005

The lifestyle challenge program: a multidisciplinary approach to weight management.

BACKGROUND: The increasing prevalence of overweight and obesity in the US has received widespread attention and is highlighted in recent government-issued health priorities. While there are many weight loss programs in different settings, few include pharmacist involvement in spite of pharmacists' recognized easy accessibility to the public. OBJECTIVE: To provide insight into a successful, collaborative, multidisciplinary approach to weight management and to encourage pharmacists and other healthcare professionals to adopt a similar approach to patient management. METHODS: Adult patients >18 years of age were recruited from an outpatient university-based setting to participate in a weight management program. The principles of the program included diet, exercise, and behavior modification. The program was conducted through weekly one-hour group sessions held over a 20-week period. Faculty involved in the program included an attending physician specializing in nutrition, a pharmacist, and a behavioral psychologist. All data are expressed as mean +/- SD unless otherwise specified. RESULTS: Ninety participants (74 female, mean age 48 +/- 10 y) entered the program between April 2001 and April 2004. Participants had multiple obesity-related comorbid diseases. The weight of completers (n = 59) decreased from 100.9 +/- 20 kg at baseline to 97.3 +/- 19.5 kg at 10 weeks and 95.9 +/- 20 kg at 20 weeks. Thirty-nine patients completed both baseline and final assessments, which showed improvement in health-related quality of life, binge-eating behavior, and depressive symptoms (p < 0.05). CONCLUSIONS: This program is a successful multidisciplinary model for the management of overweight and obese patients in an outpatient-based hospital setting.

Adult↗
PubMed1994

Comparison of cancer mortality trends in major European areas, 1960-89.

In the prospect of a political and economic 'harmonization' of the European Economic Community (EEC) and, possibly, all Europe, the identification of differences in cancer frequencies and trends in major European areas (ie EEC, non-EEC western countries, and eastern European countries) can help to set health priorities. From 1960-64 to 1985-89 all-age mortality rates of some common cancers (mouth or pharynx, pancreas, lung, kidney, prostate and skin) increased substantially especially in East Europe. Conversely, mortality rates from cancer of the stomach, uterus, testis and from Hodgkin's disease declined, but, again, trends in East Europe were less favourable. Some elevations in rare malignancies (non-Hodgkin's lymphomas, multiple myeloma and connective and soft-tissue sarcomas) emerged rather uniformly in Europe, especially in elderly people. Most favourable trends in total cancer mortality were apparent among females in the EEC (minus 7%) and non-EEC western countries (minus 14%). The picture becomes gradually less favourable with respect to non-EEC western European males and eastern European females (virtually no change) and EEC males (plus 13%). With a 25% increase in total cancer mortality rates in the past 30 years, males in East Europe emerge as the 'problem' group. The even wider gap between West and East Europe in cancer rates in young males leaves no hope for future improvements in the absence of effective interventions. Raising public awareness (especially with respect to smoking and alcohol consumption), and increasing motivation and quality controls among health professionals are badly needed in disadvantaged European areas.

Adult↗
PubMed1993

Characteristics of death certifiers and institutions where death is pronounced--Fulton County, Georgia, 1991.

Information from death certificates (DCs) is used to measure health status and to set public health priorities at all levels in the United States. However, because of limitations in the training of physicians who certify deaths, the completeness and accuracy of cause-of-death information varies (1-3). To develop a basis for targeting education of physicians who certify deaths, CDC, in cooperation with the Fulton County (Georgia) Vital Records Office, reviewed a consecutive series of 500 DCs filed in Fulton County (1990 population: 648,951) from April 10 through May 2, 1991, to characterize the number and proportion of personal physicians (PPs) (defined as physician certifiers not acting in the capacity of medical examiners or coroners [MECs]) and MECs certifying death, as well as other factors. This report summarizes the results of that review.

Coroners and Medical Examiners↗
PubMed2006

Basic oral health needs: A professional priority?

The inadequacy of access to oral health care is a complex problem facing society. Many in society who need care are unable to obtain it or do not seek it for a variety of reasons. Most commonly, these are the unfunded, who simply have inadequate resources; the "unaccepted," who may not have dental coverage or have types of coverage that are not accepted by private practitioners; the inaccessible, who may be homebound or live in sparsely populated or low-income geographic areas without dental providers; the unconvinced, who may have resources but do not believe in or recognize the need for treatment; and the unmotivated, who may realize that they need care but for them it is not a priority. While the oral health care professions cannot be expected to shoulder the entire burden to "fix" inadequate access to care, we believe that they have important responsibilities. True professions have a unique relationship with society that places them in positions of trust. With this trust comes the responsibility for public policy advocacy and to actively participate in identifying realistic ways to reduce the access problem. The leadership of organized dentistry, as well as educational institutions, and practitioners themselves must be committed to improving access and thereby the health of those currently underserved.

Attitude of Health Personnel↗
PubMedDate not supplied

Preventing amputations from diabetes mellitus: the Indian Health Service experience.

With the heavy burden of diabetes mellitus among American Indians and Alaskan Natives, lower-extremity amputation (LEA) has become a common complication. Rates of diabetes-related LEA are 2-3 times those observed in other diabetic populations. During the past 12 years, the Indian Health Service (IHS) has made LEA prevention a public health priority. From 1988 to 1992 screening criteria based on simple examinations were developed and validated in primary care Settings. Prevention efforts have focused on targeting high-risk individuals for self-care foot education, provision of protective footwear, and routine podiatry care. Follow-up studies in Alaska and northern Minnesota saw 25-50% reductions in LEA rates associated with these interventions. In settings where these efforts were augmented with system changes, such as team coordination, patient-tracking systems, comprehensive footcare practice guidelines, flowsheets, and outreach programmes, LEA incidence was reduced by 50-75%. Efforts are currently underway to disseminate system-based approaches for comprehensive diabetic footcare and to expand the availability of foot care resources to tribal communities served by the IHS.

Alaska↗