American journal of preventive medicine
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Diabetes can be prevented or delayed in high-risk adults through lifestyle modifications, including dietary changes, moderate-intensity exercise, and modest weight loss. However, the extent to which U.S. adults with prediabetes are making lifestyle changes consistent with reducing risk is unknown. ⋯ Adoption of risk reduction behaviors among U.S. adults with prediabetes is suboptimal. Efforts to improve awareness of prediabetes, increase promotion of healthy behaviors, and improve availability of evidence-based lifestyle programs are needed to slow the growth in new cases of diabetes.
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Sickle cell disease (SCD) is one of the most common monogenetic diseases worldwide. Although there have been some advances in the management of SCD in high-income countries, much remains to be learned about the mechanisms underlying the wide phenotypic diversity of the disease. In low-income countries, basic facilities for management are lacking, systematic screening is not common practice, and diagnosis is made late. ⋯ During a session on capacity building, small study groups consisting of participants from low-, middle-, and high-income countries discussed collaborations for the identification, clinical care, and study of SCD patients in low-income countries. There was agreement to establish the Global Sickle Cell Disease Network to foster a global community to advance the clinical care and study of patients with SCD. The next meeting of the network will take place in Accra, Ghana, on July 20-23, 2010.
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Although South Asians are at higher risk for coronary heart disease (CHD) than most other U.S. racial/ethnic groups, very little research has addressed this disparity. ⋯ A majority of South Asians in this study believed that CHD is not preventable and had low awareness of modifiable risk factors. As a first step, CHD education should target the knowledge gaps that may affect risk factor control and behavior change. Educational messages may need to be somewhat different for subgroups (e.g., by education and language) to be maximally effective.
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Variation in the quality of ambulatory care may be a key factor in explaining disparities in health, and these disparities have large cost implications. ⋯ Race may be a key predictor of preventable hospitalizations for some ACSCs. Racial disparities in these hospitalizations represent excess costs to Medicare. Because ACSC admissions are potentially preventable with optimal ambulatory care, improving care for minority populations may reduce disparities and lower hospital costs.
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Comparative Study
Sickle cell disease and pregnancy outcomes: women of African descent.
Sickle cell disease (SCD) is a severe hematologic condition that presents unique complications among affected pregnant women. Many studies of adverse perinatal outcomes associated with SCD are limited by small samples or fail to consider important risk factors. ⋯ Population-based linked data systems are useful for assessing risks of adverse health outcomes among women with specific medical conditions, such as SCD. Women with SCD should seek preconception care to identify and modify risk behaviors and receive counseling regarding potential adverse sequelae associated with pregnancy-related morbidity and preterm delivery.