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1.
Transfusion ; 64(6): 1008-1015, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38660952

RESUMO

BACKGROUND: Despite being the largest racial/ethnic minority group in the United States, Hispanic/Latinos (H/L) are significantly underrepresented among blood donors. A lack of proximal blood donation opportunities may be one factor contributing to these disparities. However, few studies have investigated this possibility. STUDY DESIGN AND METHODS: Proprietary data on mobile blood collections in Maricopa County, Arizona, were gathered for the period of January 01, 2022 to April 30, 2022 and paired with census tract information using ArcGIS. Maricopa County encompasses the city of Phoenix with a total population of approximately 4.5 million people, including 1.5 million H/L residents. Blood drive count was regressed on H/L ethnic density and total population, and model estimates were exponentiated to obtain odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: During the specified period, approximately 27,000 red blood cell units were collected through mobile drives. Consistent with expectations, when controlling for total neighborhood population, each 10% increase in H/L ethnic density lowered the odds of having a blood drive in the corresponding neighborhood by 12% (OR = 0.88, 95% CI (0.83, 0.92), p < .001). DISCUSSION: These findings provide initial evidence of fewer proximal donation opportunities in areas with greater H/L population density which may contribute to H/L underrepresentation in blood donation and the need for more inclusive collection efforts. Improved access to blood collection is modifiable and could help to increase the overall blood supply, enhance the ability to successfully match specific blood antigen needs of an increasingly diverse population, and bring about a more resilient blood system.


Assuntos
Doadores de Sangue , Hispânico ou Latino , Humanos , Doadores de Sangue/estatística & dados numéricos , Arizona , Feminino , Masculino , Hispânico ou Latino/estatística & dados numéricos , Características de Residência , Etnicidade , Adulto , Doação de Sangue
2.
Psychol Res ; 88(5): 1437-1447, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38573358

RESUMO

The Autobiographical Interview, a method for evaluating detailed memory of real-world events, reliably detects differences in episodic specificity at retrieval between young and older adults in the laboratory. Whether this age-associated reduction in episodic specificity for autobiographical event retrieval is present outside of the laboratory remains poorly understood. We used a videoconference format to administer the Autobiographical Interview to cognitively unimpaired older adults (N = 49, M = 69.5, SD = 5.94) and young adults (N = 54, M = 22.5, SD = 4.19) who were in their homes at the time of retrieval. Relative to young adults, older adults showed reduced episodic specificity in their home environment, as reflected by fewer episodic or "internal" details (t (101) = 3.23, p = 0.009) and more "external" details (i.e., semantic, language-based details) (t (101) = 3.60, p = 0.003). These findings, along with detail subtype profiles in the narratives, bolster the ecological validity of the Autobiographical Interview and add promise to the use of virtual cognitive testing to improve the accessibility, participant diversity, scalability, and ecological validity of memory research.


Assuntos
Memória Episódica , Rememoração Mental , Humanos , Masculino , Feminino , Idoso , Rememoração Mental/fisiologia , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Envelhecimento/fisiologia , Envelhecimento/psicologia , Narração , Fatores Etários , Adolescente , Comunicação por Videoconferência
3.
JAMA ; 332(1): 51-57, 2024 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-38833246

RESUMO

Importance: Falls are the leading cause of injury-related morbidity and mortality among older adults in the US. In 2018, 27.5% of community-dwelling adults 65 years or older reported at least 1 fall in the past year and 10.2% reported a fall-related injury. In 2021, an estimated 38 742 deaths resulted from fall-related injuries. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the effectiveness and harms of primary care-relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling adults 65 years or older. Population: Community-dwelling adults 65 years or older at increased risk of falls. Evidence Assessment: The USPSTF concludes with moderate certainty that exercise interventions provide a moderate net benefit in preventing falls and fall-related morbidity in older adults at increased risk for falls. The USPSTF concludes with moderate certainty that multifactorial interventions provide a small net benefit in preventing falls and fall-related morbidity in older adults at increased risk for falls. Recommendation: The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (B recommendation) The USPSTF recommends that clinicians individualize the decision to offer multifactorial interventions to prevent falls to community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient's values and preferences. (C recommendation).


Assuntos
Acidentes por Quedas , Terapia por Exercício , Vida Independente , Idoso , Humanos , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Comitês Consultivos , Exercício Físico , Atenção Primária à Saúde , Medição de Risco , Estados Unidos/epidemiologia
4.
JAMA ; 332(11): 906-913, 2024 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-39163015

RESUMO

Importance: Iron deficiency is the leading cause of anemia during pregnancy. According to survey data from 1999 to 2006, overall estimated prevalence of iron deficiency during pregnancy is near 18% and increases across the 3 trimesters of pregnancy (from 6.9% to 14.3% to 28.4%). An estimated 5% of pregnant persons have iron deficiency anemia. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the evidence on the benefits and harms of screening and supplementation for iron deficiency with and without anemia on maternal and infant health outcomes in asymptomatic pregnant persons. Population: Asymptomatic pregnant adolescents and adults. Evidence Assessment: The USPSTF concludes that the current evidence is insufficient, and the balance of benefits and harms of screening for iron deficiency and iron deficiency anemia in asymptomatic pregnant persons on maternal and infant health outcomes cannot be determined. The USPSTF also concludes that the current evidence is insufficient, and the balance of benefits and harms of iron supplementation in asymptomatic pregnant persons on maternal and infant health outcomes cannot be determined. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for iron deficiency and iron deficiency anemia in pregnant persons to prevent adverse maternal and infant health outcomes. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine supplementation for iron deficiency and iron deficiency anemia in pregnant persons to prevent adverse maternal and infant health outcomes. (I statement).


Assuntos
Anemia Ferropriva , Suplementos Nutricionais , Programas de Rastreamento , Complicações Hematológicas na Gravidez , Humanos , Gravidez , Feminino , Anemia Ferropriva/prevenção & controle , Anemia Ferropriva/diagnóstico , Adulto , Complicações Hematológicas na Gravidez/prevenção & controle , Adolescente , Ferro/uso terapêutico , Ferro/administração & dosagem , Deficiências de Ferro , Doenças Assintomáticas
5.
JAMA ; 332(3): 226-232, 2024 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-38888912

RESUMO

Importance: Approximately 19.7% of children and adolescents aged 2 to 19 years in the US have a body mass index (BMI) at or above the 95th percentile for age and sex, based on Centers for Disease Control and Prevention growth charts from 2000. The prevalence of high BMI increases with age and is higher among Hispanic/Latino, Native American/Alaska Native, and non-Hispanic Black children and adolescents and children from lower-income families. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the evidence on interventions (behavioral counseling and pharmacotherapy) for weight loss or weight management in children and adolescents that can be provided in or referred from a primary care setting. Population: Children and adolescents 6 years or older. Evidence Assessment: The USPSTF concludes with moderate certainty that providing or referring children and adolescents 6 years or older with a high BMI to comprehensive, intensive behavioral interventions has a moderate net benefit. Recommendation: The USPSTF recommends that clinicians provide or refer children and adolescents 6 years or older with a high BMI (≥95th percentile for age and sex) to comprehensive, intensive behavioral interventions. (B recommendation).


Assuntos
Terapia Comportamental , Índice de Massa Corporal , Obesidade Infantil , Adolescente , Criança , Feminino , Humanos , Aconselhamento , Obesidade Infantil/terapia , Obesidade Infantil/prevenção & controle , Atenção Primária à Saúde , Encaminhamento e Consulta , Redução de Peso , Indígena Americano ou Nativo do Alasca , Hispânico ou Latino , Negro ou Afro-Americano , Pobreza
6.
JAMA ; 331(11): 951-958, 2024 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-38502069

RESUMO

Importance: Child maltreatment, which includes child abuse and neglect, can have profound effects on health, development, survival, and well-being throughout childhood and adulthood. The prevalence of child maltreatment in the US is uncertain and likely underestimated. In 2021, an estimated 600 000 children were identified by Child Protective Services as experiencing abuse or neglect and an estimated 1820 children died of abuse and neglect. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate benefits and harms of primary care-feasible or referable behavioral counseling interventions to prevent child maltreatment in children and adolescents younger than 18 years without signs or symptoms of maltreatment. Population: Children and adolescents younger than 18 years who do not have signs or symptoms of or known exposure to maltreatment. Evidence Assessment: The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of primary care interventions to prevent child maltreatment in children and adolescents younger than 18 years without signs or symptoms of or known exposure to maltreatment. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care interventions to prevent child maltreatment. (I statement).


Assuntos
Maus-Tratos Infantis , Atenção Primária à Saúde , Adolescente , Criança , Humanos , Comitês Consultivos , Terapia Comportamental , Maus-Tratos Infantis/mortalidade , Maus-Tratos Infantis/prevenção & controle , Serviços de Proteção Infantil/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Encaminhamento e Consulta , Medição de Risco , Estados Unidos/epidemiologia
7.
JAMA ; 331(4): 329-334, 2024 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-38261037

RESUMO

Importance: Speech and language delays and disorders can pose significant problems for children and their families. Evidence suggests that school-aged children with speech or language delays may be at increased risk of learning and literacy disabilities, including difficulties with reading and writing. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate benefits and harms of screening for speech and language delay and disorders in children 5 years or younger. Population: Asymptomatic children 5 years or younger whose parents or clinicians do not have specific concerns about their speech, language, hearing, or development. Evidence Assessment: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for speech and language delay and disorders in children who do not present with signs or symptoms or parent/caregiver concerns. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for speech and language delay and disorders in children 5 years or younger without signs or symptoms. (I statement).


Assuntos
Transtornos do Desenvolvimento da Linguagem , Programas de Rastreamento , Criança , Humanos , Comitês Consultivos , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Pré-Escolar , Doenças Assintomáticas
8.
JAMA ; 331(22): 1918-1930, 2024 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-38687503

RESUMO

Importance: Among all US women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2023, an estimated 43 170 women died of breast cancer. Non-Hispanic White women have the highest incidence of breast cancer and non-Hispanic Black women have the highest mortality rate. Objective: The USPSTF commissioned a systematic review to evaluate the comparative effectiveness of different mammography-based breast cancer screening strategies by age to start and stop screening, screening interval, modality, use of supplemental imaging, or personalization of screening for breast cancer on the incidence of and progression to advanced breast cancer, breast cancer morbidity, and breast cancer-specific or all-cause mortality, and collaborative modeling studies to complement the evidence from the review. Population: Cisgender women and all other persons assigned female at birth aged 40 years or older at average risk of breast cancer. Evidence Assessment: The USPSTF concludes with moderate certainty that biennial screening mammography in women aged 40 to 74 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older and the balance of benefits and harms of supplemental screening for breast cancer with breast ultrasound or magnetic resonance imaging (MRI), regardless of breast density. Recommendation: The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasonography or MRI in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement).


Assuntos
Neoplasias da Mama , Detecção Precoce de Câncer , Mamografia , Humanos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/diagnóstico por imagem , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Imageamento por Ressonância Magnética , Fatores Etários , Ultrassonografia Mamária , Estados Unidos , Programas de Rastreamento
9.
Psychosom Med ; 85(2): 165-174, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36729601

RESUMO

OBJECTIVE: Hispanic/Latino(x) and African American/Black older adults experience disproportionate cardiometabolic disease burdens when compared with their non-Hispanic White counterparts. Sources of resilience such as social networks have been found to mitigate the risk of this disease and its end points like high-sensitivity C-reactive protein (hs-CRP). However, little is known about the social network infrastructure among these groups. Moreover, existing work has largely ignored the degree to which members of one's network are connected to one another (network density), which may be important for navigating structural barriers within interdependent groups. The objective of this study was to understand the association between network density and 5-year hs-CRP (blood spot) and whether this association was moderated by race-ethnicity. METHODS: A subsample of Hispanic/Latino(x), African American/Black, and non-Hispanic White older adults ( N = 1431) from the National Social Life Health and Aging Project was used. Multivariable regression was used to estimate the association between network density and its interaction with race-ethnicity, with hs-CRP 5 years later. RESULTS: Although no main effect of network density on 5-year hs-CRP was found, results revealed a significant network density by race-ethnicity interaction (Wald χ2 (2, 1242) = 3.31, p = .037). Simple slopes analyses revealed that Hispanic/Latino(x) older adults with high network density had significantly lower hs-CRP levels when compared with their same-ethnic counterparts with low network density ( b = -0.73, standard error = 0.31, 95% confidence interval = -1.33 to -0.13, p = .018). CONCLUSIONS: Results demonstrate population-level differences in social network structure and differential associations of this infrastructure with health. Implications for the Hispanic Mortality Paradox are discussed.


Assuntos
Proteína C-Reativa , Hispânico ou Latino , Rede Social , Idoso , Humanos , Proteína C-Reativa/análise , Etnicidade , Estados Unidos/epidemiologia
10.
Psychosom Med ; 85(6): 545-550, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37260255

RESUMO

OBJECTIVE: Bereavement is among the most impactful psychosocial stressors for cardiovascular health, and hypertensive episodes accompanying bereavement-related distress are one putative mechanism for this effect. The present study examined hemodynamic responses to the Grief Recall (GR), a promising method for studying the effects of acute grief on cardiovascular function, and the relationship of grief severity to blood pressure (BP) response. METHODS: N = 59 participants within 1 year of the loss of a close loved one completed the GR, a semistructured interview protocol for eliciting bereavement-related distress (a "grief pang") and cardiovascular response. Systolic (SBP) and diastolic BP (DBP) were measured at two time points: a) an attention-control baseline and (2) after a 10-minute GR interview. Baseline versus post-GR SBP and DBP differences (i.e., BP response) were measured. Grief severity was examined as a predictor of SBP and DBP response, as well as BP recovery. RESULTS: SBP and DBP increased significantly after GR (SBP, +21.10 mm Hg; DBP, +8.10 mm Hg). Adjusting for variables relevant to cardiovascular function and bereavement (antihypertensive medication use, days since death, gender, age), grief severity predicted the magnitude of increase after GR in SBP but not DBP. No relationship of grief severity and recovery was observed. CONCLUSIONS: The observed association between hemodynamic response and grief severity suggests a mechanistic contribution from hemodynamic effects of acute grief episodes to the cardiovascular impact of grief. This is the first study to show that increased symptoms of prolonged grief disorder are associated with an elevated SBP response. The GR may have further utility for research examining physiological responses to bereavement-related emotions.


Assuntos
Luto , Hipertensão , Adulto , Humanos , Transtorno do Luto Prolongado , Pesar , Pressão Sanguínea/fisiologia
11.
Brain Behav Immun ; 109: 168-174, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36681360

RESUMO

INTRODUCTION: Individuals with greater affect variability (i.e., moment-to-moment fluctuations possibly reflecting emotional dysregulation) are at risk for greater systemic inflammation, which is associated with cardiovascular disease. Some evidence suggests that affect variability is linked with poorer health indicators only among those with higher average levels of affect, particularly for positive affect (PA), and that associations may be non-linear. The present study sought to examine whether links between both PA and negative affect (NA) variability and inflammation are moderated by average level of affect. METHODS: Participants (N = 300, 50 % female, ages 21-70, 60 % non-Hispanic White, 19 % Hispanic, 15 % non-Hispanic Black) completed a lab assessment and provided a blood sample to measure systemic inflammation (i.e., TNF-α, IL-6, CRP). Affect was collected via a two-day ecological momentary assessment protocol where reports were collected about every 45-min during waking hours. Momentary affect ratings were averaged across both days (i.e., iM), separately for PA and NA, for each participant. Affect variability was calculated as the person-specific SD (i.e., iSD) of affect reports, separately for PA and NA. Linear and quadratic interactions were tested. Models included covariates for sex, race, and body mass index. RESULTS: There were significant interactions between NA iM and NA iSD predicting TNF-α (b = 6.54; p < 0.05) and between PA iM and PA iSD predicting IL-6 (b = 0.45; p < 0.05). Specifically, the association between these affect variability indicators and inflammatory markers were suggestive of a positive association among those with higher average affect but a negative association among those with lower average affect. There was no evidence of non-linear associations between affect and inflammation. DISCUSSION: Incorporating interactive effects between affect variability and average affect may be an important consideration in understanding affective-inflammatory associations.


Assuntos
Interleucina-6 , Fator de Necrose Tumoral alfa , Humanos , Feminino , Adulto Jovem , Adulto , Masculino , Inflamação , Avaliação Momentânea Ecológica , Afeto/fisiologia
12.
Behav Sleep Med ; : 1-17, 2023 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-37968911

RESUMO

OBJECTIVES: The present study investigated the roles birthplace and acculturation play in sleep estimates among Hispanic/Latino population at the US-Mexico border. MEASURES: Data were collected in 2016, from N = 100 adults of Mexican descent from the city of Nogales, AZ, at the US-Mexico border. Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index categorized as none, mild, moderate, and severe, and Multivariable Apnea Prediction Index (MAP) categorized as never, infrequently, and frequently. Acculturation was measured with the Acculturation Rating Scale for Mexican-Americans II (ARSMA-II). RESULTS: The sample consisted of majority Mexican-born (66%, vs. born in the USA 38.2%). Being born in the USA was associated with 55 fewer minutes of nighttime sleep (p = .011), and 1.65 greater PSQI score (p = .031). Compared to no symptoms, being born in the USA was associated with greater likelihood of severe difficulty falling asleep (OR = 8.3, p = .030) and severe difficulty staying asleep (OR = 11.2, p = .050), as well as decreased likelihood of breathing pauses during sleep (OR = 0.18, P = .020). These relationships remained significant after Mexican acculturation was entered in these models. However, greater Anglo acculturation appears to mediate one fewer hour of sleep per night, poorer sleep quality, and reporting of severe difficulty falling asleep and staying asleep. CONCLUSIONS: Among individuals of Mexican descent, being born in the USA (vs Mexico) is associated with about 1 hour less sleep per night, worse sleep quality, more insomnia symptoms, and less mild sleep apnea symptoms. These relationships are influenced by acculturation, primarily the degree of Anglo rather than the degree of Mexican acculturation.

13.
J Pers ; 91(3): 683-699, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-35988017

RESUMO

INTRODUCTION: Negative affective symptoms (e.g., anxiety, depression, and anger) are correlated and have parallel associations with outcomes, as do related personality traits (i.e., facets of neuroticism), often prompting statistical control (i.e., partialing) to determine independent effects. However, such adjustments among predictor variables can alter their construct validity. In three studies, the interpersonal circumplex (IPC) and a related analytic approach (i.e., Structural Summary Method) were used to evaluate changes in interpersonal correlates of negative affective characteristics resulting from partialing. METHODS: Samples of undergraduates (Sample 1 n = 3283; Sample 2 = 688) and married couples (n = 300 couples) completed self-report (three samples) and partner rating (sample 3) measures of anxiety, depression and anger, and IPC measures of interpersonal style. RESULTS: Anxiety, depression, and anger had expected interpersonal correlates across samples. Partialing depression eliminated interpersonal correlates of anxiety. When anxiety was controlled, depression measures were more strongly associated with submissiveness and less closely associated with low warmth. Adjustments involving anger magnified differences in dominance versus submissiveness associated with the negative affects. DISCUSSION: Removal of overlap among negative affective measures via partialing alters their interpersonal correlates, potentially complicating interpretation of adjusted associations.


Assuntos
Sintomas Afetivos , Relações Interpessoais , Humanos , Ansiedade/psicologia , Cônjuges/psicologia , Autorrelato
14.
Br J Sports Med ; 57(10): 595-601, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36878667

RESUMO

OBJECTIVES: To examine the internal consistency reliability and measurement invariance of a questionnaire battery designed to identify college student athletes at risk for mental health symptoms and disorders. METHODS: College student athletes (N=993) completed questionnaires assessing 13 mental health domains: strain, anxiety, depression, suicide and self-harm ideation, sleep, alcohol use, drug use, eating disorders, attention deficit hyperactivity disorder (ADHD), bipolar disorder, post-traumatic stress disorder (PTSD), gambling and psychosis. Internal consistency reliability of each measure was assessed and compared between sexes as well as to previous results in elite athletes. Discriminative ability analyses were used to examine how well the cut-off score on the strain measure (Athlete Psychological Strain Questionnaire) predicted cut-offs on other screening questionnaires. RESULTS: Strain, anxiety, depression, suicide and self-harm ideation, ADHD, PTSD and bipolar questionnaires all had acceptable or better internal consistency reliability. Sleep, gambling and psychosis questionnaires had questionable internal consistency reliability, although approaching acceptable for certain sex by measure values. The athlete disordered eating measure (Brief Eating Disorder in Athletes Questionnaire) had poor internal consistency reliability in males and questionable internal consistency reliability in females. CONCLUSIONS: The recommended mental health questionnaires were generally reliable for use with college student athletes. To truly determine the validity of the cut-off scores on these self-report questionnaires, future studies need to compare the questionnaires to a structured clinical interview to determine the discriminative abilities.


Assuntos
Atletas , Saúde Mental , Masculino , Feminino , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Estudantes
15.
JAMA ; 330(3): 253-260, 2023 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-37462699

RESUMO

Importance: Familial hypercholesterolemia and multifactorial dyslipidemia are 2 conditions that cause abnormally high lipid levels in children, which can lead to premature cardiovascular events (eg, myocardial infarction and stroke) and death in adulthood. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for lipid disorders in asymptomatic children and adolescents. Population: Asymptomatic children and adolescents 20 years or younger without a known diagnosis of a lipid disorder. Evidence Assessment: The USPSTF concludes that the current evidence is insufficient and the balance of benefits and harms for screening for lipid disorders in asymptomatic children and adolescents 20 years or younger cannot be determined. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents 20 years or younger. (I statement).


Assuntos
Dislipidemias , Programas de Rastreamento , Adolescente , Criança , Humanos , Comitês Consultivos , Dislipidemias/complicações , Dislipidemias/diagnóstico , Dislipidemias/terapia , Lipídeos , Programas de Rastreamento/efeitos adversos , Programas de Rastreamento/métodos , Serviços Preventivos de Saúde , Medição de Risco , Adulto Jovem , Doenças Assintomáticas , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle
16.
JAMA ; 330(8): 736-745, 2023 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-37606666

RESUMO

Importance: An estimated 1.2 million persons in the US currently have HIV, and more than 760 000 persons have died of complications related to HIV since the first cases were reported in 1981. Although treatable, HIV is not curable and has significant health consequences. Therefore, effective strategies to prevent HIV are an important public health and clinical priority. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of preexposure prophylaxis with antiretroviral therapy for the prevention of HIV acquisition, and the diagnostic accuracy of risk assessment tools to identify persons at increased risk of HIV acquisition. Population: Adolescents and adults who do not have HIV and are at increased risk of HIV. Evidence Assessment: The USPSTF concludes with high certainty that there is a substantial net benefit from the use of effective antiretroviral therapy to reduce the risk of acquisition of HIV in persons at increased risk of acquiring HIV. Recommendation: The USPSTF recommends that clinicians prescribe preexposure prophylaxis using effective antiretroviral therapy to persons at increased risk of HIV acquisition to decrease the risk of acquiring HIV. (A recommendation).


Assuntos
Antirretrovirais , Infecções por HIV , Profilaxia Pré-Exposição , Adolescente , Adulto , Humanos , Comitês Consultivos , Antirretrovirais/administração & dosagem , Antirretrovirais/efeitos adversos , Antirretrovirais/uso terapêutico , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/etiologia , Infecções por HIV/prevenção & controle , Profilaxia Pré-Exposição/métodos , Profilaxia Pré-Exposição/normas , Serviços Preventivos de Saúde , Saúde Pública , Medição de Risco/métodos , Medição de Risco/normas , Estados Unidos/epidemiologia
17.
JAMA ; 330(11): 1074-1082, 2023 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-37721605

RESUMO

Importance: Hypertensive disorders of pregnancy are among the leading causes of maternal morbidity and mortality in the US. The rate of hypertensive disorders of pregnancy has been increasing from approximately 500 cases per 10 000 deliveries in 1993 to 1021 cases per 10 000 deliveries in 2016 to 2017. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for hypertensive disorders of pregnancy. Population: Pregnant persons without a known diagnosis of a hypertensive disorder of pregnancy or chronic hypertension. Evidence Assessment: The USPSTF concludes with moderate certainty that screening for hypertensive disorders in pregnancy with blood pressure measurements has substantial net benefit. Recommendation: The USPSTF recommends screening for hypertensive disorders in pregnant persons with blood pressure measurements throughout pregnancy. (B recommendation).


Assuntos
Hipertensão Induzida pela Gravidez , Feminino , Humanos , Gravidez , Comitês Consultivos , Hipertensão Induzida pela Gravidez/diagnóstico , Serviços Preventivos de Saúde , Programas de Rastreamento , Determinação da Pressão Arterial
18.
JAMA ; 330(17): 1666-1673, 2023 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-37934215

RESUMO

Importance: Oral health is fundamental to health and well-being across the lifespan. Oral health conditions affect the daily lives of school-age children and adolescents, leading to loss of more than 51 million school hours every year. Untreated oral health conditions in children can lead to serious infections and affect growth, development, and quality of life. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate screening and preventive interventions for oral health conditions in children and adolescents aged 5 to 17 years. Population: Asymptomatic children and adolescents aged 5 to 17 years. Evidence Assessment: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for oral health conditions (eg, dental caries) performed by primary care clinicians in asymptomatic children and adolescents aged 5 to 17 years. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions for oral health conditions (eg, dental caries) performed by primary care clinicians in asymptomatic children and adolescents aged 5 to 17 years. Recommendations: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening performed by primary care clinicians for oral health conditions, including dental caries, in children and adolescents aged 5 to 17 years. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions performed by primary care clinicians for oral health conditions, including dental caries, in children and adolescents aged 5 to 17 years. (I statement).


Assuntos
Cárie Dentária , Saúde Bucal , Adolescente , Criança , Humanos , Comitês Consultivos , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Qualidade de Vida , Programas de Rastreamento , Pré-Escolar , Doenças Assintomáticas , Atenção Primária à Saúde , Doenças Estomatognáticas/diagnóstico , Doenças Estomatognáticas/prevenção & controle , Medição de Risco , Estados Unidos/epidemiologia
19.
JAMA ; 330(18): 1773-1779, 2023 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-37934473

RESUMO

Importance: Oral health is fundamental to health and well-being across the life span. Dental caries (cavities) and periodontal disease (gum disease) are common and often untreated oral health conditions that affect eating, speaking, learning, smiling, and employment potential. Untreated oral health conditions can lead to tooth loss, irreversible tooth damage, and other serious adverse health outcomes. Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate screening and preventive interventions for oral health conditions in adults. Population: Asymptomatic adults 18 years or older. Evidence Assessment: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for oral health conditions (eg, dental caries or periodontal disease) performed by primary care clinicians in asymptomatic adults. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions for oral health conditions (eg, dental caries or periodontal disease) performed by primary care clinicians in asymptomatic adults. Recommendations: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening performed by primary care clinicians for oral health conditions, including dental caries or periodontal-related disease, in adults. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions performed by primary care clinicians for oral health conditions, including dental caries or periodontal-related disease, in adults. (I statement).


Assuntos
Cárie Dentária , Doenças Periodontais , Adulto , Humanos , Programas de Rastreamento/efeitos adversos , Saúde Bucal , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Cárie Dentária/etiologia , Serviços Preventivos de Saúde , Doenças Periodontais/diagnóstico , Doenças Periodontais/prevenção & controle , Atenção Primária à Saúde
20.
JAMA ; 329(15): 1290-1295, 2023 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-37071089

RESUMO

Importance: Skin cancer is the most commonly diagnosed cancer in the US. There are different types of skin cancer varying in disease incidence and severity. Basal and squamous cell carcinomas are the most common types of skin cancer but infrequently lead to death or substantial morbidity. Melanomas represent about 1% of skin cancer and cause the most skin cancer deaths. Melanoma is about 30 times more common in White persons than in Black persons. However, persons with darker skin color are often diagnosed at later stages, when skin cancer is more difficult to treat. Objective: To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on the benefits and harms of screening for skin cancer in asymptomatic adolescents and adults. Population: Asymptomatic adolescents and adults who do not have a history of premalignant or malignant skin lesions. Evidence Assessment: The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in asymptomatic adolescents and adults. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adolescents and adults. (I statement).


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Detecção Precoce de Câncer , Programas de Rastreamento , Melanoma , Neoplasias Cutâneas , Adolescente , Adulto , Humanos , Detecção Precoce de Câncer/efeitos adversos , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/efeitos adversos , Programas de Rastreamento/métodos , Melanoma/diagnóstico , Exame Físico/efeitos adversos , Exame Físico/métodos , Medição de Risco , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/prevenção & controle , Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico
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