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Diagnostic and Clinical Utility of the GAD-2 for Screening Anxiety Symptoms in Individuals With Multiple Sclerosis To assess the diagnostic and clinical utility of the 2-item Generalized Anxiety Disorder Scale (GAD-2) for screening anxiety symptoms in individuals with multiple sclerosis (MS).Cross-sectional.University-affiliated MS neurology and rehabilitation center.The sample comprised adults (N=99) (ages 19-72; mean ± SD=46.2±13.0; 75% women) with a physician-confirmed MS diagnosis who were (...) clinically significant anxiety symptoms. Alternatively, a cutoff score of ≥2 provided excellent sensitivity (1.00) and fair specificity (0.76).The GAD-2 is a clinically useful and psychometrically valid tool for screening anxiety symptoms in MS rehabilitation and neurology care settings. Importantly, this tool has the potential to identify individuals with MS who are at risk for anxiety disorders and who may benefit from rehabilitation psychology interventions to ultimately improve functioning
Practice Advisory: Cervical Cancer Screening Practice Advisory: Cervical Cancer Screening (Update) - ACOG Menu ▼ Practice Advisory: Cervical Cancer Screening (Update) Page Navigation ▼ Share: Practice Advisory: Cervical Cancer Screening (Update) The Society of Gynecologic Oncology and ASCCP endorse this document. On August 21, 2018, the U.S. Preventive Services Task Force (USPSTF) published its final recommendation statement (1) on cervical cancer screening in average-risk women (Table 1 (...) ). Table 1 . 2018 USPSTF Cervical Cancer Screening Recommendations for Average-Risk Women Abbreviation: hrHPV: high-risk human papillomavirus. *These recommendations apply to women with a cervix who do not have any signs or symptoms of cervical cancer, regardless of their sexual history or human papillomavirus vaccination status. These recommendations do not apply to women who are at high risk of the disease, such as women who have previously received a diagnosis of a high-grade precancerous cervical
Development and clinimetric assessment of a nurse-administered screening tool for movement disorders in psychosis Movement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed.To develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses.Item selection and content validity assessment for the ScanMove instrument were conducted (...) by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist
Stick To It: pilot study results of an intervention using gamification to increase HIV screening among young men who have sex with men in California In the United States, young men who have sex with men (YMSM) experience a disproportionate burden of HIV and sexually transmitted infections (STIs). Mobile health (mHealth) interventions, including those that incorporate elements of games ("gamification"), have the potential to improve YMSM engagement in desirable sexual health services (...) and Hollywood, California. The gamification intervention, Stick To It, had four components: (I) recruitment (clinic-based and online), (II) online enrollment, (III) online activities, and (IV) 'real-world' activities at the clinic. Participants earned points through online activities that could be redeemed for a chance to win prizes during HIV/STI screening and care visits. The primary outcome was intervention acceptability measured with participant engagement data and in-depth interviews. The secondary
Optimizing Cervical Cancer Screening and Triage in Low-Resource Settings 30252572 2019 03 04 2378-9506 4 2018 Sep Journal of global oncology J Glob Oncol Optimizing Cervical Cancer Screening and Triage in Low-Resource Settings. 1-2 10.1200/JGO.18.00192 Seay Julia S JS Julia S. Seay and Erin Kobetz, University of Miami School of Medicine, Miami, FL. Kobetz Erin E Julia S. Seay and Erin Kobetz, University of Miami School of Medicine, Miami, FL. eng Journal Article United States J Glob Oncol
Recent advances in colorectal cancer screening 30276360 2018 11 14 2589-0514 4 3 2018 Sep Chronic diseases and translational medicine Chronic Dis Transl Med Recent advances in colorectal cancer screening. 139-147 10.1016/j.cdtm.2018.08.004 Li Dan D Department of Gastroenterology, Kaiser Permanente Medical Center, Santa Clara, CA 95051, USA. Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA. eng Editorial 2018 09 17 China Chronic Dis Transl Med 101679934 2095 (...) -882X Colonoscopy Colorectal cancer Screening 2018 06 26 2018 10 3 6 0 2018 10 3 6 0 2018 10 3 6 1 epublish 30276360 10.1016/j.cdtm.2018.08.004 S2095-882X(18)30060-4 PMC6160607 Lancet. 2013 Apr 6;381(9873):1185-93 23414648 Am J Surg Pathol. 2004 Nov;28(11):1452-9 15489648 Gastroenterology. 2016 Nov;151(5):870-878.e3 27443823 CA Cancer J Clin. 2017 May 6;67(3):177-193 28248415 Gastroenterology. 2015 Sep;149(3):777-82; quiz e16-7 26226577 Am J Gastroenterol. 2012 Sep;107(9):1315-29; quiz 1314, 1330
Screening for Syphilis Infection in Pregnant Women: US Preventive Services Task Force Reaffirmation Recommendation Statement. Untreated syphilis infection in pregnant women can be transmitted to the fetus (congenital syphilis) at any time during pregnancy or at birth. Congenital syphilis is associated with stillbirth, neonatal death, and significant morbidity in infants (eg, bone deformities and neurologic impairment). After a steady decline from 2008 to 2012, cases of congenital syphilis (...) markedly increased from 2012 to 2106, from 8.4 to 15.7 cases per 100 000 live births (an increase of 87%). At the same time, national rates of syphilis increased among women of reproductive age.To update the US Preventive Services Task Force (USPSTF) 2009 recommendation on screening for syphilis infection in pregnant women.The USPSTF commissioned a reaffirmation evidence update to identify new and substantial evidence sufficient enough to change its prior recommendation. Given the established benefits
Effectiveness of a Mailed Colorectal Cancer Screening Outreach Program in Community Health Clinics: The STOP CRC Cluster Randomized Clinical Trial Approximately 24 million US individuals receive care at federally qualified health centers, which historically have low rates of colorectal cancer screening. The US Preventive Services Task Force recommends routine colorectal cancer screening for individuals aged 50 to 75 years.To determine the effectiveness of an electronic health record (EHR (...) )-embedded mailed fecal immunochemical test (FIT) outreach program implemented in health centers as part of standard care.This cluster randomized pragmatic clinical trial was conducted in 26 federally qualified health center clinics, representing 8 health centers in Oregon and California, randomized to intervention (n = 13) or usual care (n = 13). All participants were overdue for colorectal cancer screening during the accrual interval (February 4, 2014 to February 3, 2015).Electronic health record
Development of a Primary Care Guide for Implementing Evidence-Based Screening and Counseling for Unhealthy Alcohol Use With Epic-Based Electronic Health Record Tools: A Pilot Dissemination Project Methods Research Report Development of a Primary Care Guide for Implementing Evidence-Based Screening and Counseling for Unhealthy Alcohol Use With Epic- Based Electronic Health Record Tools: A Pilot Dissemination Project Methods Research Report Development of a Primary Care Guide for Implementing (...) Evidence-Based Screening and Counseling for Unhealthy Alcohol Use With Epic- Based Electronic Health Record Tools: A Pilot Dissemination Project Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00011-I, Task Order 1 Prepared by: RTI International–University of North Carolina Evidence-based Practice Center Research Triangle Park, NC Investigators: Colleen Barclay, M.P.H. Meera
Knowledge, Beliefs, and Attitudes About Breast Cancer Screening in Latin America and the Caribbean: An In-Depth Narrative Review Purpose Breast cancer (BCA) is the most common cancer and leading cause of cancer mortality among women in Latin America and the Caribbean (LAC), and the number of deaths from BCA is expected to continue to increase. Although barriers to care include the physical accessibility of screening resources, personal and cultural barriers must be explored to understand (...) necessary next steps to increase access to preventive care. The purpose of this in-depth narrative literature review was to explore empiric literature that surrounds the knowledge, attitudes, and beliefs toward BCA screening practices among women in LAC. To our knowledge, this is the first literature review to include articles from all countries and national languages (Portuguese, English, and Spanish) that pertain to this topic. Methods OVID Medline, CINAHL, and Web of Science/SciELO were used
Advanced Hepatocellular Carcinoma Tumor Stage at Diagnosis in the 1945â€1965 Birth Cohort Reflects Poor Use of Hepatocellular Carcinoma Screening Individuals from the 1945-1965 birth cohort account for the majority of hepatocellular carcinoma (HCC) cases in the United States. Understanding trends in HCC among this birth cohort is vital given the increasing burden of chronic liver disease among this group. We retrospectively evaluated trends and disparities in HCC tumor stage at the time (...) to non-Hispanic whites (odds ratio, 0.73; 95% confidence interval, 0.68-0.78; P < 0.01). Conclusion: From 2004 to 2014, the burden of newly diagnosed HCC among the 1945-1965 birth cohort increased by 5.9% per year. While improvements in earlier staged HCC at diagnosis were observed, the majority of patients with HCC among the 1945-1965 birth cohort were beyond the Milan criteria at diagnosis; this may reflect poor utilization or suboptimal performance of HCC screening tests.
Screening for Cervical Cancer in Primary Care: A Decision Analysis for the US Preventive Services Task Force. Evidence on the relative benefits and harms of primary high-risk human papillomavirus (hrHPV) testing is needed to inform guidelines.To inform the US Preventive Services Task Force by modeling the benefits and harms of various cervical cancer screening strategies.Microsimulation model of a hypothetical cohort of women initiating screening at age 21 years.Screening with cytology, hrHPV (...) testing, and cytology and hrHPV cotesting, varying age to switch from cytology to hrHPV testing or cotesting (25, 27, 30 years), rescreening interval (3, 5 years), and triage options for hrHPV-positive results (16/18 genotype, cytology testing). Current guidelines-based screening strategies comprised cytology alone every 3 years starting at age 21 years, with or without a switch to cytology and hrHPV cotesting every 5 years from ages 30 to 65 years. Complete adherence for all 19 strategies
Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. The number of deaths from cervical cancer in the United States has decreased substantially since the implementation of widespread cervical cancer screening and has declined from 2.8 to 2.3 deaths per 100 000 women from 2000 to 2015.To update the US Preventive Services Task Force (USPSTF) 2012 recommendation on screening for cervical cancer.The USPSTF reviewed the evidence on screening for cervical cancer (...) , with a focus on clinical trials and cohort studies that evaluated screening with high-risk human papillomavirus (hrHPV) testing alone or hrHPV and cytology together (cotesting) compared with cervical cytology alone. The USPSTF also commissioned a decision analysis model to evaluate the age at which to begin and end screening, the optimal interval for screening, the effectiveness of different screening strategies, and related benefits and harms of different screening strategies.Screening with cervical
Chemical genetic-based phenotypic screen reveals novel regulators of gluconeogenesis in human primary hepatocytes Insulin resistance is a pathophysiological hallmark of type 2 diabetes and nonalcoholic fatty liver disease. Under the condition of fat accumulation in the liver, suppression of hepatic glucose production by insulin is diminished. In order to gain deeper understanding of dysregulation of glucose production in metabolic diseases, in the present study, we performed an unbiased (...) phenotypic screening in primary human hepatocytes to discover novel mechanisms that regulate gluconeogenesis in the presence of insulin. To optimize phenotypic screening process, we used a chemical genetic screening approach by building a small-molecule library with prior knowledge of activity-based protein profiling. The "positive hits" result from the screen will be small molecules with known protein targets. This makes downstream deconvolution process (i.e., determining the relevant biological targets
Effect of Cell-Free DNA Screening vs Direct Invasive Diagnosis on Miscarriage Rates in Women With Pregnancies at High Risk of Trisomy 21: A Randomized Clinical Trial. Cell-free DNA (cfDNA) tests are increasingly being offered to women in the first trimester of pregnancies at a high risk of trisomy 21 to decrease the number of required invasive fetal karyotyping procedures and their associated miscarriages. The effect of this strategy has not been evaluated.To compare the rates of miscarriage (...) ; secondary outcomes underwent 2-sided testing.Among 2051 women who were randomized and analyzed (mean age, 36.3 [SD, 5.0] years), 1997 (97.4%) completed the trial. The miscarriage rate was not significantly different between groups at 8 (0.8%) vs 8 (0.8%), for a risk difference of -0.03% (1-sided 95% CI, -0.68% to ∞; P = .47). The cfDNA detection rate for trisomy 21 was 100% (95% CI, 87.2%-100%).Among women with pregnancies at high risk of trisomy 21, offering cfDNA screening, followed by invasive
Screening for Urinary Incontinence in Women: A Recommendation From the Women's Preventive Services Initiative. Recommendation on screening for urinary incontinence in women by the Women's Preventive Services Initiative (WPSI), a national coalition of women's health professional organizations and patient representatives. The WPSI's recommendations are intended to guide clinical practice and coverage of services for the Health Resources and Services Administration and other stakeholders (...) . The target audience for this recommendation includes all clinicians providing preventive health care for women, particularly in primary care settings. This recommendation applies to women of all ages, as well as adolescents.The WPSI developed this recommendation after evaluating evidence regarding the benefits and harms of screening for urinary incontinence in women. The evaluation included a systematic review of the accuracy of screening instruments and the benefits and harms of treatments. Indirect
Outcomes of Cardiac Screening in Adolescent Soccer Players. Reports on the incidence and causes of sudden cardiac death among young athletes have relied largely on estimated rates of participation and varied methods of reporting. We sought to investigate the incidence and causes of sudden cardiac death among adolescent soccer players in the United Kingdom.From 1996 through 2016, we screened 11,168 adolescent athletes with a mean (±SD) age of 16.4±1.2 years (95% of whom were male) in the English (...) Football Association (FA) cardiac screening program, which consisted of a health questionnaire, physical examination, electrocardiography, and echocardiography. The FA registry was interrogated to identify sudden cardiac deaths, which were confirmed with autopsy reports.During screening, 42 athletes (0.38%) were found to have cardiac disorders that are associated with sudden cardiac death. A further 225 athletes (2%) with congenital or valvular abnormalities were identified. After screening, there were
Screening for Atrial Fibrillation With Electrocardiography: US Preventive Services Task Force Recommendation Statement. Atrial fibrillation is the most common type of cardiac arrhythmia (irregular heartbeat), and its prevalence increases with age, affecting about 3% of men and 2% of women aged 65 to 69 years and about 10% of adults 85 years and older. Atrial fibrillation is a major risk factor for ischemic stroke, increasing risk of stroke by as much as 5-fold. Approximately 20% of patients who (...) have a stroke associated with atrial fibrillation are first diagnosed with atrial fibrillation at the time of stroke or shortly thereafter.To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for atrial fibrillation with electrocardiography (ECG).The USPSTF reviewed the evidence on the benefits and harms of screening for atrial fibrillation with ECG in adults 65 years and older, the effectiveness of screening with ECG for detecting previously undiagnosed atrial
Surgically treated lung cancer patients: do they all smoke and would they all have been detected with lung cancer screening? Since publication of the National Lung Cancer Screening Trial (NLST) results early lung cancer detection has been widely studied, targeting individuals based on smoking history and age. However, over recent decades several changes in lung cancer epidemiology, including risk factors, have taken place. The aim of the current study was to explore smoking prevalence among