Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States

AIM:To characterize the increasing incidence and geographic variation of acute diverticulitis.METHODS:Using the nationwide inpatient sample (NIS) we identified a cohort who had been admitted with diverticulitis between 1998 and 2005.We calculated age-,sex-,and region-specific rates of hospitalizations for diverticulitis over time.RESULTS:The age-adjusted hospitalization rate for diverticulitis increased from 61.8 per 100000 to 75.5 per 100 000 between 1998 and 2005,and increased similarly in both sexes.Diverticulitis-associated admissions were male-predominant in those younger than age 45 years but were female-predominant thereafter.Admission rates increased the most among those<45 years,while remaining unchanged for those≥65 years.By 2005,the majority of hospitalized patients were<65 years.Age-adjusted rates of diverticulitis-associated hospitalizations were lower in the West(50.4/100000) compared to the Northeast(77.7/100000),South (73.9/100000),and Midwest(71.0/100000).CONCLUSION:Diverticulitis-associated hospitalizations have steeply risen,especially in young adults.These epidemiological trends vary by geographic region and warrant further investigation into potential dietary and environmental etiologies.

Global health training in Canadian family medicine residency programmes

Objective Canadian family medicine(FM)residency programmes are responding to the growing demand to provide global health(GH)education to their trainees;herein,we describe the various GH activities(GHAs)offered within Canadian FM programmes.Design A bilingual online survey was sent out to all 17 Canadian FM program directors(PDs)and/or an appointed GH representative.setting Online survey via Qualtrics Participants All 17 Canadian FM PDs and/or an appointed GH representative.results The response rate was 100%and represented 3250 first-year and second-year FM residents across English and French Canada.All schools stated that they participate in some form of GHAs.There was variation in the level of organisation,participation and types of GHAs offered.Overall,most GHAs are optional,and there is a large amount of variation in terms of resident participation.Approximately one third of programmes receive dedicated funding for their GHAs,and two thirds wish to increase the scope/variety of GHAs.Conclusion These results suggest nationwide interest in developing a workforce trained in GH,but show great discrepancies in training,implementation and education.

From potential to practice: how accelerating access to HPV tests and screen and treat programmes can help eliminate cervical cancer

Human papillomavirus(HPV)vaccination campaigns to prevent cervical cancer are being considered and implemented in countries around the world.While vaccination will protect future generations,it will not help the millions of women currently infected,leading to an estimated 311000 deaths per year globally.This paper examines a selection of strategies that when applied to both existing and new technologies,could accelerate access to HPV testing.Authors from the US Agency for International Development,the National Institutes of Health,and the Bridge to Health Medical and Dental,a non-governmental organisation,joined forces to propose a scalable and country-directed solution for preventing cervical cancer using an end-to end approach.Collectively,the authors offer seven evidence-based strategies,that when used alone or in combination have the ability to reduce HPV-caused cervical cancer deaths and disability.These strategies include(1)consistent HPV test intervals to decrease HPV DNA test costs;(2)exploring market shaping opportunities;(3)employing iterative user research methodologies like human-centred design;(4)target product profiles for new HPV tests;(5)encouraging innovation around cervical cancer screen and treat programmes;(6)developing national cancer control plans;and(7)integrating cervical cancer screen and treat services into existing infrastructure.By using the strategies outlined here,in combination with HPV vaccination campaigns,national governments will be able to scale and expand cervical cancer screening programmes and provide evidence-based treatment programmes for HPV-infected women.