American journal of preventive medicine
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Editorial Review Meta Analysis
Stage-based lifestyle interventions in primary care: are they effective?
To systematically review the literature concerning the effect of stages-of-change-based interventions in primary care on smoking, physical activity, and dietary behavior. ⋯ The scientific evidence for the effect of stages-of-change-based lifestyle interventions in primary care is limited. Limiting aspects in the stages-of-change concept with respect to complex behaviors as physical activity and dietary behavior are discussed.
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Persons from inner-city immigrant and mixed-ethnic communities are known to be at high risk for cardiovascular disease and diabetes. Such communities may also be underserved for preventive medical care. The authors hypothesized that hemoglobin A1c (HbA1c) could be used as a screening test for a community-based program to detect new cases of diabetes and persons at risk for diabetes and cardiovascular disease. ⋯ There was a high prevalence of undiagnosed diabetes, and of patients at risk for diabetes, in this community setting. Community-based screening can be used as a method for identifying high percentages of patients at risk for diabetes or with undiagnosed diabetes in an inner city, immigrant, mixed-ethnic population.
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Review Comparative Study
Population health technologies: emerging innovations for the health of the public.
At the beginning of the 21st century, we are at the dawn of a possibly unprecedented era of scientific discovery and promise. Emerging technologies, including information and communication technologies, genomics, microelectromechanical systems, robotics, sensors, and nanotechnologies, provide enormous opportunities for population health improvement. Population health technology refers to the application of an emerging technology to improve the health of populations. ⋯ If appropriately applied, population health technologies may greatly enhance existing health intervention models. However, potential adverse consequences could arise related to privacy, confidentiality, and security; quality and effectiveness; sustainability; and the technology divide. To ensure the optimal development and diffusion of population health technologies will require balancing these risks and benefits while simultaneously adopting new mechanisms of public and private support for research and development in this potentially important new domain of public health.
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Randomized Controlled Trial Comparative Study Clinical Trial
Impact of an educational program on the safety of high-risk, visually impaired, older drivers.
Older drivers (licensed drivers aged 60 years and older) have among the highest rates of motor vehicle collision involvement per mile driven of all age groups. Educational programs that promote safe driving strategies among seniors are a popular approach for addressing this problem, but their safety benefit has yet to be demonstrated. The objective of this study was to determine whether an individualized educational program that promoted strategies to enhance driver safety reduces the crash rate of high-risk older drivers. DESIGN/ SETTING: Randomized, controlled, single-masked intervention evaluation at an ophthalmology clinic. ⋯ An educational intervention that promoted safe-driving strategies among visually impaired, high-risk older drivers did not enhance driver safety, although it was associated with increased self-regulation and avoidance of challenging driving situations and decreased driving exposure by self-report.
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Comparative Study
Increased incidence of inflicted traumatic brain injury in children after a natural disaster.
The incidence of child abuse following natural disasters has not been studied thoroughly. However, parental stress and decreased social support have been linked to increased reports of child maltreatment. We hypothesized that a large-scale natural disaster (North Carolina's Hurricane Floyd) would increase the incidence of inflicted traumatic brain injury (TBI) in young children. ⋯ Families are vulnerable to an elevated risk of inflicted and non-inflicted child TBI following a disaster. This information may be useful in future disaster planning.