...Annals of Internal Medicine Clinical Guidelines Screening Mammography for Women 40 to 49 Years of Age: A Clinical Practice Guideline from the American College of Physicians Amir Qaseem, MD, PhD, MHA; Vincenza Snow, MD; Katherine Sherif, MD; Mark Aronson, MD; Kevin B. Weiss, MD, MPH; and Douglas K. Owens, MD, MS, for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians* Breast cancer is one of the most common causes of death for women in their 40s in the United States. Individualized risk assessment plays an important role when making decisions about screening mammography, especially for women 49 years of age or younger. The purpose of this guideline is to present the available evidence for screening mammography in women 40 to 49 years of age and to increase clinicians’ understanding of the benefits and risks of screening mammography. Ann Intern Med. 2007;146:511-515. For author affiliations, see end of text. www.annals.org RECOMMENDATIONS Recommendation 1: In women 40 to 49 years of age, clinicians should periodically perform individualized assessment of risk for breast cancer to help guide decisions about screening mammography. A careful assessment of a woman’s risk for breast cancer is important. The 5-year breast cancer risk can vary from 0.4% for a woman age 40 years with no risk factors to 6.0% for a woman age 49 years with several risk factors (1). Factors that increase the risk for breast cancer include older age, family...
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...Annals of Internal Medicine Clinical Guidelines Screening Mammography for Women 40 to 49 Years of Age: A Clinical Practice Guideline from the American College of Physicians Amir Qaseem, MD, PhD, MHA; Vincenza Snow, MD; Katherine Sherif, MD; Mark Aronson, MD; Kevin B. Weiss, MD, MPH; and Douglas K. Owens, MD, MS, for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians* Breast cancer is one of the most common causes of death for women in their 40s in the United States. Individualized risk assessment plays an important role when making decisions about screening mammography, especially for women 49 years of age or younger. The purpose of this guideline is to present the available evidence for screening mammography in women 40 to 49 years of age and to increase clinicians’ understanding of the benefits and risks of screening mammography. Ann Intern Med. 2007;146:511-515. For author affiliations, see end of text. www.annals.org RECOMMENDATIONS Recommendation 1: In women 40 to 49 years of age, clinicians should periodically perform individualized assessment of risk for breast cancer to help guide decisions about screening mammography. A careful assessment of a woman’s risk for breast cancer is important. The 5-year breast cancer risk can vary from 0.4% for a woman age 40 years with no risk factors to 6.0% for a woman age 49 years with several risk factors (1). Factors that increase the risk for breast cancer include older age, family...
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...Department of Veterans Affairs and United States Department of Defense Must Make Abstract Posttraumatic stress disorder (PTSD), a mental anxiety disorder, affects 13% to 20% of armed force members returning from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) (Hoge, et. al, 2004), in addition to a large population of Vietnam Veterans. Within the past 32 years, awareness of this disorder has escalated and the realism of the severity of this disorder has been noticed. Efforts to screen and treat PTSD in military veterans have been established by the United States Department of Veterans Affairs (VA). Screening is conducted once military personnel return from deployment and treatments including Cognitive Behavioral Therapy, Eye Movement Desensitization and Reprocessing, Exposure Therapy, and medications are used to relieve the symptoms of PTSD. These screening and treatment methods are evaluated and s suggestion for improvement is made. Necessary Improvements the United States Department of Veterans Affairs and the United States Department of Defense Must Make With Regards to Posttraumatic Stress Disorder In current political debate, the United States is arguing where budget cuts should be made and how the U.S. should go about spending money. The U.S. military is consistently brought up in these considerations. In such considerations, topics such as downsizing the military and the military’s budget overall is discussed. The military budget comes into play when considering...
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...Conclusion In the systematic analysis of the 23 studies we have highlighted the role of Leventhal’s Common Sense Model (SRM) in the analysis of hereditary / familial cancer and the role of the psycho-social impact on individuals affected by the disease or with high risk for the disease in the screening for hereditary / familial cancer and in the genetic testing and counseling. Thus, we have identified three themes in which we included the analyzed studies: a) identification of the predictors involved in the screening compliance, in the responses to health threats, in emotional distress; b) assessment of the emotional and cognitive impact, of the perceived risk and the perceived disease in genetic testing, of the family history of cancer or...
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...Valerie Johnson AMT2 Task 2 Western Governor’s University May 1, 2014 Trinity Community Hospital conducted a focused community health needs assessment centering on cancer, orthopedic and cardiovascular services. The information was obtained through a multitude of sources including: epidemiological surveys, focus groups, interviews with healthcare professionals and healthcare facilities’ planning guidelines. Risk Factors Oncology Services The needs assessment revealed that 15% of the population will be older than age 65 within the next 5 years. 50% of men and 33% of women are expected to develop cancer during their lifetime. New cases of cancer are expected to grow by 34% in the next 5 years. Current physician practices that serve oncology patients are at their full capacity. Additional facilities and equipment are needed to be able to provide the care that is needed. There is poor coordination of care between the different disciplines that provide care to these patients. There are delays in scheduling care for oncology patients. There are no established programs focused on cancer prevention and control. Educational programs on the risk factors for cancer are limited. Orthopedic Services The needs assessment reveals that there will be anticipated growth in orthopedics. Orthopedic cases are expected to increase by 46%. Inpatient volume is expected to increase by 30% and outpatient procedures by 350%. The community needs additional physicians in order to accommodate...
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...Student Case Studies, and Research Examples • School Examples, page 5.3 – School-Wide Screening, page 5.4 – Progress Monitoring, page 5.5 – Tiered Service Delivery, page 5.9 – Data-Based Decision Making, page 5.13 – Parent Involvement, page 5.16 – Resources, page 5.22 August 2006 Overview In November 2002, the United States Department of Education requested that the National Research Center on Learning Disabilities (NRCLD) identify, describe, and evaluate the implementation of responsiveness to intervention (RTI) in elementary schools throughout the United States. The NRCLD staff worked with the six Regional Resource Centers (RRCs) to identify potential sites and solicit school participation. More than 60 schools across the country initially were considered, and information from 41 of those schools was submitted. The NRCLD research staff reviewed the extensive amount of information submitted and judged that 19 of those schools were engaging in one or more commendable RTI practices based on a review of the following six components of an RTI service-delivery model: • School-wide screening. Screening is a type of assessment characterized by quick, low cost, repeatable testing of critical academic skills or behaviors and can be administered by individuals with minimal amounts of training. A screening measures whether a student should be judged at risk. If a student meets the criteria for at-risk status, he or she is considered for more in-depth assessment. Screenings can use...
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...practice. Cullum et al (2007) identifies four requirements:-Clinical experience, valid researched evidence, available resources and lastly but no less important the patient preferences and experiences. The area of clinical practice to be studied is within a community district nursing team consisting of 7 qualified nurses and 3 health care assistants. The location is situated within a seaside town with a large population of over 65 year olds. Through clinical experience, the author has found a flaw in quality of care when nursing staff are using the overview assessment document which has been adapted from the single assessment process produced by the Department of Health (DOH, 2002). When assessing nutrition there is a series of six questions and an asterisk to consider the “Malnutrition Universal Screening Tool” (MUST, 2003) however experience in practice would suggest the tool (MUST, 2003) isn't used and a local unknown screening tool is used on some rare occasions. The author feels management of these vulnerable patients is lacking and in order to improve patient care a clarification of guidance and service change maybe required. Exploring Cullum's (2007) theory of decision making, the author needs to justify the service change with valid researched evidence. As a nurse in practice it can be...
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...A Case Study using the Schedule of Growing Skills II Tool, in the Student’s own Clinical Practice Area. Introduction to the problem, a literature review. The term developmental delay is used to identify children that are significantly delayed in meeting developmental milestones. In children it is a major problem worldwide with an estimated prevalence rate of 3% (MacDonald & Rennie, 2011). In the United Kingdom 3% of school aged children are identified as having a special education need associated with either a learning difficulty or an autistic spectrum disorder (National Statistics, 2012). Early detection by professionals is deemed to be of great importance as recognised in a recent government drive with health visiting (DoH, 2011). It is also important because studies have highlighted the substantial benefits that early intervention can offer to children with varying needs (Camilli et al, 2010; Anderson et al, 2003). Therefore despite the implementation of child health surveillance services (Mackrides & Ryherd, 2011; Hamilton, 2006), in clinical practice, children are not being detected before they start school. In the UK and in the student’s own area of clinical practice developmental screening is undertaken by health visitors as part of the Healthy Child Programme (HCP). It is viewed as the core health service for protecting, promoting and improving the health and well-being of children (Department of Health, 2009). A review of...
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...The Effect of E-recruitment On the Recruitment Process: Evidence from Case Studies of Three Danish MNCs Anna B. Holm, Aarhus University, Denmark annah@asb.dk Abstract. The aim of this research is to determine whether the introduction of e-recruitment has an impact on the process and underlying tasks, subtasks and activities of recruitment. Three large organizations with wellestablished e-recruitment practices were included in the study. The case studies were conducted in Denmark in 2008-2009 using qualitative research methods. The findings indicate that e-recruitment had a noticeable effect on the overall recruitment process in the studied organizations. The investigation revealed changes in the sequence, divisibility and repetitiveness of a number of tasks and subtasks. The new process design supported by information and communications technologies was identified and is presented in the paper. This process allowed recruiters in the study to perform recruitment tasks more efficiently. However, practitioners should be aware of the increasing demands of the quality of online communication with applicants, and with it the electronic communication skills of recruitment professionals. Keywords: recruitment, e-recruitment, web-based recruitment, online recruitment, staffing, e-HRM 1 Introduction The first decade of the twenty-first century saw rapid growth in the use of online recruitment [25] and the transformation of electronic recruitment into one of...
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...medical costs and negatively impact survival ( Screening and management of distress web site) The authors define stress as complex with emotional and...
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...Service Line Development Task 2 A. Analyze the community health needs assessment in the case study by doing the following: Trinity Community Hospital conducted an assessment of three of their services including cardiovascular, cancer, and orthopedics. The gathered information was received from numerous avenues including the healthcare’s guidelines, interviews of healthcare employees, focused groups, and surveys. A.1. Discuss major risk factors identified in the assessment. 1. Cardiovascular Services In the United States, there are many cases of coronary artery disease and this is expected to increase. This increase will cause an increase in cardiac catheterization procedures done in Trinity Community Hospital. They are predicting that they will have an increased amount of catheterizations up to 22% and angioplasties up to 25.8% more in the upcoming five years. There will be a need for more cardiac procedure rooms and rehab programs. The addition to these needs should be done to make sure the patient is getting adequate and timely care. Otherwise, the patient’s health could be placed in jeopardy. The hospital should consider offering some programs to offer patients and their family’s educational information regarding surgical procedures and the preceding problems that can occur due to their eating habits, hypertension, diabetes, and any tobacco or substance use. These programs could offer education to assist the patients and others about how to assist themselves with...
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...Annals of Internal Medicine Clinical Guidelines Screening Mammography in Women 40 to 49 Years of Age: A Systematic Review for the American College of Physicians Katrina Armstrong, MD, MSCE; Elizabeth Moye, BA; Sankey Williams, MD; Jesse A. Berlin, ScD; and Eileen E. Reynolds, MD Background: The risks and benefits of mammography screening among women 40 to 49 years of age remain an important issue for clinical practice. Purpose: To evaluate the evidence about the risks and benefits of mammography screening for women 40 to 49 years of age. Data Sources: English-language publications in MEDLINE (1966 – 2005), Pre-MEDLINE, and the Cochrane Central Register of Controlled Trials and references of selected studies through May 2005. Study Selection: Previous systematic reviews; randomized, controlled trials; and observational studies. Data Extraction: Two independent reviewers. Data Synthesis: In addition to publications from the original mammography trials, 117 studies were included in the review. Metaanalyses of randomized, controlled trials demonstrate a 7% to 23% reduction in breast cancer mortality rates with screening mammography in women 40 to 49 years of age. Screening mammography is associated with an increased risk for mastectomy but a decreased risk for adjuvant chemotherapy and hormone therapy. The risk for death due to breast cancer from the radiation exposure involved in mammography screening is small and is outweighed by a reduction in breast cancer mortality...
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...The child may manifest impairments in communication, behavior, and socializing with others. Diagnostic practice and screening may vary depending on the individual professionals. The Checklist for Autism in Toddlers was one of the first assessments developed to screen for autism in preschoolers and was designed to be administered at routine developmental assessment at 18 months of age. This assessment was found to have good specificity but poor sensitivity, resulting in an unacceptable number of missed cases. (Pasco, p.109). The two most promising screening tools currently are the Modified CHAT and the Social Communication Questionnaire. Today, the Modified Checklist for Autism in toddlers, Revised with Follow Up is used to screen children. It has been shown to significantly lower the age of the diagnosis which facilitates early treatment. If screening for autism is positive, additional testing is performed to rule out other causes of the child’s behavior including CT scan or MRI, lead screening, metabolic studies, DNA analysis, and electroencephalogram. Early intervention helps maximize the child’s potential by improving developmental skills and behaviors, as well as establishing helpful support for parents. (Ball, Bindler, Cowen,...
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...A review of the most recent literature provides a broad view of the difficulties these children may face, however, continued research is needed to provide the proof necessary for these children to obtain more services in the school, ensuring their success. A study by Biggs et al. (2011) estimates “12% to 41% of children with UHL received additional educational services” (p. 448). These numbers are rather low considering Most et al. (2010) found that these children with a mild bilateral or unilateral hearing loss are often times functioning on a lower level academically and socially than children who have a more extreme bilateral loss. Taking a closer look at he research may provide insight as to why these children are doing so poorly, and what may be recommended for better...
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...The threat within A study on insider threat by DSCI in collaboration with PwC About Data Security Council of India (DSCI) Data Security Council of India (DSCI) is a focal body on data protection in India, setup as an independent Self-Regulatory Organisation (SRO) by NASSCOM®, to promote data protection, develop security and privacy best practices & standards and encourage the Indian industries to implement the same. DSCI is engaged with the Indian IT/BPO industry, their clients worldwide, Banking and Telecom sectors, industry associations, Data Protection Authorities and other Government agencies in different countries. It conducts industry wide surveys and publishes reports, organizes data protection awareness seminars, workshops, projects, interactions and other necessary initiatives for outreach and public advocacy. DSCI is focused on capacity building of Law Enforcement Agencies for combating cyber crimes in the country and towards this, it operates several Cyber labs across India to train police officers, prosecutors and judicial officers in cyber forensics. Public Advocacy, Thought Leadership, Awareness and Outreach and Capacity Building are the key words to continue to promote and enhance trust in India as a secure global sourcing hub, and also to promote data protection in the country. For more information about DSCI or this report, please contact: Data Security Council of India Niryat Bhawan, 3rd Floor Rao Tula Ram Marg New Delhi – 110057 ...
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