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1.
MMWR Morb Mortal Wkly Rep ; 70(13): 461-466, 2021 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-33793461

RESUMEN

Clinical preventive services play an important role in preventing deaths, and Healthy People 2020 has set national goals for using clinical preventive services to improve population health (1). The Patient Protection and Affordable Care Act (ACA) requires many health plans to cover certain recommended clinical preventive services without cost-sharing when provided in-network (covered clinical preventive services).* To ascertain prevalence of the use of selected recommended clinical preventive services among persons aged ≥18 years, CDC analyzed data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), a state-based annual nationwide survey conducted via landline and mobile phones in the United States, for 10 clinical preventive services covered in-network with no cost-sharing pursuant to the ACA. The weighted prevalence of colon, cervical, and breast cancer screening, pneumococcal and tetanus vaccination, and diabetes screening ranged from 66.0% to 79.2%; the prevalence of the other four clinical preventive services were <50%: 16.5% for human papillomavirus (HPV) vaccination, 26.6% for zoster (shingles) vaccination, 33.2% for influenza vaccination, and 45.8% for HIV testing. Prevalence of HIV testing had the widest variation (3.1-fold differences) across states among the 10 services included in this report. The prevalence of use of clinical preventive services varied by insurance status, income level, and rurality, findings that are consistent with previous studies (2-6). The use of nine of the 10 services examined was lower among the uninsured, those with lower income, and those living in rural communities. Among those factors examined, insurance status was the dominant factor strongly associated with use of clinical preventive services, followed by income-level and rurality. Understanding factors influencing use of recommended clinical preventive services can potentially help decision makers better identify policies to increase their use including strategies to increase insurance coverage.


Asunto(s)
Utilización de Instalaciones y Servicios/estadística & datos numéricos , Servicios Preventivos de Salud/estadística & datos numéricos , Adolescente , Adulto , Anciano , Sistema de Vigilancia de Factor de Riesgo Conductual , Femenino , Reforma de la Atención de Salud , Humanos , Cobertura del Seguro/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Patient Protection and Affordable Care Act , Factores Socioeconómicos , Estados Unidos , Adulto Joven
2.
Glob Health Res Policy ; 6(1): 10, 2021 03 13.
Artículo en Inglés | MEDLINE | ID: mdl-33712081

RESUMEN

BACKGROUND: Education institutions promptly implemented a set of steps to prevent the spread of COVID-19 among international Chinese students, such as restrictive physical exercise, mask wear, daily health reporting, etc. Success of such behavioral change campaigns largely depends on awareness building, satisfaction and trust on the authorities. The purpose of this current study is to assess the preventive, supportive and awareness-building steps taken during the COVID-19 pandemic for international students in China, that will be useful for planning such a behavioral change campaign in the potential pandemic situation in other parts of the world. METHODS: We conducted an online-based e-questionnaire survey among 467 international students in China through WeChat. The data collection duration was from February 20, 2020 to March 10, 2020 and we focused on their level of awareness, satisfaction, and trust in authorities regarding pandemic measures. Simple bivariate statistics was used to describe the background characteristics of the respondents along with adoption of the partial least squares-structural equation modeling (PLS-SEM) as the final model to demonstrate the relationship between the variables. RESULTS: In our study, the leading group of the respondents were within 31 to 35 years' age group (39.82%), male (61.88%), living single (58.24%) and doctoral level students (39.8%). The preventive and supportive measures taken by students and/or provided by the respective institution or authorities were positively related to students' satisfaction and had an acceptable strength (ß = 0.611, t = 9.679, p < 0.001). The trust gained in authorities also showed an acceptable strength (ß = 0.381, t = 5.653, p < 0.001) with a positive direction. Again, the personnel awareness building related to both students' satisfaction (ß = 0.295, t = 2.719, p < 0.001) and trust gain (ß = 0.131, t = 1.986, p < 0.05) in authorities had a positive and acceptable intensity. Therefore, our study clearly demonstrates the great impact of preventive and supportive measures in the development of students' satisfaction (R2 = 0.507 indicating moderate relationship). The satisfied students possessed a strong influence which eventually helped in building sufficient trust on their institutions (R2 = 0.797 indicating above substantial relationship). CONCLUSIONS: The worldwide student group is one of the most affected and vulnerable communities in this situation. So, there is a profound ground of research on how different states or authorities handle such situation. In this study, we have depicted the types and magnitude of care taken by Chinese government and educational institutions towards international students to relieve the panic of pandemic situation. Further research and such initiatives should be taken in to consideration for future emerging conditions.


Asunto(s)
Concienciación , Conocimientos, Actitudes y Práctica en Salud , Satisfacción Personal , Estudiantes/psicología , Adulto , China , Femenino , Humanos , Internacionalidad , Análisis de los Mínimos Cuadrados , Masculino , Persona de Mediana Edad , Modelos Teóricos , Servicios Preventivos de Salud/estadística & datos numéricos , Grupos de Autoayuda/estadística & datos numéricos , Adulto Joven
3.
Schweiz Arch Tierheilkd ; 163(3): 189-201, 2021 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-33650520

RESUMEN

INTRODUCTION: The main goal of the resources project «Healthy claws - the foundation for the future¼ is to establish a Swiss national claw health monitoring programme for cattle, similar to what has already been established in other countries (e. g. Finland, Sweden). So far in the course of the project, 30 claw trimmers have been trained to use a digital recording software. An appropriate training concept and information to the work environment of Swiss claw trimmers are necessary to ensure that the recorded claw health data is of good quality. The newly developed training programme for claw trimmers was evaluated using the 30 first trained claw trimmers of the project. The training consisted of group events and individual schooling sessions, during which the claw trimmers were trained to recognise, classify and digitally record foot and claw disorders according to the «ICAR claw health atlas¼. At the end of the training programme, demographic and work relevant data about the claw trimmers was collected and their abilities when using the recording software, as well as recognising and classifying foot and claw disorders using pictures or live animals, were evaluated. The demographic and work relevant data collected at the end of the training showed an ageing of the profession (43% of the participants were over 50 years old), a lack of full-time claw trimmers (23% of the claw trimmers worked 90% or 100%), a neglect of locomotion scoring during claw trimming (no locomotion scoring standing from 60% and in movement from 33% of the participants) and a broad use of the Swiss claw trimming method (90% of the claw trimmers indicate using this method). An average Cohens kappa value of 0,74, and thus an overall substantial agreement with the first author, respectively the ICAR Atlas, was achieved for the identification and classification of foot and claw disorders. It was also noted, that all the participants were capable of using the recording software in practice after their schooling. The calculation of Cohens kappa values helps to recognise claw trimmers which fall below the limiting value and therefore show an insufficient agreement. These claw trimmers can thus be excluded from the scientific evaluation or undergo further training. It was concluded that the described training concept is suitable to establish a national claw health monitoring programme.


Asunto(s)
Crianza de Animales Domésticos/educación , Pezuñas y Garras , Servicios Preventivos de Salud , Enseñanza/normas , Animales , Bovinos , Humanos , Vigilancia de la Población , Servicios Preventivos de Salud/métodos , Programas Informáticos , Suiza
4.
Inquiry ; 58: 46958021997337, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33682514

RESUMEN

The coronavirus disease pandemic has created a crisis for patients with chronic kidney disease, as far as getting treatment facilities are concerned. The crisis is more intense in developing countries where the health system is more vulnerable due to poor infrastructures and insufficient health professionals. Bangladesh, being a developing nation, is also facing similar challenges to provide sufficient services to patients with chronic kidney disease. In this short report, we have discussed the challenges and barriers non-COVID chronic kidney disease patients are facing in terms of healthcare access along with getting proper medical interventions and suggested probable strategies to minimize the suffering.


Asunto(s)
/epidemiología , Accesibilidad a los Servicios de Salud/organización & administración , Necesidades y Demandas de Servicios de Salud/organización & administración , Insuficiencia Renal Crónica/terapia , Telemedicina/organización & administración , Bangladesh , Países en Desarrollo , Humanos , Servicios Preventivos de Salud/organización & administración , Índice de Severidad de la Enfermedad
5.
Nutr Metab Cardiovasc Dis ; 31(4): 1081-1086, 2021 04 09.
Artículo en Inglés | MEDLINE | ID: mdl-33618921

RESUMEN

BACKGROUNDS AND AIMS: Hypertension is a risk factor for renal, cardiovascular and cerebrovascular diseases. It is responsible for a large proportion of overall morbidity and mortality every year. Hypertension-mediated organ damage is largely not reversible. For these reasons, prevention has primary importance: sensibilization of population on hypertension-related consequences is essential for therapeutic adherence and reduction of unhealthy lifestyle behaviour. This study aimed to evaluate awareness about hypertension among community pharmacies customers. METHODS AND RESULTS: A questionnaire about hypertension was collected by 2731 customers from 94 community pharmacies in North West Italy, during a hypertension screening program. Hypertension awareness was unsatisfactory in a large proportion of the sample, with only 15% of subjects having an overall good level of knowledge. Furthermore, lower awareness was associated to higher blood pressure values (132/79 ± 19/11 mmHg vs 128/78 ± 18/10 mmHg, p < 0.001) and subjects resulted hypertensive or uncontrolled despite antihypertensive therapy, presented worse questionnaire scores (4.7 ± 1.9 vs 4.9 ± 2.0, p = 0.03). CONCLUSION: Knowledge about hypertension is largely unsatisfactory among population. Community pharmacies may play as a setting for health education and hypertension screening.


Asunto(s)
Servicios Comunitarios de Farmacia , Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Hipertensión , Adulto , Anciano , Antihipertensivos/uso terapéutico , Presión Arterial , Femenino , Estilo de Vida Saludable , Humanos , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/fisiopatología , Hipertensión/terapia , Italia , Masculino , Persona de Mediana Edad , Servicios Preventivos de Salud , Medición de Riesgo , Factores de Riesgo , Conducta de Reducción del Riesgo , Encuestas y Cuestionarios
7.
Artículo en Inglés | PAHO-IRIS | ID: phr-53282

RESUMEN

[ABSTRACT]. This study analyzes the conditions and possibilities of sustainability of the Salud al Paso program of the Metropolitan Health Secretariat of the Municipality of Quito, Ecuador, as an example for similar initiatives, in the context of the changes made by the new administration in May 2019. The analysis of the implementation of this initiative, focused on the prevention of noncommunicable diseases (NCDs), was based on the program’s user database, the information gathered on the perspectives of operational staff, knowledge of the program, and the opinion of local leaders and opinion leaders of the Quito Metropolitan District, as well as official information. Based on this data, the study identified factors that could have facilitated or hindered its sustainability and documented the rationale to suspend the on-demand activities included in the program and limit activities to the care of populations under municipal responsibility (day-care centers, schools and colleges, markets, elder care programs, and employees) and patients with identified cardiometabolic risk. The insufficient institutionalization of the program, conceived as a project with an insufficient vision of its sustainability in time, was mentioned as a possible obstacle by leaders and operational staff. The growing prevalence of NCDs requires initiatives for their prevention, which must be institutionalized to ensure their continuity and overcome eventual changes of government. In addition, future interventions similar to Salud al Paso should establish better sectoral coordination articulation, especially with the Ministry of Public Health and other service networks.


[RESUMEN]. El presente estudio analiza las condiciones y posibilidades de permanencia del programa Salud al Paso de la Secretaría Metropolitana de Salud del Municipio de Quito, Ecuador, como ejemplo para iniciativas similares, en el contexto de los cambios efectuados por la nueva administración en mayo del 2019. El análisis de esta implementación enfocada en la prevención de enfermedades no transmisibles se centró en la base de datos de usuarios del programa, la información recabada desde las perspectivas del personal operativo, el conocimiento del programa y el posicionamiento de líderes locales y de opinión del Distrito Metropolitano de Quito, así como información oficial. Con base en estos datos, el estudio identificó factores que podrían haber facilitado u obstaculizado su permanencia y documentó la fundamentación de las nuevas autoridades para suspender las actividades de libre demanda propias del programa y limitar la atención a las poblaciones bajo responsabilidad municipal (guarderías, escuelas y colegios, mercados, programas de atención a la tercera edad y empleados) y de pacientes con riesgo cardiometabólico identificado. La institucionalización insuficiente del programa, concebido más como proyecto y con una también insuficiente visión de permanencia en el tiempo, fue mencionada como un posible obstáculo por líderes y personal operativo. La prevalencia creciente de enfermedades no transmisibles demanda iniciativas para su prevención, que deben institucionalizarse para asegurar su continuidad y superar eventuales cambios de gobierno. Además, intervenciones futuras semejantes a Salud al Paso deberán establecer una mejor articulación sectorial, en especial con el Ministerio de Salud Pública y otras redes de servicios.


Asunto(s)
Política Pública , Servicios Preventivos de Salud , Enfermedades no Transmisibles , Gestión en Salud , Ecuador , Política Pública , Servicios Preventivos de Salud , Enfermedades no Transmisibles , Gestión en Salud
8.
Med Clin North Am ; 105(2): 247-262, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33589100

RESUMEN

Individuals with rheumatoid arthritis, systemic lupus erythematosus, or gout have increased risk of cardiovascular disease (CVD) compared with the general population. This risk relates to a combination of traditional cardiovascular risk factors and disease-specific factors. Screening for CVD is important because CVD contributes to significant morbidity and mortality. Management includes tight control of disease activity to reduce inflammation, but with care to minimize use of nonsteroidal anti-inflammatory drugs and prolonged courses of high-dose corticosteroids. Traditional cardiovascular risk factors should be managed with a combination of lifestyle interventions and pharmacotherapy. The decision to start antihypertensive and lipid-lowering therapy should be based on individual CVD risk.


Asunto(s)
Enfermedades Cardiovasculares , Enfermedades Reumáticas , Enfermedades Cardiovasculares/inmunología , Enfermedades Cardiovasculares/prevención & control , Humanos , Servicios Preventivos de Salud , Enfermedades Reumáticas/inmunología , Enfermedades Reumáticas/fisiopatología , Enfermedades Reumáticas/terapia
9.
Am Fam Physician ; 103(4): 209-217, 2021 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-33587575

RESUMEN

Health maintenance for women of reproductive age includes counseling and screening tests that have been demonstrated to prevent disease and improve health. This article focuses mainly on conditions that are more common in women or have a unique impact on female patients. Family physicians should be familiar with evidence-based recommendations for contraception and preconception care and should consider screening patients for pregnancy intention. The American Academy of Family Physicians recommends against screening pelvic examinations in asymptomatic women; the U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to make a recommendation for or against screening pelvic examinations. The USPSTF recommendations for women in this age group include screening for obesity and other cardiovascular risk factors, depression, intimate partner violence, cervical cancer, HIV, hepatitis C virus, tobacco use, and unhealthy alcohol and drug use as part of routine primary care. Breast cancer screening with mammography is recommended for women 50 years and older and should be individualized for women 40 to 49 years of age, although other organizations recommend earlier screening. Screening for sexually transmitted infections is based on age and risk factors; women younger than 25 years who are sexually active should be screened routinely for gonorrhea and chlamydia, whereas screening for syphilis and hepatitis B virus should be individualized. Immunizations should be recommended according to guidelines from the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices; immunizations against influenza; tetanus; measles, mumps, and rubella; varicella; meningococcus; and human papillomavirus are of particular importance in women of reproductive age. To have the greatest impact on health, physicians should focus on USPSTF grade A and B recommendations with patients.


Asunto(s)
Detección Precoz del Cáncer/normas , Práctica Clínica Basada en la Evidencia/normas , Guías de Práctica Clínica como Asunto , Servicios Preventivos de Salud/normas , Reproducción , Servicios de Salud para Mujeres/normas , Salud de la Mujer , Adulto , Curriculum , Educación Médica Continua , Femenino , Humanos , Embarazo , Factores de Riesgo , Estados Unidos
11.
Postgrad Med ; 133(2): 154-159, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33522353

RESUMEN

OBJECTIVES: Alcohol consumption is a risk factor for stroke. However, there are no available data on the effect of alcohol consumption on the long-term outcome of ischemic stroke in China. Therefore, this study aimed to explore the association of alcohol consumption with the prognosis of ischemic stroke by subtype in different follow-up periods after stroke. METHODS: This 12-month follow-up study recruited 3830 acute ischemic stroke patients from Tianjin, China, between 2016 and 2018. Patients were categorized into two groups according to their consumption of alcohol. Differences in mortality, recurrence, and dependency rates at 3 and 12 months after stroke were compared between both groups. RESULTS: The mortality, recurrence, and dependency rates at 12 months after stroke were significantly higher in patients who previously consumed alcohol than in those without previous alcohol consumption (all P < 0.005). A similar trend was observed for mortality rate at 3 months after stroke (P < 0.001). The risk of death at 3 months after an atherothrombotic stroke decreased by 63.4% (relative risk [RR], 0.366; 95% confidence interval [CI], 0.144-0.935) among patients who previously consumed alcohol compared with those who never consumed alcohol. Moreover, for patients with small artery disease classified according to the Trial of ORG 10,172 in Acute Stroke Treatment (TOAST), the recurrence and dependency rates at 12 months after stroke decreased by 49.2% (RR, 0.508; 95% CI, 0.259-0.996) and 49.5% (RR, 0.505; 95% CI, 0.258-0.990), respectively, among patients who consumed alcohol. CONCLUSIONS: Previous alcohol consumption decreased the risk of death at 3 months after stroke among patients with atherothrombotic stroke according to the TOAST classification. Furthermore, for patients with small artery disease (according to TOAST classification), alcohol consumption significantly decreased the risk of recurrence and dependency at 12 months after stroke. This study highlights an urgent need to quantify the association of alcohol consumption with outcomes after stroke in China to improve stroke prognosis.


Asunto(s)
Consumo de Bebidas Alcohólicas , Servicios Preventivos de Salud/métodos , Medición de Riesgo/métodos , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/fisiopatología , China/epidemiología , Femenino , Hospitalización/estadística & datos numéricos , Humanos , /fisiopatología , /terapia , Masculino , Anamnesis/métodos , Anamnesis/estadística & datos numéricos , Persona de Mediana Edad , Mortalidad , Pronóstico , Recurrencia , /epidemiología
12.
Malar J ; 20(1): 20, 2021 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-33407471

RESUMEN

The COVID-19 pandemic has resulted in massive global disruptions with considerable impact on the delivery of health services and national health programmes. Since the detection of the first COVID-19 case on 5th March 2020, the Royal Government of Bhutan implemented a number of containment measures including border closure and national lockdowns. Against the backdrop of this global COVID-19 pandemic response, there was a sudden surge of locally-transmitted malaria cases between June to August 2020. There were 20 indigenous cases (zero Plasmodium falciparum and 20 Plasmodium vivax) from a total of 49 cases (seven P. falciparum and 42 P. vivax) in 2020 compared to just two from a total of 42 in 2019. Over 80% of the cases were clustered in malaria endemic district of Sarpang. This spike of malaria cases was attributed to the delay in the delivery of routine malaria preventive interventions due to the COVID-19 pandemic. As a result, Bhutan is unlikely to achieve the national goal of malaria elimination by 2020.


Asunto(s)
/epidemiología , Malaria/prevención & control , Bután/epidemiología , Objetivos , Humanos , Servicios Preventivos de Salud , Salud Pública , /aislamiento & purificación
17.
In Vivo ; 35(1): 635-639, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33402520

RESUMEN

BACKGROUND/AIM: The perspective validation of a selective approach in patients undergoing breast cancer surgery was performed in order to assess whether patients as well as Health Care Workers (HCWs) were exposed to any undue risk of COVD-19 infection. PATIENTS AND METHODS: From March 9th to June 9th 2020, 207 patients were phone-triaged by a dedicated Breast Care Nurse; a patient-tailored program was adopted with the aim of avoiding hospitalization of SARS-CoV-2 symptomatic patients, with a careful prioritization of surgical procedures according to specific disease features. RESULTS: Two hundred and three out of 207 patients underwent operation; seven patients were temporarily excluded because they tested positive at phone triage (n=3), or in-hospital triage (n=3); another asymptomatic patient with negative NP swab tested IgM Ab-positive so that surgery was re-scheduled two weeks later. Four patients had no surgery; one of them was reconsidered for neoadjuvant chemotherapy (NAC) after testing positive at phone triage; three patients were excluded because they were already hospitalized for COVID-19. Overall, mean in-hospital stay was 2.2 days (±SD, 0.7) and, after hospital discharge, no patient required readmission. CONCLUSION: This preventive program avoided any COVID-19 infection among patients and HCWs, so that an elective breast cancer surgical procedure can be safely and timely pursued without affecting the oncologic outcome.


Asunto(s)
Neoplasias de la Mama/cirugía , Personal de Salud/estadística & datos numéricos , Mastectomía/métodos , Servicios Preventivos de Salud/métodos , /aislamiento & purificación , Adulto , Neoplasias de la Mama/terapia , /virología , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Oncología Médica/métodos , Persona de Mediana Edad , Pandemias , Reproducibilidad de los Resultados , Triaje/métodos
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