This issue of Primary Care: Clinics in Office Practice, edited by Mack T. Ruffin IV, MD, MPH and Cameron G. Shultz PhD, MSW, is devoted to Preventive Medicine. Articles in this issue include Risk Assessment Approach Screening; Substance Use and Tobacco Screening; Sexually Transmitted Infections; Planned Pregnancy; Violence Screening; Breast Cancer Screening; Lung Cancer Screening; Colorectal Cancer Screening; Prostate Cancer Screening; Heart Disease Screening; Screening for Depression; and Use of Genetic Markers.

This issue of Clinics in Laboratory Medicine, Guest Edited by Anthony Odibo and David Krantz, will feature article topics such as: Screening for Chromosomal abnormalities; Cystic fibrosis screening; The role of second-trimester screening, in the post-first trimester screening era; Modifying risk for Aneuploidy with second-trimester ultrasound after a positive serum screen; Cost-effectiveness of Down syndrome screening paradigms; Biochemical and biophysical screening for the risk of Preterm delivery; Pre-implantation genetic diagnosis; Prenatal testing for infectious disease, Thrombophilias, Preeclampsia, Neural Tube Defects; Management of Multiple Pregnancy; Genetic Counseling Issues in Down syndrome Screening; First Trimester Ultrasound Markers; Quality Control of Nuchal Translucency; Clinical Implications of First Trimester Screening; Adverse Pregnancy Outcomes after Positive Screening; First Trimester Combined Screening: Instant Risks Approach.

This volume contains refereed papers submitted by participants of the third week of a six week workshop on Statistics in the Health Sciences held by the Institute of Mathematics and its Applications in Minneapolis, Minnesota during July of 1997. This week was devoted to the closely related topics of Diagnosis and Prediction. Theoretical and applied statisticians from universities, medical and public health schools, government and private research institutions, and pharmaceutical companies involved in prediction problems in the life and social sciences and in diagnostic and screening tests were brought together to discuss and exchange new results and information on these important issues. A number of papers with applications were presented and especially lively discussions ensued involving the critical issues and difficulties in using and interpreting diagnostic tests and implementing mass screening programs. Both frequentist and Bayesian approaches were employed. The importance of predicting or controlling future events such as survival, comparative survival and survival post intervention for a disease or even for certain biological or natural events is growing rapidly. This area of concern was also represented by participants who presented work that devised predictive methodology for a variety of problems mainly from a Bayesian perspective.

Within forty-eight hours after birth, the heel of every baby in the United States has been pricked and the blood sent for compulsory screening to detect or rule out a large number of disorders. Newborn screening is expanding rapidly, fueled by the prospect of saving lives. Yet many lives are also changed by it in ways not yet recognized. Testing Baby is the first book to draw on parents’ experiences with newborn screening in order to examine its far-reaching sociological consequences. Rachel Grob’s cautionary tale also explores the powerful ways that parents’ narratives have shaped this emotionally charged policy arena. Newborn screening occurs almost always without parents’ consent and often without their knowledge or understanding, yet it has the power to alter such things as family dynamics at the household level, the context of parenting, the way we manage disease identity, and how parents’ interests are understood and solicited in policy debates.

New Frontiers of Cardiovascular Screening using Unobtrusive Sensors, AI, and IoT provides insights into real-world problems in cardiovascular disease screening that can be addressed via AI, IoT and wearable based sensing. Non-Communicable Diseases (NCD) are surpassing CDS and emerging as the foremost cause of death. Hence, early screening of CVDs using wearable and other similar sensors is an extremely important global problem to solve. The digital health field is constantly changing, and this book provides a review of recent technology developments, offering unique coverage of processing time series physiological sensor data. The authors have developed this book with graduate and post graduate students in mind, making sure they provide an accessible entry point into the field. This book is particularly useful for engineers and computer scientists who want to build technologies that work in real world scenarios as it provides a practitioner's view/insights /tricks of the trade. Finally, this book helps researchers working on this important problem to quickly ramp up their knowledge and research to the state-of-the-art.

Like many words, the term "immunomics" equates to different ideas contingent on context. For a brief span, immunomics meant the study of the Immunome, of which there were, in turn, several different definitions. A now largely defunct meaning rendered the Immunome as the set of antigenic peptides or immunogenic proteins within a single microorganism - be that virus, bacteria, fungus, or parasite - or microbial population, or antigenic or allergenic proteins and peptides derived from the environment as a whole, containing also proteins from eukaryotic sources. However, times have changed and the meaning of immunomics has also changed. Other newer definitions of the Immunome have come to focus on the plethora of immunological receptors and accessory molecules that comprise the host immune arsenal. Today, Immunomics or immunogenomics is now most often used as a synonym for high-throughput genome-based immunology. This is the study of aspects of the immune system using high-throughput techniques within a conc- tual landscape borne of both clinical and biophysical thinking.

Screening for disease has become a widely accepted concept in health care. Screening in Disease Prevention takes a critical look at the practice of screening throughout the various stages of life. The book highlights three current challenges: the increasing consumer, media and commercial focus on health in general and screening in particular; providing accurate and understandable information; and tackling the continuing variation in the uptake of screening between different areas of the country and different socio-economic groups. Screening in Disease Prevention is important reading for public health professionals, particularly those involved in screening programmes. Policy makers and shapers, medical researchers, pressure groups and support organisations for people with screenable conditions will also find it a valuable reference.

The Molecular Nutrition of Amino Acids and Proteins provides an in-depth look at the involvement and role of amino acids and proteins in molecular nutrition. Editor Dominique Dardevet has assembled a collection of chapters written by leading researchers and top professors that provide the reader with a comprehensive understanding of amino acids and proteins. The book provides an introduction to the fundamentals of amino acids and proteins as well as the composition of food. It then delves into the molecular biology of the cell and genetic machinery and its function. The Molecular Nutrition of Amino Acids and Proteins also features reference guides for terms and bullet-point summaries, making it readily accessible to novices while still providing the most up-to-date and detailed information that experienced researchers need.

Breast Cancer Screening: Making Sense of Complex and Evolving Evidence covers broad aspects of breast cancer screening specifically focusing on current evidence, emerging evidence, and issues that will be critical for future breast screening practice such as tailored screening and shared decision-making in breast screening. The scope of the book is relevant to a global audience. This book provides balanced perspectives on this increasingly controversial topic, using scientific evidence to explain the evolution of knowledge relating to breast cancer screening. Breast Cancer Screening covers the key points related to this debate including the context of increasingly complex and conflicting evidence, divergent opinions on the benefits and harms of breast screening, and variability in screening practice and outcomes across settings around the world.

Taking us to the cutting edge of the new frontier of medicine, a visionary biotechnologist and a pathbreaking researcher show how we can optimize our health in ways that were previously unimaginable. We are on the cusp of a major transformation in healthcare—yet few people know it. At top hospitals and a few innovative health-tech startups, scientists are working closely with patients to dramatically extend their “healthspan”—the number of healthy years before disease sets in. In The Age of Scientific Wellness, two visionary leaders of this revolution in health take us on a thrilling journey to this new frontier of medicine. Today, most doctors wait for clinical symptoms to appear before they act, and the ten most commonly prescribed medications confer little or no benefit to most people taking them. Leroy Hood and Nathan Price argue that we must move beyond this reactive, hit-or-miss approach to usher in real precision health—a form of highly personalized care they call “scientific wellness.” Using information gleaned from our blood and genes and tapping into the data revolution made possible by AI, doctors can catch the onset of disease years before symptoms arise, revolutionizing prevention. Current applications have shown startling results: diabetes reversed, cancers eliminated, Alzheimer’s avoided, autoimmune conditions kept at bay. This is not a future fantasy: it is already happening, but only for a few patients and at high cost. It’s time to make this gold standard of care more widely available. Inspiring in its possibilities, radical in its conclusions, The Age of Scientific Wellness shares actionable insights to help you chart a course to a longer, healthier, and more fulfilling life.

Cancer screening programmes have become routine practice throughout the developed world - aiming to detect the presence of the disease prior to the manifestation of symptoms, and to increase the likelihood of successful treatment. Naturally, these programmes require regular monitoring to ensure that screening quality is maintained, and to advance the early-warning system as much as possible. Quantitative Methods for the Evaluation of Cancer Screening is a professional title designed to provide the researchers of these screening programmes with up-to-date methods and tools for improving evaluation. The book presents an introduction to cancer screening and to the methods that are employed for its monitoring, followed by an in-depth account of the more complicated modelling approaches. Each chapter is written by an international expert in the field, and imparts practical specialist information that the reader can apply to the evaluation of their own programmes. Case studies illustrate the methods in practice and provide further illumination of the fields of breast, cervix, large bowel, and neuroblastoma screening.

In this era of managed health care and a focus on quality, the appropriate use of quick and cost-ef?cient screening methods has become critical in the assessment process. From brain injury to dementia, occupational therapists working with adults with neurological difficulties must be able to efficiently use various screening methods to pinpoint deficits and determine how they affect a client's daily functioning. This update of the classic text is a functional, easy-to-understand instruction manual describing the most common screening methods for clients with neurological disorders. 10 primary areas of neurologic screening are presented: 1. Cognition 2. Vision 3. Perception 4. Sensation 5. Peripheral nerve function 6. Motor function (including deep tendon re?ex function) 7. Basal ganglia and cerebellar function (balance, postural control, automated movements) 8. Cranial nerve function 9. Dysphagia 10. Mental status. Each chapter includes functional implications of impairment, screening procedures, red flags (signs and symptoms), available in-depth assessments, and screening forms. Step-by-step instructions and extensive photographs guide clinicians through the screening process. Designed to allow therapists to easily identify possible impairment, document identi?ed dysfunction, and determine if further in-depth evaluation is warranted, this bestselling text is a valuable reference tool for students to take from the classroom to the clinic.

In Cancer Screening: A Practical Guide for Physicians, a panel of highly experienced clinicians and researchers from around the world present their up-to-date screening techniques for a wide variety of cancers. The techniques range from screening for breast, gynecological, and gastrointestinal cancers, to testing for urogenital, dermatological, and respiratory cancers. In addition to providing the busy practitioner with quick access to guidelines for particular cancers, the epidemiology and biology of the various cancers, as well as the sensitivity and specificity of the methods, are discussed in detail. Authoritative and physician-friendly, Cancer Screening: A Practical Guide for Physicians offers to all internists, oncologists, various subspecialists, and primary care physicians a concise practical review of cancer screening designed specifically for daily use in the consulting room.

No Family History presents compelling evidence of environmental links to breast cancer, ranging from everyday cosmetics to industrial waste. Sabrina McCormick weaves the story of one survivor with no family history into a powerful exploration of the big business of breast cancer. A growing number of experts argue that we should increase focus on prevention--reducing environmental exposures that have contributed to the sharp increase of breast cancer rates. But the dollars continue to pour into the search for a cure, and the companies that profit, including some pharmaceutical and cosmetics companies, may in fact contribute to the environmental causes of breast cancer. No Family History shows how profits drive our public focus on the cure rather than prevention, and suggests new ways to reduce breast cancer rates in the future.

This is a dynamic book that successfully combines global and local thinking with regard to an emerging technology that will contribute to the expansion of proteomics and pharmacogenomics, the science of tailored healthcare and treatments. Genetic testing and screening will change the way people understand health, diagnostic knowledge, illness but also crime, databases and private information, paternity, and self-knowledge. In addition to giving individuals the opportunity to think differently about their well-being, it installs a new taxonomy in terms of illness, because its probabilistic effects will introduce a new narrative in the health discourse of 21st century society. While in the past people could be classified as being healthy or sick, now, through genetic testing and screening, adults can be classified as being healthy, predisposed to an illness, probably at risk, at risk, or carriers of certain risks.

The process of discovery in science and technology may require investigation of a large number of features, such as factors, genes or molecules. In Screening, designed experiments and statistical analyses of the resulting data sets are used to identify efficiently the few features that determine key properties of the system under study.

This book brings together accounts by leading international experts that are essential reading for those working in fields such as industrial quality improvement, engineering research and development, genetic and medical screening, drug discovery, and computer simulation of manufacturing systems or economic models. Our aim is to promote cross-fertilization of ideas and methods through detailed explanations, a variety of examples and extensive references.

Topics cover both physical and computer simulated experiments. They include screening methods for detecting factors that affect the value of a response or its variability, and for choosing between various different response models. Screening for disease in blood samples, for genes linked to a disease and for new compounds in the search for effective drugs are also described. Statistical techniques include Bayesian and frequentist methods of data analysis, algorithmic methods for both the design and analysis of experiments, and the construction of fractional factorial designs and orthogonal arrays.

The material is accessible to graduate and research statisticians, and to engineers and chemists with a working knowledge of statistical ideas and techniques. It will be of interest to practitioners and researchers who wish to learn about useful methodologies from within their own areaas well as methodologies that can be translated from one area to another.

'This book gives plenty of examples of ad hominem attacks, intimidation, slander, threats of litigation, deception, dishonesty, lies and other violations of good scientific practice. For some years I kept a folder labeled Dishonesty in breast cancer screening on top of my filing cabinet, storing articles and letters to the editor that contained statements I knew were dishonest. Eventually I gave up on the idea of writing a paper about this collection, as the number of examples quickly exceeded what could be contained in a single article.' From the Introduction The most effective way to decrease women's risk of becoming a breast cancer patient is to avoid attending screening. Mammography screening is one of the greatest controversies in healthcare, and the extent to which some scientists have sacrificed sound scientific principles in order to arrive at politically acceptable results in their research is extraordinary. In contrast, neutral observers increasingly find that the benefit has been much oversold and that the harms are much greater than previously believed. This groundbreaking book takes an evidence-based, critical look at the scientific disputes and the information provided to women by governments and cancer charities. It also explains why mammography screening is unlikely to be effective today. All health professionals and members of the public will find these revelations disturbingly illuminating. It will radically transform the way healthcare policy makers view mammography screening in the future. 'If Peter Gotzsche did not exist, there would be a need to invent him ...It may still take time for the limitations and harms of screening to be properly acknowledged and for women to be enabled to make adequately informed decisions. When this happens, it will be almost entirely due to the intellectual rigour and determination of Peter Gotzsche.' From the Foreword by Iona Heath, President, RCGP 'If you care about breast cancer, and we all should, you must read this book. Breast cancer is complex and we cannot afford to rely on the popular media, or on information from marketing campaigns from those who are invested in screening. We need to question and to understand. The story that Peter tells matters very much.' From the Foreword by Fran Visco, President, National Breast Cancer Coalition

Here is an outstanding reference book of major readings in the field of social work in health care. Practitioners, educators, researchers, and students can use this landmark two-part volume to review dominant themes and critical issues in today's practice environment and to understand the evolution of current trends and emerging policies and programs. In this one desktop source book, hundreds of references relevant to the health care social work field are immediately accessible. Education, policy, practice, and research issues integral to social work's expanding role in health care are the main focus, with each chapter highlighting a theme of enduring importance to the field. Other outstanding articles related to the chapter's theme are cited in the appendix to each chapter which also includes a selected bibliography of suggested topical readings. Comprehensive new book filled with information vital to social workers in the health care field! Over 900 pages of scholarly articles by the foremost social work leaders in health care! 9 categories embrace the range of social work activity in the health care field! Exciting new ideas and practical suggestions for everyday dilemmas! Hundreds of references immediately accessible in one desktop source! Selected bibliography of topical headings provides sources for even more relevant articles! A MUST HAVE volume for instructors and students! Deepen your understanding of all aspects of social work practice in health care with this superb volume! Here is an outstanding reference book of major readings in the field of social work in health care. Practitioners, educators, researchers, and students can use this landmark two-part volume to review dominant themes and critical issues in today's practice environment and to understand the evolution of current trends and emerging policies and programs. Social Work in Health Care makes hundreds of references relevant to the health care social work field immediately accessible in this one desktop source book. Education, policy, practice, and research issues integral to social work's expanding role in health care are the main focus, with each chapter highlighting a theme of enduring importance to the field. Other outstanding articles related to the chapter's theme are cited in the appendix to each chapter which also includes a selected bibliography of suggested topical readings. Find answers and ideas for everyday dilemmas in this all-inclusive, information-packed volume!Social workers practicing in the rapidly expanding health care field call upon a repertoire of skills to fulfill a variety of functions including direct patient care and contact with patients'families, education, and influencing organizational policies on their clients'behalf. The in-depth scholarship and the diversity of multiple approaches to health care social work, as presented in Social Work in Health Care, will have a strong impact on the field. Through the intertwining network of education, policy, practice, and research issues in the book, and professsional discussion of those topics, a beginning point exists from which social workers can develop principles to guide their social work activities in the medical and health fields.

The presentation of mental illness at work has different implications and consequences depending on the specific nature of the job, work context, regulatory framework and risks for the employee, organisation and society. Naturally there are certain occupational groups where human factors and/or mental illness could impair safety and mental acuity, and with potentially devastating consequences. For pilots, the medical criteria for crew licensing are stipulated by regulatory aviation authorities worldwide, and these include specific mental illness exclusions. The challenge of assessment for mental health problems is, however, complex and the responsibility for psychological screening and testing falls to a range of different specialists and groups including AMEs (authorised aviation medical examiners), GPs and physicians, airline human resources departments, psychologists, human factor specialists and pilots themselves. Extending and developing the ideas of Aviation Mental Health (2006), which described a range of psychological issues and problems that may affect pilots and the consequences of these, this book presents an authoritative, comprehensive and practical guide to modern, evidence-based practice in the field of mental health assessment, treatment and care. It features contributions from experts in the field drawn from several countries, professions and representing a range of aviation-related organisations, displaying a range of different skills and methods that can be used for the clinical assessment of pilots and in relation to specific mental-health problems and syndromes.

Like many words, the term "immunomics" equates to different ideas contingent on context. For a brief span, immunomics meant the study of the Immunome, of which there were, in turn, several different definitions. A now largely defunct meaning rendered the Immunome as the set of antigenic peptides or immunogenic proteins within a single microorganism - be that virus, bacteria, fungus, or parasite - or microbial population, or antigenic or allergenic proteins and peptides derived from the environment as a whole, containing also proteins from eukaryotic sources. However, times have changed and the meaning of immunomics has also changed. Other newer definitions of the Immunome have come to focus on the plethora of immunological receptors and accessory molecules that comprise the host immune arsenal. Today, Immunomics or immunogenomics is now most often used as a synonym for high-throughput genome-based immunology. This is the study of aspects of the immune system using high-throughput techniques within a conc- tual landscape borne of both clinical and biophysical thinking.

No Family History presents compelling evidence of environmental links to breast cancer, ranging from everyday cosmetics to industrial waste. Sabrina McCormick weaves the story of one survivor with no family history into a powerful exploration of the big business of breast cancer. As drugs, pink products, and corporate sponsorships generate enormous revenue to find a cure, a growing number of experts argue that we should instead increase focus on prevention reducing environmental exposures that have contributed to the sharp increase of breast cancer rates. But the dollars continue to pour into the search for a cure, and the companies that profit, including some pharmaceutical and cosmetics companies, may in fact contribute to the environmental causes of breast cancer. No Family History shows how profits drive our public focus on the cure rather than prevention, and suggests new ways to reduce breast cancer rates in the future."

As screening programs for HIV, high cholesterol, high blood pressure, genetic abnormalities and other risk factors continue to proliferate, difficult questions are continually raised concerning the psychological and behavioral effects on the participants. Although members of the public health community have debated the costs and benefits of screening programs for over three decades, these questions have become especially pertinent with the current emphasis on early disease detection and prevention. While advocates argue that risk notification provides the impetus for individuals to improve their health habits and seek early treatment, skeptics contend that risk screening can have an adverse labeling effect, leading to increased anxiety, work absenteeism, and fatalism.
Now, for the first time, the widely scattered body of research on the effects of risk factor screening is comprehensively reviewed and evaluated in this volume. Here, an internationally recognized group of expert contributors summarizes and discusses current knowledge about the psychosocial consequences of risk factor testing, taking into account individual differences, gender differences, risk status, and intervention strategies. Both the public health and behavioral science viewpoints are explored through up-to-date reviews and stimulating commentary. Bridging the gap between data, theory and public health policy, this volume is essential reading for researchers, professionals and policymakers concerned with the prevention of acute and chronic disease.

A geneticist tells the stories of men, women, and children whose genes have shaped their lives in unexpected ways.

It was while listening to a colleague tell the parents of a newborn girl that their daughter was going to die that a lifelong interest in genetic medicine was sparked in Dr Edwin Kirk. Warmth and gentleness tempered a direct, sure manner - this was the medicine he wanted to practise, where the most advanced science and the most deeply human meet. Twenty-five years later, Dr Kirk works both with patients and in the lab, and he spearheads a campaign that will change the way we think about having babies. His experience is without parallel, but it is his humour and insight that make all the difference.

Find out why Dr Kirk found himself among hundreds of people, each with a glass of poison in front of them - and how you might perform the same experiment yourself (without the poison). Learn how the realisation that a young boy wasn't short ended up saving the life of his mother - and how Angelina Jolie has saved the lives of many more. Sit in the room with Dr Kirk and his patients as they navigate the world of heartbreaking uncertainties, tantalising possibilities, and thorny questions of morality. In genetics, it is the particularities of an individual's history that matter, and here, in clear and considerate writing, those individual stories are given voice.

This is a unique, in-depth discussion of the uses and conduct of cost-effectiveness analyses (CEA) as decision-making aids in the health and medical fields. The product of over two years of deiberation by a multi-disciplinary Public Health Service appointed panel that included economists, ethicists, psychometricians, and clinicians, it explores cost-effectiveness in the context of societal decision-making for resource allocation purposes. It proposes that analysts include a "reference-case" analysis in all CEA's designed to inform resource allocation and puts forth the most expicit set of guidelines (together with their rationale) ever outlined of the conduct of CEAs. Important theoretical and practical issues encountered in measuring costs and effectiveness, valuing outcomes, discounting, and dealing with uncertainty are examined in separate chapters. These discussions are complemented by additional chapters on framing and reporting of CEAs that aim to clarify the purpose of the analysis and the effective communication of its findings. Primarily intended for analysts in medicine and public health who wish to improve practice and comparability of CEAs, this book will also be of interest to decision-makers in government, managed care, and industry who wish to consider the roles and limitations of CEA and become familiar with criteria for evaluating these studies.