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Objective: A network of 18 pediatric practice locations serving predominantly commercially insured patients implemented the electronic administration of the Pediatric Symptom Checklist-17 parent-report (PSC-17P) for all 5.50- to 17.99-year-old children seen for well child visits (WCVs) and wrote up the results as a quality improvement project. The current study investigated this screening over 2 years to assess its implementation and risk rates over time., Methods: Parents completed the PSC-17P electronically before the visit and the scored data were immediately available in the patient's chart. Using billing and screening data, the study tracked rates of overall and positive screening during the first-year baseline (4 months) and full implementation phases of the project in the first (8 months) and second (12 months) year., Results: A total of 35,237 patients completed a WCV in the first year. There was a significant improvement in PSC-17P screening rates from the first-year baseline (26.3%) to full implementation (89.3%; P < .001) phases. In the second year, a total of 40,969 patients completed a WCV and 77.9% (n = 31,901) were screened, including 18,024 patients with screens in both years. PSC-17P screening rates varied significantly across the 18 locations and rates of PSC-17P risk differed significantly by practice, insurance type, sex, and age., Conclusions: The current study demonstrated the feasibility of routine psychosocial screening over 2 years using the electronically administered PSC-17P in a network of pediatric practices. This study also corroborated past reports that PSC-17 risk rates differed significantly by insurance type (Medicaid vs commercial), sex, and age group., (Copyright © 2020 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Purpose: Continuous monitoring of health determinants in populations is necessary to predict future disease burdens. The objective of this study was to assess the prevalences of major risk factors for lifestyle diseases for 8 years (1993 to 2000) in representative samples of the general population., Methods: Independent cross-sectional surveys representative of adults aged 35 to 74 years (4228 men and 4190 women) in Geneva, Switzerland, conducted continuously between 1993 and 2000., Results: Prevalence of hypertension decreased 15% in men and 10% in women (trend p's<.0001), while overweight/obesity prevalences increased 10% in men and 8% in women (trend p's<.05). The prevalences of smoking (men: 29%; women: 24%) and physical inactivity (men: 44%; women: 50%) remained high and unchanged, and the dietary unsaturated/saturated fat ratio did not change (men: 0.40; women: 0.48)., Conclusions: Because of the persistent high prevalence of risk factors, the global burden of chronic diseases is likely to grow in the next decade and beyond. Continuous monitoring provides reliable trends, beyond seasonal and sampling variations.

Purpose: To assess whether two indicators of social class, education and occupation, have independent and/or synergistic effects in determining the body mass and overweight., Methods: Body mass index (BMI), education, and occupation were assessed in a survey of 1767 men and 1268 women from a representative sample of currently working people of the general population of Geneva, Switzerland. Education and occupation were categorized as low, medium, and high. Overweight was defined as BMI > or = 25 kg/m(2)., Results: The prevalence of overweight was 52.1% in men and 28.7% in women. Men with overweight were more likely to have low education while women with overweight had lower education and lower occupation. Education and occupation were inversely related to BMI in both genders and, in women, had a synergistic effect (p-value for the interaction = 0.03)., Conclusions: Education and occupation have independent and, in women, synergistic effects on BMI. The two indicators may express different mechanisms through which low social class is related to high body mass.

It has been postulated that the relationship of environmental tobacco smoke (ETS) exposure to cancer or cardiovascular diseases may be confounded by social class or diet because women exposed to ETS by their smoker spouse belong to lower social classes and have an unhealthy diet. In a population survey in Geneva, Switzerland, 914 female never-smokers were interviewed about sociodemographic factors, health habits including a semiquantitative food frequency questionnaire, and exposure to ETS according to the site (home, work, leisure). Compared to women unexposed to ETS, those exposed to ETS at work ate less fibers, cereals, vegetables, lean meat, had a lower intake of iron and beta-carotene, and had a lower total energy intake; women exposed during leisure time ate less cereals, drank less skim milk, and had a lower intake of complex carbohydrates. But the diet of women exposed at home did not differ from the diet of those unexposed to ETS. Thus, "living with a smoker" in Geneva does not necessarily imply adopting his health and dietary habits. We conclude that confounding factors of the association of ETS and disease vary according to site and populations and therefore should not be invoked as a systematic source of bias in all studies.

A rapid and sensitive high-performance liquid chromatography-fluorescence method is described for the quantitative analysis of indomethacin and its metabolites in urine. A modified version is also shown for the detection of indomethacin in plasma. The method consists of a single extraction of an acid-buffered plasma sample or single extractions of two buffered aliquots in parallel of urine using ethyl acetate, followed by evaporation of the organic phase. Indomethacin (I) and the metabolite desmethylindomethacin (DMI) were deacylated to their fluorescent products, deschlorobenzoylindomethacin (DBI) and desmethyldeschlorobenzoylindomethacin (DMBI), respectively, prior to chromatography. The chromatographic phase utilized a reversed-phase C18-bonded column with a solvent system comprised of either 22.5% or 26% acetonitrile in 0.25% acetic acid. The elution times for indomethacin metabolites ranged from 12-26 min. The total DBI (including deacylated I) and DMBI (including deacylated DMI) in the extract were each determined using fluorometric detection, with excitation at 288 nm and emission at 390 nm (370 nm cutoff filter). An internal standard of indole-3-propionic acid was used for quantitation. The lower limit of sensitivity for I in plasma was 25 ng/ml.