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International Journal of Environmental... Jul 2020Despite the fact that American Heart Association (AHA) recommended a systematic screening for depression in cardiovascular inpatients, poor attention has been given to...
Despite the fact that American Heart Association (AHA) recommended a systematic screening for depression in cardiovascular inpatients, poor attention has been given to this issue. Furthermore, no specific guidelines exist for anxiety screening in cardiovascular inpatients. Thus, the aims of this study were to verify the feasibility of a depressive and anxiety symptoms screening protocol in an Italian hospital specializing in cardiovascular diseases and to evaluate both anxiety and depressive symptoms prevalence. A group of 2009 consecutive inpatients completed the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder (GAD-7). The rates of depressive and anxiety symptoms were almost 9% and 16% respectively. Men were less likely than women to experience both depressive and anxiety symptoms. Patients who were admitted to the heart failure unit reported higher risk of experiencing both symptoms compared to patients in other wards. Similarly, patients admitted to the cardiac surgery unit showed a higher risk of experiencing anxiety symptoms compared to other patients. The proposed screening procedure showed a good feasibility and acceptance. This study highlighted the importance of implementing a short screening procedure in hospitals dealing with cardiovascular inpatients to identify those individuals who require specific attention and interventions.
Topics: Aged; Anxiety; Anxiety Disorders; Depression; Female; Heart Diseases; Heart Failure; Humans; Inpatients; Italy; Male; Mass Screening; Middle Aged; Psychiatric Status Rating Scales; Psychometrics; Surveys and Questionnaires
PubMed: 32664632
DOI: 10.3390/ijerph17145007 -
World Journal of Gastroenterology Jan 2013Colorectal cancer is the third most common cancer in men and the second most common cancer in women worldwide. Diagnosing colorectal has been increasingly successful due... (Review)
Review
Colorectal cancer is the third most common cancer in men and the second most common cancer in women worldwide. Diagnosing colorectal has been increasingly successful due to advances in technology. Flexible endoscopy is considered to be an effective method for early diagnosis and treatment of gastrointestinal cancer, making it a popular choice for screening programs. However, millions of people who may benefit from endoscopic colorectal cancer screening fail to have the procedure performed. Main reasons include psychological barriers due to the indignity of the procedure, fear of procedure related pain, bowel preparation discomfort, and potential need for sedation. Therefore, an urgent need for new technologies addressing these issues clearly exists. In this review, we discuss a set of advanced endoscopic technologies for colorectal cancer screening that are either already available or close to clinical trial. In particular, we focus on visual-inspection-only advanced flexible colonoscopes, interventional colonoscopes with alternative propulsion mechanisms, wireless capsule colonoscopy, and technologies for intraprocedural bowel cleansing. Many of these devices have the potential to reduce exam related patient discomfort, obviate the need for sedation, increase diagnostic yield, reduce learning curves, improve access to screening, and possibly avert the need for a bowel preparation.
Topics: Capsule Endoscopes; Capsule Endoscopy; Colonoscopes; Colonoscopy; Colorectal Neoplasms; Early Detection of Cancer; Equipment Design; Humans; Mass Screening; Patient Compliance; Predictive Value of Tests; Prognosis
PubMed: 23382621
DOI: 10.3748/wjg.v19.i4.431 -
Public Health Apr 2021A systematic narrative literature review was undertaken to assess the acceptability of childhood screening interventions to identify factors to consider when planning or...
OBJECTIVES
A systematic narrative literature review was undertaken to assess the acceptability of childhood screening interventions to identify factors to consider when planning or modifying childhood screening programs to maximize participation and uptake.
STUDY DESIGN
This is a systematic narrative literature review.
METHODS
Electronic databases were searched (MEDLINE, EMBASE, PsycINFO via Ovid, CINAHL, and Cochrane Library) to identify primary research studies that assessed screening acceptability. Studies were categorized using an existing theoretical framework of acceptability consisting of seven constructs: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy. A protocol was developed and registered with PROSPERO (registration no. CRD42018099763) RESULTS: The search identified 4529 studies, and 46 studies met the inclusion criteria. Most studies involved neonatal screening. Programs identified included newborn blood spot screening (n = 22), neonatal hearing screening (n = 13), Duchenne muscular dystrophy screening (n = 4), cystic fibrosis screening (n = 3), screening for congenital heart defects (n = 2), and others (n = 2). Most studies assessed more than one construct of acceptability. The most common constructs identified were affective attitude (how a parent feels about the program) and intervention coherence (parental understanding of the program, and/or the potential consequences of a confirmed diagnosis).
CONCLUSIONS
The main acceptability component identified related to parental knowledge and understanding of the screening process, the testing procedure(s), and consent. The emotional impact of childhood screening mostly explored maternal anxiety. Further studies are needed to examine the acceptability of childhood screening across the wider family unit. When planning new (or refining existing) childhood screening programs, it is important to assess acceptability before implementation. This should include assessment of important issues such as information needs, timing of information, and when and where the screening should occur.
Topics: Child; Humans; Infant; Infant, Newborn; Mass Screening; Neonatal Screening; Parents; Patient Acceptance of Health Care
PubMed: 33831694
DOI: 10.1016/j.puhe.2021.02.005 -
Revista Espanola de Enfermedades... Dec 2022Colonoscopy is the gold standard method for the early diagnosis and prevention of colorectal cancer (CRC). Screening programs include immune determination of blood in... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Colonoscopy is the gold standard method for the early diagnosis and prevention of colorectal cancer (CRC). Screening programs include immune determination of blood in feces. Regardless of the method used, proximal colon lesions appear to be detected less frequently.
OBJECTIVE
Analyze the characteristics of proximal and distal lesions and possible predisposing factors.
METHODS
A cross-sectional study was performed of 692 patients from the CRC screening program with FIT ≥ 100ngHb/ml (October 2017 - October 2018). The right colon was examined twice as patients were participating in a randomized clinical trial to re-evaluate the right colon by forward-viewing endoscope or proximal retroflexion. The adenoma detection rate (ADR), advanced neoplasia (AN) and CRC in the proximal and distal colon, the histological and morphological characteristics in each section were analyzed.
RESULTS
52.9% of the patients were male, with a mean age of 59.5 years (SD: 7.6). 1490 polyps were found and the ADR was 57.7% (distal 42% and proximal 37%). Detection rates were 45.8% for AN, 40.9% for advanced adenomas, 5.2% for advanced SSL and CRC was diagnosed in 4.8% of patients. Males had more AN than females. The mean age of patients with AN was significantly higher. AN were associated with smoking and alcohol consumption (p=0.0001). Globally, FIT levels were higher in patients with AN (p=0.003). Sixty-six per cent of cancers were distally located and 61.3% of CRC were diagnosed in the early stages.
CONCLUSIONS
In an average-risk asymptomatic population undergoing colonoscopy after positive FIT, AN were more common in the distal colon in males, older patients, smokers and those with alcohol intake.
Topics: Female; Humans; Male; Middle Aged; Cross-Sectional Studies; Colonoscopy; Colorectal Neoplasms; Polyps; Early Detection of Cancer; Mass Screening
PubMed: 35285657
DOI: 10.17235/reed.2022.8409/2021 -
The Pan African Medical Journal 2016The study was conducted to determine the challenges and suggest solutions to conducting free cervical cancer screening among Nigerian women.
INTRODUCTION
The study was conducted to determine the challenges and suggest solutions to conducting free cervical cancer screening among Nigerian women.
METHODS
Awareness was created among women groups and mass media in Osun State for women to undergo free cervical cancer screening programme. Consenting women had their socio-demographic characteristics, awareness and uptake of HPV vaccine documented and papanicolaou smear procedure done with adequate referral for treatment given where necessary.
RESULTS
A total of 287 women had cervical cancer screening. Mean (SD) age was 51.6 (14.3) years. Most participants were urban based (87.1%), married (63.1%), had secondary education (39%) and were traders (79.1%). None of the women were aware of the preventive HPV vaccine or had been vaccinated against HPV. About 6% were pre-invasive while 0.7% had invasive cervical cancer. The highest proportions of respondents affected were young, married and had lower education. Challenges identified included poor attendance, low risk perception and logistic issues.
CONCLUSION
Most participants were urban based. There is need to decentralize cancer of cervix screening through mobile clinics and establishment of screening centres in the rural areas. Neighbour to neighbour sensitization is essential. Also, HPV vaccine should be available and affordable to all girls before sexual maturity.
Topics: Adult; Aged; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Middle Aged; Nigeria; Papanicolaou Test; Papillomavirus Infections; Papillomavirus Vaccines; Patient Acceptance of Health Care; Prospective Studies; Urban Population; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
PubMed: 28154674
DOI: 10.11604/pamj.2016.24.319.9300 -
Archives of Suicide Research : Official... 2022Youth involved in the juvenile justice system are at elevated risk for suicide and co-occurring mental health symptoms. This study aims to examine the suicide risk and...
Youth involved in the juvenile justice system are at elevated risk for suicide and co-occurring mental health symptoms. This study aims to examine the suicide risk and treatment needs of court-involved, non-incarcerated (CINI) youth, and to understand the acceptability and effectiveness of implementing a mental health screening procedure at time of first court contact. By embedding a forensic mental health screening tool into the intake process of a family court diversionary program, a total of 891 youth (aged 12-18) were assessed using the Massachusetts Youth Screening Instrument-2 (MAYSI-2). Analysis of screening responses revealed 12.5% of youth indicated risk for suicide with risk levels differentiated by youth sex, race and ethnicity. Suicide ideation was also significantly associated with flagging, an indication of clinical risk, on all other scales of the MAYSI-2, as well as subsequent referrals to treatment. Screening for suicide at first point of court contact within an existing diversionary program may serve as a critical and effective point of intervention for youth in need.
Topics: Adolescent; Humans; Juvenile Delinquency; Mass Screening; Mental Disorders; Mental Health; Suicidal Ideation
PubMed: 33076766
DOI: 10.1080/13811118.2020.1833795 -
BMC Endocrine Disorders Mar 2020The implementation of population screening and early prevention strategies targeting individuals at high-risk for type 2 diabetes (T2D) seems to be a public health... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The implementation of population screening and early prevention strategies targeting individuals at high-risk for type 2 diabetes (T2D) seems to be a public health priority. The current work aimed to describe the screening procedure applied in the Feel4Diabetes-study and examine its effectiveness in identifying individuals and families at high risk, primarily for T2D and secondarily for hypertension, among vulnerable populations in low to middle-income countries (LMICs) and high-income countries (HICs) across Europe.
METHODS
A two-stage screening procedure, using primary schools as the entry-point to the community, was applied in low socioeconomic status (SES) regions in LMICs (Bulgaria-Hungary), HICs (Belgium-Finland) and HICs under austerity measures (Greece-Spain). During the first-stage screening via the school-setting, a total of 20,501 parents (mothers and/or fathers) of schoolchildren from 11,396 families completed the Finnish Diabetes Risk Score (FINDRISC) questionnaire, while their children underwent anthropometric measurements in the school setting. Parents from the identified "high-risk families" (n = 4484) were invited to participate in the second-stage screening, including the measurement of fasting plasma glucose (FPG) and blood pressure (BP). In total, 3153 parents participated in the second-stage screening (mean age 41.1 ± 5.6 years, 65.8% females).
RESULTS
Among parents who attended the second-stage screening, the prevalence of prediabetes (as defined by impaired fasting glucose; FPG 100-125 mg/dl) and T2D (FPG > 126 mg/dl) was 23.2 and 3.0% respectively, and it was found to be higher in the higher FINDRISC categories. The percentage of undiagnosed T2D among the participants identified with T2D was 53.5%. The prevalence of high normal BP (systolic BP 130-139 mmHg and/ or diastolic BP 85-89 mmHg) and hypertension (systolic BP ≥ 140 mmHg and/ or diastolic BP ≥ 90 mmHg) was 14 and 18.6% respectively, which was also higher in the higher FINDRISC categories. The percentage of cases not receiving antihypertensive treatment among the participants identified with hypertension was 80.3%.
CONCLUSION
The findings of the current study indicate that the two-stage school and community-based screening procedure followed, effectively identified high-risk individuals and families in vulnerable populations across Europe. This approach could be potentially scalable and sustainable and support initiatives for the early prevention of T2D and hypertension.
TRIAL REGISTRATION
The Feel4Diabetes-intervention is registered at https://clinicaltrials.gov/ (NCT02393872; date of trial registration: March 20, 2015).
Topics: Adult; Child; Community Networks; Diabetes Mellitus, Type 2; Europe; Family; Feasibility Studies; Female; Humans; Implementation Science; Male; Mass Screening; Middle Aged; Prediabetic State; Prevalence; Preventive Health Services; Program Evaluation; Residence Characteristics; Risk Factors; School Health Services; Schools; Vulnerable Populations
PubMed: 32164646
DOI: 10.1186/s12902-019-0478-9 -
Value in Health : the Journal of the... 2017Because early detection of lung cancer can substantially improve survival, there is increasing attention for lung cancer screening.
BACKGROUND
Because early detection of lung cancer can substantially improve survival, there is increasing attention for lung cancer screening.
OBJECTIVES
To estimate public preferences for lung cancer screening and to identify subgroups in preferences.
METHODS
Seven important attributes were selected using the literature, interviews, and a panel session. Preferences were elicited using a swing weighting questionnaire. The resulting attribute weights indicate the relative importance of swings from the worst to the best level between attributes. Hierarchical clustering was used to identify subgroups with different attribute weights.
RESULTS
One thousand thirty-four respondents from a representative Dutch panel aged between 40 and 80 years were included. The identified attributes were location of screening (weight = 0.18 ± 0.16), mode of screening (weight = 0.17 ± 0.14), sensitivity (weight = 0.16 ± 0.13) and specificity (weight = 0.13 ± 0.12) of the screening modality, waiting time until results (weight = 0.13 ± 0.12), radiation burden (weight = 0.13 ± 0.12), and duration of screening procedure (weight = 0.10 ± 0.09). Most respondents preferred breath analysis (45%) to giving blood samples (31%) or going through a scanner (24%) as screening modality; 59% preferred screening at the general practitioner's office instead of at the hospital. There was a significant difference in education between the five identified preference subgroups (P < 0.01).
CONCLUSIONS
There is considerable variation in how people value attributes of lung cancer screening. Different screening policies and implementation strategies may be appropriate for particular preference subgroups. Our results indicate that people prefer breath analysis and that they are more likely to attend screening modalities that can be used at a primary care facility.
Topics: Adult; Aged; Aged, 80 and over; Cluster Analysis; Early Detection of Cancer; Female; Humans; Lung Neoplasms; Male; Mass Screening; Middle Aged; Netherlands; Patient Preference; Sensitivity and Specificity; Surveys and Questionnaires
PubMed: 28712626
DOI: 10.1016/j.jval.2017.04.001 -
Cancer Oct 2014Breast cancer screening holds a prominent place in public health, health care delivery, policy, and women's health care decisions. Several factors are driving shifts in... (Review)
Review
Breast cancer screening in an era of personalized regimens: a conceptual model and National Cancer Institute initiative for risk-based and preference-based approaches at a population level.
Breast cancer screening holds a prominent place in public health, health care delivery, policy, and women's health care decisions. Several factors are driving shifts in how population-based breast cancer screening is approached, including advanced imaging technologies, health system performance measures, health care reform, concern for "overdiagnosis," and improved understanding of risk. Maximizing benefits while minimizing the harms of screening requires moving from a "1-size-fits-all" guideline paradigm to more personalized strategies. A refined conceptual model for breast cancer screening is needed to align women's risks and preferences with screening regimens. A conceptual model of personalized breast cancer screening is presented herein that emphasizes key domains and transitions throughout the screening process, as well as multilevel perspectives. The key domains of screening awareness, detection, diagnosis, and treatment and survivorship are conceptualized to function at the level of the patient, provider, facility, health care system, and population/policy arena. Personalized breast cancer screening can be assessed across these domains with both process and outcome measures. Identifying, evaluating, and monitoring process measures in screening is a focus of a National Cancer Institute initiative entitled PROSPR (Population-based Research Optimizing Screening through Personalized Regimens), which will provide generalizable evidence for a risk-based model of breast cancer screening, The model presented builds on prior breast cancer screening models and may serve to identify new measures to optimize benefits-to-harms tradeoffs in population-based screening, which is a timely goal in the era of health care reform.
Topics: Adult; Aged; Breast Neoplasms; Decision Making; Early Detection of Cancer; Evidence-Based Medicine; False Positive Reactions; Female; Humans; Magnetic Resonance Imaging; Mammography; Mass Screening; Middle Aged; National Cancer Institute (U.S.); Practice Guidelines as Topic; Precision Medicine; Risk Assessment; United States
PubMed: 24830599
DOI: 10.1002/cncr.28771 -
African Health Sciences Jun 2022Cervical cancer is the second most frequent cancer and cause of cancer-related deaths among women in Nigeria. The Visual inspection with acetic acid and cryotherapy "see...
BACKGROUND
Cervical cancer is the second most frequent cancer and cause of cancer-related deaths among women in Nigeria. The Visual inspection with acetic acid and cryotherapy "see and treat" screening approach is a feasible and effective method that can be implemented in low resource settings like Nigeria; however, screening utilization is still low.
OBJECTIVE
This systematic review aims at offering a comprehensive synthesis of studies that assessed the barriers preventing women from utilizing cervical cancer screening services in Nigeria.
METHODS
Electronic data search was performed on PubMed, Cochrane Library, EMbase, Directory of Open Access Journals, Google Scholar, and ScienceDirect, and quality assessment was conducted for the included studies. Data were extracted independently by two authors and thematically analysed for barriers to cervical cancer screening utilization.
RESULTS
Fifteen studies, consisting of 9,995 women aged 15 and above published between 2007 and 2020, were included. Frequently reported barriers to cervical screening include lack of knowledge of cervical cancer and screening, health service factors, screening is unnecessary, fear of outcome and procedure, and financial constraints.
CONCLUSION
Lack of adequate information about cervical cancer is a significant hindrance to screening; this factor is strongly associated with the numerous misconceptions and negative perceptions. The study highlights the need for further assessment of the sociodemographic determinants of cervical cancer screening uptake in Nigeria. Preventive strategies should be targeted at improving the dissemination of valid information, reducing the knowledge gap among women, and addressing the financial and health service factors.
Topics: Humans; Female; Early Detection of Cancer; Uterine Cervical Neoplasms; Nigeria; Health Knowledge, Attitudes, Practice; Mass Screening
PubMed: 36407354
DOI: 10.4314/ahs.v22i2.33