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4.
J Public Health Manag Pract ; 27(4): 417, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34004626
5.
J Public Health Manag Pract ; 27(3): E126-E142, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-31688741

RESUMO

CONTEXT: The US government manages a large number of data sets, including federally funded data collection activities that examine infectious and chronic conditions, as well as risk and protective factors for adverse health outcomes. Although there currently is no mature, comprehensive metadata repository of existing data sets, US federal agencies are working to develop and make metadata repositories available that will improve discoverability. However, because these repositories are not yet operating at full capacity, researchers must rely on their own knowledge of the field to identify available data sets. PROGRAM OR POLICY: We sought to identify and consolidate a practical and annotated listing of those data sets. IMPLEMENTATION AND/OR DISSEMINATION: Creative use of data resources to address novel questions is an important research skill in a wide range of fields including public health. This report identifies, promotes, and encourages the use of a range of data sources for health, behavior, economic, and policy research efforts across the life span. EVALUATION: We identified and organized 28 federal data sets by the age-group of primary focus; not all groups are mutually exclusive. These data sets collectively represent a rich source of information that can be used to conduct descriptive epidemiologic studies. DISCUSSION: The data sets identified in this article are not intended to represent an exhaustive list of all available data sets. Rather, we present an introduction/overview of the current federal data collection landscape and some of its largest and most frequently utilized data sets.


Assuntos
Longevidade , Coleta de Dados , Humanos , Estados Unidos
8.
Gerontologist ; 59(Suppl 1): S1-S6, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31511747

RESUMO

Over two-thirds of all new cancers are diagnosed among adults aged ≥60 years. As the number of adults living to older ages continues to increase, so too will the number of new cancer cases. Can we do more as a society to reduce cancer risk and preserve health as adults enter their 60s, 70s, and beyond? Cancer development is a multi-step process involving a combination of factors. Each cancer risk factor represents a component of cancer causation, and opportunities to prevent cancer may exist at any time up to the final component, even years after the first. The characteristics of the community in which one lives often shape cancer risk-related behaviors and exposures over time, making communities an ideal setting for efforts to reduce cancer risk at a population level. A comprehensive approach to cancer prevention at older ages would lower exposures to known causes of cancer, promote healthy social and physical environments, expand the appropriate use of clinical preventive services, and engage older adults in these efforts. The collection of articles in this supplement provide innovative insights for exciting new directions in research and practice to expand cancer prevention efforts for older adults. This brief commentary sets the stage for the papers that follow.


Assuntos
Promoção da Saúde/métodos , Neoplasias/prevenção & controle , Medicina Preventiva/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Fatores de Risco
9.
South Med J ; 112(1): 45-51, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30608632

RESUMO

OBJECTIVES: Zika virus is an emerging infection that has posed vexing challenges to the US public health system. Improved characterization of patients with possible and confirmed infection is needed to better understand risks for infection in US travelers and to inform evolving evaluation guidelines. METHODS: We performed a retrospective electronic health record review of patients evaluated for Zika virus infection at an academic travel clinic in Atlanta, Georgia, from January 1 through August 31, 2016. We evaluated 46 patients who presented to the clinic during this period for evaluation of possible Zika virus infection, including patients with Zika virus symptoms, asymptomatic patients with possible exposure to Zika virus, and referral visits for Zika virus testing. RESULTS: Among the 46 patients evaluated, 30 (65.2%) were tested for Zika virus, 8 of whom (17.4%) had laboratory evidence of infection (7 confirmed, 1 probable). Cases, including confirmed and probable infections, most commonly had fever, rash, conjunctivitis, headache, and myalgia, although differences compared with noncases were not statistically significant. Many patients evaluated were not tested because of stringent testing criteria. CONCLUSIONS: Our findings may help inform improvements in timely clinical decision making for Zika virus testing. This may assist clinicians and public health agencies. Wider access to accurate screening modalities will help providers evaluate and advise patients.


Assuntos
Viagem , Infecção por Zika virus/diagnóstico , Adulto , Instituições de Assistência Ambulatorial , Infecções Assintomáticas , Conjuntivite/etiologia , Conjuntivite/fisiopatologia , Exantema/etiologia , Exantema/fisiopatologia , Feminino , Febre/etiologia , Febre/fisiopatologia , Georgia/epidemiologia , Cefaleia/etiologia , Cefaleia/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Mialgia/etiologia , Mialgia/fisiopatologia , Encaminhamento e Consulta , Estudos Retrospectivos , Infecção por Zika virus/complicações , Infecção por Zika virus/fisiopatologia
10.
Am J Prev Med ; 54(3): 444-448, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29241720

RESUMO

Cancer is the second leading cause of morbidity and mortality in the U.S. Although reducing the number of new cancer cases is a national health goal, the continuing growth of the older adult population ensures that the burden of cancer will increase. Despite documentation of the shortage of oncologists to meet the growing need, relatively limited attention has been focused on increasing the physician workforce trained in the prevention and control of cancer. The existing physician workforce with such specialized training in cancer prevention and control is small, aging, increasing at a low rate, and likely to decrease because of an imbalance between retiring physicians and new entrants. This commentary addresses the imperative for increasing the number of physicians trained in preventive medicine with a specialization in cancer prevention and control by first providing a brief overview of U.S. cancer morbidity and mortality, then describing the status of, and trends in, physician training in cancer prevention and control, and concluding by suggesting opportunities for bolstering physician training in cancer prevention and control.


Assuntos
Atenção à Saúde/organização & administração , Educação Médica Continuada/métodos , Mão de Obra em Saúde/organização & administração , Neoplasias/prevenção & controle , Oncologistas/educação , Atenção à Saúde/métodos , Educação Médica Continuada/organização & administração , Humanos , Morbidade/tendências , Mortalidade/tendências , Neoplasias/epidemiologia , Saúde da População/estatística & dados numéricos , Estados Unidos/epidemiologia
11.
Alzheimers Dement ; 13(1): 28-37, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27172148

RESUMO

INTRODUCTION: Rapid growth of the older adult population requires greater epidemiologic characterization of dementia. We developed national prevalence estimates of diagnosed dementia and subtypes in the highest risk United States (US) population. METHODS: We analyzed Centers for Medicare & Medicaid administrative enrollment and claims data for 100% of Medicare fee-for-service beneficiaries enrolled during 2011-2013 and age ≥68 years as of December 31, 2013 (n = 21.6 million). RESULTS: Over 3.1 million (14.4%) beneficiaries had a claim for a service and/or treatment for any dementia subtype. Dementia not otherwise specified was the most common diagnosis (present in 92.9%). The most common subtype was Alzheimer's (43.5%), followed by vascular (14.5%), Lewy body (5.4%), frontotemporal (1.0%), and alcohol induced (0.7%). The prevalence of other types of diagnosed dementia was 0.2%. DISCUSSION: This study is the first to document concurrent prevalence of primary dementia subtypes among this US population. The findings can assist in prioritizing dementia research, clinical services, and caregiving resources.


Assuntos
Demência/classificação , Demência/epidemiologia , Planos de Pagamento por Serviço Prestado , Medicare/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Demência/terapia , Feminino , Humanos , Masculino , Medicare/economia , Prevalência , Estudos Retrospectivos , Estados Unidos/epidemiologia
12.
Ann Am Thorac Soc ; 13(3): S12-21, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26963362

RESUMO

Coexistence of multiple chronic conditions (i.e., multimorbidity) is the most common chronic health problem in adults. However, clinical practice guidelines have primarily focused on patients with a single disease, resulting in uncertainty about the care of patients with multimorbidity. The American Thoracic Society convened a workshop with the goal of establishing a strategy to address multimorbidity within clinical practice guidelines. In this Workshop Report, we describe a framework that addresses multimorbidity in each of the key steps of guideline development: topic selection, panel composition, identifying clinical questions, searching for and synthesizing evidence, rating the quality of that evidence, summarizing benefits and harms, formulating recommendations, and rating the strength of the recommendations. For the consideration of multimorbidity in guidelines to be successful and sustainable, the process must be both feasible and pragmatic. It is likely that this will be achieved best by the step-wise addition and refinement of the various components of the framework.


Assuntos
Comorbidade , Estado Terminal/epidemiologia , Pneumopatias/epidemiologia , Guias de Prática Clínica como Assunto/normas , Transtornos do Sono-Vigília/epidemiologia , Gerenciamento Clínico , Medicina Baseada em Evidências/normas , Humanos , Sociedades Médicas , Estados Unidos
14.
J Am Geriatr Soc ; 62(11): 2159-62, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25366821

RESUMO

Landmark articles from the peer-reviewed literature can be used to teach the fundamental principles of geriatric medicine. Three approaches were used in sequential combination to identify landmark articles as a resource for geriatricians and other healthcare practitioners. Candidate articles were identified first through a literature review and expert opinion survey of geriatric medicine faculty. Candidate articles in a winnowed list (n = 30) were then included in a bibliometric analysis that incorporated the journal impact factor and average monthly citation index. Finally, a consensus panel reviewed articles to assess each manuscript's clinical relevance. For each article, a final score was determined by averaging, with equal weight, the opinion survey, bibliometric analysis, and consensus panel review. This process ultimately resulted in the identification of 27 landmark articles. Overall, there was weak correlation between articles that the expert opinion survey and bibliometric analysis both rated highly. This process demonstrates a feasible method combining subjective and objective measures that can be used to identify landmark papers in geriatric medicine for the enhancement of geriatrics education and practice.


Assuntos
Bibliometria , Educação Médica Continuada , Geriatria/educação , Manuscritos Médicos como Assunto , Publicações Periódicas como Assunto , Currículo , Docentes de Medicina , Humanos , Fator de Impacto de Revistas , Revisão da Pesquisa por Pares , Estados Unidos
18.
Lancet ; 384(9937): 45-52, 2014 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-24996589

RESUMO

With non-communicable conditions accounting for nearly two-thirds of deaths worldwide, the emergence of chronic diseases as the predominant challenge to global health is undisputed. In the USA, chronic diseases are the main causes of poor health, disability, and death, and account for most of health-care expenditures. The chronic disease burden in the USA largely results from a short list of risk factors--including tobacco use, poor diet and physical inactivity (both strongly associated with obesity), excessive alcohol consumption, uncontrolled high blood pressure, and hyperlipidaemia--that can be effectively addressed for individuals and populations. Increases in the burden of chronic diseases are attributable to incidence and prevalence of leading chronic conditions and risk factors (which occur individually and in combination), and population demographics, including ageing and health disparities. To effectively and equitably address the chronic disease burden, public health and health-care systems need to deploy integrated approaches that bundle strategies and interventions, address many risk factors and conditions simultaneously, create population-wide changes, help the population subgroups most affected, and rely on implementation by many sectors, including public-private partnerships and involvement from all stakeholders. To help to meet the chronic disease burden, the US Centers for Disease Control and Prevention (CDC) uses four cross-cutting strategies: (1) epidemiology and surveillance to monitor trends and inform programmes; (2) environmental approaches that promote health and support healthy behaviours; (3) health system interventions to improve the effective use of clinical and other preventive services; and (4) community resources linked to clinical services that sustain improved management of chronic conditions. Establishment of community conditions to support healthy behaviours and promote effective management of chronic conditions will deliver healthier students to schools, healthier workers to employers and businesses, and a healthier population to the health-care system. Collectively, these four strategies will prevent the occurrence of chronic diseases, foster early detection and slow disease progression in people with chronic conditions, reduce complications, support an improved quality of life, and reduce demand on the health-care system. Of crucial importance, with strengthened collaboration between the public health and health-care sectors, the health-care system better uses prevention and early detection services, and population health is improved and sustained by solidifying collaborations between communities and health-care providers. This collaborative approach will improve health equity by building communities that promote health rather than disease, have more accessible and direct care, and focus the health-care system on improving population health.


Assuntos
Causas de Morte , Doença Crônica/epidemiologia , Doença Crônica/prevenção & controle , Pessoas com Deficiência/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Acessibilidade aos Serviços de Saúde , Saúde Pública , Comportamento de Redução do Risco , Consumo de Bebidas Alcoólicas , Causas de Morte/tendências , Doença Crônica/economia , Doença Crônica/mortalidade , Efeitos Psicossociais da Doença , Ambiente Controlado , Comportamento Alimentar , Acessibilidade aos Serviços de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde , Humanos , Hiperlipidemias/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Saúde Pública/normas , Saúde Pública/tendências , Parcerias Público-Privadas , Características de Residência , Comportamento Sedentário , Tabagismo/epidemiologia , Estados Unidos/epidemiologia
19.
Prev Med ; 67 Suppl 1: S58-61, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25069043

RESUMO

In this commentary, we review definition frameworks for community health and examine factors having core relevance to shaping the meaning of this term and growing field. We conclude by suggesting a potential framework for conceptualizing and advancing this field of public health practice through improved understanding of the meaning, scope, and science of community health.


Assuntos
Serviços de Saúde Comunitária , Prática de Saúde Pública , Serviços de Saúde Comunitária/métodos , Prática Clínica Baseada em Evidências , Promoção da Saúde , Nível de Saúde , Humanos , Medicina Preventiva , Saúde Pública , Qualidade de Vida
20.
Ann Fam Med ; 12(3): 256-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24821897

RESUMO

BACKGROUND: The increasing prevalence of Americans with multiple (2 or more) chronic conditions raises concerns about the appropriateness and applicability of clinical practice guidelines for patient management. Most guidelines clinicians currently rely on have been designed with a single chronic condition in mind, and many such guidelines are inattentive to issues related to comorbidities. PURPOSE: In response to the need for guideline developers to address comorbidities in guidelines, the Department of Health and Human Services convened a meeting in May 2012 in partnership with the Institute of Medicine to identify principles and action options. RESULTS: Eleven principles to improve guidelines' attentiveness to the population with multiple chronic conditions were identified during the meeting. They are grouped into 3 interrelated categories: (1) principles intended to improve the stakeholder technical process for developing guidelines; (2) principles intended to strengthen content of guidelines in terms of multiple chronic conditions; and (3) principles intended to increase focus on patient-centered care. CONCLUSION: This meeting built upon previously recommended actions by identifying additional principles and options for government, guideline developers, and others to use in strengthening the applicability of clinical practice guidelines to the growing population of people with multiple chronic conditions. The suggested principles are helping professional societies to improve guidelines' attentiveness to persons with multiple chronic conditions.


Assuntos
Doença Crônica/terapia , Comorbidade , Guias de Prática Clínica como Assunto , Congressos como Assunto , Humanos , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division , Assistência Centrada no Paciente/métodos , Assistência Centrada no Paciente/normas , Guias de Prática Clínica como Assunto/normas , Estados Unidos , United States Dept. of Health and Human Services
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