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4.
Mayo Clin Proc ; 95(1): 169-183, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31902413

RESUMO

In vaccinating adults, clinicians face 2 types of challenges: (1) staying current on recommendations for influenza, pneumococcal, hepatitis A and B, zoster, and other vaccines and (2) addressing systemic barriers to implementing practices that increase vaccination rates. Although adult immunization rates remain suboptimal, there has been much good news in adult vaccination recently. New high-dose and adjuvanted influenza vaccines help improve immune response and may reduce influenza complications in older adults. The new recombinant zoster vaccine offers significantly more efficacy against zoster outbreaks and postherpetic neuralgia than zoster vaccine live. Pertussis vaccine given during the third trimester of pregnancy may prevent between 50% and 90% of pertussis infections in infants. Shorter time for completion (1 vs 6 months) of new, adjuvanted hepatitis B vaccine may increase adherence. Clinicians can address systemic barriers to increasing vaccination rates in their clinics and health care systems by following the Centers for Disease Control and Prevention's Standards for Adult Immunization Practice. Clinicians can help increase vaccination rates by writing standing orders and by advocating for nurses or medical assistants to receive training and protected time for assessing and documenting vaccination histories and administration. Strong recommendations that presume acceptance of vaccination are effective with most patients. Communication techniques similar to motivational interviewing can help with vaccine-hesitant patients. Clinicians, as experts on providing preventive services, can educate community leaders about the benefits of immunization and can inform vaccine experts about challenges of implementing vaccination recommendations in clinical practice and strategies that can work to raise vaccination rates.


Assuntos
Vacinação em Massa , Infecções Pneumocócicas/prevenção & controle , Viroses/prevenção & controle , Adulto , Humanos , Vacinação em Massa/métodos , Vacinação em Massa/organização & administração , Infecções Pneumocócicas/epidemiologia , Serviços Preventivos de Saúde/normas , Estados Unidos , Cobertura Vacinal/métodos , Cobertura Vacinal/estatística & dados numéricos , Viroses/epidemiologia
6.
Adv Parasitol ; 105: 125-132, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31530393

RESUMO

Schistosomiasis, helminthic zoonoses and NTDs constitute a considerable majority of the diseases of poverty in the world. The RNAS+ targeted zoonoses are not only problems to human and animal health, but also cause poverty in 1 billion poor livestock keepers as well as result in 2.3 billion cases of human illness and 1.7 million human deaths a year. The gaps in research of those targeted zoonoses are urgently addressed by identifying the research priority, fulfilled by improving the multisectoral cooperation and strengthening the interventions in the control programme.


Assuntos
Erradicação de Doenças/tendências , Helmintíase/prevenção & controle , Zoonoses/prevenção & controle , Animais , Humanos , Serviços Preventivos de Saúde/normas , Serviços Preventivos de Saúde/tendências
7.
Adv Parasitol ; 105: 69-93, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31530396

RESUMO

From the time it was conceptualized in 1998 to the present, RNAS+ has largely concentrated on research that will generate results to facilitate control, prevention and elimination of its target diseases. Diagnostics has remained an active field of research in order to develop tools that are appropriate for each stage from the first efforts until attempts to block transmission. For example, with regard to schistosomiasis, chemotherapy has excellent impact on morbidity, while better diagnostics and vaccine research have been promoted to complement the other components of the control programme. The need for surveillance in areas where the prevalence has been brought down to very low levels necessitated development of spatio-temporal tools and ecological models based on geographical information systems (GIS) to produce risk and distribution maps for monitoring and evaluation of programme success. New knowledge and experiences in management of the diseases contribute to the formulation of new schemes in management and treatment. Ways of drawing attention to the disease, such as determining disability weights for use in computation of burden of disease, updating epidemiological profile and unravelling new aspects of the disease provide bases for modifying the operation of control programmes as we move forward. Programme evaluation based on reports of actual implementation of activities brought to the fore problems related to the distribution of chemotherapy as well as social, cultural and behavioural aspects of endemic communities. Importantly, this highlighted the necessity of adapting control activities to specific situations of the endemic areas. New models evolving from reviews of this kind and success stories, such us the elimination of lymphatic filariasis (LF) in PR China and Cambodia are presented.


Assuntos
Serviços Preventivos de Saúde/tendências , Esquistossomose/prevenção & controle , Pesquisa Médica Translacional/tendências , Animais , Humanos , Serviços Preventivos de Saúde/normas , Esquistossomose/diagnóstico , Esquistossomose/tratamento farmacológico , Esquistossomose/transmissão
8.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 339-342, 2019 Jun 05.
Artigo em Chinês | MEDLINE | ID: mdl-31544423

RESUMO

OBJECTIVE: To evaluate the effect of integrated schistosomiasis control measures in Honghu City during the period from 2008 through 2018. METHODS: The data pertaining to schistosomiasis control measures and the endemic situation of schistosomiasis in Honghu City were collected from 2008 to 2018, and the effect of integrated schistosomiasis control measures implemented was evaluated. RESULTS: The resources from agriculture, water resources, forestry, land, education and communication sectors were integrated to implement the integrated schistosomiasis control strategy with the focus on the control of source of Schistosoma japonicum infection in Honghu City from 2008 to 2018. The prevalence of S. japonicum infection reduced from 3.03% in 2008 to 0 in 2018 in humans in the city, and no acute infection was detected since 2009. In addition, the prevalence of S. japonicum infection in cattle reduced from 2.85% in 2008 to 0 in 2018, and no snail infection was found since 2012. Transmission control of schistosomiasis was achieved in the city in 2013, and transmission interruption was achieved in 2018. CONCLUSIONS: The integrated schistosomiasis control measures achieve remarkable effects in Honghu City; however, there is still a risk of schistosomiasis transmission.


Assuntos
Doenças dos Bovinos , Serviços Preventivos de Saúde/normas , Esquistossomose , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/prevenção & controle , China/epidemiologia , Água Doce/parasitologia , Humanos , Prevalência , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Esquistossomose Japônica , Caramujos/parasitologia
9.
PLoS One ; 14(7): e0219813, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31339919

RESUMO

BACKGROUND: Despite considerable efforts to prevent HIV and other sexually transmitted infections (STI) among female sex workers (FSW), other sexual and reproductive health (SRH) needs, such preventing unintended pregnancies, among FSW have received far less attention. Programs targeting FSW with comprehensive, accessible services are needed to address their broader SRH needs. This study tested the effectiveness of an intervention to increase dual contraceptive method use to prevent STIs, HIV and unintended pregnancy among FSW attending services in drop-in centers (DIC) in two cities in Kenya. The intervention included enhanced peer education, and routine screening for family planning (FP) needs plus expanded non-condom FP method availability in the DIC. METHODS: We conducted a two-group, pre-/posttest, quasi-experimental study with 719 FSW (360 intervention group, 359 comparison group). Participants were interviewed at baseline and 6 months later to examine changes in condom and non-condom FP method use. RESULTS: The intervention had a significant positive effect on non-condom, FP method use (OR = 1.38, 95%CI (1.04, 1.83)), but no effect on dual method use. Consistent condom use was reported to be high; however, many women also reported negotiating condom use with both paying and non-paying partners as difficult or very difficult. The strongest predictor of consistent condom use was partner type (paying versus non-paying/emotional); FSW reported both paying and non-paying partners also influence non-condom contraceptive use. Substantial numbers of FSW also reported experiencing sexual violence by both paying and non-paying partners. CONCLUSIONS: Self-reported difficulties with consistent condom use and the sometimes dangerous conditions under which they work leave FSW vulnerable to unintended pregnancy STIs/HIV. Adding non-barrier FP methods to condoms is crucial to curb unintended pregnancies and their potential adverse health, social and economic consequences. Findings also highlight the need for additional strategies beyond condoms to reduce HIV and STI risk among FSW. TRIAL REGISTRATION: Clinicaltrials.gov NCT01957813.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Anticoncepção/normas , Serviços Preventivos de Saúde/normas , Educação Sexual/normas , Profissionais do Sexo/estatística & dados numéricos , Adolescente , Adulto , Utilização de Instalações e Serviços/estatística & dados numéricos , Feminino , Humanos , Quênia , Pessoa de Meia-Idade , Gravidez , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/estatística & dados numéricos , Saúde Reprodutiva , Profissionais do Sexo/educação
10.
Geriatr Gerontol Int ; 19(8): 723-729, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31146300

RESUMO

AIM: In the present study, we aimed to update the data of frailty status in the European community-dwelling population of older adults, based on the latest data released (wave 6) of the Survey of Health, Aging and Retirement in Europe database, and to study the impact of each criterion on frailty assessment. METHODS: Frailty status was assessed applying a version of the Fried phenotype operationalized for the Survey of Health, Aging and Retirement in Europe. We included all participants who answered all the questions used in a frailty assessment and who disclosed their sex and, furthermore, who were aged ≥50 years. Our final sample was 60 816 individuals. Of these, the mean age was 67.45 ± 9.71 years; 38 497 (56.4%) were women. RESULTS: The overall prevalence of pre-frailty was 42.9% (ranging from 34.0% in Austria to 52.8% in Estonia), and frailty was 7.7% (ranging from 3.0% in Switzerland to 15.6% in Portugal). Pre-frailty and frailty prevalence increased along with age, and were more frequent among women. Regarding the five criteria considered on frailty assessment, exhaustion seems to be the criterion that contributes most to frailty status, followed by low activity, weakness, loss of appetite and slowness. CONCLUSIONS: With this work, we showed that >50% of the European population aged >50 years are pre-frail/frail, which must be considered when designing interventions to reduce/postpone/mitigate the progression of this condition, thus reducing the burden associated with it. Geriatr Gerontol Int 2019; 19: 723-729.


Assuntos
Idoso Fragilizado/estatística & dados numéricos , Fragilidade , Vida Independente/estatística & dados numéricos , Idoso , Avaliação da Deficiência , Europa (Continente)/epidemiologia , Feminino , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Prevalência , Serviços Preventivos de Saúde/normas , Aposentadoria/estatística & dados numéricos , Fatores Sexuais
12.
Asian Pac J Cancer Prev ; 20(4): 1265-1269, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31030504

RESUMO

Introduction: India fights massive cervical cancer burden. This article highlights an innovative feasible approach enabling tertiary hospitals to contribute to cancer prevention without compromising their primary mandate to provide treatment. Methodology: Since 1979, National Institute of Cancer Prevention and Research (NICPR) support a tertiary hospital in cervical cancer screening through a satellite clinic. Record review of 5328 attendees of this clinic between January-December 2016 was done. Pap-smear testing and reporting were performed by trained NICPR personnel. Patients' demographics, reproductive history, Pap-test date, cytology results were recorded and results were communicated to respective units for further management. Results: Among 5328 women screened, 2% (96/5328) had abnormal cytology, which included malignancy(33%; 32/96), Atypical Squamous Cells-Undetermined Significance(ASC-US) (20%; 19/96), Atypical Glandular Cells(AGC) (23%; 22/96) with complaints of pain in lower abdomen 65.6%(59/90), white discharge per vaginum 46.7%(42/90) and backache 23.3%(21/90). In which, Muslims- 67% (65/96), illiterates- 58% (56/96). Age>35(p<0.001), parity>3(p<0.05), illiteracy (p<0.05), Muslim women (p<0.05) had positive association with abnormal cytology. Conclusion: Awareness about cervical cancer screening is the immediate need in resource-limited countries. Government hospitals in such countries should house dedicated preventive oncology unit for cancer screening.


Assuntos
Células Escamosas Atípicas do Colo do Útero/patologia , Detecção Precoce de Câncer/normas , Infecções por Papillomavirus/complicações , Serviços Preventivos de Saúde/normas , Lesões Intraepiteliais Escamosas Cervicais/diagnóstico , Atenção Terciária à Saúde/normas , Neoplasias do Colo do Útero/diagnóstico , Adulto , Células Escamosas Atípicas do Colo do Útero/virologia , Feminino , Seguimentos , Humanos , Índia , Teste de Papanicolaou , Papillomaviridae , Infecções por Papillomavirus/virologia , Prognóstico , Estudos Retrospectivos , Lesões Intraepiteliais Escamosas Cervicais/epidemiologia , Lesões Intraepiteliais Escamosas Cervicais/virologia , Centros de Atenção Terciária/normas , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal
13.
Int Urol Nephrol ; 51(7): 1219-1227, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31020627

RESUMO

PURPOSE: For early prevention, information regarding the incidence of major adverse cardiovascular events (MACEs) in middle-aged patients with chronic kidney disease (CKD) may be more beneficial than that regarding MACE prevalence. But, literature comparing the incidence and risk of MACEs in middle-aged patients with CKD with the controls using a population-based cohort study is scant. Our aim was to estimate the incidence and risk of MACEs, such as congestive heart failure (CHF) and ischemic heart disease (IHD), in middle-aged patients with advanced (stages 3-5) CKD. METHODS: From the National Health Insurance Research Database, 261 patients aged 35-65 years who had received advanced CKD diagnoses in 2000 and 1305 age-, sex-, and comorbidity-matched controls were recruited. Patients with CHF alone (MACE 1), IHD alone (MACE 2), or CHF and IHD (MACE 3) diagnoses between January 1, 2001, and December 31, 2008, were identified in the CKD and control groups. RESULTS: Patients (mean age ± standard deviation, 50.0 ± 8.3 years; female, 56%) exhibited a higher incidence of MACE 1, MACE 2, and MACE 3 (11.9 vs. 1.4/1000, 30.7 vs. 13.4/1000, and 13.4 vs. 1.7/1000 person-years, respectively, all p < 0.001) and were at a higher risk of experiencing MACEs than the controls (adjusted hazard ratios: MACE 1, MACE 2, and MACE 3: 8.57, 2.26, and 3.80, respectively, all p < 0.001). CONCLUSIONS: CKD is an independent risk factor for CHF and IHD among patients aged 35-65 years. Early intervention for preventing CHF and IHD in middle-aged patients with CKD is crucial.


Assuntos
Doenças Cardiovasculares/epidemiologia , Insuficiência Cardíaca , Isquemia Miocárdica , Insuficiência Renal Crônica/epidemiologia , Adulto , Estudos de Coortes , Comorbidade , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/epidemiologia , Isquemia Miocárdica/prevenção & controle , Determinação de Necessidades de Cuidados de Saúde , Serviços Preventivos de Saúde/normas , Fatores de Risco , Taiwan/epidemiologia
14.
Endocrinol Metab Clin North Am ; 48(2): 377-390, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31027546

RESUMO

The preventive health care needs of transgender persons are nearly identical to the rest of the population. Special consideration should be given, however, to the impact of gender-affirming hormone regimens and surgical care on preventive screenings. Providers should integrate a more comprehensive view of health when caring for transgender persons and address the impact of social determinants and other barriers to accessing affirming, inclusive health care. In individual interactions, providers must consider the unique impact that a gender identity and expression different from the assigned gender at birth affects patient-provider interactions, including the history, physical examination, and diagnostic testing.


Assuntos
Acesso aos Serviços de Saúde/normas , Serviços Preventivos de Saúde/normas , Atenção Primária à Saúde/normas , Pessoas Transgênero , Transexualidade , Humanos
15.
Inquiry ; 56: 46958019841514, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31018737

RESUMO

This policy brief examines preventive services state legislation trends in the United States during uncertainty regarding the Affordable Care Act (ACA), which requires certain coverage of 4 evidence-based preventive services categories without additional patient costs under §2713. We used a legal mapping approach to search for and analyze state legislation related to preventive services proposed or enacted over a 25-month period of ACA uncertainty. We screened 1231 bills and coded the 76 screened-in bills. Next, we determined their characteristics and examined trends. Bills originated in 28 states, and 69.7% were not enacted. Only 3.9% contained requirements contingent on ACA modifications. About 56.6% referenced services covered by §2713, but usually not entire §2713 categories. Bills also mentioned preventive services in general (53.9%) and services outside §2713's scope (21.1%). About 55.3% applied to private insurance, and 75.0% only to one patient group. Bills generally promoted access, and 51.3% specifically prohibited cost-sharing. But 26.3% of the bills limited access to preventive services. State-level legislation targets preventive services, usually expanding, but sometimes limiting, access. Most bills single out specific services without fully incorporating evidence-based recommendations. State legislation may therefore promote access to preventive services but can favor certain services, deviate from experts' recommendations, and increase nationwide variability. State legislation can function as an important lever for access to preventive services across patient groups. This may be especially important during uncertainty about federal policy. However, the design of state-level proposals is critical for maximizing access to preventive services.


Assuntos
Reforma dos Serviços de Saúde/legislação & jurisprudência , Acesso aos Serviços de Saúde , Serviços Preventivos de Saúde/normas , Incerteza , Humanos , Cobertura do Seguro/tendências , Patient Protection and Affordable Care Act/legislação & jurisprudência , Serviços Preventivos de Saúde/legislação & jurisprudência , Serviços Preventivos de Saúde/estatística & dados numéricos , Governo Estadual
16.
Medicine (Baltimore) ; 98(8): e14664, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30813211

RESUMO

South Africa recently implemented the 'test and treat' strategy for all HIV-infected individuals receiving diagnosis at the health facility level. However, the impact of this programme in terms of the prevention of HIV transmission, morbidity and mortality associated with HIV can only be maximized if patients are diagnosed early. This study determines the prevalence of late presentation among newly diagnosed HIV-infected individuals and also examines the socio-demographic and clinical determinants for late presentation in health facilities in the Eastern Cape Province, South Africa.In this cross-sectional study, a total of 335 newly diagnosed patients were recruited consecutively between August 2016 and July 2017. Late presenter for HIV care was defined in accordance with the European Late Presenter Consensus working group as a patient who reports for care when the CD4 count is below 350 cells/µL and/or when there is an established AIDS-defining clinical condition, irrespective of CD4 count. Adjusted and unadjusted logistic regression analysis was used to examine the determinants of late HIV diagnosis.Participants' mean age was 33.6 (SD: 10.6). Almost 96% of the participants believed their route of HIV infection was heterosexual sex. Most newly diagnosed HIV-infected patients (60%) were late presenters (CD4+ count ≤350 cells/µL and/or having an AIDS-defining illness in World Health Organisation (WHO)-defined stage III/IV), with 35% presenting with Acquired Immune Deficiency Syndrome (AIDS)-related complications. In the adjusted model, only male sex (AOR: 2.81; CI: 1.51-5.23), no formal education (AOR: 5.63; CI: 1.68-18.85), and overweight body mass category (AOR: 2.45; CI: 1.04-5.75) were independently associated with late HIV diagnosis.The majority of newly diagnosed HIV-infected individuals were late presenters. To maximize the impact of the 'test and treat' policy aimed at reducing new HIV transmissions and preventing the morbidity and mortality associated with HIV, there is a need for programmes to improve early detection of HIV in the study settings. This programme should target males and individuals with no formal education for maximum impact.


Assuntos
Controle de Doenças Transmissíveis , Diagnóstico Tardio , Diagnóstico Precoce , Infecções por HIV , Serviços Preventivos de Saúde , Adolescente , Adulto , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Estudos Transversais , Diagnóstico Tardio/prevenção & controle , Diagnóstico Tardio/estatística & dados numéricos , Demografia , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Prevalência , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/normas , Fatores de Risco , Fatores Socioeconômicos , África do Sul/epidemiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-30708998

RESUMO

Background: The aim of this study was to assess the efficacy of the school-based "Dat-e Adolescence" prevention program in the reduction of dating aggression and victimization and bullying in adolescents. Method: a RCT design with three waves (pre-test, post-test and follow-up six months apart) and two groups (an experimental group and a control group) were used. One thousand four hundred and twenty three (1423) adolescents, mean age 14.98 (557 in the experimental group) participated in the study. Results: Efficacy evaluation was analyzed using Multiple-group latent growth models and showed that the Dat-e Adolescence program was effective in reducing sexual and severe physical dating violence and bullying victimization. Conclusions: The results suggest that dating violence prevention programs could be an effective approach for tackling different behavioral problems in adolescence given the protective and risk factors shared between dating violence and bullying.


Assuntos
Comportamento do Adolescente , Bullying/prevenção & controle , Violência por Parceiro Íntimo/prevenção & controle , Serviços Preventivos de Saúde/normas , Adolescente , Agressão , Vítimas de Crime , Feminino , Humanos , Relações Interpessoais , Masculino , Avaliação de Programas e Projetos de Saúde , Fatores de Risco , Comportamento Sexual , Adulto Jovem
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