Objectives
To summarize participation and coverage rates in population mammographic screening programmes for breast cancer in Europe.
Methods
We used the European Network for Information on Cancer ...(EUNICE), a web-based data warehouse (EUNICE Breast Cancer Screening Monitoring, EBCSM) for breast cancer screening, to obtain information on programme characteristics, coverage and participation from its initial application in 10 national and 16 regional programmes in 18 European countries.
Results
The total population targeted by the screening programme services covered in the report comprised 26.9 million women predominantly aged 50–69. Most of the collected data relates to 2005, 2006 and/or 2007. The average participation rate across all programmes was 53.4% (range 19.4–88.9% of personally invited); or 66.4% excluding Poland, a large programme that initiated personal invitations in 2007. Thirteen of the 26 programmes achieved the European Union benchmark of acceptable participation (>70%), nine achieved the desirable level (>75%). Despite considerable invitation coverage across all programmes (79.3%, range 50.9–115.2%) only 48.2% (range 28.4–92.1%) of the target population were actually screened. The overall invitation and examination coverage excluding Poland was 70.9% and 50.3%, respectively.
Conclusions
The results demonstrate the feasibility of European-wide screening monitoring using the EBCSM data warehouse, although further efforts to refine the system and to harmonize standards and data collection practices will be required, to fully integrate all European countries. The more than three-fold difference in the examination coverage should be taken into account in the evaluation of service screening programmes.
Objective
To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment.
Methods
A ...literature review was conducted to identify studies of the cumulative risk of a false-positive result in European screening programmes (390,000 women). We then examined aggregate data, cross-sectional information about further assessment procedures among women with positive results in 20 mammographic screening programmes from 17 countries (1.7 million initial screens, 5.9 million subsequent screens), collected by the European Network for Information on Cancer project (EUNICE).
Results
The estimated cumulative risk of a false-positive screening result in women aged 50–69 undergoing 10 biennial screening tests varied from 8% to 21% in the three studies examined (pooled estimate 19.7%). The cumulative risk of an invasive procedure with benign outcome ranged from 1.8% to 6.3% (pooled estimate 2.9%). The risk of undergoing surgical intervention with benign outcome was 0.9% (one study only). From the EUNICE project, the proportions of all screening examinations in the programmes resulting in needle biopsy were 2.2% and 1.1% for initial and subsequent screens, respectively, though the rates differed between countries; the corresponding rates of surgical interventions among women without breast cancer were 0.19% and 0.07%.
Conclusion
The specific investigative procedures following a recall should be considered when examining the cumulative risk of a false-positive screening result. Most women with a positive screening test undergo a non-invasive assessment procedure. Only a small proportion of recalled women undergo needle biopsy, and even fewer undergo surgical intervention.
The evolution of smoking rates according to migrant status has not been examined in France, despite a recent reduction in overall smoking rates.
DePICT is a two waves (2016: n = 4356; 2017: n = 4114) ...nationwide telephone survey, representative of the French adult population. We compared smoking-related behaviors before and after implementation of tobacco-control measures (2017), according to the geographical region of birth.
Compared to 2016, individuals originating from Africa or the Middle East had a slightly higher smoking prevalence in 2017 (34.7% vs 31.3%), despite a higher intention to quit or attempt in the preceding year (adjusted OR(ORa) = 2.721.90; 3.90) compared to non-immigrants. They were also less likely to experience an unsuccessful quit attempt (ORa = 1.761.18; 2.62).
Tobacco-control measures could have widened smoking inequalities related to migrant status. The evolution of smoking-related behaviors among immigrants should be examined when studying the long-term effects of such policies.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Organizational factors may influence surgical outcomes, regardless of extensively studied factors such as patient preoperative risk and surgical complexity. This study was designed to explore how ...operating room organization determines surgical performance and to identify gaps in the literature that necessitate further investigation.
We conducted a systematic review according to PRISMA guidelines to identify original studies in Pubmed and Scopus from January 1, 2000 to December 31, 2019. Studies evaluating the association between five determinants (team composition, stability, teamwork, work scheduling, disturbing elements) and three outcomes (operative time, patient safety, costs) were included. Methodology was assessed based on criteria such as multicentric investigation, accurate population description, and study design.
Out of 2625 studies, 76 met inclusion criteria. Of these, 34 (44.7%) investigated surgical team composition, 15 (19.7%) team stability, 11 (14.5%) teamwork, 9 (11.8%) scheduling, and 7 (9.2%) examined the occurrence of disturbing elements in the operating room. The participation of surgical residents appeared to impact patient outcomes. Employing specialized and stable teams in dedicated operating rooms showed improvements in outcomes. Optimization of teamwork reduced operative time, while poor teamwork increased morbidity and costs. Disturbances and communication failures in the operating room negatively affected operative time and surgical safety.
While limited, existing scientific evidence suggests that operating room staffing and environment significantly influences patient outcomes. Prioritizing further research on these organizational drivers is key to enhancing surgical performance.
•Social inequalities in health increased especially during lockdown.•Homeless persons felt neglected as lockdown was designed for those with stable housing.•Access to an emergency shelter had ...positive impacts on homeless persons.•Sudden implementation of lockdown reminded prior violent or traumatic circumstances.•Crisis communication should be adapted to improve adherence to preventive measures.
Social inequalities tended to increase in the context of the pandemic, particularly in relation to the measures taken to manage and reduce the risk of COVID-19. When lockdown measures required the general population “to stay home”, what were homeless people expected to do? The ECHO study is a cross-sectional, descriptive study with a convergent mixed-method design. Data were collected across shelters in France both during and immediately following the lockdown (April – June 2020). This article presents the study’s qualitative findings, with a focus on understanding both the experiences and perceptions among these populations of the measures taken to limit the COVID-19 infection. A total of 26 semi-directed individual interviews were conducted across seven shelters in both Lyon (42%) and Paris (58%). Data were analysed using thematic content analysis with partial blinded coding. Four key themes were identified: 1- Reactions to the introduction of lockdown: a sudden implementation reminiscent of prior violent or traumatic circumstances amongst participants, 2- Accommodation during lockdown: participants’ conflicting visions of the shelter, 3- Influence of the media and public communication: an abundant flow of information impacting participant’s wellbeing and representations on the pandemic, and 4- The individual impact of lockdown: perceived health and limitations to daily life activities. The most vulnerable populations have borne the heaviest burden during the pandemic. It is therefore crucial that we improve both the availability of information, and the health literacy of, all groups within the national population.
Objectives:
To record the prevalence and risk factors of substance use amongst homeless persons during the COVID-19 pandemic.
Methods:
The ECHO study consisted in two independent cross-sectional ...waves of data collection in the regions of Paris, Lyon, and Strasbourg during the Spring of 2020 (
n
= 530) and 2021 (
n
= 319). Factors associated with substance use were explored using generalised logistic regression models.
Results:
The most prevalent substance used was tobacco (38%–43%), followed by alcohol (26%–34%). The use of both substances positively associated with each other, although risk factors varied depending on the substance. The only factors consistently associated with alcohol and tobacco use were being male, exposure to theft/assault and participants’ region of origin. Whilst the rate of tobacco use was relatively stable between Spring 2020 and 2021, alcohol use was more common in 2021.
Conclusion:
These findings highlight a high prevalence of substance use amongst homeless persons. People experiencing homelessness face specific challenges in the context of the pandemic, alongside greater vulnerability to illness and low healthcare access, therefore the need to improve prevention and support services for substance abuse within this population is vital.
In-process promotions focus on promotional activities during marketing events such as auctions, crowdfunding, or fund-raising. Firms can observe consumers' responses to these promotions and use this ...information to adjust future promotions sent during the same events. The authors study the impact of promotions on market outcomes and focus on one use of such promotions: messages sent during online auctions, in which the outcome is the final auction price. They propose that the effect of these messages can be understood by observing their aggregate impact on final auction prices and by examining how messages affect behaviors at the bid level, namely, new-bidder entry and jump bidding. These bid-level behaviors can, when summed at the auction level, affect auction prices. Besides examining the messages' impact on bidder behavior, the authors study the auctioneer's strategy in issuing these messages. They distinguish between informative messages, which focus on product attributes, and persuasive messages, which try to motivate the message recipients to bid. They test hypotheses derived from their framework using data from online auctions of Air France airline tickets. The authors also conduct "what-if" simulations to help auctioneers identify the optimal number of messages to send during an auction.
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