Preventive medicine
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Preventive medicine · Jul 2019
The effects of community pharmacy-delivered public health interventions on population health and health inequalities: A review of reviews.
Community pharmacies have great potential to deliver services aimed at promoting health and preventing disease, and are well placed in deprived communities. This review of reviews aimed to assess the effectiveness of community pharmacy-delivered public health services and assess how they impact on inequalities in health using PROGRESS-Plus characteristics. Twenty databases were searched from their start date until January 2018. ⋯ At present, little is known how community pharmacy-delivered public health interventions impact on health inequalities. It would be prudent for future studies to address this by explicitly reporting outcomes according to the PROGRESS-Plus framework. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42017056264.
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Preventive medicine · Jul 2019
Chronic sleep disturbance, not chronic sleep deprivation, is associated with self-rated health in adolescents.
Improving our understanding of the cumulative effects of persistent sleep problems on adolescent health has been identified as an important area of research. This prospective study aimed to ascertain prospectively gender-specific associations between quantity and quality of sleep and self-reported health. Data from a cohort of 3104 adolescents (13-18 y) with repeated measures of sleep deprivation and sleep disturbance (2011 fall, 2012 spring, 2012 fall), and self-reported health (SRH) (2011 fall, 2012 fall) were analysed with multivariable logistic regression models adjusted for confounders. ⋯ Young women reporting chronic exposure to sleep disturbance had over twice the odds of reporting sub-optimal health at follow-up (OR 2.18 [CI95: 1.13, 4.22]), compared to those with no history. Similar results were found in chronically sleep disturbed young men (OR 2.41 [1.05, 5.51]). These findings suggest that chronic exposure to impaired quality of sleep, such as difficulty falling or staying asleep, is related to adolescent self-reported health and thus may be an important determinant of young people's wellbeing.
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Preventive medicine · Jul 2019
Oral cancer examinations and lesion discovery as reported by U.S. general dentists: Findings from the National Dental Practice-Based Research Network.
General dentists (GDs) have the opportunity to examine their patients for oral premalignancy/malignancy. We estimated the annualized per dentist number of oral lesions suspicious for premalignancy/malignancy discovered by United States (U. S.) general dentists and the annualized per dentist number of histologically-confirmed cancers subsequently diagnosed. ⋯ Crude and adjusted mean numbers of histologically-confirmed oral cancers were both 0.4 cancers/dentist/year. Our findings suggest that many U. S. general dentists are actively identifying oral lesions suspicious for premalignancy/malignancy, thereby aiding in the discovery of oral malignancies and representing an important component in the frontline against cancer.
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Preventive medicine · Jul 2019
Population-based primary HPV mRNA cervical screening compared with cytology screening.
Primary HPV screening for cervical cancer by HPV mRNA testing (Aptima) was implemented in January 2017, for women ≥30 through 70 years, in the Region of Skåne, Sweden. HPV positive samples underwent cytology assessment, and women with any degree of abnormal cytology were referred for colposcopy. The aim was to audit the primary HPV screening program, by comparing the cytology results to those of corresponding women (aged ≥30 through 65 years) screened with conventional cytology during 2016. ⋯ The colposcopy referral rate increased by 54% (3.70 vs 2.41%), when primary HPV screening was introduced. In conclusion, the implemented primary HPV screening approach demonstrated similar prevalence of ASCUS+ cytology as conventional screening. In addition, primary HPV screening decreased cytology assessments by 86% in our screening population of women 30 through 70 years taken into account the co-tested women.
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Preventive medicine · Jul 2019
Race and sex differences in patient provider communication and awareness of lung cancer screening in the health information National Trends Survey, 2013-2017.
Despite demonstrated reduction in lung cancer mortality, lung cancer screening uptake has been low. We investigated differences in discussions with physicians about lung cancer screening and awareness using repeated cross-sectional data from three cycles [4.2 (2013); 4.4(2014) and 5.1 (2017)] of the Health Information National Trends Survey. We included 4207 respondents age 55 to 80 who responded to this question: 'In the past year, have you talked with your doctor about having a test to check for lung cancer?'. ⋯ Females were 32% less likely than males to be aware of a lung cancer screening test (OR: 0.68, 95% CI: 0.47-0.99) and this association was strongest for non-Hispanic Black females (OR: 0.38, 95% CI: 0.19-0.77). Too few providers have discussed lung cancer screening with potentially eligible patients, particularly female patients. Further research is needed to evaluate possible causes for this finding.