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Despite the well-recognised relevance of screening in colorectal cancer (CRC) control, adherence to screening is often suboptimal. Improving adherence represents an important public health strategy. We investigated the influence of family doctors (FDs) as determinant of CRC screening adherence by comparing each FDs practice participation probability to that of the residents in the same geographic areas using the whole population geocoded.
We used multilevel logistic regression model to investigate factors associated with CRC screening adherence, among 333,843 people at their first screening invitation. Standardized Adherence Rates (SAR) by age, gender, and socioeconomic status were calculated comparing FDs practices to the residents in the same geographic areas using geocoded target population.
Screening adherence increased from 41.0% (95% CI, 40.8-41.2) in 2006-2008 to 44.7% (95% CI, 44.5-44.9) in 2011-2012. Males, the most deprived and foreign-born people showed low adherence. FD practices and the percentage of foreign-born people in a practice were significant clustering factors. SAR for 145 (21.4%) FDs practices differed significantly from people living in the same areas. Predicted probabilities of adherence were 31.7% and 49.0% for FDs with low and high adherence, respectively.
FDs showed a direct and independent effect to the CRC screening adherence of the people living in their practice. FDs with significantly high adherence level could be the key to adherence improvement.
Most deprived individuals and foreigners represent relevant targets for interventions in public health aimed to improve CRC screening adherence.
Geospatial analysis of the influence of family doctor on colorectal cancer screening adherence
Fabrizio Stracci, Conceptualization, Funding acquisition, Methodology, Project administration, Supervision, Writing - original draft, Writing - review & editing,#1,2,* Alessio Gili, Formal analysis, Methodology,2 Giulia Naldini, Writing - review & editing,3 Vincenza Gianfredi, Writing - original draft,3 Morena Malaspina, Data curation, Writing - review & editing,4 Basilio Passamonti, Data curation, Writing - review & editing,4 and Fortunato Bianconi, Conceptualization, Data curation, Formal analysis, Methodology, Software, Supervision, Validation, Visualization, Writing - review & editing#2 Hajo Zeeb, Editor
The crystal and molecular structures of two triphenyltin dithiocarbamates, [Sn(C6H5)3(C16H16NS2)], (I), and [Sn(C6H5)3(C7H14NO2S2)], (II), are described. In (I), the dithiocarbamate ligand coordinates the SnIV atom in an asymmetric manner, leading to a highly distorted trigonal-bipyramidal coordination geometry defined by a C3S2 donor set with the weakly bound S atom approximately trans to one of the ipso-C atoms. A similar structure is found in (II), but the dithiocarbamate ligand coordinates in an even more asymmetric fashion. The packing in (I) features supramolecular chains along the c axis sustained by C—H⋯π interactions; chains pack with no directional interactions between them. In (II), supramolecular layers are formed, similarly sustained by C—H⋯π interactions; these stack along the b axis. An analysis of the Hirshfeld surfaces for (I) and (II) confirms the presence of the C—H⋯π interactions but also reveals the overall dominance of H⋯H contacts in the respective crystals
crystal structure, organotin, dithiocarbamate, Hirshfeld surface analysis
[N-Benzyl-N-(2-phenylethyl)dithiocarbamato-κ2 S,S′]triphenyltin(IV) and [bis(2-methoxyethyl)dithiocarbamato-κ2 S,S′]triphenyltin(IV): crystal structures and Hirshfeld surface analysis
Rapidah Mohamad,a Normah Awang,b,‡ Nurul Farahana Kamaludin,b,§ Mukesh M. Jotani,c and Edward R. T. Tiekinkd,*
2016 Oct 1
Dyspepsia has a significant impact on the quality of life. Health-related quality of life (HRQoL) can be assessed by disease-specific and generic HRQoL instruments. The present study evaluated HRQoL and compared it among dyspepsia subgroups by using EQ (Euro QoL)-5D questionnaire.
Patients and Methods:
Patients with abnormal findings on upper gastrointestinal endoscopy were classified to have organic dyspepsia, whereas those with normal endoscopy were classified as functional dyspepsia if they met the ROME III criteria or as endoscopy negative recent dyspepsia if symptom duration was <6 months. HRQoL was assessed using the EQ-5D questionnaire, and the overall health status on a visual analogue scale (VAS); and the frequency of impairment in each dimension were compared between the dyspepsia subgroups. Results: The overall health status was affected equally in all three dyspepsia subgroups. Impairment in HRQoL was commonly seen in the dimensions of pain (98.4%), usual activities (66.20%), and anxiety/depression (70.60%), however, much less so in mobility (22.70%) and self-care (10.9%). Any impairment in HRQoL was not significantly different between the three subgroups in the dimensions of mobility and usual activities. Self-care was more commonly affected in organic dyspepsia, anxiety/depression was more common with functional dyspepsia, while pain, though significantly different among various subgroups, was very common in all three subgroups. Conclusion: HRQoL was equally affected in all three subgroups of dyspepsia but variably so in the different domains of EQ-5D. These differences need to be studied further to improve the management of different etiological subgroups of dyspepsia.
Dyspepsia, endoscopy, quality of life
Quality of Life in Dyspepsia and its Subgroups Using EQ-5D (EuroQol) Questionnaire
Anurag J. Shetty, Girisha Balaraju, Shiran Shetty, and Cannanore G. Pai