mass Screening

Relationships between early motor development and language and reading skills were studied in 154 children, of whom 75 had familial risk of dyslexia (37 females, 38 males; at-risk group) and 79 constituted a control group (32 females, 47 males). Motor development was assessed by a structured parental questionnaire during the child's first year of life. Vocabulary and inflectional morphology skills were used as early indicators of language skills at 3 years 6 months and 5 years or 5 years 6 months of age, and reading speed was used as a later indicator of reading skills at 7 years of age. The same subgroups as in our earlier study (in which the cluster analysis was described) were used in this study. The three subgroups of the control group were 'fast motor development', 'slow fine motor development', and 'slow gross motor development', and the two subgroups of the at-risk group were 'slow motor development' and 'fast motor development'. A significant difference was found between the development of expressive language skills. Children with familial risk of dyslexia and slow motor development had a smaller vocabulary with poorer inflectional skills than the other children. They were also slower in their reading speed at the end of the first grade at the age of 7 years. Two different associations are discussed, namely the connection between early motor development and language development, and the connection between early motor development and reading speed.

Purpose . To estimate workforce participation characteristics and employees' attitudes regarding participation in workplace wellness programs. Design . Data from a statewide stratified random sample were used to compare small (<50 employees) and larger (50+ employees) workplaces to estimate participation in screening programs and likelihood of participation in workplace wellness programs. Setting . A telephone survey of employed Iowans registered to vote. Subjects . Surveyed were 1171 employed Iowans registered to vote, ages 18 to 65. Measure . Among questionnaire survey modules were items from the Wellness Council of America Employee Needs and Interest Survey, the U.S. Census Bureau for employment documentation, and the World Health Organization Health and Work Performance Questionnaire for assessment of sickness absenteeism and presenteeism. Analysis . Prevalence of participation in screening and wellness programs was analyzed by employment size and levels of likeliness to ...

The Questionnaire for Crying, Feeding and Sleeping of an infant, constructed based on theory and factor analysis, is assessed for internal consistency, inter-correlations, and its relation to a behaviour diary. A clinical and a non-clinical sample are compared. The sample of in total 704 infants younger than one year consists of different subsamples. To test the differences between a clinical and a non-clinical sample assessed with the questionnaire, data of 134 infants brought to the outpatient unit for parents with their infants and toddlers and a matched sample are used. The principal components analysis results in three well-interpretable scales correlating with each other, which all show a high internal consistency. The connections to the diary records and the differences between the means of the clinical and the non-clinical sample are found in the expected directions. The results of the Questionnaire for Crying, Feeding and Sleeping, including the criterion of Wessel, are con...

OBJECTIVE To determine the frequency of microalbuminuria and its associations in type-2 diabetic subjects attending diabetes centers/clinics across Karachi, Pakistan. METHODS Two thousand one hundred subjects with type-2 diabetes were screened for microalbuminuria using Micral test strip II. A single screening test was performed in 25 diabetes centers/units in different districts of Karachi from January 2003 to December 2003. RESULTS The overall prevalence of microalbuminuria was 34%. Mean age of subjects was 53.1 years +/- 11.9 years, mean BMI was 25.8 +/- 4.1 and mean duration of diabetes was 8.8 +/- 5.21 years. Fifty seven percent were males and 43% females. Sixty two percent of the subjects had a systolic blood pressure > or = 130 mmHg. Forty five percent had a family history of diabetes and 5% had a family history of hypertension. Univariate analyses demonstrated significant associations between microalbuminuria and age, duration of diabetes, male gender, smoking status, mic...

Key words: prostate biopsy, prostate cancer, prostate-specific antigen, screening. ... Correspondence to: Stefano Ciatto, CSPO, Viale A. Volta 171, 50131 Florence, Italy. Tel 055-5012275; fax 055-5001623; e-mail s.ciatto@cspo.it ... PSA use and incidence of prostate biopsy

The goals of this study were to develop a computer-based electronic screening tool (eScreening) and determine the feasibility of implementing eScreening for rural users of primary care. This descriptive pilot adapted existing screening measures for depression and alcohol abuse to a portable computer-based format and examined the feasibility of its adoption and use. This was a three-step design using convenience samples for (1) a focus group with providers,(2) usability testing with selected rural patients using the ...

Ovarian cancer has received national attention as a highly virulent disease. Its lack of early warning symptoms and the failure to develop highly sensitive screening tests have led some physicians to recommend prophylactic oophorectomies to women with relatives who have had ovarian cancer. Others have recommended routine screening of otherwise normal women for CA 125, a circulating tumor marker, and ultrasound examinations. Each of these techniques is associated with substantial false-positive rates that could lead to unnecessary surgery. A review of epidemiologic data suggests that familial ovarian cancer kindreds are rare, but women with first-degree relatives who have had ovarian cancer have a significant risk themselves for developing ovarian cancer. In addition, women with a great number of ovulatory cycles are at an increased risk for the disease. Circulating tumor markers are frequently elevated in women with advanced ovarian cancer, but their value in early detection of ovar...

It is essential for children suffering from or at risk of lead poisoning to have regular follow-up, and specifically for their blood lead (Pb) levels to be monitored. The present study assessed the occurrence of late follow-up testing of blood lead levels in children in Greater Paris, and factors related to such delays. Since 1992, the SSSIILF has been systematically recording data on lead levels in blood tests conducted for screening and follow-up in Greater Paris. For Pb greater or equal to 45 microg/dL (Group 4), a further blood lead test has to be done within three weeks. For levels of 25 microg/dL < or = Pb < 45 microg/dL (Group 3) and 10 microg/dL < or = Pb < 25 microg/dL (Group 2), a second test must be done within 6 months. For Pb less than 10 microg/dL combined with one or more risk factors (Group 1: children at risk of poisoning), a second test is required within 6 to 12 months. Children aged 1 to 6 years who were screened between 1992 and 2002 were selected. T...

It is important to identify patients with Barrett's esophagus (BE), the precursor to esophageal adenocarcinoma (EAC). Patients with BE are usually identified by endoscopy, which is expensive. The cytosponge, which collects tissue from the esophagus non-invasively, could be a cost-effective tool for screening individuals with gastroesophageal reflux disease (GERD), who are at increased risk for BE. We developed a model to analyze the cost effectiveness of using cytosponge in first-line screening of patients with GERD for BE with endoscopic confirmation, compared to endoscopy screening only, METHODS: We incorporated data from a large clinical trial of cytosponge performance into 2 validated microsimulation models of EAC progression (the esophageal adenocarcinoma model from the Massachusetts General Hospital and the microsimulation screening analysis model from Erasmus University Medical Center). The models had been calibrated for United States Surveillance, Epidemiology and End Re...

Long-term follow-up data on the effects of screening are scarce and debate exists on the relative contribution of screening versus treatment to breast cancer mortality reduction. Our aim was therefore to assess the long-term effect of screening by age and time of implementation. We obtained data on 69,630 breast cancer deaths between 1980 and 2010 by municipality (N=431) and age of death (40-79) in the Netherlands. Breast cancer mortality trends were analysed by defining the municipality-specific calendar year of introduction of screening as year 0. Additionally, log-linear Poisson regression was used to estimate the turning point in the trend after year 0, per municipality, and the annual percentage change (APC) before and after this point. Twenty years after introduction of screening breast cancer mortality was reduced by 30% in women aged 55-74 and by 34% in women aged 75-79, compared to year 0. A similar and significant decrease was present in municipalities that started early (...

Although considerable attention has been placed on the role of prostitutes in the AIDS epidemic, little attention has been directed to features of prostitutes' work lives which are relevant to the control of AIDS. This article reviews several aspects of prostitution in the United States which have implications for control of the epidemic. The article first reviews the epidemiology of human immunodeficiency virus (HIV) infection among prostitutes. The legalized system of prostitution in Nevada serves as a basis for comparison to illegal prostitution. This article examines the effectiveness of mandatory testing of prostitutes for monitoring and controlling the epidemic. And finally, a peer education approach as a means to control HIV infection among prostitutes is explored.

The purpose of periodic health examinations is to prevent disease through early intervention and through stratifying individual patients' health risk. The German health examination as defined in section 25 of the Social Code Book V (Sozialgesetzbuch V) seems to be outdated in many respects. In order to develop an alternative to the current German system an international comparison of periodic health examinations in other healthcare systems is useful. The study investigates the measures taken for primary prevention of cardiovascular disease in seven countries. Content, implementation and organisation of the various programmes are analysed in the present paper. The present study was designed as a qualitative multiple case study. The collection of data on cardiovascular screening programmes in the seven different healthcare systems in this study relies on information publicly available on the Internet. The data were entered into a matrix which had been created prior to the data col...

A sample of 6237 adult inhabitants of the Canary Islands (Spain) was randomly divided into two subgroups: one yielded data used to develop the instrument, and the other yielded data used for validation testing. Performance of the instrument was compared in persons with ...

The aim was to develop a comprehensive screening instrument for evaluation of orofacial dysfunction that was easy to perform for different health professionals without special equipment. The Nordic Orofacial Test--Screening (NOT-S), consisting of a structured interview and clinical examination,was developed with a picture manual illustrating the different tasks in the examination. It was first tested in a Swedish version, and later translated to other Nordic languages, and to English. The interview reflected six domains, (I) Sensory function, (II) Breathing, (III) Habits, (IV) Chewing and swallowing, (V) Drooling, and (VI) Dryness of the mouth, and the examination included six domains representing (1) The face at rest, and tasks regarding (2) Nose breathing, (3) Facial expression, (4) Masticatory muscle and jaw function, (5) Oral motor function, and (6) Speech. One or more "yes" for impairment in a domain resulted in one point (maximum NOT-S score 12 points). The mean NOT-...

As Canada's population ages, frailty - with its increased risk of functional decline, deterioration in health status, and death - will become increasingly common. The physiology of frailty reflects its multisystem, multi-organ origins. About a quarter of Canadians over age 65 are frail, increasing to over half in those older than 85. Our health care system is organized around single-organ systems, impairing our ability to effectively treat people having multiple disorders and functional limitations. To address frailty, we must recognize when it occurs, increase awareness of its significance, develop holistic models of care, and generate better evidence for its treatment. Recognizing how frailty impacts lifespan will allow for integration of care goals into treatment options. Different settings in the Canadian health care system will require different strategies and tools to assess frailty. Given the magnitude of challenges frailty poses for the health care system as currently or...

Diabetes has become an epidemic and the incidence of undiagnosed diabetes is growing at an alarming rate. Diabetes is an associated risk factor for chronic periodontitis and has several other oral symptoms including dry mouth and oral infection. Expanding the role of the dentist may prove to be an efficient method of early detection and management of diabetes. The aim of this paper is to critically analyse the literature and determine whether screening for undiagnosed diabetes mellitus is within the dentist's scope of practice. A PubMed/Google Scholar/Google literature search was conducted of papers published in the English language in the years 1980-2013. Over 140 articles were examined. Reference lists of key articles were also sourced and analysed. The most pertinent articles are presented in this review. Screening for diabetes mellitus in the dental office should only be carried out for high-risk patients in order for such screenings to be cost-effective. Dentists have an et...

As Canada's population ages, frailty - with its increased risk of functional decline, deterioration in health status, and death - will become increasingly common. The physiology of frailty reflects its multisystem, multi-organ origins. About a quarter of Canadians over age 65 are frail, increasing to over half in those older than 85. Our health care system is organized around single-organ systems, impairing our ability to effectively treat people having multiple disorders and functional limitations. To address frailty, we must recognize when it occurs, increase awareness of its significance, develop holistic models of care, and generate better evidence for its treatment. Recognizing how frailty impacts lifespan will allow for integration of care goals into treatment options. Different settings in the Canadian health care system will require different strategies and tools to assess frailty. Given the magnitude of challenges frailty poses for the health care system as currently or...

Evidence supports the implementation of task shifting to address health worker shortages that are common in resource-limited settings. However, there is need to learn from established programs to identify ways to achieve the strongest, most sustainable impact. This study examined the Botswana lay counselor cadre, a task shifting initiative, to explore effectiveness and contribution to the health workforce. This evaluation used multiple methods, including a desk review, a national lay counselor survey (n = 385; response = 94%), in-depth interviews (n = 79), lay counselors focus group discussions (n = 7), lay counselors observations (n = 25), and client exit interviews (n = 47). Interview and focus group data indicate that lay counselors contribute to essentially all HIV-related programs in Botswana and they conduct the majority of HIV tests and related counseling at public health facilities throughout the country. Interviews showed that the lay counselor cadre is making the workload ...