(1/1834) Retirement is no excuse for physical inactivity or isolation.
At all age levels and especially in the elderly population, a sedentary lifestyle and low fitness levels are independent risk factors for all causes of mortality, including cardiovascular mortality. Exercise improves cardiovascular outcomes by increasing vagal activity and attenuating sympathetic hyperactivity. The risk of diabetes mellitus type 2 developing is reduced by 40% in men of normal weight and 60% in overweight men when on a regular exercise program. Physical activity in the elderly sustains cerebral perfusion, maintaining cognitive function. Isolation, which is not uncommon among the elderly, fosters cognitive decline. Stimulating mental activity can protect against dementia. (+info)
(2/1834) Accuracy of responses from postal surveys about continuing medical education and information behavior: experiences from a survey among German diabetologists.
BACKGROUND: Postal surveys are a popular instrument for studies about continuing medical education habits. But little is known about the accuracy of responses in such surveys. The objective of this study was to quantify the magnitude of inaccurate responses in a postal survey among physicians. METHODS: A sub-analysis of a questionnaire about continuing medical education habits and information management was performed. The five variables used for the quantitative analysis are based on a question about the knowledge of a fictitious technical term and on inconsistencies in contingency tables of answers to logically connected questions. RESULTS: Response rate was 52%. Non-response bias is possible but seems not very likely since an association between demographic variables and inconsistent responses could not be found. About 10% of responses were inaccurate according to the definition. CONCLUSION: It was shown that a sub-analysis of a questionnaire makes a quantification of inaccurate responses in postal surveys possible. This sub-analysis revealed that a notable portion of responses in a postal survey about continuing medical education habits and information management was inaccurate. (+info)
(3/1834) Physician perceptions of primary prevention: qualitative base for the conceptual shaping of a practice intervention tool.
BACKGROUND: A practice intervention must have its basis in an understanding of the physician and practice to secure its benefit and relevancy. We used a formative process to characterize primary care physician attitudes, needs, and practice obstacles regarding primary prevention. The characterization will provide the conceptual framework for the development of a practice tool to facilitate routine delivery of primary preventive care. METHODS: A focus group of primary care physician Opinion Leaders was audio-taped, transcribed, and qualitatively analyzed to identify emergent themes that described physicians' perceptions of prevention in daily practice. RESULTS: The conceptual worth of primary prevention, including behavioral counseling, was high, but its practice was significantly countered by the predominant clinical emphasis on and rewards for secondary care. In addition, lack of health behavior training, perceived low self-efficacy, and patient resistance to change were key deterrents to primary prevention delivery. Also, the preventive focus in primary care is not on cancer, but on predominant chronic nonmalignant conditions. CONCLUSIONS: The success of the future practice tool will be largely dependent on its ability to "fit" primary prevention into the clinical culture of diagnoses and treatment sustained by physicians, patients, and payers. The tool's message output must be formatted to facilitate physician delivery of patient-tailored behavioral counseling in an accurate, confident, and efficacious manner. Also, the tool's health behavior messages should be behavior-specific, not disease-specific, to draw on shared risk behaviors of numerous diseases and increase the likelihood of perceived salience and utility of the tool in primary care. (+info)
(4/1834) Regular use of aspirin and pancreatic cancer risk.
BACKGROUND: Regular use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) has been consistently associated with reduced risk of colorectal cancer and adenoma, and there is some evidence for a protective effect for other types of cancer. As experimental studies reveal a possible role for NSAIDs is reducing the risk of pancreatic cancer, epidemiological studies examining similar associations in human populations become more important. METHODS: In this hospital-based case-control study, 194 patients with pancreatic cancer were compared to 582 age and sex-matched patients with non-neoplastic conditions to examine the association between aspirin use and risk of pancreatic cancer. All participants received medical services at the Roswell Park Cancer Institute in Buffalo, NY and completed a comprehensive epidemiologic questionnaire that included information on demographics, lifestyle factors and medical history as well as frequency and duration of aspirin use. Patients using at least one tablet per week for at least six months were classified as regular aspirin users. Unconditional logistic regression was used to compute crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Pancreatic cancer risk in aspirin users was not changed relative to non-users (adjusted OR = 1.00; 95% CI 0.72-1.39). No significant change in risk was found in relation to greater frequency or prolonged duration of use, in the total sample or in either gender. CONCLUSIONS: These data suggest that regular aspirin use may not be associated with lower risk of pancreatic cancer. (+info)
(5/1834) HIV infection and pregnancy status among adults attending voluntary counseling and testing in 2 developing countries.
OBJECTIVES: This study investigated the impact of HIV voluntary counseling and testing (VCT) on reproduction planning among 1634 adults in 2 sub-Saharan countries. METHODS: Data were obtained from a multisite randomized controlled trial. RESULTS: At 6 months post-VCT, the women more likely to be pregnant were younger (odds ratio [OR] = 2.5; 95% confidence interval [CI] = 1.0, 6.5), not using contraceptives (OR = 0.1; 95% CI = 0.1, 0.3), and HIV infected (OR = 3.0; 95% CI = 1.3, 7.0). An interaction emerged linking pregnancy intention at baseline and HIV serostatus with pregnancy at follow-up (OR = 0.1; 95% CI =.0, 0.4) Partner pregnancy rates did not differ by HIV serostatus among men. CONCLUSIONS: HIV diagnosis may influence reproduction planning for women but not for men. (+info)
(6/1834) Reductions in injury crashes associated with red light camera enforcement in oxnard, california.
OBJECTIVES: This study estimated the impact of red light camera enforcement on motor vehicle crashes in one of the first US communities to employ such cameras-Oxnard, California. METHODS: Crash data were analyzed for Oxnard and for 3 comparison cities. Changes in crash frequencies were compared for Oxnard and control cities and for signalized and nonsignalized intersections by means of a generalized linear regression model. RESULTS: Overall, crashes at signalized intersections throughout Oxnard were reduced by 7% and injury crashes were reduced by 29%. Right-angle crashes, those most associated with red light violations, were reduced by 32%; right-angle crashes involving injuries were reduced by 68%. CONCLUSIONS: Because red light cameras can be a permanent component of the transportation infrastructure, crash reductions attributed to camera enforcement should be sustainable. (+info)
(7/1834) Will screening mammography in the East do more harm than good?
OBJECTIVES: We sought to systematically review the evidence for population-based mammography as applied to a Chinese population. METHODS: Primary reports for meta-analysis were identified by a search of MEDLINE and the Cochrane Library. Outcome measures included breast cancer-related mortality, the number needed to be screened to prevent 1 death, and the positive predictive value of mammography. RESULTS: Pooled relative risk for breast cancer-related death in the screened group was 0.80 (95% confidence interval = 0.71, 0.90). Applied to Hong Kong, this figure translates into a number needed to screen of 1 302 healthy women screened annually for 10 years to prevent 1 death. CONCLUSIONS: Evidence is insufficient to justify population-based breast cancer screening by mammography for women in Hong Kong and other Asian populations with low breast cancer prevalence. (+info)
(8/1834) A stage model for assessing a community-based diabetes prevention program in Sweden.
Type 2 diabetes is the most common type of diabetes, with a prevalence of at least 4% in Sweden. Aiming at primary prevention of the disease, the Stockholm Diabetes Prevention Program (SDPP) was developed as a joint program between the Departments of Endocrinology, Social Medicine and Epidemiology at the Karolinska Institute. The program was designed to include three stages, i.e. a combined baseline and aetiological study, a community-based intervention program and a follow-up study after 10 years. In 1995, the intervention program was initiated in Stockholm County with the aim of reducing the incidence of type 2 diabetes. The intervention has focused on the whole adult population in three intervention municipalities, where the local authorities have been involved in planning, initiating and implementing the program. Activities to prevent diabetes, aiming at risk factors such as obesity, low physical activity, dietary habits and tobacco use, have been initiated together with people from different fields and backgrounds, and with different ideas and approaches to health promotion and diabetes prevention. This paper provides a description and reflects upon the development and implementation process of SDPP as well as its interaction with the intervention communities. The stage model that was used for planning SDPP will be used for describing the various phases of the program. Over the period of the program, interest and responsibility has grown at the municipal authorities. The program has been a concern for the municipalities, as the program intermediate goals are also important for other health promotion issues. (+info)