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Current Obesity Reports Sep 2016Obesity is a major risk factor for chronic diseases with significant morbidity, mortality and health care cost. There is concern due to the dramatic increase in... (Review)
Review
Obesity is a major risk factor for chronic diseases with significant morbidity, mortality and health care cost. There is concern due to the dramatic increase in overweight and obesity in Canada in the last 20 years. The causes of obesity are multifactorial, with underestimation by patients and healthcare providers of the long-term nature of the condition, and its complexity. Solutions related to prevention and management will require multifaceted strategies involving education, health policy, public health and health systems across the care continuum. We believe that to support such strategies we need to have a strong primary care workforce equipped with appropriate knowledge, skills and attitudes to support persons at risk for, or with, obesity. To achieve this end, significant skills building is required to improve primary care obesity prevention and management efforts. This review will first examine the current state, and then will outline how we can improve.
Topics: Canada; Chronic Disease; Health Knowledge, Attitudes, Practice; Health Policy; Health Promotion; Humans; Obesity; Population Surveillance; Practice Patterns, Physicians'; Primary Prevention; Public Health
PubMed: 27342445
DOI: 10.1007/s13679-016-0222-y -
Progress in Cardiovascular Diseases 2017
Topics: Disease Management; Humans; Primary Prevention; Secondary Prevention; Stroke
PubMed: 28648183
DOI: 10.1016/j.pcad.2017.05.006 -
Expert Opinion on Investigational Drugs Nov 2016Cardiovascular diseases (CVD) remain the leading cause of death worldwide with an estimated 17.5 million deaths per year. Since its initial conception over a decade ago,... (Review)
Review
Cardiovascular diseases (CVD) remain the leading cause of death worldwide with an estimated 17.5 million deaths per year. Since its initial conception over a decade ago, the use of cardiovascular polypills has gained increasing momentum as a strategy to lower risk factor levels and prevent CVD. Several new data have emerged including the recent publication of the first outcomes trial using polypills. Areas covered: In this review, the authors summarize the current literature on the safety, efficacy, and cost-effectiveness of polypills for primary and secondary prevention of CVD, describe the current controversies in this field, and identify important areas for future research. The authors searched PubMed, CENTRAL, and ClinicalTrials.gov from inception till 25 June 2016 using the search term 'polypill.' Expert opinion: Cardiovascular polypills containing aspirin, statin, and one or more anti-hypertensive medications, along with lifestyle interventions, represent an attractive, safe, and cost-effective strategy for primary and secondary prevention of CVD. Future research efforts should focus on identifying patients who will benefit the most from the use of polypills, marketing several polypills with different components and doses, and developing novel regulatory strategies for making polypills more readily available in all countries worldwide.
Topics: Cardiovascular Agents; Cardiovascular Diseases; Cost-Benefit Analysis; Drug Combinations; Humans; Primary Prevention; Risk Factors; Secondary Prevention
PubMed: 27645895
DOI: 10.1080/13543784.2016.1236912 -
Nature Reviews. Neurology Sep 2016The increasing global stroke burden strongly suggests that currently implemented primary stroke prevention strategies are not sufficiently effective, and new primary... (Review)
Review
The increasing global stroke burden strongly suggests that currently implemented primary stroke prevention strategies are not sufficiently effective, and new primary prevention strategies with larger effect sizes are needed. Here, we review the latest stroke epidemiology literature, with an emphasis on the recently published Global Burden of Disease 2013 Study estimates; highlight the problems with current primary stroke and cardiovascular disease (CVD) prevention strategies; and outline new developments in primary stroke and CVD prevention. We also suggest key priorities for the future, including comprehensive prevention strategies that target people at all levels of CVD risk; implementation of an integrated approach to promote healthy behaviours and reduce health disparities; capitalizing on information technology to advance prevention approaches and techniques; and incorporation of culturally appropriate education about healthy lifestyles into standard education curricula early in life. Given the already immense and fast-increasing burden of stroke and other major noncommunicable diseases (NCDs), which threatens worldwide sustainability, governments of all countries should develop and implement an emergency action plan addressing the primary prevention of NCDs, possibly including taxation strategies to tackle unhealthy behaviours that increase the risk of stroke and other NCDs.
Topics: Global Health; Humans; Primary Prevention; Stroke
PubMed: 27448185
DOI: 10.1038/nrneurol.2016.107 -
Advances in Pediatrics Aug 2014There is no safe lead level in children. Primary prevention is the most effective way to bring about the complete removal of lead from the environment and eliminate lead... (Review)
Review
There is no safe lead level in children. Primary prevention is the most effective way to bring about the complete removal of lead from the environment and eliminate lead poisoning as a public health concern. The National Lead Information Center can be reached via the Internet at www.epa.gov/lead and www.hud.gov/lead, or via phone at 1-800-424-LEAD (5323).
Topics: Child; Global Health; Humans; Incidence; Lead Poisoning; Prevalence; Primary Prevention
PubMed: 25037135
DOI: 10.1016/j.yapd.2014.04.004 -
Preventive Medicine Jul 2015Anxiety disorders are the most prevalent psychiatric disorders in primary care and have significant social, economic, and interpersonal costs. Primary care is an ideal... (Review)
Review
OBJECTIVE
Anxiety disorders are the most prevalent psychiatric disorders in primary care and have significant social, economic, and interpersonal costs. Primary care is an ideal setting to prevent the appearance of anxiety disorders. The aim of this study was to evaluate the efficacy and cost-effectiveness of primary prevention interventions in anxiety disorders in the adult population receiving primary health care.
METHODS
A literature search was carried out in four databases-PubMed, PsycInfo, Cochrane, and Web of Science-from January 1980 to November 2013. Clinical trials and systematic reviews published in English and non-English languages and that evaluated the efficacy and/or cost-effectiveness of interventions of primary prevention for anxiety in primary care in the general adult population were included. Risk of bias was assessed by the Cochrane Risk Bias Tool and Overview Quality Assessment Questionnaire.
RESULTS
No high-quality research was identified that studied primary prevention of anxiety disorders in the adult population in the primary care setting. The few studies that exist focus on the child-adolescent population or on other types of interventions, usually as secondary prevention.
CONCLUSION
This study emphasizes the need for the development of high-quality clinical trials on the prevention of anxiety disorders in primary care.
Topics: Anxiety Disorders; Humans; Mental Health; Primary Health Care; Primary Prevention
PubMed: 25456801
DOI: 10.1016/j.ypmed.2014.10.015 -
Lancet (London, England) Jul 2014In the first three decades of life, more individuals in the USA die from injuries and violence than from any other cause. Millions more people survive and are left with... (Review)
Review
In the first three decades of life, more individuals in the USA die from injuries and violence than from any other cause. Millions more people survive and are left with physical, emotional, and financial problems. Injuries and violence are not accidents; they are preventable. Prevention has a strong scientific foundation, yet efforts are not fully implemented or integrated into clinical and community settings. In this Series paper, we review the burden of injuries and violence in the USA, note effective interventions, and discuss methods to bring interventions into practice. Alliances between the public health community and medical care organisations, health-care providers, states, and communities can reduce injuries and violence. We encourage partnerships between medical and public health communities to consistently frame injuries and violence as preventable, identify evidence-based interventions, provide scientific information to decision makers, and strengthen the capacity of an integrated health system to prevent injuries and violence.
Topics: Accidental Falls; Brain Injuries; Cost-Benefit Analysis; Evidence-Based Medicine; Government Programs; Humans; Primary Prevention; Public Health; Residence Characteristics; United States; Violence; Wounds and Injuries
PubMed: 24996591
DOI: 10.1016/S0140-6736(14)60074-X -
Indian Heart Journal 2019Aspirin is one of the oldest and most commonly used cardiovascular drugs. Despite there being high-quality evidence supporting the use of aspirin for patients with known... (Review)
Review
Aspirin is one of the oldest and most commonly used cardiovascular drugs. Despite there being high-quality evidence supporting the use of aspirin for patients with known cardiovascular disease, a definitive consensus regarding its use for patients at risk for cardiovascular disease (and without established cardiovascular disease) has never been reached. Many randomized control trials have produced conflicting results, and consequently, society guidelines have issued differring recommendations. Three major trials were published in 2018, which supplement the existing data on aspirin's role in primary prevention and provide further guidance on this contentious issue. This article reviews the history of aspirin through the last two decades, with special emphasis on these new trials.
Topics: Aspirin; Cardiovascular Diseases; Humans; Primary Prevention
PubMed: 31280821
DOI: 10.1016/j.ihj.2019.04.001 -
The British Journal of General Practice... Oct 2014
Topics: Attitude of Health Personnel; Chronic Disease; Early Diagnosis; Evidence-Based Medicine; Humans; Mass Screening; Primary Prevention; United Kingdom
PubMed: 25267022
DOI: 10.3399/bjgp14X681625 -
European Journal of Preventive... Jan 2018Sudden death is a major health problem all over the world. The most common causes of sudden death are cardiac but there are also other causes such as neurological... (Review)
Review
Sudden death is a major health problem all over the world. The most common causes of sudden death are cardiac but there are also other causes such as neurological conditions (stroke, epileptic attacks and brain trauma), drugs, catecholamine toxicity, etc. A common feature of all these diverse pathologies underlying sudden death is the imbalance of the autonomic nervous system control of the cardiovascular system. This paper reviews different pathologies underlying sudden death with emphasis on the autonomic nervous system contribution, possibilities of early diagnosis and prognosis of sudden death using various clinical markers including autonomic markers (heart rate variability and baroreflex sensitivity), present possibilities of management and promising prevention by electrical neuromodulation.
Topics: Animals; Autonomic Nervous System; Autonomic Nervous System Diseases; Baroreflex; Cardiovascular System; Death, Sudden, Cardiac; Early Diagnosis; Genetic Predisposition to Disease; Heart Rate; Humans; Predictive Value of Tests; Primary Prevention; Prognosis; Risk Factors
PubMed: 29053016
DOI: 10.1177/2047487317736827