Science.gov

Sample records for interdisciplinary secondary prevention

  1. A Model and Strategies for Realizing Secondary Level Interdisciplinary Instruction.

    ERIC Educational Resources Information Center

    Rye, James A.; Campbell, Star; Bardwell, Jenny

    This paper discusses strategies that can be used to realize interdisciplinary instruction at the secondary level and details a sample curriculum that employs themes related to human nutrition. The Secondary Level Interdisciplinary Curriculum is organized around five thematic units that present nutrition issues highly relevant to adolescents:…

  2. [Interdisciplinary quality management in preventive medicine institutions].

    PubMed

    Fischer, Robert

    2004-12-01

    Like all health care institutions, preventive medicine institutions, too, need a quality assurance structure. An integrated system consisting of "balanced score card", "finite-elements-model" and "interdisciplinary quality circles" is presented. This organisational structure allows the implementation of quality assurance in complex institutions as well, such as health care organisations. In addition, this concept guarantees broad acceptance by all team members, not least due to complexity reduction. PMID:15675427

  3. AIDS: An Inter-Disciplinary Secondary Curriculum Supplement.

    ERIC Educational Resources Information Center

    Carr, Marianne

    This curriculum guide to teaching secondary students about Acquired Immune Deficiency Syndrome (AIDS) using an interdisciplinary approach includes lessons that are meant to supplement the existing curriculum, but may be used to supplant existing lessons. Most of the lessons employ the investigative approach to learning and require student…

  4. The adoption of an interdisciplinary instructional model in secondary education

    NASA Astrophysics Data System (ADS)

    Misicko, Martin W.

    This study describes the experiences of a secondary high school involved in the adoption of an interdisciplinary curriculum. An interdisciplinary curriculum is defined as both the precalculus and physics curriculums taught collaboratively throughout the school year. The students' academic performances were analyzed to gage the success of the interdisciplinary model. The four year study compared students taught precalculus in a traditional discipline-based classroom versus those facilitated in an interdisciplinary precalculus/physics model. It also documents the administrative changes necessary in restructuring a high school to an interdisciplinary team teaching model. All of the students in both pedagogical models received instruction from the same teacher, and were given identical assessment materials. Additionally, the curriculum guidelines and standards of learning were duplicated for both models. The primary difference of the two models focused on the applications of mathematics in the physics curriculum. Prerequisite information was compared in both models to ensure that the students in the study had comparable qualifications prior to the facilitation of the precalculus curriculum. Common trends were analyzed and discussed from the student's performance data. The students enrolled in the interdisciplinary model appeared to outperform the discipline-based students in common evaluative assessments. The themes and outcomes described in this study provide discussion topics for further investigation by other school districts. Further study is necessary to determine whether scheduling changes may have influenced student performances, and to examine whether other content areas may experience similar results.

  5. Preventing Dance Injuries: An Interdisciplinary Perspective.

    ERIC Educational Resources Information Center

    Solomon, Ruth, Ed.; And Others

    This book on the interdisciplinary nature of dance medicine as an emerging field of inquiry contains the following chapters: (1) "A Comparison of Patterns of Injury in Ballet, Modern, and Aerobic Dance" (Marie Schafle, And Others); (2) "Pronation as a Predisposing Factor in Overuse Injuries" (Steven R. Kravitz); (3) "Some Common Foot and Ankle…

  6. There's Madness in These Methods: Teaching Secondary Methods Students to Develop Interdisciplinary Units.

    ERIC Educational Resources Information Center

    Combs, Dorie; White, Rodney

    2000-01-01

    Discusses interdisciplinary instruction at the high school level, examines the imperatives of statewide reform in Kentucky, and outlines how and when interdisciplinary instruction improves learning. Describes an interdisciplinary learning project taught in secondary methods classes at Eastern Kentucky University in which students experience…

  7. Of Organelles and Octagons: What Do Preservice Secondary Teachers Learn from Interdisciplinary Teaching?

    ERIC Educational Resources Information Center

    Spalding, Elizabeth

    2002-01-01

    Examined the impact of an interdisciplinary teacher project on the learning of preservice secondary teachers enrolled in a graduate level teacher education program. Data on four successive cohorts of students indicated that participants successfully created and implemented interdisciplinary curriculum and were quite positive about the experience.…

  8. [Primary prevention of adult obesity. an interdisciplinary analysis].

    PubMed

    Hilbert, Anja; Ried, Jens; Schneider, Daniel; Juttner, Clemens; Sosna, Marc; Dabrock, Peter; Lingenfelder, Michael; Voit, Wolfgang; Rief, Winfried; Hebebrand, Johannes

    2007-10-01

    on risk factors for obesity is also crucial to inform network approaches and to justify restrictive legal options for the purpose of prevention. Here, self-defeating sanctions of the relevant industries may be a viable first step toward obesity prevention. As taxes or subsidies are limited in feasibility (Figure 2), relevant industries could be involved in the design and promotion of "healthy" products, stimulating greater request of such products. Network approaches appear suited to involve companies and other relevant stakeholders of prevention efforts on adult obesity. Yet these approaches require greater societal conscience about the severity of the obesity problem in adults and its multifactorial etiology. Recognizing the multifactorial etiology of obesity and acknowledging that weight regulation is only somewhat within personal responsibility may therefore lead to destigmatize obese individuals as the focus is shifted away from blaming them toward a more realistic understanding of this condition. Responsibility for the development of obesity and the prevention of weight gain is in multiple areas: law, policy, industry, health-care institutions, medical professions, and the individual - all should contribute to obesity prevention. Overall, the current analysis shows that an interdisciplinary perspective furthers understanding of the complexity of this condition and can inform public-health strategies on the prevention of adult obesity. PMID:17972027

  9. Community to Community: An Interdisciplinary Investigation for Secondary Students.

    ERIC Educational Resources Information Center

    Wilder, Melinda S.

    1998-01-01

    Presents an activity designed to help secondary students understand how population density affects their own community. Contains background information on the population issue and detailed procedures for the activity. (DDR)

  10. Compendium of Interdisciplinary Activities for an Introductory Course in Communication Systems at the Secondary Level.

    ERIC Educational Resources Information Center

    Lasko, David J.

    This compendium of interdisciplinary learning activities is designed to assist technology education instructors who are conducting an introductory secondary-level course in communication technology. The 12 activities, which are sequenced from introductory, low-cost activities to more advanced and more involved activities, deal with the following…

  11. [Cause of secondary caries and prevention].

    PubMed

    Feng, Xiping

    2014-04-01

    Secondary caries is a disease that occurs on the tooth after the filling has been used for a period of time. Secondary caries is also the main reason for the replacement of dental restorations. Regardless of the material used for fillings, secondary caries cannot be completely avoided. The proportion of secondary caries is very high after filling in permanent teeth or primary teeth. Secondary caries mainly occurs because of the formation of micro cracks after filling. When the micro crack width exceeds 50 microm, saliva will enter the micro cracks between the filling and tooth tissue. The cariogenic bacteria in the saliva will grow when the environment of micro cracks is appropriate, thereby producing secondary caries. The prevention of secondary caries includes micro crack control, fluoride use, teeth cleaning, tooth decay and gum disease treatment, and regular checkups. PMID:24881200

  12. [Secondary prevention of ischemic non cardioembolic stroke].

    PubMed

    Armario, Pedro; Pinto, Xavier; Soler, Cristina; Cardona, Pere

    2015-01-01

    Stroke patients are at high risk for recurrence or new occurrence of other cardiovascular events or cardiovascular mortality. It is estimated that a high percentage of non-cardioembolic ischemic stroke can be prevented by a suitable modification of lifestyle (diet and exercise), reducing blood pressure (BP) with antihypertensive medication, platelet aggregation inhibitors, statins and high intake reducing consumption of. Unfortunately the degree of control of the different risk factors in secondary prevention of stroke is low. The clinical practice guidelines show clear recommendations with corresponding levels of evidence, but only if implemented in a general way they will get a better primary and secondary stroke prevention. PMID:25771074

  13. [FLS - three letters alter secondary fracture prevention].

    PubMed

    Suhm, N; Meier, C; Kraenzlin, M; Kungler, E; Savic, B; Mueller, S; Jakob, M; Rikli, D

    2016-01-01

    The increasing importance of preventive measures in the field of orthopedics and trauma surgery becomes apparent because of the demographic changes and the high risk for secondary fractures following osteoporotic fractures. Within the fracture treatment chain, orthopedics and trauma surgery are in the "pole position" to initiate these measures in geriatric patients. In the past orthopedists and trauma surgeons have constantly accused of neglecting secondary fracture prevention in fragility fracture patients. There are several reasons that speak in favor of us undertaking a role in secondary fracture prevention: osteoporosis medication is highly effective in fracture prevention when correctly indicated, the positive effects of osteoporosis therapy on fracture healing and legal issues. Arguments that have been used to justify neglect of secondary fracture prevention are undesired side effects related to osteoporosis medications, such as atypical femoral fractures and osteonecrosis of the jaws, interference of some specific drugs with fracture healing and the working conditions in emergency departments. These run contrary to the consideration of chronic diseases such as osteoporosis, secondary osteoporosis and the underlying disease could be overlooked and the increasing complexity of medicinal osteoporosis therapy. In the first part of the article these arguments are weighed against each other. In the second part the concept of a fracture liaison service (FLS) is discussed. The FLS framework now allows an active role to be taken with respect to secondary fracture prevention despite the busy daily routine schedule. Implementation of an FLS is facilitated by dedicated instruction protocols and programs. Self-financing of an FLS is currently possible only in some specific healthcare systems. In healthcare systems in German-speaking areas a cross-financing must be available and the value of an FLS indirectly presented. Apart from the financial aspects, implementation of

  14. The Effects of an Interdisciplinary Program on Secondary Art Students Participating in an Interdisciplinary Chemistry-Art Program and in an Art Only Program

    ERIC Educational Resources Information Center

    Kariuki, Patrick; Hopkins, Beth

    2010-01-01

    The purpose of this study was to determine the effects of an interdisciplinary program on the secondary level. The sample consisted of 17 students enrolled in a high school advanced photography class. The students in the sample varied in their chemistry background. The sample was randomly assigned to experimental and control groups. The…

  15. Secondary prevention and estimation of fracture risk.

    PubMed

    Mitchell, Paul James; Chem, C

    2013-12-01

    The key questions addressed in this chapter are: • How can individual risk of fracture be best estimated? • What is the best system to prevent a further fracture? • How to implement systems for preventing further fractures? Absolute fracture risk calculators (FRCs) provide a means to estimate an individual's future fracture risk. FRCs are widely available and provide clinicians and patients a platform to discuss the need for intervention to prevent fragility fractures. Despite availability of effective osteoporosis medicines for almost two decades, most patients presenting with new fragility fractures do not receive secondary preventive care. The Fracture Liaison Service (FLS) model has been shown in a number of countries to eliminate the care gap in a clinically and cost-effective manner. Leading international and national organisations have developed comprehensive resources and/or national strategy documents to provide guidance on implementation of FLS in local, regional and national health-care systems. PMID:24836336

  16. Dendrite preventing separator for secondary lithium batteries

    NASA Technical Reports Server (NTRS)

    Shen, David H. (Inventor); Surampudi, Subbarao (Inventor); Huang, Chen-Kuo (Inventor); Halpert, Gerald (Inventor)

    1993-01-01

    Dendrites are prevented from shorting a secondary lithium battery by use of a first porous separator, such as porous polypropylene, adjacent to the lithium anode that is unreactive with lithium and a second porous fluoropolymer separator between the cathode and the first separator, such as polytetrafluoroethylene, that is reactive with lithium. As the tip of a lithium dendrite contacts the second separator, an exothermic reaction occurs locally between the lithium dendrite and the fluoropolymer separator. This results in the prevention of the dendrite propagation to the cathode.

  17. Dendrite preventing separator for secondary lithium batteries

    NASA Technical Reports Server (NTRS)

    Shen, David H. (Inventor); Surampudi, Subbarao (Inventor); Huang, Chen-Kuo (Inventor); Halpert, Gerald (Inventor)

    1995-01-01

    Dendrites are prevented from shorting a secondary lithium battery by use of a first porous separator such as porous polypropylene adjacent the lithium anode that is unreactive with lithium and a second porous fluoropolymer separator between the cathode and the first separator such as polytetrafluoroethylene that is reactive with lithium. As the tip of a lithium dendrite contacts the second separator, an exothermic reaction occurs locally between the lithium dendrite and the fluoropolymer separator. This results in the prevention of the dendrite propagation to the cathode.

  18. The Diversity of Anti-Microbial Secondary Metabolites Produced by Fungal Endophytes: An Interdisciplinary Perspective

    PubMed Central

    Mousa, Walaa Kamel; Raizada, Manish N.

    2013-01-01

    Endophytes are microbes that inhabit host plants without causing disease and are reported to be reservoirs of metabolites that combat microbes and other pathogens. Here we review diverse classes of secondary metabolites, focusing on anti-microbial compounds, synthesized by fungal endophytes including terpenoids, alkaloids, phenylpropanoids, aliphatic compounds, polyketides, and peptides from the interdisciplinary perspectives of biochemistry, genetics, fungal biology, host plant biology, human and plant pathology. Several trends were apparent. First, host plants are often investigated for endophytes when there is prior indigenous knowledge concerning human medicinal uses (e.g., Chinese herbs). However, within their native ecosystems, and where investigated, endophytes were shown to produce compounds that target pathogens of the host plant. In a few examples, both fungal endophytes and their hosts were reported to produce the same compounds. Terpenoids and polyketides are the most purified anti-microbial secondary metabolites from endophytes, while flavonoids and lignans are rare. Examples are provided where fungal genes encoding anti-microbial compounds are clustered on chromosomes. As different genera of fungi can produce the same metabolite, genetic clustering may facilitate sharing of anti-microbial secondary metabolites between fungi. We discuss gaps in the literature and how more interdisciplinary research may lead to new opportunities to develop bio-based commercial products to combat global crop and human pathogens. PMID:23543048

  19. [Primary and secondary prevention of stroke].

    PubMed

    Trenkwalder, Peter; Rüchardt, Andreas

    2015-10-01

    The basis for primary and secondary prevention of stroke (and also TIA) are both a healthy lifestyle with a healthy diet, non smoking, weight reduction and regular exercise, and consistent treatment of arterial hypertension with a target of < 140 /90 mmHg. The choice of the antihypertensive is depending on concomitant diseases, more important than the class of antihypertensive is treatment to target. Reduction of cholesterol with statins in primary prevention is dependant on total cardiovascular risk, in secondary prevention statins are integral part of modern treatment in non cardioembolic stroke. Atrial fibrillation is one of the major causes of stroke and should be treated with anticoagulation depending on the CHA2DS2-VASc score. Platelet inhibition is mandatory lifelong in all non cardioembolic strokes, in primary prevention only for patients with high total cardiovascular risk. Treatment of asymptomatic carotid artery stenosis should be determined on an individual basis. Symptomatic carotid artery stenosis should be treated immediately after the index stroke. PMID:26488098

  20. RNA Secondary Structure Prediction by Using Discrete Mathematics: An Interdisciplinary Research Experience for Undergraduate Students

    PubMed Central

    Ellington, Roni; Wachira, James

    2010-01-01

    The focus of this Research Experience for Undergraduates (REU) project was on RNA secondary structure prediction by using a lattice walk approach. The lattice walk approach is a combinatorial and computational biology method used to enumerate possible secondary structures and predict RNA secondary structure from RNA sequences. The method uses discrete mathematical techniques and identifies specified base pairs as parameters. The goal of the REU was to introduce upper-level undergraduate students to the principles and challenges of interdisciplinary research in molecular biology and discrete mathematics. At the beginning of the project, students from the biology and mathematics departments of a mid-sized university received instruction on the role of secondary structure in the function of eukaryotic RNAs and RNA viruses, RNA related to combinatorics, and the National Center for Biotechnology Information resources. The student research projects focused on RNA secondary structure prediction on a regulatory region of the yellow fever virus RNA genome and on an untranslated region of an mRNA of a gene associated with the neurological disorder epilepsy. At the end of the project, the REU students gave poster and oral presentations, and they submitted written final project reports to the program director. The outcome of the REU was that the students gained transferable knowledge and skills in bioinformatics and an awareness of the applications of discrete mathematics to biological research problems. PMID:20810968

  1. RNA secondary structure prediction by using discrete mathematics: an interdisciplinary research experience for undergraduate students.

    PubMed

    Ellington, Roni; Wachira, James; Nkwanta, Asamoah

    2010-01-01

    The focus of this Research Experience for Undergraduates (REU) project was on RNA secondary structure prediction by using a lattice walk approach. The lattice walk approach is a combinatorial and computational biology method used to enumerate possible secondary structures and predict RNA secondary structure from RNA sequences. The method uses discrete mathematical techniques and identifies specified base pairs as parameters. The goal of the REU was to introduce upper-level undergraduate students to the principles and challenges of interdisciplinary research in molecular biology and discrete mathematics. At the beginning of the project, students from the biology and mathematics departments of a mid-sized university received instruction on the role of secondary structure in the function of eukaryotic RNAs and RNA viruses, RNA related to combinatorics, and the National Center for Biotechnology Information resources. The student research projects focused on RNA secondary structure prediction on a regulatory region of the yellow fever virus RNA genome and on an untranslated region of an mRNA of a gene associated with the neurological disorder epilepsy. At the end of the project, the REU students gave poster and oral presentations, and they submitted written final project reports to the program director. The outcome of the REU was that the students gained transferable knowledge and skills in bioinformatics and an awareness of the applications of discrete mathematics to biological research problems. PMID:20810968

  2. OM-85 BV: primary versus secondary prevention.

    PubMed

    Collet, J P; Boissel, J P

    1994-01-01

    Recurrent upper respiratory tract infections in children have an important socioeconomic impact, with consequences on both the quality of life of the children, the possible medical sequelae and the inherent direct and indirect costs. The possibility to prevent these infections is limited in the absence of specific vaccines against microorganisms responsible for most of the respiratory tract infections (i.e. respiratory syncitial virus, adenovirus, rhinovirus). Immunoactive bacterial extracts that stimulate the nonspecific component of the immune system may protect against a large variety of microorganisms that enter the body by the oral and respiratory pathway; they may, therefore, play an important role with regard to this preventive action. OM-85 BV is an IBE that has been used in children who suffer from repeated infections to prevent the occurrence of new episodes (secondary prevention). In this condition, the drug has been shown to be effective in protecting children against recurrent airway infections. Its use as a primary preventive agent to prevent the development of repeated infections in children attending day-care centers (a very high-risk environment for repeated infections), however, did not show a similar efficacy. The risk of having > or = 4 episodes of upper respiratory tract infections over a period of 7.5 months was 26.7% in the verum group and 33.8% in the placebo group (relative risk 0.79, confidence interval 0.59-1.06]. In an exploratory analysis concentrating on the 3-month treatment period, however, a 48% reduction of the risk of presenting > or = 3 episodes was observed. Furthermore, this exploratory analysis showed a strong correlation between drug efficacy and age of the children.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7800967

  3. Primary and Secondary Prevention of Cardiovascular Disease

    PubMed Central

    Vandvik, Per Olav; Lincoff, A. Michael; Gore, Joel M.; Gutterman, David D.; Sonnenberg, Frank A.; Alonso-Coello, Pablo; Akl, Elie A.; Lansberg, Maarten G.; Guyatt, Gordon H.

    2012-01-01

    Background: This guideline focuses on long-term administration of antithrombotic drugs designed for primary and secondary prevention of cardiovascular disease, including two new antiplatelet therapies. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: We present 23 recommendations for pertinent clinical questions. For primary prevention of cardiovascular disease, we suggest low-dose aspirin (75-100 mg/d) in patients aged > 50 years over no aspirin therapy (Grade 2B). For patients with established coronary artery disease, defined as patients 1-year post-acute coronary syndrome, with prior revascularization, coronary stenoses > 50% by coronary angiogram, and/or evidence for cardiac ischemia on diagnostic testing, we recommend long-term low-dose aspirin or clopidogrel (75 mg/d) (Grade 1A). For patients with acute coronary syndromes who undergo percutaneous coronary intervention (PCI) with stent placement, we recommend for the first year dual antiplatelet therapy with low-dose aspirin in combination with ticagrelor 90 mg bid, clopidogrel 75 mg/d, or prasugrel 10 mg/d over single antiplatelet therapy (Grade 1B). For patients undergoing elective PCI with stent placement, we recommend aspirin (75-325 mg/d) and clopidogrel for a minimum duration of 1 month (bare-metal stents) or 3 to 6 months (drug-eluting stents) (Grade 1A). We suggest continuing low-dose aspirin plus clopidogrel for 12 months for all stents (Grade 2C). Thereafter, we recommend single antiplatelet therapy over continuation of dual antiplatelet therapy (Grade 1B). Conclusions: Recommendations continue to favor single antiplatelet therapy for patients with established coronary artery disease. For patients with acute coronary

  4. Identifying interdisciplinary research priorities to prevent and treat pediatric obesity in New York City

    PubMed Central

    Gallagher, Dympna; Larson, Elaine L.; Wang, Yun-Hsin Claire; Richards, Boyd; Weng, Chunhua; Hametz, Patricia; Begg, Melissa D.; Chung, Wendy K.; Boden-Albala, Bernadette; Akabas, Sharon R.

    2013-01-01

    It is well recognized that an interdisciplinary approach is essential in the development and implementation of solutions to address the current pediatric obesity epidemic. In two half-day meetings that included workshops and focus groups, faculty from diverse fields identified critically important research challenges and gaps to childhood obesity prevention. The purpose of this white paper is to describe the iterative, interdisciplinary process that unfolded in an academic health center setting with a specific focus on under-represented minority groups of Black and Hispanic communities, and to summarize the research challenges and gaps related to pediatric obesity which were identified in the process. Although the research challenges and gaps were developed in the context of an urban setting including high risk populations (the northern Manhattan communities of Washington Heights, Inwood, and Harlem), many of the issues raised are broadly applicable. The processes by which the group identified research gaps and methodological challenges that impede a better understanding of how to prevent and treat obesity in children has resulted in an increase in research and community outreach collaborations and interdisciplinary pursuit of funding opportunities across units within the academic health center and overall University. PMID:20718818

  5. Identifying interdisciplinary research priorities to prevent and treat pediatric obesity in New York City.

    PubMed

    Gallagher, Dympna; Larson, Elaine L; Wang, Yun-Hsin Claire; Richards, Boyd; Weng, Chunhua; Hametz, Patricia; Begg, Melissa D; Chung, Wendy K; Boden-Albala, Bernadette; Akabas, Sharon R

    2010-08-01

    It is well recognized that an interdisciplinary approach is essential in the development and implementation of solutions to address the current pediatric obesity epidemic. In two half-day meetings that included workshops and focus groups, faculty from diverse fields identified critically important research challenges, and gaps to childhood obesity prevention. The purpose of this white paper is to describe the iterative, interdisciplinary process that unfolded in an academic health center setting with a specific focus on underrepresented minority groups of Black and Hispanic communities, and to summarize the research challenges and gaps related to pediatric obesity that were identified in the process. Although the research challenges and gaps were developed in the context of an urban setting including high-risk populations (the northern Manhattan communities of Washington Heights, Inwood, and Harlem), many of the issues raised are broadly applicable. The processes by which the group identified research gaps and methodological challenges that impede a better understanding of how to prevent and treat obesity in children has resulted in an increase in research and community outreach collaborations and interdisciplinary pursuit of funding opportunities across units within the academic health center and overall university. PMID:20718818

  6. Putting Professionalism Back into Teaching: Secondary Preservice and In-Service Teachers Engaging in Interdisciplinary Unit Planning

    ERIC Educational Resources Information Center

    Stolle, Elizabeth Petroelje; Frambaugh-Kritzer, Charlotte

    2014-01-01

    Recently, interdisciplinary instruction has come back to the educational scene, specifically supported through the Common Core State Standards. As teacher educators and former middle-level teachers, the authors see this as a positive move to enhance learning for adolescents. This qualitative study sought to answer: How do secondary preservice and…

  7. Secondary stroke prevention: challenges and solutions.

    PubMed

    Esenwa, Charles; Gutierrez, Jose

    2015-01-01

    Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke), the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies. PMID:26300647

  8. Personalizing Treatment: Between Primary and Secondary Prevention.

    PubMed

    Blaha, Michael J

    2016-09-15

    Current American College of Cardiology/American Heart Association guidelines for the management of patients with elevated blood cholesterol increasingly emphasize assessment of atherosclerotic cardiovascular disease (ASCVD) risk in deciding when to initiate pharmacotherapy. The decision to treat is based primarily on mathematical integration of traditional risk factors, including age, sex, race, lipid values, systolic blood pressure, hypertension therapy, diabetes mellitus, and smoking. Advanced risk testing is selectively endorsed for patients when the decision to treat is otherwise uncertain, or more broadly interpreted as those patients who are at so-called "intermediate risk" of ASCVD events using traditional risk factors alone. These new guidelines also place new emphasis on a clinician-patient risk discussion, a process of shared decision making in which patient and physician consider the potential benefits of treatment, risk of adverse events, and patient preferences before making a final decision to initiate treatment. Advanced risk testing is likely to play an increasingly important role in this process as weaknesses in exclusive reliance on traditional risk factors are recognized, new non-statin therapies become available, and guidelines are iteratively updated. Comparative efficacy studies of the various advanced risk testing options suggest that coronary artery calcium scoring is most strongly predictive of ASCVD events. Most importantly, coronary artery calcium scoring appears to identify an important subgroup of patients with advanced subclinical atherosclerosis-who are "between" primary and secondary prevention-that might benefit from the most aggressive lipid-lowering pharmacotherapy. PMID:27620358

  9. Secondary stroke prevention: challenges and solutions

    PubMed Central

    Esenwa, Charles; Gutierrez, Jose

    2015-01-01

    Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke), the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies. PMID:26300647

  10. Suicide Prevention for Counselors Working with Youth in Secondary and Post-Secondary School

    ERIC Educational Resources Information Center

    Wiley, Cindy

    2012-01-01

    According to the latest statistics, suicide is the 3rd leading cause of death in those aged 15-24 (CDC, 2010), when many are enrolled in secondary and post-secondary institutions. Because of such alarming statistics, the need for prevention education is great. However, many counselors and educators feel ill- equipped in prevention and intervention…

  11. Preventing secondary traumatic stress in educators.

    PubMed

    Hydon, Stephen; Wong, Marleen; Langley, Audra K; Stein, Bradley D; Kataoka, Sheryl H

    2015-04-01

    Teachers can be vulnerable to secondary traumatic stress (STS) because of their supportive role with students and potential exposure to students' experiences with traumas, violence, disasters, or crises. STS symptoms, similar to those found in posttraumatic stress disorder, include nightmares, avoidance, agitation, and withdrawal, and can result from secondary exposure to hearing about students' traumas. This article describes how STS presents, how teachers can be at risk, and how STS can manifest in schools. A US Department of Education training program is presented, and thoughts on future directions are discussed. PMID:25773327

  12. Strategies for Preventing Behavioral Incidents in the Nation's Secondary Schools.

    ERIC Educational Resources Information Center

    Purvis, Johnny; Leonard, Rex

    1985-01-01

    Discusses strategies that can be used to prevent the five most common behavioral problems in secondary schools: (1) failure to complete assigned work, (2) tardiness, (3) inattentiveness, (4) littering, and (5) failure to bring materials to class. (FL)

  13. Helpers in Distress: Preventing Secondary Trauma

    ERIC Educational Resources Information Center

    Whitfield, Natasha; Kanter, Deborah

    2014-01-01

    Those in close contact with trauma survivors are themselves at risk for trauma (e.g., Bride, 2007; Figley, 1995). Family, friends, and professionals who bear witness to the emotional retelling and re-enacting of traumatic events can experience what is called "secondary trauma" (Elwood, Mott, Lohr, & Galovski, 2011). The literature…

  14. Violence Prevention in United States Society of Jesus Secondary Schools

    ERIC Educational Resources Information Center

    Simonds, Thomas Andrew

    2009-01-01

    Using data from a representative number of Society of Jesus secondary schools, the researcher reports what these schools are doing to prevent violence, and tests an explanatory model of school violence he created. The researcher proposes that this model can be used to explain and prevent school violence by identifying and addressing the…

  15. Ergonomic principles and tools for best interdisciplinary psycho-physical stress prevention.

    PubMed

    Dal Cason, Dott Luigi

    2012-01-01

    The psycho-physical stress is a risk to all intents and purposes,finally acknowledged, it requires increasing attention. Measures forits protection are reflected in the appropriate application of organizational policies on a human scale, or in respect of the"macro-ergonomics". This work consists on several inter-disciplinary tools available to the proper prevention, outbreaks of work-related stress.During work, adequate rests are important to prevent work related physical and mental fatigue. The strategies for maintaining a healthy balance between work rate and work breaks, may differ depending on the individual, subjective habits and peculiarities related to the work environment. Resting does not necessarily mean "going to break". The break-time is important as the work-time. While the latter is regulated, the first is not always clearly defined, though necessary. Knowing the employment contract is the first step towards the implementation of their rights relating to periods of suspension from the activity of work is also essential for high performance working. Breathing exercises, massage therapy, biofeedback, role-playing are some of the tools used during work breaks to prevent mental and physical fatigue. At the end music has a rhythm by alternating strong and weak accents. If the musical notes represent the "vertical" trend of music (melody), figures and pauses, inserted into the rhythmic structure of the measure, regulate the duration of sounds over time and determine the "horizontal" trend of a song. Transferring this concept on work, is meant to understand, using a metaphor, the importance of respect of changes in both vertical and horizontal trends inside a cycle. PMID:22317321

  16. [Human ecology and interdisciplinary cooperation for primary prevention of environmental risk factors for public health].

    PubMed

    Dobrowolski, Jan W

    2007-01-01

    Human ecology makes a scientific base for more effective prevention against contamination of the air, water and food, and other environmental factors making common risk factors for human health. It integrates interdisciplinary cooperation of experts from natural, technological, socio-economical and other sciences. Complex study is necessary for better estimation of real risk factors for an individual person. This risk is connected with the exposure of people to pollutants in working places, housing environment, areas for recreation and by food (including synergistic effects). Such study implicates real tasks for representatives of different sciences (technological and agricultural in particular) as well as for teachers and journalists. Especially dangerous are environmental risk factors when principles of human ecology are not taking into consideration at the intensification of food production, processing and conservation, as well as at designing of housing environment (where the exposure to harmful physical, chemical and biological factors is the longest) and also while selecting of the main directions of development of technical infrastructure for motorization (e.g. designing of cars, roads and their surrounding). EU recognize study of the human ecology as basis for sustainable development (sponsoring e.g. diploma and doctoral studies in this field at the Free University of Brussels). Author's experiences connected with the participation as a visiting professor taking part in related training activity at this University as well as during study visits in several countries were useful for the introduction of human ecology in linkage with ecotoxicology and environmental biotechnology as the subject of study at environmental engineering at the Faculty of Mining Surveying and Environmental Engineering at AGH-UST. Methodological experience of 40 years of interdisciplinary case studies and problem-oriented education in this field may be useful for modernization of

  17. Meteorology Meets Engineering: An Interdisciplinary STEM Module for Middle- and Secondary-School Students

    NASA Astrophysics Data System (ADS)

    Barrett, B.; Moran, A.; Woods, J. E.

    2014-12-01

    Given the continued need to educate the public on both the meteorological and engineering hazards posed by the severe winds of a tornado, an interdisciplinary STEM module designed by faculty from the Oceanography and Mechanical Engineering departments at the U.S. Naval Academy was developed to engage students ages 12-16 in the fields of meteorology and engineering. Interdisciplinary educational modules such as this one are becoming increasingly common components of academic outreach programs, but to our knowledge, this is one of the first to combine the fields of meteorology and engineering. While many studies have examined changes in student engagement and interest in the STEM fields as a result of participating in interdisciplinary activities such as this one, relatively fewer have focused on quantifying changes in student content knowledge. The primary purposes of this paper are to (1) describe our interdisciplinary STEM module in detail, and (2) report immediate changes in students' knowledge of basic meteorological and engineering content as a result of their participation in the module. Results from a quick, easy-to-administer assessment instrument given to students immediately before and after their participation in the 1-hour module indicated that they learned basic content in both meteorology and engineering. Mean improvement of scores on the assessment questions was 40.2%, a change that was statistically significant at the 95% confidence level. Future studies of student learning could gain additional insight into the value of the module by lengthening the time between student participation in the module and the administration of the post-module assessment.

  18. RNA Secondary Structure Prediction by Using Discrete Mathematics: An Interdisciplinary Research Experience for Undergraduate Students

    ERIC Educational Resources Information Center

    Ellington, Roni; Wachira, James; Nkwanta, Asamoah

    2010-01-01

    The focus of this Research Experience for Undergraduates (REU) project was on RNA secondary structure prediction by using a lattice walk approach. The lattice walk approach is a combinatorial and computational biology method used to enumerate possible secondary structures and predict RNA secondary structure from RNA sequences. The method uses…

  19. Personalized approach to primary and secondary prevention of ischemic stroke

    PubMed Central

    2014-01-01

    Primary and secondary prevention of ischemic stroke represents a significant part of stroke management and health care. Although there are official guidelines concerning stroke management, new knowledge are introduced to them with a slight delay. This article provides an overview of current information on primary and secondary prevention of ischemic stroke. It summarizes information especially in the field of cardioembolic stroke, the use of new anticoagulants and the management of carotid stenosis based on the results of recent clinical studies. The optimal approach in stroke management is to follow these recommendations, to know new strategies and to apply an individual personalized approach in our clinical decisions. PMID:24949113

  20. Preventing the Obesity Epidemic by Second Generation Tailored Health Communication: An Interdisciplinary Review

    PubMed Central

    Enwald, Heidi Päivyt Karoliina

    2010-01-01

    Background The prevention of obesity and health concerns related to obesity are major challenges worldwide. The use of eHealth communication and the tailoring of information delivered via the Internet at the individual level may increase the effectiveness of interventions. Mastering behaviors related to nutrition, physical activity, and weight management are the main issues in preventing obesity, and the need for interdisciplinary knowledge within this area is obvious. Objective The objectives were to review the literature on tailored health communication and to present an interdisciplinary analysis of studies on “second” generation tailored interventions aimed at behavior change in nutrition, physical activity, or weight management. Methods A literature search was conducted of the main electronic information sources on health communication. Selection criteria were defined, and 23 intervention studies were selected. The content analysis focused on the following: study designs, objectives of behavior change, target groups, sample sizes, study lengths, attrition rates, theories applied, intervention designs, computer-based channels used, statistically significant outcomes from the perspective of tailoring, and possible biases of the studies. However, this was not a structured meta-analysis and cannot be replicated as such. Results Of the 23 studies, 21 were randomized controlled trials, and all focused on behavior change: 10 studies focused on behavior change in nutrition, 7 on physical activity, 2 on nutrition and physical activity, and 4 on weight management. The target groups and the number of participants varied: 8 studies included more than 500 participants, and 6 studies included less than 100. Most studies were short; the duration of 20 studies was 6 months or less. The Transtheoretical Model was applied in 14 of the 23 studies, and feedback as a tailoring mechanism was used in addition to an Internet site (or program) in 15 studies and in addition to

  1. Project Prevention - A Curriculum Specifically Designed To Prevent Illegal Drug Use among Students with Disabilties: Secondary.

    ERIC Educational Resources Information Center

    Devlin, Sandy; And Others

    The Project Prevention curriculum is specifically designed for the prevention of substance abuse among students with disabilities and was piloted in 10 classrooms serving students with mild, moderate, and severe disabilities. This component of the curriculum is intended for secondary students and includes four sections with a total of 67 lesson…

  2. The Jung Curriculum. An Interdisciplinary Curriculum and Resource Packet Designed for Secondary Students.

    ERIC Educational Resources Information Center

    Doyle, Patricia E.; Fuller, Roger J.

    The ideas and concepts of Carl Jung are the basis for the materials of this curriculum guide for teaching gifted students at the secondary level. Entitled "Man and His Symbols," the guide is organized in five parts: (1) Approaching the Unconscious; (2) Ancient Myths and Modern Man; (3) The Process of Individuation; (4) Symbolism in the Visual…

  3. Creating and Executing an Applied Interdisciplinary Campaign for Domestic Violence Prevention

    ERIC Educational Resources Information Center

    Keller, Sarah N.; Otjen, A. J.

    2007-01-01

    This article describes an interdisciplinary, experiential learning project that combined marketing and communications courses at a state university. Two professors from different colleges partnered with a domestic violence center to enable students to create a community-based social marketing campaign. Student assessments indicated success in…

  4. Secondary preventive medication persistence and adherence 1 year after stroke

    PubMed Central

    Olson, D.M.; Zhao, X.; Pan, W.; Zimmer, L.O.; Goldstein, L.B.; Alberts, M.J.; Fagan, S.C.; Fonarow, G.C.; Johnston, S.C.; Kidwell, C.; LaBresh, K.A.; Ovbiagele, B.; Schwamm, L.; Peterson, E.D.

    2011-01-01

    Objective: Data on long-term use of secondary prevention medications following stroke are limited. The Adherence eValuation After Ischemic stroke–Longitudinal (AVAIL) Registry assessed patient, provider, and system-level factors influencing continuation of prevention medications for 1 year following stroke hospitalization discharge. Methods: Patients with ischemic stroke or TIA discharged from 106 hospitals participating in the American Heart Association Get With The Guidelines–Stroke program were surveyed to determine their use of warfarin, antiplatelet, antihypertensive, lipid-lowering, and diabetes medications from discharge to 12 months. Reasons for stopping medications were ascertained. Persistence was defined as continuation of all secondary preventive medications prescribed at hospital discharge, and adherence as continuation of prescribed medications except those stopped according to health care provider instructions. Results: Of the 2,880 patients enrolled in AVAIL, 88.4% (2,457 patients) completed 1-year interviews. Of these, 65.9% were regimen persistent and 86.6% were regimen adherent. Independent predictors of 1-year medication persistence included fewer medications prescribed at discharge, having an adequate income, having an appointment with a primary care provider, and greater understanding of why medications were prescribed and their side effects. Independent predictors of adherence were similar to those for persistence. Conclusions: Although up to one-third of stroke patients discontinued one or more secondary prevention medications within 1 year of hospital discharge, self-discontinuation of these medications is uncommon. Several potentially modifiable patient, provider, and system-level factors associated with persistence and adherence may be targets for future interventions. PMID:21900638

  5. Preventing Problem Behaviors: Primary, Secondary, and Tertiary Level Prevention Interventions for Young Children

    ERIC Educational Resources Information Center

    Tobin, Tary J.; Sugai, George

    2005-01-01

    The purpose of this report is to compare changes in social skills, problem behaviors, and academic competence for kindergarten or first grade students identified as being at risk for serious behavior problems who received primary, secondary, or tertiary level preventive interventions. Of the 93 participants in this study, 73% were male; 86% were…

  6. [Secondary prevention of stroke through arterial blood pressure reduction].

    PubMed

    Mancia, G; Grassi, G

    1997-07-01

    Large scale observational studies have conclusively demonstrated that systolic and diastolic blood pressure values are linearly related to the incidence of cerebrovascular diseases and that high blood pressure is an important risk factor for both primary and secondary development of stroke. Interventional studies have shown that blood pressure lowering by antihypertensive treatment reduces the incidence of stroke in hypertensive patients without a history of previous stroke. Whether this is the case also for the secondary prevention of cerebral ischemic attacks has not been unequivocally shown, however. The PROGRESS ("Perindopril Protection Against Recurrent Stroke Study") study has been designed and is under way to collect information on this important issue of the antihypertensive treatment, its purpose being to evaluate the blood pressure lowering effects with an ACE-inhibitor on recurrent stroke in an overall population of 6000 patients with a positive history of previous cerebral ischemic attacks or stroke. PMID:9340173

  7. [Prevention and treatment of the complications of polycystic ovarian syndrome--the significance of evidence-based, interdisciplinary management].

    PubMed

    Gődény, Sándor; Csenteri, Orsolya Karola

    2015-12-13

    Polycystic ovary syndrome is the most common hormonal and metabolic disorder likely to affect women. The syndrome is often associated with obesity, hyperinsulinemia and adversely affects endocrine, metabolic, and cardiovascular health. The complex feature of the syndrome requires an interdisciplinary approach to treatment, where cooperation of paediatrician, internist, gynaecologist, endocrinologist, dermatologist, psychologist and oncologist is essential. The prevention and the treatment should be based on the best available evidence. This should include physical examination, laboratory tests for hormones, serum insulin, glucose, lipids, in addition patient's preferences should be considered, too. To maximise health gain of polycystic ovarian syndrome, adequate, effective, efficient and safe treatment is necessary. This article summarises the highest available evidence provided by meta-analyses and systematic reviews of the prevention of metabolic and cardiovascular complications of the syndrome, and discusses the relevant evidence published in the literature. PMID:26639643

  8. Preventing secondary infections among HIV-positive persons.

    PubMed Central

    Filice, G A; Pomeroy, C

    1991-01-01

    Secondary infectious diseases contribute substantially to morbidity and mortality of people infected with human immunodeficiency virus (HIV). The authors developed comprehensive, practical recommendations for prevention of infectious complications in HIV-infected people. Recommendations are concerned with the pathogens that are more common or more severe in HIV-infected people. Several infectious complications can be prevented by avoiding ingestion of contaminated food or water. Zoonoses can be prevented by precautions to be taken in contacts with animals. The risk of several fungal diseases can be reduced if activities likely to lead to inhalation of spores are avoided. HIV-infected people should be advised how to lower adverse health effects of travel, especially international travel. The potential for infectious complications of sexual activity and illicit drug use should be stressed, and recommendations to reduce the risk are discussed. Recommendations for use of vaccines in HIV-infected people are reviewed. Blood CD4+ lymphocyte concentrations, tuberculin skin testing, Toxoplasma serology, and sexually transmitted disease screening should be performed in certain subsets of HIV-infected people. Guidelines for chemoprophylaxis against Pneumocystis carinii and tuberculosis are presented. Recent data suggest that intravenous immunoglobulin therapy may prevent bacterial infections in HIV-infected children. PMID:1910184

  9. The Effects of an Interdisciplinary Curriculum Unit on the Environmental Decision-Making of Secondary School Students.

    ERIC Educational Resources Information Center

    McConney, Amanda W.; And Others

    In the first phase of this study an interdisciplinary curriculum unit was developed centered on the concept of sustainable development in tropical rainforests. The centerpiece of the interdisciplinary unit was the investigation of a simulated environmental problem which required students to develop and then decide on a solution, having weighed a…

  10. Ocular Toxoplasmosis: Controversies in Primary and Secondary Prevention

    PubMed Central

    Saffra, Norman A.; Seidman, Carly J.; Weiss, Louis M.

    2013-01-01

    Ocular toxoplasmosis is the most common cause of posterior uveitis in the United States and worldwide. It commonly follows a relapsing course with the potential for multiple adverse visual sequelae and, rarely, blindness. Both immune-competent and immune-suppressed populations can develop severe relapsing disease. There is considerable debate regarding the initial treatment of ocular toxoplasmosis in both groups, with multiple antiparasitic agents commonly used with little evidence to support any particular regimen. The precise role of corticosteroids in treatment also has yet to be rigorously defined. Secondary prevention is commonly implemented in the immune suppressed population, but there is a lack of level one evidence to support its role in immune-competent patients, though it warrants future investigation. PMID:24380083

  11. [Prevention from secondary nerve root adhesion: an experimental study].

    PubMed

    Yao, M; Sun, Y; Yan, J

    1996-06-01

    In the study, 27 dogs were divided into three groups: A, B and C. Then all of the dogs had their lumbar intervertebral disks removed. Into the wounded cavity of group A, 1 ml of dimethicone was dropped and gelatin sponge was applied on the surface of the nerve root of group B. Group C was served as the control. The dogs were killed and the operation area was removed respectively 2 weeks, 4 weeks, and 12 weeks after the operation for macroscopical observation, nerve root motility measurement and histological examination. The result of the experiment proved that dimethicone was fairly effective in the prevention from secondary nerve root adhesion. While gelatin sponge in the process of its absorption induced the formation of quite a few scar tissues, thus aggrevating nerve root adhesion. PMID:9594172

  12. An Interdisciplinary Approach for the Integration and Diffusion of Substance Abuse Prevention Programs

    ERIC Educational Resources Information Center

    Bechtel, Lori J.; Vicary, Judith; Swisher, John; Smith, Edward; Hopkins, Abigail; Henry, Kimberly; Minner, Daphne

    2006-01-01

    Effective substance abuse prevention programs help students develop knowledge as well as psychosocial competencies that can help them resist or delay the initiation of alcohol, tobacco and other drug (ATOD) use. This paper describes the integration process used in a five-year project, Adoption of Drug Abuse Prevention Training (ADAPT), to study…

  13. Beyond primary prevention of alcohol use: a culturally specific secondary prevention program for Mexican heritage adolescents.

    PubMed

    Marsiglia, Flavio F; Ayers, Stephanie; Gance-Cleveland, Bonnie; Mettler, Kathleen; Booth, Jaime

    2012-06-01

    Classroom-based primary prevention programs with adolescents are effective in inhibiting the onset of drug use, but these programs are not designed to directly address the unique needs of adolescents at higher risk of use or already using alcohol and other drugs. This article describes the initial efficacy evaluation of a companion psychosocial small group program which aims at addressing the needs of Mexican heritage students identified by their teachers as being at higher risk for substance use or already experimenting with alcohol and other drugs. The adolescent (7th grade) small group curricula, REAL Groups, is a secondary prevention program which supplements the primary classroom-based substance use prevention program, keepin' it REAL. Following a mutual aid approach, a total of 109 7th grade students were referred by their teachers and participated in the REAL Groups. The remaining 252 7th grade students who did not participate served as the control group. To account for biased selection into REAL Groups, propensity score matching (PSM) was employed. The estimated average treatment effect for participants' use of alcohol was calculated at the end of the 8th grade. Results indicate that alcohol use decreased among students who participated in the REAL Groups relative to matched students who did not participate. These findings suggest that REAL Groups may be an effective secondary prevention program for higher-risk Mexican heritage adolescents. PMID:22193861

  14. Prevention of Root Caries: A Literature Review of Primary and Secondary Preventive Agents

    PubMed Central

    Gluzman, Rima; Frey, Barbara J.; McGowan, Richard

    2012-01-01

    Purpose This literature review summarizes the effectiveness of the seven leading root caries preventive agents and provides recommendations for use of those agents in clinical practice with older adults and vulnerable elderly. Method Studies were eligible if they assessed the effectiveness of either fluoride, chlorhexidine, xylitol, amorphous calcium phosphate, sealants, saliva stimulators, or silver diamine fluoride to prevent/control root caries in an English-language articles between 1979–2010 Results In the 31 eligible studies, the most effective primary (1°) prevention agents had reductions in RC incidence ranging from 72% to nearly 200% as compared to a placebo while for secondary (2°) prevention, the best agents demonstrated arrest rates between 67–80%. Conclusion For 1° prevention of root caries the recommended ‘best choice’ is a 38% Silver Diamine Fluoride solution professionally applied annually, while for the 2° prevention of root caries, the recommended ‘best choice’ is a 22,500 ppm Sodium Fluoride varnish professionally applied every 3 months. PMID:23600985

  15. Vorapaxar for secondary stroke prevention: perspectives and obstacles.

    PubMed

    Serebruany, Victor L; Kim, Moo Hyun; Fortmann, Seth D; Hanley, Dan F

    2015-01-01

    Vorapaxar, a novel antiplatelet thrombin protease-activated receptor 1 (PAR-1) inhibitor, has been evaluated in the successful TRA2P trial and failed TRACER trial. The drug is currently approved for post myocardial infarction and peripheral artery disease indications on top of clopidogrel and/or aspirin. The stroke data after vorapaxar are mixed, dominated with heavy excess of intracranial bleeding risks and slightly worsened second stroke rates, but show less primary ischemic strokes. Fortunately, these conflicting data do not belong purely to vorapaxar per se but rather, reflect unreasonably aggressive strategies, including predominantly triple antiplatelet therapy, utilized in both Trial to Assess the Effects of SCH 530348 in Preventing Heart Attack and Stroke in Patients with Arteriosclerosis (TRA2P) and especially in Thrombin-Receptor Antagonist Vorapaxar in Acute Coronary Syndromes (TRACER). The FDA-confirmed evidence strongly suggests that unique pharmacokinetics and a very mild "comfort zone" antiplatelet profile makes vorapaxar a good candidate for improved secondary stroke prevention. The outcome-driven, randomized trial should test head-to-head monotherapy with vorapaxar (Zontivity®) versus clopidogrel (Plavix®) and versus dipyridamole with very low dose aspirin (Aggrenox®). The advantages and potential pitfalls of such a trial are discussed in this article. PMID:26566105

  16. Secondary prevention of HAPE in a Mount Everest summiteer.

    PubMed

    Dunin-Bell, Ola; Boyle, Suzanne

    2009-01-01

    Climbers who have suffered a previous episode of high altitude pulmonary edema (HAPE) are at significantly increased risk of developing it again on return to high altitude. In spite of the high mortality associated with HAPE, some climbers are willing to take this risk in order to summit the tallest mountains in the world. This is a case report of a climber who suffered an episode of HAPE partway up Mount Everest. He was determined to complete his summit attempt that same climbing season, which would involve a return to extreme altitude less than 3 weeks following recovery. Based on experimental evidence suggesting that sildenafil, salmeterol, and acetazolamide may have therapeutic value for both the prevention and treatment of HAPE, he used these medications for secondary prevention. He was able to successfully reach the summit of Mount Everest and return to base camp without any evidence of recurrence of pulmonary edema. This provides clinical evidence that medication can be used to increase the safety margin for HAPE-susceptible individuals traveling to extremely high altitudes. PMID:19775220

  17. The Uptake of Secondary Prevention by Adults with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Ouellette-Kuntz, H.; Cobigo, V.; Balogh, R.; Wilton, A.; Lunsky, Y.

    2015-01-01

    Background: Secondary prevention involves the early detection of disease while it is asymptomatic to prevent its progression. For adults with intellectual and developmental disabilities, secondary prevention is critical as they may not have the ability to recognize the early signs and symptoms of disease or lack accessible information about these.…

  18. Secondary prevention of stroke--results from the Southern Africa Stroke Prevention Initiative (SASPI) study.

    PubMed Central

    Thorogood, M.; Connor, M. D.; Lewando-Hundt, G.; Tollman, S.; Ngoma, B.

    2004-01-01

    OBJECTIVE: To describe the prevalence of risk factors and experience of preventive interventions in stroke survivors, and identilfy barriers to secondary prevention in rural South Africa. METHODS: A clinician visited individuals in the Agincourt field site (in South Africa's rural north east) who were identified in a census as possible stroke victims to confirm the diagnosis of stroke. We explored the impact of stroke on the individual's family, and health-seeking behaviour following stroke by conducting in-depth interviews in the households of 35 stroke survivors. We held two workshops to understand the knowledge, experience, and views of primary care nurses, who provide the bulk of professional health care. FINDINGS :We identified 103 stroke survivors (37 men), 73 (71%) of whom had hypertension, but only 8 (8%) were taking anti-hypertensive treatment. Smoking was uncommon; 8 men and 1 woman smoked a maximum of ten cigarettes daily. 94 (91%) stroke survivors had sought help, which involved allopathic health care for most of them (81; 79%). 42 had also sought help from traditional healers and churches, while another 13 people had sought help only from those sources. Of the 35 survivors who were interviewed, 29 reported having been prescribed anti-hypertensive pills after their stroke. Barriers to secondary prevention included cost of treatment, reluctance to use pills, difficulties with access to drugs, and lack of equipment to measure blood pressure. A negative attitude to allopathic care was not an important factor. CONCLUSION: In this rural area hypertension is the most important modifiable risk factor in stroke survivors. Effective secondary prevention may reduce the incidence of recurrent strokes, but there is no system to deliver such care. New strategies for care are needed involving both allopathic and non-allopathic-health care providers. PMID:15500283

  19. Interdisciplinary Coleadership of High School Groups for Dropout Prevention: Practice Issues.

    ERIC Educational Resources Information Center

    Arons, RoseMarie D.; Schwartz, Florence S.

    1993-01-01

    Describes dropout prevention model of teamwork between teacher and graduate social work intern at inner-city alternative public high school. Notes that model provides framework for programmatic responses to problems of school dropouts among inner-city minority youths and also furnishes new opportunities for intern training in school social work.…

  20. Mathematical modeling is also physics—interdisciplinary teaching between mathematics and physics in Danish upper secondary education

    NASA Astrophysics Data System (ADS)

    Michelsen, Claus

    2015-07-01

    Mathematics plays a crucial role in physics. This role is brought about predominantly through the building, employment, and assessment of mathematical models, and teachers and educators should capture this relationship in the classroom in an effort to improve students’ achievement and attitude in both physics and mathematics. But although there are overwhelming amounts of literature on modeling in science and mathematics education, the interdisciplinary position is seldom addressed explicitly. Furthermore, there has been a striking lack of exposure of the question of how future teachers, who are largely educated in a mono-disciplinary fashion, can best become equipped to introduce genuinely interdisciplinary teaching activities to their future pupils. This paper presents some preliminary reflections upon a graduate course, which aims to prepare future physics and mathematics teachers for interdisciplinary teaching, and which has been designed on the basis of influential theoretical expositions of the concept of interdisciplinarity.

  1. Statement of the Spanish Interdisciplinary Cardiovascular Prevention Committee (CEIPC for its Spanish acronym) on the 2012 European Cardiovascular Prevention Guidelines.

    PubMed

    Royo-Bordonada, M A; Lobos Bejarano, J M; Villar Alvarez, F; Sans, S; Pérez, A; Pedro-Botet, J; Moreno Carriles, R M; Maiques, A; Lizcano, Á; Lizarbe, V; Gil Núñez, A; Fornés Ubeda, F; Elosua, R; de Santiago Nocito, A; de Pablo Zarzosa, C; de Álvaro Moreno, F; Cortés, O; Cordero, A; Camafort Babkowski, M; Brotons Cuixart, C; Armario, P

    2016-04-01

    Based on the two main frameworks for evaluating scientific evidence (SEC and GRADE) European cardiovascular prevention guidelines recommend interventions across all life stages using a combination of population-based and high-risk strategies with diet as the cornerstone of prevention. The evaluation of cardiovascular risk (CVR) incorporates HDL levels and psychosocial factors, a very high risk category, and the concept of age-risk. They also recommend cognitive-behavioural methods (e.g., motivational interviewing, psychological interventions) led by health professionals and with the participation of the patient's family, to counterbalance psychosocial stress and reduce CVR through the institution of positive habits such as a healthy diet, physical activity, smoking cessation, and adherence to treatment. Additionally, public health interventions - such as smoking ban in public areas or the elimination of trans fatty acids from the food chain - are also essential. Other innovations include abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure within the 130-139/80-85 mmHg range in diabetic patients and individuals with high CVR. Finally, due to the significant impact on patient progress and medical costs, special emphasis is given to the low therapeutic adherence levels observed. In sum, improving cardiovascular prevention requires a true partnership among the political class, public administrations, scientific and professional associations, health foundations, consumer associations, patients and their families. Such partnership would promote population-based and individual strategies by taking advantage of the broad spectrum of scientific evidence available, from clinical trials to observational studies and mathematical models to evaluate population-based interventions, including cost-effectiveness analyses. PMID:23969295

  2. [Anticoagulant therapy in secondary prevention of coronary events].

    PubMed

    Bultas, Jan

    2014-12-01

    Secondary prevention of atherothrombotic events is the domain of antiplatelet therapy and according to present risk is used one drug strategy or combination of acetylsalicylic acid with ADP receptor blockers. The importance of the combination of dual antiplatelet therapy together with xabans or dabigatran was investigated in 6 clinical trials. Only one of them (ATLAS ACS 2-TIMI 51) indicated that treatment with small dose of rivaroxaban (2 × 2.5 mg) may be added to dual strategy of acetylsalicylic acid and clopidogrel. The risk of major bleeding event is increased and net clinical benefit is only about 0.5 % per year. Dual therapy with aspirin and prasugrel or tikagrelor is beneficial. In the second part of the review is discussed higher incidence of myocardial infarction in controlled group in the trial comparing treatment of dabigatran with warfarin. This relationship has not been resolved, however, in patients with higher risk of coronary events and indication of anticoagulant treatment with direct oral anticoagulants it is recommended to choose from xabans (apixaban and rivaroxaban). PMID:25692828

  3. [Secondary prevention of osteoporosis and identification of high risk patients].

    PubMed

    Lehmann, R; Pfeifer, M; Minne, H; Allolio, B

    2000-08-01

    Low bone mass is a major determinant of bone fragility. With respect to hip fracture risk however, there is limited contribution of BMD to the exponential age-related increase in hip fracture incidence. Large prospective studies have identified a number of additional risk factors for hip fractures independent of bone density. These can be classified as skeletal factors and fall-related factors. Body height and hip axis length are positively correlated with fracture risk. Neuromuscular impairment with low gait speed, difficulty in doing a tandem walk, lower limb dysfunction, body sway or inability to rise from a chair without using one's arms predict future fracture risk. According to the concept of evidence-based medicine (EBM) preventive strategies are now available. Supplementation with calcium and vitamin D restores bone quality through suppression of secondary hyperparathyroidism and decreases the risk of falling through improvement of neuromuscular co-ordination and body sway. Treatment with the bisphosphonates alendronate and risedronate increase bone strength and result in a significant reduction of vertebral as well as non-vertebral fractures. Hip protectors absorb energy during a fall and reduce hip fracture risk by 56%. Risk factor based patient selection may improve the cost-effectiveness of therapy. PMID:10996933

  4. Secondary Prevention in an RTI Model: A Step toward Academic Recovery

    ERIC Educational Resources Information Center

    Friedman, Esther Klein

    2010-01-01

    The secondary level of a Response to Intervention system, sometimes referred to as Tier II intervention, targets students who experience inadequate response to good classroom instruction for 10-15 weeks of validated small-group instruction. The twin purposes of secondary prevention are to (a) prevent the development of long-term reading difficulty…

  5. Adapting postdoctoral training to interdisciplinary science in the 21st century: the Cancer Prevention Fellowship Program at the National Cancer Institute.

    PubMed

    Chang, Shine; Hursting, Stephen D; Perkins, Susan N; Dores, Graça M; Weed, Douglas L

    2005-03-01

    Preparing junior scientists for careers in the health sciences has become an immense challenge for many reasons, including the emerging demand for multidisciplinary approaches to solving problems in the health sciences. For those choosing careers in hybrid and interdisciplinary fields, the "traditional" postdoctoral training model may not perform well, particularly in light of other problems that plague postdoctoral success. New approaches are required. Using the interdisciplinary field of cancer prevention as an example, the authors describe the Cancer Prevention Fellowship Program (CPFP) of the National Cancer Institute, a three-year postdoctoral program of which the goal is to provide its fellows with a strong foundation in cancer prevention through education, mentored research, and structured professional development training activities that emphasize multidisciplinary approaches and leadership skills. Over time, the CPFP has incorporated the best aspects of the traditional postdoctoral training model with newer training approaches in an effort to overcome existing problems in postdoctoral training and to address the additional complexities inherent in training those who seek careers in interdisciplinary science. Many aspects of the CPFP, including an efficient infrastructure, a dedicated staff, a capacity to provide educational activities, and the provision of rich research opportunities, may translate well to other postdoctoral programs that face similar issues. PMID:15734808

  6. Organizing your practice for screening and secondary prevention among adults.

    PubMed

    Knierim, Kyle E; Fernald, Douglas H; Staton, Elizabeth W; Nease, Donald E

    2014-06-01

    Prevention plays an important role in achieving the triple aim of decreasing per capita health care costs, improving the health of populations, and bettering the patient experience. Primary care is uniquely positioned to provide preventive services. External forces are aligning to support the transition of primary care from traditional models focused on disease-specific, acute episodes of care to new ways of organizing that are more patient centered, team based, and quality driven. By aligning leadership, building change capacity, and selectively choosing relevant processes to change, those practicing primary care can successfully organize their practice environment to deliver preventive services. PMID:24830604

  7. Prevention of allergic disease in childhood: clinical and epidemiological aspects of primary and secondary allergy prevention.

    PubMed

    Halken, Susanne

    2004-06-01

    The development and phenotypic expression of atopic diseases depends on a complex interaction between genetic factors, environmental exposure to allergens,and non-specific adjuvant factors, such as tobacco smoke, air pollution and infections. Preventive measures may include both exposure to allergens and adjuvant risk/protective factors and pharmacological treatment. These measures may address the general population, children at risk for development of atopic disease (high-risk infants), children with early symptoms of allergic disease or children with chronic disease. The objective for this review was to evaluate possible preventive measures as regards prevention of development of allergic disease in childhood--primary prevention--and also some aspects of the effect of specific allergy treatment as regards secondary prevention in children with allergic asthma and allergic rhinoconjunctivitis. In one prospective observational study of a birth cohort of unselected infants we evaluated possible predictive/risk factors. In two prospective intervention studies including 1 yr birth cohorts of high-risk(HR) infants we investigated the effect of feeding HR infants exclusively breast milk (BM) and/or hydrolyzed cow's milk-based formula the first 4-6 months as regards: (i) the allergy preventive effect of BM/extensively hydrolysed formula (eHF) compared with ordinary cow's milk-based formula, (ii) the effect of two different eHFs, a whey (Profylac) and a casein-based (Nutramigen) formula, as regards development of cow's milk protein allergy (CMA), and (iii) a comparison of the preventive effect of eHF (Profylac/Nutramigen) with a partially hydrolyzed cow's milk-based formula (pHF) (NanHA) as regards development of CMA. None of the mothers had a restricted diet during pregnancy or lactation period. In two prospective randomized intervention studies we evaluated the preventive effect of specific allergen avoidance and specific immunotherapy (SIT) in children with allergic

  8. Measuring Promotion and Prevention Orientations of Secondary School Students: It Is More Than Meets the Eye

    ERIC Educational Resources Information Center

    Hodis, Flaviu A.; Hattie, John A. C.; Hodis, Georgeta M.

    2016-01-01

    The General Regulatory Focus Measure has been used extensively in psychological research to gauge promotion and prevention orientations. Findings of this research show that for New Zealand secondary school students, the General Regulatory Focus Measure does not measure promotion and prevention as theoretically independent constructs.

  9. You Can Help Prevent Alcohol and Other Drug Use among Secondary School Students. The Fact Is...

    ERIC Educational Resources Information Center

    Alcohol, Drug Abuse, and Mental Health Administration (DHHS/PHS), Rockville, MD. Office for Substance Abuse Prevention.

    This resource list on preventing alcohol and other drug use among secondary school students was compiled by the Office for Substance Abuse Prevention (OSAP). All resources have been reviewed to ensure that they reflect the latest scientific facts and convey a clear no-use message. The list is divided into three major sections: (1) resources for…

  10. Parental Communication as a Tool Kit for Preventing Sexual Abuse among Adolescent Secondary School Students

    ERIC Educational Resources Information Center

    Tayo, Ajayi Beatrice; Olawuyi, B. O.

    2016-01-01

    This study employed the survey design to investigate the relevance of parent communication in preventing sexual abuse among secondary school students in Nigeria. The instrument for data collection tagged "Parent Communication Strategy for Preventing Sexual Abuse questionnaire" (PCOSPSAQ), was a researcher designed instrument. It was…

  11. Reinforcing Alcohol Prevention (RAP) Program: A Secondary School Curriculum to Combat Underage Drinking and Impaired Driving

    ERIC Educational Resources Information Center

    Will, Kelli England; Sabo, Cynthia Shier

    2010-01-01

    The Reinforcing Alcohol Prevention (RAP) Program is an alcohol prevention curriculum developed in partnership with secondary schools to serve their need for a brief, evidence-based, and straightforward program that aligned with state learning objectives. Program components included an educational lesson, video, and interactive activities delivered…

  12. DECIDE: Developing Extensive Curriculum for Interdisciplinary Drug Education. A Resource Guide for Secondary Teachers. Bulletin No. 6, 1979.

    ERIC Educational Resources Information Center

    Alabama State Dept. of Education, Montgomery.

    This guide is designed to assist secondary school teachers in developing sequential drug education activities for infusion into the general curriculum, particularly in the communicative arts areas. The scope of the materials encompasses health habits, drug use and abuse, drug laws, and the pharmacology of drugs in specific sections by subject…

  13. An open debate about the object and purpose of global health knowledge in the context of an interdisciplinary research partnership on HIV/STI prevention priorities in Peru

    PubMed Central

    2014-01-01

    Background With the failure of the latest vaccine trial, HVTN-505, HIV prevention efforts remain critical. Social and structural factors contributing to HIV and STI transmission include stigma regarding sexual violence, HIV infection and sexual orientation. For instance, HIV prevention and overall sexual health programs in Peru have been implemented yet key populations of youth (sex workers, male and transgender youth) continue to be overrepresented in new cases of HIV and STI. This suggests that interventions must take new directions and highlights the need for additional research. Discussion While interdisciplinary, international research collaborations often are indicated as best practice in developing new knowledge in global health and an important component of the leadership in health systems, this does not mean they are free of challenges. In this debate we document our reflections on some of the challenges in developing an interdisciplinary and international research team to understand HIV and STI prevention priorities among youth in two culturally diverse cities in Peru: Lima, the capital city, and Ayacucho, in the Andean region. Summary Rather than offering solutions we aim to contribute to the debate about the object and purpose of global health research in the context of developing international research partnerships that genuinely promote a reciprocal and bidirectional flow of knowledge between the Global South and the Global North, and researchers at intersections of these locations. PMID:24886493

  14. Preventing and treating secondary bacterial infections with antiviral agents

    PubMed Central

    McCullers, Jonathan A.

    2016-01-01

    Summary Bacterial super-infections contribute to the significant morbidity and mortality associated with influenza and other respiratory virus infections. There are robust animal model data but only limited clinical information on the effectiveness of licensed antiviral agents for the treatment of bacterial complications of influenza. The association of secondary bacterial pathogens with fatal pneumonia during the recent H1N1 influenza pandemic highlights the need for new development in this area. Basic and clinical research into viral-bacterial interactions over the last decade has revealed several mechanisms that underlie this synergism. By applying these insights to antiviral drug development, the potential exists to improve outcomes by means other than direct inhibition of the virus. PMID:21447860

  15. Role of primary and secondary prevention in atopic dermatitis

    PubMed Central

    Michalak, Iwonna; Gutfreund, Katarzyna; Bienias, Wojciech; Matych, Marta; Szewczyk, Anna; Kaszuba, Andrzej

    2015-01-01

    Atopic dermatitis (AD) is a serious epidemiological problem in industrialized countries. The incidence of AD has increased considerably over the last 30 years. Atopic dermatitis is a chronic, recurrent, inflammatory skin disease accompanied by strong itching. It is characterized by typical features depending on age. The parents of children suffering from AD must be prepared to change their lifestyle. They should avoid factors which can promote skin lesions and apply appropriate, regular skin care. The article describes primary prevention of AD as well as prophylactic measures to avoid skin eczema. It presents the role of infections, vaccinations, breastfeeding and the influence of domestic animals, house renovation and moulds on development of AD. The article also describes the significance of the epidermal barrier, skin colonization by microbial agents, pruritus, stress, food and inhalant allergy among people who suffer from AD. PMID:26755903

  16. Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease.

    PubMed

    Park, Linda G; Beatty, Alexis; Stafford, Zoey; Whooley, Mary A

    2016-01-01

    Mobile health in the form of text messaging and mobile applications provides an innovative and effective approach to promote prevention and management of cardiovascular disease (CVD); however, the magnitude of these effects is unclear. Through a comprehensive search of databases from 2002-2016, we conducted a quantitative systematic review. The selected studies were critically evaluated to extract and summarize pertinent characteristics and outcomes. A large majority of studies (22 of 28, 79%) demonstrated text messaging, mobile applications, and telemonitoring via mobile phones were effective in improving outcomes. Some key factors associated with successful interventions included personalized messages with tailored advice, greater engagement (2-way text messaging, higher frequency of messages), and use of multiple modalities. Overall, text messaging appears more effective than smartphone-based interventions. Incorporating principles of behavioral activation will help promote and sustain healthy lifestyle behaviors in patients with CVD that result in improved clinical outcomes. PMID:27001245

  17. Secondary preventive potential of nitrates in ischaemic heart disease.

    PubMed

    Thadani, U

    1996-12-01

    Nitrates exert their anti-anginal activity by a number of mechanisms. By reducing venous return and left ventricular end-diastolic pressure they lower myocardial oxygen demand and at the same time enhance blood flow to the sub-endocardium. They also directly increase myocardial oxygen supply by dilating the coronary artery stenoses and increasing collateral blood flow. These pharmacodynamic attributes are clinically efficacious in all the ischaemic myocardial syndromes. In stable angina pectoris, nitrates reduce myocardial ischaemia and ischaemic pain and increase exercise tolerance. In unstable angina, nitrates similarly reduce electrocardiographic evidence of myocardial ischaemia and relieve anginal pain. Following acute myocardial infarction, nitrates reduce ventricular dilatation and by so doing reduce pulmonary congestion and mitral regurgitation. The weak anti-aggregatory effect of nitrates on platelets may also play an adjuvant role in their anti-ischaemic activity. Early small-scale studies with both intravenous and oral nitrates demonstrated a trend to reduced mortality and reinfarction in survivors of acute myocardial infarction. However, the later and larger ISIS-4 and GISSI-3 trials have not confirmed this trend possibly due to the smaller doses of nitrates used and the diluting effect of the widespread use of open-label nitrates in the placebo group. In patients with congestive heart failure, including those of ischaemic aetiology, nitrates together with hydralazine have clearly demonstrated a significant reduction in the medium term mortality risk. Nitrates have the undoubted ability, probably greater than any other single anti-anginal drug, to rapidly and often completely relieve the pain and breathlessness associated with myocardial ischaemia. They are haemodynamically efficacious in reducing dilatation of the ischaemic left ventricle and enhancing coronary blood flow to ischaemic areas. Although their preventative impact in survivors of acute

  18. Omega-3 polyunsaturated fatty acids: a necessity for a comprehensive secondary prevention strategy

    PubMed Central

    Patel, Jeetesh V; Tracey, Inessa; Hughes, Elizabeth A; Lip, Gregory YH

    2009-01-01

    Long-chain omega-3 polyunsaturated fatty acid (PUFA) supplementation has been used for the secondary prevention of fatal and nonfatal myocardial infarction (MI). However, the benefit of this therapy is frequently confused with other established treatments in the therapeutic strategy among such patients. We review the data on omega-3 PUFA use in secondary care and consider indications for its use which include post-MI and raised triglycerides. We suggest that the available evidence supports the use of omega-3 supplementation as part of the comprehensive secondary care package for post-MI patients. PMID:19812692

  19. "Comets, Origins, and Life:” Promoting Interdisciplinary Science in Secondary and Middle Schools in the Washington, DC and Saint Louis, MO Metro Areas

    NASA Astrophysics Data System (ADS)

    Bonev, Boncho; Gibb, E. L.; Brewer, G.; Novak, R.; Mandell, A. M.; Seaton, P.; Price, J.; Long, T.; Bahar, S.; Edwards, S. S.

    2010-10-01

    Developing a full-year program to support secondary and middle school science education is a key part of the "broader impact” component of NSF Grant AST- 0807939 (PI/Co-PI Bonev/Gibb). This program is realized at two stages: (1) a professional development course for teachers is offered during the summer; (2) during the subsequent academic year we collaborate with educators in lessons planning or curriculum development as demanded in their particular schools. We successfully offered the course “ Comets, Origins, and Life: Interdisciplinary Science in the Secondary Classroom ” (45 contact hours; 3 credits) in the summers of 2009 and 2010 at the Catholic University of America. This class demonstrates how a complex hypothesis - for the delivery of water and prebiotic organic matter to early Earth - is being tested by integrating astronomy, physics, chemistry, biology, and Earth and planetary science. Collaborations with participants from the 2009 class include curriculum development within the Earth Science program in Prince Georges county, MD and strengthening science in Washington DC public schools. Our next step is to offer our class in the Saint Louis, MO area. The main challenge in our work with educators is not to present them with "interesting information", but to fit what we offer within the very particular curriculum expectations of their school districts. These curriculum expectations often vary from district to district and sometimes from year to year. We gratefully acknowledge the support by the NSF, allowing to fully integrate our research area into education. We also gratefully acknowledge our collaborations with the Goddard Center for Astrobiology and the Howard B. Owens Science Center (both in MD) in developing our class curriculum. Educators interested in this program can contact Boncho Bonev (bonev@cua.edu; for the Washington DC and Baltimore, MD areas) and Erika Gibb (gibbe@umsl.edu; for the Saint Louis, MO area).

  20. Low use of statins and other coronary secondary prevention therapies in primary and secondary care in India

    PubMed Central

    Sharma, Krishna K; Gupta, Rajeev; Agrawal, Aachu; Roy, Sanjeeb; Kasliwal, Atul; Bana, Ajeet; Tongia, Ravindra K; Deedwania, Prakash C

    2009-01-01

    Objective: To determine the frequency of use of pharmacotherapy with aspirin, beta blocker, statin, and angiotensin-converting enzyme (ACE) inhibitor in patients with stable coronary heart disease (CHD) among physicians at different levels of health care in Rajasthan state, India. Methods: Physicians practicing at tertiary hospitals and clinics at tertiary, secondary and primary levels were contacted. Prescriptions of CHD patients were audited and descriptive statistics reported. Results: We evaluated 2,993 prescriptions (tertiary hospital discharge 711, tertiary 688, secondary 1,306, and primary 288). Use of aspirin was in 2,713 (91%) of prescriptions, beta blockers 2,057 (69%), ACE inhibitors or angiotensin receptor blockers (ARBs) 2,471 (82%), and statins 2,059 (69%). Any one of these drugs was prescribed in 2,991 (100%), any two in 2,880 (96%), any three in 1,740 (58%), and all four in 1,062 (35.5%) (P < 0.001). As compared to tertiary hospital, prescriptions at tertiary, secondary, and primary levels were lower: aspirin (96% vs 95%, 91%, 67%), beta blockers (80% vs 62%, 66%, 70%), statins (87% vs 82%, 62%, 21%): two drugs (98% vs 96%, 98%, 85%), three drugs (75% vs 58%, 55%, 28%), or four drugs (54% vs 44%, 28%, 7%) (P < 0.01). Use of ACE inhibitors/ARBs was similar while nitrates (43% vs 23%, 43%, 70%), dihydropyridine calcium channel blockers (12% vs 15%, 30%, 47%), and multivitamins (6% vs 26%, 37%, 47%) use was more in secondary and primary care. Conclusions: There is suboptimal use of various evidence-based drugs (aspirin, beta blockers, ACE inhibitors, and statins) for secondary prevention of CHD in India. PMID:19997570

  1. Cranialization of the Frontal Sinus for Secondary Mucocele Prevention following Open Surgery for Benign Frontal Lesions

    PubMed Central

    Horowitz, Gilad; Amit, Moran; Ben-Ari, Oded; Gil, Ziv; Abergel, Abraham; Margalit, Nevo; Cavel, Oren; Wasserzug, Oshri; Fliss, Dan M.

    2013-01-01

    Objective To compare frontal sinus cranialization to obliteration for future prevention of secondary mucocele formation following open surgery for benign lesions of the frontal sinus. Study Design Retrospective case series. Setting Tertiary academic medical center. Patients Sixty-nine patients operated for benign frontal sinus pathology between 1994 and 2011. Interventions Open excision of benign frontal sinus pathology followed by either frontal obliteration (n = 41, 59%) or frontal cranialization (n = 28, 41%). Main Outcome Measures The prevalence of post-surgical complications and secondary mucocele formation were compiled. Results Pathologies included osteoma (n = 34, 49%), mucocele (n = 27, 39%), fibrous dysplasia (n = 6, 9%), and encephalocele (n = 2, 3%). Complications included skin infections (n = 6), postoperative cutaneous fistula (n = 1), telecanthus (n = 4), diplopia (n = 3), nasal deformity (n = 2) and epiphora (n = 1). None of the patients suffered from postoperative CSF leak, meningitis or pneumocephalus. Six patients, all of whom had previously undergone frontal sinus obliteration, required revision surgery due to secondary mucocele formation. Statistical analysis using non-inferiority test reveal that cranialization of the frontal sinus is non-inferior to obliteration for preventing secondary mucocele formation (P<0.0001). Conclusion Cranialization of the frontal sinus appears to be a good option for prevention of secondary mucocele development after open excision of benign frontal sinus lesions. PMID:24376760

  2. CRACKDOWN: A Guide to Preventing Substance Abuse Secondary. Citywide Teach-in--September 30.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

    This secondary school curriculum guide, the subject of a citywide teach-in in the New York City schools, provides facts, lessons, and learning activities designed to provide information about and to prevent the use of crack, a form of cocaine. The guide covers the facts about crack, the reasons given for using crack, strategies for saying no to…

  3. The "Social Norms" Approach to Alcohol Misuse Prevention: Testing Transferability in a Scottish Secondary School Context

    ERIC Educational Resources Information Center

    Martinus, Theresa; Melson, Ambrose John; Davies, John Booth; Mclaughlin, Ann

    2012-01-01

    Aim: To report baseline findings and discuss their implications for the transferability of the predominantly American "Social Norms" approach to alcohol misuse prevention to a UK (Scottish) secondary school setting. Design, setting, participants and measurement: Baseline data from a 3-year control case study are reported here, and data from the…

  4. Early enteral feeding in severe acute pancreatitis: can it prevent secondary pancreatic (super) infection?

    PubMed

    Lehocky, P; Sarr, M G

    2000-01-01

    Sepsis continues to account for a second peak in mortality in patients with severe acute pancreatitis. The prevention of these septic complications and subsequent development of multiple organ dysfunction syndrome remains a major focus for investigators, yet despite considerable clinical and experimental work addressing its etiology, septic complications remain high. Several studies have been designed to demonstrate the mechanism of origin of these septic complications with an attempt to define strategies for their prevention to improve patient outcomes. There is clear evidence that the origin of this secondary bacterial infection arises from enteric bacterial translocation secondary to disruption of the gut mucosal barrier during acute pancreatitis. Strategies designed to prevent secondary pancreatic infection include aggressive fluid resuscitation to maximize organ perfusion, early systemic antibiotic treatment or selective gut decontamination, and recently attempts to block mediators of the systemic inflammatory response. This discussion will summarize our present understanding of the etiopathogenesis of secondary bacterial 'superinfection' of necrotizing pancreatitis and how the initiation of enteral feeding early in the course of acute pancreatitis may prove to be an effective means of preventing and/or reversing the breakdown of the gut mucosal defense barrier. PMID:11155001

  5. An Analysis of Family-School Collaboration in Preventing Adolescent Violence in Urban Secondary Schools

    ERIC Educational Resources Information Center

    Bender, C. J. Gerda; Emslie, Annemarie

    2010-01-01

    The purpose of this article is to describe how school staff members, learners and parents collaborate to prevent adolescent learner violence in two different urban secondary schools. The increase in acts of interpersonal learner violence has a destructive effect on the safe and positive development of young people. Empirical evidence indicates…

  6. Preventing Teen Pregnancy. Secondary Learning Guide 4. Project Connect. Linking Self-Family-Work.

    ERIC Educational Resources Information Center

    Emily Hall Tremaine Foundation, Inc., Hartford, CT.

    This competency-based secondary learning guide on preventing teen pregnancy is part of a series that are adaptations of guides developed for adult consumer and homemaking education programs. The guides provide students with experiences that help them learn to do the following: make decisions; use creative approaches to solve problems; establish…

  7. [Spanish interdisciplinary committee for cardiovascular disease prevention and the spanish society of cardiology position statement on dyslipidemia management. Differences between the European and american guidelines].

    PubMed

    Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

    2015-04-01

    The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention. PMID:25450438

  8. [Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology Position Statement on Dyslipidemia Management. Differences Between the European and American Guidelines].

    PubMed

    Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

    2015-01-01

    The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention. PMID:26179969

  9. [Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology position statement on dyslipidemia management. Differences between the European and American guidelines].

    PubMed

    Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

    2015-01-01

    The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention. Full English text available from:www.revespcardiol.org/en. PMID:25444651

  10. Exercise Training and Cardiac Rehabilitation in Primary and Secondary Prevention of Coronary Heart Disease

    PubMed Central

    Lavie, Carl J.; Thomas, Randal J.; Squires, Ray W.; Allison, Thomas G.; Milani, Richard V.

    2009-01-01

    Substantial data have established a sedentary lifestyle as a major modifiable risk factor for coronary heart disease (CHD). Increased levels of physical activity, exercise training, and overall cardiorespiratory fitness have provided protection in the primary and secondary prevention of CHD. This review surveys data from observational studies supporting the benefits of physical activity, exercise training, and overall cardiorespiratory fitness in primary prevention. Clearly, cardiac rehabilitation/secondary prevention (CRSP) programs have been greatly underused by patients with CHD. We review the benefits of CRSP programs on CHD risk factors, psychological factors, and overall CHD morbidity and mortality. These data support the routine referral of patients with CHD to CRSP programs. Patients should be vigorously encouraged to attend these programs. PMID:19339657

  11. Knowledge and views of secondary school students in Kuala Lumpur on cervical cancer and its prevention.

    PubMed

    Rashwan, Hesham; Ishak, Ismarulyusda; Sawalludin, Nurhidayah

    2013-01-01

    Cervical cancer is one of the most frequent cancers in women worldwide. Persistent infection with a human papillomavirus (HPV) is the main cause for cervical cancer. Vaccination and Pap smear screening are the best methods for prevention of the disease. The objective of this cross-sectional study was to assess the knowledge and views of upper secondary school female students in Kuala Lumpur, Malaysia, toward prevention of cervical cancer. This study was conducted from April 2009 to September 2009 in 8 schools in Kuala Lumpur area using pre-tested and validated questionnaires. Results indicated that the respondents had low knowledge of cervical cancer and its prevention although the majority of students (80.4%) had heard about the disease. The level of knowledge of cervical cancr and its prevention was significantly higher among students from the science stream (p<0.001) compared to students from the art stream. Most students (69.3%) agreed to take the vaccination if the service was available in schools. A high percentage of students (82.2%) agreed that the vaccination should be compulsory to the students. In conclusion, most students had low knowledge of cervical cancer and its prevention but they had positive attitude toward vaccination and agreed that vaccination should be compulsory. Therefore, suitable educational programmes should be developed to improve the knowledge of secondary school students on the prevention of cervical cancer. PMID:23725172

  12. Primary and secondary prevention of gallstone disease: implications for patient management and research priorities.

    PubMed

    Hofmann, A F

    1993-04-01

    Primary prevention is defined as the prevention of gallstone formation; secondary prevention is defined as the prevention of clinical manifestations of gallstones--symptoms or more severe complications. For primary prevention, general "wellness" measures can be recommended from a theoretic standpoint. These include elimination of obesity (to decrease excessive cholesterol biosynthesis or mobilization of tissue cholesterol during rapid weight loss); a high-fiber, high-calcium diet (to diminish input of deoxycholic acid); ingestion of meals at regular intervals (to diminish gallbladder storage and interruption of the enterohepatic circulation of bile acids); and vigorous exercise (to permit frequent meals without excessive caloric intake). In addition, based on animal studies, intake of low saturated fatty acids may diminish the nucleation of supersaturated bile. Secondary prevention is recommended only when gallstones become symptomatic because of the benign natural history of asymptomatic gallstones, the intrinsic limitations of medical therapy, and the absence of predictors that would enable selection of asymptomatic patients at high risk for becoming symptomatic. Secondary prevention involves nonsurgical approaches (dissolution with ursodiol, extracorporeal shock-wave lithotripsy plus adjuvant bile acids, and, rarely, contact dissolution with organic solvents). For patients with symptomatic gallstones, nonsurgical therapy will be used by those patients who cannot or will not have surgery, as well as those patients who wish to explore a trial of nonsurgical therapy before having surgery. Because of the intrinsic limitations of nonsurgical therapy in comparison to the efficacy and safety of surgery, most patients will undergo surgery. Future research priorities include elucidation of factors responsible for: (1) bile that is supersaturated in cholesterol; (2) elevated biliary deoxycholic acid levels in patients with cholesterol gallstones; (3) rapid nucleation in

  13. Awareness of prevention of teenage pregnancy amongst secondary school learners in Makhado municipality

    PubMed Central

    Radzilani-Makatu, Makondelele; Takalani, James F.

    2016-01-01

    Background Sexuality plays a very significant role in the lives of both boys and girls. It is, therefore, considered important for schools to recognise and accept sexuality as part of the development process of the child. Professor Kader Asmal (previous South African Minister of Education) suggested that the earlier the school begins to teach learners about sexuality, the better because they can be easily misled by their peers if proper guidance regarding their sexuality is not given. Aim The current study was conducted to assess the awareness of teenagers on the prevention of teenage pregnancy (TP) in six secondary school learners situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Setting The study was conducted at six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province in 2014. Methodology A quantitative descriptive survey study was conducted where data were collected, using self-administered questionnaires, from 381 systematically sampled participants from six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Data were analysed descriptively using the Statistical Package for the Social Sciences (SPSS) software, version 22.0. Necessary approval procedures and ethical clearance were obtained prior to data collection. Results Ninety-four percent of participants agreed that TP can be prevented through abstaining from sex, whilst 65% of participants agreed that TP could be prevented by using contraceptives such as pills and injections. Eighty-three percent of participants agreed that TP could be prevented through the use of condoms. Seventy-four percent participants disagreed that bathing after sex prevents teenage pregnancies. Furthermore, 28% participants agreed that TP can be prevented by oral sex. Conclusion The conclusion drawn was that learners are aware of the measures for preventing TP. PMID:27380836

  14. Pre-Exercise Screening and Health Coaching in CHD Secondary Prevention: A Qualitative Study of the Patient Experience

    ERIC Educational Resources Information Center

    Shaw, R.; Gillies, M.; Barber, J.; MacIntyre, K.; Harkins, C.; Findlay, I. N.; McCloy, K.; Gillie, A.; Scoular, A.; MacIntyre, P. D.

    2012-01-01

    Secondary prevention programmes can be effective in reducing morbidity and mortality from coronary heart disease (CHD). In particular, UK guidelines, including those from the Department of Health, emphasize physical activity. However, the effects of secondary prevention programmes with an exercise component are moderate and uptake is highly…

  15. [Primary and secondary prevention procedures of temporo-mandibular joint disease in the evolutive age].

    PubMed

    Ciavarella, D; Mastrovincenzo, M; Sabatucci, A; Campisi, G; Di Cosola, M; Suriano, M; Lo Muzio, L

    2009-02-01

    In the last years prevention of temporomandiboular joint (TMJ) disease had acquired great importance. According to the neuro-occlusal rehabilitation (RNO) it is possible to say that TMJ disease starts since first years of life. So it is important both for dentist and for pediatric know what are the conditions and the atypical functions which predispose to this pathology. The aim of this work was to show how it is possible to intercept since primary teeth and the correct norms of primary and secondary prevention. PMID:19180004

  16. Emphasis: Interdisciplinary.

    ERIC Educational Resources Information Center

    Crabbe, John K., Ed.; Crabbe, Katharyn F., Ed.

    1977-01-01

    The articles collected in this issue of "The English Record" examine various aspects of the use of interdisciplinary approaches in English instruction. Titles are "Zen, the Arts, and Motorcycle Maintenance" by Janet Gane and Tom Reigstad, which describes the formation of a course in creative inquiry; "Career Education and the English Curriculum"…

  17. [Primary and secondary prevention of cardiovascular events through hormone replacement therapy (HRT)].

    PubMed

    Pilz, Heidemarie

    2005-09-01

    A recently (2002) published, randomised, double blind placebo controlled trial of hormone replace ment therapy (HRT), the Women's Health Initiative (WHI), is not consistent with the decrease in cardiovascular disease under CEE/HPA seen in observational primary prevention studies like the Nurses' Health Study. Baseline characteristics of participants like age, body mass index, years since menopause and preexistent cardiovascular diseases may be responsible for the lack of benefit seen in this trial. Clinical outcome data of HRT from randomised trials in secondary prevention of cardiovasular diseases are limited. The first prospective, randomised placebo controlled trial, the Heart and Estrogen/Progestin Replacement Study (HERS) in secondary prevention did not show any difference in CHD events between treatment groups and placebo during a follow up of 4.1 years. However, an increased risk of CHD was seen especially during the first year on HRT, subsequent years showed a decrease in event rate compared with never-users. One explanation for this lack of benefit may be a bi-directional effect of estrogen - early risk and late benefit - especially in an elderly study population with established atherosclerotic lesions. In postmenopausal women, estrogen replacement therapy affects LDL- and HDL-cholesterol levels favorably, causes vasodilatation by activating NOS, inhibits platelet aggregation and proinflammatory cell adhesion on endothelial cells of vascular wall. Estrogen can affect the cardiovascular system adversely by increasing triglycerid levels, CPR and proinflammatory cytokines like tumor necrosis factor alpha (TNF-alpha). Alternatives to HRT like phytoestrogens act via estrogen alpha and beta receptor modulation. Phytoestrogens may lower LDL-cholesterol levels without increasing triglyceride levels, they have shown antioxidannt properties as well as favorable effects on vascular reactivity. The importance of HRT and phytoestrogens in primary and secondary

  18. Prevention of Secondary Conditions in Fetal Alcohol Spectrum Disorders: Identification of Systems-Level Barriers

    PubMed Central

    Petrenko, Christie L. M.; Tahir, Naira; Mahoney, Erin C.; Chin, Nancy P.

    2013-01-01

    Objective Fetal alcohol spectrum disorders (FASD) impact 2 to 5 percent of the U.S. population and are associated with life-long cognitive and behavioral impairments. Individuals with FASD have high rates of secondary conditions, including mental health problems, school disruptions, and trouble with the law. This study focuses on systems-level barriers that contribute to secondary conditions and interfere with prevention and treatment. Methods Using a phenomenological methodology, semi-structured interviews and focus groups were conducted with parents of children with FASD and service providers. Data were analyzed using a framework approach. Results Participants emphasized the pervasive lack of knowledge of FASD throughout multiple systems. This lack of knowledge contributes to multi-system barriers including delayed diagnosis, unavailability of services, and difficulty qualifying for, implementing, and maintaining services. Conclusions FASD is a major public health problem. Broad system changes using a public health approach are needed to increase awareness and understanding of FASD, improve access to diagnostic and therapeutic services, and create responsive institutional policies to prevent secondary conditions. These changes are essential to improve outcomes for individuals with FASD and their families and facilitate dissemination of empirically supported interventions. PMID:24178158

  19. Controversies and future perspectives of antiplatelet therapy in secondary stroke prevention

    PubMed Central

    Weber, Ralph; Diener, Hans-Christoph

    2010-01-01

    Abstract Antiplatelet agents are a cornerstone in the treatment of acute arterial thrombotic events and in the prevention of thrombus formation. However, existing antiplatelet agents (mainly aspirin, the combination of aspirin and dipyridamole and clopidogrel) reduce the risk of vascular events only by about one quarter compared with placebo. As a consequence, more efficacious antiplatelet therapies with a reduced bleeding risk are needed. We give an overview of several new antiplatelet agents that are currently investigated in secondary stroke prevention: adenosine 5′-diphosphonate receptor antagonists, cilostazol, sarpogrelate, terutroban and SCH 530348. There are unique features in secondary stroke prevention that have to be taken into account: ischaemic stroke is a heterogeneous disease caused by multiple aetiologies and the blood–brain barrier is disturbed after stroke which may result in a higher intracerebral bleeding risk. Several small randomized trials indicated that the combination of aspirin and clopidogrel might be superior to antiplatelet monotherapy in the acute and early post-ischaemic phase. There is an ongoing debate about antiplatelet resistance. Decreasing response to aspirin is correlated independently with an increased risk of cardiovascular events. However, there is still no evidence from randomized trials linking aspirin resistance and recurrent ischaemic events. Similarly, randomized trials have not demonstrated a clinical significantly decreased antiplatelet effect by the concomitant use of clopidogrel and proton pump inhibitors. Nevertheless, a routine use of this drug combination is not recommended. PMID:20738445

  20. Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demo...

  1. Nurses' perspectives on nurse-coordinated prevention programmes in secondary prevention of cardiovascular disease: a pilot survey

    PubMed Central

    Jorstad, H.T.; Chan, Y.K.; Scholte op Reimer, W.J.M.; Doornenbal, J.; Tijssen, J.G.P.; Peters, R.J.G.

    2015-01-01

    Background: Secondary prevention of coronary artery disease (CAD) is increasingly provided by nurse-coordinated prevention programs (NCPP). Little is known about nurses’ perspectives on these programs. Aim: To investigate nurses’ perspectives/experiences in NCPPs in acute coronary syndrome patients. Methods: Thirteen nurses from NCPPs in 11 medical centers in the RESPONSE trial completed an online survey containing 45 items evaluating 3 outcome categories: (1) conducting NCPP visits; (2) effects of NCPP interventions on risk profiles and (3) process of care. Results: Nurses felt confident in counseling/motivating patients to reduce CAD risk. Interventions targeting LDL, blood pressure and medication adherence were reported as successful, corresponding with significant improvements of these risk factors. Improving weight, smoking and physical activity was reported as less effective. Screening for anxiety/depression was suggested as an improvement. Conclusions: Nurses acknowledge the importance and effectiveness of NCPPs, and correctly identify which components of the program are the most successful. Our study provides a basis for implementation and quality improvement for NCCPs. PMID:26572788

  2. School Violence in Secondary Education in the Governorate of Mafraq: Forms, Causes and Prevention--A Case Study

    ERIC Educational Resources Information Center

    Khaled, Mohammad S. Bani

    2014-01-01

    This study considers school violence. It was investigated in secondary schools in the governorate of Mafraq. The aim is to identify the forms and causes of the phenomenon; hence to come out with the preventive and remedial measures, accordingly. The study was conducted in one of the secondary schools selected randomly in the city of Mafraq in the…

  3. Probiotics for the Primary and Secondary Prevention of C. difficile Infections: A Meta-analysis and Systematic Review

    PubMed Central

    McFarland, Lynne V.

    2015-01-01

    Clostridium difficile infections are a global clinical concern and are one of the leading causes of nosocomial outbreaks. Preventing these infections has benefited from multidisciplinary infection control strategies and new antibiotics, but the problem persists. Probiotics are effective in preventing antibiotic-associated diarrhea and may also be a beneficial strategy for C. difficile infections, but randomized controlled trials are scarce. This meta-analysis pools 21 randomized, controlled trials for primary prevention of C. difficile infections (CDI) and four trials for secondary prevention of C. difficile recurrences and assesses the efficacy of specific probiotic strains. Four probiotics significantly improved primary CDI prevention: (Saccharomyces boulardii, Lactobacillus casei DN114001, a mixture of L. acidophilus and Bifidobacterium bifidum, and a mixture of L. acidophilus, L. casei and L. rhamnosus). None of the tested probiotics significantly improved secondary prevention of CDI. More confirmatory randomized trials are needed to establish if probiotics are useful for preventing C. difficile infections. PMID:27025619

  4. [Stroke from the Perspective of Neurologists (Part 3): Update in the Secondary Prevention].

    PubMed

    Schur, Patrick; Luft, Andreas

    2016-05-25

    In this third edition the secondary prevention of stroke will be discussed. After the acute phase in which recanalization of an occluded brain artery is in the focus, the risks for a recurrent stroke have to be minimized and rehabilitation should be started. A systematic workup, an extended evaluation of (non-) modifiable risk factors and the clinical-radiological findings are the source of an effective preventive therapy. Risk assessment of the major risk factors such as arterial hypertension, atrial fibrillation, diabetes and dyslipidemia is established. The obstructive sleep apnea syndrome and the complex atheromatosis with a complex structure are independent risk factors for stroke. The search for an etiology is usually a definition of probabilities. The most probable cause of stroke is assumed. PMID:27223418

  5. Optimal Stroke Prevention in the Geriatric Patient with Atrial Fibrillation: Position Paper of an Interdisciplinary Expert Panel.

    PubMed

    Bahrmann, P; Wehling, M; Ropers, D; Flohr, J; Leischker, A; Röther, J

    2015-10-01

    The present position paper summarises the outcomes of an expert panel discussion held by hospital-based and office-based physicians with ample experience in the treatment of geriatric patients. The optimal approach to stroke prevention in geriatric patients with atrial fibrillation (AF) has not been adequately clarified. Despite their high risk of stroke and clear indication for anticoagulation according to established risk scores, in practice geriatric AF patients often are withheld treatment because of comorbidities and comedications, concerns about low treatment adherence or fear of bleeding events, in particular due to falls. The panel agreed that geriatric patients should receive oral anticoagulation as a rule, unless a comprehensive neurological and geriatric assessment (including clinical examination, gait tests and validated instruments such as Modified Rankin Scale, Mini-mental state examination or Timed Test of Money Counting) provides sound reasons for refraining from treatment. All patients with a history of falls should be thoroughly evaluated for further evaluation of the causes. Patients with CHADS2 score ≥ 2 should receive anticoagulation even if at high risk for falls. The novel oral anticoagulants (NOAC) facilitate management in the geriatric population with AF (no INR monitoring needed, easier bridging during interventions) and have, based on available data, an improved benefit-risk ratio compared to vitamin K antagonists. Drugs with predominantly non-renal elimination are safer in geriatric patients and should be preferred. PMID:25285794

  6. The emergency department: first line of defense in preventing secondary stroke.

    PubMed

    Ovbiagele, Bruce

    2006-02-01

    Stroke and transient ischemic attack (TIA) are increasingly common conditions that are associated with significant morbidity and mortality. The strongest predictor of recurrent stroke risk is an initial stroke or TIA; in fact, nearly 30% of all strokes are recurrent events. It is often the emergency department (ED) physician who, while treating the initial event, has the first opportunity to initiate effective preventive strategies, including pharmacotherapy and behavior modification. Evidence- and consensus-based guidelines are well established for the use of antiplatelet medications, anticoagulants, and antihypertensives for prevention of secondary stroke. Recent evidence suggests that the use of statins may be associated with improved clinical outcomes after ischemic stroke. In addition, behavioral interventions, such as smoking cessation, exercise, diet, and stroke education, can help patients avoid stroke recurrence. By initiating prevention therapies during the acute stroke or TIA encounter, EPs convey the message to patients that these therapies are important for the prevention of recurrent events and are an essential part of the treatment. PMID:16436789

  7. Restructuring for an Interdisciplinary Curriculum.

    ERIC Educational Resources Information Center

    Jenkins, John M., Ed.; Tanner, Daniel, Ed.

    Articles for developing an integrated secondary curriculum are presented in this book. The articles include: "Synthesis Versus Fragmentation: The Way Out of Curriculum Confusion," by Daniel Tanner; "The Interrelated Curriculum," by Steven S. Means; "Integrated Teaching and Learning in Essential Schools," by Richard Lear; "Interdisciplinary Teaming…

  8. Teaching Bioethics from an Interdisciplinary Perspective.

    ERIC Educational Resources Information Center

    Singleton, Rivers, Jr.; Brock, D. Heyward

    1982-01-01

    Outlines an interdisciplinary workshop in bioethics for secondary teachers taught by a team consisting of a scientist, a philosopher, and a literary critic. Discusses definitions, topics, reading selections, problems, and value. (DC)

  9. Project Roadmap: Reeducating Older Adults in Maintaining AIDS Prevention--A Secondary Intervention for Older HIV-Positive Adults

    ERIC Educational Resources Information Center

    Illa, Lourdes; Echenique, Marisa; Saint Jean, Gilbert; Bustamante-Avellaneda, Victoria; Metsch, Lisa; Mendez-Mulet, Luis; Eisdorfer, Carl; Sanchez-Martinez, Mario

    2010-01-01

    The number of older adults living with HIV/AIDS is larger than ever. Little is known about their sexual behaviors, although contrary to stereotypes, older adults desire and engage in sexual activity. Despite increased recognition of the need for prevention interventions targeting HIV-positive individuals, no secondary HIV prevention interventions…

  10. Microcapsule-Type Organogel-Based Self-Healing System Having Secondary Damage Preventing Capability.

    PubMed

    Yang, Hye-In; Kim, Dong-Min; Yu, Hwan-Chul; Chung, Chan-Moon

    2016-05-01

    We have developed a novel microcapsule-type organogel-based self-healing system in which secondary damage does not occur in the healed region. A mixture of an organogelator, poor and good solvents for the gelator is used as the healing agent; when the good solvent evaporates from this agent, a viscoelastic organogel forms. The healing agent is microencapsulated with urea-formaldehyde polymer, and the resultant microcapsules are integrated into a polymer coating to prepare self-healing coatings. When the coatings are scratched, they self-heal, as demonstrated by means of corrosion testing, electrochemical testing, optical microscopy, and scanning electron microscopy (SEM). After the healed coatings are subjected to vigorous vibration, it is demonstrated that no secondary damage occurs in the healed region. The secondary damage preventing capability of the self-healing coating is attributable to the viscoelasticity of the organogel. The result can give insight into the development of a "permanent" self-healing system. PMID:27070306

  11. The use of secondary medical prevention after primary vascular reconstruction: studies on usage and effectiveness.

    PubMed

    Høgh, Annette L

    2012-09-01

    Peripheral arterial disease (PAD) is a common manifestation of symptomatic atherosclerosis that leads to a significantly elevated risk of cardiovascular events, including major limb loss, myocardial infarction, stroke and death. The prevalence proportions of PAD increase dramatically with age and appear to progress more aggressively in women than in men. Several studies have indicated that the use of secondary medical prevention is generally insufficient among PAD patients. However, current national and international guidelines recommend lipid-lowering and anti-platelet therapy, supplemented with aggressive blood pressure lowering treatment. We aimed to determine whether there were age-, gender-, geography or time related differences in the use of secondary medical prevention, following primary vascular reconstruction. We also sought to describe the prognoses for the same population, according to the association between the use of ACE/ATII inhibitors (angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists) or beta blockers and clinical outcomes (all cause mortality, myocardial infarction, stroke, major amputation and/or recurrent vascular surgery) in a population-based, long-term follow-up study. We established a data base by linking four population based administrative and health-care registries. All Danish patients undergoing primary vascular surgical reconstruction due to atherosclerotic disease between 1997 and 2007 were included and identified in the Danish Vascular Registry; a total of 20,761 patients were followed during a median of 582 days (range of 30 to 4,379 days). Data regarding all prescriptions filled by the study population were obtained from the Medical Registry of the Danish Medicines Agency. Study I: Age- and gender-related differences. We found moderate to low use of secondary medical prevention. However, this use has increased in recent years and the age- and gender-related differences in use have been reduced or

  12. Novel oral anticoagulants for the secondary prevention of cerebral ischemia: a network meta-analysis

    PubMed Central

    Katsanos, Aristeidis H.; Mavridis, Dimitris; Parissis, John; Deftereos, Spyridon; Frogoudaki, Alexandra; Vrettou, Agathi-Rosa; Ikonomidis, Ignatios; Chondrogianni, Maria; Safouris, Apostolos; Filippatou, Angeliki; Voumvourakis, Konstantinos; Triantafyllou, Nikos; Ellul, John; Karapanayiotides, Theodore; Giannopoulos, Sotirios; Alexandrov, Anne W.; Alexandrov, Andrei V.; Tsivgoulis, Georgios

    2016-01-01

    Background: Novel oral anticoagulants (NOACs) have shown to be both safe and effective for ischemic stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). We conducted a network meta-analysis (NMA) using published data from secondary prevention subgroups of different phase III randomized clinical trials (RCTs) comparing individual NOACs with warfarin. Methods: Eligible studies were identified by searching MEDLINE and SCOPUS and the Cochrane Central Register of Controlled Trials databases. First, we conducted a pairwise meta-analysis for each pairwise comparison, and then we performed NMA to combine direct and indirect evidence for any given pair of treatments. The comparative effects of all NOACs against warfarin were ranked with the surface under the cumulative ranking (SUCRA) curve for each outcome. Results: We identified four RCTs (including 15,240 patients) comparing individual NOACs (apixaban, dabigatran, rivaroxaban) with warfarin. Using indirect evidence, dabigatran was related to a significantly lower risk of hemorrhagic stroke compared with rivaroxaban [risk ratio (RR) 0.28; 95% confidence interval (CI) 0.11–0.75], while rivaroxaban was associated with a significantly lower risk of major gastrointestinal bleeding compared with dabigatran (RR 0.14; 95% CI 0.03–0.74). We also performed clustered ranking plot for the primary efficacy and safety endpoints to identify the treatment with the probably best benefit-to-risk ratio profile. Conclusions: The three NOACs showed differences in terms of safety and efficacy for secondary stroke prevention in NVAF. Our findings can serve only as hypothesis generation and require independent confirmation in head-to-head RCTs, owing to the sparse available evidence and increased uncertainty in both indirect effect estimates and ranking of treatments. PMID:27582891

  13. Gender-specific secondary prevention? Differential psychosocial risk factors for major cardiovascular events

    PubMed Central

    Kure, Christina E; Chan, Yih-Kai; Ski, Chantal F; Thompson, David R; Carrington, Melinda J

    2016-01-01

    Objective To explore the psychosocial determinants and interhospital variability on a major acute cardiovascular event (MACE), during follow-up of a multicenter cohort of patients hospitalised with heart disease, participating in a nurse-led secondary prevention programme. Methods Outcome data were retrospectively analysed from 602 cardiac inpatients randomised to postdischarge standard care (n=296), or home-based intervention (n=306), with prolonged follow-up of individualised multidisciplinary support. Baseline psychosocial profiling comprised depressive status, health-related quality of life (HRQoL), social isolation and mild cognitive impairment (MCI). Multivariate analyses examined the independent correlates of a composite 2-year MACE rate of all-cause mortality and unplanned cardiovascular-related hospitalisation, according to gender. Results Participants were aged 70±10 years, 431 (72%) were men and 377 (63%) had coronary artery disease. During 2-year follow-up, 165 (27%) participants (114 men, 51 women; p=0.431) experienced a MACE. Independent correlates of a MACE in men were depressive status (OR 1.95, 95% CI 1.06 to 3.58; p=0.032), low physical HRQoL (OR 0.98, 95% CI 0.96 to 1.00; p=0.027) and increasing comorbidity (OR 1.14, 95% CI 1.04 to 1.25; p=0.004). In women, age (OR 1.06, 95% CI 1.02 to 1.12; p=0.008), MCI (OR 2.38, 95% CI 1.09 to 5.18; p=0.029) and hospital site predicted a MACE (OR 2.32, 95% CI 1.09 to 4.93; p=0.029). Conclusions Psychological determinants, cognitive impairment and responses to secondary prevention are different for men and women with heart disease and appear to modulate cardiovascular-specific outcomes. Early detection of psychosocial factors through routine screening and gender-specific secondary prevention is encouraged. Trial registration number 12608000014358. PMID:27099759

  14. Cardioembolic stroke: practical considerations for patient risk management and secondary prevention.

    PubMed

    Amin, Hardik; Nowak, Richard J; Schindler, Joseph L

    2014-01-01

    Cardioembolic (CE) stroke constitutes approximately 20% of all occurrence of ischemic stroke in patients. Atrial fibrillation remains the most common and most studied mechanism underlying CE stroke events. Cardioembolic strokes carry high morbidity and are associated with early recurrence in patients. Our understanding of other patient mechanisms associated with CE stroke, including valvular disease, left ventricular dysfunction, and patent foramen ovale, continues to grow. Our review summarizes the diagnosis and management of patients who have sustained CE stroke as a result of the aforementioned cardiac mechanisms. Advances in primary and secondary risk management for prevention of CE stroke are also highlighted in our article-specifically, emerging data regarding monitoring of patients with atrial fibrillation, new anticoagulation therapy, and management of patients with decreased ejection fraction. PMID:24393752

  15. Vorapaxar: A novel agent to be considered in the secondary prevention of myocardial infarction

    PubMed Central

    Kehinde, Obamiro; Kunle, Rotimi

    2016-01-01

    Patients receiving therapy for the secondary prevention of myocardial infarction (MI) are still at high risk of a major cardiovascular event or death despite the use of currently available treatment strategy. Vorapaxar, an oral protease-activated receptor antagonist, is a novel antiplatelet drug that has been recently approved to provide further risk reduction. The results of two Phase III trials (thrombin receptor antagonists for clinical event reduction and the TRA 2°P-TIMI 50) have showed that vorapaxar, in addition to standard of care therapy, has the potential to provide further risk reduction in patients with prior MI. A search was made on PubMed on articles related to clinical trials and clinical consideration with the use of vorapaxar. This review article summarizes the results of Phase II trials, Phase III trials, subgroup analysis, precautions, and drug interaction with the use of vorapaxar. PMID:27134460

  16. Secondary Effects of an Alcohol Prevention Program Targeting Students and/or Parents.

    PubMed

    Koning, Ina M; Vollebergh, Wilma A M

    2016-08-01

    The secondary effects of an alcohol prevention program (PAS) on onset of weekly smoking and monthly cannabis use are examined among >3000 Dutch early adolescents (M age=12.64) randomized over four conditions: 1) parent intervention (PI), 2) student intervention (SI), 3) combined intervention (CI) and 4) control condition (CC). Rules about alcohol, alcohol use, and adolescents' self-control were investigated as possible mediators. PI had a marginal aversive effect, slightly increasing the risk of beginning to smoke at T1, and increased the likelihood of beginning to use cannabis use at T1 and T2. SI delayed the onset of monthly cannabis use at T3. CI increased the risk to use cannabis at T3. No mediational processes were found. In conclusion, though this study show mixed results, negative side effects of the PI were found, particularly at earlier ages. Moreover, these results indicate the need for multi-target interventions. PMID:27296663

  17. Development of a multifunctional adhesive system for prevention of root caries and secondary caries

    PubMed Central

    Zhang, Ning; Melo, Mary A. S.; Chen, Chen; Liu, Jason; Weir, Michael D.; Bai, Yuxing; Xu, Hockin H. K.

    2015-01-01

    Objectives The objectives of this study were to: (1) develop a novel adhesive for prevention of tooth root caries and secondary caries by possessing a combination of protein-repellent, antibacterial, and remineralization capabilities for the first time; and (2) investigate the effects of 2-methacryloyloxyethyl phosphorylcholine (MPC), dimethylaminohexadecyl methacrylate (DMAHDM), and nanoparticles of amorphous calcium phosphate (NACP) on dentine bond strength, protein-repellent properties, and dental plaque microcosm biofilm response. Methods MPC, DMAHDM and NACP were added into Scotchbond Multi-Purpose primer and adhesive. Dentine shear bond strengths were measured. Adhesive coating thickness, surface texture and dentine-adhesive interfacial structure were examined. Protein adsorption onto adhesive resin surface was determined by the micro bicinchoninic acid method. A human saliva microcosm biofilm model was used to investigate biofilm metabolic activity, colony-forming unit (CFU) counts, and lactic acid production. Results The resin with 7.5% MPC + 5% DMAHDM + 30% NACP did not adversely affect dentine shear bond strength (p > 0.1). The resin with 7.5% MPC + 5% DMAHDM + 30% NACP produced a coating on root dentine with a thickness of approximately 70 μm and completely sealed all the dentinal tubules. The resin with 7.5% MPC + 5% DMAHDM + 30% NACP had 95% reduction in protein adsorption, compared to SBMP control (p < 0.05). The resin with 7.5% MPC + 5% DMAHDM + 30% NACP was strongly antibacterial, with biofilm CFU being four orders of magnitude lower than that of SBMP control. Significance The novel multifunctional adhesive with strong protein-repellent, antibacterial and remineralization properties is promising to coat tooth roots to prevent root caries and secondary caries. The combined use of MPC, DMAHDM and NACP may have wide applicability to bonding agents, cements, sealants and composites to inhibit caries. PMID:26187532

  18. HIV/AIDS prevention through peer education and support in secondary schools in South Africa.

    PubMed

    Visser, Maretha J

    2007-11-01

    The implementation and evaluation of a peer education and support programme in secondary schools to prevent and reduce high-risk sexual behaviour amongst adolescents is discussed.The aims of the programme were to provide accurate information about HIV/AIDS, discuss and reconsider peer group norms, and establish support for learners. In the programme that was implemented in 13 secondary schools in Tshwane, South Africa, peer educators were identified, trained and supported to implement the programme in their schools with the assistance of a teacher and postgraduate students as facilitators. Peer educators organised HIV awareness activities, facilitated class discussions on risk behaviour and gender relationships, and supported learners in solving personal problems. Process evaluation included weekly reports and focus group discussions with peer educators and teachers. A quasiexperimental design involving an experimental and control group, as well as pre- and post-assessments, was used to evaluate the impact of the programme on psychological well-being, personal control, school climate and reported high-risk behaviour of learners aged between 13 and 20 years.The results showed that the percentage of learners in the experimental group who were sexually experienced remained unchanged over the time period of 18 months. In contrast, a significantly increased percentage of learners in the control group were sexually experienced after the same time period.The control group also perceived more of their friends to be sexually experienced. No differences were reported in condom use in either of the groups.The findings of this study suggest that peer education can contribute to a delayed onset of sexual activity, and can therefore contribute to the prevention of HIV/AIDS amongst adolescents. PMID:18185895

  19. Use of medicines recommended for secondary prevention of acute coronary syndrome

    PubMed Central

    Gaedke, Mari Ângela; da Costa, Juvenal Soares Dias; Manenti, Euler Roberto Fernandes; Henn, Ruth Liane; Paniz, Vera Maria Vieira; Nunes, Marcelo Felipe; da Motta, Monique Adriane; Olinto, Maria Teresa Anselmo

    2015-01-01

    ABSTRACT OBJECTIVE : To analyze if the demographic and socioeconomic variables, as well as percutaneous coronary intervention are associated with the use of medicines for secondary prevention of acute coronary syndrome. METHODS : In this cohort study, we included 138 patients with acute coronary syndrome, aged 30 years or more and of both sexes. The data were collected at the time of hospital discharge, and after six and twelve months. The outcome of the study was the simultaneous use of medicines recommended for secondary prevention of acute coronary syndrome: platelet antiaggregant, beta-blockers, statins and angiotensin-converting-enzyme inhibitor or angiotensin receptor blocker. The independent variables were: sex, age, education in years of attending, monthly income in tertiles and percutaneous coronary intervention. We described the prevalence of use of each group of medicines with their 95% confidence intervals, as well as the simultaneous use of the four medicines, in all analyzed periods. In the crude analysis, we verified the outcome with the independent variables for each period through the Chi-square test. The adjusted analysis was carried out using Poisson Regression. RESULTS : More than a third of patients (36.2%; 95%CI 28.2;44.3) had the four medicines prescribed at the same time, at the moment of discharge. We did not observe any differences in the prevalence of use in comparison with the two follow-up periods. The most prescribed class of medicines during discharge was platelet antiaggregant (91.3%). In the crude analysis, the demographic and socioeconomic variables were not associated to the outcome in any of the three periods. CONCLUSIONS : The prevalence of simultaneous use of medicines at discharge and in the follow-ups pointed to the under-utilization of this therapy in clinical practice. Intervention strategies are needed to improve the quality of care given to patients that extend beyond the hospital discharge, a critical point of transition

  20. Alternative erythropoietin-mediated signaling prevents secondary microvascular thrombosis and inflammation within cutaneous burns

    PubMed Central

    Bohr, Stefan; Patel, Suraj J.; Shen, Keyue; Vitalo, Antonia G.; Brines, Michael; Cerami, Anthony; Berthiaume, Francois; Yarmush, Martin L.

    2013-01-01

    Alternate erythropoietin (EPO)–mediated signaling via the heteromeric receptor composed of the EPO receptor and the β-common receptor (CD131) exerts the tissue-protective actions of EPO in various types of injuries. Herein we investigated the effects of the EPO derivative helix beta surface peptide (synonym: ARA290), which specifically triggers alternate EPO-mediated signaling, but does not bind the erythropoietic EPO receptor homodimer, on the progression of secondary tissue damage following cutaneous burns. For this purpose, a deep partial thickness cutaneous burn injury was applied on the back of mice, followed by systemic administration of vehicle or ARA290 at 1, 12, and 24 h postburn. With vehicle-only treatment, wounds exhibited secondary microvascular thrombosis within 24 h postburn, and subsequent necrosis of the surrounding tissue, thus converting to a full-thickness injury within 48 h. On the other hand, when ARA290 was systemically administered, patency of the microvasculature was maintained. Furthermore, ARA290 mitigated the innate inflammatory response, most notably tumor necrosis factor-alpha–mediated signaling. These findings correlated with long-term recovery of initially injured yet viable tissue components. In conclusion, ARA290 may be a promising therapeutic approach to prevent the conversion of partial- to full-thickness burn injuries. In a clinical setting, the decrease in burn depth and area would likely reduce the necessity for extensive surgical debridement as well as secondary wound closure by means of skin grafting. This use of ARA290 is consistent with its tissue-protective properties previously reported in other models of injury, such as myocardial infarction and hemorrhagic shock. PMID:23401545

  1. Alternative erythropoietin-mediated signaling prevents secondary microvascular thrombosis and inflammation within cutaneous burns.

    PubMed

    Bohr, Stefan; Patel, Suraj J; Shen, Keyue; Vitalo, Antonia G; Brines, Michael; Cerami, Anthony; Berthiaume, Francois; Yarmush, Martin L

    2013-02-26

    Alternate erythropoietin (EPO)-mediated signaling via the heteromeric receptor composed of the EPO receptor and the β-common receptor (CD131) exerts the tissue-protective actions of EPO in various types of injuries. Herein we investigated the effects of the EPO derivative helix beta surface peptide (synonym: ARA290), which specifically triggers alternate EPO-mediated signaling, but does not bind the erythropoietic EPO receptor homodimer, on the progression of secondary tissue damage following cutaneous burns. For this purpose, a deep partial thickness cutaneous burn injury was applied on the back of mice, followed by systemic administration of vehicle or ARA290 at 1, 12, and 24 h postburn. With vehicle-only treatment, wounds exhibited secondary microvascular thrombosis within 24 h postburn, and subsequent necrosis of the surrounding tissue, thus converting to a full-thickness injury within 48 h. On the other hand, when ARA290 was systemically administered, patency of the microvasculature was maintained. Furthermore, ARA290 mitigated the innate inflammatory response, most notably tumor necrosis factor-alpha-mediated signaling. These findings correlated with long-term recovery of initially injured yet viable tissue components. In conclusion, ARA290 may be a promising therapeutic approach to prevent the conversion of partial- to full-thickness burn injuries. In a clinical setting, the decrease in burn depth and area would likely reduce the necessity for extensive surgical debridement as well as secondary wound closure by means of skin grafting. This use of ARA290 is consistent with its tissue-protective properties previously reported in other models of injury, such as myocardial infarction and hemorrhagic shock. PMID:23401545

  2. Interdisciplinary technology

    NASA Astrophysics Data System (ADS)

    Nichols, Lester D.

    1993-12-01

    The 'computational test-cell' will enable the incorporation of new methodologies, such as concurrent engineering and probabilistic methods, into the propulsion design process. This will provide the capability to conduct credible, interdisciplinary analyses of new propulsion concepts and designs. Probabilistic methods can be used as the basis for reliability-based design. Recently methods have been devised that provide the capability of simulating the performance of propulsion systems at several levels of resolution. These methods make it possible to quantify uncertainty and to establish confidence bounds for the calculated values. The introduction of reliability-based design methodology along with probabilistic analyses will provide a tool to reduce the design space for new systems and to reduce our dependence on hardware testing for proof-of-concept and system integration demonstrations. The resulting simulations will reduce the need for testing and identify potential operational problems early in the design process. This capability will make it possible to compute the expected performance, stability, reliability, and life of propulsion components, subsystems, and systems at design and off-design conditions, to bring life cycle cost trade-offs early into the design process and to determine optimum designs to satisfy specified mission requirements.

  3. Interdisciplinary technology

    NASA Technical Reports Server (NTRS)

    Nichols, Lester D.

    1993-01-01

    The 'computational test-cell' will enable the incorporation of new methodologies, such as concurrent engineering and probabilistic methods, into the propulsion design process. This will provide the capability to conduct credible, interdisciplinary analyses of new propulsion concepts and designs. Probabilistic methods can be used as the basis for reliability-based design. Recently methods have been devised that provide the capability of simulating the performance of propulsion systems at several levels of resolution. These methods make it possible to quantify uncertainty and to establish confidence bounds for the calculated values. The introduction of reliability-based design methodology along with probabilistic analyses will provide a tool to reduce the design space for new systems and to reduce our dependence on hardware testing for proof-of-concept and system integration demonstrations. The resulting simulations will reduce the need for testing and identify potential operational problems early in the design process. This capability will make it possible to compute the expected performance, stability, reliability, and life of propulsion components, subsystems, and systems at design and off-design conditions, to bring life cycle cost trade-offs early into the design process and to determine optimum designs to satisfy specified mission requirements.

  4. Resolvin D2 prevents secondary thrombosis and necrosis in a mouse burn wound model.

    PubMed

    Bohr, Stefan; Patel, Suraj J; Sarin, Dhruv; Irimia, Daniel; Yarmush, Martin L; Berthiaume, Francois

    2013-01-01

    Deep partial thickness burns are subject to delayed necrosis of initially viable tissues surrounding the primary zone of thermally induced coagulation, which results in an expansion of the burn wound, both in area and depth, within 48 hours postburn. Neutrophil sequestration and activation leading to microvascular damage is thought to mediate this secondary tissue damage. Resolvins, a class of endogenous mediators derived from omega-3 polyunsaturated fatty acids, have been shown to regulate the resolution of inflammation. We hypothesized that exogenous resolvins could mitigate the deleterious impact of the inflammatory response in burn wounds. Using two different mouse burn injury models involving significant partial thickness injuries, we found that a systemically administered single dose of resolvin D2 (RvD2) as low as 25 pg/g bw given within an interval of up to 4 hours postburn effectively prevented thrombosis of the deep dermal vascular network and subsequent dermal necrosis. By preserving the microvascular network, RvD2 enhanced neutrophil access to the dermis, but prevented neutrophil-mediated damage through other anti-inflammatory actions, including inhibition of tumor necrosis factor-α, interleukin-1β, and neutrophil platelet-endothelial cell adhesion molecule-1. In a clinical context, RvD2 may be therapeutically useful by reducing the need for surgical debridement and the area requiring skin grafting. PMID:23110665

  5. Direct Oral Anticoagulants and Their Use in Treatment and Secondary Prevention of Acute Symptomatic Venous Thromboembolism.

    PubMed

    Granziera, Serena; Hasan, Arjumand; Cohen, Alexander Ander T

    2016-04-01

    Direct oral anticoagulants (DOACs) have been compared with standard therapy in large phase III studies to assess their safety and efficacy in the treatment of deep vein thrombosis and/or pulmonary embolism and in the secondary prevention of recurrent venous thromboembolism. Although the mean population age and the gross inclusion and exclusion criteria were similar across these studies, they differed in other aspects such as overall study design and acute treatment strategies. The 4 DOACs examined in phase III trials (apixaban, edoxaban, rivaroxaban, and dabigatran) showed noninferiority compared with standard therapy for the treatment of deep vein thrombosis and/or pulmonary embolism and for the prevention of recurrent venous thromboembolism. Furthermore, these DOACs exhibited a similar safety profile to standard therapy, with the risk of major bleeding significantly reduced in some of these studies. Rivaroxaban and apixaban were tested as a single-drug approach, whereas in the dabigatran and edoxaban studies, initial bridging with parenteral agents was employed. The purpose of this review is to compare the phase III studies of DOACs in this indication, to highlight the differences, and to discuss a series of clinically relevant issues, including the management of key patient subgroups (eg, fragile patients, those with cancer or renal impairment), extended treatment, use of comedications, heparin pretreatment versus a single-drug approach, and the bleeding profiles of the DOACs. PMID:26329910

  6. Secondary prevention after PCI: the cost-effectiveness of statin therapy in the Netherlands

    PubMed Central

    Chaplin, S.; Scuffham, P.A.; Alon, M.; van den Boom, G.

    2004-01-01

    Background Little is known about the cost-effectiveness of secondary prevention after percutaneous coronary intervention (PCI). The aim of this study was to estimate the cost-effectiveness of statin therapy. Methods A cost-effectiveness analysis was performed using data from the Lescol Intervention Prevention Study (LIPS). In the LIPS trial, patients with normal-to-moderate hypercholesterolaemia who had undergone a first PCI were randomised to receive either fluvastatin 40 mg twice-daily plus dietary counselling or dietary counselling alone. A Markov model was used to estimate the incremental costs per quality-adjusted life year (QALY) and life year gained (LYG). Costs were based on prices and reimbursed charges, utility data were drawn from literature. Monte Carlo simulations and multivariate analysis were used to assess uncertainty. Results Routine statin treatment costs an additional €734 (SD €686) per patient over ten years compared with controls. It resulted in an additional 0.078 (0.047) QALYs or 0.082 (0.041) LYG. The incremental costs per QALY and LYG were €9312 (€14,648) and €8954 (€16,617) respectively. Anticipating a willingness to pay of €20,000 per QALY, there is a 75.1% chance that fluvastatin treatment is cost-effective. Conclusion Statin therapy with fluvastatin is economically efficient with regard to reducing heart disease in the Netherlands when given routinely to all patients following PCI. PMID:25696357

  7. A program to improve secondary stroke prevention: the Colorado Neurological Institute stroke preventing recurrence of thromboembolic events through coordinated treatment program.

    PubMed

    Menard, Michelle M; Smith, Don B; Taormina, Cristina

    2011-08-01

    The key to secondary stroke prevention often lies in improved control of traditional stroke risk factors. Studies have shown that there is an evidence-practice gap, for both physicians and patients, when it comes to adhering to national stroke prevention guidelines. We developed a program to reinforce stroke prevention messages for 1 year after a patient's ischemic stroke or transient ischemic attack. Our results show encouraging improvement in our patients' adherence to treatment guidelines for 1 year after the event, as well as a reduction in recurrent strokes as compared with the number expected. PMID:21796042

  8. Secondary Prevention Beyond Hospital Discharge for Acute Coronary Syndrome: Evidence-Based Recommendations.

    PubMed

    Fitchett, David H; Goodman, Shaun G; Leiter, Lawrence A; Lin, Peter; Welsh, Robert; Stone, James; Grégoire, Jean; Mcfarlane, Philip; Langer, Anatoly

    2016-07-01

    In the past 3 decades, a better understanding of the pathophysiology of cardiovascular disease has resulted in innovations in the treatment and prevention of its clinical manifestations such as death, myocardial infarction, or stroke. After an acute coronary syndrome there are short- and long-term risks of subsequent cardiovascular events. This leads to opportunities to initiate strategies to reduce complications resulting from myocardial injury (cardiac protection) and to prevent recurrent acute coronary events (vascular protection). The results from clinical trials inform best practice and guidelines for patient management. Despite clear and consistent guidelines, an important number of patients are not receiving these treatments. Moreover, many others do not receive treatment that follows the strategy proven in the clinical trial and this is associated with a significant loss of opportunities to improve outcomes. The Canadian Heart Research Centre has therefore assembled a panel of experts to provide a review of available data and distill it to specific evidence-based recommendations that can be used by specialists and primary care physicians as a platform for secondary prevention. The therapeutic recommendations are conveniently divided into vascular protection (dual antiplatelet therapy, lipid-lowering, and renin angiotensin system inhibition) which should be considered in all patients; cardiac protection (addition of β-blocker therapy) in patients with left ventricular dysfunction including consideration for management of heart failure; and continuing management of risk factors and comorbid conditions on the basis of the specific patient profile. These recommendations are intended as a decision support tool and a quick reference for Canadian physicians. PMID:27342696

  9. Successful Treatment and Secondary Prevention of Venous Thrombosis Secondary to Behçet Disease with Rivaroxaban

    PubMed Central

    Lambert, Catherine; Hermans, Cedric

    2016-01-01

    We here present the successful initial treatment and secondary prophylaxis of superficial venous thrombosis secondary to Behçet's disease by a novel anticoagulant drug, rivaroxaban (Xarelto®). To our knowledge, this is the first case of using an oral direct inhibitor of FXa in this setting. Our findings are promising; the outcome was favourable without any adverse effect noted. We propose that the patients with Behçet's disease and venous thrombosis might benefit from the advantages of the new anticoagulant drug. PMID:27437154

  10. Building Program Acceptability: Perceptions of Gay and Bisexual Men on Peer or Prevention Case Manager Relationships in Secondary HIV Prevention Counseling

    PubMed Central

    DRISKELL, JEFFREY R.; O’CLEIRIGH, CONALL; COVAHEY, CHARLES; RIPTON, JESSICA; MAYER, KENNETH; PERRY, D’HANA; SALOMON, ELIZABETH; SAFREN, STEVEN

    2013-01-01

    There is growing interest in integrating HIV prevention counseling for HIV-infected gay and bisexual men into HIV primary care. HIV-infected peers and professionally trained prevention case managers (PCMs) have been used to provide prevention counseling services. The current qualitative study seeks to examine participant perceptions of the acceptability of HIV-infected peer counselors and of trained prevention case managers from the perspective of 41 HIV-infected gay and bisexual men. Semi-structured interviews were conducted with HIV-infected men who were currently receiving primary HIV health care. Positive peer counselor themes included shared experiences and para-professional. Positive themes specific to the PCM relationships included were provision of resources and professional skills and knowledge. Common themes identified across both peer and PCM counselor relationships were creating a comfortable environment, non-judgmental stance, and rapport building/communication skills. Recommendations for HIV secondary prevention interventions are presented. PMID:23710120

  11. Sustainability of Gains Made in a Primary School HIV Prevention Programme in Kenya into the Secondary School Years

    ERIC Educational Resources Information Center

    Maticka-Tyndale, Eleanor

    2010-01-01

    The question addressed in this paper is whether the beneficial effects of Primary School Action for Better Health (PSABH), an HIV prevention programme delivered in Kenyan primary schools, continue once students move on to secondary schools. Questionnaires were completed in December 2005 and January 2006 by all form 1-3 students in 154 randomly…

  12. Principles help to analyse but often give no solution--secondary prevention after a cardiac event.

    PubMed

    Westin, Lars; Nilstun, Tore

    2006-06-01

    The aim of this paper is to investigate whether or not ethical conflicts can be identified, analysed and solved using ethical principles. The relation between the physician and the patient with ischemic heart disease (IHD) as life style changes are recommended in a secondary prevention program is used as an example. The principal persons affected (the patient and his or her spouse) and the ethical principles (respect for autonomy, non-maleficence, beneficence and justice) are combined in a two dimensional model. The most important person affected by the recommendations is the patient. His or her autonomy is challenged by the suggested life style changes, the purpose of which is to promote the future wellbeing and health of the patient. The spouse is indirectly involved in and affected by the process. He or she often feels neglected by caregivers. Ethical conflicts can both be identified and analysed using ethical principles, but often no solution is implied. Most (if not all) physicians would strongly encourage life style changes, but surprisingly there is no uncontroversial justification for this conclusion using principles. PMID:17195579

  13. Antiplatelet therapy for secondary prevention of noncardioembolic ischemic stroke: a critical review.

    PubMed

    O'Donnell, Martin J; Hankey, Graeme J; Eikelboom, John W

    2008-05-01

    For patients with ischemic stroke or transient ischemic attack caused by atherothromboembolism, immediate and long-term aspirin reduces the relative risk of recurrent stroke, MI, and death attributable to vascular causes. Oral anticoagulation is not more effective than aspirin. Long-term clopidogrel reduces the relative risk of stroke, MI, or vascular death by about 9% (0.3% to 16.5%) compared with aspirin. Any long-term benefits of clopidogrel combined with aspirin, compared with aspirin or clopidogrel alone, appear to be offset by increased major bleeding. The combination of aspirin and extended-release dipyridamole reduces the relative odds of stroke, MI, or vascular death by about 18% (odds ratio 0.82, 0.74 to 0.91) compared with aspirin alone without causing more bleeding. Cilostazole reduces the risk of stroke, MI, or vascular death by 39% compared to placebo. A large clinical trial comparing clopidogrel with the combination of aspirin and dipyridamole, in >20 000 patients with recent (<120 days) atherothrombotic ischemic stroke, is expected to report in 2008. Emerging antiplatelet therapies presently being evaluated for secondary prevention of atherothromboembolism include other P(2)Y(12) ADP receptor antagonists (prasugrel, cangrelor, AZD 6140), thromboxane receptor antagonists (eg, S18886 - terutroban), and thrombin receptor (PAR-1) antagonists (eg, SCH530348). PMID:18369175

  14. Primary and Secondary HIV Prevention Among Persons with Severe Mental Illness: Recent Findings.

    PubMed

    Hobkirk, Andréa L; Towe, Sheri L; Lion, Ryan; Meade, Christina S

    2015-12-01

    Persons with severe mental illness (SMI) have been disproportionately affected by the HIV epidemic, with higher rates of HIV prevalence and morbidity than the general population. Recent research has advanced our understanding of the complex factors that influence primary and secondary HIV prevention for those with SMI. Sex risk in this population is associated with socioeconomic factors (e.g., low income, history of verbal violence) and other health risk behaviors (e.g., substance use, no prior HIV testing). Several interventions are effective at reducing risk behavior, and reviews highlight the need for more well-controlled studies that assess long-term outcomes. Recent research has elucidated barriers that interfere with HIV treatment for SMI populations, including individual (e.g., apathy, substance use), social (e.g., stigma), and system factors (e.g., transportation, clinic wait times). Interventions that coordinate HIV care for individuals with SMI show promise as cost-effective methods for improving medication adherence and quality of life. PMID:26428958

  15. Canadian Stroke Best Practice Recommendations: secondary prevention of stroke guidelines, update 2014.

    PubMed

    Coutts, Shelagh B; Wein, Theodore H; Lindsay, M Patrice; Buck, Brian; Cote, Robert; Ellis, Paul; Foley, Norine; Hill, Michael D; Jaspers, Sharon; Jin, Albert Y; Kwiatkowski, Brenda; MacPhail, Carolyn; McNamara-Morse, Dana; McMurtry, Michael S; Mysak, Tania; Pipe, Andrew; Silver, Karen; Smith, Eric E; Gubitz, Gord

    2015-04-01

    Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2014 update of the Canadian Secondary Prevention of Stroke guideline is a comprehensive summary of current evidence-based recommendations for clinicians in a range of settings, who provide care to patients following stroke. Notable changes in this 5th edition include an emphasis on treating the highest risk patients who present within 48 h of symptom onset with transient or persistent motor or speech symptoms, who need to be transported to the closest emergency department with capacity for advanced stroke care; a recommendation for brain and vascular imaging (of the intra- and extracranial vessels) to be completed urgently using computed tomography/computed tomography angiography; prolonged cardiac monitoring for patients with suspective cardioembolic stroke but without evidence for atrial fibrillation on electrocardiogram or holter monitoring; and de-emphasizing the need for routine echocardiogram. The Canadian Stroke Best Practice Recommendations include a range of supporting materials such as implementation resources to facilitate the adoption of evidence to practice, and related performance measures to enable monitoring of uptake and effectiveness of the recommendations using a standardized approach. The guidelines further emphasize the need for a systems approach to stroke care, involving an interprofessional team, with access to specialists regardless of patient location, and the need to overcome geographical barriers to ensure equity in access within a universal health-care system. PMID:25535808

  16. The ADAPTABLE Trial and Aspirin Dosing in Secondary Prevention for Patients with Coronary Artery Disease.

    PubMed

    Johnston, Abigail; Jones, W Schuyler; Hernandez, Adrian F

    2016-08-01

    Coronary artery disease (CAD) is the underlying cause of death in one out of seven deaths in the USA. Aspirin therapy has been proven to decrease mortality and major adverse cardiovascular events in patients with CAD. Despite a plethora of studies showing the benefit of aspirin in secondary prevention of cardiovascular events, debate remains regarding the optimal dose due to relatively small studies that had disparate results when comparing patients taking different aspirin dosages. More recently, aspirin dosing has been thoroughly studied in the CAD population with concomitant therapy (such as P2Y12 inhibitors); however, patients in these studies were not randomized to aspirin dose. No randomized controlled trial has directly measured aspirin dosages in a population of patients with established coronary artery disease. In 2015, the Patient-Centered Outcomes Research Institute (PCORI) developed a network, called PCORnet, that includes patient-powered research networks (PPRN) and clinical data research networks (CDRN). The main objective of PCORnet is to conduct widely generalizable observational studies and clinical trials (including large, pragmatic clinical trials) at a low cost. The first clinical trial, called Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness (ADAPTABLE), will randomly assign 20,000 subjects with established coronary heart disease to either low dose (81 mg) or high dose (325 mg) and should be able to finally answer which dosage of aspirin is best for patients with established cardiovascular disease. PMID:27423939

  17. Secondary Prevention following CABG: Findings of a National Randomized Controlled Trial and Sustained Society-Led Incorporation into Practice

    PubMed Central

    Williams, Judson B.; DeLong, Elizabeth R.; Peterson, Eric D.; Dokholyan, Rachel S.; Ou, Fang-Shu; Ferguson, T. Bruce

    2013-01-01

    Background Despite evidence supporting the use of aspirin, B-blockers, ACE inhibitors, and lipid-lowering therapies in eligible patients, adoption of these secondary prevention measures following coronary artery bypass grafting (CABG) has been inconsistent. We sought to rigorously test on a national scale whether low-intensity continuous quality improvement (CQI) interventions can be used to speed secondary prevention adherence following CABG. Methods and Results A total of 458 hospitals participating in the Society of Thoracic Surgeons National Cardiac Database and treating 361,328 patients undergoing isolated CABG were randomized to either a control or an intervention group. The intervention group received CQI materials designed to influence the prescription of the secondary prevention medications at discharge. The primary outcome measure was discharge prescription rates of the targeted secondary prevention medications at intervention vs. control sites, assessed by measuring pre-intervention and post-intervention site differences. Pre-randomization treatment patterns and baseline data were similar in the control (N=234) and treatment (N=224) groups. Individual medication use as well as composite adherence increased over 24 months in both groups, with a markedly more rapid rate of adherence uptake among the intervention hospitals and a statistically significant therapy hazard ratio in the intervention vs. control group for all 4 secondary prevention medications. Conclusions Provider-led, low-intensity CQI efforts can improve the adoption of care processes into national practice within the context of a medical specialty society infrastructure. The findings of the present trial have led to the incorporation of study outcome metrics into a medical society rating system for ongoing quality improvement. PMID:21173357

  18. The role of nonpharmaceutic conservative interventions in the treatment and secondary prevention of epilepsy.

    PubMed

    Wolf, Peter

    2002-01-01

    Nonpharmacologic conservative treatments receive too little attention. Depending on the clinical condition of the patients, they may be used alone or in conjunction with other therapies. Their target is the single seizure rather than the epileptic condition as such. They belong mainly to one of three domains. NONSPECIFIC PREVENTION OF SEIZURES: The first step is the identification of factors facilitating the occurrence of seizures. In the second step, strategies to control these factors are developed. Most common are disturbances of the sleep-wake cycle, especially reduction of sleep. Patients should follow a regular sleep schedule with deviations of not >2 h. Sometimes a sleep calendar is helpful. Night shifts are not compatible with seizure prevention in these cases. Sleep disturbances as a facilitating factor of seizures are particularly common in juvenile idiopathic generalized epilepsies, in which their avoidance is in many cases an indispensable part of the therapeutic regimen, along with appropriate drug treatment. They are the most common precipitating factor in adolescents and adults with a first epileptic [mostly generalized tonic-clonic (GTC)] seizure. In these instances, their avoidance is central to the secondary prevention of epilepsy developing from the single seizure, whereas the prescription of antiepileptic drugs (AEDs) is rarely effective. Other nonspecific facilitators of seizures include uncontrolled use of alcohol and extraordinary stress. Patients must learn how to cope with stressful events. SPECIFIC PREVENTION OF SEIZURES: In reflex epilepsies, specific precipitants of seizures are the targets of interventions. Thus, most patients with primary reading epilepsy begin to have, with prolonged reading, perioral reflex myoclonias, which enable them to stop reading and thus to avoid a GTC seizure. In photosensitive patients, seizures are often precipitated by television. These can be avoided by viewing from a distance and using a remote control

  19. Behavioral Sciences in Secondary Schools: An Inquiry-Oriented Interdisciplinary Approach to the Human Behavioral Sciences in Social Studies. Professional Education Series.

    ERIC Educational Resources Information Center

    Anderson, Randall C.

    Trends in secondary-level behavioral science curriculum development, informational background, and strategies for teaching behavioral science concepts are provided in this book. Chapters one through three define the behavioral sciences and examine their changing role and status in social studies education. Chapters four through six develop…

  20. Risk factors for secondary transmission of Shigella infection within households: implications for current prevention policy

    PubMed Central

    2012-01-01

    Background Internationally, guidelines to prevent secondary transmission of Shigella infection vary widely. Cases, their contacts with diarrhoea, and those in certain occupational groups are frequently excluded from work, school, or daycare. In the Netherlands, all contacts attending pre-school (age 0–3) and junior classes in primary school (age 4–5), irrespective of symptoms, are also excluded pending microbiological clearance. We identified risk factors for secondary Shigella infection (SSI) within households and evaluated infection control policy in this regard. Methods This retrospective cohort study of households where a laboratory confirmed Shigella case was reported in Amsterdam (2002–2009) included all households at high risk for SSI (i.e. any household member under 16 years). Cases were classified as primary, co-primary or SSIs. Using univariable and multivariable binomial regression with clustered robust standard errors to account for household clustering, we examined case and contact factors (Shigella serotype, ethnicity, age, sex, household size, symptoms) associated with SSI in contacts within households. Results SSI occurred in 25/ 337 contacts (7.4%): 20% were asymptomatic, 68% were female, and median age was 14 years (IQR: 4–38). In a multivariable model adjusted for case and household factors, only diarrhoea in contacts was associated with SSI (IRR 8.0, 95% CI:2.7-23.8). In a second model, factors predictive of SSI in contacts were the age of case (0–3 years (IRRcase≥6 years:2.5, 95% CI:1.1-5.5) and 4–5 years (IRRcase≥6 years:2.2, 95% CI:1.1-4.3)) and household size (>6 persons (IRR2-4 persons 3.4, 95% CI:1.2-9.5)). Conclusions To identify symptomatic and asymptomatic SSI, faecal screening should be targeted at all household contacts of preschool cases (0–3 years) and cases attending junior class in primary school (4–5 years) and any household contact with diarrhoea. If screening was limited to these groups, only one

  1. Using intervention mapping to develop and adapt a secondary stroke prevention program in Veterans Health Administration medical centers

    PubMed Central

    2010-01-01

    Secondary stroke prevention is championed by the stroke guidelines; however, it is rarely systematically delivered. We sought to develop a locally tailored, evidence-based secondary stroke prevention program. The purpose of this paper was to apply intervention mapping (IM) to develop our locally tailored stroke prevention program and implementation plan. We completed a needs assessment and the five Steps of IM. The needs assessment included semi-structured interviews of 45 providers; 26 in Indianapolis and 19 in Houston. We queried frontline clinical providers of stroke care using structured interviews on the following topics: current provider practices in secondary stroke risk factor management; barriers and needs to support risk factor management; and suggestions on how to enhance secondary stroke risk factor management throughout the continuum of care. We then describe how we incorporated each of the five Steps of IM to develop locally tailored programs at two sites that will be evaluated through surveys for patient outcomes, and medical records chart abstraction for processes of care. PMID:21159171

  2. Qi-Shen-Yi-Qi Dripping Pills for the Secondary Prevention of Myocardial Infarction: A Randomised Clinical Trial

    PubMed Central

    Shang, Hongcai; Zhang, Junhua; Yao, Chen; Liu, Baoyan; Gao, Xiumei; Ren, Ming; Cao, Hongbao; Dai, Guohua; Weng, Weiliang; Zhu, Sainan; Wang, Hui; Xu, Hongjuan; Zhang, Boli

    2013-01-01

    Background. Several types of drugs have been recommended for the secondary prevention of myocardial infarction (MI). However, these conventional strategies have several limitations, such as low adherence, high cost, and side effects during long time use. Novel approaches to this problem are still needed. This trial aimed to test the effectiveness and safety of Qi-Shen-Yi-Qi Dripping Pills (QSYQ), a multi-ingredient Chinese patent medicine, for the secondary prevention of MI. Methods and Findings. A total of 3505 eligible patients were randomly assigned to QSYQ group (1746 patients) or aspirin group (1759). Patients took their treatments for 12 months. The final follow-up visit took place 6 months after the end of the trial drugs. The 12-month and 18-month estimated incidences of the primary outcome were 2.98% and 3.67%, respectively, in the QSYQ group. The figures were 2.96% and 3.81% in the aspirin group. No significant difference was identified between the groups. Conclusions. This trial did not show significant difference of primary and secondary outcomes between aspirin and QSYQ in patients who have had an MI. Though inconclusive, the result suggests that QSYQ has similar effects to aspirin in the secondary prevention of MI. PMID:23935677

  3. Prevention of secondary hyperparathyroidism in hemodialysis patients: the key role of native vitamin D supplementation.

    PubMed

    Jean, G; Vanel, T; Terrat, J-C; Chazot, C

    2010-10-01

    Secondary hyperparathyroidism (SHPT) is a frequent complication in chronic kidney disease, especially in hemodialysis (HD) patients. Treatments for SHPT include calcitriol analogues (CA), phosphate binders, cinacalcet (CC), and surgical parathyroidectomy (PTX). This study aimed to assess the incidence and prevalence of SHPT in a single center during the period when native vitamin D (N-VitD) supplementation and CC treatment became available. All incident and prevalent HD patients were prospectively recorded and compared using 3 periods from 2004 to 2005 (period 1), 2006 to 2007 (period 2), and 2008 to 2009 (period 3). SHPT was diagnosed with serum parathyroid hormone (PTH) levels >300 pg/mL or the need for CA, CC, or PTX. Between periods 1 and 3, in incident patients (n=120 and 101), N-VitD prescription increased from 11% to 68% (P<0.0001), CA prescription remained stable (40%), and patients with PTH>300 pg/mL decreased from 40% to 12% (P<0.0001). In prevalent HD patients (n=235), N-VitD treatment increased from 55% to 91% (P<0.0001), whereas treatment with CA decreased from 67% to 17% (P<0.0001). Patients with serum PTH>300 pg/mL decreased from 38% to 13% (P<0.001), whereas patients with PTH<150 pg/mL remained stable (<30%). New CC prescriptions decreased from 45 to 3 (P<0.0001). Since 2004, SHPT has decreased drastically in incident and prevalent HD patients. The preventive role of N-VitD supplementation appears to be obvious and represents one more argument for its general recommendation in CKD patients. PMID:20955282

  4. Primary and secondary prevention of drink driving by the use of alcolock device and program: Swedish experiences.

    PubMed

    Bjerre, Bo

    2005-11-01

    To prevent drinking and driving, alcolock (or alcohol-interlock) devices and programs were introduced in Sweden in 1999. Two types of prevention programs were begun. A primary prevention strategy was initiated to prevent alcohol impaired driving by individuals not pre-selected for having prior DWI offences. This approach was first applied as a pilot project in three commercial transport companies (buses, trucks, taxis). Also a secondary prevention trial was begun as a voluntary 2-year program for DWI offenders involving strict medical requirements, including counseling and regular checkups by a medical doctor. The program did not require a prior period of hard suspension and focused on changing alcohol use habits. Alcolocks in commercial vehicles have been well accepted by professional drivers, their employers, and their passengers, and the number of vehicles with alcolocks as a primary prevention measure is rapidly growing in Sweden. Three of 1000 starts in the primary prevention program were blocked by the alcolock after measuring a BAC higher than the legal limit and lock point of 0.02% (20mg/dl). Only 11% of eligible DWI offenders took part in the voluntary, secondary prevention program. Of these, 60% had diagnoses of alcohol dependence or abuse. During the program, alcohol consumption generally decreased significantly as measured through five biological alcohol markers, and the rate of DWI recidivism fell sharply from a yearly rate of approximately 5% to almost 0. These effects on DWI recidivism are paralleled by reduced rates of police-reported traffic accidents involving injuries and hospital admissions due to road accidents. Successful completion of the program appears to have lasting effects (even 2.5 years later) in terms of far lower rates of DWI recidivism and maybe also lower crash rates. On the other hand those being dismissed from the program appear to rapidly return to previous behaviour. Hard suspension seems almost to have an adverse effect on DWI

  5. Stroke survivors', caregivers' and GPs' attitudes towards a polypill for the secondary prevention of stroke: a qualitative interview study

    PubMed Central

    Jamison, James; Graffy, Jonathan; Mullis, Ricky; Mant, Jonathan; Sutton, Stephen

    2016-01-01

    Objectives To understand the perspectives of stroke survivors, caregivers and general practitioners (GPs) on a polypill approach, consisting of blood pressure and cholesterol-lowering therapies, with or without aspirin, for the secondary prevention of stroke. Methods A qualitative interview study was undertaken in 5 GP surgeries in the East of England. 28 survivors of stroke/transient ischaemic attack (TIA) were interviewed, 14 of them with a caregiver present, along with a convenience sample of 5 GPs, to assess attitudes towards a polypill and future use. Topic guides explored participants attitudes, potential uptake and long-term use, management of polypill medication and factors influencing the decision to prescribe. Data were analysed using a grounded theory approach. Key themes are presented and illustrated with verbatim quotes. Results The analysis identified 3 key themes: polypill benefits, polypill concerns and polypill lessons for implementation. Stroke/TIA survivors were positive about the polypill concept and considered it acceptable in the secondary prevention of stroke. Perceived benefits of a polypill included convenience resulting in improved adherence and reduced burden of treatment. Caregivers felt that a polypill would improve medication-taking practices, and GPs were open to prescribing it to those at increased cardiovascular risk. However, concerns raised included whether a polypill provided equivalent therapeutic benefit, side effects through combining medications, consequences of non-adherence, lack of flexibility in regulating dosage, disruption to current treatment and suitability to the wider stroke population. Conclusions Participants acknowledged potential advantages in a polypill approach for secondary prevention of stroke; however, significant concerns remain. Further research on the efficacy of a polypill is needed to reassure practitioners whose concerns around inflexibility and treatment suitability are likely to influence the

  6. Barriers to medication adherence for the secondary prevention of stroke: a qualitative interview study in primary care

    PubMed Central

    Jamison, James; Graffy, Jonathan; Mullis, Ricky; Mant, Jonathan; Sutton, Stephen

    2016-01-01

    Background Medications are highly effective at reducing risk of recurrent stroke, but success is influenced by adherence to treatment. Among survivors of stroke and transient ischaemic attack (TIA), adherence to medication is known to be suboptimal. Aim To identify and report barriers to medication adherence for the secondary prevention of stroke/TIA. Design and setting A qualitative interview study was conducted within general practice surgeries in the East of England, UK. Method Patients were approached by letter and invited to take part in a qualitative research study. Semi-structured interviews were undertaken with survivors of stroke, caregivers, and GPs to explore their perspectives and views around secondary prevention and perceived barriers to medication adherence. Key themes were identified using a grounded theory approach. Verbatim quotes describing the themes are presented here. Results In total, 28 survivors of stroke, including 14 accompanying caregivers and five GPs, were interviewed. Two key themes were identified. Patient level barriers included ability to self-care, the importance people attach to a stroke event, and knowledge of stroke and medication. Medication level barriers included beliefs about medication and beliefs about how pills work, medication routines, changing medications, and regimen complexity and burden of treatment. Conclusion Patients who have had a stroke are faced with multiple barriers to taking secondary prevention medications in UK general practice. This research suggests that a collaborative approach between caregivers, survivors, and healthcare professionals is needed to address these barriers and facilitate medication-taking behaviour. PMID:27215572

  7. HIV/AIDS prevention: knowledge, attitudes and education practices of secondary school health personnel in 14 cities of China.

    PubMed

    Chen, J Q; Dunne, M P; Zhao, D C

    2004-01-01

    This study assessed the preparedness of school health personnel to develop and deliver HIV/AIDS prevention education programmes for young people in China. A survey of 653 personnel working in secondary schools in 14 cities was conducted. More than 90% had basic knowledge of ways in which HIV can be transmitted, but knowledge of ways in which the virus is not transmitted needs improvement. Substantial numbers of teachers were not sure whether there was an effective preventive vaccine (42%) or did not know whether AIDS was a curable illness or not (32%). The great majority approved of AIDS prevention programmes in universities (98%) and secondary schools (91%), although fewer (58%) agreed that the topic was appropriate for primary schools. Currently, most classroom activities focuses on teaching facts about HIV/AIDS transmission, while less than half are taught about HIV/AIDS related discrimination and life skills to reduce peer pressure. Personnel with some prior training on HIV/ AIDS education (53%) had better factual knowledge, more tolerant attitudes and more confidence in teaching about HIV/AIDS than those without training. The majority of teachers indicated a need for more resource books, audiovisual products, expert guidance, school principal support and dissemination of national AIDS prevention education guidelines to schools. PMID:18839862

  8. α-Casein Inhibits Insulin Amyloid Formation by Preventing the Onset of Secondary Nucleation Processes.

    PubMed

    Librizzi, Fabio; Carrotta, Rita; Spigolon, Dario; Bulone, Donatella; San Biagio, Pier Luigi

    2014-09-01

    α-Casein is known to inhibit the aggregation of several proteins, including the amyloid β-peptide, by mechanisms that are not yet completely clear. We studied its effects on insulin, a system extensively used to investigate the properties of amyloids, many of which are common to all proteins and peptides. In particular, as for other proteins, insulin aggregation is affected by secondary nucleation pathways. We found that α-casein strongly delays insulin amyloid formation, even at extremely low doses, when the aggregation process is characterized by secondary nucleation. At difference, it has a vanishing inhibitory effect on the initial oligomer formation, which is observed at high concentration and does not involve any secondary nucleation pathway. These results indicate that an efficient inhibition of amyloid formation can be achieved by chaperone-like systems, by sequestering the early aggregates, before they can trigger the exponential proliferation brought about by secondary nucleation mechanisms. PMID:26278257

  9. The Prevention and Mending of Burnout among Secondary School Teachers. Technical Report.

    ERIC Educational Resources Information Center

    Evers, Will J. G.; Gerrichhauzen, John; Tomic, Welco

    This paper examines research on teacher burnout, using the self-efficacy theory as the framework. It explains that designing a program to help teachers improve classroom management and thus prevent classroom disorder may contribute to the prevention of burnout. Chapter 1 introduces the issue of teacher burnout. Chapter 2 discusses burnout…

  10. [Violence prevention in secondary schools: the Faustlos-curriculum for middle school].

    PubMed

    Schick, Andreas; Cierpka, Manfred

    2009-01-01

    Schools and kindergartens are particularly suitable for the implementation of violence prevention programs. Many German schools and kindergartens have securely established the violence prevention curriculum Faustlos. The Faustlos programs for kindergartens and elementary schools are now complemented with the version for middle schools. As the kindergarten- and elementary school versions the middle school program too focuses on the theoretically profound, age group-tailored promotion of empathy, impulse control and anger management. These dimensions are subdivided into the five themes "understanding the problem" "training for empathy"; "anger management", "problem solving" and "applying skills" and taught stepwise, highly structured and based on several video sequences in 31 lessons. US-American evaluation studies proof the effectiveness and the violence prevention potential of the program. With the curriculum for middle schools a comprehensive Faustlos program package is now made available to sustainably promote core violence prevention competences of children and adolescents on a developmentally appropriate level and with a consistent didactic approach. PMID:19961127

  11. Strategies for Prevention and Intervention of Drug Abuse among Students in Secondary Schools in Kenya

    ERIC Educational Resources Information Center

    Marais, Petro; Maithya, Redempta

    2015-01-01

    Drug abuse is becoming an increasing problem among students in Kenya. The major cause for concern is that a high proportion of the Kenyan youth in secondary schools are involved in drugs (NACADA 2012). As a result, these young people eventually become addicted, posing a threat to their own health and safety. This study sought to establish the…

  12. Prevention Rather than Cure? Primary or Secondary Intervention for Dealing with Media Exposure to Terrorism

    ERIC Educational Resources Information Center

    Slone, Michelle; Shoshani, Anat

    2010-01-01

    The authors examined the efficacy of primary versus secondary intervention in moderating state anxiety and state anger from media-based exposure to terrorism. Two hundred participants, allocated to a terrorism or nonterrorism media exposure and to antecedent or subsequent therapeutic or control intervention, were assessed for state anxiety and…

  13. Resources for Interdisciplinary Studies

    ERIC Educational Resources Information Center

    Klein, Julie Thompson

    2006-01-01

    Resources for interdisciplinary studies (IDS) appear in a multitude of print publications, online forums, and the "fugitive" or "gray" literature of conference papers, reports, and curriculum materials. The quantity is not surprising, since interdisciplinary discussions have expanded as new fields and approaches emerged across all domains of…

  14. Interdisciplinary Course Design.

    ERIC Educational Resources Information Center

    Ruwe, Donelle; Leve, James

    2001-01-01

    Describes problems faced in an interdisciplinary course taught by the authors on major 19th and 20th century figures and ideas in the humanities (literature, music, art, and philosophy). Tells how they refashioned it to focus on depth rather than breadth. Offers some hard-won insights and advice for those embarking on interdisciplinary teaching.…

  15. Dropout Prevention Intervention with Secondary Students: A Pilot Study of Project GOAL

    ERIC Educational Resources Information Center

    Wexler, Jade; Pyle, Nicole; Fall, Anna Maria

    2015-01-01

    Project GOAL is a systematic dropout prevention model including individual and peer-mediated group interventions for at-risk students. This article provides an overview of the Project GOAL model and describes a 2-year experimental pilot study of Project GOAL with a cohort of eighth-and ninth-grade students in a low-income school district in the…

  16. A Review of Eating Disorders in Athletes: Recommendations for Secondary School Prevention and Intervention Programs

    ERIC Educational Resources Information Center

    Hildebrandt, Tom

    2005-01-01

    The current review aims to evaluate the literature on eating disorders and athletes with the purpose of making recommendations for sport psychologists and other relevant personnel on how to proceed in identifying, managing, and preventing eating disorders in school settings. Whereas the intention of this review is to make recommendations for…

  17. Stress-Prevention in Secondary Schools: Online- versus Face-to-Face-Training

    ERIC Educational Resources Information Center

    Fridrici, Mirko; Lohaus, Arnold

    2009-01-01

    Purpose: The purpose of this paper is to focus on the evaluation of an internet-delivered stress-prevention program for adolescents as a possible alternative for school-based implementation of mental health promotion. Design/methodology/approach: A total of 904 adolescents in grades eight and nine were assigned to four treatment conditions…

  18. Wraparound Services: Infusion into Secondary Schools as a Dropout Prevention Strategy

    ERIC Educational Resources Information Center

    Fries, Derrick; Carney, Karen J.; Blackman-Urteaga, Laura; Savas, Sue Ann

    2012-01-01

    For more than 20 years, the efficacy of using the wraparound approach to support high-risk youth has been examined in educational and community settings. Few studies show the value of wraparound service from either a school- or community-based agency as a dropout prevention strategy. Findings from a federal research grant project suggest that many…

  19. Using EQUIP for Educators to Prevent Peer Victimization in Secondary School

    ERIC Educational Resources Information Center

    van der Meulen, Kevin; Granizo, Laura; del Barrio, Cristina

    2010-01-01

    Peer victimization has received much attention from researchers and educators over the last decade, since it is a problem that affects children and adolescents. As more time-extensive programs do not seem to be used in schools, in this article the "EQUIP" program for "Educators" is proposed as an instrument for the prevention of peer bullying and…

  20. Secondary Prevention Efforts at the Middle School Level: An Application of the Behavior Education Program

    ERIC Educational Resources Information Center

    Lane, Kathleen Lynne; Capizzi, Andrea M.; Fisher, Marisa H.; Ennis, Robin Parks

    2012-01-01

    In this study we examine the impact of the Behavior Education Program (BEP; Hawken, MacLeod, & Rawlings, 2007) with four middle school students who were not responsive to a comprehensive primary prevention program including academic, behavioral and social components. To extend this line of inquiry we (a) conducted a functional behavioral…

  1. Laying the Groundwork for an Interdisciplinary Effort Aimed at Prevention of Pregnancy among Middle School Students. Phase IV: Revised Curriculum. Final Report. July 1981 to June 1982.

    ERIC Educational Resources Information Center

    University of West Florida, Pensacola.

    This revised curriculum, developed for use in Florida middle schools, is a comprehensive family life education course. The content of the course was determined (1) through a "Needs Assessment Inventory for Teenage Pregnancy Prevention," which was sent to more than 1,200 home economics teachers in Florida (and returned by the majority of them), and…

  2. Cancer prevention as biomodulation: targeting the initiating stimulus and secondary adaptations.

    PubMed

    Furth, Priscilla A

    2012-10-01

    In a medical sense, biomodulation could be considered a biochemical or cellular response to a disease or therapeutic stimulus. In cancer pathophysiology, the initial oncogenic stimulus leads to cellular and biochemical changes that allow cells, tissue, and organism to accommodate and accept the oncogenic insult. In epithelial cell cancer development, the process of carcinogenesis is frequently characterized by sequential cellular and biochemical adaptations as cells transition through hyperplasia, dysplasia, atypical dysplasia, carcinoma in situ, and invasive cancer. In some cases, the adaptations may persist after the initial oncogenic stimulus is gone in a type of "hit-and-run" oncogenesis. These pathophysiological changes may interfere with cancer prevention therapies targeted solely to the initial oncogenic insult, perhaps contributing to resistance development. Characterization of these accommodating adaptations could provide insight for the development of cancer preventive regimens that might more effectively biomodulate preneoplastic cells toward a more normal state. PMID:23050958

  3. Analyzing Direct Effects in Randomized Trials with Secondary Interventions: An Application to HIV Prevention Trials.

    PubMed

    Rosenblum, Michael; Jewell, Nicholas P; van der Laan, Mark; Shiboski, Steve; van der Straten, Ariane; Padian, Nancy

    2009-04-01

    The Methods for Improving Reproductive Health in Africa (MIRA) trial is a recently completed randomized trial that investigated the effect of diaphragm and lubricant gel use in reducing HIV infection among susceptible women. 5,045 women were randomly assigned to either the active treatment arm or not. Additionally, all subjects in both arms received intensive condom counselling and provision, the "gold standard" HIV prevention barrier method. There was much lower reported condom use in the intervention arm than in the control arm, making it difficult to answer important public health questions based solely on the intention-to-treat analysis. We adapt an analysis technique from causal inference to estimate the "direct effects" of assignment to the diaphragm arm, adjusting for condom use in an appropriate sense. Issues raised in the MIRA trial apply to other trials of HIV prevention methods, some of which are currently being conducted or designed. PMID:20827388

  4. Analyzing Direct Effects in Randomized Trials with Secondary Interventions: An Application to HIV Prevention Trials

    PubMed Central

    Rosenblum, Michael; Jewell, Nicholas P.; van der Laan, Mark; Shiboski, Steve; van der Straten, Ariane; Padian, Nancy

    2010-01-01

    Summary The Methods for Improving Reproductive Health in Africa (MIRA) trial is a recently completed randomized trial that investigated the effect of diaphragm and lubricant gel use in reducing HIV infection among susceptible women. 5,045 women were randomly assigned to either the active treatment arm or not. Additionally, all subjects in both arms received intensive condom counselling and provision, the “gold standard” HIV prevention barrier method. There was much lower reported condom use in the intervention arm than in the control arm, making it difficult to answer important public health questions based solely on the intention-to-treat analysis. We adapt an analysis technique from causal inference to estimate the “direct effects” of assignment to the diaphragm arm, adjusting for condom use in an appropriate sense. Issues raised in the MIRA trial apply to other trials of HIV prevention methods, some of which are currently being conducted or designed. PMID:20827388

  5. Prevention at school level. Hong Kong: a kit for secondary school teachers.

    PubMed

    1993-01-01

    The Social Studies (Secondary) Curriculum Development Team in Hong Kong began work on acquired immunodeficiency syndrome (AIDS) education in 1987. Since then, a teaching kit consisting of four parts has been prepared as a reference for secondary school teachers. The kit provides basic information on AIDS and suggests student activities that cultivate fuller understanding and healthy attitudes in students. Part I, Reference Materials for Teachers, consists of information sheets, a glossary of terms, and a list of materials on AIDS and other blood-borne diseases. Part II, Information Sheets for Students, like Part I, discusses one aspect of the disease per page; however, the information given is the minimum essential amount and the pages are illustrated for better understanding. Part III, Worksheets for Students, is experimental; teachers may use other exercises or activities. A key and audio-visual materials are provided. The latter illustrate Parts I and II; the ideas may be used for making posters or designing bulletin boards. Part IV, Overhead Transparencies, can be used for classroom teaching. PMID:12179321

  6. The Role of Diet and Lifestyle in Primary, Secondary, and Tertiary Diabetes Prevention: A Review of Meta-Analyses

    PubMed Central

    Psaltopoulou, Theodora; Ilias, Ioannis; Alevizaki, Maria

    2010-01-01

    Prevention of diabetes is crucial to lowering disease incidence, and thus minimizing the individual, familial, and public health burden. The purpose of this review is to gather current information from meta-analyses on dietary and lifestyle practices concerning reduction of risk to develop type 2 diabetes. Low glycemic index dietary patterns reduce both fasting blood glucose and glycated proteins independent of carbohydrate consumption. Diets rich in whole-grain, cereal high fiber products, and non-oil-seed pulses are beneficial. Whereas, frequent meat consumption has been shown to increase risk. Regarding non-alcoholic beverages, 4 cups/day of filtered coffee or tea are associated with a reduced diabetes risk. In contrast, the consumption of alcoholic beverages should not exceed 1-3 drinks/day. Intake of vitamin E, carotenoids, and magnesium can be increased to counteract diabetes risk. Obesity is the most important factor accounting for more than half of new diabetes' cases; even modest weight loss has a favorable effect in preventing the appearance of diabetes. Also, physical exercise with or without diet contributes to a healthier lifestyle, and is important for lowering risk. Finally, there is a positive association between smoking and risk to develop type 2 diabetes. As far as secondary and tertiary prevention is concerned, for persons already diagnosed with diabetes, there is limited evidence of the effectiveness of diet or lifestyle modification on glycemic control, but further studies are necessary. PMID:20703436

  7. The role of diet and lifestyle in primary, secondary, and tertiary diabetes prevention: a review of meta-analyses.

    PubMed

    Psaltopoulou, Theodora; Ilias, Ioannis; Alevizaki, Maria

    2010-01-01

    Prevention of diabetes is crucial to lowering disease incidence, and thus minimizing the individual, familial, and public health burden. The purpose of this review is to gather current information from meta-analyses on dietary and lifestyle practices concerning reduction of risk to develop type 2 diabetes. Low glycemic index dietary patterns reduce both fasting blood glucose and glycated proteins independent of carbohydrate consumption. Diets rich in whole-grain, cereal high fiber products, and non-oil-seed pulses are beneficial. Whereas, frequent meat consumption has been shown to increase risk. Regarding non-alcoholic beverages, 4 cups/day of filtered coffee or tea are associated with a reduced diabetes risk. In contrast, the consumption of alcoholic beverages should not exceed 1-3 drinks/day. Intake of vitamin E, carotenoids, and magnesium can be increased to counteract diabetes risk. Obesity is the most important factor accounting for more than half of new diabetes' cases; even modest weight loss has a favorable effect in preventing the appearance of diabetes. Also, physical exercise with or without diet contributes to a healthier lifestyle, and is important for lowering risk. Finally, there is a positive association between smoking and risk to develop type 2 diabetes. As far as secondary and tertiary prevention is concerned, for persons already diagnosed with diabetes, there is limited evidence of the effectiveness of diet or lifestyle modification on glycemic control, but further studies are necessary. PMID:20703436

  8. Insects: An Interdisciplinary Unit

    ERIC Educational Resources Information Center

    Leger, Heather

    2007-01-01

    The author talks about an interdisciplinary unit on insects, and presents activities that can help students practice communication skills (interpersonal, interpretive, and presentational) and learn about insects with hands-on activities.

  9. Interdisciplinary Approaches to Astronomy.

    ERIC Educational Resources Information Center

    Fraknoi, Andrew

    1986-01-01

    Provides a bibliography of materials which deal with astronomy and: (1) science fiction; (2) poetry; (3) general fiction; (4) music; (5) psychology; and (6) the law. Also cites two general references on interdisciplinary approaches with astronomy topics. (JN)

  10. Lead-tainted crayons from China. Part 1: Secondary prevention in Arizona

    SciTech Connect

    Arreola, P.; Fowler, C.; Schaller, K.; Weaver, Z.; Neumann, C.; Boyer, L.

    1996-03-01

    The Arizona Department of Health Services (ADHS) identified lead-containing crayons from China as a likely source in the lead poisoning of an 11 month-old child. This finding sparked nationwide attention which, in coordination with data from the Oregon Health Division (OHD), led to the US Consumer Product Safety Commission (CPSC) recall of 13 brands of crayons. This paper describes the events leading to the recall and illustrates the role of public health agencies in a comprehensive childhood lead poisoning prevention program. In particular, background screening and surveillance were key to the identification of this previously unknown lead poisoning risk, lead-tainted crayons.

  11. Effects of Steroids and Curcumin on Prevention of Laryngeal Stenosis Secondary to Trauma

    PubMed Central

    Iravani, Kamyar; Babaie, Zahra; Ashraf, Mohammad-Javad; Tanideh, Nader

    2016-01-01

    Introduction: The aim of this study was to compare the preventive effects of corticosteroids and curcumin on subglottic stenosis in an animal model. Materials and Methods: Twenty-one male German Shepherd dogs were used for this study. After standardized trauma to the subglottic area, the dogs were divided into three groups. Group A received curcumin (450 mg/ day) for 15 days; Group B received beclomethasone (2 puffs/day, 50 µg/dose) for 15 days; Group C received saline spray only. At 6 weeks after the injury, the larynx specimens were examined histopathologically to assess epithelialization, inflammation, and fibrosis. Results: Complete epithelial covering of the steroid-treated group was significantly less than that of the control group. Despite inflammation and fibrosis, there was no significant difference between the steroid and control groups. In the curcumin-treated group, there was no significant difference between the groups. Conclusion: Topically applied steroid decreases epithelialization after induced subglottic injury. It is recommended that further studies be conducted in order to investigate the effects of the two drugs on airway stenosis prevention. PMID:27602335

  12. [Statins in the secondary prevention of stroke: New evidence from the SPARCL Study].

    PubMed

    Castilla-Guerra, Luis; Fernández-Moreno, María Del Carmen; López-Chozas, José Manuel

    2016-01-01

    Until recently there was little evidence that statin therapy reduced the risk of stroke recurrence. The SPARCL trial, published in 2006, was the first trial to show the benefits of statin therapy in preventing recurrent stroke. The SPARCL trial showed that treatment with atorvastatin 80mg/day reduced recurrent stroke in patients with a recent stroke or transient ischemic attack (TIA). Several post hoc analyses of different subgroups followed the SPARCL trial. They have not revealed any significant differences when patients were grouped by age, sex or type of stroke. The SPARCL trial has also helped to identify patients who may have a greater benefit from statins: Patients with carotid stenosis, with more intense lipid lowering, and those who achieve optimal levels of LDL-C, HDL-C, triglycerides, and blood pressure. The trial has also helped to identify individuals at high risk of new vascular events. Clearly there is a before and after in stroke prevention since the SPARCL trial was published. PMID:26150172

  13. Prevention of medication-related osteonecrosis of the jaws secondary to tooth extractions. A systematic review

    PubMed Central

    Limeres, Jacobo

    2016-01-01

    Background A study was made to identify the most effective protocol for reducing the risk of osteonecrosis of the jaws (ONJ) following tooth extraction in patients subjected to treatment with antiresorptive or antiangiogenic drugs. Material and Methods A MEDLINE and SCOPUS search (January 2003 - March 2015) was made with the purpose of conducting a systematic literature review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. All articles contributing information on tooth extractions in patients treated with oral or intravenous antiresorptive or antiangiogenic drugs were included. Results Only 13 of the 380 selected articles were finally included in the review: 11 and 5 of them offered data on patients treated with intravenous and oral bisphosphonates, respectively. No randomized controlled trials were found – all publications corresponding to case series or cohort studies. The prevalence of ONJ in the patients treated with intravenous and oral bisphosphonates was 6,9% (range 0-34.7%) and 0.47% (range 0-2.5%), respectively. The main preventive measures comprised local and systemic infection control. Conclusions No conclusive scientific evidence is available to date on the efficacy of ONJ prevention protocols in patients treated with antiresorptive or antiangiogenic drugs subjected to tooth extraction. Key words:Bisphosphonates, angiogenesis inhibitors, antiresorptive drugs, extraction, osteonecrosis. PMID:26827065

  14. A polypill strategy to improve global secondary cardiovascular prevention: from concept to reality.

    PubMed

    Castellano, José M; Sanz, Ginés; Fernandez Ortiz, Antonio; Garrido, Ester; Bansilal, Sameer; Fuster, Valentin

    2014-08-12

    The prevention of cardiovascular disease (CVD) by using a polypill has gained increasing momentum as a strategy to contain progression of the disease. Since its initial conception just over a decade ago, only a handful of trials have been completed assessing the efficacy and safety of this innovative concept. The results of these trials have supported the viability of the polypill in CVD prevention and management, albeit with a few caveats, essentially related to the lack of evidence on the effect of the polypill to effectively reduce cardiovascular events. The polypill has the potential to control the global health epidemic of CVD by effectively reaching underdeveloped regions of the world, simplifying healthcare delivery, improving cost-effectiveness, increasing medication adherence, and supporting a comprehensive prescription of evidence-based cardioprotective drugs. Major trials underway will provide definitive evidence on the efficacy of the polypill in reducing cardiovascular events in a cost-effective manner. The results of these studies will determine whether a polypill strategy can quell the burgeoning public health challenge of CVD and will potentially provide the evidence to implement an effective, simple, and innovative solution to restrain the global CVD pandemic. PMID:25104532

  15. PA32540 for the secondary prevention of cardiovascular disease in patients at risk for aspirin-associated gastric ulcers

    PubMed Central

    Duffy, Danielle; Rooney, Bridget; Adams, Suzanne; Whellan, David J

    2014-01-01

    Prescribed in patients with a history of myocardial infarction, stroke, transient ischemic attack, coronary intervention or bypass surgery, aspirin is one of the medications most commonly used in the secondary prevention of cardiovascular diseases. It has become a mainstay of therapy after years of solid evidence supporting its efficacy in clinical trials. However, a number of risks and side effects accompany its benefits, including the notable risk of bleeding and gastrointestinal side effects. Numerous mechanisms have been proposed to attenuate these effects to promote adherence and to expand the population for which aspirin is a reasonable treatment option. A polypill or combination formulation that includes a proton pump inhibitor, a drug commonly prescribed alongside aspirin, is one potential avenue of therapy. One such combination pill, PA32540, has undergone Phase I and Phase III trials and shows promising safety and efficacy results in these preliminary trials. PMID:25300316

  16. Management of stroke risk factors during the process of rehabilitation. Secondary stroke prevention.

    PubMed

    Halar, E M

    1999-11-01

    Epidemiologic and prospective cohort studies have shown a strong correlation between risk factors and stroke morbidity and mortality. The reduction or control of risk factors, on the other hand, can reduce stroke morbidity and mortality. Rehabilitation professionals involved in comprehensive rehabilitation of stroke patients may include the management of risk factors in the scope of their practice and thus contribute to longer life expectancy and improved quality of life of these patients. Decreasing disability, improving quality of life, and prolonging life are chief goals of the rehabilitation process. This article reviews the rationale for risk management and stresses the value of aerobic and conditioning exercises and is intended to supplement the article on stroke prevention co-authored by Daryl Gress and Vineeta Singh. PMID:10573711

  17. Basis and consequences of primary and secondary prevention of gastrointestinal tumors.

    PubMed

    Goldin-Lang, P; Kreuser, E D; Zunft, H J

    1996-01-01

    Carcinomas of the gastrointestinal tract (GI) are among the most common malignancies with regard to their incidence and mortality. Nutritional factors play an important role in the tumor development. The strength of their influence varies with the localization in the GI tract. Epidemiological studies focusing on GI cancer incidence or mortality as an endpoint necessitate large numbers of subjects to achieve significant results. Generally, a low energy and fat intake and a high intake of antioxidative vitamins (vitamin C, E, beta-carotene) and secondary plant metabolites (especially polyphenols) appear to be protective in GI carcinogenesis. Moderate drinking of alcohol and increased consumption of whole grain products, as opposed to highly refined carbohydrates, may help to reduce the risk of colon cancer. The recommended type of diet is low in fat, especially in saturated fatty acids, includes monounsaturated fatty acids, and includes moderate amounts of polyunsaturated fatty acids (no more than 10% of calories). Moderate consumption of salt and of highly salted, smoked, and barbecued foods should be encouraged. Obesity should be avoided by trying to match energy intake with expenditure while increasing physical activity levels. The mechanisms by which nutritional factors act especially on molecular events still remain to be examined. The use of molecular biomarkers will help us better understand cancer development as well as the role and significance of nutritional factors in this process. PMID:8893341

  18. The plant secondary metabolite citral alters water status and prevents seed formation in Arabidopsis thaliana.

    PubMed

    Graña, E; Díaz-Tielas, C; López-González, D; Martínez-Peñalver, A; Reigosa, M J; Sánchez-Moreiras, A M

    2016-05-01

    Based on previous results, which showed that the secondary metabolite citral causes disturbances to plant water status, the present study is focused on demonstrating and detailing these effects on the water-related parameters of Arabidopsis thaliana adult plants, and their impact on plant fitness. Clear evidence of effects on water status and fitness were observed: plants treated with 1200 and 2400 μm citral showed decreased RWC, reduced Ψs , increased Ψw and reduced stomatal opening, even 7 days after the beginning of the experiment. Plant protection signals, such as leaf rolling or increased anthocyanin content, were also detected in these plants. In contrast, 14 days after beginning the treatment, treated plants showed signs of citral-related damage. Moreover, the reproductive success of treated plants was critically compromised, with prematurely withered flowers and no silique or seed development. This effect of citral on fitness of adult plants suggests a promising application of this natural compound in weed management by reducing the weed seed bank in the soil. PMID:26587965

  19. Contemporary Reflections on the Safety of Long-Term Aspirin Treatment for the Secondary Prevention of Cardiovascular Disease.

    PubMed

    Fanaroff, Alexander C; Roe, Matthew T

    2016-08-01

    Aspirin has been the cornerstone of therapy for the secondary prevention treatment of patients with cardiovascular disease since landmark trials were completed in the late 1970s and early 1980s that demonstrated the efficacy of aspirin for reducing the risk of ischemic events. Notwithstanding the consistent benefits demonstrated with aspirin for both acute and chronic cardiovascular disease, there are a number of toxicities associated with aspirin that have been showcased by recent long-term clinical trials that have included an aspirin monotherapy arm. As an inhibitor of cyclooxygenase (COX), aspirin impairs gastric mucosal protective mechanisms. Previous trials have shown that up to 15-20 % of patients developed gastrointestinal symptoms with aspirin monotherapy, and approximately 1 % of patients per year had a clinically significant bleeding event, including 1 in 1000 patients who suffered an intracranial or fatal bleed. These risks have been shown to be compounded for patients with acute coronary syndromes (ACS) and those undergoing percutaneous coronary intervention (PCI) who are also treated with other antithrombotic agents during the acute care/procedural period, as well as for an extended time period afterwards. Given observations of substantial increases in bleeding rates from many prior long-term clinical trials that have evaluated aspirin together with other oral platelet inhibitors or oral anticoagulants, the focus of contemporary research has pivoted towards tailored antithrombotic regimens that attempt to either shorten the duration of exposure to aspirin or replace aspirin with an alternative antithrombotic agent. While these shifts are occurring, the safety profile of aspirin when used for the secondary prevention treatment of patients with established cardiovascular disease deserves further consideration. PMID:27028617

  20. Antiplatelet Agents for the Secondary Prevention of Ischemic Stroke or Transient Ischemic Attack: A Network Meta-Analysis.

    PubMed

    Wang, Wen; Zhang, Lu; Liu, Weiming; Zhu, Qin; Lan, Qing; Zhao, Jizong

    2016-05-01

    Stroke can cause high morbidity and mortality, and ischemic stroke (IS) and transient ischemic attack (TIA) patients have a high stroke recurrence rate. Antiplatelet agents are the standard therapy for these patients, but it is often difficult for clinicians to select the best therapy from among the multiple treatment options. We therefore performed a network meta-analysis to estimate the efficacy of antiplatelet agents for secondary prevention of recurrent stroke. We systematically searched 3 databases (PubMed, Embase, and Cochrane) for relevant studies published through August 2015. The primary end points of this meta-analysis were overall stroke, hemorrhagic stroke, and fatal stroke. A total of 30 trials were included in our network meta-analysis and abstracted data. Among the therapies evaluated in the included trials, the estimates for overall stroke and hemorrhagic stroke for cilostazol (Cilo) were significantly better than those for aspirin (odds ratio [OR] = .64, 95% credibility interval [CrI], .45-.91; OR = .23, 95% CrI, .08-.58). The estimate for fatal stroke was highest for Cilo plus aspirin combination therapy, followed by Cilo therapy. The results of our meta-analysis indicate that Cilo significantly improves overall stroke and hemorrhagic stroke in IS or TIA patients and reduces fatal stroke, but with low statistical significance. Our results also show that Cilo was significantly more efficient than other therapies in Asian patients; therefore, future trials should focus on Cilo treatment for secondary prevention of recurrent stroke in non-Asian patients. PMID:26856461

  1. A retrospective comparison of techniques to prevent secondary cataract formation following posterior chamber intraocular lens implantation in infants and children.

    PubMed Central

    Koch, D D; Kohnen, T

    1997-01-01

    PURPOSE: To determine the effect of various methods of managing the posterior capsule and anterior vitreous on the rate of posterior capsular opacification in children implanted with posterior chamber intraocular lenses (PC IOL). METHODS: We reviewed the charts of 20 eyes of 15 children (1.5-12 years) who underwent primary cataract surgery with PC IOL in the last 5 years. The posterior capsule and anterior vitreous were managed in a variety of ways: in 5 eyes the posterior capsule was left intact, and 15 eyes underwent posterior continuous curvilinear capsulorhexis (PCCC)-nine cases without and 6 with anterior vitrectomy. In 8 eyes posterior optic capture was performed, 3 with and 5 without vitrectomy. The follow-up ranged from 1 to 4.5 years (mean: 2 years). RESULTS: Visually significant secondary cataract developed in all 5 eyes with intact posterior capsules and in the 4 eyes that underwent PCCC without vitrectomy and without posterior optic capture (i.e., the optic was left in the capsular bag). The optical axis remained clear in all 6 eyes that underwent PC IOL implantation with vitrectomy (with or without posterior optic capture). Initially, all optic capture cases without vitrectomy also remained clear, but after 6 months 4 out of 5 developed opacification. CONCLUSIONS: In this series posterior capsulorhexis with anterior vitrectomy was the only effective method of preventing or delaying secondary cataract formation in infants and children. Images FIGURE 2 FIGURE 4 A FIGURE 4 B FIGURE 4 C PMID:9440179

  2. A Web-Based, Computer-Tailored Smoking Prevention Program to Prevent Children From Starting to Smoke After Transferring to Secondary School: Randomized Controlled Trial

    PubMed Central

    Mercken, Liesbeth; Candel, Math; de Vries, Hein; Oenema, Anke

    2015-01-01

    Background Smoking prevalence rates among Dutch children increase rapidly after they transit to secondary school, in particular among children with a low socioeconomic status (SES). Web-based, computer-tailored programs supplemented with prompt messages may be able to empower children to prevent them from starting to smoke when they transit to secondary school. Objective The main aim of this study is to evaluate whether computer-tailored feedback messages, with and without prompt messages, are effective in decreasing children’s smoking intentions and smoking behavior after 12 and 25 months of follow-up. Methods Data were gathered at baseline (T0), and after 12 months (T1) and 25 months (T2) of follow-up of a smoking prevention intervention program called Fun without Smokes. A total of 162 schools were randomly allocated to a no-intervention control group, an intervention prompt group, or an intervention no-prompt group. A total of 3213 children aged 10 to 12 years old participated in the study and completed a Web-based questionnaire assessing their smoking intention, smoking behavior, and sociocognitive factors, such as attitude, social influence, and self-efficacy, related to smoking. After completion, children in the intervention groups received computer-tailored feedback messages in their own email inbox and those messages could be accessed on the intervention website. Children in the prompt group received prompt messages, via email and short message service (SMS) text messaging, to stimulate them to reuse the intervention website with nonsmoking content. Multilevel logistic regression analyses were performed using multiple imputations to assess the program effects on smoking intention and smoking behavior at T1 and T2. Results A total of 3213 children participated in the Fun without Smokes study at T0. Between T0 and T1 a total of 1067 children out of the original 3213 (33.21%) dropped out of the study. Between T0 and T2 the number of children that did not

  3. Familial Breast Cancer – Targeted Therapy in Secondary and Tertiary Prevention

    PubMed Central

    Kast, Karin; Rhiem, Kerstin

    2015-01-01

    Summary The introduction of an increasing number of individualized molecular targeted therapies into clinical routine mirrors their importance in modern cancer prevention and treatment. Well-known examples for targeted agents are the monoclonal antibody trastuzumab and the selective estrogen receptor modulator tamoxifen. The identification of an unaltered gene in tumor tissue in colon cancer (KRAS) is a predictor for the patient's response to targeted therapy with a monoclonal antibody (cetuximab). Targeted therapy for hereditary breast and ovarian cancer has become a reality with the approval of olaparib for platin-sensitive late relapsed BRCA-associated ovarian cancer in December 2014. This manuscript reviews the status quo of poly-ADP-ribose polymerase inhibitors (PARPi) in the therapy of breast and ovarian cancer as well as the struggle for carboplatin as a potential standard of care for triple-negative and, in particular, BRCA-associated breast cancer. Details of the mechanism of action with information on tumor development are provided, and an outlook for further relevant research is given. The efficacy of agents against molecular targets together with the identification of an increasing number of cancer-associated genes will open the floodgates to a new era of treatment decision-making based on molecular tumor profiles. Current clinical trials involving patients with BRCA-associated cancer explore the efficacy of the molecular targeted therapeutics platinum and PARPi. PMID:25960722

  4. The prevalence of intolerance for low-dose acetylsalicylacid in the secondary prevention of atherothrombosis.

    PubMed

    Tournoij, E; Peters, R J G; Langenberg, M; Kanhai, K J K; Moll, F L

    2009-05-01

    Daily low-dose acetylsalicylacid (ASA) is prescribed to patients with atherothrombosis frequently to prevent vascular complications. In reports on complications and side effects of low-dose ASA use in the literature there is a range of definitions. We explored the incidence, characteristics and consequences of symptoms suggestive of ASA intolerance in patients on low-dose ASA. General practitioners and specialists in 105 centres were asked to review their patient files for the last 10 consecutive patients who were prescribed ASA. Participating patients completed a questionnaire about their current ASA use (doctors completed the questionnaire together with the patients), use of co-medication and symptoms suggestive of ASA intolerance. A total of 947 patients were included in this study. Sixty patients (6.6%) had ceased ASA treatment, predominantly because of the occurrence of side effects suspected to be caused by ASA use. A quarter of the patients concomitantly used an anti-acid agent. Of the 947 patients, 271 (30.6%) indicated symptoms during ASA intake. The most common symptoms were related to the gastrointestinal tract (25.1%). In patients prescribed a low-dose of ASA monotherapy, side effects suggestive of intolerance are common. More awareness should be created to detect and treat these symptoms, because the occurrence of side effects is the most important reason for patients to discontinue ASA treatment. PMID:19297216

  5. Prevention

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Prevention Basic Facts & Information Some factors that affect your ... control of the things that you can change. Preventive Recommendations for Adults Aged 65 and Older The ...

  6. Lithium prevents early cytosolic calcium increase and secondary injurious calcium overload in glycolytically inhibited endothelial cells

    SciTech Connect

    Bosche, Bert; Schäfer, Matthias; Graf, Rudolf; Härtel, Frauke V.; Schäfer, Ute; Noll, Thomas

    2013-05-03

    Highlights: •We investigate free calcium as a central signalling element in endothelial cells. •Inhibition of glycolysis with 2-deoxy-D-glucose reduces cellular ATP. •This manoeuvre leads to a biphasic increase and overload of free calcium. •Pre-treatment with lithium for 24 h abolishes both phases of the calcium increase. •This provides a new strategy to protect endothelial calcium homeostasis and barrier function. -- Abstract: Cytosolic free calcium concentration ([Ca{sup 2+}]{sub i}) is a central signalling element for the maintenance of endothelial barrier function. Under physiological conditions, it is controlled within narrow limits. Metabolic inhibition during ischemia/reperfusion, however, induces [Ca{sup 2+}]{sub i} overload, which results in barrier failure. In a model of cultured porcine aortic endothelial monolayers (EC), we addressed the question of whether [Ca{sup 2+}]{sub i} overload can be prevented by lithium treatment. [Ca{sup 2+}]{sub i} and ATP were analysed using Fura-2 and HPLC, respectively. The combined inhibition of glycolytic and mitochondrial ATP synthesis by 2-desoxy-D-glucose (5 mM; 2-DG) plus sodium cyanide (5 mM; NaCN) caused a significant decrease in cellular ATP content (14 ± 1 nmol/mg protein vs. 18 ± 1 nmol/mg protein in the control, n = 6 culture dishes, P < 0.05), an increase in [Ca{sup 2+}]{sub i} (278 ± 24 nM vs. 71 ± 2 nM in the control, n = 60 cells, P < 0.05), and the formation of gaps between adjacent EC. These observations indicate that there is impaired barrier function at an early state of metabolic inhibition. Glycolytic inhibition alone by 10 mM 2-DG led to a similar decrease in ATP content (14 ± 2 nmol/mg vs. 18 ± 1 nmol/mg in the control, P < 0.05) with a delay of 5 min. The [Ca{sup 2+}]{sub i} response of EC was biphasic with a peak after 1 min (183 ± 6 nM vs. 71 ± 1 nM, n = 60 cells, P < 0.05) followed by a sustained increase in [Ca{sup 2+}]{sub i}. A 24-h pre-treatment with 10 mM of lithium

  7. Prevention and Immunotherapy of Secondary Murine Alveolar Echinococcosis Employing Recombinant EmP29 Antigen

    PubMed Central

    Boubaker, Ghalia; Hemphill, Andrew; Huber, Cristina Olivia; Spiliotis, Markus; Babba, Hamouda; Gottstein, Bruno

    2015-01-01

    Alveolar echinococcosis (AE) is caused by infection with the larval stage of the tapeworm Echinococcus multilocularis. An increasing understanding of immunological events that account for the metacestode survival in human and murine AE infection prompted us to undertake explorative experiments tackling the potential of novel preventive and/or immunotherapeutic measures. In this study, the immunoprotective and immunotherapeutic ability of recombinant EmP29 antigen (rEmP29) was assessed in mice that were intraperitoneally infected with E. multilocularis metacestodes. For vaccination, three intraperitoneal injections with 20μg rEmP29 emulsified in saponin adjuvants were applied over 6 weeks. 2 weeks after the last boost, mice were infected, and at 90 days post-infection, rEmP29-vaccinated mice exhibited a median parasite weight that was reduced by 75% and 59% when compared to NaCl- or saponin–treated control mice, respectively. For immunotherapeutical application, the rEmP29 (20μg) vaccine was administered to experimentally infected mice, starting at 1 month post-infection, three times with 2 weeks intervals. Mice undergoing rEmP29 immunotherapy exhibited a median parasite load that was reduced by 53% and 49% when compared to NaCl- and saponin–treated control mice, respectively. Upon analysis of spleen cells, both, vaccination and treatment with rEmP29, resulted in low ratios of Th2/Th1 (IL-4/IFN-γ) cytokine mRNA and low levels of mRNA coding for IL-10 and IL-2. These results suggest that reduction of the immunosuppressive environment takes place in vaccinated as well as immunotreated mice, and a shift towards a Th1 type of immune response may be responsible for the observed increased restriction of parasite growth. The present study provides the first evidence that active immunotherapy may present a sustainable route for the control of AE. PMID:26053794

  8. Secondary syphilis in the oral cavity and the role of the dental surgeon in STD prevention, diagnosis and treatment: a case series study.

    PubMed

    Seibt, Creta Elisa; Munerato, Maria Cristina

    2016-01-01

    Syphilis is an infectious disease caused by the bacterium Treponema pallidum. Syphilis has three clinical stages and may present various oral manifestations, mainly at the secondary stage. The disease mimics other more common oral mucosa lesions, going undiagnosed and with no proper treatment. Despite the advancements in medicine toward prevention, diagnosis, and treatment syphilis remains a public health problem worldwide. In this sense, dental surgeons should be able to identify the most common manifestations of the disease in the oral cavity, pointing to the role of this professional in prevention and diagnosis. This study describes a case series of seven patients with secondary syphilis presenting different oral manifestations. PMID:27208390

  9. Long-term secondary prevention programs after cardiac rehabilitation for the reduction of future cardiovascular events: focus on regular physical activity.

    PubMed

    Scrutinio, Domenico; Temporelli, Pier Luigi; Passantino, Andrea; Giannuzzi, Pantaleo

    2009-05-01

    Cardiac rehabilitation/secondary prevention programs are recognized as integral to the comprehensive care of patients with coronary heart disease, and as such are recommended in most contemporary clinical practice guidelines. The interventions are aimed at reducing disability, optimizing cardiovascular risk reduction by drug therapy and promoting healthy behavior. Healthy lifestyle habits must be recognized as capable of substantially reducing the risk for cardiovascular events in patients with coronary heart disease. This review highlights the recommended components of cardiac rehabilitation/secondary prevention programs, with special emphasis on regular physical activity. PMID:19450055

  10. [Effectiveness of secondary preventive programs for patients with asthma and rhinitis in the baking industry].

    PubMed

    Grieshaber, R; Nolting, H D; Rosenau, C; Stauder, J; Vonier, J

    1998-11-01

    Since 1992 the German industrial professional association for the food industry and gastronomy (Berufsgenossenschaft Nahrungsmittel und Gaststätten), which is responsible for statutory accident insurance has been offering a specific patient education programme to bakers suffering from occupationally induced obstructive pulmonary disease or allergic rhino-conjunctivitis, who do not quit their jobs and wish to continue working as bakers. The programme aims at preventing aggravation of the disease 74 male bakers with a mean duration of illness of 10 years on entering the programme were examined between 1 and 5 years (mean: 2.9) after participating in the patient education seminar. For a subpopulation of 55 of these patients spirometric measurements were available for the time before programme entry and at follow-up. Data on time spent at the bakehouse, prevalence of symptoms, frequency of symptoms at the site of working and during leisure hours, sleep disturbances and emergency situations were collected at the follow-up examination both for the time before programme entry and at follow-up, respectively. Direct ratings of the amount of changes in distress caused by the disease and of the quality of life were also obtained. The prevalence of 8 of the 9 most frequently reported symptoms decreased significantly, e.g. dysponoea from 70% to 42% and fear of suffocation from 30% to 3%. Participants reported on highly significant reductions in the frequency of disease-specific complaints during work and outside the working place, sleep disturbances and situations requiring immediate medical intervention. Between 64% and 85% of the patients experienced improvement of distress, physical and work performance, private and family life, and ability for self-management. Lung function did not deteriorate: mean FEV1 was 88% (+/- 23) at first and 90% (+/- 19) at second measurement. These results could not be explained by changes in medication. It is concluded that the programme is

  11. Pharmacological primary and secondary cardiovascular prevention among diabetic patients in a multiethnic general practice population: still room for improvements

    PubMed Central

    2013-01-01

    Background Ethnic minority groups have higher prevalence of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). We assessed general practitioners’ (GPs’) performance with respect to the pharmacological prevention of CVD in patients with T2DM from different ethnic backgrounds in Oslo. Methods Of 1653 T2DM patients cared for by 49 GPs in 2005, 380 had a diagnosis of CVD. Ethnicity was categorized as Norwegian, South Asian and other. Risk factor levels, medication use, achievement of treatment targets (HbA1c ≤ 7.5%, systolic blood pressure (SBP) ≤ 140 mmHg, total cholesterol/HDL-cholesterol < 4) and therapeutic intensity (number of drugs targeting each risk factor) were recorded. Chi-square, Wald tests and multiple linear regression analyses were used. Results Of the 1273 patients receiving primary prevention, 1.5% had their Hb1Ac, 4.8% SBP and 12.7% lipids levels above treatment thresholds without relevant prescriptions. Among patients on pharmacological therapy, 66% reached the HbA1c, 62% SBP and 62% lipid target. Proportions not achieving the HbA1c target were 26% in Norwegians, 38% in South Asians and 29% in others (p = 0.008). Proportions not achieving the SBP target were 42% in Norwegians, 22% in South Asians and 25% in others (p ≤ 0.001). Of those not achieving the HbA1c and SBP targets, 43% and 35% respectively, used only one agent. In secondary prevention, 0.8% of the patients had their HbA1c, 0.5% SBP and 7.4% lipid levels above treatment thresholds without relevant prescriptions. Among patients on pharmacological therapy, 65% reached the HbA1c, 64% SBP and 66% lipid target. Proportions not achieving the HbA1c target were 26% in Norwegians, 47% in South Asians and 40% in others (p = 0.03). Proportions not achieving the SBP target were 36% in Norwegians, 22% in South Asians and 56% in others (p = 0.050). Of those not achieving HbA1c and SBP targets, 49% and 21% respectively, were on mono-therapy. Conclusions Norwegian GPs comply

  12. Incorporating Primary and Secondary Prevention Approaches To Address Childhood Obesity Prevention and Treatment in a Low-Income, Ethnically Diverse Population: Study Design and Demographic Data from the Texas Childhood Obesity Research Demonstration (TX CORD) Study

    PubMed Central

    Butte, Nancy F.; Barlow, Sarah; Vandewater, Elizabeth A.; Sharma, Shreela V.; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O.; Durand, Casey; Li, Linlin; Kelder, Steven H.

    2015-01-01

    Abstract Background: There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2–12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Methods: Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Results: Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3–83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Conclusions: Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity. PMID:25555188

  13. Investigating Bogs: An Interdisciplinary Adventure.

    ERIC Educational Resources Information Center

    Pankiewicz, Philip R.; Schneider, Lois

    1995-01-01

    Presents the case for the use of bogs as ideal sites for hundreds of interdisciplinary lessons that combine chemistry, geology, various branches of biology, and wetlands archaeology. Includes general guidelines to aid in the design of interdisciplinary bog studies. (DDR)

  14. Interdisciplinary Exercises in Biology

    ERIC Educational Resources Information Center

    Gastonguay, Paul R.

    1975-01-01

    Lists a series of thought questions to stimulate a student to undertake his own interdisciplinary exercises to correlate his learnings in his own way. The statements are designed to challenge the mind, in order to develop a personal framework on topics such as life, the meaning of man, and the evolution and bondage of social structure. (BR)

  15. Planning for Interdisciplinary Research

    ERIC Educational Resources Information Center

    Sa, Creso

    2007-01-01

    This article examines trends in university planning and management concerning interdisciplinary research. The analysis of institutional documents of 99 research universities reveals regularities in the types of approaches employed. In addition to the traditional approach of creating centers and institutes, universities have taken actions to…

  16. Charting the Territory: Interdisciplinary Studies.

    ERIC Educational Resources Information Center

    Eason, Douglas O.

    Although enrollment in interdisciplinary studies is increasing in the two-year college, much remains to be done in defining and planning interdisciplinary programs. A valuable distinction can be made between interdisciplinary and intradisciplinary studies. The first refers to exploring significant relationships between or among unrelated…

  17. Evidence of poor adherence to secondary prevention after acute coronary syndromes: possible remedies through the application of new technologies.

    PubMed

    Cheng, Kevin; Ingram, Nicola; Keenan, Jan; Choudhury, Robin P

    2015-01-01

    Adherence to secondary prevention medications following acute coronary syndrome (ACS) is disappointingly low, standing around 40-75% by various estimates. This is an inefficient use of the resources devoted to their development and implementation, and also puts patients at higher risk of poor outcomes post-ACS. Numerous factors contribute to low adherence including poor motivation, forgetfulness, lack of education about medications, complicated polypharmacy of ACS regimens, (fear of) adverse side effects and limited practical support. Using technology to improve adherence in ACS is an emerging strategy and has the potential to address many of the above factors-computer-based education and mobile phone reminders are among the interventions trialled and appear to improve adherence in patients with ACS. As we move into an increasingly technological future, there is potential to use devices such as smartphones and tablets to encourage patient responsibility for medications. These handheld technologies have great scope for allowing patients to view online medical records, education modules and reminder systems, and although research specific to ACS is limited, they have shown initial promise in terms of uptake and improved adherence among similar patient populations. Given the overwhelming enthusiasm for handheld technologies, it would seem timely to further investigate their role in improving ACS medication adherence. PMID:25713726

  18. Prevention

    MedlinePlus

    ... Prevention Treatment 2003 U.S. Outbreak African Rodent Importation Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox ... Examining Animals with Suspected Monkeypox African Rodent Importation Ban Resources Related Links Poxvirus Molluscum Contagiosum Orf Virus ( ...

  19. Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease.

    PubMed

    Byrnes, Joshua; Carrington, Melinda; Chan, Yih-Kai; Pollicino, Christine; Dubrowin, Natalie; Stewart, Simon; Scuffham, Paul A

    2015-01-01

    The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI) in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95% CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95% CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95% CI: -$22,843, $14,863]). This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most. PMID:26657844

  20. Achieved Blood Pressures in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study: Challenges and Lessons Learned

    PubMed Central

    Pergola, Pablo E.; Szychowski, Jeff M.; Talbert, Robert; del Brutto, Oscar; Castellanos, Mar; Graves, John W.; Matamala, Gonzalo; Pretell, Edwin Javier; Yee, Jerry; Rebello, Rosario; Zhang, Yu; Benavente, Oscar R.

    2014-01-01

    BACKGROUND Lowering blood pressure (BP) after stroke remains a challenge, even in the context of clinical trials. The Secondary Prevention of Small Subcortical Strokes (SPS3) BP protocol, BP management during the study, and achieved BPs are described here. METHODS Patients with recent symptomatic lacunar stroke were randomized to 1 of 2 levels of systolic BP (SBP) targets: lower: <130mm Hg, or higher: 130–149mm Hg. SBP management over the course of the trial was examined by race/ethnicity and other baseline conditions. RESULTS Mean SBP decreased for both groups from baseline to the last follow-up, from 142.4 to 126.7mm Hg for the lower SBP target group and from 143.6 to 137.4mm Hg for the higher SBP target group. At baseline, participants in both groups used an average of 1.7±1.2 antihypertensive medications, which increased to a mean of 2.4±1.4 (lower group) and 1.8±1.4 (higher group) by the end-study visit. It took an average of 6 months for patients to reach their SBP target, sustained to the last follow-up. Black participants had the highest proportion of SBP ≥150mm Hg at both study entry (40%) and end-study visit (17%), as compared with whites (9%) and Hispanics (11%). CONCLUSIONS These results show that it is possible to safely lower BP even to a SBP goal <130mm Hg in a variety of patients and settings, including private and academic centers in multiple countries. This provides further support for protocol-driven care in lowering BP and consequently reducing the burden of stroke. PMID:24610884

  1. Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease

    PubMed Central

    Byrnes, Joshua; Carrington, Melinda; Chan, Yih-Kai; Pollicino, Christine; Dubrowin, Natalie; Stewart, Simon; Scuffham, Paul A.

    2015-01-01

    The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI) in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95%CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95%CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95%CI: -$22,843, $14,863]). This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most. PMID:26657844

  2. A Strange and Wonderful Interdisciplinary Juxtaposition: Using Mathematical Ideas to Teach English

    ERIC Educational Resources Information Center

    Seo, Byung-In

    2009-01-01

    Interdisciplinary concepts and methodology are increasingly common in today's secondary schools. However, many interdisciplinary lessons combine courses in related areas (e.g., English with history or science with mathematics). This article examines the use of mathematical ideas in the teaching of literature and writing. Employing mathematical…

  3. Toward a Theory of Interdisciplinary Connections: A Classroom Study of Talk and Text

    ERIC Educational Resources Information Center

    Nowacek, Rebecca S.

    2007-01-01

    Despite the general trend to embrace interdisciplinarity in post-secondary education, we remain remarkably unclear concerning what we mean by interdisciplinarity and how it is achieved. Reporting on research conducted in a team-taught interdisciplinary course, I propose a new way of conceptualizing interdisciplinary connections, grounded in…

  4. Preparing High School Students for the Interdisciplinary Nature of Modern Biology

    ERIC Educational Resources Information Center

    Nagle, Barbara

    2013-01-01

    Fostering interdisciplinary learning in biology will require significant changes in the way one teaches science to K-12 students. The perspective on interdisciplinary biology teaching and learning in this essay is based on the author's experiences as a former research cell biologist, high school science teacher, and developer of secondary science…

  5. Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors.

    PubMed

    DeBate, Rita D; Severson, Herbert H; Cragun, Deborah L; Gau, Jeff M; Merrell, Laura K; Bleck, Jennifer R; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; McCormack Brown, Kelli R; Tedesco, Lisa A; Hendricson, William

    2013-06-01

    Oral healthcare providers have a clinical opportunity for early detection of disordered eating behaviors because they are often the first health professionals to observe overt oral and physical signs. Curricula regarding early recognition of this oral/systemic medical condition are limited in oral health educational programs. Web-based learning can supplement and reinforce traditional learning and has the potential to develop skills. The study purpose was to determine the efficacy of a theory-driven Web-based training program to increase the capacity of oral health students to perform behaviors related to the secondary prevention of disordered eating behaviors. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework, a longitudinal group-randomized controlled trial involving 27 oral health classes from 12 oral health education programs in the United States was implemented to assess the efficacy of the Web-based training on attitudes, knowledge, self-efficacy and skills related to the secondary prevention of disordered eating behaviors. Mixed-model analysis of covariance indicated substantial improvements among students in the intervention group (effect sizes: 0.51-0.83) on all six outcomes of interest. Results suggest that the Web-based training program may increase the capacity of oral healthcare providers to deliver secondary prevention of disordered eating behaviors. Implications and value of using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework are discussed. PMID:23564725

  6. Aspirin underuse, non-compliance or cessation: definition, extent, impact and potential solutions in the primary and secondary prevention of cardiovascular disease.

    PubMed

    Biondi-Zoccai, Giuseppe; Wu, Yangfeng; Serrano, Carlos V; Frati, Giacomo; Agostoni, Pierfrancesco; Abbate, Antonio

    2015-03-01

    Despite momentous breakthroughs in unraveling the pathophysiology of many chronic conditions and developing novel therapeutic agents, everyday clinical practice is still fraught with inadequate or inappropriate use of treatments with proven benefits. Aspirin is a paradigmatic example, as it is used for the primary and secondary prevention of cardiovascular disease and appears to have a beneficial impact on cancer risk. Yet, underuse, non-compliance or cessation of aspirin are not uncommon, may have an important clinical impact, and are not aggressively prevented or managed. Increasing the awareness of the extent and impact of aspirin underuse, non-compliance or cessation, and intensifying efforts at preventing them are worthy goals likely to yield significant benefits on cardiovascular morbidity and mortality worldwide, and possibly also on cancer outcomes. PMID:25577751

  7. The Development of Interdisciplinary Teaching Approaches among Pre-service Science and Mathematics Teachers

    NASA Astrophysics Data System (ADS)

    Miranda Martins, Dominique

    This study sought to understand how a group of pre-service teachers in a combined secondary science and mathematics teaching methods course conceptualized and experienced interdisciplinary approaches to teaching. Although knowing how to plan interdisciplinary activities is an essential teaching practice in Quebec, these pre-service teachers faced many challenges during the process of learning to teach with this approach. By using two interdisciplinary frameworks (Nikitina, 2005; Boix Mansilla & Duraising, 2007), I qualitatively analyzed the development of the pre-service teachers' prior and emerging ideas about interdisciplinarity and their ability to plan interdisciplinary teaching activities. The provincial curriculum and issues related to time greatly shaped students' conceptions about interdisciplinarity in the classroom and constrained their ability to plan for and envision the enactment of interdisciplinary lessons in secondary science and mathematics classes. In addition, images of themselves as content-specialists, self-efficacy beliefs in relation to interdisciplinary teaching, and student learning as a source of teacher motivation emerged as key factors promoting or interrupting the development of interdisciplinary teaching approaches. Examination of these factors highlights the need for teacher-education programs to provide opportunities for pre-service teachers to explore how they see themselves as educators, increase their instructional self-efficacy beliefs, and motivate them to teach in an interdisciplinary fashion. Keywords: interdisciplinary teaching, student-teachers, curriculum, teacher-education program, self-efficacy, motivation.

  8. Interdisciplinary Study: Towards the Millennium.

    ERIC Educational Resources Information Center

    Garbowsky, Maryanne M.

    Interdisciplinary studies attempt to bring together disparate areas such as English, history, and art into a common curriculum which crosses divisional boundaries. An interdisciplinary approach allows colleges to add to its course offerings without the expense of hiring new faculty, attracts new students and retains them at higher rates, provides…

  9. Promoting Interdisciplinary Research among Faculty

    ERIC Educational Resources Information Center

    Novak, Elena; Zhao, Weinan; Reiser, Robert A.

    2014-01-01

    With the growing recognition of the importance of interdisciplinary research, many faculty have increased their efforts to form interdisciplinary research teams. Oftentimes, attempts to put together such teams are hampered because faculty have a limited picture of the research interests and expertise of their colleagues. This paper reports on…

  10. Interdisciplinary Studies at a Crossroads

    ERIC Educational Resources Information Center

    Kleinberg, Ethan

    2008-01-01

    In today's competitive college market, "interdisciplinary studies" are a major selling point for colleges and universities. Yet, on closer examination, it is apparent that the academic structure and place of the majority of interdisciplinary programs, departments, and centers are not substantially different from the academic disciplines,…

  11. Interdisciplinary Astronomy Activities

    NASA Astrophysics Data System (ADS)

    Nerantzis, Nikolaos; Mitrouda, Aikaterini; Reizopoulou, Ioanna; Sidiropoulou, Eirini; Hatzidimitriou, Antonios

    2016-04-01

    On November 9th, 2015, three didactical hours were dedicated to Interdisciplinary Astronomy Activities (http://wp.me/p6Hte2-1I). Our students and their teachers formed three groups and in rotation, were engaged with the following activities: (a) viewing unique images of the Cosmos in the mobile planetarium STARLAB (http://www.planitario.gr/tholos-starlab-classic-standard.html), (b) watching the following videos: Journey to the end of the universe (https://youtu.be/Ufl_Nwbl8xs), Rosetta update (https://youtu.be/nQ9ivd7wv30), The Solar System (https://youtu.be/d66dsagrTa0), Ambition the film (https://youtu.be/H08tGjXNHO4) in the school's library. Students and teachers were informed about our solar system, the Rosetta mission, the universe, etc. and (c) tactile activities such as Meet our home and Meet our neighbors (http://astroedu.iau.org, http://nuclio.org/astroneighbours/resources) and the creation of planets' 3D models (Geology-Geography A' Class Student's book, pg.15). With the activities above we had the pleasure to join the Cosmic Light Edu Kit / International Year of Light 2015 program. After our Interdisciplinary Astronomy Activities, we did a "small" research: our students had to fill an evaluation about their educational gains and the results can be found here http://wp.me/p6Hte2-2q. Moreover, we discussed about Big Ideas of Science (http://wp.me/p3oRiZ-dm) and through the "big" impact of the Rosetta mission & the infinity of our universe, we print posters with relevant topics and place them to the classrooms. We thank Rosa Doran (Nuclio - President of the Executive Council) for her continuous assistance and support on innovative science teaching proposals. She is an inspiration.

  12. Evidence-Based Integrated Environmental Solutions For Secondary Lead Smelters: Pollution Prevention And Waste Minimization Technologies And Practices

    EPA Science Inventory

    An evidence-based methodology was adopted in this research to establish strategies to increase lead recovery and recycling via a systematic review and critical appraisal of the published literature. In particular, the research examines pollution prevention and waste minimization...

  13. The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems

    PubMed Central

    Corrrigan, Mairead; Cupples, Margaret E; Smith, Susan M; Byrne, Molly; Leathem, Claire S; Clerkin, Pauline; Murphy, Andrew W

    2006-01-01

    Background Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems. Methods In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis. Results Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration, integrating

  14. Health Promotion and Industry: Where Interdisciplinary Research Meets Reality.

    ERIC Educational Resources Information Center

    Ricketts, Thomas C.; Kaluzny, Arnold D.

    1987-01-01

    Evaluation research in work-site health promotion offers an opportunity to test the effectiveness of work-site health promotion and disease prevention programs. Based on an evaluation of the research, an interdisciplinary approach to data collection and analysis is suggested, and policy implications are outlined. (TJH)

  15. [Geriatrics - an interdisciplinary challenge].

    PubMed

    Nau, Roland; Djukic, Marija; Wappler, Manfred

    2016-06-01

    The care of elderly patients will continue to challenge the healthcare system over the next decades. As a rule geriatric patients suffer from multimorbidities with complex disease patterns, and the ability to cope with everyday life is severely reduced. Treatment is provided by a multiprofessional geriatric team, and the primary goal is improvement of functional status, quality of life in the social environment and autonomy by employing a holistic approach. In Germany geriatric care is provided by physicians from various medical specialties (e.g. general practitioners, internists, neurologists and psychiatrists). In the training for the subspecialty clinical geriatrics, these specialties enjoy equal rights. Recent efforts to establish a qualification as physician for internal medicine and geriatrics have initiated a discussion to make the suitability for qualification as a geriatrician dependent on the medical specialty. Geriatric patients benefit from multidisciplinary cooperation. Neurologists possess great expertise in the treatment of patients with dementia, depression, delirium, consequences of degenerative spinal cord diseases and vertebral bone fractures, stroke, Parkinson's syndrome, epileptic seizures, vertigo and dizziness, neuropathies, lesions of peripheral nerves and in the multimodal therapy of pain. To function in a position of responsibility in a geriatric department, neurologists need skills in general internal medicine. These are acquired either on a geriatric ward or during specialization as a neurologist by full time secondment to large neurological or interdisciplinary intensive care units. PMID:27167886

  16. Microdosimetry: An interdisciplinary approach

    SciTech Connect

    Goodhead, D.T.; O`Neill, P.; Menzel, H.G.

    1997-12-31

    The Twelfth Symposium on Microdosimetry was held at Keble College, Oxford, September 29--October 4, 1996. The aim of the meeting was to provide a forum to bring together experts in physics, chemistry, molecular and cell biology and oncogenesis, with a common interest in understanding molecular mechanisms that can be gained from studies of the dependence of radiation effects on radiation quality, to advance the application of microdosimetry to other fields such as medicine, to promote and advance education and training in the field of radiation sciences. These proceedings contain a selection of review articles presented by keynote speakers, complemented by original contributions from participants reflecting the interdisciplinary nature of the field. The specific topics have been regrouped into sections to give the reader a more balanced view of that area. The topics are: Track structure and damage simulation; Chemical processes from radiation to DNA; Clustered DNA damage; Chromosome architecture and aberrations; Radiation quality and biological effectiveness; Risk extrapolation and cancer; Microdosimetry applied to radiotherapy; Microdistribution in tissues; Single particle effects; Proportional counter microdosimetry; and Nanodosimetric devices and other detectors. Separate abstracts for selected papers have been indexed for the Energy Science and Technology Database.

  17. How interdisciplinary is nanotechnology?

    PubMed Central

    Youtie, Jan

    2009-01-01

    Facilitating cross-disciplinary research has attracted much attention in recent years, with special concerns in nanoscience and nanotechnology. Although policy discourse has emphasized that nanotechnology is substantively integrative, some analysts have countered that it is really a loose amalgam of relatively traditional pockets of physics, chemistry, and other disciplines that interrelate only weakly. We are developing empirical measures to gauge and visualize the extent and nature of interdisciplinary interchange. Such results speak to research organization, funding, and mechanisms to bolster knowledge transfer. In this study, we address the nature of cross-disciplinary linkages using “science overlay maps” of articles, and their references, that have been categorized into subject categories. We find signs that the rate of increase in nano research is slowing, and that its composition is changing (for one, increasing chemistry-related activity). Our results suggest that nanotechnology research encompasses multiple disciplines that draw knowledge from disciplinarily diverse knowledge sources. Nano research is highly, and increasingly, integrative—but so is much of science these days. Tabulating and mapping nano research activity show a dominant core in materials sciences, broadly defined. Additional analyses and maps show that nano research draws extensively upon knowledge presented in other areas; it is not constricted within narrow silos. PMID:21170124

  18. LEAH interdisciplinary training program.

    PubMed

    Robbins, Cynthia L; Rickert, Vaughn D

    2016-08-01

    This article describes the Leadership Education in Adolescent Health (LEAH) interdisciplinary training program in the United States. The Maternal and Child Health Bureau authorized by legislation provides monies to train leaders in adolescent health through a competitive grant process. Currently, seven academic medical centers have funding to provide leadership in adolescent health (LEAH) training in five core disciplines: medicine, nursing, psychology, social work and nutrition. LEAH training programs both ensure high clinical competence in core disciplines serving adolescents and prepare trainees for leadership positions in adolescent health and public health care realms. Together, these programs trained almost 1000 long-term trainees across these five disciplines, and graduates from these programs are working in 45 of the 50 states within the United States. About 90% of these graduates are working with maternal and child/adolescent health populations, and almost all have held leadership positions in the areas of public health, advocacy, public policy, academic medical centers and/or clinical care settings. PMID:26115496

  19. Nutrition-education research: an interdisciplinary evaluation and review.

    PubMed

    Levy, S R; Iverson, B K; Walberg, H J

    1980-01-01

    An interdisciplinary evaluation approach was developed to analyze and compare school nutrition education programs systematically. Theoretical models from education, preventive medicine, health education and statistical evaluation were applied to 22 studies published between 1968 and 1978 to judge program impact on nutrition knowledge, behavior, and attitudes. Six studies reported XS and SDs for control and experimental groups. Effect sizes, showing average treatment effect in standard deviation units, were calculated for those six studies. It can be concluded that the more interdisciplinary criteria a study fulfills, the more likely it is to influence knowledge, behavior, and attitudes. PMID:7275638

  20. More Is Not Always Better: Comprehensive Evaluation of a Summer Institute on Interdisciplinary Teamed Instruction for School-Level Teams.

    ERIC Educational Resources Information Center

    Meehan, Merrill L.; Cowley, Kimberly S.; Burns, Rebecca C.

    The Interdisciplinary Teamed Instruction (ITI) project investigated the effects of interdisciplinary, teamed instruction on secondary school teaching and learning. It examined the effectiveness of a professional development model that facilitated the development, implementation, and evaluation of ITI. Through summer institutes and onsite…

  1. Changes in school environment, awareness and actions regarding overweight prevention among Dutch secondary schools between 2006–2007 and 2010–2011

    PubMed Central

    2013-01-01

    Background Schools can be an important setting for the prevention of overweight. This nation-wide survey investigated changes in the obesogenity of the school environment, the awareness of schools regarding overweight, school health policy, and actions taken by schools to prevent overweight. Methods In 2006/2007 and 2010/2011, questionnaires were sent to all Dutch secondary schools, (n = 1250 and n = 1145, response rate 44% and 33% respectively, repeated data for 187 schools). Results The percentage of schools with vending machines for soft drinks (~90%) and sweets (~80%) remained fairly stable, whereas slightly more schools indicated to have a canteen (87%-91%). The food supply was reported to be healthier in 2010/2011 compared to 2006/2007. Canteens and/or vending machines offered more often fresh fruits (+8%), sandwiches (+11%), water (+11%) and salad (+7%) and less often sugar sweetened soft drinks (−10%). However, unfavorable changes such as an increase in the supply of pizza slices (+13%) and milk and yoghurt drinks with added sugar (+12%) were also reported. Between 2006/2007 and 2010/2011, the presence of water coolers increased (12% versus 33%) as well as facilities for physical activity (67% versus 77%). However, more schools had vending places of unhealthy foods in the vicinity (73% versus 85%). Compared to 2006/2007, a higher percentage of schools indicated that they have taken actions to stimulate healthy eating behavior (72% versus 80%) or to prevent overweight (34% versus 52%) in 2010/2011. Less schools indicated that they expect to pay more attention to overweight prevention in the near future (56% versus 43%), but none of them expected to pay less attention. Conclusions Several aspects of the school environment changed in a positive way. However, schools should be encouraged to contribute to the prevention of overweight, or to continue to do so. PMID:23870483

  2. Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: a comprehensive narrative overview of English-language studies.

    PubMed

    Fischer, Benedikt; Blanken, Peter; Da Silveira, Dartiu; Gallassi, Andrea; Goldner, Elliot M; Rehm, Jürgen; Tyndall, Mark; Wood, Evan

    2015-04-01

    There are an estimated several million crack-cocaine users globally; use is highest in the Americas. Most crack users are socio-economically marginalized (e.g., homeless), and feature elevated risks for morbidity (e.g., blood-borne viruses), mortality and crime/violence involvement, resulting in extensive burdens. No comprehensive reviews of evidence-based prevention and/or treatment interventions specifically for crack use exist. We conducted a comprehensive narrative overview of English-language studies on the efficacy of secondary prevention and treatment interventions for crack (cocaine) abuse/dependence. Literature searches (1990-2014) using pertinent keywords were conducted in main scientific databases. Titles/abstracts were reviewed for relevance, and full studies were included in the review if involving a primary prevention/treatment intervention study comprising a substantive crack user sample. Intervention outcomes considered included drug use, health risks/status (e.g., HIV or sexual risks) and select social outcome indicators. Targeted (e.g., behavioral/community-based) prevention measures show mixed and short-term effects on crack use/HIV risk outcomes. Material (e.g., safer crack use kit distribution) interventions also document modest efficacy in risk reduction; empirical assessments of environmental (e.g., drug consumption facilities) for crack smokers are not available. Diverse psycho-social treatment (including contingency management) interventions for crack abuse/dependence show some positive but also limited/short-term efficacy, yet likely constitute best currently available treatment options. Ancillary treatments show little effects but are understudied. Despite ample studies, pharmaco-therapeutic/immunotherapy treatment agents have not produced convincing evidence; select agents may hold potential combined with personalized approaches and/or psycho-social strategies. No comprehensively effective 'gold-standard' prevention

  3. Get Vaccinated! and Get Tested! Developing Primary and Secondary Cervical Cancer Prevention Videos for a Haitian Kreyòl-Speaking Audience.

    PubMed

    Frett, Brigitte; Aquino, Myra; Fatil, Marie; Seay, Julia; Trevil, Dinah; Fièvre, Michèle Jessica; Kobetz, Erin

    2016-05-01

    Although routine screening reduces cervical cancer rates between 60% and 90%, thousands of women worldwide are diagnosed with the disease on an annual basis because of inadequate screening. Haitian women in South Florida experience a disproportionate burden of cervical cancer, with disease rates 4 times higher than the average for women in Miami. An ongoing community-based participatory research initiative to assess and reduce this burden has revealed that a complex interplay of factors contributes to a lack of access to screening in this community, including socioeconomics, language barriers, and traditional understandings of health and disease. In an effort to address some of these barriers and encourage uptake of primary and secondary cervical cancer prevention strategies, 2 videos on cervical cancer prevention were created using a community-based participatory research framework. The video screenplays were created by a Haitian screenwriter using evidence-based medical information provided by academic researchers. The films feature Haitian actors speaking a Haitian Kreyòl dialogue with a storyline portraying friends and family discussing human papillomavirus disease and vaccination, Papanicolaou testing, and cervical cancer. Focus groups held with Haitian women in South Florida suggested that the films are engaging; feature relatable characters; and impact knowledge about human papillomavirus, cervical cancer development, and current prevention recommendations. PMID:27050619

  4. Describing variation in the delivery of secondary fracture prevention after hip fracture: an overview of 11 hospitals within one regional area in England

    PubMed Central

    Drew, Sarah; Sheard, Sally; Chana, Jasroop; Cooper, Cyrus; Javaid, M Kassim; Judge, Andy

    2014-01-01

    Purpose Hip fractures are usually the result of low impact falls and underlying osteoporosis. Since the risk of further fractures in osteoporotic patients can be reduced by between 20 - 70% with bone protection therapy, the NHS is under an obligation to provide effective fracture prevention services for hip fracture patients to reduce risk of further fractures. Evidence suggests there is variation in service organisation. The objective of the study was to explore this variation in more detail by looking at the services provided in one region in England. Methods A questionnaire was designed which included questions around staffing, models of care and how the four components of fracture prevention (case finding, osteoporosis assessment, treatment initiation and adherence (monitoring) were undertaken. We also examined falls prevention services. Clinicians involved in the delivery of osteoporosis services at 11 hospitals in one region in England completed the questionnaire. Results The service overview showed significant variation in service organisation across all aspects of care examined. All sites provided some form of case finding and assessment. However, interesting differences arose when we examined how these components were structured. Eight sites generally initiated treatment in an inpatient setting, two in outpatients and one in primary care. Monitoring was undertaken by secondary care at seven sites and the remainder conducted by GPs. Conclusions The variability in service provision was not explained by local variations in care need. Further work is now needed to establish how the variability in service provision affects key patient, clinical and health economic outcomes. PMID:24964893

  5. Engaging the Entire Care Cascade in Western Kenya: A Model to Achieve the Cardiovascular Disease Secondary Prevention Roadmap Goals.

    PubMed

    Vedanthan, Rajesh; Kamano, Jemima H; Bloomfield, Gerald S; Manji, Imran; Pastakia, Sonak; Kimaiyo, Sylvester N

    2015-12-01

    Cardiovascular disease (CVD) is the leading cause of death in the world, with a substantial health and economic burden confronted by low- and middle-income countries. In low-income countries such as Kenya, there exists a double burden of communicable and noncommunicable diseases, and the CVD profile includes many nonatherosclerotic entities. Socio-politico-economic realities present challenges to CVD prevention in Kenya, including poverty, low national spending on health, significant out-of-pocket health expenditures, and limited outpatient health insurance. In addition, the health infrastructure is characterized by insufficient human resources for health, medication stock-outs, and lack of facilities and equipment. Within this socio-politico-economic reality, contextually appropriate programs for CVD prevention need to be developed. We describe our experience from western Kenya, where we have engaged the entire care cascade across all levels of the health system, in order to improve access to high-quality, comprehensive, coordinated, and sustainable care for CVD and CVD risk factors. We report on several initiatives: 1) population-wide screening for hypertension and diabetes; 2) engagement of community resources and governance structures; 3) geographic decentralization of care services; 4) task redistribution to more efficiently use of available human resources for health; 5) ensuring a consistent supply of essential medicines; 6) improving physical infrastructure of rural health facilities; 7) developing an integrated health record; and 8) mobile health (mHealth) initiatives to provide clinical decision support and record-keeping functions. Although several challenges remain, there currently exists a critical window of opportunity to establish systems of care and prevention that can alter the trajectory of CVD in low-resource settings. PMID:26704963

  6. Emerging interdisciplinary fields in the coming intelligence/convergence era

    NASA Astrophysics Data System (ADS)

    Noor, Ahmed

    2012-09-01

    Dramatic advances are in the horizon resulting from rapid pace of development of several technologies, including, computing, communication, mobile, robotic, and interactive technologies. These advances, along with the trend towards convergence of traditional engineering disciplines with physical, life and other science disciplines will result in the development of new interdisciplinary fields, as well as in new paradigms for engineering practice in the coming intelligence/convergence era (post-information age). The interdisciplinary fields include Cyber Engineering, Living Systems Engineering, Biomechatronics/Robotics Engineering, Knowledge Engineering, Emergent/Complexity Engineering, and Multiscale Systems engineering. The paper identifies some of the characteristics of the intelligence/convergence era, gives broad definition of convergence, describes some of the emerging interdisciplinary fields, and lists some of the academic and other organizations working in these disciplines. The need is described for establishing a Hierarchical Cyber-Physical Ecosystem for facilitating interdisciplinary collaborations, and accelerating development of skilled workforce in the new fields. The major components of the ecosystem are listed. The new interdisciplinary fields will yield critical advances in engineering practice, and help in addressing future challenges in broad array of sectors, from manufacturing to energy, transportation, climate, and healthcare. They will also enable building large future complex adaptive systems-of-systems, such as intelligent multimodal transportation systems, optimized multi-energy systems, intelligent disaster prevention systems, and smart cities.

  7. Alcohol-related injury among Greek-letter college students: Defining a target population for secondary prevention

    PubMed Central

    O’Brien, Mary Claire; McNamara, Robert S; McCoy, Thomas P; Sutfin, Erin L; Wolfson, Mark; Rhodes, Scott D

    2013-01-01

    Members of Greek-letter societies are the heaviest drinkers on college campuses, and experience more alcohol-related problems than their peers. This study reports the results of a web-based survey administered to stratified random samples of college students from ten North Carolina universities. Greek-letter status was a significant independent risk factor for increased injury (both experienced and caused to others), even after adjusting for drinking behaviors. Prevention, screening, and intervention strategies are discussed in the context of these results. PMID:22689586

  8. Antithrombotic therapy in the primary and secondary prevention of coronary-related death and infarction: focus on gender differences.

    PubMed

    Clyne, C A

    1990-01-01

    Much of our understanding of the role of antithrombotic therapy for postmyocardial infarction patients comes from studies which often included few or no women. Despite this shortcoming there are data available which identify gender differences in risk factors, presentation, natural history and treatment results for myocardial infarction. The use of anticoagulants and antiplatelet agents in the prevention and management of myocardial infarction has evolved over 30 years of investigation. The major randomized, controlled and blinded studies of antithrombotics and myocardial infarction are reviewed, with special emphasis on the female population. PMID:2198101

  9. The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors. Methods/design This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140) are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health) care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program starts (T1), and one week

  10. Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

    PubMed Central

    Byeon, Hee Ja; Yang, Young-Mo; Choi, Eun Joo

    2016-01-01

    Background Acute coronary syndrome (ACS) is a fatal cardiovascular disease caused by atherosclerotic plaque erosion or rupture and formation of coronary thrombus. The latest guidelines for ACS recommend the combined drug regimen, comprising aspirin, P2Y12 inhibitor, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and statin, at discharge after ACS treatment to reduce recurrent ischemic cardiovascular events. This study aimed to examine prescription patterns of secondary prevention drugs in Korean patients with ACS after hospital discharge, to access the appropriateness of secondary prevention drug therapy for ACS, and to evaluate whether to persistently use discharge medications for 18 months. Methods This study was retrospectively conducted with the patients who were discharged from the tertiary hospital, located in South Korea, after ACS treatment between September 2009 and August 2013. Data were collected through electronic medical record. Results Among 3,676 patients during the study period, 494 were selected based on inclusion and exclusion criteria. The regimen of aspirin + clopidogrel + β-blocker + angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker + statin was prescribed to 374 (75.71%) patients with ACS at discharge. Specifically, this regimen was used in 177 (69.69%) unstable angina patients, 44 (70.97%) non-ST-segment elevation myocardial infarction patients, and 153 (85.96%) ST-segment elevation myocardial infarction patients. Compared with the number of ACS patients with all five guideline-recommended drugs at discharge, the number of ACS patients using them 12 (n=169, 34.21%) and 18 (n=105, 21.26%) months after discharge tended to be gradually decreased. Conclusion The majority of ACS patients in this study received all five guideline-recommended medications at discharge from the hospital. However, the frequency of using all of them had been gradually decreased 3, 6, 12, and 18 months after

  11. Nailfold capillaroscopy microscopy - an interdisciplinary appraisal.

    PubMed

    Klein-Weigel, Peter Franz; Sunderkötter, Cord; Sander, Oliver

    2016-09-01

    Nailfold capillaroscopy is a method of great diagnostic value in the differential diagnosis of primary versus secondary Raynaud´s phenomenon, of systemic sclerosis versus other so called connective tissue diseases and of additional diagnostic value in other entities. Rheumatologists, dermatologists, and angiologists in Germany have convened in an interdisciplinary working group in which they synergistically combined their expertise to develop a common nomenclature and standards for the technical performance of nailfold capillary microscopy. The article gives an overview of historical and technical aspects of capillaroscopy, morphologic findings, and disease-specific patterns. It also provides a critical appraisal of its significance in the diagnosis and sequelae of these interdisciplinarily-managed diseases including its performance in children and gives an excursion in the potential perspectives of capillaroscopy in less common indications. PMID:27594391

  12. Women, Minorities, and Interdisciplinary Research

    NASA Astrophysics Data System (ADS)

    Pfirman, S.; Rhoten, D.

    2007-05-01

    Two major issues face the scientific enterprise: the need to engage the next generation of scientists and the recognition that research frontiers don't necessarily fall within disciplinary lines. While research has focused on each of these trends independently, surprisingly few studies have considered how intellectual preferences for and professional consequences of interdisciplinary science might be influenced by one's gender. This presentation assembles some of the first empirical data on gender and interdisciplinarity, showing that women appear to be disproportionately involved in interdisciplinary science. It considers what draws women in this direction and explores the implications of such a tendency. Interdisciplinary research may present a promising angle by which to engage women in the scientific enterprise, and institutions interested in increasing interdisciplinary research may have a greater chance for success if they involve women. Similarly, institutions interested in increasing their diversity may have a greater chance for success if they value interdisciplinary scholarship, which is still an issue on most campuses where disciplinary departments dominate.

  13. The PRESLO study: evaluation of a global secondary low back pain prevention program for health care personnel in a hospital setting. Multicenter, randomized intervention trial

    PubMed Central

    2012-01-01

    Background Common low back pain represents a major public health problem in terms of its direct cost to health care and its socio-economic repercussions. Ten percent of individuals who suffer from low back pain evolve toward a chronic case and as such are responsible for 75 to 80% of the direct cost of low back pain. It is therefore imperative to highlight the predictive factors of low back pain chronification in order to lighten the economic burden of low back pain-related invalidity. Despite being particularly affected by low back pain, Hospices Civils de Lyon (HCL) personnel have never been offered a specific, tailor-made treatment plan. The PRESLO study (with PRESLO referring to Secondary Low Back Pain Prevention, or in French, PREvention Secondaire de la LOmbalgie), proposed by HCL occupational health services and the Centre Médico-Chirurgical et de Réadaptation des Massues – Croix Rouge Française, is a randomized trial that aims to evaluate the feasibility and efficiency of a global secondary low back pain prevention program for the low back pain sufferers among HCL hospital personnel, a population at risk for recurrence and chronification. This program, which is based on the concept of physical retraining, employs a multidisciplinary approach uniting physical activity, cognitive education about low back pain and lumbopelvic morphotype analysis. No study targeting populations at risk for low back pain chronification has as yet evaluated the efficiency of lighter secondary prevention programs. Methods/Design This study is a two-arm parallel randomized controlled trial proposed to all low back pain sufferers among HCL workers, included between October 2008 and July 2011 and followed over two years. The personnel following their usual treatment (control group) and those following the global prevention program in addition to their usual treatment (intervention group) are compared in terms of low back pain recurrence and the impairments measured at the

  14. Dropping the Ball and Falling Off the Care Wagon. Factors Correlating With Nonadherence to Secondary Fracture Prevention Programs.

    PubMed

    Chandran, Manju; Cheen, Mcvin; Ying, Hao; Lau, Tang Ching; Tan, Matthew

    2016-01-01

    Health care systems and hospitals in several countries have implemented Fracture Liaison Services (FLSs). Success rates of FLSs with regard to osteoporosis assessment and treatment, fracture reduction, and adherence to osteoporosis medications have been reported by several groups including ours. A significant drop-out rate among patients in these programs may occur. This has not been evaluated before. We explored the factors correlating with nonadherence among a multiethnic population of patients in the FLS at our institution, the largest tertiary teaching hospital in South East Asia. Our secondary objective was to explore whether patients who defaulted follow-up visits continued to be compliant with medications. A retrospective analysis of our FLS's computerized database was performed. Of 938 patients followed up more than 2 years, 237 defaulted at various time points. A significant percentage of patients who dropped out of the program opined that it was because the follow-up visits were too time consuming. Non-Chinese patients were more likely than Chinese (adjusted hazard ratio [aHR] = 1.98, 1.33-2.94), patients with primary school education and below were more likely than those with secondary school and above education (aHR = 1.65, 1.11-2.45) and those with nonvertebral and/or multiple fractures were more likely than those with spine fractures (aHR = 1.38, 1.06-1.81) to be nonadherent. A fraction of patients who defaulted continued to fill osteoporosis medication prescriptions. Median medication possession ratio among the patients who defaulted was 12.3% (interquartile range: 4.1%-36.7%) at 2 years. Persistence ranged from 15.1% to 20.8% and from 1.9% to 7.5% at 1 and 2 years, respectively after defaulting from the program. Our study, which to the best of our knowledge is the first of its kind, provides insight into the factors correlating with nonadherence to FLSs. Knowledge of the challenges faced by patients may be of help to health care providers

  15. [Is primary or secondary prevention of diabetes mellitus in hyperliporoteinemia possible under long-term clofibrate therapy?].

    PubMed

    Haller, H; Michaelis, D; Hanefeld, M; Leonhardt, W; Schulze, J

    1976-07-01

    The investigations of metabolism explained speak for an improved condition of the carbohydrate metabolism during the first months of the therapy. However, they are not sufficient to prove a preventive effect of clofibrat per se during long-term treatment. Our examinations by means of the glucose infusion test show that on certain defined conditions with intensive general treatment positive effects may be registered, which, however, cannot be reproduced in a large collective during outpatient care. On the contrary, it is to be assumed that the whole therapeutic regime has an influence. Nevertheless, one may establish that the incidence portion of the diabetes manifestation in patients with hyperlipoproteinaemia treated with regadrin corresponds nearly to that one of the average population of Dresden. It is puzzling that the death rate in patients with hyperlipoproteinaemia and diabetic condition of metabolism is significantly higher than in hyperlipoproteinaemia without disturbance of the carbohydrate metabolism. PMID:822610

  16. Using Principles of Complex Adaptive Systems to Implement Secondary Prevention of Coronary Heart Disease in Primary Care

    PubMed Central

    Kottke, Thomas E; Huebsch, Jacquelyn A; McGinnis, Paul; Nichols, Jolleen M; Parker, Emily D; Tillema, Juliana O; Maciosek, Michael V

    2016-01-01

    Context: Primary care practice. Objective: To test whether the principles of complex adaptive systems are applicable to implementation of team-based primary care. Design: We used complex adaptive system principles to implement team-based care in a private, five-clinic primary care practice. We compared randomly selected samples of patients with coronary heart disease (CHD) and diabetes before system implementation (March 1, 2009, to February 28, 2010) and after system implementation (December 1, 2011, to March 31, 2013). Main Outcome Measures: Rates of patients meeting the composite goals for CHD (blood pressure < 140/90 mmHg, low-density lipoprotein cholesterol level < 100 mg/dL, tobacco-free, and using aspirin unless contraindicated) and diabetes (CHD goal plus hemoglobin A1c concentration < 8%) before and after the intervention. We also measured provider and patient satisfaction with preventive services. Results: The proportion of patients with CHD who met the composite goal increased from 40.3% to 59.9% (p < 0.0001) because documented aspirin use increased (65.2%–97.5%, p < 0.0001) and attainment of the cholesterol goal increased (77.0%–83.9%, p = 0.0041). The proportion of diabetic patients meeting the composite goal rose from 24.5% to 45.4% (p < 0.0001) because aspirin use increased (58.6%–97.6%, p < 0.0001). Increased percentages of patients meeting the CHD and diabetes composite goals were not significantly different (p = 0.2319). Provider satisfaction with preventive services delivery increased significantly (p = 0.0017). Patient satisfaction improved but not significantly. Conclusion: Principles of complex adaptive systems can be used to implement team-based care systems for patients with CHD and possibly diabetic patients. PMID:26784851

  17. Psychodynamic Motivation and Training program (PMT) for the secondary prevention in patients with stable coronary heart disease: study protocol for a randomized controlled trial of feasibility and effects

    PubMed Central

    2013-01-01

    Background Nonpharmacological secondary prevention of coronary heart disease is considered a safe and effective measure to substantially reduce mortality. Despite the effectiveness of lifestyle changes, the compliance rate of patients is very low mainly due to psychosocial barriers. Psychotherapeutic approaches that address how persons think about themselves and their behaviors appear to have a significant potential for improving health behavior. Methods/design Against this background, our study aims to examine the feasibility and effects of a Psychodynamic Motivation and Training program (PMT) as compared to one session of advice in exercise training (EX) and treatment as usual (TAU). For that purpose, 90 patients with stable coronary heart disease and a physically inactive lifestyle will be randomly assigned to the three groups (each with n = 30). The primary outcome is the change in the individual anaerobic threshold as determined by spiroergometry from baseline to six month follow-up. Secondary endpoints include change in endothelial function, biomarkers of inflammation and oxidative stress, quality of life, symptoms of fatigue, illness perception and feasibility of the treatment approach. We hypothesize that physical fitness will improve more in PMT than in EX and TAU, with PMT and EX more than TAU, and that the effects will be more pronounced for participants with current mental or psychosocial distress. Discussion The results of the study will help to determine the effectiveness of a psychodynamic lifestyle change approach and to identify measures for designing specifically tailored interventions to improve compliance with cardiovascular prevention. Trial registration ClinicalTrials.gov Identifier: NCT01445808 PMID:24066805

  18. Long-term use and cost-effectiveness of secondary prevention drugs for heart disease in Western Australian seniors (WAMACH): a study protocol

    PubMed Central

    Gunnell, Anthony S; Knuiman, Matthew W; Geelhoed, Elizabeth; Hobbs, Michael S T; Katzenellenbogen, Judith M; Hung, Joseph; Rankin, Jamie M; Nedkoff, Lee; Briffa, Thomas G; Ortiz, Michael; Gillies, Malcolm; Cordingley, Anne; Messer, Mitch; Gardner, Christian; Lopez, Derrick; Atkins, Emily; Mai, Qun; Sanfilippo, Frank M

    2014-01-01

    Introduction Secondary prevention drugs for cardiac disease have been demonstrated by clinical trials to be effective in reducing future cardiovascular and mortality events (WAMACH is the Western Australian Medication Adherence and Costs in Heart disease study). Hence, most countries have adopted health policies and guidelines for the use of these drugs, and included them in government subsidised drug lists to encourage their use. However, suboptimal prescribing and non-adherence to these drugs remains a universal problem. Our study will investigate trends in dispensing patterns of drugs for secondary prevention of cardiovascular events and will also identify factors influencing these patterns. It will also assess the clinical and economic consequences of non-adherence and the cost-effectiveness of using these drugs. Methods and analysis This population-based cohort study will use longitudinal data on almost 40 000 people aged 65 years or older who were hospitalised in Western Australia between 2003 and 2008 for coronary heart disease, heart failure or atrial fibrillation. Linking of several State and Federal government administrative data sets will provide person-based information on drugs dispensed precardiac and postcardiac event, reasons for hospital admission, emergency department visits, mortality and medical visits. Dispensed drug trends will be described, drug adherence measured and their association with future all-cause/cardiovascular events will be estimated. The cost-effectiveness of these long-term therapies for cardiac disease and the impact of adherence will be evaluated. Ethics and dissemination Human Research Ethics Committee (HREC) approvals have been obtained from the Department of Health (Western Australian #2011/62 and Federal) and the University of Western Australia (RA/4/1/1130), in addition to HREC approvals from all participating hospitals. Findings will be published in peer-reviewed medical journals and presented at local, national and

  19. Pioglitazone for Secondary Prevention after Ischemic Stroke and Transient Ischemic Attack: Rationale and Design of the Insulin Resistance Intervention after Stroke (IRIS) Trial

    PubMed Central

    Viscoli, Catherine M.; Brass, Lawrence M.; Carolei, Antonio; Conwit, Robin; Ford, Gary A.; Furie, Karen L.; Gorman, Mark; Guarino, Peter D.; Inzucchi, Silvio E.; Lovejoy, Anne M.; Parsons, Mark W.; Peduzzi, Peter N.; Ringleb, Peter; Schwartz, Gregory G.; Spence, J. David; Tanne, David; Young, Lawrence H.; Kernan, Walter N.

    2014-01-01

    Background: Recurrent vascular events remain a major source of morbidity and mortality after stroke or transient ischemic attack (TIA). The Insulin Resistance Intervention after Stroke (IRIS) trial is evaluating an approach to secondary prevention based on the established association between insulin resistance and increased risk for ischemic vascular events. Specifically, IRIS will test the effectiveness of pioglitazone, an insulin-sensitizing drug of the thiazolidinedione class, for reducing the risk for stroke and myocardial infarction (MI) among insulin resistant, non-diabetic patients with a recent ischemic stroke or TIA. Design: Eligible patients for IRIS must have had insulin resistance defined by a Homeostasis Model Assessment-Insulin Resistance greater than 3.0 without meeting criteria for diabetes. Within 6 months of the index stroke or TIA, patients were randomly assigned to pioglitazone (titrated from 15mg to 45mg/day) or matching placebo and followed for up to 5 years. The primary outcome is time to stroke or MI. Secondary outcomes include time to stroke alone, acute coronary syndrome, diabetes, cognitive decline and all-cause mortality. Enrollment of 3876 participants from 179 sites in seven countries was completed in January, 2013. Participant follow-up will continue until July, 2015. Summary: The IRIS Trial will determine whether treatment with pioglitazone improves cardiovascular outcomes of non-diabetic, insulin-resistant patients with stroke or TIA. Results are expected in early 2016. PMID:25458644

  20. Making Interdisciplinary Subjects Relevant to Students: An Interdisciplinary Approach

    ERIC Educational Resources Information Center

    Yang, Min

    2009-01-01

    This paper examines issues relating to the design/redesign of the pedagogy of interdisciplinary undergraduate subjects. Examples include: (a) law subjects for students in Business Management or Building and Surveying; (b) "English Communication for Business" for students in English; and (c) "Information technology in Business" for students in…

  1. Six-year follow-up of the SPHERE RCT: secondary prevention of heart disease in general practice

    PubMed Central

    Murphy, A W; Cupples, M E; Murphy, E; Newell, J; Scarrott, C J; Vellinga, A; Gillespie, P; Byrne, M; Kearney, C; Smith, S M

    2015-01-01

    Objective To determine the long-term effectiveness of a complex intervention in primary care aimed at improving outcomes for patients with coronary heart disease. Design A 6-year follow-up of a cluster randomised controlled trial, which found after 18 months that both total and cardiovascular hospital admissions were significantly reduced in intervention practices (8% absolute reduction). Setting 48 general practices in the Republic of Ireland and Northern Ireland. Participants 903 patients with established coronary heart disease at baseline in the original trial. Intervention The original intervention consisted of tailored practice and patient plans; training sessions for practitioners in medication prescribing and behavioural change; and regular patient recall system. Control practices provided usual care. Following the intervention period, all supports from the research team to intervention practices ceased. Outcome measures Primary outcome: hospital admissions, all cause and cardiovascular; secondary outcomes: mortality; blood pressure and cholesterol control. Results At 6-year follow-up, data were collected from practice records of 696 patients (77%). For those who had died, we censored their data at the point of death and cause of death was established. There were no significant differences between the intervention and control practices in either total (OR 0.83 (95% CI 0.54 to 1.28)) or cardiovascular hospital admissions (OR 0.91 (95% CI 0.49 to 1.65)). We confirmed mortality status of 886 of the original 903 patients (98%). There were no significant differences in mortality (15% in intervention and 16% in control) or in the proportions of patients above target control for systolic blood pressure or total cholesterol. Conclusions Initial significant differences in the numbers of total and cardiovascular hospital admissions were not maintained at 6 years and no differences were found in mortality or blood pressure and cholesterol control. Policymakers need

  2. Lemon-flavored cod liver oil and a multivitamin-mineral supplement for the secondary prevention of otitis media in young children: pilot research.

    PubMed

    Linday, Linda A; Dolitsky, Jay N; Shindledecker, Richard D; Pippenger, C E

    2002-07-01

    We measured blood levels of fatty acids, vitamin A, and trace metals in children undergoing ambulatory surgery for placement of tympanostomy tubes and a comparison group having other ambulatory surgical procedures. We then performed a small, outpatient, secondary prevention study using nutritional supplements chosen on the basis of those blood levels. The study subjects had lower levels of red blood cell eicosapentaenoic acid (EPA) than did adult controls. Consistent with previous reports, the levels of vitamin A were < or = 40 microg/dL for 69% of our subjects, and the plasma selenium levels for children were lower than published values for adults. We then studied one otitis media (OM) season; 8 children (0.8 to 4.4 years of age) received 1 teaspoon of lemon-flavored cod liver oil (containing both EPA and vitamin A) and 1 half-tablet of a selenium-containing children's chewable multivitamin-mineral tablet per day. During this OM season, study subjects received antibiotics for OM for 12.3% +/- 13.4% (SD; p < .05) fewer days during supplementation than before supplementation. Larger, controlled trials are warranted to assess the utility of cod liver oil (of acceptable purity and taste) and a children's multivitamin-mineral preparation containing selenium, both for the prevention of OM and for the acceptance of delayed prescription of antibiotics for this disorder. PMID:12126022

  3. Dropout Prevention and Reentry Act of 1985. Hearing before the Subcommittee on Education, Arts and Humanities of the Committee on Labor and Human Resources. United States Senate, Ninety-Ninth Congress, First Session on S. 1525 to Amend the Elementary and Secondary Education Act of 1965 to Provide Grants to Local Educational Agencies for Dropout Prevention Demonstration Projects (October 17, 1985).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    This document presents the text of the Senate hearing on the Dropout Prevention and Reentry Act of 1985, a bill designed to amend the Elementary and Secondary Education Act of 1965 to provide grants to local educational agencies for dropout prevention demonstration projects. Testimony is delivered by Senators Stafford, Pell, Chafee, Bradley,…

  4. Exploring the Possibilities of Interdisciplinary Teaming.

    ERIC Educational Resources Information Center

    Clark, Sally N.; Clark, Donald C.

    1997-01-01

    Discusses careful planning, enlightened leadership, informed and enthusiastic teachers, and continuous evaluation as prerequisites for successful interdisciplinary teamwork. Suggests that interdisciplinary teaming allows better use of faculty members' skills, and provides better strategies for dealing with diversified populations, better…

  5. The Challenge of Integration in Interdisciplinary Education

    ERIC Educational Resources Information Center

    Minnis, Michele; John-Steiner, Vera

    2005-01-01

    Focused on an interdisciplinary graduate program in water resources management, this case study illustrates how theory-into-practice integration occurred in a field course and clarified students' expectations that faculty model interdisciplinary ways of knowing.

  6. Boundary Breaking for Interdisciplinary Learning

    ERIC Educational Resources Information Center

    Kidron, Adi; Kali, Yael

    2015-01-01

    The purpose of this work is to contribute to the body of knowledge on processes by which students develop interdisciplinary understanding of contents, as well as to suggest technology-enhanced means for supporting them in these processes in the context of higher education. In doing so, we suggest a rethinking of three traditional practices that…

  7. General Education: An Interdisciplinary Approach.

    ERIC Educational Resources Information Center

    Scott, Charles V.; Moore, Kenneth D.

    The University of Science and Arts of Oklahoma, an experimental college, has developed an innovative general education program. Teaching approaches and organizational structures of the program have been changed to accommodate the new curriculum. The general education core, called the Interdisciplinary Studies Sequence (IDS), includes courses in…

  8. Interdisciplinary Curriculum: Challenges to Implementation.

    ERIC Educational Resources Information Center

    Wineburg, Sam, Ed.; Grossman, Pam, Ed.

    The reputed merits of the interdisciplinary curriculum movement are explored in this collection of works by leading educators. Context is laid out in the introduction, "When Theory Meets Practice in the World of School," by Pam Grossman, Sam Wineburg, and Scott Beers. The chapters are as follows: (1) "On Disciplinary Lenses and Interdisciplinary…

  9. Interdisciplinary Curriculum: An Abandoned Concept?

    ERIC Educational Resources Information Center

    Brand, Brenda R.; Triplett, Cheri F.

    2012-01-01

    Because present initiatives guiding educational decision-making place a high emphasis on accountability, there was a need to explore the educational value of the literacy and science education courses' joint interdisciplinary focus for elementary education. With current research alluding to time constraints, scripted curriculum, and memorization…

  10. Interdisciplinary Collaboration in EHDI Programs

    ERIC Educational Resources Information Center

    Nelson, Lauri; Houston, K. Todd; Hoffman, Jeff; Bradham, Tamala S.

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs were asked to complete a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the interdisciplinary area, 47 coordinators responded with 224 items, and themes were identified within each SWOT…