Clinical Trials Registry First published: 21 March 2006 https://doi.org/10.1111/j.1526-4610.2006.00400.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume46, Issue3March 2006Pages 546-547 RelatedInformation
Universal access to health care has historically faced strident opposition from political conservatives in the United States, although it has long been accepted by most conservatives in the rest of the industrialized world. Now, in a global economy where American business is crippled by the rising cost of market-based health care, the time may be ripe for change. The key to fostering a new mindset among American conservatives is to show why universal access fulfills many of the basic values that all conservatives hold.
Concerns about screening mammography include questions of efficacy, high recall rates, false positives, and age at which to institute annual screening. Annual screening mammography can decrease breast cancer mortality by 45% in women over fifty and 23% in women between forty and fifty years of age. Patient recall rates and accuracy of interpretation vary among radiologists. Suggestions for improving accuracy of mammographic interpretation include continuing education with emphasis on quality of interpretation, computer-assisted detection, double reading, increased volume per reader, and performance-related skills testing. Having fewer radiologists reading more mammograms may result in decreased patient access to mammography services. Poor reimbursement for mammography and high prevalence of breast cancer-related litigation are disincentives for radiologists to provide mammography services; these issues must be addressed to ensure patient access to mammography. The public must be educated so that reasonable expectations on the benefits and limitations of mammography will develop.
The DHSS and federal agencies have expanded their surveillance efforts to improve existing methods of reporting notifiable communicable diseases and to include additional data sources that might provide a more comprehensive view of disease activity in New Jersey. Currently, the DHSS is evaluating these efforts and recognizes several issues that need to be addressed, including: assessment of the timeliness, completeness, and accuracy of surveillance data; validation of surveillance data through comparison with hospital uniform billing data; characterization of the sensitivity of alerts through examination of reasons for identified aberrations in disease activity; evaluation of DHSS staffs and LINCS epidemiologists' follow-up efforts in response to alerts; evaluation of cumulative data trends to determine patterns in baseline disease activity (e.g., variations in disease activity attributed to seasonality); development of methods to integrate data from all surveillance efforts to provide timely, comprehensive, and coordinated summaries of disease activity and to distribute these summaries regularly to all New Jersey public health partners to better inform public health and clinical management; and development of a coordinated multi-agency response plan in conjunction with adjacent states. Though the DHSS hopes that these surveillance efforts will contribute to the early detection of sentinel events that might represent possible bioterrorist or emerging infectious disease threats, the DHSS will also need to engage the medical community more fully in surveillance activities. In previous experiences, astute clinicians were responsible for the identification of the first cases of West Nile virus, anthrax, and SARS. Therefore, to further ensure the success of its surveillance efforts, the DHSS will also need to continue educating clinicians about its surveillance activities and the importance of timely reporting of patients with illness patterns that might suggest an unusual infectious disease outbreak associated with bioterrorism or emerging infectious diseases.
A radiological terrorist attack on the United States is a possibility. This could involve the dispersal of radioactive material by an attack on a nuclear facility, deployment of a radiation dispersal device, or, less likely, detonation of a nuclear weapon. To decrease our vulnerability to this type of threat, the medical community should have a basic understanding of radiation hazards and their medical management, and it should be prepared to interact with appropriate federal agencies to facilitate the employment of emergency response plans.
In the event of a severe nuclear power plant emergency resulting in the release of radioactive iodine, potassium iodide, a relatively safe and effective salt, may be used as prophylaxis. This article presents a history of thyroid cancer due to radiation exposure and the risks and benefits of potassium iodide prophylaxis.
