Prevention of hospital-acquired pneumonia: European perspective.

PubMed

Bonten, Marc J M

2003-12-01

Several preventive measures for VAP have been empirically tested. There is clear evidence that antibiotic-containing preventive strategies, such as SDD and oropharyngeal decontamination, are very effective in different patient populations. Selection of antibiotic resistance remains the major disadvantage of these strategies, however, limiting its applicability in settings with high levels of antibiotic resistance. This probably precludes the use of these strategies in many American settings, but may allow their use in European countries with much lower endemic levels of resistance. There is little evidence that systemic prophylaxis is effective for the prevention of VAP, and initial studies were associated with resistance problems. Of the non antibiotic-containing preventive strategies, subglottic aspiration was effective in several studies, whereas other strategies, such as immunonutrition with glutamine or the semirecumbent patient position, were effective in single studies. All these studies were executed in European ICUs. For these interventions, more data are needed on the generalizability, feasibility, and cost effectiveness. Few data support the use of sucralfate for stress ulcer prophylaxis and modulation of enteral nutrition practices as preventive measures for VAP.

76 FR 76023 - National Impaired Driving Prevention Month, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... enforcement measures and effective substance abuse prevention programs. During National Impaired Driving... legislation, and support successful, evidence-based prevention programs. These ongoing initiatives are... National Impaired Driving Prevention Month, 2011 By the President of the United States of America A...

Do female primary care physicians practise preventive care differently from their male colleagues?

PubMed Central

Woodward, C. A.; Hutchison, B. G.; Abelson, J.; Norman, G.

1996-01-01

OBJECTIVE: To assess whether female primary care physicians' reported coverage of patients eligible for certain preventive care strategies differs from male physicians' reported coverage. DESIGN: A mailed survey. SETTING: Primary care practices in southern Ontario. PARTICIPANTS: All primary care physicians who graduated between 1972 and 1988 and practised in a defined geographic area of Ontario were selected from the Canadian Medical Association's physician resource database. Response rate was 50%. MAIN OUTCOME MEASURES: Answers to questions on sociodemographic and practice characteristics, attitudes toward preventive care, and perceptions about preventive care behaviour and practices. RESULTS: In general, reported coverage for Canadian Task Force on the Periodic Health Examination's (CTFPHE) A and B class recommendations was low. However, more female than male physicians reported high coverage of women patients for female-specific preventive care measures (i.e., Pap smears, breast examinations, and mammography) and for blood pressure measurement. Female physicians appeared to question more patients about a greater number of health risks. Often, sex of physician was the most salient factor affecting whether preventive care services thought effective by the CTFPHE were offered. However, when evidence for effectiveness of preventive services was equivocal or lacking, male and female physicians reported similar levels of coverage. CONCLUSION: Female primary care physicians are more likely than their male colleagues to report that their patients eligible for preventive health measures as recommended by the CTFPHE take advantage of these measures. PMID:8969856

Effectiveness of the United Nations Security Council to Prevent Conflict Related Sexual Violence

DTIC Science & Technology

2017-06-09

security. This thesis seeks to determine if the effectiveness of the UNSC’s efforts to prevent CRSV. In doing so, this thesis asks the following...leaders as they continue to develop CRSV preventive measures. The overall objective of this study is to 5 determine the relevancy, developmental

Is a Mass Prevention and Control Program for Pandemic (H1N1) 2009 Good Value for Money? Evidence from the Chinese Experience.

PubMed

Wang, Biyan; Xie, Jinliang; Fang, Pengqian

2012-01-01

In order to provide guidance on the efficient allocation of health resources when handling public health emergencies in the future, the study evaluated the H1N1 influenza prevention and control program in Hubei Province of China using cost-benefit analysis. The costs measured the resources consumed and other expenses incurred in the prevention and control of H1N1. The assumed benefits include resource consumption and economic losses which could be avoided by the measures for the prevention and control of H1N1. The benefit was evaluated by counterfactual thinking, which estimates the resource consumption and economic losses could be happened without any measures for the prevention and control, which have been avoided after measures were taken to prevent and control H1N1 in Hubei Province, these constitutes the benefit of this project. The total costs of this program were 38.81 million U.S. dollars, while the total benefit was assessed as 203.71 million U.S. dollars. The net benefit was 164.9 million U.S. dollars with a cost-effectiveness ratio of 1:5.25. The joint prevention and control strategy introduced by Hubei for H1N1 influenza is cost-effective.

People's perception and cost-effectiveness of home confinement during an influenza pandemic: evidence from the French case.

PubMed

Orset, Caroline

2018-04-23

In France, home confinement is not a common preventive measure against an influenza pandemic, although it is used around the world. Based on a stated method approach, we analyze the attitude that the French would adopt if this measure were put in place. Next, we propose a cost-benefit analysis to discuss the cost-effectiveness of this measure. We find that over three-quarters of respondents report complying with home confinement. Their choice depends on their individual characteristics, the interaction they may have with an infected person and home confinement conditions, but not their experience with preventive measures. We find that behaviors such as sensitivity to certainty, selfishness and altruism emerge. As far as cost-effectiveness is concerned, our study shows that home confinement is a prevention path that should not be neglected and should even be prescribed.

Venous Thromboembolism Quality Measures Fail to Accurately Measure Quality.

PubMed

Lau, Brandyn D; Streiff, Michael B; Pronovost, Peter J; Haut, Elliott R

2018-03-20

Venous thromboembolism (VTE) is 1 of the most common causes of preventable harm for patients in hospitals. Consequently, the Joint Commission, the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, the United Kingdom Care Quality Commission, the Australian Commission on Safety and Quality in Health Care, the Maryland Health Services Cost Review Commission, and the American College of Surgeons have prioritized measuring and reporting VTE outcomes with the goal of reducing the incidence of and preventable harm from VTE. We developed a rubric for defect-free VTE prevention, graded each organizational VTE quality measure, and found that none of the current VTE-related quality measures adequately characterizes VTE prevention efforts or outcomes in hospitalized patients. Effective VTE prevention is multifactorial: clinicians must assess patients' risk for VTE and prescribe therapy appropriate for each patient's risk profile, patients must accept the prescribed therapy, and nurses must administer the therapy as prescribed. First, an ideal, defect-free VTE prevention process measure requires: (1) documentation of a standardized VTE risk assessment; (2) prescription of optimal, risk-appropriate VTE prophylaxis; and (3) administration of all risk-appropriate VTE prophylaxis as prescribed. Second, an ideal VTE outcome measure should define potentially preventable VTE as VTE that developed in patients who experienced any VTE prevention process failures. © 2018 American Heart Association, Inc.

An economic framework for preventive care advice.

PubMed

Pauly, Mark V; Sloan, Frank A; Sullivan, Sean D

2014-11-01

Under the Affordable Care Act, preventive care measures, including vaccinations and screenings, recommended by the Advisory Committee on Immunization Practices and the US Preventive Services Task Force must be covered in full by insurance. These recommendations affect the cost of medical care. Yet neither organization explicitly incorporates measures of efficiency or cost-effectiveness in making its recommendations. To redress this shortcoming, we propose a decision-making framework for these two organizations based on the principles of economic efficiency. Our analysis suggests that routine use of a preventive service should be recommended for full insurance coverage if the service's cost-effectiveness exceeds a socially determined threshold. For less cost-effective services, we suggest that information about effectiveness and cost should be provided to consumers by physicians or government, but the choice of care and insurance coverage for care should be made by individuals. For the least cost-effective services, the two organizations should discourage public and private insurers from covering such services and report their unfavorable cost-effectiveness. Project HOPE—The People-to-People Health Foundation, Inc.

Management of dental caries among children: a look at the cost-effectiveness.

PubMed

Ladewig, Nathalia Miranda; Camargo, Lucila Basto; Tedesco, Tamara Kerber; Floriano, Isabela; Gimenez, Thais; Imparato, José Carlos P; Mendes, Fausto Medeiros; Braga, Mariana Minatel; Raggio, Daniela Prócida

2018-04-01

Dental caries is the most prevalent non-communicative disease worldwide. Although the etiological factors are well known for years, reducing the number of decayed and missing teeth in children still remains as a barrier. Preventive and curative options are numerous but little is known about their economical advantages. Selecting the intervention that offers the best balance of effectiveness and financial resources becomes crucial in the current situation of budget restrictions worldwide. Areas covered: This expert review summarizes available evidence on cost-effectiveness analyses of preventive and curative measures to manage dental caries in children. Expert commentary: Preventive measures have been more extensively studied than dental caries treatment. Only water fluoridation and tooth brushing are well-established as cost-effective preventive approaches. Despite the increasing number of cost analysis treatment studies in the literature, most of them focus on the cost description, with no correlation to the intervention effectiveness. There is a current need of well-designed and well-reported cost-effectiveness regarding dental caries management.

[Prevention of allergic diseases in childhood: from theory to reality].

PubMed

2016-06-01

Allergic diseases have an increasing worldwide prevalence and a great impact on the health related costs. The research is focused on the study of etiological and risk factors of allergic diseases that can potentially be modified with primary, secondary and tertiary prevention strategies. Many of these measures do not have a definitively proven effect taking place in a controlled context different to what happens in real life. This paper aims to review the latest evidence on prevention of allergic diseases considering certainties and unresolved issues and focuses mainly on environmental, dietary, pharmacological and immunological preventive strategies for different levels of prevention. It is imperative to have a better understanding of genetic and environmental factors that cause allergic diseases to optimize preventive measures that are effective in reversing the increasing trend in the prevalence of allergic illnesses in childhood. Sociedad Argentina de Pediatría.

Geriatrics and the triple aim: defining preventable hospitalizations in the long-term care population.

PubMed

Ouslander, Joseph G; Maslow, Katie

2012-12-01

Reducing preventable hospitalizations is fundamental to the "triple aim" of improving care, improving health, and reducing costs. New federal government initiatives that create strong pressure to reduce such hospitalizations are being or will soon be implemented. These initiatives use quality measures to define which hospitalizations are preventable. Reducing hospitalizations could greatly benefit frail and chronically ill adults and older people who receive long-term care (LTC) because they often experience negative effects of hospitalization, including hospital-acquired conditions, morbidity, and loss of functional abilities. Conversely, reducing hospitalizations could mean that some people will not receive hospital care they need, especially if the selected measures do not adequately define hospitalizations that can be prevented without jeopardizing the person's health and safety. An extensive literature search identified 250 measures of preventable hospitalizations, but the measures have not been validated in the LTC population and generally do not account for comorbidity or the capacity of various LTC settings to provide the required care without hospitalization. Additional efforts are needed to develop measures that accurately differentiate preventable from necessary hospitalizations for the LTC population, are transparent and fair to providers, and minimize the potential for gaming and unintended consequences. As the new initiatives take effect, it is critical to monitor their effect and to develop and disseminate training and resources to support the many community- and institution-based healthcare professionals and emergency department staff involved in decisions about hospitalization for this population. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Comparing Different Suicide Prevention Measures at Bridges and Buildings: Lessons We Have Learned from a National Survey in Switzerland

PubMed Central

Hemmer, Alexander; Meier, Philipp; Reisch, Thomas

2017-01-01

The goal of the study was to compare the effectiveness of different suicide prevention measures implemented on bridges and other high structures in Switzerland. A national survey identified all jumping hotspots that have been secured in Switzerland; of the 15 that could be included in this study, 11 were secured by vertical barriers and 4 were secured by low-hanging horizontal safety nets. The study made an overall and individual pre-post analysis by using Mantel-Haenszel Tests, regression methods and calculating rate ratios. Barriers and safety nets were both effective, with mean suicide reduction of 68.7% (barriers) and 77.1% (safety nets), respectively. Measures that do not secure the whole hotspot and still allow jumps of 15 meters or more were less effective. Further, the analyses revealed that barriers of at least 2.3 m in height and safety-nets fixed significantly below pedestrian level deterred suicidal jumps. Secured bridgeheads and inbound angle barriers seemed to enhance the effectiveness of the measure. Findings can help to plan and improve the effectiveness of future suicide prevention measures on high structures. PMID:28060950

Adoption of preventive measures during and after the 2009 influenza A (H1N1) virus pandemic peak in Spain.

PubMed

Agüero, Fernando; Adell, Manel Nebot; Pérez Giménez, Anna; López Medina, María José; Garcia Continente, Xavier

2011-09-01

This study describes the preventive measures adopted by the Spanish population towards 2009 influenza A (H1N1) virus and their associated factors. An anonymous computer-assisted telephone interview survey was conducted in Spain in December 2009 and February 2010. Respondents were asked about their perceptions of influenza A (H1N1) virus and the preventive measures adopted. Factors associated with the adoption of preventive measures were assessed by logistic regression analyses. Out of 4892 households approached, 1627 valid responses were obtained (response rate of 33.3%). The most commonly adopted preventive measures were respiratory hygiene and hand washing. Factors independently associated with the adoption of the preventive measures recommended by the Spanish Ministry of Health were female gender, higher educational level, size of municipality of residence >50,000 inhabitants, high perceived susceptibility to infection, high perceived effectiveness of the measures and high perceived usefulness of the information provided by the government. The presence of school-aged children in household was associated with purchasing masks and hand sanitizer. In addition to demographic factors, modifiable factors such as personal beliefs and expectations play a role in the adoption of preventive measures. Copyright © 2011 Elsevier Inc. All rights reserved.

Backache and its prevention.

PubMed

Dwyer, A P

1987-09-01

Low back pain (LBP) is a symptom produced by disorders of the lumbar spine. It may be impossible to prevent all LBP, and while most episodes of acute LBP are self-limiting, the disorders producing recurrent and chronic LBP are usually incurable. The difficulties in diagnosing the disorders complicate effective management and prevention; however, prevention of spinal trauma reduces the incidence and prevalence of LBP. Effective preventive measures include the reduction of road trauma and smoking, improved vehicle seating, the control of vehicle vibrations, careful worker selection, job redesign, improved physical fitness, and the proper use of the spine in the home, at school, at work, and in sports. Frymoyer includes these and other measures in his tips to prevent LBP. Medical and paramedical professionals must be sure their investigations and treatments do not contribute to making the disorder chronic and more complex. The inappropriate use and interpretation of spinal investigations and the overzealous use of surgical procedures certainly add to the problem. An agreement on an acceptable "glossary" of lumbar terms and clinical syndromes is needed together with a new research emphasis on prevention and a continuation of research efforts in epidemiology, etiology, and management of LBP. Effective public education is vital, so that everyone is aware of the causes and methods of prevention of LBP. Discussion on the "20th-century epidemic of LBP" may be concluded on an optimistic note by citing White, who considers most LBP to be preventable and controllable with simple measures, reinforcable through public education, which can do for LBP what has been done in the field of dental hygiene.

Defining success with HIV pre-exposure prophylaxis: A prevention-effective adherence paradigm

PubMed Central

Haberer, Jessica E.; Bangsberg, David R.; Baeten, Jared M.; Curran, Kathryn; Koechlin, Florence; Amico, K. Rivet; Anderson, Peter; Mugo, Nelly; Venter, Francois; Goicochea, Pedro; Caceres, Carlos; O’Reilly, Kevin

2015-01-01

Clinical trial data have shown that oral pre-exposure prophylaxis (PrEP) is efficacious when taken as prescribed; however, PrEP adherence is complex and must be understood within the context of variable risk for HIV infection and use of other HIV prevention methods. Different levels of adherence may be needed in different populations to achieve HIV prevention, and the optimal methods for achieving the necessary adherence for both individual and public health benefits are unknown. Guidance for PrEP use must consider these questions to determine the success of PrEP-based HIV prevention programs. In this article, we propose a new paradigm for understanding and measuring PrEP adherence, termed prevention-effective adherence, which incorporates dynamic HIV acquisition risk behaviors and the use of HIV alternative prevention strategies. We discuss the need for daily PrEP use only during periods of risk for HIV exposure, describe key issues for measuring and understanding relevant behaviors, review lessons from another health prevention field (i.e., family planning), and provide guidance for prevention-effective PrEP use. Moreover, we challenge emerging calls for sustained, near perfect PrEP adherence regardless of risk exposure and offer a more practical and public health-focused vision for this prevention intervention. PMID:26103095

[Using TRM to Enhance the Accuracy of Ventilator-Associated Pneumonia Preventive Measures Implemented by Neonatal Intensive Care Unit Medical Staffs].

PubMed

Huang, Yu-Ting; Huang, Chao-Ya; Su, Hsiu-Ya; Ma, Chen-Te

2018-06-01

Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in the neonatal intensive care unit (NICU). The average VAP infection density was 4.7‰ in our unit between June and August 2015. The results of a status survey indicated that in-service education lacked specialization, leading to inadequate awareness among staffs regarding the proper care of newborns with VAP and a lack of related care guides. This, in turn, resulted in inconsistencies in care measures for newborns with VAP. To improve the accuracy of implementation of preventive measures for VAP among medical staffs and reduce the density of VAP infections in the NICU. Conduct a literature search and adopt medical team resources management methods; establish effective team communication; establish monitoring mechanisms and incentives; establish mandatory in-service specialization education contents and a VAP preventive care guide exclusively for newborns as a reference for medical staffs during care execution; install additional equipment and aids and set reminders to ensure the implementation of VAP preventive measures. The accuracy rate of preventive measure execution by medical staffs improved from 70.1% to 97.9% and the VAP infection density in the NICU decreased from 4.7‰ to 0.52‰. Team integration effectively improved the accuracy of implementation of VAP-prevention measures, reduced the density of VAP infections, enhanced quality of care, and ensured that newborns received care that was more in line with specialization needs.

Is a Mass Prevention and Control Program for Pandemic (H1N1) 2009 Good Value for Money? Evidence from the Chinese Experience

PubMed Central

Wang, Biyan; Xie, Jinliang; Fang, Pengqian

2012-01-01

Background In order to provide guidance on the efficient allocation of health resources when handling public health emergencies in the future, the study evaluated the H1N1 influenza prevention and control program in Hubei Province of China using cost-benefit analysis. Methods: The costs measured the resources consumed and other expenses incurred in the prevention and control of H1N1. The assumed benefits include resource consumption and economic losses which could be avoided by the measures for the prevention and control of H1N1. The benefit was evaluated by counterfactual thinking, which estimates the resource consumption and economic losses could be happened without any measures for the prevention and control, which have been avoided after measures were taken to prevent and control H1N1 in Hubei Province, these constitutes the benefit of this project. Results: The total costs of this program were 38.81 million U.S. dollars, while the total benefit was assessed as 203.71 million U.S. dollars. The net benefit was 164.9 million U.S. dollars with a cost-effectiveness ratio of 1:5.25. Conclusions: The joint prevention and control strategy introduced by Hubei for H1N1 influenza is cost-effective. PMID:23304674

PREvention STudy On preventing or reducing disability from musculoskeletal complaints in music school students (PRESTO): protocol of a randomised controlled trial.

PubMed

Baadjou, Vera A E; Verbunt, Jeanine A M C F; Eijsden-Besseling, Marjon D F van; Samama-Polak, Ans L W; Bie, Rob A D E; Smeets, Rob J E M

2014-12-01

Up to 87% of professional musicians develop work-related complaints of the musculoskeletal system during their careers. Music school students are at specific risk for developing musculoskeletal complaints and disabilities. This study aims to evaluate the effectiveness of a biopsychosocial prevention program to prevent or reduce disabilities from playing-related musculoskeletal disorders. Secondary objectives are evaluation of cost-effectiveness and feasibility. Healthy, first or second year students (n=150) will be asked to participate in a multicentre, single-blinded, parallel-group randomised controlled trial. Students randomised to the intervention group (n=75) will participate in a biopsychosocial prevention program that addresses playing-related health problems and provides postural training according to the Mensendieck or Cesar methods of postural exercise therapy, while incorporating aspects from behavioural change theories. A control group (n=75) will participate in a program that stimulates a healthy physical activity level using a pedometer, which conforms to international recommendations. No long-term effects are expected from this control intervention. Total follow-up duration is two years. The primary outcome measure is disability (Disabilities of Arm, Shoulder and Hand questionnaire). The secondary outcome measures are pain, quality of life and changes in health behaviour. Multilevel mixed-effect logistic or linear regression analyses will be performed to analyse the effects of the program on the aforementioned outcome measurements. Furthermore, cost-effectiveness, cost-utility and feasibility will be analysed. It is believed that this is the first comprehensive randomised controlled trial on the effect and rationale of a biopsychosocial prevention program for music students. Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Effects of a Single-Lesson Tobacco Prevention Curriculum on Knowledge, Skill Identification and Smoking Intention

ERIC Educational Resources Information Center

Brown, Stephen; Birch, David; Thyagaraj, Sujan; Teufel, James; Phillips, Cheryl

2007-01-01

One in five students report experimenting with tobacco before the age of 13 and most prevention efforts take place in the school setting. This study measures the effect of a single-lesson tobacco prevention curriculum, conducted by a health education center, focusing on knowledge of tobacco, ability to identify refusal techniques, and intent not…

Preventing Infectious Disease in Sports.

ERIC Educational Resources Information Center

Howe, Warren B.

2003-01-01

Preventing infectious disease in sports is fundamental to maintaining team effectiveness and helping athletes avoid the adverse effects of illness. Good hygiene, immunization, minimal exposure to specific diseases, and certain prophylactic measures are essential. Teammates, coaches, trainers, officials, healthcare providers, and community public…

Measures to prevent nosocomial infections during mechanical ventilation.

PubMed

Ramirez, Paula; Bassi, Gianluigi L; Torres, Antonio

2012-02-01

Endotracheal intubation and mechanical ventilation are lifesaving measures in critically ill patients. However, these interventions increase the risk of respiratory infections, particularly ventilator-associated pneumonia (VAP). VAP constitutes a serious burden for the healthcare system and worsens the patient's outcomes; thus, several preventive strategies have been implemented. This communication reviews the current knowledge on VAP pathogenesis and the latest preventive measures. Pathogen-laden oropharyngeal secretions leak across the endotracheal tube (ETT) cuff; thus, a continuous control of the internal cuff pressure and cuffs made of polyurethane improve sealing effectiveness and associated risks of infections. Subglottic secretions aspiration prevents VAP, and the latest evidence demonstrated a reduction in the incidence of late-onset VAP. The role of ETT biofilm in the pathogenesis of VAP is not fully elucidated. Nevertheless, antimicrobial-coated ETTs have showed beneficial effects in VAP incidence. Recent experimental evidence has challenged the benefits associated with the use of the semirecumbent position; yet, these findings need to be corroborated in clinical trials. The latest results from trials testing the effects of selective digestive decontamination (SDD) showed beneficial effects on patients' outcomes, but concerns remain regarding the emergence of bacterial resistance, specifically upon digestive tract re-colonization. The use of oropharyngeal decontamination with antiseptics and the use of probiotics are potential alternatives to SDD. There is consistent evidence that strategies affecting the primary mechanisms of VAP pathogenesis efficiently reduce the occurrence of the disease. Preventive measures should be implemented grouped into bundles to improve overall efficacy.

Capturing transitions and trajectories: the role of socioeconomic status in later life disability.

PubMed

Taylor, Miles G

2010-11-01

Disability is conceptualized as a life course process and measured using either transitions or trajectories. Previous research does not simultaneously explore both aspects of disablement, accounting for timing and trajectory. The role of education is noted in disability research, but its independent effects over time have not been fully examined. I investigate the effects of education and income on disability onset and progression over a decade. I use a latent curve modeling approach with four waves of the Duke Established Populations for Epidemiologic Studies of the Elderly data to independently test the preventive and mediating effects education and income provide for disability. Education has a preventive effect for disability onset but no significant effect on progression once income is held constant. Income has both a preventive and mediating effect on disability, although preventive effects are stronger for education. Later life disability is measured here using both onset and trajectory. Findings are consistent with health research suggesting that education and income work through shared and independent mechanisms to affect disability over time. These findings also highlight the importance of modeling timing when studying health trajectories.

Collective effect of personal behavior induced preventive measures and differential rate of transmission on spread of epidemics

NASA Astrophysics Data System (ADS)

Sagar, Vikram; Zhao, Yi

2017-02-01

In the present work, the effect of personal behavior induced preventive measures is studied on the spread of epidemics over scale free networks that are characterized by the differential rate of disease transmission. The role of personal behavior induced preventive measures is parameterized in terms of variable λ, which modulates the number of concurrent contacts a node makes with the fraction of its neighboring nodes. The dynamics of the disease is described by a non-linear Susceptible Infected Susceptible model based upon the discrete time Markov Chain method. The network mean field approach is generalized to account for the effect of non-linear coupling between the aforementioned factors on the collective dynamics of nodes. The upper bound estimates of the disease outbreak threshold obtained from the mean field theory are found to be in good agreement with the corresponding non-linear stochastic model. From the results of parametric study, it is shown that the epidemic size has inverse dependence on the preventive measures (λ). It has also been shown that the increase in the average degree of the nodes lowers the time of spread and enhances the size of epidemics.

[Surveillance as an effective approach to infectious diseases control and prevention].

PubMed

Wang, L P; Cao, W C

2017-04-10

Infectious disease surveillance have played an important role in the national diseases prevention and control strategies. In line with the reporting system, infectious disease surveillance has been greatly improved and played pivotal role in preventing epidemics since 1949 in China. To date, surveillance remains an effective approach to infectious disease control and prevention because of the global serious situation. In this column "infectious disease surveillance" , we have involved articles as systematic analysis of surveillance data and solid evidence related to the development of strategies and measures for infectious diseases control and prevention.

A quality control circle process to improve implementation effect of prevention measures for high-risk patients.

PubMed

Feng, Haixia; Li, Guohong; Xu, Cuirong; Ju, Changping; Suo, Peiheng

2017-12-01

The aim of the study was to analyse the influence of prevention measures on pressure injuries for high-risk patients and to establish the most appropriate methods of implementation. Nurses assessed patients using a checklist and factors influencing the prevention of a pressure injury determined by brain storming. A specific series of measures was drawn up and an estimate of risk of pressure injury determined using the Braden Scale, analysis of nursing documents, implementation of prevention measures for pressure sores and awareness of the system both before and after carrying out a quality control circle (QCC) process. The overall scores of implementation of prevention measures ranged from 74.86 ± 14.24 to 87.06 ± 17.04, a result that was statistically significant (P < 0.0025). The Braden Scale scores ranged from 8.53 ± 3.21 to 13.48 ± 3.57. The nursing document scores ranged from 7.67 ± 3.98 to 10.12 ± 1.63; prevention measure scores ranged from 11.48 ± 4.18 to 13.96 ± 3.92. Differences in all of the above results are statistically significant (P < 0.05). Implementation of a QCC can standardise and improve the prevention measures for patients who are vulnerable to pressure sores and is of practical importance to their prevention and control. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

[The General Principles of Suicide Prevention Policy from the perspective of clinical psychiatry].

PubMed

Cho, Yoshinori; Inagaki, Masatoshi

2014-01-01

In view of the fact that the suicide rate in Japan has remained high since 1998, the Basic Act on Suicide Prevention was implemented in 2006 with the objective of comprehensively promoting suicide prevention measures on a national scale. Based on this Basic Act, in 2007, the Japanese government formulated the General Principles of Suicide Prevention Policy as a guideline for recommended suicide prevention measures. These General Principles were revised in 2012 in accordance with the initial plan of holding a review after five years. The Basic Act places an emphasis on the various social factors that underlie suicides and takes the perspective that suicide prevention measures are also social measures. The slogan of the revised General Principles is "Toward Realization of a Society in which Nobody is Driven to Commit Suicide". The General Principles list various measures that are able to be used universally. These contents would be sufficient if the objective of the General Principles were "realization of a society that is easy to live in"; however, the absence of information on the effectiveness and order of priority for each measure may limit the specific effectiveness of the measures in relation to the actual prevention of suicide. In addition, considering that nearly 90% of suicide victims are in a state at the time of committing suicide in which a psychiatric disorder would be diagnosed, it would appear from a psychiatric standpoint that measures related to mental health, including expansion of psychiatric services, should be the top priority in suicide prevention measures. However, this is not the case in the General Principles, in either its original or revised form. Revisions to the General Principles related to clinical psychiatry provide more detailed descriptions of measures for individuals who unsuccessfully attempt suicide and identify newly targeted mental disorders other than depression; however, the overall proportion of contents relating to psychiatric care remains small. In particular, it must be noted that almost no measures are provided for individuals with chronic psychiatric disorders. We believe that the role of academic societies involved in suicide prevention, including our own, is to organize the contents of the General Principles based on evidence, to advance research in areas lacking in evidence, and to promote support for implementation of activities in areas with clear evidence.

Uridine prevents tamoxifen-induced liver lipid droplet accumulation.

PubMed

Le, Thuc T; Urasaki, Yasuyo; Pizzorno, Giuseppe

2014-05-23

Tamoxifen, an agonist of estrogen receptor, is widely prescribed for the prevention and long-term treatment of breast cancer. A side effect of tamoxifen is fatty liver, which increases the risk for non-alcoholic fatty liver disease. Prevention of tamoxifen-induced fatty liver has the potential to improve the safety of long-term tamoxifen usage. Uridine, a pyrimidine nucleoside with reported protective effects against drug-induced fatty liver, was co-administered with tamoxifen in C57BL/6J mice. Liver lipid levels were evaluated with lipid visualization using coherent anti-Stokes Raman scatting (CARS) microscopy, biochemical assay measurement of triacylglyceride (TAG), and liquid chromatography coupled with mass spectrometry (LC-MS) measurement of membrane phospholipid. Blood TAG and cholesterol levels were measured. Mitochondrial respiration of primary hepatocytes in the presence of tamoxifen and/or uridine was evaluated by measuring oxygen consumption rate with an extracellular flux analyzer. Liver protein lysine acetylation profiles were evaluated with 1D and 2D Western blots. In addition, the relationship between endogenous uridine levels, fatty liver, and tamoxifen administration was evaluated in transgenic mice UPase1-/-and UPase1-TG. Uridine co-administration prevented tamoxifen-induced liver lipid droplet accumulation in mice. The most prominent effect of uridine co-administration with tamoxifen was the stimulation of liver membrane phospholipid biosynthesis. Uridine had no protective effect against tamoxifen-induced impairment to mitochondrial respiration of primary hepatocytes or liver TAG and cholesterol export. Uridine had no effect on tamoxifen-induced changes to liver protein acetylation profile. Transgenic mice UPase1-/-with increased pyrimidine salvage activity were protected against tamoxifen-induced liver lipid droplet accumulation. In contrast, UPase1-TG mice with increased pyrimidine catabolism activity had intrinsic liver lipid droplet accumulation, which was aggravated following tamoxifen administration. Uridine co-administration was effective at preventing tamoxifen-induced liver lipid droplet accumulation. The ability of uridine to prevent tamoxifen-induced fatty liver appeared to depend on the pyrimidine salvage pathway, which promotes biosynthesis of membrane phospholipid.

How low an effect of a preventive measure against diarrhoea are travellers willing to pay for?: A survey of Norwegian travellers.

PubMed

Hasle, Gunnar; Heier, Lise

Traveller's diarrhoea (TD) is the most common infectious problem for travellers, and we lack effective ways of preventing it, apart from antibiotic prophylaxis. This study aims to quantify the risk reduction of a hypothetic TD vaccine Norwegian travellers are willing to pay for. 1204 clients at Reiseklinikken responded to a questionnaire asking what level of effectiveness would be required of a hypothetical vaccine against TD costing US$65. 18.7% of the respondents would buy the vaccine even if it was only 20% effective. Among respondents older than 50 years, the proportion was 28.8%. Our findings should encourage the development of vaccines and other preventive measures against travellers' diarrhoea. Copyright © 2016 Elsevier Ltd. All rights reserved.

Medical and health economic evaluation of prevention- and control measures related to MRSA infections or -colonisations at hospitals.

PubMed

Korczak, Dieter; Schöffmann, Christine

2010-03-16

Methicillin-resistant Staphylococcus aureus (MRSA) are dangerous agents of nosocomial infections. In 2007 the prevalence of MRSA is 20.3% in Germany (Oxacilline-resistance according to EUCAST-criteria [EUCAST = European Committee on Antimicrobial Susceptibility Testing]). Which measurements are effective in the prevention and control of MRSA-infections in the hospital?How effective are contact precautions, screening, decolonisation, education and surveillance?Which recommendations can be given to health care politics on the basis of cost-effectiveness studies?Have there been any adverse effects on patients and clinical staff?What kind of liability problems exist? Based on a systematic review of the literature studies are included which have been published in German or English language since 2004. 1,508 articles have been found. After having surveyed the full text, 33 medical, eight economic and four ethical/juridical studies are included for the Health Technology Assessment (HTA) report. The key result of the HTA report is that different measurements are effective in the prevention and control of MRSA-infections in hospitals, though the majority of the studies has a low quality. Effective are the conduction of differentiated screening measurements if they take into account the specific endemic situation, the use of antibiotic-control programs and the introduction and control of hygienic measurements. The break even point of preventive and control measurements cannot be defined because the study results differ too much. In the future it has to be more considered that MRSA-infections and contact precautions lead to a psycho-social strain for patients. It is hardly possible to describe causal efficacies because in the majority of the studies confounders are not sufficiently considered. In many cases bundles of measurements have been established but not analyzed individually. The internal and external validity of the studies is too weak to evaluate single interventions. Hygienic measurements prove to be effective in combination with other measurements. But it cannot be said which of the single measurements (gloves, washing hands, wearing gowns or masks) has the strongest effect on the reduction of MRSA. It is irritating that there are high differences in the compliance concerning hand hygiene between different studies. A general decolonisation is questionable for different reasons: first because of the side-effects for patients, second because of the high rate of spontaneous remissions in the untreated control group, third because of the differentiated process from colonisation to infection. Severalfold Hawthorne effects have been reported. One of them is that the competition between hospitals to reduce MRSA-rates leads already to a reduction. It is evident that selective screening programs of risk patients considering the particular MRSA-prevalence are of use. The application of rapid tests seems to be only recommendable for risk patients and a high MRSA-prevalence. The improvement of the compliance of hand hygiene should be the basis of any prevention strategy. Training of staff members (with feedback mechanisms) is effective to improve compliance and to optimise the use of antibiotics. Antibiotic management programs are effective as well. Obviously multimodal approaches can lead to overadditive effects. Therefore the catalogue of preventive and control measurements has to be further evaluated. Good cost-efficacy studies are missing in Germany. The psychosocial effects of MRSA-infections are not researched in Germany. There is only punctual information on the risk management of hospitals.

Mathematical modeling of HIV prevention measures including pre-exposure prophylaxis on HIV incidence in South Korea.

PubMed

Kim, Sun Bean; Yoon, Myoungho; Ku, Nam Su; Kim, Min Hyung; Song, Je Eun; Ahn, Jin Young; Jeong, Su Jin; Kim, Changsoo; Kwon, Hee-Dae; Lee, Jeehyun; Smith, Davey M; Choi, Jun Yong

2014-01-01

Multiple prevention measures have the possibility of impacting HIV incidence in South Korea, including early diagnosis, early treatment, and pre-exposure prophylaxis (PrEP). We investigated how each of these interventions could impact the local HIV epidemic, especially among men who have sex with men (MSM), who have become the major risk group in South Korea. A mathematical model was used to estimate the effects of each these interventions on the HIV epidemic in South Korea over the next 40 years, as compared to the current situation. We constructed a mathematical model of HIV infection among MSM in South Korea, dividing the MSM population into seven groups, and simulated the effects of early antiretroviral therapy (ART), early diagnosis, PrEP, and combination interventions on the incidence and prevalence of HIV infection, as compared to the current situation that would be expected without any new prevention measures. Overall, the model suggested that the most effective prevention measure would be PrEP. Even though PrEP effectiveness could be lessened by increased unsafe sex behavior, PrEP use was still more beneficial than the current situation. In the model, early diagnosis of HIV infection was also effectively decreased HIV incidence. However, early ART did not show considerable effectiveness. As expected, it would be most effective if all interventions (PrEP, early diagnosis and early treatment) were implemented together. This model suggests that PrEP and early diagnosis could be a very effective way to reduce HIV incidence in South Korea among MSM.

Mathematical Modeling of HIV Prevention Measures Including Pre-Exposure Prophylaxis on HIV Incidence in South Korea

PubMed Central

Kim, Sun Bean; Yoon, Myoungho; Ku, Nam Su; Kim, Min Hyung; Song, Je Eun; Ahn, Jin Young; Jeong, Su Jin; Kim, Changsoo; Kwon, Hee-Dae; Lee, Jeehyun; Smith, Davey M.; Choi, Jun Yong

2014-01-01

Background Multiple prevention measures have the possibility of impacting HIV incidence in South Korea, including early diagnosis, early treatment, and pre-exposure prophylaxis (PrEP). We investigated how each of these interventions could impact the local HIV epidemic, especially among men who have sex with men (MSM), who have become the major risk group in South Korea. A mathematical model was used to estimate the effects of each these interventions on the HIV epidemic in South Korea over the next 40 years, as compared to the current situation. Methods We constructed a mathematical model of HIV infection among MSM in South Korea, dividing the MSM population into seven groups, and simulated the effects of early antiretroviral therapy (ART), early diagnosis, PrEP, and combination interventions on the incidence and prevalence of HIV infection, as compared to the current situation that would be expected without any new prevention measures. Results Overall, the model suggested that the most effective prevention measure would be PrEP. Even though PrEP effectiveness could be lessened by increased unsafe sex behavior, PrEP use was still more beneficial than the current situation. In the model, early diagnosis of HIV infection was also effectively decreased HIV incidence. However, early ART did not show considerable effectiveness. As expected, it would be most effective if all interventions (PrEP, early diagnosis and early treatment) were implemented together. Conclusions This model suggests that PrEP and early diagnosis could be a very effective way to reduce HIV incidence in South Korea among MSM. PMID:24662776

Expert opinions on good practice in evaluation of health promotion and primary prevention measures related to children and adolescents in Germany.

PubMed

Korber, Katharina; Becker, Christian

2017-10-02

Determining what constitutes "good practice" in the measurement of the costs and effects of health promotion and disease prevention measures is of particular importance. The aim of this paper was to gather expert knowledge on (economic) evaluations of health promotion and prevention measures for children and adolescents, especially on the practical importance, the determinants of project success, meaningful parameters for evaluations, and supporting factors, but also on problems in their implementation. This information is targeted at people responsible for the development of primary prevention or health promotion programs. Partially structured open interviews were conducted by two interviewers and transcribed, paraphrased, and summarized for further use. Eight experts took part in the interviews. The interviewed experts saw evaluation as a useful tool to establish the effects of prevention programs, to inform program improvement and further development, and to provide arguments to decision making. The respondents' thought that determinants of a program's success were effectiveness with evidence of causality, cost benefit relation, target-group reach and sustainability. It was considered important that hard and soft factors were included in an evaluation; costs were mentioned only by one expert. According to the experts, obstacles to evaluation were lacking resources, additional labor requirements, and the evaluators' unfamiliarity with a program's contents. It was recommended to consider evaluation design before a program is launched, to co-operate with people involved in a program and to make use of existing structures. While in in this study only a partial view of expert knowledge is represented, it could show important points to consider when developing evaluations of prevention programs. By considering these points, researchers could further advance towards a more comprehensive approach of evaluation targeting measures in children and adolescents.

[The actual approaches to the economic analysis of effectiveness of functioning of multi-profile curative preventive medical institution].

PubMed

Gaĭdarov, G M; Alekseeva, N Iu; Latysheva, E A

2010-01-01

The article deals with the technique of economic analysis of effectiveness of functioning of multi-profile curative preventive medical institution in the conditions of transition to the payment according the completed case of treatment. The necessity of the measures targeted to prevent the financial losses under the new form of payment for hospital care is proved.

Treatment effect expressed as the novel Delay of Event measure is associated with high willingness to initiate preventive treatment - A randomized survey experiment comparing effect measures.

PubMed

Berglund, Erik; Westerling, Ragnar; Sundström, Johan; Lytsy, Per

2016-12-01

This study aimed to investigate patients' willingness to initiate a preventive treatment and compared two established effect measures to the newly developed Delay of Events (DoE) measure that expresses treatment effect as a gain in event-free time. In this cross-sectional, randomized survey experiment in the general Swedish population,1079 respondents (response rate 60.9%) were asked to consider a preventive cardiovascular treatment. Respondents were randomly allocated to one of three effect descriptions: DoE, relative risk reduction (RRR), or absolute risk reduction (ARR). Univariate and multivariate analyses were performed investigating willingness to initiate treatment, views on treatment benefit, motivation and importance to adhere and willingness to pay for treatment. Eighty-one percent were willing to take the medication when the effect was described as DoE, 83.0% when it was described as RRR and 62.8% when it was described as ARR. DoE and RRR was further associated with positive views on treatment benefit, motivation, importance to adhere and WTP. Presenting treatment effect as DoE or RRR was associated with a high willingness to initiate treatment. An approach based on the novel time-based measure DoE may be of value in clinical communication and shared decision making. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Tracheal Tube Design and Ventilator-Associated Pneumonia.

PubMed

Rouzé, Anahita; Jaillette, Emmanuelle; Poissy, Julien; Préau, Sébastien; Nseir, Saad

2017-10-01

Microaspiration of contaminated oropharyngeal and gastric secretions is the main mechanism for ventilator-associated pneumonia (VAP) in critically ill patients. Improving the performance of tracheal tubes in reducing microaspiration is one potential means to prevent VAP. The aim of this narrative review is to discuss recent findings on the impact of tracheal tube design on VAP prevention. Several randomized controlled studies have reported that subglottic secretion drainage (SSD) is efficient in VAP prevention. Meta-analyses have reported conflicting results regarding the impact of SSD on duration of mechanical ventilation, and one animal study raised concern about SSD-related tracheal lesions. However, this measure appears to be cost-effective. Therefore, SSD should probably be used in all patients with expected duration of mechanical ventilation > 48 h. Three randomized controlled trials have shown that tapered-cuff tracheal tubes are not useful to prevent VAP and should probably not be used in critically ill patients. Further studies are required to confirm the promising effects of continuous control of cuff pressure, polyurethane-cuffed, silver-coated, and low-volume low-pressure tracheal tubes. There is moderate evidence for the use of SSD and strong evidence against the use of tapered-cuff tracheal tubes in critically ill patients for VAP prevention. However, more data on the safety and cost-effectiveness of these measures are needed. Other tracheal tube-related preventive measures require further investigation. Copyright © 2017 by Daedalus Enterprises.

The US Air Force suicide prevention program: implications for public health policy.

PubMed

Knox, Kerry L; Pflanz, Steven; Talcott, Gerald W; Campise, Rick L; Lavigne, Jill E; Bajorska, Alina; Tu, Xin; Caine, Eric D

2010-12-01

We evaluated the effectiveness of the US Air Force Suicide Prevention Program (AFSPP) in reducing suicide, and we measured the extent to which air force installations implemented the program. We determined the AFSPP's impact on suicide rates in the air force by applying an intervention regression model to data from 1981 through 2008, providing 16 years of data before the program's 1997 launch and 11 years of data after launch. Also, we measured implementation of program components at 2 points in time: during a 2004 increase in suicide rates, and 2 years afterward. Suicide rates in the air force were significantly lower after the AFSPP was launched than before, except during 2004. We also determined that the program was being implemented less rigorously in 2004. The AFSPP effectively prevented suicides in the US Air Force. The long-term effectiveness of this program depends upon extensive implementation and effective monitoring of implementation. Suicides can be reduced through a multilayered, overlapping approach that encompasses key prevention domains and tracks implementation of program activities.

A community intervention trial of multimodal suicide prevention program in Japan: a novel multimodal community intervention program to prevent suicide and suicide attempt in Japan, NOCOMIT-J.

PubMed

Ono, Yutaka; Awata, Shuichi; Iida, Hideharu; Ishida, Yasushi; Ishizuka, Naoki; Iwasa, Hiroto; Kamei, Yuichi; Motohashi, Yutaka; Nakagawa, Atsuo; Nakamura, Jun; Nishi, Nobuyuki; Otsuka, Kotaro; Oyama, Hirofumi; Sakai, Akio; Sakai, Hironori; Suzuki, Yuriko; Tajima, Miyuki; Tanaka, Eriko; Uda, Hidenori; Yonemoto, Naohiro; Yotsumoto, Toshihiko; Watanabe, Naoki

2008-09-15

To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. This study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals). The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas. UMIN Clinical Trials Registry (UMIN-CTR) UMIN000000460.

Social Justice and HIV Vaccine Research in the Age of Pre-Exposure Prophylaxis and Treatment as Prevention

PubMed Central

Bailey, Theodore C.; Sugarman, Jeremy

2014-01-01

The advent of pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) as means of HIV prevention raises issues of justice concerning how most fairly and equitably to apportion resources in support of the burgeoning variety of established HIV treatment and prevention measures and further HIV research, including HIV vaccine research. We apply contemporary approaches to social justice to assess the ethical justification for allocating resources in support of HIV vaccine research given competing priorities to support broad implementation of HIV treatment and prevention measures, including TasP and PrEP. We argue that there is prima facie reason to believe that a safe and effective preventive HIV vaccine would offer a distinct set of ethically significant benefits not provided by current HIV treatment or prevention methods. It is thereby possible to justify continued support for HIV vaccine research despite tension with priorities for treatment, prevention, and other research. We then consider a counter-argument to such a justification based on the uncertainty of successfully developing a safe and effective preventive HIV vaccine. Finally, we discuss how HIV vaccine research might now be ethically designed and conducted given the new preventive options of TasP and PrEP, focusing on the ethically appropriate standard of prevention for HIV vaccine trials. PMID:24033297

Measuring waste prevention.

PubMed

Zorpas, Antonis A; Lasaridi, Katia

2013-05-01

The Waste Framework Directive (WFD-2008/98/EC) has set clear waste prevention procedures, including reporting, reviewing, monitoring and evaluating. Based on the WFD, the European Commission and will offer support to Member States on how to develop waste prevention programmes through guidelines and information sharing on best practices. Monitoring and evaluating waste prevention activities are critical, as they constitute the main tools to enable policy makers, at the national and local level, to build their strategic plans and ensure that waste prevention initiatives are effective and deliver behaviour change. However, how one can measure something that is not there, remains an important and unresolved research question. The paper reviews and attempts to evaluate the methods that are being used for measuring waste prevention and the impact of relevant implemented activities at the household level, as the available data is still limited. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effectiveness of a Technology-Based Injury Prevention Program for Enhancing Mothers’ Knowledge of Child Safety: Protocol for a Randomized Controlled Trial

PubMed Central

Chow, Chun Bong; Wong, Wilfred Hing-Sang; Leung, Wing Cheong; Tang, Mary Hoi-Yin; Chan, Ko Ling; Or, Calvin KL; Li, Tim MH; Ho, Frederick Ka Wing; Lo, Daniel

2016-01-01

Background Provision of anticipatory guidance for parents is recommended as an effective strategy to prevent injuries among young children. Technology-based anticipatory guidance has been suggested to reinforce the effectiveness of injury prevention and improve parents’ knowledge of child safety. Objective This study aims to examine the effectiveness of a technology-based injury prevention program with parental anticipatory guidance for enhancing mothers’ knowledge of child safety. Methods In this randomized controlled trial, 308 mothers will be recruited from the antenatal clinics and postnatal wards of two major public hospitals in Hong Kong. Participating mothers will be randomly assigned into intervention and control groups. Mothers in the intervention group will be given free access to a technology-based injury prevention program with anticipatory guidance, whereas mothers in the control group will be given a relevant booklet on parenting. The injury prevention program, available as a website or on a mobile app, includes behavioral components based on the Theory of Planned Behavior. The primary outcome measure will be the change in the mother’s knowledge of child safety. The secondary outcome measures will be age-appropriate domestic safety knowledge, attitudes, intentions, perceived behavioral control, and self-reported behavior related to home safety practice. We will also determine dose-response relationships between the outcome measures and the website and mobile app usage. Results Enrolment of participants will begin in October 2016. Results are expected by June 2018. Conclusions Parents will be able to easily access the domestic injury prevention website to find information regarding child injury prevention. It is anticipated that the technology-based intervention will help parents improve their knowledge of child safety and raise their awareness about the consequences of domestic injuries and the importance of prevention. Trial Registration Clinicaltrials.gov Clinicaltrials.gov NCT02835768; http://clinicaltrials.gov/ct2/show/NCT02835768 (Archived by WebCite at http://www.webcitation/6lbXYM6b9) PMID:27799138

Can We Measure Success in Preventing Child Abuse? Issues in Policy, Programming and Research.

ERIC Educational Resources Information Center

Garbarino, James

1986-01-01

The article reviews efforts to set child abuse prevention goals in the U.S., noting research on program effectiveness and the role of maltreatment in child mortality. Alternative models for assessing the impact of prevention are described and the need to clarify and specify goals in prevention is stressed. (CL)

[The organization of the comprehensive prevention of urolithiasis among ferrous metallurgy workers].

PubMed

Egorova, A M

2009-01-01

The purpose of study is to evaluate the effectiveness of the set of preventive measures as applied to 321 workers of basic ferrous metallurgy specialties (steel makers, mill men, hot metal shearers). During the clinical examination all the workers were divided on three groups: the workers without any pathology (11.83%, the first group), the workers with metabolic disorders only without urolitiasis (64.81%, the second group) and the workers with urolitiasis diagnosis approved by ultrasonography (23.36%, the third group). The effectiveness of rehabilitation measures was evaluated during half a year (diet therapy, drinking regimen, medicinal plants treatment). After the course of preventive measures was applied the overall health condition of most workers ameliorated and the number of workers with urolitiasis development risk factors reliably decreased up to 6-12%.

Drug prevention programmes for young people: where have we been and where should we be going?

PubMed

Midford, Richard

2010-10-01

Substance use by young people has long been a concern of western society, but opinion is mixed as to which prevention approach offers the greatest benefit, and whether indeed there is any benefit at all. This paper reviews the nature of prevention programmes, the research evidence that underpins these programmes and the prevention objectives against which effectiveness is measured. The aim of this is to create better understanding of the elements that maximize programme effectiveness, what can be achieved by prevention programmes and how programmes can be improved. There is a range of prevention approaches for which there is evidence of effectiveness. Some are classroom-based; some focus upon parenting; some have substantial whole-of-school and community elements; and some target risk and protective factors in early childhood. All, however, are based substantially on the social influence model. In an attempt to improve practice lists of effective programmes have been developed, but there are concerns about the science behind selection. On balance, there is consistent evidence that social influence prevention programmes do have a small, positive effect on drug use, but this then raises the question as to whether harm, rather than use, would be the more worthwhile target for prevention. Prevention that seeks to reduce harm has been demonstrably effective, but has found little support in some jurisdictions. Research has created a progressively better understanding of how to optimize programme effectiveness and what can be achieved realistically by even the most effective programmes. However, further research is required to identify which, if any, particular approach offers greater promise. The effectiveness of harm reduction should be compared with more traditional abstinence and the additional effects of whole of school, parent and community elements need to be measured more accurately. Contemporary social influence prevention programmes are flawed, but the approach is still the best way of influencing drug use behaviour in young people as a whole. Evidence-based refinement is the best option for greater benefit. © 2009 The Author, Addiction © 2009 Society for the Study of Addiction.

Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial.

PubMed

Hoek, Rianne J A; Havermans, Bo M; Houtman, Irene L D; Brouwers, Evelien P M; Heerkens, Yvonne F; Zijlstra-Vlasveld, Moniek C; Anema, Johannes R; van der Beek, Allard J; Boot, Cécile R L

2017-07-17

Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative learning network. The digital platform contains a stepwise protocol to implement work-related stress-management interventions. It includes stress screeners, interventions and intervention providers to facilitate access to and the selection of matching work-related stress-management interventions. The collaborative learning network, including stakeholders from various organizations, plans meetings focussing on an exchange of experiences and good practices among organizations for the implementation of stress prevention measures. This paper describes the design of an integral stress-prevention strategy, Stress Prevention@Work, and the protocol for the evaluation of: 1) the effects of the strategy on perceived stress and work-related outcomes, and 2) the barriers and facilitators for implementation of the strategy. The effectiveness of Stress Prevention@Work will be evaluated in a cluster controlled trial, in a large healthcare organization in the Netherlands, at six and 12 months. An independent researcher will match teams on working conditions and size and allocate the teams to the intervention or control group. Teams in the intervention group will be offered Stress Prevention@Work. For each intervention team, one employee is responsible for applying the strategy within his/her team using the digital platform and visiting the collaborative learning network. Using a waiting list design, the control group will be given access to the strategy after 12 months. The primary outcome is the employees' perceived stress measured by the stress subscale of the Depression, Anxiety, and Stress Scale (DASS-21). Secondary outcome measures are job demands, job resources and the number of preventive stress measures implemented at the team level. Alongside the trial, a process evaluation, including barriers and facilitators of the implementation of Stress Prevention@Work, will be conducted in one healthcare organisation. If Stress Prevention@Work is found to be effective in one healthcare organisation, further implementation on a broader scale might lead to increased productivity and decreased stress and sick leave in other organizations. Results are expected in 2018. NTR5527 . Registered 7 Dec 2015.

Report: EPA Needs Accurate Data on Results of Pollution Prevention Grants to Maintain Program Integrity and Measure Effectiveness of Grants

EPA Pesticide Factsheets

Report #15-P-0276, September 4, 2015. Inaccurate reporting of results misrepresents the impacts of pollution prevention activities provided to the public, and misinforms EPA management on the effectiveness of its investment in the program.

Falls prevention for the elderly.

PubMed

Balzer, Katrin; Bremer, Martina; Schramm, Susanne; Lühmann, Dagmar; Raspe, Heiner

2012-01-01

An ageing population, a growing prevalence of chronic diseases and limited financial resources for health care underpin the importance of prevention of disabling health disorders and care dependency in the elderly. A wide variety of measures is generally available for the prevention of falls and fall-related injuries. The spectrum ranges from diagnostic procedures for identifying individuals at risk of falling to complex interventions for the removal or reduction of identified risk factors. However, the clinical and economic effectiveness of the majority of recommended strategies for fall prevention is unclear. Against this background, the literature analyses in this HTA report aim to support decision-making for effective and efficient fall prevention. The pivotal research question addresses the effectiveness of single interventions and complex programmes for the prevention of falls and fall-related injuries. The target population are the elderly (> 60 years), living in their own housing or in long term care facilities. Further research questions refer to the cost-effectiveness of fall prevention measures, and their ethical, social and legal implications. Systematic literature searches were performed in 31 databases covering the publication period from January 2003 to January 2010. While the effectiveness of interventions is solely assessed on the basis of randomised controlled trials (RCT), the assessment of the effectiveness of diagnostic procedures also considers prospective accuracy studies. In order to clarify social, ethical and legal aspects all studies deemed relevant with regard to content were taken into consideration, irrespective of their study design. Study selection and critical appraisal were conducted by two independent assessors. Due to clinical heterogeneity of the studies no meta-analyses were performed. Out of 12,000 references retrieved by literature searches, 184 meet the inclusion criteria. However, to a variable degree the validity of their results must be rated as compromised due to different biasing factors. In summary, it appears that the performance of tests or the application of parameters to identify individuals at risk of falling yields little or no clinically relevant information. Positive effects of exercise interventions may be expected in relatively young and healthy seniors, while studies indicate opposite effects in the fragile elderly. For this specific vulnerable population the modification of the housing environment shows protective effects. A low number of studies, low quality of studies or inconsistent results lead to the conclusion that the effectiveness of the following interventions has to be rated unclear yet: correction of vision disorders, modification of psychotropic medication, vitamin D supplementation, nutritional supplements, psychological interventions, education of nursing personnel, multiple and multifactorial programs as well as the application of hip protectors. For the context of the German health care system the economic evaluations of fall prevention retrieved by the literature searches yield very few useful results. Cost-effectiveness calculations of fall prevention are mostly based on weak effectiveness data as well as on epidemiological and cost data from foreign health care systems. Ethical analysis demonstrates ambivalent views of the target population concerning fall risk and the necessity of fall prevention. The willingness to take up preventive measures depends on a variety of personal factors, the quality of information, guidance and decision-making, the prevention program itself and social support. THE ANALYSIS OF PAPERS REGARDING LEGAL ISSUES SHOWS THREE MAIN CHALLENGES: the uncertainty of which standard of care has to be expected with regard to fall prevention, the necessity to consider the specific conditions of every single case when measures for fall prevention are applied, and the difficulty to balance the rights to autonomous decision making and physical integrity. The assessment of clinical effectiveness of interventions for fall prevention is complicated by inherent methodological problems (esp. absence of blinding) and meaningful clinical heterogeneity of available studies. Therefore meta-analyses are not appropriate, and single study results are difficult to interpret. Both problems also impair the informative value of economic analyses. With this background it has to be stated that current recommendations regarding fall prevention in the elderly are not fully supported by scientific evidence. In particular, for the generation of new recommendations the dependency of probable effects on specific characteristics of the target populations or care settings should be taken into consideration. This also applies to the variable factors influencing the willingness of the target population to take up and pursue preventive measures. In the planning of future studies equal weight should be placed on methodological rigour (freedom from biases) and transferability of results into routine care. Economic analyses require input of German data, either in form of a "piggy back study" or in form of a modelling study that reflects the structures of the German health care system and is based on German epidemiological and cost data.

Quantitative PCR monitoring of the effect of azoxystrobin treatments on Mycosphaerella graminicola epidemics in the field.

PubMed

Rohel, Eric A; Laurent, Paul; Fraaije, Bart A; Cavelier, Nadine; Hollomon, Derek W

2002-03-01

Quantitative PCR and visual monitoring of Mycosphaerella graminicola epidemics were performed to investigate the effect of curative and preventative applications of azoxystrobin in wheat field crops. A non-systemic protectant and a systemic curative fungicide, chlorothalonil and epoxiconazole, respectively, were used as references. PCR diagnosis detected leaf infection by M graminicola 3 weeks before symptom appearance, thereby allowing a clear distinction between curative and preventative treatments. When applied 1 week after the beginning of infection, azoxystrobin curative activity was intermediate between chlorothalonil (low effect) and epoxiconazole. When applied preventatively, none of the fungicides completely prevented leaf infection. There was some indication that azoxystrobin preventative treatments may delay fungal DNA increase more than epoxiconazole at the beginning of leaf infection. Both curative and preventative treatments increased the time lapse between the earliest PCR detection and the measurement of a 10% necrotic leaf area. Azoxystrobin only slightly decreased the speed of necrotic area increase compared with epoxiconazole. Hence, azoxystrobin activity toward M graminicola mainly resides in lengthening the time lapse between the earliest PCR detection and the measurement of a 10% necrotic leaf area. Information generated in this way is useful for optimal positioning of azoxystrobin treatments on M graminicola.

The hook effect in calcitonin immunoradiometric assay: a case report.

PubMed

Fangous, Marie-Sarah; Kerspern, Hélène; Moineau, Marie-Pierre; Kerlan, Véronique; Alavi, Zarrin; Carré, Jean-Luc

2012-12-01

The hook effect, which has long been detected and documented for immunoradiometric assays (IRMA) such as those measuring prolactin or thyroglobulin, occurs when the serum antigen level is extremely high, thus inducing a bias in the methodology of measurement. We report the case of an 80-year-old man with confirmed medullary thyroid carcinoma (MTC). In the case reported here, the clinical status of the patient contrasts with his tumor antigen, serum calcitonin (CT), concentrations. The measured increased CT concentrations revealed the presence of a hook effect. This phenomenon occurs due to an excess of antigen during the one-step IRMA where the signal antibodies, bound to the non-captured antigens, are washed out during the measurement, inducing the loss of signal. Aiming to prevent the "hook effect", successive dilutions of the same sample of serum were done. Previous studies have shown when one-step IRMA reveals high concentrations of a tumor serum antigen (i.e. prolactin or thyroglobulin), a two-step IRMA or a systematic 1:10 dilution of the serum sample prevents the formation of the "hook effect". In our case report, the CT "hook effect" formation was prevented by performing serial dilutions of the serum sample. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Risk factors and effectiveness of preventive measures against influenza in the community

PubMed Central

Castilla, Jesús; Godoy, Pere; Domínguez, Ángela; Martín, Vicente; Delgado‐Rodríguez, Miguel; Martínez‐Baz, Iván; Baricot, Maretva; Soldevila, Nuria; Mayoral, José M.; Astray, Jenaro; Quintana, José M.; Cantón, Rafael; Castro, Ady; González‐Candelas, Fernando; Alonso, Jordi; Saez, Marc; Tamames, Sonia; Pumarola, Tomás

2012-01-01

Please cite this paper as: Castilla et al. (2013) Risk factors and effectiveness of preventive measures against influenza in the community. Influenza and Other Respiratory Viruses 7(2) 177–183. Background  The role of different risk exposures and preventive measures against influenza has not been well established. Objective  The aim of this study was to evaluate risk factors and measures to prevent influenza infection in the community. Methods  We conducted a multicenter case–control study. Cases were 481 outpatients aged 18 years or older with laboratory‐confirmed influenza A(H1N1)09 in the 2009–2010 season in Spain. A control was selected for each case from outpatients from the same area matched by age and date of consultation. Information on risk situations, preventive measures and other variables was obtained by interview and review of the medical record. Results  In the multivariate conditional logistic regression analysis, the risk of a diagnosis of influenza increased with the number of cohabitants (compared with <3 cohabitants, three cohabitants had an OR = 1·80, 95% CI 1·12–2·89, and ≥5 cohabitants had an OR = 2·66, 95% CI 1·31–5·41) and for health care workers (OR = 2·94, 95% CI 1·53–5·66). The use of metropolitan public transport was associated with a lower frequency of a diagnosis of influenza (OR = 0·45, 95% CI 0·30–0·68) but not the use of taxis or long‐distance transport. The influenza A(H1N1)09 vaccine had a protective effect (OR = 0·13, 95% CI 0·04–0·48), unlike hand washing after touching contaminated surfaces or the use of alcohol‐based hand sanitizers. Conclusion  The home environment appears to play an important role in the spread of influenza in adults, but not the use of public transport. Health care workers have a higher risk of contracting influenza. Vaccination was the most effective preventive measure. PMID:22458533

Stay@Work: Participatory Ergonomics to prevent low back and neck pain among workers: design of a randomised controlled trial to evaluate the (cost-)effectiveness

PubMed Central

Driessen, Maurice T; Anema, Johannes R; Proper, Karin I; Bongers, Paulien M; Beek, Allard J van der

2008-01-01

Background Low back pain (LBP) and neck pain (NP) are a major public health problem with considerable costs for individuals, companies and society. Therefore, prevention is imperative. The Stay@Work study investigates the (cost-)effectiveness of Participatory Ergonomics (PE) to prevent LBP and NP among workers. Methods In a randomised controlled trial (RCT), a total of 5,759 workers working at 36 departments of four companies is expected to participate in the study at baseline. The departments consisting of about 150 workers are pre-stratified and randomised. The control departments receive usual practice and the intervention departments receive PE. Within each intervention department a working group is formed including eight workers, a representative of the management, and an occupational health and safety coordinator. During a one day meeting, the working group follows the steps of PE in which the most important risk factors for LBP and NP, and the most adequate ergonomic measures are identified on the basis of group consensus. The implementation of ergonomic measures at the department is performed by the working group. To improve the implementation process, so-called 'ergocoaches' are trained. The primary outcome measure is an episode of LBP and NP. Secondary outcome measures are actual use of ergonomic measures, physical workload, psychosocial workload, intensity of pain, general health status, sick leave, and work productivity. The cost-effectiveness analysis is performed from the societal and company perspective. Outcome measures are assessed using questionnaires at baseline and after 6 and 12 months. Data on the primary outcome as well as on intensity of pain, sick leave, work productivity, and health care costs are collected every 3 months. Discussion Prevention of LBP and NP is beneficial for workers, employers, and society. If the intervention is proven (cost-)effective, the intervention can have a major impact on LBP and NP prevention and, thereby, on work disability prevention. Results are expected in 2010. Trial registration ISRCTN27472278 PMID:18959799

An external domino effects investment approach to improve cross-plant safety within chemical clusters.

PubMed

Reniers, Genserik

2010-05-15

Every company situated within a chemical cluster faces the risk of being struck by an escalating accident at one of its neighbouring plants (the so-called external domino effect risks). These cross-plant risks can be reduced or eliminated if neighbouring companies are willing to invest in systems and measures to prevent them. However, since reducing such multi-plant risks does not lead to direct economic benefits, enterprises tend to be reluctant to invest more than needed for meeting minimal legal requirements and they tend to invest without collaborating. The suggested approach in this article indicates what information is required to evaluate the available investment options in external domino effects prevention. To this end, game theory is used as a promising scientific technique to investigate the decision-making process on investments in prevention measures simultaneously involving several plants. The game between two neighbouring chemical plants and their strategic investment behaviour regarding the prevention of external domino effects is described and an illustrative example is provided. Recommendations are formulated to advance cross-plant prevention investments in a two-company cluster. Copyright (c) 2009 Elsevier B.V. All rights reserved.

Rape Prevention With College Men

PubMed Central

Stephens, Kari A.; George, William H.

2014-01-01

This study evaluates the effectiveness of a theoretically based rape prevention intervention with college men who were at high or low risk to perpetrate sexually coercive behavior. Participants (N = 146) are randomly assigned to the intervention or control group. Outcomes include rape myth acceptance, victim empathy, attraction to sexual aggression, sex-related alcohol expectancies, and behavioral indicators, measured across three time points. Positive effects are found for rape myth acceptance, victim empathy, attraction to sexual aggression, and behavioral intentions to rape. Only rape myth acceptance and victim empathy effects sustain at the 5-week follow-up. High-risk men are generally unaffected by the intervention although low-risk men produced larger effects than the entire sample. Results suggest rape prevention studies must assess risk status moderation effects to maximize prevention for high-risk men. More research is needed to develop effective rape prevention with men who are at high risk to rape. PMID:18591366

Steps in the design, development and formative evaluation of obesity prevention-related behavior change trials

USDA-ARS?s Scientific Manuscript database

Obesity prevention interventions through dietary and physical activity change have generally not been effective. This paper uses the Mediating Variable Model (MVM) as a conceptual framework for examining why obesity prevention interventions have not worked. Problems were identified in measurement of...

Benefits of invasion prevention: Effect of time lags, spread rates, and damage persistence

Treesearch

Rebecca S. Epanchin-Niell; Andrew M. Liebhold

2015-01-01

Quantifying economic damages caused by invasive species is crucial for cost-benefit analyses of biosecurity measures. Most studies focus on short-term damage estimates, but evaluating exclusion or prevention measures requires estimates of total anticipated damages from the time of establishment onward. The magnitude of such damages critically depends on the timing of...

Breast cancer epidemic in the early twenty-first century: evaluation of risk factors, cumulative questionnaires and recommendations for preventive measures.

PubMed

Golubnitschaja, Olga; Debald, Manuel; Yeghiazaryan, Kristina; Kuhn, Walther; Pešta, Martin; Costigliola, Vincenzo; Grech, Godfrey

2016-10-01

Rapidly increasing incidence of breast cancer is a new social challenge resulting from a spectrum of internal and external risk factors which appear to be well accepted as an attribute of the early twenty-first century, being, however, new for female sub-populations compared to the past. These include altered socio-economical conditions such as occupational exposure, rotating shift work, specific environmental factors (increased pollution and environmental toxicity, altered dietary habits, quality and composition of meal) as well as consequently shifted and/or adapted physiologic factors such as lower age at menarche, late age of first full-term pregnancy, if any, shorter periods of breastfeeding and later menopause. Consolidated expert statements suggest that over 50 % of all breast cancer cases may be potentially prevented by risk reduction strategy such as regulation of modifiable risk factors. Currently available risk assessment models may estimate potential breast cancer predisposition, in general; however, they are not able to predict the disease manifestation individually. Further, current deficits in risk assessment and effective breast cancer prevention have been recently investigated and summarised as follows: gaps in risk estimation, preventive therapy, lifestyle prevention, understanding of the biology of breast cancer risk and implementation of known preventive measures. This paper overviews the most relevant risk factors, provides recommendations for improved risk assessment and proposes an extended questionnaire for effective preventive measures.

Secondary Prevention of Chronic PTSD by Early and Short-Term Administration of Escitalopram: A Prospective Randomized, Placebo-Controlled, Double-Blind Trial.

PubMed

Zohar, Joseph; Fostick, Leah; Juven-Wetzler, Alzabeta; Kaplan, Zeev; Shalev, Hadar; Schreiber, Gavriel; Miroshnik, Natalie; Shalev, Arieh Y; Stein, Dan J; Seedat, Soraya; Suliman, Sharain; Klein, Ehud

Prospective studies have not identified a viable pharmacologic strategy for secondary prevention of posttraumatic stress disorder (PTSD). The authors examined whether preventive intervention via early and short-term administration of a selective serotonin reuptake inhibitor (SSRI), within 1 month of exposure to a traumatic event (before diagnosis of PTSD could be made), may reduce the severity of PTSD symptoms according to DSM-IV at 13 months' follow-up. Over 25,000 screening calls to patients referred to an emergency department for a traumatic event performed between June 2006 and December 2008 yielded 353 participants who were recruited within the month following a traumatic event . Participants were randomly assigned in a double-blind design to escitalopram (n = 176) or placebo (n = 177). The per-protocol analysis comprised 198 participants (escitalopram, n = 102; placebo, n = 96) who received treatment for 12 to 24 weeks and were available for follow-up at week 56. The primary outcome measure, the Clinician Administered PTSD Scale (CAPS), revealed no prevention effect. However, a secondary outcome, the Pittsburgh Sleep Quality Inventory (PSQI), showed better results for the SSRI group than for the placebo group. For a subset of participants who experienced intentional trauma (missile attacks, rape, or physical assault; n = 50), the prevention effect was found on both primary and secondary measures (CAPS, PSQI and measures of depression and global illness severity). Early and short-term administration of escitalopram was not shown to prevent PTSD, although it did improve sleep quality. In a subgroup of participants who experienced intentional trauma, however, this early-treatment approach may be effective as secondary prevention. This large study is the first to investigate the preventive effect of early administration of escitalopram on PTSD. It highlights the relevance of the type of trauma (intentional vs unintentional) to the outcome. ClinicalTrials.gov identifier: NCT00300313​​. © Copyright 2018 Physicians Postgraduate Press, Inc.

Indicators for Evaluating Community- and Societal-Level Risk and Protective Factors for Violence Prevention: Findings From a Review of the Literature.

PubMed

Armstead, Theresa L; Wilkins, Natalie; Doreson, Amanda

Programs geared toward preventing violence before it occurs at the community and societal levels of the social ecology are particularly challenging to evaluate. These programs are often focused on impacting the antecedents (or risk and protective factors) to violence, making it difficult to determine program success when solely relying on measures of violence reduction. The goal of this literature review is to identify indicators to measure risk and protective factors for violence that are accessible and measured at the community level. Indicators of community- and societal-level risk and protective factors from 116 articles are identified. These indicators strengthen violence prevention researchers' and practitioners' ability to detect proximal effects of violence prevention programs, practices, and policies, and provide timely feedback on the impact of their work. Thus, opportunities exist for violence prevention researchers to further study the associations between various indicators and different violent outcomes and to inform practitioner, evaluator, and funder developed logic models that include indicators of relevant risk and protective factors for crosscutting violence prevention measures and outcomes.

Knowledge level of nurses in Jordan on ventilator-associated pneumonia and preventive measures.

PubMed

Hassan, Zeinab M; Wahsheh, Moayad A

2017-05-01

Ventilator-associated pneumonia is the most prevalent infection in Intensive Care Units, with the highest mortality rate; crude mortality rates may be as high as 20-75%. Many practices such as prevention measures (e.g. hand washing, wearing gloves, suctioning, elevated head of bed between 30° and 45°) have demonstrated an effect of reducing the incidence of this infection. To identify the level of nurses' knowledge of ventilator-associated pneumonia and prevention measures before an educational programme, identify the level of nurses' knowledge on ventilator-associated pneumonia and prevention post an educational programme and identify the reasons for not applying ventilator-associated pneumonia prevention measures among nurses in Jordan. Pre- and post-intervention observational study. Data based on a self-reported questionnaire from 428 nurses who worked in intensive care units were analysed. PowerPoint lectures, videos, printed materials and electronic materials were used in the intervention. Paired t-tests were used to test research questions. More than three-quarters of nurses had a low knowledge level regarding pathophysiology, risk factors and ventilator-associated pneumonia preventative measures. Nurses showed significant improvements in mean scores on the knowledge level of ventilator-associated pneumonia and prevention measures after an educational programme (p < 0.05). The main reasons for not applying prevention measures were the lack of time and no followed protocols in the units. Health education programmes about ventilator-associated pneumonia must be conducted among nurses in Jordan through continuous education. Hospital and nursing administrators should be actively involved in educational programmes and in assuring support for continuing education. Protocol for ventilator-associated pneumonia prevention should be developed based on current evidence-based guidelines. © 2016 British Association of Critical Care Nurses.

Uridine prevents tamoxifen-induced liver lipid droplet accumulation

PubMed Central

2014-01-01

Background Tamoxifen, an agonist of estrogen receptor, is widely prescribed for the prevention and long-term treatment of breast cancer. A side effect of tamoxifen is fatty liver, which increases the risk for non-alcoholic fatty liver disease. Prevention of tamoxifen-induced fatty liver has the potential to improve the safety of long-term tamoxifen usage. Methods Uridine, a pyrimidine nucleoside with reported protective effects against drug-induced fatty liver, was co-administered with tamoxifen in C57BL/6J mice. Liver lipid levels were evaluated with lipid visualization using coherent anti-Stokes Raman scatting (CARS) microscopy, biochemical assay measurement of triacylglyceride (TAG), and liquid chromatography coupled with mass spectrometry (LC-MS) measurement of membrane phospholipid. Blood TAG and cholesterol levels were measured. Mitochondrial respiration of primary hepatocytes in the presence of tamoxifen and/or uridine was evaluated by measuring oxygen consumption rate with an extracellular flux analyzer. Liver protein lysine acetylation profiles were evaluated with 1D and 2D Western blots. In addition, the relationship between endogenous uridine levels, fatty liver, and tamoxifen administration was evaluated in transgenic mice UPase1−/−and UPase1-TG. Results Uridine co-administration prevented tamoxifen-induced liver lipid droplet accumulation in mice. The most prominent effect of uridine co-administration with tamoxifen was the stimulation of liver membrane phospholipid biosynthesis. Uridine had no protective effect against tamoxifen-induced impairment to mitochondrial respiration of primary hepatocytes or liver TAG and cholesterol export. Uridine had no effect on tamoxifen-induced changes to liver protein acetylation profile. Transgenic mice UPase1−/−with increased pyrimidine salvage activity were protected against tamoxifen-induced liver lipid droplet accumulation. In contrast, UPase1-TG mice with increased pyrimidine catabolism activity had intrinsic liver lipid droplet accumulation, which was aggravated following tamoxifen administration. Conclusion Uridine co-administration was effective at preventing tamoxifen-induced liver lipid droplet accumulation. The ability of uridine to prevent tamoxifen-induced fatty liver appeared to depend on the pyrimidine salvage pathway, which promotes biosynthesis of membrane phospholipid. PMID:24887406

Intervention strategies to reduce the risk of zoonotic infection with avian influenza viruses: scientific basis, challenges and knowledge gaps.

PubMed

Sims, Leslie D

2013-09-01

A range of measures has been recommended and used for the control and prevention of avian influenza. These measures are based on the assessment of local epidemiological situations, field observations and other scientific information. Other non-technical factors are (or in some cases should be) taken into account when developing and recommending control measures. The precise effects under field conditions of most individual interventions applied to control and prevent avian influenza have not been established or subjected to critical review, often because a number of measures are applied simultaneously without controls. In most cases, the combination of measures used results in control or elimination of the virus although there are some countries where this has not been the case. In others, especially those with low poultry density, it is not clear whether the link between the adoption of a set of measures and the subsequent control of the disease is causative. This article discusses the various measures recommended, with particular emphasis on stamping out and vaccination, examines how these measures assist in preventing zoonotic infections with avian influenza viruses and explores gaps in knowledge regarding their effectiveness. © 2013 Blackwell Publishing Ltd.

Interventions to improve water quality for preventing diarrhoea: systematic review and meta-analysis

PubMed Central

Schmidt, Wolf-Peter; Rabie, Tamer; Roberts, Ian; Cairncross, Sandy

2007-01-01

Objective To assess the effectiveness of interventions to improve the microbial quality of drinking water for preventing diarrhoea. Design Systematic review. Data sources Cochrane Infectious Diseases Group's trials register, CENTRAL, Medline, Embase, LILACS; hand searching; and correspondence with experts and relevant organisations. Study selection Randomised and quasirandomised controlled trials of interventions to improve the microbial quality of drinking water for preventing diarrhoea in adults and in children in settings with endemic disease. Data extraction Allocation concealment, blinding, losses to follow-up, type of intervention, outcome measures, and measures of effect. Pooled effect estimates were calculated within the appropriate subgroups. Data synthesis 33 reports from 21 countries documenting 42 comparisons were included. Variations in design, setting, and type and point of intervention, and variations in defining, assessing, calculating, and reporting outcomes limited the comparability of study results and pooling of results by meta-analysis. In general, interventions to improve the microbial quality of drinking water are effective in preventing diarrhoea. Effectiveness was not conditioned on the presence of improved water supplies or sanitation in the study setting and was not enhanced by combining the intervention with instructions on basic hygiene, a water storage vessel, or improved sanitation or water supplies—other common environmental interventions intended to prevent diarrhoea. Conclusion Interventions to improve water quality are generally effective for preventing diarrhoea in all ages and in under 5s. Significant heterogeneity among the trials suggests that the level of effectiveness may depend on a variety of conditions that research to date cannot fully explain. PMID:17353208

Correlation between pill counts and biologic effects in an HIV-1 prevention clinical trial: implications for measuring adherence.

PubMed

Donnell, Deborah J; Baeten, Jared M; Hong, Ting; Lingappa, Jairam R; Mujugira, Andrew; Nakku-Joloba, Edith; Bangsberg, David; Celum, Connie

2013-02-01

Clinic-based pill counts of unused study medication are frequently used to measure adherence in HIV-1 prevention trials. Monthly pill count adherence data from the Partners in Prevention HSV/HIV Transmission Study, a double-blind, placebo controlled trial of twice-daily acyclovir suppression of herpes simplex virus type 2 (HSV-2) in HIV-1 infected persons was used to compare changes between 3,381 placebo and active arm participants in two objective biologic measures of acyclovir's drug activity: reduction in plasma HIV-1 RNA and HSV-2 genital ulcer disease (GUD). Higher acyclovir pill count adherence was associated with greater reductions in plasma HIV-1 RNA and GUD, indicating pill count data is strongly correlated with biological effects of adherence. However, when calculated adherence exceeded 102 % (i.e., fewer pills returned than expected) and when pill counts were missing because bottles were not returned, plasma HIV-1 RNA and GUD effects were diminished, likely indicating periods of non-adherence.

Personalised Normative Feedback for Preventing Alcohol Misuse in University Students: Solomon Three-Group Randomised Controlled Trial

PubMed Central

Moreira, Maria T.; Oskrochi, Reza; Foxcroft, David R.

2012-01-01

Background Young people tend to over-estimate peer group drinking levels. Personalised normative feedback (PNF) aims to correct this misperception by providing information about personal drinking levels and patterns compared with norms in similar aged peer groups. PNF is intended to raise motivation for behaviour change and has been highlighted for alcohol misuse prevention by the British Government Behavioural Insight Team. The objective of the trial was to assess the effectiveness of PNF with college students for the prevention of alcohol misuse. Methodology Solomon three-group randomised controlled trial. 1751 students, from 22 British Universities, allocated to a PNF group, a normal control group, or a delayed measurement control group to allow assessment of any measurement effects. PNF was provided by email. Participants completed online questionnaires at baseline, 6- and 12-months (only 12-months for the delayed measurement controls). Drinking behaviour measures were (i) alcohol disorders; (ii) frequency; (iii) typical quantity, (iv) weekly consumption; (v) alcohol-related problems; (vi) perceived drinking norms; and (vii) positive alcohol expectancies. Analyses focused on high-risk drinkers, as well as all students, because of research evidence for the prevention paradox in student drinkers. Principal Findings Follow-up rates were low, with only 50% and 40% responding at 6- and 12-months, respectively, though comparable to similar European studies. We found no evidence for any systematic attrition bias. Overall, statistical analyses with the high risk sub-sample, and for all students, showed no significant effects of the intervention, at either time-point, in a completed case analysis and a multiple imputation analysis. Conclusions We found no evidence for the effectiveness of PNF for the prevention of alcohol misuse and alcohol-related problems in a UK student population. Registration Controlled-Trials.com ISRCTN30784467 PMID:22984466

Immediate Post Intervention Effects of Two Brief Youth Suicide Prevention Interventions.

ERIC Educational Resources Information Center

Randell, Brooke P.; Eggert, Leona L.; Pike, Kenneth C.

2001-01-01

Two brief suicide prevention protocols, Counselors CARE (C-Care) and C-Care plus a 12-session Coping and Support Training (CAST) peer group intervention, were evaluated for immediate post intervention effects. The predicted patterns of change were assessed using trend analyses on data available from three repeated measures. Both groups experienced…

The US Air Force Suicide Prevention Program: Implications for Public Health Policy

PubMed Central

Pflanz, Steven; Talcott, Gerald W.; Campise, Rick L.; Lavigne, Jill E.; Bajorska, Alina; Tu, Xin; Caine, Eric D.

2010-01-01

Objectives. We evaluated the effectiveness of the US Air Force Suicide Prevention Program (AFSPP) in reducing suicide, and we measured the extent to which air force installations implemented the program. Methods. We determined the AFSPP's impact on suicide rates in the air force by applying an intervention regression model to data from 1981 through 2008, providing 16 years of data before the program's 1997 launch and 11 years of data after launch. Also, we measured implementation of program components at 2 points in time: during a 2004 increase in suicide rates, and 2 years afterward. Results. Suicide rates in the air force were significantly lower after the AFSPP was launched than before, except during 2004. We also determined that the program was being implemented less rigorously in 2004. Conclusions. The AFSPP effectively prevented suicides in the US Air Force. The long-term effectiveness of this program depends upon extensive implementation and effective monitoring of implementation. Suicides can be reduced through a multilayered, overlapping approach that encompasses key prevention domains and tracks implementation of program activities. PMID:20466973

Evaluation of preventive programs in high caries active preschool children.

PubMed

Sundell, Anna Lena; Ullbro, Christer; Koch, Göran

2013-01-01

Although caries prevalence in preschool children has dramatically decreased during the last decades it is still a large problem for a minor group of these children. Great efforts have been invested in finding effective preventive programs for the high caries active preschool children. However, few studies have evaluated and discussed which approach will give the best effect. The aim of the present study was to compare the effect of a "standard" preventive program with a series of programs with more extensive measures during a two-year period. At start one hundred and sixty high caries active preschool children (mean age 4 years) were included in the study. The children were randomly distributed to four groups. All groups were exposed to the basic program composed of dietary counselling, oral hygiene instructions and fluoride varnish application. Three groups were exposed to one additional preventive measure e.g. 1% chlorhexidine gel in trays, 0.2% NaF gel in trays or daily tooth brushing with 1% chlorhexidine gel. The programs were repeated seven times during the two-year study period and were executed by trained dental hygienists. Caries examination and saliva sampling for Streptococcus mutans measurements were performed at start of the study and after two years. The mean defs at start was between 10.8 and 12.6 for the four groups (NS). After two years the caries increment was 1.9 ds in the basic preventive group and between 1.9 and 2.6 (NS) in the other groups. Numerically there were more children in the chlorhexidine groups that showed reduction of Streptococcus mutans counts compared to the other groups, but the differences were small. The mean caries increment of about 1.9 ds per year in all groups indicate that all programs were effective taken into account that the children had about 11 defs at start. There were no differences in caries increment between the basic preventive group and the other groups. The conclusion was that addition of preventive measures on top of an effective basic program is a waste of resources. The effect on oral health of individual reinstruction and motivation, by a dental hygienist, seven times during the two-year study period should not be underestimated.

A school-based program implemented by community providers previously trained for the prevention of eating and weight-related problems in secondary-school adolescents: the MABIC study protocol.

PubMed

Sánchez-Carracedo, David; López-Guimerà, Gemma; Fauquet, Jordi; Barrada, Juan Ramón; Pàmias, Montserrat; Puntí, Joaquim; Querol, Mireia; Trepat, Esther

2013-10-12

The prevention of eating disorders and disordered eating are increasingly recognized as public health priorities. Challenges in this field included moving from efficacy to effectiveness and developing an integrated approach to the prevention of a broad spectrum of eating and weight-related problems. A previous efficacy trial indicated that a universal disordered eating prevention program, based on the social cognitive model, media literacy educational approach and cognitive dissonance theory, reduced risk factors for disordered eating, but it is unclear whether this program has effects under more real-world conditions. The main aim of this effectiveness trial protocol is to test whether this program has effects when incorporating an integrated approach to prevention and when previously-trained community providers implement the intervention. The research design involved a multi-center non-randomized controlled trial with baseline, post and 1-year follow-up measures. Six schools from the city of Sabadell (close to Barcelona) participated in the intervention group, and eleven schools from four towns neighboring Sabadell participated in the control group. A total of 174 girls and 180 boys in the intervention group, and 484 girls and 490 boys in the control group were registered in class lists prior to baseline. A total of 18 community providers, secondary-school class tutors, nurses from the Catalan Government's Health and School Program, and health promotion technicians from Sabadell City Council were trained and delivered the program. Shared risk factors of eating and weight-related problems were assessed as main measures. It will be vital for progress in disordered eating prevention to conduct effectiveness trials, which test whether interventions are effective when delivered by community providers under ecologically valid conditions, as opposed to tightly controlled research trials. The MABIC project will provide new contributions in this transition from efficacy to effectiveness and new data about progress in the integrated approach to prevention. Pending the results, the effectiveness trial meets the effectiveness standards set down by the Society for Prevention Research. This study will provide new evidence to improve and enhance disordered eating prevention programs. Current Controlled Trials ISRCTN47682626.

Intervention Strategies Used in Sport Injury Prevention Studies: A Systematic Review Identifying Studies Applying the Haddon Matrix.

PubMed

Vriend, Ingrid; Gouttebarge, Vincent; Finch, Caroline F; van Mechelen, Willem; Verhagen, Evert A L M

2017-10-01

Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the 'pre-event' phase (n = 73) and the use of equipment to avoid injury in the 'event phase' (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention.

A model of translational research for diabetes prevention in low and middle-income countries: The Diabetes Community Lifestyle Improvement Program (D-CLIP) trial.

PubMed

Weber, Mary Beth; Ranjani, Harish; Meyers, Gaya Celeste; Mohan, Viswanathan; Narayan, K M Venkat

2012-04-01

The Diabetes Community Lifestyle Improvement Program (D-CLIP) aims to implement and evaluate in a controlled, randomized trial the effectiveness, cost-effectiveness, and sustainability of a culturally appropriate, low-cost, and sustainable lifestyle intervention for the prevention of type 2 diabetes mellitus in India. D-CLIP, a translational research project adapted from the methods and curriculum developed and tested for efficacy in the Diabetes Prevention Program, utilizes innovated methods (a step-wise model of diabetes prevention with lifestyle and metformin added when needed; inclusion of individuals with isolated glucose tolerance, impaired fasting glucose, and both; classes team-taught by professionals and trained community educators) with the goals of increasing diabetes prevention, community acceptability, and long-term dissemination and sustainability of the program. The study outcomes are: diabetes incidence (primary measure of effectiveness), cost-effectiveness, changes in anthropometric measures, plasma lipids, blood pressure, blood glucose, and HbA(1c,) Program acceptability and sustainability will be assessed using a mixed methods approach. D-CLIP, a low-cost, community-based, research program, addresses the key components of translational research and can be used as a model for prevention of chronic diseases in other low and middle-income country settings. Copyright © 2011 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Using science to improve communications about suicide among military and veteran populations: looking for a few good messages.

PubMed

Langford, Linda; Litts, David; Pearson, Jane L

2013-01-01

Concern about suicide in US military and veteran populations has prompted efforts to identify more effective prevention measures. Recent expert panel reports have recommended public communications as one component of a comprehensive effort. Messaging about military and veteran suicide originates from many sources and often does not support suicide prevention goals or adhere to principles for developing effective communications. There is an urgent need for strategic, science-based, consistent messaging guidance in this area. Although literature on the effectiveness of suicide prevention communications for these populations is lacking, this article summarizes key findings from several bodies of research that offer lessons for creating safe and effective messages that support and enhance military and veteran suicide prevention efforts.

Cost-effectiveness analysis of a multifactorial fall prevention intervention in older home care clients at risk for falling.

PubMed

Isaranuwatchai, Wanrudee; Perdrizet, Johnna; Markle-Reid, Maureen; Hoch, Jeffrey S

2017-09-01

Falls among older adults can cause serious morbidity and pose economic burdens on society. Older age is a known risk factor for falls and age has been shown to influence the effectiveness of fall prevention programs. To our knowledge, no studies have explicitly investigated whether cost-effectiveness of a multifactorial fall prevention intervention (the intervention) is influenced by age. This economic evaluation explores: 1) the cost-effectiveness of a multifactorial fall prevention intervention compared to usual care for community-dwelling adults ≥ 75 years at risk of falling in Canada; and 2) the influence of age on the cost-effectiveness of the intervention. Net benefit regression was used to examine the cost-effectiveness of the intervention with willingness-to-pay values ranging from $0-$50,000. Effects were measured as change in the number of falls, from baseline to 6-month follow-up. Costs were measured using a societal perspective. The cost-effectiveness analysis was conducted for both the total sample and by age subgroups (75-84 and 85+ years). For the total sample, the intervention was not economically attractive. However, the intervention was cost-effective at higher willingness-to-pay (WTP) (≥ $25,000) for adults 75-84 years and at lower WTP (< $5,000) for adults 85+ years. The cost-effectiveness of the intervention depends on age and decision makers' WTP to prevent falls. Understanding the influence of age on the cost-effectiveness of an intervention may help to target resources to those who benefit most. Retrospectively registered. Clinicaltrials.gov identifier: NCT00463658 (18 April 2007).

The effect of obesity prevention interventions according to socioeconomic position: a systematic review.

PubMed

Beauchamp, A; Backholer, K; Magliano, D; Peeters, A

2014-07-01

Obesity prevention is a major public health priority. It is important that all groups benefit from measures to prevent obesity, but we know little about the differential effectiveness of such interventions within particular population subgroups. This review aimed to identify interventions for obesity prevention that evaluated a change in adiposity according to socioeconomic position (SEP) and to determine the effectiveness of these interventions across different socioeconomic groups. A systematic search of published and grey literature was conducted. Studies that described an obesity prevention intervention and reported anthropometric outcomes according to a measure of SEP were included. Evidence was synthesized using narrative analysis. A total of 14 studies were analysed, representing a range of study designs and settings. All studies were from developed countries, with eight conducted among children. Three studies were shown to have no effect on anthropometric outcomes and were not further analysed. Interventions shown to be ineffective in lower SEP participants were primarily based on information provision directed at individual behaviour change. Studies that were shown to be effective in lower SEP participants primarily included community-based strategies or policies aimed at structural changes to the environment. Interventions targeting individual-level behaviour change may be less successful in lower SEP populations. It is essential that our efforts to prevent obesity do not leave behind the most disadvantaged members of society. © 2014 The Authors. obesity reviews © 2014 International Association for the Study of Obesity.

Cost-effectiveness of a pragmatic structured education intervention for the prevention of type 2 diabetes: economic evaluation of data from the Let's Prevent Diabetes cluster-randomised controlled trial

PubMed Central

Ahrabian, D; Davies, M J; Khunti, K; Yates, T; Gray, A M

2017-01-01

Objectives Prevention of type 2 diabetes mellitus (TD2M) is a priority for healthcare systems. We estimated the cost-effectiveness compared with standard care of a structured education programme (Let's Prevent) targeting lifestyle and behaviour change to prevent progression to T2DM in people with prediabetes. Design Cost-effectiveness analysis alongside randomised controlled trial. Setting 44 general practices in Leicestershire, England. Participants 880 participants with prediabetes randomised to receive either standard care or a 6-hour group structured education programme with follow-up sessions in a primary care setting. Main outcome measure Incremental cost utility from the UK National Health Service (NHS) perspective. Quality of life and resource use measured from baseline and during the 36 months follow-up using the EuroQoL EQ-5D and 15D instruments and an economic questionnaire. Outcomes measured using quality-adjusted life years (QALYs) and healthcare costs calculated in 2012–2013 prices. Results After accounting for clustering and missing data, the intervention group was found to have a net gain of 0.046 (95% CI −0.0171 to 0.109) QALYs over 3 years, adjusted for baseline utility, at an additional cost of £168 (95% CI −395 to 732) per patient compared with the standard care group. The incremental cost-effectiveness ratio is £3643/QALY with an 86% probability of being cost-effective at a willingness to pay threshold of £20 000/QALY. Conclusions The education programme had higher costs and higher quality of life compared with the standard care group. The Let's Prevent programme is very likely to be cost-effective at a willingness to pay threshold of £20 000/QALY gained. Trial registration number ISRCTN80605705. PMID:28069625

Cost and cost-effectiveness of HIV/AIDS prevention strategies in developing countries: is there an evidence base?

PubMed

Walker, Damian

2003-03-01

Many donors and countries are striving to respond to the HIV/AIDS epidemic by implementing prevention programmes. However, the resources available for providing these activities relative to needs are limited. Hence, decision-makers must choose among various types of interventions. Cost information, both measures of cost and cost-effectiveness, serves as a critical input into the processes of setting priorities and allocating resources efficiently. This paper reviews the cost and cost-effectiveness evidence base of HIV/AIDS prevention programmes in low- and middle-income countries (LMICs). None of the studies found have complete cost data for a full range of HIV/AIDS prevention programmes in any one country. However, the range of studies highlight the relative emphasis of different types of HIV/AIDS prevention strategies by region, reflecting the various modes of transmission and hence, to a certain extent, the stage of the epidemic. The costing methods applied and results obtained in this review give rise to questions of reliability, validity and transparency. First, not all of the studies report the methods used to calculate the costs, and/or do not provide all the necessary data inputs such that recalculation of the results is possible. Secondly, methods that are documented vary widely, rendering different studies, even within the same country and programme setting, largely incomparable. Finally, even with consistent and replicable measurement, the results as presented are generally not comparable because of the lack of a common outcome measure. Therefore, the extent to which the available cost and cost-effectiveness evidence base on HIV/AIDS prevention strategies can provide guidance to decision-makers is limited, and there is an urgent need for the generation of this knowledge for planning and decision-making.

Measuring Associations of the Department of Veterans Affairs' Suicide Prevention Campaign on the Use of Crisis Support Services.

PubMed

Karras, Elizabeth; Lu, Naiji; Zuo, Guoxin; Tu, Xin M; Stephens, Brady; Draper, John; Thompson, Caitlin; Bossarte, Robert M

2016-08-01

Campaigns have become popular in public health approaches to suicide prevention; however, limited empirical investigation of their impact on behavior has been conducted. To address this gap, utilization patterns of crisis support services associated with the Department of Veterans Affairs' Veterans Crisis Line (VCL) suicide prevention campaign were examined. Daily call data for the National Suicide Prevention Lifeline, VCL, and 1-800-SUICIDE were modeled using a novel semi-varying coefficient method. Analyses reveal significant increases in call volume to both targeted and broad resources during the campaign. Findings underscore the need for further research to refine measurement of the effects of these suicide prevention efforts. © 2016 The American Association of Suicidology.

Rib stress fractures among rowers: a systematic review on return to sports, risk factors and prevention.

PubMed

D'Ailly, Philip N; Sluiter, Judith K; Kuijer, Paul P

2016-06-01

Rib stress fractures (RSFs) are injuries frequently sustained by elite rowers with an injury rate of 8-16% over the course of a rowing career, resulting in negative effects on training and performance. For clinical management, the aim of this review was to describe time to return to sports, summarize potentially preventive measures and appraise the evidence on risk factors. A search strategy was performed in PubMed, SportDiscus, Web of Science and Embase till June 1st 2015. All studies were graded on their quality. The search resulted in 124 studies, of which 17 were included: Ten reported on return to sports, 17 reported on risk factors and nine on preventive measures. For return to sports, nine studies mentioned a loss of training of 4-6 weeks. The shortest period was one week and the longest 16 weeks. For risk factors, insufficient or conflicting evidence was found for changes in the training program, incorrect rowing technique, female gender, low bone mineral density, inadequate equipment, and training type. For prevention, gradual changes in the training program, alertness on the part of coaches and clinicians, and supplementation of diet and hormones are suggested as effective measures. However, no effect studies have been found. The main outcome of this review on RSFs is that little evidence is available on return to sports, risk factors and preventive measures. Coaches and clinicians should carefully guide and assist rowers suffering from RSFs in off training and in the subsequent training period to regain their pre-injury level.

Sport-related concussions in adolescent athletes: a critical public health problem for which prevention remains an elusive goal

PubMed Central

Fidrocki, Diana; Parachuri, Venu

2017-01-01

Sport-related concussions in young athletes are common, generally under reported and often unrecognized. Preventive strategies include education, modification of sport rules, use of equipment such as headgears, face masks and mouth guards, and neck muscle training. Evidence is limited to support effectiveness of these preventive measures with the exception of rule modification in some sports. In the United States, laws have been enacted that require medical evaluation and clearance prior to return to play; however, evidence thus far does not show that laws have been effective in reducing the incidence of concussions in sport. More research is needed in all areas of preventive measures. Sports participation is a complex personal decision on the part of the adolescent and his or her family. They should be provided with all information on inherent risks so that they can make an informed decision. PMID:28795000

Prevention of overweight in the school arena.

PubMed

Lissau, Inge

2007-04-01

This paper gives an overview of studies with the main purpose to intervene against obesity in children at the school arena. Through databases and Cochrane reviews, 14 studies fulfilled the criteria for inclusion. Most of the studies are American and none were performed in Scandinavia. The European studies were performed in Germany and in the United Kingdom. The studies, which had a significant effect on overweight were 'Dance for Health', 'Planet Health', 'San Jose Study', 'Kiel Obesity Prevention Study', 'Healthy Schools' programme, 'El Paso Catch', and 'Medical College of Georgia FitKid Project'. The studies differ greatly in regards to age group, type of and length of intervention and type and amount of actions. Furthermore, the measures used to evaluate the effect differed. It seems to be important to use several measures of obesity in order to accurately detect a possible effect. In conclusion, half of the studies were successful and had an effect on either overweight or obesity. Much more research is needed in order to effectively prevent paediatric obesity.

Update on child abuse prevention.

PubMed

Krugman, Scott D; Lane, Wendy G; Walsh, Christina M

2007-12-01

Child abuse remains a significant problem in the United States with 2.9 million reports and 825 000 indicated cases in 2005. This report will highlight recent efforts toward child abuse prevention, focusing on home visiting programs, abusive head trauma primary prevention, parent training programs, sexual abuse prevention, and the effectiveness of laws banning corporal punishment. Most home visitation programs have demonstrated a lack of effectiveness in recent randomized trials. One exception is the Nurse Family Partnership, which remains the most effective and longest enduring intervention for high-risk families. Child sexual abuse prevention programs and parent training programs need further evaluation with more rigorous methodology and outcome measures. Providing universal parent education about coping with crying infants appears to be effective in lowering the incidence of abusive head trauma. Although advocated for, further study will determine the effectiveness of laws banning corporal punishment or mandating abusive head trauma education to parents of newborns. Pediatricians play an important role in the prevention of child maltreatment. Their knowledge of the effectiveness of different programs can help guide parents toward appropriate services.

Life Review: Preventing Despair in Newly Relocated Nursing Home Residents--Short- and Long-Term Effects.

ERIC Educational Resources Information Center

Haight, Barbara K.; Michel, Yvonne; Hendrix, Shirley

1998-01-01

Elders newly relocated to a nursing home (N=256) were followed for five years using a Solomon Four research design. Life review was shown to be more effective than a friendly visit for preventing despair and promoting integrity immediately and at one-year follow-up. Additional measures are discussed. (Author/EMK)

Inexpensive and Time-Efficient Hand Hygiene Interventions Increase Elementary School Children's Hand Hygiene Rates

ERIC Educational Resources Information Center

Snow, Michelle; White, George L.; Kim, Han S.

2008-01-01

Routine hand hygiene has been cited by the World Health Organization and the Centers for Disease Control and Prevention as a cost-effective and important hygiene measure in preventing the spread of infectious diseases. Several studies have explored children's hand hygiene habits, effects of scheduled hand hygiene, hand hygiene environmental…

Assessment of risk factors and preventive measures and their relations to work-related musculoskeletal pain among dentists.

PubMed

Pejčić, Nataša; Petrović, Vanja; Marković, Dejan; Miličić, Biljana; Dimitrijević, Ivana Ilić; Perunović, Neda; Čakić, Saša

2017-01-01

Dentists have a high prevalence of musculoskeletal (MS) pain, which is the most common symptom associated with work-related musculoskeletal disorders (WMSDs). To overcome this problem, identification of the risk factors and preventive measures for MS pain are of paramount importance to dentists in order to improve their quality of life and work. The aims of this study were to recognize the risk factors for MS pain and their impact on dental work, as well as to identify preventive measures of MS pain among dentists. Self-reporting questionnaire consisting of 78 questions was exclusively developed for the study and sent to 500 working active dentists in Serbia. Response rate was 71.2% (356 dentists). The prevalence of MS pain was 82.6% among dentists. The main risk factors for MS pain were advanced age, female dentists, presence of chronic diseases, long working hours, and high frequency of treated patients. The most effective preventive measures in preventing MS pain were massage treatments and physical activities. Followed by use of ergonomically designed equipment, correct and dynamic working positions, and an adequate workflow organization. The risk factors for MS pain and their impact on dental work should widely be disseminated among dentists. Importantly, proper implementation in everyday life of adequate preventive measures is essential for preventing MS pain and development of WMSDs.

Dutch monitor on stress and physical load: risk factors, consequences, and preventive action.

PubMed

Houtman, I L; Goudswaard, A; Dhondt, S; van der Grinten, M P; Hildebrandt, V H; van der Poel, E G

1998-02-01

Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks, and (c) organisational and environmental variables that facilitate preventive actions. Information was gathered from employers, employees, and employees' representatives. The monitor was used with a nationally representative sample of companies in industry, wholesale trade, and banking and finance, 782 companies in total. The information from the employees, aggregated at the company level, was not found to be correlated with that from the employer from the same companies. Although many employers do recognise risk factors for both physical load and stress as a problem they often seem to underestimate the problem when compared with employees or their representatives. This is particularly the case for psychosocial risk factors. Also, the perception of outcome measures, especially employers who consider emotional exhaustion to be work related, were fewer than the employees' representatives of the same organisation. Preventive measures on physical load are much more popular than measures against stress. It is the responsibility of the employer to take more preventive action of all kinds. They need to recognise risk factors as problems and health outcomes to be related to work. Employees of larger companies should participate with employers to consider effective measures, and more use should be made of support at branch level. For specific preventive measures, specific predictors emerged. Except for measures to prevent work stress, information from employees did not sufficiently contribute to the initiation of preventive measures in the workplace.

From lead to manganese through mercury: mythology, science, and lessons for prevention.

PubMed

Alessio, Lorenzo; Campagna, Marcello; Lucchini, Roberto

2007-11-01

Lead (Pb), mercury (Hg), and manganese (Mn) are well-known neurotoxic metals. The knowledge of toxicity was developed through an extensive amount of research, starting with lead and mercury and proceeding today with manganese. Unfortunately, the consequent implementation of preventive measures was generally delayed, causing important negative effects to the exposed populations. A review and historical reconstruction of the research development that yielded modern understanding of lead and mercury neurotoxicity was conducted to derive useful lessons for the prevention of manganese neurotoxicity. Medieval alchemists named planets and metals from gods since they were already aware of the toxicity and the adverse effects caused by lead and mercury. Historical lessons learned from these two metals may help to avoid the repetition of further mistakes regarding other neurotoxic metals like manganese. The knowledge and experience on the toxicokinetics and toxicodynamics of lead and mercury is useful and valuable to identify a proper approach to "safe" exposure levels for manganese. Further information is still needed on the early neurotoxic and neurobehavioral effects after prolonged exposure to very low doses of lead, mercury, and manganese. Nevertheless, according to the precautionary principle, effective preventive measures should be already undertaken to prevent the onset of more severe health effects in the population. This is the most important lesson to be learned and applied from more than 30 years of occupational and environmental neurotoxicology of metals. (c) 2007 Wiley-Liss, Inc.

A Meta-Analysis of the Effectiveness of Interactive Middle School Cannabis Prevention Programs

PubMed Central

Lize, Steven E.; Iachini, Aidyn L.; Tang, Weizhou; Tucker, Joshua; Seay, Kristen D.; Clone, Stephanie; DeHart, Dana; Browne, Teri

2017-01-01

This meta-analysis examines the effectiveness of interactive middle school-based drug prevention programs on adolescent cannabis use in North America, as well as program characteristics that could moderate these effects. Interactive programs, compared to more didactic, lecture style programs, involve participants in skill-building activities and focus on interaction among participants. A systematic literature search was conducted for English-language studies from January 1998 to March 2014. Studies included evaluations using random assignment or a quasi-experimental design of interactive school-based substance use prevention programs delivered to adolescents (aged 12–14) in North American middle schools (grades 6–8). Data were extracted using a coding protocol. The outcomes of interest were post-treatment cannabis use, intent to use, and refusal skills compared across intervention and control groups. Effect sizes (Cohen’s d) were calculated from continuous measures, and dichotomous measures were converted to the d index. A total of 30 studies yielding 23 independent samples were included. The random effects pooled effect size for cannabis use (k=21) was small (d̄=−0.07, p<0.01) and favorable for the prevention programs. The pooled effect sizes for intention to use (k=3) and refusal skills (k=3) were not significant. Moderator analyses indicated significant differences in program effectiveness between instructor types, with teachers found to be most effective (d̄ =−0.08, p=0.02). The findings provide further support for the use of interactive school-based programs to prevent cannabis use among middle school students in North America. PMID:27785662

A Meta-analysis of the Effectiveness of Interactive Middle School Cannabis Prevention Programs.

PubMed

Lize, Steven E; Iachini, Aidyn L; Tang, Weizhou; Tucker, Joshua; Seay, Kristen D; Clone, Stephanie; DeHart, Dana; Browne, Teri

2017-01-01

This meta-analysis examines the effectiveness of interactive middle school-based drug prevention programs on adolescent cannabis use in North America, as well as program characteristics that could moderate these effects. Interactive programs, compared to more didactic, lecture style programs, involve participants in skill-building activities and focus on interaction among participants. A systematic literature search was conducted for English-language studies from January 1998 to March 2014. Studies included evaluations using random assignment or a quasi-experimental design of interactive school-based substance use prevention programs delivered to adolescents (aged 12-14) in North American middle schools (grades 6-8). Data were extracted using a coding protocol. The outcomes of interest were post-treatment cannabis use, intent to use, and refusal skills compared across intervention and control groups. Effect sizes (Cohen's d) were calculated from continuous measures, and dichotomous measures were converted to the d index. A total of 30 studies yielding 23 independent samples were included. The random effects pooled effect size for cannabis use (k = 21) was small ([Formula: see text]= -0.07, p < 0.01) and favorable for the prevention programs. The pooled effect sizes for intention to use (k = 3) and refusal skills (k = 3) were not significant. Moderator analyses indicated significant differences in program effectiveness between instructor types, with teachers found to be most effective ([Formula: see text]= -0.08, p = 0.02). The findings provide further support for the use of interactive school-based programs to prevent cannabis use among middle school students in North America.

Preventing Smoking in Open Public Places in University Campus Settings: A Situational Crime Prevention Approach

ERIC Educational Resources Information Center

Sun, Jing; Prenzler, Tim; Buys, Nicholas; McMeniman, Marilyn

2012-01-01

Purpose: The purpose of the study was to evaluate the effectiveness of interventions using situational crime prevention approaches to reduce the smoking rate in outdoor areas of a university campus. Design/methodology/approach: A prospective intervention design was designed for the study. Surveys and observations were used to measure the impacts…

Design of an internet-based health economic evaluation of a preventive group-intervention for children of parents with mental illness or substance use disorders.

PubMed

Woolderink, Marla; Smit, Filip; van der Zanden, Rianne; Beecham, Jennifer; Knapp, Martin; Paulus, Aggie; Evers, Silvia

2010-08-10

Preventive interventions are developed for children of parents with mental and substance use disorders (COPMI), because these children have a higher risk of developing a psychological or behavioral disorder in the future. Mental health and substance use disorders contribute significantly to the global burden of disease. Although the exact number of parents with a mental illness is unclear, the subject of mentally ill parents is gaining attention. Moreover there is a lack of interventions for COPMI-children, as well of (cost-) effectiveness studies evaluating COPMI interventions. Innovative interventions such as e-health provide a new field for exploration. There is no knowledge about the opportunities for using the internet to prevent problems in children at risk. In the current study we will focus on the (cost-) effectiveness of an online health prevention program for COPMI-children. We designed a randomized controlled trial to examine the (cost-) effectiveness of the Kopstoring intervention. Kopstoring is an online intervention for COPMI-children to strengthen their coping skills and prevent behavioral and psychological problems. We will compare the Kopstoring intervention with (waiting list) care as usual. This trial will be conducted entirely over the internet. An economic evaluation, from a societal perspective will be conducted, to examine the trial's cost-effectiveness. Power calculations show that 214 participants are needed, aged 16-25. Possible participants will be recruited via media announcements and banners on the internet. After screening and completing informed consent procedures, participants will be randomized. The main outcome is internalizing and externalizing symptoms as measured by the Youth Self Report. For the economic evaluation, healthcare costs and costs outside the healthcare sector will be measured at the same time as the clinical measures, at baseline, 3, 6 and 9 months. An extended measure for the intervention group will be provided at 12 months, to examine the long-term effects. In addition, a process evaluation will be conducted. Recent developments, such as international conferences and policy discussions, show the pressing need to study the (cost-) effectiveness of interventions for vulnerable groups of children. This study will shed light on the (cost-) effectiveness of an online preventive intervention. NTR1982.

Health professionals' attitudes towards suicide prevention initiatives.

PubMed

Brunero, S; Smith, J; Bates, E; Fairbrother, G

2008-09-01

Preventing suicide can depend upon the ability of a range of different health professionals to make accurate suicide risk assessments and treatment plans. The attitudes that clinicians hold towards suicide prevention initiatives may influence their suicide risk assessment and management skills. This study measures a group of non-mental health professionals' attitude towards suicide prevention initiatives. Health professionals that had attended suicide prevention education showed significantly more positive attitudes towards suicide prevention initiatives. The findings in this study further support the effectiveness of educating non-mental health professionals in suicide risk awareness and management.

Fleet equipment performance measurement preventive maintenance model : final report.

DOT National Transportation Integrated Search

2014-04-01

The concept of preventive maintenance is very important in the effective management and deployment of : vehicle fleets. The Texas Department of Transportation (TxDOT) operates a large fleet of on-road and offroad : equipment. Newer engines and vehicl...

Measuring sustainment of prevention programs and initiatives: a study protocol.

PubMed

Palinkas, Lawrence A; Spear, Suzanne E; Mendon, Sapna J; Villamar, Juan; Valente, Thomas; Chou, Chi-Ping; Landsverk, John; Kellam, Shepperd G; Brown, C Hendricks

2016-07-16

Sustaining prevention efforts directed at substance use and mental health problems is one of the greatest, yet least understood, challenges in the field of implementation science. A large knowledge gap exists regarding the meaning of the term "sustainment" and what factors predict or even measure sustainability of effective prevention programs and support systems. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) supports a diverse portfolio of prevention and treatment grant programs that aim to improve population and individual level behavioral health. This study focuses on four SAMHSA prevention grant programs, two of which target substance abuse prevention at the state or single community level, one targets suicide prevention, and one targets prevention of aggressive/disruptive behavior in elementary schools. An examination of all four grant programs simultaneously provides an opportunity to determine what is meant by the term sustainment and identify and support both the unique requirements for improving sustainability for each program as well as for developing a generalizable framework comprised of core components of sustainment across diverse prevention approaches. Based on an analysis of qualitative and quantitative data of 10 grantees supported by these four programs, we will develop a flexible measurement system, with both general and specific components, that can bring precision to monitoring sustainment of infrastructure, activities, and outcomes for each prevention approach. We will then transform this system for use in evaluating and improving the likelihood of achieving prevention effort sustainment. To achieve these goals, we will (1) identify core components of sustainment of prevention programs and their support infrastructures; (2) design a measurement system for monitoring and providing feedback regarding sustainment within the four SAMHSA's prevention-related grant programs; and (3) pilot test the predictability of this multilevel measurement system across these programs and the feasibility and acceptability of a measurement system to evaluate and improve the likelihood of sustainment. This project is intended to improve sustainment of the supporting prevention infrastructure, activities, and outcomes that are funded by federal, state, community, and foundation sources.

Health promotion and prevention in higher music education: results of a longitudinal study.

PubMed

Zander, Mark F; Voltmer, Edgar; Spahn, Claudia

2010-06-01

Music-related symptoms can already be found among student musicians during their years of university training. The goals of the present study were to ascertain the state and developmental course of the student musicians' health and to test the effectiveness of a preventive curriculum given to student musicians during their first two semesters at university. Within a longitudinal, observational study, we assessed students' psychological and physical health during the first 2 years of university training. We compared data from the group of students who had followed the prevention program (intervention group, IG, n = 144) with data of a comparison group (CG, n = 103) of students who had not followed the program. Using standardized questionnaires, we measured physical and psychological symptoms as well as health behavior in a sequential plan (duration, 3.5 yrs). Student musicians (n = 247) showed elevated ratings in psychological and physical health in comparison with nonmusicians of the same age. These ratings decreased at the end of the students' second year. The prevention program had a preventive effect on the students' psychological health: while IG students remained stable in their performance and powers of concentration, CG students got worse in those same areas. However, the prevention program did not reduce physical symptoms. In comparison with their younger colleagues, upper-level students took more courses in body-oriented methods, relaxation, and mental techniques, which focus on preventive measures for musicians. At present, the study offers evidence supporting the use of the prevention curriculum for young musicians. In higher music education, preventive education has a positive impact on students' performance and their attitude toward health. The preventive curriculum does not have an effect on preexisting physical symptoms, and those symptoms related to the students musicians' activity should rather be treated in an additional therapeutic setting.

Using Science to Improve Communications About Suicide Among Military and Veteran Populations: Looking for a Few Good Messages

PubMed Central

Litts, David; Pearson, Jane L.

2013-01-01

Concern about suicide in US military and veteran populations has prompted efforts to identify more effective prevention measures. Recent expert panel reports have recommended public communications as one component of a comprehensive effort. Messaging about military and veteran suicide originates from many sources and often does not support suicide prevention goals or adhere to principles for developing effective communications. There is an urgent need for strategic, science-based, consistent messaging guidance in this area. Although literature on the effectiveness of suicide prevention communications for these populations is lacking, this article summarizes key findings from several bodies of research that offer lessons for creating safe and effective messages that support and enhance military and veteran suicide prevention efforts. PMID:23153130

Regression analysis on the variation in efficiency frontiers for prevention stage of HIV/AIDS.

PubMed

Kamae, Maki S; Kamae, Isao; Cohen, Joshua T; Neumann, Peter J

2011-01-01

To investigate how the cost effectiveness of preventing HIV/AIDS varies across possible efficiency frontiers (EFs) by taking into account potentially relevant external factors, such as prevention stage, and how the EFs can be characterized using regression analysis given uncertainty of the QALY-cost estimates. We reviewed cost-effectiveness estimates for the prevention and treatment of HIV/AIDS published from 2002-2007 and catalogued in the Tufts Medical Center Cost-Effectiveness Analysis (CEA) Registry. We constructed efficiency frontier (EF) curves by plotting QALYs against costs, using methods used by the Institute for Quality and Efficiency in Health Care (IQWiG) in Germany. We stratified the QALY-cost ratios by prevention stage, country of study, and payer perspective, and estimated EF equations using log and square-root models. A total of 53 QALY-cost ratios were identified for HIV/AIDS in the Tufts CEA Registry. Plotted ratios stratified by prevention stage were visually grouped into a cluster consisting of primary/secondary prevention measures and a cluster consisting of tertiary measures. Correlation coefficients for each cluster were statistically significant. For each cluster, we derived two EF equations - one based on the log model, and one based on the square-root model. Our findings indicate that stratification of HIV/AIDS interventions by prevention stage can yield distinct EFs, and that the correlation and regression analyses are useful for parametrically characterizing EF equations. Our study has certain limitations, such as the small number of included articles and the potential for study populations to be non-representative of countries of interest. Nonetheless, our approach could help develop a deeper appreciation of cost effectiveness beyond the deterministic approach developed by IQWiG.

Domino effects within a chemical cluster: a game-theoretical modeling approach by using Nash-equilibrium.

PubMed

Reniers, Genserik; Dullaert, Wout; Karel, Soudan

2009-08-15

Every company situated within a chemical cluster faces domino effect risks, whose magnitude depends on every company's own risk management strategies and on those of all others. Preventing domino effects is therefore very important to avoid catastrophes in the chemical process industry. Given that chemical companies are interlinked by domino effect accident links, there is some likelihood that even if certain companies fully invest in domino effects prevention measures, they can nonetheless experience an external domino effect caused by an accident which occurred in another chemical enterprise of the cluster. In this article a game-theoretic approach to interpret and model behaviour of chemical plants within chemical clusters while negotiating and deciding on domino effects prevention investments is employed.

Preventing the Wernicke-Korsakoff syndrome in Australia: cost-effectiveness of thiamin-supplementation alternatives.

PubMed

Connelly, L; Price, J

1996-04-01

Alcoholic Wernicke's encephalopathy has been commonplace in Australia for many years and, as this syndrome is attributed to a deficiency in the diet, it should be preventable. This study employs conventional cost-effectiveness methodology to compare the economic efficiency of several thiamin-supplementation alternatives that have been proposed for the prevention of Wernicke's encephalopathy. A series of rankings of these measures is derived from an estimated cost per case averted for each of the alternatives studied. These rankings identify the least cost-effective thiamin-supplementation alternative as that of enriching bread-making flour with thiamin.

Prevention of peripheral side-effects of transdermal hyoscine by adjunctive therapy with low dosage of pyridostigmine.

PubMed Central

Ziv, I; Versano, D; Ruach, M; Izraeli, S; Almog, S; Alhalel, A; Alkalay, M; Menahem, S; Tochner, Z

1992-01-01

1. The value of low dosage of pyridostigmine (30 mg three times daily) in preventing peripheral anti-muscarinic side effects of a transdermal controlled-release formulation of hyoscine, was tested in a double-blind placebo-controlled study, involving 47 healthy subjects. 2. Salivary excretion was repeatedly measured during 48 h of combined therapy of two transdermal hyoscine patches with pyridostigmine and 14 h after its cessation. Blood acetylcholinesterase activity was also measured, serving as an index of pyridostigmine bioavailability. 3. The adjunctive therapy with pyridostigmine was highly effective in preventing the substantial impairment in salivary flow caused by the transdermal formulation. An associated 23% inhibition of blood acetylcholinesterase activity was observed. 4. Small doses of pyridostigmine may therefore have a role in increasing the tolerability of transdermal hyoscine therapy. In some patients this drug combination might also allow some increment of the hyoscine dose. PMID:1524963

How to study the aetiology of burn injury: the epidemiological approach.

PubMed

Bouter, L M; Knipschild, P G; van Rijn, J L; Meertens, R M

1989-06-01

Effective prevention of burn injury should be based on sound aetiological knowledge. This article deals with epidemiological methods to study the incidence of burn injury as a function of its risk factors. Central methodological issues are comparability of baseline prognosis, comparability of measurements (of effects in cohort studies and of risk factors in case-control studies), and comparability of external circumstances. These principles are clarified with a number of fictitious examples of risk factors for burn injury. It is explained that in preventive trials comparability may be achieved by randomization, blinding and placebo intervention. The main tools in non-experimental studies are deliberate selection and multivariate analysis. Special attention is given to the definition of the source population and to reducing measurement incomparability in case-control studies. Some well-designed case-control studies following these principles might bring effective prevention of burn injury some steps nearer.

Adolescents' mental health and the Greek family: preventive aspects.

PubMed

Ierodiakonou, C S

1988-03-01

Preventive mental health measures can be properly planned only if the various factors leading to the adolescent's personality structure are extensively investigated. Starting with the specific attitudes of a couple towards genetic counselling, the disadvantages of urbanization and of the dissolution of the traditional extended family are discussed with regard to their effect on the younger members. Data are produced concerning the child-rearing practices of Greek in comparison to American parents and their effect on the adolescent's emotional life. Extreme dependence on the family, pressure for school achievements, lack of sexual education, etc. are characteristic of the stresses a Greek adolescent undergoes. Socio-cultural conditions, like immigration, adoption, etc. are shown to have a different psychological effect on an adolescent in Greece than in America. Specific stresses regarding the adolescent's future, like preparing for university entrance examinations, are discussed and preventive measures are proposed.

Testing demographic differences for alcohol use initiation among adolescents for the decisional balance and situational temptation prevention inventories.

PubMed

Sillice, Marie A; Paiva, Andrea L; Babbin, Steven F; McGee, Heather A; Rossi, Joseph S; Redding, Colleen A; Meier, Kathryn S; Oatley, Karin; Velicer, Wayne F

2014-09-01

Alcohol use by middle school-aged students is a public health concern because of the numerous adverse social, health and psychological outcomes. Prevention programs attempt to intervene before alcohol use begins. A tailored, computer-delivered program for the prevention of alcohol use and a series of new transtheoretical model measures were developed, including decisional balance (Pros and Cons) of alcohol use and Situational Temptations to Try Alcohol. This study investigated if there were any demographic differences on these measures in a sample of 6th grade middle school students from 20 schools (N=4151) at baseline. Three factorial analysis of variance tests were conducted to explore the impact of race (whites vs. non-whites), ethnicity (Hispanics vs. Non-Hispanics) and gender (males vs. females). A significant two-way interaction effect was found between gender and ethnicity for Pros of Alcohol Use. A significant three-way interaction effect was found between gender, race and ethnicity for Cons of Alcohol Use. Main effects were found for the three demographic factors for Situational Temptations to Try Alcohol. However, the effect sizes for the interaction effects and main effects were very small (all below η(2)=.01), suggesting that race/ethnicity and gender alone may not be highly influential factors in the Decisional Balance for the Prevention of Alcohol and Situational Temptations to Try Alcohol in adolescence. The implications for these results and alcohol use prevention among this group are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Testing Demographic Differences for Alcohol Use Initiation among Adolescents for the Decisional Balance and Situational Temptations Prevention Inventories

PubMed Central

Sillice, Marie A.; Paiva, Andrea L.; Babbin, Steven F.; McGee, Heather A.; Rossi, Joseph R.; Redding, Colleen A.; Meier, Kathryn S.; Oatley, Karin; Velicer, Wayne F.

2014-01-01

Alcohol use by middle school-aged students is a public health concern because of the numerous adverse social, health and psychological outcomes. Prevention programs attempt to intervene before alcohol use begins. A tailored, computer-delivered program for the prevention of alcohol use and a series of new transtheoretical model measures were developed, including decisional balance (Pros and Cons) of alcohol use and Situational Temptations to Try Alcohol. This study investigated if there were any demographic differences on these measures in a sample of 6th grade middle school students from 20 schools (N=4151) at baseline. Three factorial analysis of variance tests were conducted to explore the impact of race (whites vs. non-whites), ethnicity (Hispanics vs. Non-Hispanics) and gender (males vs. females). A significant two-way interaction effect was found between gender and ethnicity for Pros of Alcohol Use. A significant three-way interaction effect was found between gender, race and ethnicity for Cons of Alcohol Use. Main effects were found for the three demographic factors for Situational Temptations to Try Alcohol. However, the effect sizes for the interaction effects and main effects were very small (all below η2=. 01), suggesting that race/ethnicity and gender alone may not be highly influential factors in the Decisional Balance for the Prevention of Alcohol and Situational Temptations to Try Alcohol in adolescence. The implications for these results and alcohol use prevention among this group are discussed. PMID:24916916

The Role of Aspirin in the Prevention of Cardiovascular Disease

PubMed Central

Ittaman, Sunitha V.; VanWormer, Jeffrey J.; Rezkalla, Shereif H.

2014-01-01

Aspirin therapy is well-accepted as an agent for the secondary prevention of cardiovascular events and current guidelines also define a role for aspirin in primary prevention. In this review, we describe the seminal trials of aspirin use in the context of current guidelines, discuss factors that may influence the effectiveness of aspirin therapy for cardiovascular disease prevention, and briefly examine patterns of use. The body of evidence supports a role for aspirin in both secondary and primary prevention of cardiovascular events in selected population groups, but practice patterns may be suboptimal. As a simple and inexpensive prophylactic measure for cardiovascular disease, aspirin use should be carefully considered in all at-risk adult patients, and further measures, including patient education, are necessary to ensure its proper use. PMID:24573704

Early-Life Obesity Prevention: Critique of Intervention Trials During the First One Thousand Days.

PubMed

Reilly, John J; Martin, Anne; Hughes, Adrienne R

2017-06-01

To critique the evidence from recent and ongoing obesity prevention interventions in the first 1000 days in order to identify evidence gaps and weaknesses, and to make suggestions for more informative future intervention trials. Completed and ongoing intervention trials have had fairly modest effects, have been limited largely to high-income countries, and have used relatively short-term interventions and outcomes. Comparison of the evidence from completed prevention trials with the evidence from systematic reviews of behavioral risk factors shows that some life-course stages have been neglected (pre-conception and toddlerhood), and that interventions have neglected to target some important behavioral risk factors (maternal smoking during pregnancy, infant and child sleep). Finally, while obesity prevention interventions aim to modify body composition, few intervention trials have used body composition measures as outcomes, and this has limited their sensitivity to detect intervention effects. The new WHO Healthy Lifestyles Trajectory (HeLTI) initiative should address some of these weaknesses. Future early obesity prevention trials should be much more ambitious. They should, ideally: extend their interventions over the first 1000 days; have longer-term (childhood) outcomes, and improved outcome measures (body composition measures in addition to proxies for body composition such as the BMI for age); have greater emphasis on maternal smoking and child sleep; be global.

Prevention of cardiovascular events in elderly people.

PubMed

Andrawes, Wafik Farah; Bussy, Caroline; Belmin, Joël

2005-01-01

Cardiovascular disease has been identified as the leading cause of morbidity and mortality in developed countries. Given the increase in life expectancy and the development of cardiovascular preventive measures, it has become increasingly important to detect and prevent cardiovascular diseases in the elderly. We reviewed the scientific literature concerning cardiovascular prevention to assess the importance of cardiovascular preventive measures in old (> or =65 years of age) individuals. We undertook a systematic search for references relating to prevention of cardiovascular disease in the elderly, mainly ischaemic stroke, coronary artery disease and heart failure, on the MEDLINE database 1962-2005. For cardiovascular prevention by drugs or surgery, emphasis was placed on randomised controlled trials, review articles and meta-analyses. For cardiovascular prevention by lifestyle modification, major cohort studies were also considered. Stroke, coronary heart disease and heart failure were found to be the main targets for cardiovascular prevention in published studies. Antihypertensive treatment has proven its efficacy in primary prevention of fatal or nonfatal stroke in hypertensive and high-risk patients >60 years of age, particularly through treatment of systolic hypertension. Systolic blood pressure reduction is equally important in the secondary prevention of stroke. Similarly, in nonvalvular atrial fibrillation, an adjusted dose of warfarin with a target International Normalized Ratio (INR) of between 2 to 3 prevents ischaemic stroke in elderly patients with an acceptable haemorrhagic risk but is still under prescribed. Antiplatelet agents are indicated in elderly patients with nonembolic strokes. Few large-scale studies have investigated the effect of HMG-CoA reductase inhibitors (statins) on stroke prevention in old individuals. To date, the largest trials suggest a beneficial effect for stroke prevention with use of statins in high-risk elderly subjects < or =82 years of age. Carotid endarterectomy is indicated in carotid artery stenosis >70% and outcomes are even better in elderly than in younger patients. However, medical treatment is still the first-line treatment in asymptomatic elderly patients with <70% stenosis. In ischaemic heart disease, different trials in elderly individuals have shown that use of statins, antithrombotic agents, beta-adrenoceptor antagonists and ACE inhibitors plays an important role either in primary or in secondary cardiovascular prevention. Hormone replacement therapy has been used to treat climacteric symptoms and postmenopausal osteoporosis and was thought to confer a cardiovascular protection. However, controlled trials in elderly individuals changed this false belief when it was found that there was no benefit and even a harmful cardiovascular effect during the first year of treatment. Smoking cessation, regular physical activity and healthy diet are, as in younger individuals, appropriate and effective measures for preventing cardiovascular events in the elderly. Finally, antihypertensive treatment and influenza vaccination are useful for heart failure prevention in elderly individuals. Cardiovascular prevention should be more widely implemented in the elderly, including individuals aged > or =75 years, and this might contribute to improved healthy status and quality of life in this growing population.

The Effectiveness of Policy and Health Education Strategies for Reducing Adolescent Smoking: A Review of the Evidence.

ERIC Educational Resources Information Center

Willemsen, Marc C.; de Zwart, Wil M.

1999-01-01

Reviews international literature to identify the most effective measures to prevent smoking among adolescents. Concludes that isolated measures produce little effect. Most effect may be expected from a combination of a complete ban on tobacco advertising, increasing prices, restricting tobacco product sales to tobacconists, mass media education…

Regulatory systems for prevention and control of rabies, Japan.

PubMed

Takahashi-Omoe, Hiromi; Omoe, Katsuhiko; Okabe, Nobuhiko

2008-09-01

Japan is one of the few rabies-free countries. Although 3 imported cases of human rabies were seen in 1970 and 2006, no other cases have been reported for approximately 50 years. The elimination of rabies in Japan is attributed to not only its geographic isolation but also to effective prevention and control measures, such as registration and vaccination of domestic dogs, required quarantine of susceptible imported animals, and national plans of action based on scientific research. Countermeasures against rabies have been upgraded; an improved management system for domestic dogs under the amended Enforcement Regulations of the Rabies Prevention Law has been in effect since April 2007. The latest regulatory systems for preventing and controlling rabies provide an effective model for elimination of the disease worldwide.

Maternal Anemia in Pregnancy: Assessing the Effect of Routine Preventive Measures in a Malaria-Endemic Area

PubMed Central

Ouédraogo, Smaïla; Koura, Ghislain K.; Bodeau-Livinec, Florence; Accrombessi, Manfred M. K.; Massougbodji, Achille; Cot, Michel

2013-01-01

We investigated the effectiveness of routine preventive measures for anemia in Beninese pregnant women during pregnancy. Anemia (hemoglobin < 110 g/L) was common: 68.3% at first antenatal visit (ANV1), 64.7% at second antenatal visit (ANV2), and 40.6% at delivery. Parasitic infections and nutritional deficiencies were the most preventable causes. After intermittent preventive treatment (IPTp) and antihelminthic treatments, malaria prevalence decreased from 15.1% (ANV1) to 4.0% (ANV2) and increased again to 9.6% at delivery. Helminth infections dropped from 11.1% (ANV1) to 7.2% (ANV2) and 2.4% at delivery. Malaria was associated with lower mean hemoglobin on ANV1 and delivery, and iron deficiency was associated with lower mean hemoglobin on ANV1 and ANV2. IPTp and antihelminthic treatments were efficacious to clear parasitic infections and improve hematologic status, whereas the effectiveness of daily iron and folic acid supplements to correct iron and folate deficiencies and decrease anemia was less marked, possibly because of lack of compliance. PMID:23296448

Maternal anemia in pregnancy: assessing the effect of routine preventive measures in a malaria-endemic area.

PubMed

Ouédraogo, Smaïla; Koura, Ghislain K; Bodeau-Livinec, Florence; Accrombessi, Manfred M K; Massougbodji, Achille; Cot, Michel

2013-02-01

We investigated the effectiveness of routine preventive measures for anemia in Beninese pregnant women during pregnancy. Anemia (hemoglobin < 110 g/L) was common: 68.3% at first antenatal visit (ANV1), 64.7% at second antenatal visit (ANV2), and 40.6% at delivery. Parasitic infections and nutritional deficiencies were the most preventable causes. After intermittent preventive treatment (IPTp) and antihelminthic treatments, malaria prevalence decreased from 15.1% (ANV1) to 4.0% (ANV2) and increased again to 9.6% at delivery. Helminth infections dropped from 11.1% (ANV1) to 7.2% (ANV2) and 2.4% at delivery. Malaria was associated with lower mean hemoglobin on ANV1 and delivery, and iron deficiency was associated with lower mean hemoglobin on ANV1 and ANV2. IPTp and antihelminthic treatments were efficacious to clear parasitic infections and improve hematologic status, whereas the effectiveness of daily iron and folic acid supplements to correct iron and folate deficiencies and decrease anemia was less marked, possibly because of lack of compliance.

A model of genetic guidance for hemoglobinopathy patients and laboratory diagnosis of family members as educational and preventive measures

PubMed Central

Ferreira, Tatiana Dela-Sávia; Freire, Adriana Sousa; Silveira-Lacerda, Elisângela de Paula; García-Zapata, Marco Túlio Antônio

2012-01-01

Background: The high frequency of hemoglobinopathies in Brazil constitutes a public health problem and thus educational and preventive measures are necessary to reduce the incidence. Genetic guidance, a modality of genetic counseling, and family screening are measures that can assist in reproductive decisions and mitigate clinical, psychological and social problems of families with these disorders. Objetive: The objective of the current study was to evaluate the effectiveness of educational and preventive measures for hemoglobinopathies using genetic guidance and laboratory screening of families. Methods: The diagnoses of patients with hemoglobinopathies were confirmed and then the level of knowledge about their disease was evaluated and genetic guidance was provided. Three months later, the level of assimilated information of these patients was evaluated. In addition, laboratory diagnosis of family members was carried out. Results: Diagnosis of sickle cell anemia was confirmed for most patients. Moreover, the majority of the patients who had a low level of knowledge before genetic guidance (68.8%) demonstrated a higher level of assimilated information after the process (81.8%). Almost 70% of the family members had hemoglobin changes and some had hemoglobinopathies(2.6%). They were duly informed about the results of the examinations, which made it possible to investigate further. Conclusion: Genetic guidance and family screening were effective preventive and educational measures that improved the quality of life of patients, preventing complications and sequels and allowed the referral of those who may transmit altered genes for clinical diagnosis and to genetic counseling services. PMID:23125541

Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian children.

PubMed

Mezones-Holguín, Edward; Bolaños-Díaz, Rafael; Fiestas, Víctor; Sanabria, César; Gutiérrez-Aguado, Alfonso; Fiestas, Fabián; Suárez, Víctor J; Rodriguez-Morales, Alfonso J; Hernández, Adrián V

2014-12-15

Pneumococcal pneumonia (PP) has a high burden of morbimortality in children. Use of pneumococcal conjugate vaccines (PCVs) is an effective preventive measure. After PCV 7-valent (PCV7) withdrawal, PCV 10-valent (PCV10) and PCV 13-valent (PCV13) are the alternatives in Peru. This study aimed to evaluate cost effectiveness of these vaccines in preventing PP in Peruvian children <5 years-old. A cost-effectiveness analysis was developed in three phases: a systematic evidence search for calculating effectiveness; a cost analysis for vaccine strategies and outcome management; and an economic model based on decision tree analysis, including deterministic and probabilistic sensitivity analysis using acceptability curves, tornado diagram, and Monte Carlo simulation. A hypothetic 100 vaccinated children/vaccine cohort was built. An incremental cost-effectiveness ratio (ICER) was calculated. The isolation probability for all serotypes in each vaccine was estimated: 38% for PCV7, 41% PCV10, and 17% PCV13. Avoided hospitalization was found to be the best effectiveness model measure. Estimated costs for PCV7, PCV10, and PCV13 cohorts were USD13,761, 11,895, and 12,499, respectively. Costs per avoided hospitalization were USD718 for PCV7, USD333 for PCV10, and USD 162 for PCV13. At ICER, PCV7 was dominated by the other PCVs. Eliminating PCV7, PCV13 was more cost effective than PCV10 (confirmed in sensitivity analysis). PCV10 and PCV13 are more cost effective than PCV7 in prevention of pneumonia in children <5 years-old in Peru. PCV13 prevents more hospitalizations and is more cost-effective than PCV10. These results should be considered when making decisions about the Peruvian National Inmunizations Schedule.

[New research progress on atrophic nonunion].

PubMed

Wei, Jun-Qiang; Zhang, Bo-Xun; Chen, Hua; Tang, Pei-Fu; Wang, Yan

2012-12-01

Occurance of atrophic nonunion is a complex process. Previous studies suggested that atrophic nonunion was mainly due to lack of blood supply of fracture fragments, but recent studies found that blood supply was not deficiency in middle and late stages, indicating that decreased osteogenic factors and blood supply in early stages might play an important role in morbidity. Current effective treatment measures for atrophic nonunion mainly include bone graft and fixation,physical therapy, local injection therapy. All-round preventive could reduce incidence of atrophic nonunion. Atrophic nonunion is still a troublesome complication of fractures in orthopaedics, and more attention should be paid for its effective prevention and treatment. The paper summarized recent original articles about atrophic nonunion and reviewed the occurrence mechanisms, diagnosis, prevention and treatment measures of this disease.

Prevention and treatment of diaper dermatitis.

PubMed

Blume-Peytavi, Ulrike; Kanti, Varvara

2018-03-01

Diaper dermatitis (DD) is one of the most common skin conditions that infants suffer from and their caregivers manage in the first months post-birth. As such, questions of effective prevention and treatment of the condition often arise. Nonmedical skincare practices that support healthy skin barrier function can prevent DD manifestation or alleviate the condition in many cases. The usage of barrier emollients and improved diaper technology contributes to keeping moisture and irritants away from an infant's delicate skin. This paper addresses facts behind commonly asked questions from caregivers regarding DD and discusses effective measures to prevent and treat the condition. © 2018 Wiley Periodicals, Inc.

A multifaceted program to prevent ventilator-associated pneumonia: impact on compliance with preventive measures.

PubMed

Bouadma, Lila; Mourvillier, Bruno; Deiler, Véronique; Le Corre, Bertrand; Lolom, Isabelle; Régnier, Bernard; Wolff, Michel; Lucet, Jean-Christophe

2010-03-01

To determine the effect of a 2-yr multifaceted program aimed at preventing ventilator-acquired pneumonia on compliance with eight targeted preventive measures. Pre- and postintervention observational study. A 20-bed medical intensive care unit in a teaching hospital. A total of 1649 ventilator-days were observed. The program involved all healthcare workers and included a multidisciplinary task force, an educational session, direct observations with performance feedback, technical improvements, and reminders. It focused on eight targeted measures based on well-recognized published guidelines, easily and precisely defined acts, and directly concerned healthcare workers' bedside behavior. Compliance assessment consisted of five 4-wk periods (before the intervention and 1 month, 6 months, 12 months, and 24 months thereafter). Hand-hygiene and glove-and-gown use compliances were initially high (68% and 80%) and remained stable over time. Compliance with all other preventive measures was initially low and increased steadily over time (before 2-yr level, p < .0001): backrest elevation (5% to 58%) and tracheal cuff pressure maintenance (40% to 89%), which improved after simple technical equipment implementation; orogastric tube use (52% to 96%); gastric overdistension avoidance (20% to 68%); good oral hygiene (47% to 90%); and nonessential tracheal suction elimination (41% to 92%). To assess overall performance of the last six preventive measures, using ventilator-days as the unit of analysis, a composite score for preventive measures applied (range, 0-6) was developed. The median (interquartile range) composite scores for the five successive assessments were 2 (1-3), 4 (3-5), 4 (4-5), 5 (4-6), and 5 (4-6) points; they increased significantly over time (p < .0001). Ventilator-acquired pneumonia prevalence rate decreased by 51% after intervention (p < .0001). Our active, long-lasting program for preventing ventilator-acquired pneumonia successfully increased compliance with preventive measures directly dependent on healthcare workers' bedside performance. The multidimensional framework was critical for this marked, progressive, and sustained change.

Effectiveness of the Civil Aviation Security Program.

DTIC Science & Technology

1985-04-12

other crimes against civil aviation prevented or deterred by airline and airport security procedures cannot be determined with certainty. However...were prevented from doing so by airline and airport security measures. As noted elsewhere in this report, 1,632 firearms were detected at screening...enforcement sQp:)t’ for airline and airport security measures. Finally, with the inc.asoDr of security costs in airline ticket prices, the passengers

A quantitative risk assessment model to evaluate effective border control measures for rabies prevention.

PubMed

Weng, Hsin-Yi; Wu, Pei-I; Yang, Ping-Cheng; Tsai, Yi-Lun; Chang, Chao-Chin

2010-01-01

Border control is the primary method to prevent rabies emergence. This study developed a quantitative risk model incorporating stochastic processes to evaluate whether border control measures could efficiently prevent rabies introduction through importation of cats and dogs using Taiwan as an example. Both legal importation and illegal smuggling were investigated. The impacts of reduced quarantine and/or waiting period on the risk of rabies introduction were also evaluated. The results showed that Taiwan's current animal importation policy could effectively prevent rabies introduction through legal importation of cats and dogs. The median risk of a rabid animal to penetrate current border control measures and enter Taiwan was 5.33 x 10(-8) (95th percentile: 3.20 x 10(-7)). However, illegal smuggling may pose Taiwan to the great risk of rabies emergence. Reduction of quarantine and/or waiting period would affect the risk differently, depending on the applied assumptions, such as increased vaccination coverage, enforced custom checking, and/or change in number of legal importations. Although the changes in the estimated risk under the assumed alternatives were not substantial except for completely abolishing quarantine, the consequences of rabies introduction may yet be considered to be significant in a rabies-free area. Therefore, a comprehensive benefit-cost analysis needs to be conducted before recommending these alternative measures.

A school-based program implemented by community providers previously trained for the prevention of eating and weight-related problems in secondary-school adolescents: the MABIC study protocol

PubMed Central

2013-01-01

Background The prevention of eating disorders and disordered eating are increasingly recognized as public health priorities. Challenges in this field included moving from efficacy to effectiveness and developing an integrated approach to the prevention of a broad spectrum of eating and weight-related problems. A previous efficacy trial indicated that a universal disordered eating prevention program, based on the social cognitive model, media literacy educational approach and cognitive dissonance theory, reduced risk factors for disordered eating, but it is unclear whether this program has effects under more real-world conditions. The main aim of this effectiveness trial protocol is to test whether this program has effects when incorporating an integrated approach to prevention and when previously-trained community providers implement the intervention. Methods/design The research design involved a multi-center non-randomized controlled trial with baseline, post and 1-year follow-up measures. Six schools from the city of Sabadell (close to Barcelona) participated in the intervention group, and eleven schools from four towns neighboring Sabadell participated in the control group. A total of 174 girls and 180 boys in the intervention group, and 484 girls and 490 boys in the control group were registered in class lists prior to baseline. A total of 18 community providers, secondary-school class tutors, nurses from the Catalan Government’s Health and School Program, and health promotion technicians from Sabadell City Council were trained and delivered the program. Shared risk factors of eating and weight-related problems were assessed as main measures. Discussion It will be vital for progress in disordered eating prevention to conduct effectiveness trials, which test whether interventions are effective when delivered by community providers under ecologically valid conditions, as opposed to tightly controlled research trials. The MABIC project will provide new contributions in this transition from efficacy to effectiveness and new data about progress in the integrated approach to prevention. Pending the results, the effectiveness trial meets the effectiveness standards set down by the Society for Prevention Research. This study will provide new evidence to improve and enhance disordered eating prevention programs. Trial registration Current Controlled Trials ISRCTN47682626 PMID:24118981

Industry sponsored anti‐smoking ads and adolescent reactance: test of a boomerang effect

PubMed Central

Henriksen, L; Dauphinee, A L; Wang, Y; Fortmann, S P

2006-01-01

Objective To examine whether adolescents' exposure to youth smoking prevention ads sponsored by tobacco companies promotes intentions to smoke, curiosity about smoking, and positive attitudes toward the tobacco industry. Design A randomised controlled experiment compared adolescents' responses to five smoking prevention ads sponsored by a tobacco company (Philip Morris or Lorillard), or to five smoking prevention ads sponsored by a non‐profit organisation (the American Legacy Foundation), or to five ads about preventing drunk driving. Setting A large public high school in California's central valley. Subjects A convenience sample of 9th and 10th graders (n  =  832) ages 14–17 years. Main outcome measures Perceptions of ad effectiveness, intention to smoke, and attitudes toward tobacco companies measured immediately after exposure. Results As predicted, adolescents rated Philip Morris and Lorillard ads less favourably than the other youth smoking prevention ads. Adolescents' intention to smoke did not differ as a function of ad exposure. However, exposure to Philip Morris and Lorillard ads engendered more favourable attitudes toward tobacco companies. Conclusions This study demonstrates that industry sponsored anti‐smoking ads do more to promote corporate image than to prevent youth smoking. By cultivating public opinion that is more sympathetic toward tobacco companies, the effect of such advertising is likely to be more harmful than helpful to youth. PMID:16436398

Quantitative evaluation of waste prevention on the level of small and medium sized enterprises (SMEs).

PubMed

Laner, David; Rechberger, Helmut

2009-02-01

Waste prevention is a principle means of achieving the goals of waste management and a key element for developing sustainable economies. Small and medium sized enterprises (SMEs) contribute substantially to environmental degradation, often not even being aware of their environmental effects. Therefore, several initiatives have been launched in Austria aimed at supporting waste prevention measures on the level of SMEs. To promote the most efficient projects, they have to be evaluated with respect to their contribution to the goals of waste management. It is the aim of this paper to develop a methodology for evaluating waste prevention measures in SMEs based on their goal orientation. At first, conceptual problems of defining and delineating waste prevention activities are briefly discussed. Then an approach to evaluate waste prevention activities with respect to their environmental performance is presented and benchmarks which allow for an efficient use of the available funds are developed. Finally the evaluation method is applied to a number of former projects and the calculated results are analysed with respect to shortcomings and limitations of the model. It is found that the developed methodology can provide a tool for a more objective and comprehensible evaluation of waste prevention measures.

Adolescent Sex Education: A Preventive Mental Health Measure.

ERIC Educational Resources Information Center

Obstfeld, Lisa S.; Meyers, Andrew W.

1984-01-01

This article addresses the issue of adolescent sex education as a means of preventing sexuality-related disorders, including: sexual dysfunction; sexual deviance; physical health problems often contracted from sexual activity; and various psychological and sociological ill effects resulting from unplanned pregnancies. (Author/CJB)

Road Traffic Injury Prevention Initiatives: A Systematic Review and Metasummary of Effectiveness in Low and Middle Income Countries

PubMed Central

Staton, Catherine; Vissoci, Joao; Gong, Enying; Toomey, Nicole; Wafula, Rebeccah; Abdelgadir, Jihad; Zhou, Yi; Liu, Chen; Pei, Fengdi; Zick, Brittany; Ratliff, Camille D.; Rotich, Claire; Jadue, Nicole; de Andrade, Luciano; von Isenburg, Megan; Hocker, Michael

2016-01-01

Background Road traffic injuries (RTIs) are a growing but neglected global health crisis, requiring effective prevention to promote sustainable safety. Low- and middle-income countries (LMICs) share a disproportionately high burden with 90% of the world’s road traffic deaths, and where RTIs are escalating due to rapid urbanization and motorization. Although several studies have assessed the effectiveness of a specific intervention, no systematic reviews have been conducted summarizing the effectiveness of RTI prevention initiatives specifically performed in LMIC settings; this study will help fill this gap. Methods In accordance with PRISMA guidelines we searched the electronic databases MEDLINE, EMBASE, Scopus, Web of Science, TRID, Lilacs, Scielo and Global Health. Articles were eligible if they considered RTI prevention in LMICs by evaluating a prevention-related intervention with outcome measures of crash, RTI, or death. In addition, a reference and citation analysis was conducted as well as a data quality assessment. A qualitative metasummary approach was used for data analysis and effect sizes were calculated to quantify the magnitude of emerging themes. Results Of the 8560 articles from the literature search, 18 articles from 11 LMICs fit the eligibility and inclusion criteria. Of these studies, four were from Sub-Saharan Africa, ten from Latin America and the Caribbean, one from the Middle East, and three from Asia. Half of the studies focused specifically on legislation, while the others focused on speed control measures, educational interventions, enforcement, road improvement, community programs, or a multifaceted intervention. Conclusion Legislation was the most common intervention evaluated with the best outcomes when combined with strong enforcement initiatives or as part of a multifaceted approach. Because speed control is crucial to crash and injury prevention, road improvement interventions in LMIC settings should carefully consider how the impact of improvements will affect speed and traffic flow. Further road traffic injury prevention interventions should be performed in LMICs with patient-centered outcomes in order to guide injury prevention in these complex settings. PMID:26735918

Primary prevention research: a preliminary review of program outcome studies.

PubMed

Schaps, E; Churgin, S; Palley, C S; Takata, B; Cohen, A Y

1980-07-01

This article reviews 35 drug abuse prevention program evaluations employing drug-specific outcome measures. Many of these evaluations assessed the effects of "new generation" prevention strategies: affective, peer-oriented, and multidimensional approaches. Only 14 studies evaluated purely informational programs. Evaluations were analyzed to ascertain (1) characteristics of the programs under study, (2) characteristics of the research designs, and (3) patterns among findings. This review provides some evidence that the newer prevention strategies may produce more positive and fewer negative outcomes than did older drug information approaches. Over 70% of the programs using the newer strategies produced some positive effects; only 29% showed negative effects. In contrast, 46% of informational programs showed positive effects; 46% showed negative effects. These findings must be approached with great caution, since the research was frequently scientifically inadequate, and since rigor of research was negatively correlated with intensity and duration of program services.

Malaria prevention knowledge, attitudes, and practices (KAP) among international flying pilots and flight attendants of a US commercial airline.

PubMed

Selent, Monica; de Rochars, Valery M Beau; Stanek, Danielle; Bensyl, Diana; Martin, Barbara; Cohen, Nicole J; Kozarsky, Phyllis; Blackmore, Carina; Bell, Teal R; Marano, Nina; Arguin, Paul M

2012-12-01

In 2010, malaria caused approximately 216 million infections in people and 655,000 deaths. In the United States, imported malaria cases occur every year, primarily in returning travelers and immigrants from endemic countries. In 2010, five Plasmodium falciparum malaria cases occurred among crew members of one US commercial airline company (Airline A). This investigation aimed to assess the malaria prevention knowledge, attitudes, and practices (KAP) of Airline A crew members to provide information for potential interventions. The web link to a self-administered on-line survey was distributed by internal company communications to Airline A pilots and flight attendants (FA) eligible for international travel. The survey collected demographic information as well as occupation, work history, and malaria prevention education. Of approximately 7,000 nonrandomly selected crew members, 220 FA and 217 pilots completed the survey (6%). Respondents correctly identified antimalarial medication (91% FA, 95% pilots) and insect repellents (96% FA, 96% pilots) as effective preventive measures. While in malaria-intense destinations, few FA and less than half of pilots always took antimalarial medication (4% FA, 40% pilots) yet many often spent greater than 30 minutes outdoors after sundown (71% FA, 66% pilots). Less than half in both groups always used insect repellents (46% FA, 47% pilots). Many respondents were unaware of how to get antimalarial medications (52% FA, 30% pilots) and were concerned about their side effects (61% FA, 31% pilots). Overall, FA and pilots demonstrated good knowledge of malaria prevention, but many performed risky activities while practicing only some recommended malaria preventive measures. Malaria prevention education should focus on advance notification if traveling to a malaria-endemic area, how to easily obtain antimalarial medications, and the importance of practicing all recommended preventive measures. © 2012 International Society of Travel Medicine.

Feasibility of a community intervention for the prevention of suicide and alcohol abuse with Yup'ik Alaska Native youth: the Elluam Tungiinun and Yupiucimta Asvairtuumallerkaa studies.

PubMed

Mohatt, Gerald V; Fok, Carlotta Ching Ting; Henry, David; Allen, James

2014-09-01

The Elluam Tungiinun and Yupiucimta Asvairtuumallerkaa studies evaluated the feasibility of a community intervention to prevent suicide and alcohol abuse among rural Yup'ik Alaska Native youth in two remote communities. The intervention originated in an Indigenous model of protection, and its development used a community based participatory research process. Feasibility assessment aimed to assess the extent to which (1) the intervention could be implemented in rural Alaska Native communities, and (2) the intervention was capable of producing measurable effects. Scales maximally sensitive to change were derived from earlier measurement work, and the study contrasted implementation process and outcomes across the two communities. In one community, medium dose response effects (d = .30-.50), with dose defined as number of intervention activities attended, were observed in the growth of intermediate protective factors and ultimate variables. In the other community, medium dose effects were observed for one intermediate protective factor variable, and small dose effects were observed in ultimate variables. Differences across communities in resources supporting intervention explain these contrasting outcomes. Results suggest implementation in these rural Alaska settings is feasible when sufficient resources are available to sustain high levels of local commitment. In such cases, measureable effects are sufficient to warrant a prevention trial.

Effect of Anisotropy on Shape Measurement Accuracy of Silicon Wafer Using Three-Point-Support Inverting Method

NASA Astrophysics Data System (ADS)

Ito, Yukihiro; Natsu, Wataru; Kunieda, Masanori

This paper describes the influences of anisotropy found in the elastic modulus of monocrystalline silicon wafers on the measurement accuracy of the three-point-support inverting method which can measure the warp and thickness of thin large panels simultaneously. Deflection due to gravity depends on the crystal orientation relative to the positions of the three-point-supports. Thus the deviation of actual crystal orientation from the direction indicated by the notch fabricated on the wafer causes measurement errors. Numerical analysis of the deflection confirmed that the uncertainty of thickness measurement increases from 0.168µm to 0.524µm due to this measurement error. In addition, experimental results showed that the rotation of crystal orientation relative to the three-point-supports is effective for preventing wafer vibration excited by disturbance vibration because the resonance frequency of wafers can be changed. Thus, surface shape measurement accuracy was improved by preventing resonant vibration during measurement.

The influence of land urbanization on landslides: An empirical estimation based on Chinese provincial panel data.

PubMed

Li, Gerui; Lei, Yalin; Yao, Huajun; Wu, Sanmang; Ge, Jianping

2017-10-01

This study used panel data for 28 provinces and municipalities in China from 2003 to 2014 to investigate the relationship between land urbanization and landslides by building panel models for a national sample and subsamples from the three regions of China and studied the problems of landslide prevention measures based on the relationship. The results showed that 1) at the national level, the percentage of built-up area and road density are respectively negative and positive for landslides. 2) At the regional level, the improvement of landslide prevention measures with increasing economic development only appears in built-up areas. The percentage of built-up areas increases the number of landslides in the western region and decreases the number in the central and eastern regions; the degree of decrease in the eastern region is larger than in the central region. Road density increases the number of landslides in each region, and the degree increases gradually from the west to the east. 3) The effect of landslide prevention funding is not obvious. Although the amount of landslide prevention funds decreases the number of landslides at the national level, the degree of increase is too small. Except in the central region, the amount of landslide prevention funding did not decrease the number of landslides effectively in the western and eastern regions. We propose a series of policy implications based on these test results that may help to improve landslide prevention measures. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevention of gentamicin ototoxicity with N-acetylcysteine and vitamin A.

PubMed

Aladag, I; Guven, M; Songu, M

2016-05-01

To investigate the use of systemic N-acetylcysteine and vitamin A in the prevention of gentamicin ototoxicity in rats. Forty-two Wistar rats were divided into four groups according to treatment: intratympanic saline, intratympanic gentamicin, intraperitoneal vitamin A after intratympanic gentamicin, and intraperitoneal N-acetylcysteine after intratympanic gentamicin. Signal-to-noise ratio and distortion product otoacoustic emissions were evaluated in all groups. N-acetylcysteine had a significant protective effect at 1.5, 2, 3, 4, 6 and 8 kHz, whilst vitamin A had a significant protective effect at 2, 3, 4 and 6 kHz, as determined by the distortion product otoacoustic emission measurements. According to the signal-to-noise measurements, N-acetylcysteine had a significant protective effect at 1.5, 2, 3, 4, 6 and 8 kHz, whilst vitamin A had a significant protective effect at 3, 6 and 8 kHz. Gentamicin-induced hearing loss in rats may be prevented by the concomitant use of vitamin A and N-acetylcysteine. Specifically, N-acetylcysteine appeared to have a more protective effect than vitamin A for a greater range of noise frequencies.

The preservation of urine samples for determination of renal stone risk factors

NASA Technical Reports Server (NTRS)

Nicar, M. J.; Hsu, M. C.; Johnson, T.; Pak, C. Y.

1987-01-01

A preservation technique for urine specimens before determination of stone risk factors was evaluated. The purpose of these experiments was to prove the effectiveness of the preservatives used to prevent changes in the concentrations of those constituents measured. Measured concentrations in fresh specimens were compared with those in the same specimens after storage with the preservatives. Refrigeration at 4 degrees C up to five days was appropriate in a laboratory setting, as no significant changes in urinary concentrations occurred. Refrigeration, however, did not offer a convenient method for shipping. Chemical preservation was found to be an effective alternative to refrigeration. Thymol prevented changes in concentration of pH, citrate, uric acid, sulfate, sodium, potassium, and cyclic AMP, while a mixture of hydrochloric (HCl) acid and boric acid prevented changes in calcium, magnesium, phosphorus, oxalate, ammonium, and creatinine. Thus, the addition of thymol or HCl/boric acid to urine specimens will prevent significant changes in the concentrations of stone risk factors.

[Human papillomavirus and penile cancer : Thinking about measures for prevention].

PubMed

Schneede, P; Schlenker, B

2018-04-01

Two major pathways of penile carcinogenesis are known: human papillomavirus (HPV)-induced penile cancer and HPV-negative cancers associated with chronic dermatoses. Therefore, modern measures for prevention of penile cancer may for example include prophylactic HPV vaccination. The resulting B‑cell-mediated immunity to HPV capsid proteins is effective protection against future HPV infections. Contrarily when treating existing HPV infections or HPV-associated cancers an antigen-specific T‑cell immunity is necessary. To date, screening and treatment of precancerous lesions to prevent penile cancer are not established in the German health care program and the highly expected therapeutic HPV vaccines are still on the horizon. In this article, we focus on possible strategies to prevent HPV-related penile cancer on different levels of carcinogenesis.

[Improving prevention activities of infectious diseases during preparation and holding of the XXII Olympic Winter Games and XI Paralympic Winter Games 2014 in Sochi].

PubMed

Onishchenko, G G; Bragina, I V; Ezhlova, E B; Demina, Iu V; Grechanaia, T V; Nikolaevich, P N; Balaeva, M I; Tesheva, S Ch; Biriukov, V A; Kulichenko, A N; Vasilenko, N F; Maletskaia, O V; Manin, E A; Orobeĭ, V G

2015-01-01

The article presents data on the implementation of a set of preventive activities to ensure sanitation and epidemiological welfare during the XXII Olympic Winter Games and XI Paralympic Winter Games 2014 in Sochi. The importance of monitoring and evaluation of epidemiological risk, as the basis of formation of preventive measures is noticed. The questions of specific, and nonspecific prevention of infectious diseases, especially the work done during the pre-Olympic period are considered. The importance of specifically developed regulatory basis, and health education are emphasized. The conclusion about the effectiveness of the measures taken, which led to a significant reduction of infectious diseases in the region is made.

Prevention of disuse osteoporosis: Effect of sodium fluoride during five weeks of bed rest

NASA Technical Reports Server (NTRS)

Schneider, Victor S.

1987-01-01

An attempt was made to modify factors which promote disuse osteoporosis and thereby prevent it from occurring. Since fluoride is currently used to enhance bone formation in the treatment of low turnover osteoporosis, it was hypothesized that if the fluoride ion was available over a long period of time that it would slow the demonstrated loss of calcium by inhibiting bone resorption and enhancing bone formation. This study was used to determine whether oral medication with sodium F will modify or prevent 5 weeks of bed rest induced disuse osteoporosis, to determine the longitudinal effects of 5 weeks of bed rest on PTH, CT and calcitriol, to measure muscle volume changes and metabolic activity by magnetic resonance imaging and magnetic resonance spectroscopy during prolonged bed rest, to measure changes in peak muscle strength and fatigability, and to measure bone turnover in bone biopsies. Subjects were studied during 1 week of equilibration, 4 weeks of control ambulation, 5 weeks of bed rest, and 1 week of reambulation.

Prevention of alveolar echinococcosis--ecosystem and risk management perspectives in Japan.

PubMed

Konno, Keita; Oku, Yuzaburo; Tamashiro, Hiko

2003-12-01

We focused on the epidemiology of alveolar echinococcosis especially in Japan and discussed control measures to prevent an epidemic. No effective control measures against alveolar echinococcosis have been identified thus far because it is difficult to fully understand the ecology of the parasite and its hosts, i.e. the precise infection route to humans. In Hokkaido, Japan, infection rates among red foxes have recently risen even in low endemic districts. Infection seems to be spreading not only among wild foxes but also among domestic dogs. Despite only sporadic reports of human cases in Japan, we predict that the incidence of alveolar echinococcosis will increase in the near future if no effective preventive measures are put in place. An Echinococcus multilocularis epidemic would have the potential to affect the economy of Hokkaido, due to its impact on the agricultural and tourist industries. Well-designed epidemiological surveys are, therefore, urgently required prior to large outbreaks, based on understanding of the ecosystem around E. multilocularis.

A meta-analysis of the effects of dropout prevention programs on school absenteeism.

PubMed

Tanner-Smith, Emily E; Wilson, Sandra Jo

2013-10-01

This study reports findings from a systematic review and meta-analysis of literature examining the effects of school dropout prevention and intervention programs on students' school absenteeism outcomes. The meta-analysis synthesized 74 effect sizes measuring posttest differences in school absenteeism outcomes for youth enrolled in dropout prevention programs relative to a comparison group. Although results from randomized controlled trials indicated significant beneficial program effects, findings from quasi-experimental studies indicated no significant beneficial or detrimental effects. Examination of study characteristics suggested that dropout programs may have beneficial effects on school absenteeism among primarily male samples, and younger samples. Although no single type of intervention program was consistently more effective than others, vocational oriented and supplemental academic training programs showed some promise. However, the inconsistency in results and the possibility of small study bias mean the quality of evidence in this literature is low; at this time there is not enough evidence to conclude that dropout prevention programs have a universal impact on youth's school absenteeism outcomes.

The effectiveness of job rotation to prevent work-related musculoskeletal disorders: protocol of a cluster randomized clinical trial.

PubMed

Comper, Maria Luiza Caires; Padula, Rosimeire Simprini

2014-05-22

Job rotation has often been used in situations where the level of exposure cannot be reduced due to the characteristics of the job or through physical measures. However, the effectiveness of the job rotation strategy at preventing musculoskeletal complaints lacks adequate scientific data. A cluster randomized controlled trial will be used to investigate the effectiveness of job rotation to prevent musculoskeletal disorders in industrial workers. The randomized cluster was based in characteristics of production sectors. A total cluster will be 4 sectors, and 957 workers will be recruited from a textile industry and randomly allocated into intervention or control groups. Both groups will receive training on ergonomics guidelines. In addition, the intervention group will perform job rotation, switching between tasks with low, moderate, and high risk for musculoskeletal complaints. The primary outcome will be the number of working hours lost due to sick leave by musculoskeletal injuries recorded in employee administrative data bases. Secondary outcomes measured via survey include: body parts with musculoskeletal pain, the intensity of this pain, physical workload, fatigue, general health status, physical activity level, and work productivity. Secondary outcome measures will be assessed at baseline and after 3, 6, 9, and 12 months. The cost-effectiveness analysis will be performed from the societal and company perspective. Prevention of work-related musculoskeletal disorders is beneficial for workers, employers, and society. The results of this study will provide new information about the effectiveness of job rotation as a strategy to reduce work-related musculoskeletal disorders. NCT01979731, November 3, 2013.

The effectiveness of job rotation to prevent work-related musculoskeletal disorders: protocol of a cluster randomized clinical trial

PubMed Central

2014-01-01

Background Job rotation has often been used in situations where the level of exposure cannot be reduced due to the characteristics of the job or through physical measures. However, the effectiveness of the job rotation strategy at preventing musculoskeletal complaints lacks adequate scientific data. Methods/Design A cluster randomized controlled trial will be used to investigate the effectiveness of job rotation to prevent musculoskeletal disorders in industrial workers. The randomized cluster was based in characteristics of production sectors. A total cluster will be 4 sectors, and 957 workers will be recruited from a textile industry and randomly allocated into intervention or control groups. Both groups will receive training on ergonomics guidelines. In addition, the intervention group will perform job rotation, switching between tasks with low, moderate, and high risk for musculoskeletal complaints. The primary outcome will be the number of working hours lost due to sick leave by musculoskeletal injuries recorded in employee administrative data bases. Secondary outcomes measured via survey include: body parts with musculoskeletal pain, the intensity of this pain, physical workload, fatigue, general health status, physical activity level, and work productivity. Secondary outcome measures will be assessed at baseline and after 3, 6, 9, and 12 months. The cost-effectiveness analysis will be performed from the societal and company perspective. Discussion Prevention of work-related musculoskeletal disorders is beneficial for workers, employers, and society. The results of this study will provide new information about the effectiveness of job rotation as a strategy to reduce work-related musculoskeletal disorders. Trial registration NCT01979731, November 3, 2013 PMID:24885958

Environmental Approaches to Prevention in College Settings

PubMed Central

Saltz, Robert F.

2011-01-01

Because of concerns regarding drinking among college students and its harmful consequences, numerous prevention efforts have been targeted to this population. These include individual-level and community-level interventions, as well as other measures (e.g., online approaches). Community-level interventions whose effects have been evaluated in college populations include programs that were developed for the community at large as well as programs aimed specifically at college students, such as A Matter of Degree, the Southwest DUI Enforcement Project, Neighborhoods Engaging With Students, the Study to Prevent Alcohol-Related Consequences, and Safer California Universities. Evaluations of these programs have found evidence of their effectiveness in reducing college drinking and related consequences. The most effective approaches to reducing alcohol consumption among college students likely will blend individual-, group-, campus-, and community-level prevention components. PMID:22330219

The Effect of Commonly Used Excipients on the Epithelial Integrity of Human Cervicovaginal Tissue.

PubMed

Hu, Minlu; Zhou, Tian; Dezzutti, Charlene S; Rohan, Lisa C

Pharmaceutical excipients are widely used in vaginal drug products. The epithelial integrity of the cervicovaginal tissue is important for HIV-1 prevention. However, the effects of excipients on cervicovaginal epithelium remain unknown. This study aims at assessing the effects of vaginal product excipients on the integrity of human cervicovaginal epithelium and on a lead HIV prevention antiretroviral drug, tenofovir (TFV). In the current study, nine excipients commonly used in vaginal formulations were incubated for 6 h with excised human ectocervical tissue. The effects of the excipients were examined by measuring the transepithelial electrical resistance (TEER), epithelial morphology, paracellular/transcellular permeability, and cell viability. The efficacy of TFV for preventing HIV-1 infection in the ex vivo cultured ectocervix was also tested. We found that disodium ethyl-enediaminetetraacetate (EDTA), sorbic acid, and benzoic acid had no effect on the tissue TEER. Butylated hydroxyanisole, glycerin, propylene glycol, methylparaben, and propylparaben slightly to moderately decreased tissue TEER, whereas citric acid significantly decreased the TEER in a time-dependent manner. Tissue morphology observed post-exposure strongly correlated with TEER data; however, a less strong correlation was observed between paracellular permeability and TEER data after exposure to different excipients. In addition, treatment with EDTA, methylparaben, and propylene glycol at tested levels had no effect on the efficacy of TFV in preventing tissue HIV-1 infection. In conclusion, the combined measurements of TEER, morphology, permeability, and viability using human cervicovaginal tissue represent a clinically relevant platform for safety evaluation of excipients and formulated products for HIV-1 prevention.

Systematic review: internet-based program for youth smoking prevention and cessation.

PubMed

Park, Eunhee; Drake, Emily

2015-01-01

To review the characteristics and effects Internet-based youth smoking prevention and cessation programs. Systematic review of published articles in peer-reviewed journals in the past 10 years, focused on Internet-based youth smoking prevention and cessation programs. Twelve articles were selected based on the following criteria: studies reporting the outcomes of Internet-based smoking cessation or prevention intervention programs for adolescents who are younger than 24 years. The components of youth Internet-based smoking intervention programs are analyzed based on study features (i.e., sample, design, theoretical basis, analysis, outcome measures) and program characteristics (i.e., focus, setting, frequency, duration, intensity, and different components) that make the programs effective. The most common components of effective Internet-based programs are identified as the following: the use of multimedia, tailored approaches, personalized feedback, and interactive features. The characteristics and effects of the programs vary, but most programs show positive results in youth smoking prevention and cessation in spite of the studies' limitations. The evidence from this review provides useful information of recent efforts related to Internet-based youth smoking prevention and cessation programs, which can have significant clinical implications in developing future innovative youth smoking prevention and intervention programs. © 2014 Sigma Theta Tau International.

Standing Height as a Prevention Measure for Overuse Injuries of the Back in Alpine Ski Racing: A Kinematic and Kinetic Study of Giant Slalom

PubMed Central

Spörri, Jörg; Kröll, Josef; Fasel, Benedikt; Aminian, Kamiar; Müller, Erich

2018-01-01

Background: In alpine ski racing, typical loading patterns of the back include a combined occurrence of spinal bending, torsion, and high peak loads. These factors are known to be associated with high spinal disc loading and have been suggested to be attributable to different types of spine deterioration. However, little is known about the effect of standing height (ie, the distance between the bottom of the running surface of the ski and the ski boot sole) on the aforementioned back loading patterns. Purpose: To investigate the effect of reduced standing height on the skier’s overall trunk kinematics and the acting ground-reaction forces in giant slalom (GS) from an overuse injury prevention perspective. Study Design: Controlled laboratory study. Methods: Seven European Cup–level athletes skied a total of 224 GS turns with 2 different pairs of skis varying in standing height. Their overall trunk movement (frontal bending, lateral bending, and torsion angles) was measured based on 2 inertial measurement units located at the sacrum and sternum. Pressure insoles were used to determine the total ground-reaction force. Results: During the turn phase in which the greatest spinal disc loading is expected to occur, significantly lower total ground-reaction forces were observed for skis with a decreased standing height. Simultaneously, the skier’s overall trunk movement (ie, frontal bending, lateral bending, and torsion angles) remained unwaveringly high. Conclusion: Standing height is a reasonable measure to reduce the skier’s overall back loading in GS. Yet, when compared with the effects achievable by increased gate offsets in slalom, for instance, the preventative benefits of decreased standing height seem to be rather small. Clinical Relevance: To reduce the magnitude of overall back loading in GS and to prevent overuse injuries of the back, decreasing standing height might be an efficient approach. Nevertheless, the clinical relevance of the current findings, as well as the effectiveness of the measure “reduced standing height,” must be verified by epidemiological studies before its preventative potential can be judged as conclusive. PMID:29344540

Enhancing Documentation of Pressure Ulcer Prevention Interventions: A Quality Improvement Strategy to Reduce Pressure Ulcers.

PubMed

Jacobson, Therese M; Thompson, Susan L; Halvorson, Anna M; Zeitler, Kristine

2016-01-01

Prevention of hospital-acquired pressure ulcers requires the implementation of evidence-based interventions. A quality improvement project was conducted to provide nurses with data on the frequency with which pressure ulcer prevention interventions were performed as measured by documentation. Documentation reports provided feedback to stakeholders, triggering reminders and reeducation. Intervention reports and modifications to the documentation system were effective both in increasing the documentation of pressure ulcer prevention interventions and in decreasing the number of avoidable hospital-acquired pressure ulcers.

Reducing cultural and psychological barriers to Latino enrollment in HIV-prevention counseling: initial data on an enrollment meta-intervention.

PubMed

Wilson, Kristina; Durantini, Marta R; Albarracín, Julia; Crause, Candi; Albarracín, Dolores

2013-01-01

Aspects of Latino culture (e.g., machismo, marianism) can act as barriers to enrollment in HIV-prevention programs. To lift these barriers, a culturally appropriate meta-intervention was designed to increase intentions to enroll in HIV-prevention counseling by Latinos. Latino participants (N=41) were recruited from the community and randomly assigned to either an experimental or control meta-intervention condition that varied the introduction to a HIV-prevention counseling program. Following the meta-intervention, participants were issued an invitation to take part in HIV-prevention counseling. The outcome measure was the intention to enroll in a HIV-prevention counseling session. Findings indicated that enrollment intentions were higher in the experimental meta-intervention condition (96%) than in the control meta-intervention condition (53%). In addition, the effects of the meta-intervention were comparable across genders and participant ages. Findings suggest that the use of a culturally appropriate meta-intervention may be an effective strategy for increasing Latino enrollment in HIV-prevention programs. These promising findings warrant further investigation into the efficacy and effectiveness of this meta-intervention.

Reducing cultural and psychological barriers to Latino enrollment in HIV-prevention counseling: Initial data on an enrollment meta-intervention

PubMed Central

Wilson, Kristina; Durantini, Marta R.; Albarracín, Julia; Crause, Candi; Albarracín, Dolores

2013-01-01

Aspects of Latino culture (e.g., machismo, marianism) can act as barriers to enrollment in HIV-prevention programs. To lift these barriers, a culturally appropriate meta-intervention was designed to increase intentions to enroll in HIV-prevention counseling by Latinos. Latino participants (N = 41) were recruited from the community and randomly assigned to either an experimental or control meta-intervention condition that varied the introduction to a HIV-prevention counseling program. Following the meta-intervention, participants were issued an invitation to take part in HIV-prevention counseling. The outcome measure was the intention to enroll in a HIV-prevention counseling session. Findings indicated that enrollment intentions were higher in the experimental meta-intervention condition (96%) than in the control meta-intervention condition (53%). In addition, the effects of the meta-intervention were comparable across genders and participant ages. Findings suggest that the use of a culturally appropriate meta-intervention may be an effective strategy for increasing Latino enrollment in HIV-prevention programs. These promising findings warrant further investigation into the efficacy and effectiveness of this meta-intervention. PMID:23398305

Effects of the cyberbullying prevention program media heroes (Medienhelden) on traditional bullying.

PubMed

Chaux, Enrique; Velásquez, Ana María; Schultze-Krumbholz, Anja; Scheithauer, Herbert

2016-01-01

There is considerable debate over whether cyberbullying is just another form of bullying, or whether it is a problem distinct enough to require specific intervention. One way to explore this issue is to analyze whether programs designed to prevent traditional bullying help prevent cyberbullying, and whether programs designed to prevent cyberbullying prevent traditional bullying. The main goal of the current study was to analyze the spillover effects of the cyberbullying prevention program Media Heroes (Medienhelden) on traditional bullying. Media Heroes promotes empathy, knowledge of risks and consequences, and strategies that allow bystanders to defend victims from cyberbullying. Mixed ANOVAs were conducted comparing pretest and post-test (6 months after intervention) measures of 722 students (ages 11-17) assigned to a long (15 sessions) intervention, a short (1 day) intervention, and a control group. In addition to confirming the previously reported effects on cyberbullying, Media Heroes was found to reduce traditional bullying. Effects were larger for the long-version of the program than for the short 1-day version. No effects were found on victimization by either cyberbullying or traditional bullying. Strategies to complement traditional and cyberbullying prevention efforts are discussed. Aggr. Behav. 42:157-165, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Optimising implementation of reforms to better prevent and respond to child sexual abuse in institutions: Insights from public health, regulatory theory, and Australia's Royal Commission.

PubMed

Mathews, Ben

2017-12-01

The Australian Royal Commission Into Institutional Responses to Child Sexual Abuse has identified multiple systemic failures to protect children in government and non-government organizations providing educational, religious, welfare, sporting, cultural, arts and recreational activities. Its recommendations for reform will aim to ensure organizations adopt more effective and ethical measures to prevent, identify and respond to child sexual abuse. However, apart from the question of what measures institutions should adopt, an under-explored question is how to implement and regulate those measures. Major challenges confronting reform include the diversity of organizations providing services to children; organizational resistance; and the need for effective oversight. Failure to adopt theoretically sound strategies to overcome implementation barriers will jeopardize reform and compromise reduction of institutional child sexual abuse. This article first explains the nature of the Royal Commission, and focuses on key findings from case studies and data analysis. It then analyzes public health theory and regulatory theory to present a novel analysis of theoretically justified approaches to the implementation of measures to prevent, identify and respond to CSA, while isolating challenges to implementation. The article reviews literature on challenges to reform and compliance, and on prevention of institutional CSA and situational crime prevention, to identify measures which have attracted emerging consensus as recommended practice. Finally, it applies its novel integration of regulatory theory and public health theory to the context of CSA in institutional contexts, to develop a theoretical basis for a model of implementation and regulation, and to indicate the nature and functions of a regulatory body for this context. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.

Do young adults with atopic dermatitis avoid harmful workplace exposure at their first job? A prospective cohort study.

PubMed

Wei, Junxiang; Gerlich, Jessica; Vogelberg, Christian; von Mutius, Erika; Windstetter, Doris; Genuneit, Jon; Weinmayr, Gudrun; Nowak, Dennis; Radon, Katja

2016-04-01

Patients with atopic dermatitis (AD) are at high risk of chronic hand eczema. In this prospective cohort study, we assessed the influence of pre-hire-onset AD on the first job choice. We also analysed the potential association between AD and usage of preventive measures in high-risk occupations. Subjects (aged 19-24 years) who were followed from childhood until the second Study on Occupational Allergy Risks and indicated a job were included (n = 1566). We defined AD as doctor-diagnosed AD and symptoms of an itchy rash during the past 12 months before the study. Pre-hire-onset AD was having AD prior to the first job. Preventive measure usage was self-reported gloves use or use of ointment or moisturizer. We performed multiple imputations to deal with missing values and analysed associations using logistic regression models adjusted for several potential confounders. Risk categories of the first job did not differ between participants with pre-hire-onset AD and those without (odds ratio 1.05, 95 % confidence interval 0.59-1.87). AD status was not statistically significantly associated with usage of preventive measures (1.22, 0.56-2.64). Conversely, having received job counselling (2.76, 1.15-6.63) and a family history of AD (2.09, 1.01-4.31) were associated with a higher use of such measures. We could not confirm a healthy hire effect in this cohort of young adults. Although subjects with AD in high-risk occupations do not seem to use more preventive measures than their non-affected peers, job counselling seems to be an effective approach to encourage secondary prevention.

Evaluation of an education and activation programme to prevent chronic shoulder complaints: design of an RCT [ISRCTN71777817

PubMed Central

Bruijn, Camiel De; de Bie, Rob; Geraets, Jacques; Goossens, Marielle; Köke, Albère; van den Heuvel, Wim; van der Heijden, Geert; Dinant, Geert-Jan

2005-01-01

Background About half of all newly presented episodes of shoulder complaints (SC) in general practice are reported to last for at least six months. Early interventions aimed at the psychological and social determinants of SC are not common in general practice, although such interventions might prevent the development of chronic SC. The Education and Activation Programme (EAP) consists of an educational part and a time-contingent activation part. The aim of the EAP is to provide patients with the proper cognitions by means of education, and to stimulate adequate behaviour through advice on activities of daily living. Design The article describes the design of a randomised clinical trial (RCT) to evaluate the effectiveness and cost-effectiveness of an EAP in addition to usual care, compared to usual care only, in the prevention of chronic SC after six months. It also describes the analysis of the cost and effect balance. Patients suffering from SC for less than three months are recruited in general practice and through open recruitment. A trained general practitioner or a trained therapist administers the EAP. Primary outcome measures are patient-perceived recovery, measured by self-assessment on a seven-point scale, and functional limitations in activities of daily living. Questionnaires are used to study baseline measures, prognostic measures, process measures and outcome measures. Discussion The inclusion of patients in the study lasted until December 31st 2003. Data collection is to end in June 2004. PMID:15715914

Prevention praised, cure preferred: results of between-subjects experimental studies comparing (monetary) appreciation for preventive and curative interventions

PubMed Central

2013-01-01

Background 'An ounce of prevention is worth a pound of cure’ is a common saying, and indeed, most health economic studies conclude that people are more willing to pay for preventive measures than for treatment activities. This may be because most health economic studies ask respondents to compare preventive measures with treatment, and thus prompt respondents to consider other uses of resources. However, psychological theorizing suggests that, when methods do not challenge subjects to consider other uses of resources, curative treatment is favored over prevention. Could it be that while prevention is praised, cure is preferred? Methods In two experimental studies, we investigated, from a psychological perspective and using a between-subjects design, whether prevention or treatment is preferred and why. In both studies, participants first read a lung cancer prevention or treatment intervention scenario that varied on the prevention-treatment dimension, but that were the same on factors like 'costs per saved life’ and kind of disease. Then participants completed a survey measuring appreciation (general and monetary) as well as a number of potential mediating variables. Results Both studies clearly demonstrated that, when the design was between-subjects, participants had greater (general and monetary) appreciation for treatment interventions than for preventive interventions with perceived urgency of the intervention quite consistently mediating this effect. Differences in appreciation of treatment over preventive treatment were shown to be .59 (Study 1) and .45 (Study 2) on a 5-point scale. Furthermore, participants thought that health insurance should compensate more for the treatment than for preventive measures, differences of 16% (Study 1), and 22% (Study 2). When participants were asked to directly compare both interventions on the basis of a short description, they preferred the preventive intervention. Conclusion It appears that people claim to prefer prevention when they are asked to consider other use of resources, but otherwise they prefer treatment. This preference is related to perceived urgency. The preference for treatment may be related to the prevention-treatment dimension itself, but also to variations on other dimensions that are inherently linked to prevention and treatment (like different efficacy rates and costs per treatment). PMID:24344779

Modelling preventive effectiveness to estimate the equity tipping point: at what coverage can individual preventive interventions reduce socioeconomic disparities in diabetes risk?

PubMed

Manuel, D G; Ho, T H; Harper, S; Anderson, G M; Lynch, J; Rosella, L C

2014-07-01

Most individual preventive therapies potentially narrow or widen health disparities depending on the difference in community effectiveness across socioeconomic position (SEP). The equity tipping point (defined as the point at which health disparities become larger) can be calculated by varying components of community effectiveness such as baseline risk of disease, intervention coverage and/or intervention efficacy across SEP. We used a simple modelling approach to estimate the community effectiveness of diabetes prevention across SEP in Canada under different scenarios of intervention coverage. Five-year baseline diabetes risk differed between the lowest and highest income groups by 1.76%. Assuming complete coverage across all income groups, the difference was reduced to 0.90% (144 000 cases prevented) with lifestyle interventions and 1.24% (88 100 cases prevented) with pharmacotherapy. The equity tipping point was estimated to be a coverage difference of 30% for preventive interventions (100% and 70% coverage among the highest and lowest income earners, respectively). Disparities in diabetes risk could be measurably reduced if existing interventions were equally adopted across SEP. However, disparities in coverage could lead to increased inequity in risk. Simple modelling approaches can be used to examine the community effectiveness of individual preventive interventions and their potential to reduce (or increase) disparities. The equity tipping point can be used as a critical threshold for disparities analyses.

Lung cancer deaths from indoor radon and the cost effectiveness and potential of policies to reduce them

PubMed Central

Read, Simon; McGale, Paul; Darby, Sarah

2009-01-01

Objective To determine the number of deaths from lung cancer related to radon in the home and to explore the cost effectiveness of alternative policies to control indoor radon and their potential to reduce lung cancer mortality. Design Cost effectiveness analysis. Setting United Kingdom. Data sources Epidemiological data on risks from indoor radon and from smoking, vital statistics on deaths from lung cancer, survey information on effectiveness and costs of radon prevention and remediation. Main outcome measures Estimated number of deaths from lung cancer related to indoor radon, lifetime risks of death from lung cancer before and after various potential interventions to control radon, the cost per quality adjusted life year (QALY) gained from different policies for control of radon, and the potential of those policies to reduce lung cancer mortality. Results The mean radon concentration in UK homes is 21 becquerels per cubic metre (Bq/m3). Each year around 1100 deaths from lung cancer (3.3% of all deaths from lung cancer) are related to radon in the home. Over 85% of these arise from radon concentrations below 100 Bq/m3 and most are caused jointly by radon and active smoking. Current policy requiring basic measures to prevent radon in new homes in selected areas is highly cost effective, and such measures would remain cost effective if extended to the entire UK, with a cost per QALY gained of £11 400 ( €12 200; $16 913). Current policy identifying and remediating existing homes with high radon levels is, however, neither cost effective (cost per QALY gained £36 800) nor effective in reducing lung cancer mortality. Conclusions Policies requiring basic preventive measures against radon in all new homes throughout the UK would be cost effective and could complement existing policies to reduce smoking. Policies involving remedial work on existing homes with high radon levels cannot prevent most radon related deaths, as these are caused by moderate exposure in many homes. These conclusions are likely to apply to most developed countries, many with higher mean radon concentrations than the UK. PMID:19129153

[Transcultural prevention of alcohol-related disorders : effects of a culture- and migration-sensitive approach in elderly migrants with respect to attitudes and behavior: a cluster randomized controlled trial].

PubMed

Bermejo, Isaac; Frank, F; Komarahadi, F; Albicker, J; Ries, Z; Kriston, L; Härter, M

2015-07-01

For migrants who are older than 50, alcohol frequently becomes a problem. Simultaneously alcohol-related prevention measures only reach this group insufficiently. Therefore, a transcultural concept for preventing alcohol-related disorders in elderly (≥ 45 years) migrants has been developed. The transcultural concept, which consisted of a prevention event as well as a cultural and language-sensitive information booklet, was evaluated in a cluster-randomized controlled trial (n = 310 immigrants). As a control condition there was a prevention event with materials from Deutsche Hauptstelle für Suchtfragen (German Centre for Addiction Issues). Data were obtained before and after the event, as well as after 6 months. All materials were available both in German and in Russian, Italian, Spanish and Turkish. Directly after the event, as well as 6 months thereafter, the transcultural approach was rated significantly better than the general prevention event. 73.4 % of the participants read the cultural and migration-sensitive booklet, whereas only 21.2 % in the control condition (p = 0.0001). Furthermore, significantly more participants of the transcultural approach reported a reduced alcohol consumption (49.4 vs. 16.7 %; p = 0.004) after 6 months. The consideration of diversity with respect to cultural, migration-related, socio demographic und linguistic aspects improves the effectiveness of prevention measures.

Design and Feasibility of a Text Messaging Intervention to Prevent Indoor Tanning Among Young Adult Women: A Pilot Study

PubMed Central

Mays, Darren

2016-01-01

Background Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages. Objective The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs. Methods We conducted a pilot study of indoor tanning prevention messages delivered via mobile phone text messaging in a sample of 21 young adult women who indoor tan. Participants completed baseline measures, were randomly assigned to receive gain-, loss-, or balanced-framed text messages, and completed postexposure outcome measures on indoor tanning cognitions and behaviors. Participants received daily mobile phone indoor tanning prevention text messages for 1 week and completed the same postexposure measures as at baseline. Results Over the 1-week period there were trends or significant changes after receipt of the text messages, including increased perceived susceptibility (P<.001), response efficacy beliefs (P<.001), and message receptivity (P=.03). Ordinary least squares stepwise linear regression models showed an effect of text message exposure on self-efficacy to quit indoor tanning (t6=–2.475, P<.02). Ordinary least squares linear regression including all measured scales showed a marginal effect of SMS texts on self-efficacy (t20=1.905, P=.08). Participants endorsed highly favorable views toward the text messaging protocol. Conclusions This study supports this use of mobile text messaging as an indoor tanning prevention strategy. Given the nature of skin cancer risk perceptions, the addition of multimedia messaging service is another area of potential innovation for disseminating indoor tanning prevention messages. PMID:28007691

Design and Feasibility of a Text Messaging Intervention to Prevent Indoor Tanning Among Young Adult Women: A Pilot Study.

PubMed

Evans, William D; Mays, Darren

2016-12-22

Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages. The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs. We conducted a pilot study of indoor tanning prevention messages delivered via mobile phone text messaging in a sample of 21 young adult women who indoor tan. Participants completed baseline measures, were randomly assigned to receive gain-, loss-, or balanced-framed text messages, and completed postexposure outcome measures on indoor tanning cognitions and behaviors. Participants received daily mobile phone indoor tanning prevention text messages for 1 week and completed the same postexposure measures as at baseline. Over the 1-week period there were trends or significant changes after receipt of the text messages, including increased perceived susceptibility (P<.001), response efficacy beliefs (P<.001), and message receptivity (P=.03). Ordinary least squares stepwise linear regression models showed an effect of text message exposure on self-efficacy to quit indoor tanning (t 6 =-2.475, P<.02). Ordinary least squares linear regression including all measured scales showed a marginal effect of SMS texts on self-efficacy (t 20 =1.905, P=.08). Participants endorsed highly favorable views toward the text messaging protocol. This study supports this use of mobile text messaging as an indoor tanning prevention strategy. Given the nature of skin cancer risk perceptions, the addition of multimedia messaging service is another area of potential innovation for disseminating indoor tanning prevention messages. ©William Evans, Darren Mays. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 22.12.2016.

The crime prevention value of hot spots policing.

PubMed

Braga, Anthony A

2006-08-01

This paper reviews the available research evidence on the effectiveness of hot spots policing programs in reducing crime and disorder. The research identified five randomized controlled experiments and four non-equivalent control group quasi-experiments evaluating the effects of hot spots policing interventions on crime. Seven of nine selected evaluations reported noteworthy crime and disorder reductions. Meta-analyses of the randomized experiments revealed statistically significant mean effect sizes favoring hot spots policing interventions in reducing citizen calls for service in treatment places relative to control places. When immediate spatial displacement was measured, it was very limited and unintended crime prevention benefits were associated with the hot spots policing programs. The results of this review suggest that hot spots policing is an effective crime prevention strategy.

Investigating the Effects of Mass Media Exposure on the Uptake of Preventive Measures by Hong Kong Residents during the 2015 MERS Outbreak: The Mediating Role of Interpersonal Communication and the Perception of Concern.

PubMed

Ludolph, Ramona; Schulz, Peter J; Chen, Ling

2018-01-01

In 2015, South Korea experienced the largest outbreak to date of the Middle East Respiratory Syndrome (MERS-CoV) outside the Middle East. Fears related to a potential spread of the disease led to an increased alert level as well as heightened media coverage in the neighboring Hong Kong. A cross-sectional survey (N = 533) among residents of Hong Kong was conducted to assess the relationships between the effects of outbreak-related mass media coverage, interpersonal communication, the perceived level of concern in one's close environment, and the uptake of preventive measures. A serial multiple mediator model finds that interpersonal communication and higher perceived concern indirectly influence the effects of media coverage on the engagement in preventive actions. These results expand previous research on the mediating role of interpersonal communication and support assumptions about a modified two-step flow of communication in the context of a public health emergency.

The Different Roles of Perceived Stress in the Association Between Older Adults’ Physical Activity and Physical Health

PubMed Central

Rueggeberg, Rebecca; Wrosch, Carsten; Miller, Gregory E.

2011-01-01

This 4-yr longitudinal study examined the different roles of perceived stress in the association between older adults’ physical activities and physical health. We hypothesized that physical activities would exert beneficial effects on physical health by preventing chronically high levels of perceived stress. Design and Measures We assessed baseline levels of physical activities and repeated measures of perceived stress and physical symptoms in three waves of data from a sample of 157 older adults. Results Among participants with high (but not low) baseline levels of perceived stress, physical activity predicted a 2-yr reduction of perceived stress and a 4-yr prevention of physical health symptoms. Moreover, the interaction effect on 4-yr changes in physical symptoms was mediated by 2-yr changes in perceived stress. Conclusions Physical health benefits of physical activity are particularly pronounced among older adults who perceive high levels of stress, and this effect is mediated by a prevention of chronically high perceptions of stress. PMID:21875206

Effects of a prevention program for divorced families on youth cortisol reactivity 15 years later

PubMed Central

Luecken, Linda J.; Hagan, Melissa J.; Mahrer, Nicole E.; Wolchik, Sharlene A.; Sandler, Irwin N.; Tein, Jenn-Yun

2015-01-01

Objective We examined whether an empirically-based, randomized controlled trial of a preventive intervention for divorced mothers and children had a long-term impact on offspring cortisol regulation. Design Divorced mothers and children (age 9-12) were randomly assigned to a literature control condition or the 11-week New Beginnings Program (NBP), a family-focused group preventive intervention for mothers and children in newly divorced families. Main Outcome Measures Fifteen years after the trial, offspring salivary cortisol (n=161) was measured before and after a social stress task. Results Multilevel mixed models were used to predict cortisol from internalizing symptoms, externalizing symptoms, group assignment and potential moderators of intervention effects. Across the sample, higher externalizing symptoms were associated with lower cortisol reactivity. There was a significant group by age interaction such that older offspring in the control group had higher reactivity relative to the intervention group, and younger offspring in the control group exhibited a decline across the task relative to younger offspring in the intervention group. Conclusions Preventive interventions for youth from divorced families may have a long-term impact on cortisol reactivity to stress. Results highlight the importance of examining moderators of program effects. PMID:25367835

A prevention programme for somatoform disorders is effective for affective disorders.

PubMed

García-Campayo, Javier; Arevalo, Elisa; Claraco, Luis Manuel; Alda, Marta; Lopez del Hoyo, Yolanda

2010-04-01

To assess the effectiveness of a psycho-educational programme for the primary prevention of somatoform disorders in healthy primary care patients. Randomized, controlled trial. Participants (N=104) were randomly assigned to: (1) a psycho-educational intervention, or (2) no intervention at all. The primary outcome measure was somatoform disorder psychiatric diagnosis at 5-year follow-up. Secondary outcome measures were hypochondriasis, locus of control and attribution of symptoms and psychological distress. At 3 and 6 months, and 5 years, the intervention group significantly decreased hypochondriasis and somatic attributions; and increased psychological and normalizing attributions and internal locus of control. Five years after baseline, the prevalence of somatoform disorders showed no differences between both groups. Nevertheless, overall psychiatric morbidity was less prevalent in the intervention group (odds ratio: 2.72; 95%CI:1.10-6.72). In addition, a decrease in depression and anxiety subscales and in overall General Health Questionnaire scoring (p<.05) was found in the intervention group. A primary prevention programme for somatization seems to be useful, not to decrease somatoform disorders, but to prevent anxiety and depressive disorders. The effects of overlapping psychobiological mechanisms are discussed. Copyright 2009 Elsevier B.V. All rights reserved.

Effectiveness of an intervention for prevention and treatment of burnout in primary health care professionals.

PubMed

Gómez-Gascón, Tomás; Martín-Fernández, Jesús; Gálvez-Herrer, Macarena; Tapias-Merino, Ester; Beamud-Lagos, Milagros; Mingote-Adán, José Carlos

2013-11-17

Burnout syndrome is an important health problem that affects many professionals and must be addressed globally, with both organizational measures and personal interventions. Burnout of health professionals can be prevented in order to avoid personal, familial, and social consequences, as well as repercussions for patients. This work describes a protocol for a controlled, pragmatic, randomized clinical trial in 2 parallel groups: intervention and control. All health professionals from 7 health care centers will form the intervention group, and all health professionals from 7 different health care centers will form the control group. The intervention group will receive 16 hours of training at their work place. The Maslach's burnout inventory, the Cuestionario de Desgaste Profesional Médico or the Cuestionario de Desgaste Profesional de Enfermería, and the 28-item Goldberg's General Health Questionnaire, validated for our setting, will be used as measurement tools. Change in the average scores from the Maslach's burnout inventory emotional exhaustion scale will be compared between the intervention and control groups, measured as intention-to-treat, and the intervention will be considered effective if a minimum decrease of 20% is achieved. Due to the deleterious consequences of burnout syndrome for people suffering from it and for the organization where they work, it is necessary to evaluate the effectiveness of certain interventions for its prevention. Organizational measures are important for preventing burnout syndrome, but so is providing professionals with coping strategies, as this group intervention intends to do. ClinicalTrials.gov processed this record on June 10, 2013. ClinicalTrials.gov Identifier: NCT01870154.

A quantitative risk assessment model to evaluate effective border control measures for rabies prevention

PubMed Central

Weng, Hsin-Yi; Wu, Pei-I; Yang, Ping-Cheng; Tsai, Yi-Lun; Chang, Chao-Chin

2009-01-01

Border control is the primary method to prevent rabies emergence. This study developed a quantitative risk model incorporating stochastic processes to evaluate whether border control measures could efficiently prevent rabies introduction through importation of cats and dogs using Taiwan as an example. Both legal importation and illegal smuggling were investigated. The impacts of reduced quarantine and/or waiting period on the risk of rabies introduction were also evaluated. The results showed that Taiwan’s current animal importation policy could effectively prevent rabies introduction through legal importation of cats and dogs. The median risk of a rabid animal to penetrate current border control measures and enter Taiwan was 5.33 × 10−8 (95th percentile: 3.20 × 10−7). However, illegal smuggling may pose Taiwan to the great risk of rabies emergence. Reduction of quarantine and/or waiting period would affect the risk differently, depending on the applied assumptions, such as increased vaccination coverage, enforced custom checking, and/or change in number of legal importations. Although the changes in the estimated risk under the assumed alternatives were not substantial except for completely abolishing quarantine, the consequences of rabies introduction may yet be considered to be significant in a rabies-free area. Therefore, a comprehensive benefit-cost analysis needs to be conducted before recommending these alternative measures. PMID:19822125

"Until people start dying in droves, no actions will be taken": perception and experience of HIV-preventive measures among people who inject drugs in northwestern Russia.

PubMed

Meylakhs, Peter; Aasland, Aadne; Grønningsæter, Arne

2017-06-05

The HIV epidemic among people who inject drugs (PWID) in Russia continues to spread. This exploratory study examines how HIV-prevention measures are perceived and experienced by PWID in the northwestern region of Russia. Purposive sampling was used to obtain a variety of cases that could reflect possible differences in perception and experience of HIV-prevention efforts. We conducted 22 semi-structured interviews with PWID residing in the Arkhangelsk and St. Petersburg regions. The main sources of prevention information on HIV for PWID were media campaigns directed to the general population. These campaigns were effective with regard to communicating general knowledge on HIV but were ineffective in terms of risk behavior change. The subjects generally had trust in medical professionals and their advice but did not follow prevention recommendations. Most informants had no or very little prior contact with harm reduction services. On the level of attitudes towards HIV prevention efforts, we discovered three types of fatalism among PWID: "personal fatalism" - uselessness of HIV prevention efforts, if one uses drugs; "prevention-related fatalism" - prevention programs are low effective, because people do not pay attention to them before they get infected; "state-related fatalism" - the lack of belief that the state is concerned with HIV prevention issues. Despite this fatalism the participants opined that NGOs would do a better job than the state as they are "really working" with risk groups. As HIV prevention campaigns targeted at the general population and prevention advice received from medical professionals are not sufficiently effective for PWID in terms of risk behavior change, prevention programs, such as community-based and peer-based interventions specifically tailored to the needs of PWID are needed, which can be achieved by a large expansion of harm reduction services in the region. Personal communication should be a crucial element in such interventions in addition to harm reduction materials provision. Training programs, peer outreach, and culture-change interventions which try to alter widespread fatalistic norms or attitudes towards their health are especially needed, since this study indicates that fatalism is a major barrier for behavior change.

The Impact of a Psychoeducational Prevention Program for Behaviorally At-Risk Students: EQUIP for Educators

ERIC Educational Resources Information Center

DiBiase, Ann-Marie

2010-01-01

This study examined the effectiveness of a multicomponent psychoeducational prevention program ("EQUIP for Educators") Two aspects were examined: (1) if there was a significant relationship among the three psychometric measures: Social Skills Rating System (SSRS), Children's Inventory of Anger (ChIA), Sociomoral Reflection and…

77 FR 74695 - Preventing Backover Injuries and Fatalities

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-17

... backovers may be prevented by new technology or other methods, and how effective those measures are. DATES..., DC. 2. University of Texas at Arlington, OSHA Education Center, Bluebonnet Ballroom in the University... Communications, Room N-3647, U.S. Department of Labor, 200 Constitution Avenue NW., Washington, DC 20210...

Moderating effect of age on the association between future time perspective and preventive coping.

PubMed

Chen, Tao; Liu, Lu-Lu; Cui, Ji-Fang; Chen, Xing-Jie; Shi, Hai-Song; Neumann, David L; Shum, David H K; Wang, Ya; Chan, Raymond C K

2017-09-01

The present study aimed to investigate the moderating effect of age on the relationship between future time perspective (FTP) and future-oriented coping. A total of 1,915 participants aged 9-84 years completed measures of FTP and future-oriented coping. Moderation analyses were conducted to examine whether age played a role in the association between FTP and future-oriented coping (proactive and preventive). Results showed that proactive and preventive coping were negatively correlated with age, and age moderated the association between FTP and preventive coping but not proactive coping. Furthermore, the strength of the positive association between FTP and preventive coping was strongest among the older participants, moderate among the middle-aged participants, and weakest among the younger participants. These results suggest that the association between FTP and preventive coping varies across the lifespan. © 2017 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

[Prevention and regeneration of barrier disturbances in occupational dermatology].

PubMed

Schürer, Nanna Y; Schwanitz, Hans J

2004-11-01

Over the past 10 years primary, secondary and tertiary prevention of occupational skin disorders has been shown to be successful, documented with appropriate statistical methods. Interventional strategies are the main features of secondary and tertiary prevention, now well-established in occupational dermatology. Primary prevention is best accomplished by health education measures, both in the form on individual counseling and seminars. This overview reviews the scientific background of hand eczema with respect to barrier damage and repair and then considers the options for individualized and focused prevention. Special anatomical features of the interdigital space and palms, as well as functional disorders, such as palmar hyperhidrosis, are discussed. The importance of barrier regeneration is considered in light of the role of an acid pH, the epidermal calcium gradient and aspects of percutaneous absorption. The effects of anti-oxidants are considered, and new bioengineering methods which rely on physiologic measuring techniques are reviewed.

A Youth Suicide Prevention Plan for Canada: A Systematic Review of Reviews.

PubMed

Bennett, Kathryn; Rhodes, Anne E; Duda, Stephanie; Cheung, Amy H; Manassis, Katharina; Links, Paul; Mushquash, Christopher; Braunberger, Peter; Newton, Amanda S; Kutcher, Stanley; Bridge, Jeffrey A; Santos, Robert G; Manion, Ian G; Mclennan, John D; Bagnell, Alexa; Lipman, Ellen; Rice, Maureen; Szatmari, Peter

2015-06-01

We conducted an expedited knowledge synthesis (EKS) to facilitate evidence-informed decision making concerning youth suicide prevention, specifically school-based strategies and nonschool-based interventions designed to prevent repeat attempts. Systematic review of review methods were applied. Inclusion criteria were as follows: systematic review or meta-analysis; prevention in youth 0 to 24 years; peer-reviewed English literature. Review quality was determined with AMSTAR (a measurement tool to assess systematic reviews). Nominal group methods quantified consensus on recommendations derived from the findings. No included review addressing school-based prevention (n = 7) reported decreased suicide death rates based on randomized controlled trials (RCTs) or controlled cohort studies (CCSs), but reduced suicide attempts, suicidal ideation, and proxy measures of suicide risk were reported (based on RCTs and CCSs). Included reviews addressing prevention of repeat suicide attempts (n = 14) found the following: emergency department transition programs may reduce suicide deaths, hospitalizations, and treatment nonadherence (based on RCTs and CCSs); training primary care providers in depression treatment may reduce repeated attempts (based on one RCT); antidepressants may increase short-term suicide risk in some patients (based on RCTs and meta-analyses); this increase is offset by overall population-based reductions in suicide associated with antidepressant treatment of youth depression (based on observational studies); and prevention with psychosocial interventions requires further evaluation. No review addressed sex or gender differences systematically, Aboriginal youth as a special population, harm, or cost-effectiveness. Consensus on 6 recommendations ranged from 73% to 100%. Our EKS facilitates decision maker access to what is known about effective youth suicide prevention interventions. A national research-to-practice network that links researchers and decision makers is recommended to implement and evaluate promising interventions; to eliminate the use of ineffective or harmful interventions; and to clarify prevention intervention effects on death by suicide, suicide attempts, and suicidal ideation. Such a network could position Canada as a leader in youth suicide prevention.

A Youth Suicide Prevention Plan for Canada: A Systematic Review of Reviews

PubMed Central

Bennett, Kathryn; Rhodes, Anne E; Duda, Stephanie; Cheung, Amy H; Manassis, Katharina; Links, Paul; Mushquash, Christopher; Braunberger, Peter; Newton, Amanda S; Kutcher, Stanley; Bridge, Jeffrey A; Santos, Robert G; Manion, Ian G; McLennan, John D; Bagnell, Alexa; Lipman, Ellen; Rice, Maureen; Szatmari, Peter

2015-01-01

Objective: We conducted an expedited knowledge synthesis (EKS) to facilitate evidence-informed decision making concerning youth suicide prevention, specifically school-based strategies and nonschool-based interventions designed to prevent repeat attempts. Methods: Systematic review of review methods were applied. Inclusion criteria were as follows: systematic review or meta-analysis; prevention in youth 0 to 24 years; peer-reviewed English literature. Review quality was determined with AMSTAR (a measurement tool to assess systematic reviews). Nominal group methods quantified consensus on recommendations derived from the findings. Results: No included review addressing school-based prevention (n = 7) reported decreased suicide death rates based on randomized controlled trials (RCTs) or controlled cohort studies (CCSs), but reduced suicide attempts, suicidal ideation, and proxy measures of suicide risk were reported (based on RCTs and CCSs). Included reviews addressing prevention of repeat suicide attempts (n = 14) found the following: emergency department transition programs may reduce suicide deaths, hospitalizations, and treatment nonadherence (based on RCTs and CCSs); training primary care providers in depression treatment may reduce repeated attempts (based on one RCT); antidepressants may increase short-term suicide risk in some patients (based on RCTs and meta-analyses); this increase is offset by overall population-based reductions in suicide associated with antidepressant treatment of youth depression (based on observational studies); and prevention with psychosocial interventions requires further evaluation. No review addressed sex or gender differences systematically, Aboriginal youth as a special population, harm, or cost-effectiveness. Consensus on 6 recommendations ranged from 73% to 100%. Conclusions: Our EKS facilitates decision maker access to what is known about effective youth suicide prevention interventions. A national research-to-practice network that links researchers and decision makers is recommended to implement and evaluate promising interventions; to eliminate the use of ineffective or harmful interventions; and to clarify prevention intervention effects on death by suicide, suicide attempts, and suicidal ideation. Such a network could position Canada as a leader in youth suicide prevention. PMID:26175322

Research on Chinese life cycle-based wind power plant environmental influence prevention measures.

PubMed

Wang, Hanxi; Xu, Jianling; Liu, Yuanyuan; Zhang, Tian

2014-08-19

The environmental impact of wind power plants over their life cycle is divided into three stages: construction period, operation period and retired period. The impact is mainly reflected in ecological destruction, noise pollution, water pollution and the effect on bird migration. In response to these environmental effects, suggesting reasonable locations, reducing plant footprint, optimizing construction programs, shielding noise, preventing pollution of terrestrial ecosystems, implementing combined optical and acoustical early warning signals, making synthesized use of power generation equipment in the post-retired period and using other specific measures, including methods involving governance and protection efforts to reduce environmental pollution, can be performed to achieve sustainable development.

New targets in the search for preventive and therapeutic agents for botulism.

PubMed

Anniballi, Fabrizio; Lonati, Davide; Fiore, Alfonsina; Auricchio, Bruna; De Medici, Dario; Locatelli, Carlo Alessandro

2014-09-01

Botulism is a severe neuroparalytic disease resulting from exposure to one of the most poisonous toxins to humans. Because of this high potency and the use of toxins as biological weapons, botulism is a public health concern and each case represents an emergency. Current therapy involves respiratory supportive care and anti-toxins administration. As a preventive measure, vaccination against toxins represents an effective strategy but is undesirable due the rarity of botulism and the effectiveness of toxins in treating several neuromuscular disorders. This paper summarizes the current issues in botulism treatment and prevention, highlighting the challenge for future researches.

[Evaluation on intervention measures of comprehensive control for parasitic diseases in demonstration plot of Xiangyun County].

PubMed

Wen-Juan, Li; Shao-Rong, Chen; Yan-Hong, Li; Wen, Fang; Chun-Rong, Ke; Li-Bo, Wang

2011-10-01

To evaluate the effect of comprehensive intervention measures to control and prevent parasitic diseases in the demonstration plot of Xiangyun County, so as to provide the evidence for establishing appropriate measures of parasitic diseases control and prevention. The baseline data of soil-transmitted nematode infections were obtained in 2006. A series of intervention measures, including health education, deworming, drinking water improvement,latrine improvement, and environment reconstruction, were performed for three years and the effect of the comprehensive intervention measures was evaluated by the national expert group in 2009. The awareness rate of parasitic disease knowledge of residents in 2009 (86.96%) was significantly higher than that in 2006 (35.20%) (Chi2 = 122.95, P < 0.01). The passing rate of resident health behavior in 2009 (97.10%) was significantly higher than that in 2006 (48.00%) (Chi2 = 122.95, P < 0.01). The general infection rate of parasites in 2009 (2.47%) was significantly lower than that in 2006 (19.14%) (Chi2 = 162.88, P < 0.01). Of soil-transmitted nematode infections, the infection rates of Ascaris lumbricoides in both 2006 and 2009 were the highest and the rates were 18.74% and 2.08%, respectively. In the demonstration plots for parasitic diseases control and prevention of Xiangyun County, the effect of the comprehensive intervention measures which take health education as the forerunner and give priority to control source of parasite infection is remarkable. The measures implemented can achieve the purpose to reduce the infection rates of parasites and improve human health.

Breast cancer prevention across the cancer care continuum.

PubMed

Klemp, Jennifer R

2015-05-01

To review the current state of breast cancer prevention from primary prevention through survivorship, highlight cross-cutting issues, and discuss strategies for clinical integration and future research. Published articles between 1985 and 2015 and original research. Cancer risk persists across the lifespan. Interprofessional strategies to reduce morbidity and mortality from cancer include primary, secondary, and tertiary prevention (survivorship). Prevention strategies across the cancer care continuum are cross-cutting and focus on measures to: prevent the onset of disease, identify and treat asymptomatic persons who have already developed risk factors or preclinical disease, and restore function, minimize the negative effects of disease, and prevent disease-related complications. Oncology nurses and advanced practice nurses are vital in the delivery of breast cancer prevention strategies. Published by Elsevier Inc.

Prevention of acute kidney injury in Intensive Care Units.

PubMed

Mas-Font, S; Ros-Martinez, J; Pérez-Calvo, C; Villa-Díaz, P; Aldunate-Calvo, S; Moreno-Clari, E

2017-03-01

Acute kidney injury (AKI) is a growing concern in Intensive Care Units. The advanced age of our patients, with the increase in associated morbidity and the complexity of the treatments provided favor the development of AKI. Since no effective treatment for AKI is available, all efforts are aimed at prevention and early detection of the disorder in order to establish secondary preventive measures to impede AKI progression. In critical patients, the most frequent causes are sepsis and situations that result in renal hypoperfusion; preventive measures are therefore directed at securing hydration and correct hemodynamics through fluid perfusion and the use of inotropic or vasoactive drugs, according to the underlying disease condition. Apart from these circumstances, a number of situations could lead to AKI, related to the administration of nephrotoxic drugs, intra-tubular deposits, the administration of iodinated contrast media, liver failure and major surgery (mainly heart surgery). In these cases, in addition to hydration, there are other specific preventive measures adapted to each condition. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

[Evaluation of the efficiency of preventive medical examinations of railway transport workers].

PubMed

Pankova, V B; Golysheva, G V; Khvastunov, R M; Makarov, A A

2006-01-01

The paper reflects the priority role of preliminary and periodic medical examinations in the system of measures implemented by therapeutic-and-prophylactic institutions of the Ministry of Railway of Russia. It gives a comprehensive assessment of the medical, social, and economic aspects of the efficiency of preventive medical examinations. Emphasis is laid on the necessity of elaborating methods to evaluate the economic efficiency of medical measures under the conditions of market economy. At the same time, light is shed on the difficulties available when a full-scale, within the whole industry, economic evaluation of periodic medical examinations is made. The role of a cost-effect analysis is shown as the most flexible existing principle in the evaluation of the efficiency of medical preventive measures.

Effects of complex interventions in ‘skin cancer prevention and treatment’: protocol for a mixed-method systematic review with qualitative comparative analysis

PubMed Central

Breitbart, Eckhard; Köberlein-Neu, Juliane

2017-01-01

Introduction Occurring from ultraviolet radiation combined with impairing ozone levels, uncritical sun exposure and use of tanning beds an increasing number of people are affected by different types of skin cancer. But preventive interventions like skin cancer screening are still missing the evidence for effectiveness and therefore are criticised. Fundamental for an appropriate course of action is to approach the defined parameters as measures for effectiveness critically. A prerequisite should be the critical application of used parameter that are defined as measures for effectiveness. This research seeks to establish, through the available literature, the effects and conditions that prove the effectiveness of prevention strategies in skin cancer. Method and analysis A mixed-method approach is employed to combine quantitative to qualitative methods and answer what effects can display effectiveness considering time horizon, perspective and organisational level and what are essential and sufficient conditions to prove effectiveness and cost-effectiveness in skin cancer prevention strategies. A systematic review will be performed to spot studies from any design and assess the data quantitatively and qualitatively. Included studies from each key question will be summarised by characteristics like population, intervention, comparison, outcomes, study design, endpoints, effect estimator and so on. Beside statistical relevancies for a systematic review the qualitative method of qualitative comparative analysis (QCA) will be performed. The estimated outcomes from this review and QCA are the accomplishment and absence of effects that are appropriate for application in effectiveness assessments and further cost-effectiveness assessment. Ethics and dissemination Formal ethical approval is not required as primary data will not be collected. Trial registration number International Prospective Register for Systematic Reviews number CRD42017053859. PMID:28877950

[Internet-based resilience training and prevention of mental disorders].

PubMed

Lehr, D; Kunzler, A; Helmreich, I; Behrendt, D; Chmitorz, A; Lieb, K

2018-05-30

Resilience is associated with a positive and resource-oriented perspective. Therefore, it seems especially attractive for health promotion and prevention. In recent years, interventions to foster resilience have been increasingly developed, which train resilience factors and are mainly conducted in a face to face group format. The question is raised what potential internet-based interventions (i-interventions) that train resilience factors have for health promotion and prevention. Based on a narrative overview, the possibilities for i‑interventions that train resilience factors for health promotion and prevention are investigated and the state of research is described. The effects of the i‑interventions presented here, which aim at fostering resilience, on measures of mental health and well-being are heterogeneous and vary between low to high effects. Stronger evidence for the efficacy of these measures exists for more general i‑interventions that also train resilience factors but are conceptualized for the prevention of specific disorders, such as depression or for stress reduction. Given the heterogeneous nature of intervention contents, theoretical foundations and therapeutic methods used, the heterogeneity of the evidence is discussed. In addition, perspectives for the further development of resource-oriented resilience interventions are outlined.

Preventive education to cope with the drug problems of Latin America.

PubMed

Massun, E

1990-01-01

Insufficient resources, services, staff, facilities and attention at the policymaking level are devoted to demand reduction measures, especially preventive education for young persons. Instead, emphasis is placed on and disproportionate resources are allocated to supply reduction measures and activities such as suppressing and/or limiting the availability of illicit drugs. Prevention policy constitutes a viable approach to solving the problem of illicit drug trafficking and consumption. The crux of the problem is not the availability of illicit drugs, but the demand of consumers for the substances. Preventive education for the young is an indispensable ingredient of effective prevention policy. The school environment can be instrumental in developing systematic and lasting preventive education. An essential condition, which, according to the author, is lacking in Latin America, is that educators should be provided with the training and training tools needed to enable them to perform properly as agents of prevention policy. A number of recommendations to reduce illicit drug demand and consumption through prevention are made, including giving priority to a comprehensive and systematically applied prevention policy focusing on the young and involving an educational approach and tools that are progressive and highly specialized, as well as research that is intensified and of better quality.

Performance measures for improving the prevention of venous thromboembolism: achievement in clinical practice.

PubMed

Wilson, Kenneth C; Merli, Geno J

2011-10-01

Venous thromboembolism (VTE) is a common complication during and after hospitalization for acute medical illness or surgery. Despite the existence of evidence-based guidelines for VTE prevention, real-world prescribing practices are frequently suboptimal. Specific performance measures relating to VTE prevention and treatment have been developed by US health care organizations to increase adherence with best-practice recommendations and ultimately reduce the number of preventable VTE events. Two measures developed by the Surgical Care Improvement Project have been endorsed by the National Quality Forum (NQF) and focus on VTE prevention. In addition, six measures have been developed recently by The Joint Commission in collaboration with the NQF; three measures relate to VTE prevention and three focus on treatment. To attain widespread achievement of these performance goals, it is essential to raise awareness of their existence and specifications. It is also imperative that hospitals develop and implement effective VTE protocols. The use of multiple, active strategies, such as computer decision support systems with regular audit and feedback, may be particularly valuable approaches to improve current practices within an integrated quality improvement program. During practical implementation of VTE protocols at Norton Healthcare (Kentucky's largest healthcare system), strong leadership, physician engagement, and caregiver accountability were identified as key factors influencing the process. As such, more hospitals may be able to increase adherence with guidelines, improve achievement of quality goals, and help to reduce the substantial burden associated with avoidable VTE.

Prevention of nosocomial infection in the ICU setting.

PubMed

Corona, A; Raimondi, F

2004-05-01

The aim of this review is to focus the epidemiology and preventing measures of nosocomial infections that affect the critically ill patients. Most of them (over 80%) are related to the device utilization needed for patient life support but responsible for such complications as ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSI), surgical site infections (SSI) and urinary tract infections (UTI). General recommendations include staff education and use of a surveillance program with a restrictive antibiotic policy. Adequate time must be allowed for hand washing and barrier precautions must always be used during device manipulation. The routine changing of central catheters is not necessary and increases costs; it is necessary to decrease the handling of administration sets, to use a more careful insertion technique and less frequent set replacement. Specific measures for VAP prevention are: 1). use of multi-use, closed-system suction catheters; 2). no routine change of the breathing circuit; 3). lubrication of the the endotracheal tube cuff with a water-soluble gel; 4). maintenance of patient in semi-recumbent position to improve chest physiotherapy. Specific measures for UTI prevention include: 1). use of a catheter-valve instead of a standard drainage system; 2). use of a silver-alloy, hydro gel-coated latex urinary catheter instead of uncoated catheters. By implementing effective preventive measures and maintaining strict surveillance of ICU infections, we hope to affect the associated morbidity, mortality, and cost that our patients and society bare. More clinical trials are needed to verify the efficacy of prevention measures of ICU infections.

Implementing and evaluating a program to facilitate chronic disease prevention and screening in primary care: a mixed methods program evaluation.

PubMed

Manca, Donna Patricia; Aubrey-Bassler, Kris; Kandola, Kami; Aguilar, Carolina; Campbell-Scherer, Denise; Sopcak, Nicolette; O'Brien, Mary Ann; Meaney, Christopher; Faria, Vee; Baxter, Julia; Moineddin, Rahim; Salvalaggio, Ginetta; Green, Lee; Cave, Andrew; Grunfeld, Eva

2014-10-08

The objectives of this paper are to describe the planned implementation and evaluation of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER 2) program which originated from the BETTER trial. The pragmatic trial, informed by the Chronic Care Model, demonstrated the effectiveness of an approach to Chronic Disease Prevention and Screening (CDPS) involving the use of a new role, the prevention practitioner. The desired goals of the program are improved clinical outcomes, reduction in the burden of chronic disease, and improved sustainability of the health-care system through improved CDPS in primary care. The BETTER 2 program aims to expand the implementation of the intervention used in the original BETTER trial into communities across Canada (Alberta, Ontario, Newfoundland and Labrador, the Northwest Territories and Nova Scotia). This proactive approach provides at-risk patients with an intervention from the prevention practitioner, a health-care professional. Using the BETTER toolkit, the prevention practitioner determines which CDPS actions the patient is eligible to receive, and through shared decision-making and motivational interviewing, develops a unique and individualized 'prevention prescription' with the patient. This intervention is 1) personalized; 2) addressing multiple conditions; 3) integrated through linkages to local, regional, or national resources; and 4) longitudinal by assessing patients over time. The BETTER 2 program brings together primary care providers, policy/decision makers and researchers to work towards improving CDPS in primary care. The target patient population is adults aged 40-65. The reach, effectiveness, adoption, implementation, maintain (RE-AIM) framework will inform the evaluation of the program through qualitative and quantitative methods. A composite index will be used to quantitatively assess the effectiveness of the prevention practitioner intervention. The CDPS actions comprising the composite index include the following: process measures, referral/treatment measures, and target/change outcome measures related to cardiovascular disease, diabetes, cancer and associated lifestyle factors. The BETTER 2 program is a collaborative approach grounded in practice and built from existing work (i.e., integration not creation). The program evaluation is designed to provide an understanding of issues impacting the implementation of an effective approach for CDPS within primary care that may be adapted to become sustainable in the non-research setting.

The implementation effectiveness of the ‘Strengthen your ankle’ smartphone application for the prevention of ankle sprains: design of a randomized controlled trial

PubMed Central

2014-01-01

Background Ankle sprains continue to pose a significant burden to the individual athlete, as well as to society as a whole. However, despite ankle sprains being the single most common sports injury and despite an active approach by various Dutch organisations in implementing preventive measures, large-scale community uptake of these preventive measures, and thus actual prevention of ankle sprains, is lagging well behind. In an attempt to bridge this implementation gap, the Dutch Consumer Safety Institute VeiligheidNL developed a freely available interactive App (‘Strenghten your ankle’ translated in Dutch as: ‘Versterk je enkel; available for iOS and Android) that contains - next to general advice on bracing and taping - a proven cost-effective neuromuscular program. The ‘Strengthen your ankle’ App has not been evaluated against the ‘regular’ prevention approach in which the neuromuscular program is advocated through written material. The aim of the current project is to evaluate the implementation value of the ‘Strengthen your ankle’ App as compared to the usual practice of providing injured athletes with written materials. In addition, as a secondary outcome measure, the cost-effectiveness will be assessed against usual practice. Methods/Design The proposed study will be a randomised controlled trial. After stratification for medical caregiver, athletes will be randomised to two study groups. One group will receive a standardized eight-week proprioceptive training program that has proven to be cost-effective to prevent recurrent ankle injuries, consisting of a balance board (machU/ MSG Europe BVBA), and a traditional instructional booklet. The other group will receive the same exercise program and balance board. However, for this group the instructional booklet is exchanged by the interactive ‘Strengthen your ankle’ App. Discussion This trial is the first randomized controlled trial to study the implementation effectiveness of an App for proprioceptive balance board training program in comparison to a traditional printed instruction booklet, with the recurrence of ankle sprains among athletes as study outcome. Results of this study could possibly lead to changes in practical guidelines on the treatment of ankle sprains and in the use of mobile applications for injury prevention. Results will become available in 2014. Trial registration The Netherlands National Trial Register NTR4027. The NTR is part of the WHO Primary Registries. PMID:24393146

The implementation effectiveness of the 'Strengthen your ankle' smartphone application for the prevention of ankle sprains: design of a randomized controlled trial.

PubMed

Van Reijen, Miriam; Vriend, Ingrid I; Zuidema, Victor; van Mechelen, Willem; Verhagen, Evert A

2014-01-07

Ankle sprains continue to pose a significant burden to the individual athlete, as well as to society as a whole. However, despite ankle sprains being the single most common sports injury and despite an active approach by various Dutch organisations in implementing preventive measures, large-scale community uptake of these preventive measures, and thus actual prevention of ankle sprains, is lagging well behind. In an attempt to bridge this implementation gap, the Dutch Consumer Safety Institute VeiligheidNL developed a freely available interactive App ('Strenghten your ankle' translated in Dutch as: 'Versterk je enkel; available for iOS and Android) that contains - next to general advice on bracing and taping - a proven cost-effective neuromuscular program. The 'Strengthen your ankle' App has not been evaluated against the 'regular' prevention approach in which the neuromuscular program is advocated through written material. The aim of the current project is to evaluate the implementation value of the 'Strengthen your ankle' App as compared to the usual practice of providing injured athletes with written materials. In addition, as a secondary outcome measure, the cost-effectiveness will be assessed against usual practice. The proposed study will be a randomised controlled trial. After stratification for medical caregiver, athletes will be randomised to two study groups. One group will receive a standardized eight-week proprioceptive training program that has proven to be cost-effective to prevent recurrent ankle injuries, consisting of a balance board (machU/ MSG Europe BVBA), and a traditional instructional booklet. The other group will receive the same exercise program and balance board. However, for this group the instructional booklet is exchanged by the interactive 'Strengthen your ankle' App. This trial is the first randomized controlled trial to study the implementation effectiveness of an App for proprioceptive balance board training program in comparison to a traditional printed instruction booklet, with the recurrence of ankle sprains among athletes as study outcome. Results of this study could possibly lead to changes in practical guidelines on the treatment of ankle sprains and in the use of mobile applications for injury prevention. Results will become available in 2014. The Netherlands National Trial Register NTR4027. The NTR is part of the WHO Primary Registries.

Moving from Efficacy to Effectiveness Trials in Prevention Research

PubMed Central

Marchand, Erica; Stice, Eric; Rohde, Paul; Becker, Carolyn Black

2013-01-01

Efficacy trials test whether interventions work under optimal, highly controlled conditions whereas effectiveness trials test whether interventions work with typical clients and providers in real-world settings. Researchers, providers, and funding bodies have called for more effectiveness trials to understand whether interventions produce effects under ecologically valid conditions, which factors predict program effectiveness, and what strategies are needed to successfully implement programs in practice settings. The transition from efficacy to effectiveness with preventive interventions involves unique considerations, some of which are not shared by treatment research. The purpose of this article is to discuss conceptual and methodological issues that arise when making the transition from efficacy to effectiveness research in primary, secondary, and tertiary prevention, drawing on the experiences of two complimentary research groups as well as the existing literature. We address (a) program of research, (b) intervention design and conceptualization, (c) participant selection and characteristics, (d) providers, (e) context, (f) measurement and methodology, (g) outcomes, (h) cost, and (i) sustainability. We present examples of research in eating disorder prevention that demonstrate the progression from efficacy to effectiveness trials. PMID:21092935

Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis.

PubMed

Asker, Martin; Brooke, Hannah L; Waldén, Markus; Tranaeus, Ulrika; Johansson, Fredrik; Skillgate, Eva; Holm, Lena W

2018-03-26

To assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports. Systematic review with best-evidence synthesis. Medline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017. Randomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria. Of 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power. All investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports. CRD42015026850. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations.

PubMed

Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana

2016-09-13

Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention.

Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations

PubMed Central

Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana

2016-01-01

Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention. PMID:27649218

[The Nutrition Commission of the Austrian Society of Pediatrics and Adolescent Medicine. Prevention of caries].

PubMed

Haschke, F

1992-01-01

Effective preventive programs must be instituted early in the life of a child. The pediatrician plays an important role in preventive oral health care, because most children do not visit a dentist before 3 years of age. Fluoride therapy decreases the caries vulnerability of the tooth, oral hygiene measures are important to remove bacterial plaque, and dietary modifications reduce the number of carbohydrate exposures per day. Community water fluoridation is proposed in Austrian cities, because it continues to be the most cost-effective caries prevention measure available. As long as the population does not have access to optimally fluoridated water, dietary fluoride supplementation offers an effective alternative. The recommended dosage of fluoride supplements for children depends on the amount of fluoride present in their drinking water and on the child's age. Liquid fluoride supplements and chewable tablets are proposed for children between 0.5 and 3 years and children between 3 and 13 years, respectively. Home use topical fluorides and professionally applied topical fluorides are useful beyond 3 years of age. Teaching of oral hygiene measures should be continued in kindergarten and school. The 3-6 year-old children require parental assistance to achieve effective plaque removal. Semiannual dental visits should begin at the age of three and continue throughout childhood and adolescence. As far as the diet is concerned, the frequency of exposure to sugar appears to be the most important factor in the development of dental caries. It now appears that most sugars are nearly equally cariogenic in a pure form.

The population cost-effectiveness of delivering universal and indicated school-based interventions to prevent the onset of major depression among youth in Australia.

PubMed

Lee, Y Y; Barendregt, J J; Stockings, E A; Ferrari, A J; Whiteford, H A; Patton, G A; Mihalopoulos, C

2017-10-01

School-based psychological interventions encompass: universal interventions targeting youth in the general population; and indicated interventions targeting youth with subthreshold depression. This study aimed to: (1) examine the population cost-effectiveness of delivering universal and indicated prevention interventions to youth in the population aged 11-17 years via primary and secondary schools in Australia; and (2) compare the comparative cost-effectiveness of delivering these interventions using face-to-face and internet-based delivery mechanisms. We reviewed literature on the prevention of depression to identify all interventions targeting youth that would be suitable for implementation in Australia and had evidence of efficacy to support analysis. From this, we found evidence of effectiveness for the following intervention types: universal prevention involving group-based psychological interventions delivered to all participating school students; and indicated prevention involving group-based psychological interventions delivered to students with subthreshold depression. We constructed a Markov model to assess the cost-effectiveness of delivering universal and indicated interventions in the population relative to a 'no intervention' comparator over a 10-year time horizon. A disease model was used to simulate epidemiological transitions between three health states (i.e., healthy, diseased and dead). Intervention effect sizes were based on meta-analyses of randomised control trial data identified in the aforementioned review; while health benefits were measured as Disability-adjusted Life Years (DALYs) averted attributable to reductions in depression incidence. Net costs of delivering interventions were calculated using relevant Australian data. Uncertainty and sensitivity analyses were conducted to test model assumptions. Incremental cost-effectiveness ratios (ICERs) were measured in 2013 Australian dollars per DALY averted; with costs and benefits discounted at 3%. Universal and indicated psychological interventions delivered through face-to-face modalities had ICERs below a threshold of $50 000 per DALY averted. That is, $7350 per DALY averted (95% uncertainty interval (UI): dominates - 23 070) for universal prevention, and $19 550 per DALY averted (95% UI: 3081-56 713) for indicated prevention. Baseline ICERs were generally robust to changes in model assumptions. We conducted a sensitivity analysis which found that internet-delivered prevention interventions were highly cost-effective when assuming intervention effect sizes of 100 and 50% relative to effect sizes observed for face-to-face delivered interventions. These results should, however, be interpreted with caution due to the paucity of data. School-based psychological interventions appear to be cost-effective. However, realising efficiency gains in the population is ultimately dependent on ensuring successful system-level implementation.

A worksite prevention program for construction workers: design of a randomized controlled trial.

PubMed

Oude Hengel, Karen M; Joling, Catelijne I; Proper, Karin I; Blatter, Birgitte M; Bongers, Paulien M

2010-06-14

A worksite prevention program was developed to promote the work ability of construction workers and thereby prolong a healthy working life. The objective of this paper is to present the design of a randomized controlled trial evaluating the effectiveness of that intervention program compared with usual care for construction workers. The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are construction workers performing actual construction work. The worksite intervention will be compared with usual care. This intervention was developed by using the Intervention Mapping approach and consists of the following components: (1) two individual training sessions of a physical therapist to lower the physical workload, (2) a Rest-Break tool to improve the balance between work and recovery, and (3) two empowerment training sessions to increase the influence of the construction workers at the worksite. Outcome measures are assessed at baseline, 3, 6, and 12 months. The primary outcome measures of this study are work ability and health-related quality of life. Secondary outcome measures include need for recovery, musculoskeletal complaints, work engagement and self efficacy. Cost-effectiveness will be evaluated from the company perspective. Moreover, a process evaluation will be conducted. The feasibility of the intervention and the study has been enhanced by creating an intervention program that explicitly appeals to construction workers and will not interfere too much with the ongoing construction. The feasibility and effectiveness of this worksite prevention program will be investigated by means of an effect- and a process evaluation. If proven effective, this worksite prevention program can be implemented on a larger scale within the construction industry. NTR1278.

A worksite prevention program for construction workers: design of a randomized controlled trial

PubMed Central

2010-01-01

Background A worksite prevention program was developed to promote the work ability of construction workers and thereby prolong a healthy working life. The objective of this paper is to present the design of a randomized controlled trial evaluating the effectiveness of that intervention program compared with usual care for construction workers. Methods The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are construction workers performing actual construction work. The worksite intervention will be compared with usual care. This intervention was developed by using the Intervention Mapping approach and consists of the following components: (1) two individual training sessions of a physical therapist to lower the physical workload, (2) a Rest-Break tool to improve the balance between work and recovery, and (3) two empowerment training sessions to increase the influence of the construction workers at the worksite. Outcome measures are assessed at baseline, 3, 6, and 12 months. The primary outcome measures of this study are work ability and health-related quality of life. Secondary outcome measures include need for recovery, musculoskeletal complaints, work engagement and self efficacy. Cost-effectiveness will be evaluated from the company perspective. Moreover, a process evaluation will be conducted. Discussion The feasibility of the intervention and the study has been enhanced by creating an intervention program that explicitly appeals to construction workers and will not interfere too much with the ongoing construction. The feasibility and effectiveness of this worksite prevention program will be investigated by means of an effect- and a process evaluation. If proven effective, this worksite prevention program can be implemented on a larger scale within the construction industry. Trial Registration NTR1278 PMID:20546568

The primary prevention of alcohol problems: a critical review of the research literature.

PubMed

Moskowitz, J M

1989-01-01

The research evaluating the effects of programs and policies in reducing the incidence of alcohol problems is critically reviewed. Four types of preventive interventions are examined including: (1) policies affecting the physical, economic and social availability of alcohol (e.g., minimum legal drinking age, price and advertising of alcohol), (2) formal social controls on alcohol-related behavior (e.g., drinking-driving laws), (3) primary prevention programs (e.g., school-based alcohol education), and (4) environmental safety measures (e.g., automobile airbags). The research generally supports the efficacy of three alcohol-specific policies: raising the minimum legal drinking age to 21, increasing alcohol taxes and increasing the enforcement of drinking-driving laws. Also, research suggests that various environmental safety measures reduce the incidence of alcohol-related trauma. In contrast, little evidence currently exists to support the efficacy of primary prevention programs. However, a systems perspective of prevention suggests that prevention programs may become more efficacious after widespread adoption of prevention policies that lead to shifts in social norms regarding use of beverage alcohol.

Effectiveness of biosecurity measures in preventing badger visits to farm buildings.

PubMed

Judge, Johanna; McDonald, Robbie A; Walker, Neil; Delahay, Richard J

2011-01-01

Bovine tuberculosis caused by Mycobacterium bovis is a serious and economically important disease of cattle. Badgers have been implicated in the transmission and maintenance of the disease in the UK since the 1970s. Recent studies have provided substantial evidence of widespread and frequent visits by badgers to farm buildings during which there is the potential for close direct contact with cattle and contamination of cattle feed. Here we evaluated the effectiveness of simple exclusion measures in improving farm biosecurity and preventing badger visits to farm buildings. In the first phase of the study, 32 farms were surveyed using motion-triggered infrared cameras on potential entrances to farm buildings to determine the background level of badger visits experienced by each farm. In the second phase, they were divided into four treatment groups; "Control", "Feed Storage", "Cattle Housing" and "Both", whereby no exclusion measures were installed, exclusion measures were installed on feed storage areas only, cattle housing only or both feed storage and cattle housing, respectively. Badger exclusion measures included sheet metal gates, adjustable metal panels for gates, sheet metal fencing, feed bins and electric fencing. Cameras were deployed for at least 365 nights in each phase on each farm. Badger visits to farm buildings occurred on 19 of the 32 farms in phase one. In phase two, the simple exclusion measures were 100% effective in preventing badger entry into farm buildings, as long as they were appropriately deployed. Furthermore, the installation of exclusion measures also reduced the level of badger visits to the rest of the farmyard. The findings of the present study clearly demonstrate how relatively simple practical measures can substantially reduce the likelihood of badger visits to buildings and reduce some of the potential for contact and disease transmission between badgers and cattle.

Community coalitions as a system: effects of network change on adoption of evidence-based substance abuse prevention.

PubMed

Valente, Thomas W; Chou, Chich Ping; Pentz, Mary Ann

2007-05-01

We examined the effect of community coalition network structure on the effectiveness of an intervention designed to accelerate the adoption of evidence-based substance abuse prevention programs. At baseline, 24 cities were matched and randomly assigned to 3 conditions (control, satellite TV training, and training plus technical assistance). We surveyed 415 community leaders at baseline and 406 at 18-month follow-up about their attitudes and practices toward substance abuse prevention programs. Network structure was measured by asking leaders whom in their coalition they turned to for advice about prevention programs. The outcome was a scale with 4 subscales: coalition function, planning, achievement of benchmarks, and progress in prevention activities. We used multiple linear regression and path analysis to test hypotheses. Intervention had a significant effect on decreasing the density of coalition networks. The change in density subsequently increased adoption of evidence-based practices. Optimal community network structures for the adoption of public health programs are unknown, but it should not be assumed that increasing network density or centralization are appropriate goals. Lower-density networks may be more efficient for organizing evidence-based prevention programs in communities.

Update on infection control challenges in special pediatric populations.

PubMed

Balkhy, Hanan H; Zingg, Walter

2014-08-01

Compared with adults, neonatal and pediatric populations are especially vulnerable patients who have specific diagnostic and therapeutic differences; therefore, the standard infection control practices designed for adults are sometimes not effective or need modifications to work. This review focuses on the recent literature addressing the challenges and successes in preventing healthcare-associated infections (HAIs) in children. Improving the implementation of pediatric versions of preventive bundles focusing on proper catheter insertion and maintenance, mainly as a part of a larger multimodal strategy, is effective in reducing the central-line-associated bloodstream infections in neonatal and pediatric populations including oncology patients. Appropriate feeding, antimicrobial stewardship, and infection control measures should be combined in reducing necrotizing enterocolitis in preterm neonates. Implementing a multimodal bundle strategy adapted for pediatric population is successful in preventing ventilator-associated pneumonia. Appropriate use of antimicrobial prophylaxis remains the cornerstone for preventing surgical-site infections irrespective of age, with few additional effective adjuvant preventive practices in specific pediatric patients. Several evidence-based practices are effective in reducing the incidence and the impact of HAIs in children; however, proper implementation remains a challenge. Additionally, several adult preventive practices are still unestablished in children and need further thorough examination.

Relevant Measures to Prevent the Spread of African Swine Fever in the European Union Domestic Pig Sector

PubMed Central

Jurado, Cristina; Martínez-Avilés, Marta; De La Torre, Ana; Štukelj, Marina; de Carvalho Ferreira, Helena Cardoso; Cerioli, Monica; Sánchez-Vizcaíno, José Manuel; Bellini, Silvia

2018-01-01

During the past decade, African swine fever (ASF) has spread from the Caucasus region to eastern European Union countries affecting domestic pig and wild boar populations. In order to avert ASF spread, mitigation measures targeting both populations have been established. However, despite these efforts, ASF has been reported in thirteen different countries (Georgia, Azerbaijan, Armenia, the Russian Federation, Ukraine, Belarus, Estonia, Latvia, Lithuania, Poland, Moldova, Czech Republic, and Romania). In the absence of an effective vaccine or treatment to ASF, introduction and spread of ASF onto domestic pig farms can only be prevented by strict compliance to control measures. This study systematically reviewed available measures to prevent the spread of ASF in the EU domestic pig sector distinguishing between commercial, non-commercial, and outdoor farms. The search was performed in PubMed and using a common browser. A total of 52 documents were selected for the final review process, which included scientific articles, reports, EU documents and official recommendations, among others. From this literature review, 37 measures were identified as preventive measures for the introduction and spread of ASF. Subsequently, these measures were assessed by ASF experts for their relevance in the mitigation of ASF spread on the three mentioned types of farms. All experts agreed that some of the important preventive measures for all three types of farms were: the identification of animals and farm records; strict enforcement of the ban on swill feeding; and containment of pigs, so as to not allow direct or indirect pig–pig and/or pig–wild boar contacts. Other important preventive measures for all farms were education of farmers, workers, and operators; no contact between farmers and farm staff and external pigs; appropriate removal of carcasses, slaughter residues, and food waste; proper disposal of manure and dead animals, and abstaining from hunting activities during the previous 48 h (allowing a 48 h interval between hunting and being in contact with domestic pigs). Finally, all experts identified that the important preventive measures for non-commercial and outdoor farms is to improve access of those farms to veterinarians and health services. PMID:29713637

Relevant Measures to Prevent the Spread of African Swine Fever in the European Union Domestic Pig Sector.

PubMed

Jurado, Cristina; Martínez-Avilés, Marta; De La Torre, Ana; Štukelj, Marina; de Carvalho Ferreira, Helena Cardoso; Cerioli, Monica; Sánchez-Vizcaíno, José Manuel; Bellini, Silvia

2018-01-01

During the past decade, African swine fever (ASF) has spread from the Caucasus region to eastern European Union countries affecting domestic pig and wild boar populations. In order to avert ASF spread, mitigation measures targeting both populations have been established. However, despite these efforts, ASF has been reported in thirteen different countries (Georgia, Azerbaijan, Armenia, the Russian Federation, Ukraine, Belarus, Estonia, Latvia, Lithuania, Poland, Moldova, Czech Republic, and Romania). In the absence of an effective vaccine or treatment to ASF, introduction and spread of ASF onto domestic pig farms can only be prevented by strict compliance to control measures. This study systematically reviewed available measures to prevent the spread of ASF in the EU domestic pig sector distinguishing between commercial, non-commercial, and outdoor farms. The search was performed in PubMed and using a common browser. A total of 52 documents were selected for the final review process, which included scientific articles, reports, EU documents and official recommendations, among others. From this literature review, 37 measures were identified as preventive measures for the introduction and spread of ASF. Subsequently, these measures were assessed by ASF experts for their relevance in the mitigation of ASF spread on the three mentioned types of farms. All experts agreed that some of the important preventive measures for all three types of farms were: the identification of animals and farm records; strict enforcement of the ban on swill feeding; and containment of pigs, so as to not allow direct or indirect pig-pig and/or pig-wild boar contacts. Other important preventive measures for all farms were education of farmers, workers, and operators; no contact between farmers and farm staff and external pigs; appropriate removal of carcasses, slaughter residues, and food waste; proper disposal of manure and dead animals, and abstaining from hunting activities during the previous 48 h (allowing a 48 h interval between hunting and being in contact with domestic pigs). Finally, all experts identified that the important preventive measures for non-commercial and outdoor farms is to improve access of those farms to veterinarians and health services.

Cost-effectiveness of a pragmatic structured education intervention for the prevention of type 2 diabetes: economic evaluation of data from the Let's Prevent Diabetes cluster-randomised controlled trial.

PubMed

Leal, J; Ahrabian, D; Davies, M J; Gray, L J; Khunti, K; Yates, T; Gray, A M

2017-01-09

Prevention of type 2 diabetes mellitus (TD2M) is a priority for healthcare systems. We estimated the cost-effectiveness compared with standard care of a structured education programme (Let's Prevent) targeting lifestyle and behaviour change to prevent progression to T2DM in people with prediabetes. Cost-effectiveness analysis alongside randomised controlled trial. 44 general practices in Leicestershire, England. 880 participants with prediabetes randomised to receive either standard care or a 6-hour group structured education programme with follow-up sessions in a primary care setting. Incremental cost utility from the UK National Health Service (NHS) perspective. Quality of life and resource use measured from baseline and during the 36 months follow-up using the EuroQoL EQ-5D and 15D instruments and an economic questionnaire. Outcomes measured using quality-adjusted life years (QALYs) and healthcare costs calculated in 2012-2013 prices. After accounting for clustering and missing data, the intervention group was found to have a net gain of 0.046 (95% CI -0.0171 to 0.109) QALYs over 3 years, adjusted for baseline utility, at an additional cost of £168 (95% CI -395 to 732) per patient compared with the standard care group. The incremental cost-effectiveness ratio is £3643/QALY with an 86% probability of being cost-effective at a willingness to pay threshold of £20 000/QALY. The education programme had higher costs and higher quality of life compared with the standard care group. The Let's Prevent programme is very likely to be cost-effective at a willingness to pay threshold of £20 000/QALY gained. ISRCTN80605705. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cost of malaria control in Sri Lanka.

PubMed

Konradsen, F; Steele, P; Perera, D; van der Hoek, W; Amerasinghe, P H; Amerasinghe, F P

1999-01-01

The study provides estimates of the cost of various malaria control measures in an area of North-Central Province of Sri Lanka where the disease is endemic. We assumed that each measure was equally effective. In these terms, impregnating privately purchased bednets with insecticide was estimated to cost Rs 48 (US(40.87) per individual protected per year, less than half the cost of spraying houses with residual insecticides. Larviciding of vector breeding sites and especially the elimination of breeding habitats by flushing streams through seasonal release of water from upstream reservoirs was estimated to be cheaper than other preventive measures (Rs 27 (US$ 0.49) and Rs 13 (US$ 0.24) per individual protected, respectively). Inclusion of both operational and capital costs of treatment indicates that the most cost-effective intervention for the government was a centrally located hospital with a relatively large catchment area (Rs 71 (US$ 1.29) per malaria case treated). Mobile clinics (Rs 153 (US$ 2.78) per malaria case treated) and a village treatment centre (Rs 112 (US$ 2.04)) per malaria case treated) were more expensive options for the government, but were considerably cheaper for households than the traditional hospital facilities. This information can guide health planners and government decision-makers in choosing the most appropriate combination of curative and preventive measures to control malaria. However, the option that is cheapest for the government may not be so for the householders, and further studies are needed to estimate the effectiveness of the various preventive measures.

Cost of malaria control in Sri Lanka.

PubMed Central

Konradsen, F.; Steele, P.; Perera, D.; van der Hoek, W.; Amerasinghe, P. H.; Amerasinghe, F. P.

1999-01-01

The study provides estimates of the cost of various malaria control measures in an area of North-Central Province of Sri Lanka where the disease is endemic. We assumed that each measure was equally effective. In these terms, impregnating privately purchased bednets with insecticide was estimated to cost Rs 48 (US(40.87) per individual protected per year, less than half the cost of spraying houses with residual insecticides. Larviciding of vector breeding sites and especially the elimination of breeding habitats by flushing streams through seasonal release of water from upstream reservoirs was estimated to be cheaper than other preventive measures (Rs 27 (US$ 0.49) and Rs 13 (US$ 0.24) per individual protected, respectively). Inclusion of both operational and capital costs of treatment indicates that the most cost-effective intervention for the government was a centrally located hospital with a relatively large catchment area (Rs 71 (US$ 1.29) per malaria case treated). Mobile clinics (Rs 153 (US$ 2.78) per malaria case treated) and a village treatment centre (Rs 112 (US$ 2.04)) per malaria case treated) were more expensive options for the government, but were considerably cheaper for households than the traditional hospital facilities. This information can guide health planners and government decision-makers in choosing the most appropriate combination of curative and preventive measures to control malaria. However, the option that is cheapest for the government may not be so for the householders, and further studies are needed to estimate the effectiveness of the various preventive measures. PMID:10327708

ECONOMIC IMPORTANCE OF THE PREVENTIVE MEASURES IN DENTISTRY.

PubMed

Deljo, Emsudina; Sijercic, Zinaida; Mulaosmanovic, Amina; Musanovic, Alma; Prses, Nedim

2016-10-01

Previous studies have shown that the state of oral health in the area of Podrinje Canton is really poor. Taking into account that in the last five years are implemented two projects in the municipality it is necessary to examine the impact of preventive measures in dentistry on the oral health. a) To evaluate the impact of continuing education and local fluoridation on the state of oral health; b) To analyze the economic importance of preventive measures. For the purpose of the research on activities of continuing education on the importance of oral health and local fluoridation of teeth and to determine the economic aspects of the application of preventive measures is tested and reviewed 900 students from fourth to ninth grade. The children were divided into three groups of 300 students in each group: a) In the first group of children is carried out continuous education about proper tooth brushing and the importance of oral hygiene and local fluoridation twice a year during the last three years, b) In the second group children carried out local fluoridation twice a year during the last three years while in the third group, there were no continuous prevention measures; c) Used is a single questionnaire for all respondents. Data obtained in this study were analyzed by descriptive and inferential statistical methods. The importance of continuing education and local fluoridation is clearly reflected in the different values DMF-index, which was the subject of research. In the first group, in which is carried out continuous education and local fluoridation value of DMF index was 2.7, in the second group with local fluorination this value was 3.56, while in the third group, in which is not implemented preventive measures, the value DMF- index was 5.93. From an economic point the preventive measures are the cheapest, most effective and the best solution in order to maintain oral health.

Interaction of cord factor (alpha, alpha'-trehalose-6,6'-dimycolate) with phospholipids.

PubMed

Crowe, L M; Spargo, B J; Ioneda, T; Beaman, B L; Crowe, J H

1994-08-24

We previously reported that cord factor (alpha,alpha'-trehalose-6,6'-dimycolate) isolated from Nocardia asteroides strain GUH-2 strongly inhibits fusion between unilamellar vesicles containing acidic phospholipid. We chose to study the effects of this molecule on liposome fusion since the presence of N. asteroides GUH-2 in the phagosomes of mouse macrophages had been shown to prevent phagosomal acidification and inhibit phagosome-lysosome fusion. A virtually non-virulent strain, N. asteroides 10905, does not prevent acidification or phagosome-lysosome fusion and, further, contains only trace amounts of cord factor. In the present paper, we have investigated the effects of cord factor on phospholipid bilayers that could be responsible for the inhibition of fusion. We show that cord factor increases molecular area, measured by isothermal compression of a monolayer film, in a mixed monolayer more than would be expected based in its individual contribution to molecular area. Cord factor, as well as other glycolipids investigated, increased the overall hydration of bilayers of dipalmitoylphosphatidylcholine by 50%, as estimated from the unfrozen water fraction measured by differential scanning calorimetry. The effect of calcium on this increased molecular area and headgroup hydration was measured by fluorescence anisotropy and FTIR spectroscopy of phosphatidylserine liposomes. Both techniques showed that cord factor, incorporated at 10 mol%, increased acyl chain disorder over controls in the presence of Ca2+. However, FTIR showed that cord factor did not prevent headgroup dehydration by the Ca2+. The other glycolipids tested did not prevent either the Ca(2+)-induced chain crystallization or headgroup dehydration of phosphatidylserine bilayers. These data point to a possible role of the bulky mycolic acids of cord factor in preventing Ca(2+)-induced fusion of liposomes containing acidic phospholipids.

Prevention of Anxiety Symptoms in Children: Results from a Universal School-Based Trial

ERIC Educational Resources Information Center

Essau, Cecilia A.; Conradt, Judith; Sasagawa, Satoko; Ollendick, Thomas H.

2012-01-01

The present study evaluated the effectiveness of a universal school-based cognitive behavior prevention program (the FRIENDS program) for childhood anxiety. Participants were 638 children, ages 9 to 12 years, from 14 schools in North Rhine-Westphalia, Germany. All the children completed standardized measures of anxiety and depression, social and…

Project SuperHeart: An Evaluation of a Heart Disease Intervention Program For Children.

ERIC Educational Resources Information Center

Way, Joyce W.

1981-01-01

An effective way to prevent coronary heart disease in later life is to concentrate on preventive measures in the early years before coronary heart disease becomes established. Project SuperHeart, a heart disease intervention program for young children, includes physical fitness and classroom activities emphasizing basic nutritional habits. (JN)

PAL[R] Services Being Measured through Scientifically-Based Evaluation Process

ERIC Educational Resources Information Center

Perspectives in Peer Programs, 2007

2007-01-01

In January 2006, PAL[R] Peer Assistance and Leadership, a Promising Prevention Program of Workers Assistance Program, Inc. (WAP), received a $30,000 grant from the Center for Substance Abuse Prevention (CSAP) in order to be scientifically-evaluated on the outcomes and effectiveness of its programs and services. According to the grant, the…

An Evaluation of a Mixed-Gender Sexual Assault Prevention Program

ERIC Educational Resources Information Center

Bradley, April R.; Yeater, Elizabeth A.; O'Donohue, William

2009-01-01

This study evaluated the short-term effectiveness of a mixed-gender sexual assault prevention program developed for college students. Program participants (n = 177) were compared to non-program participants (n = 132) prior to the program and during a 2-week follow-up period on measures of rape myths, victim empathy, perceived negative consequences…

Community Prevention Coalition Context and Capacity Assessment: Comparing the United States and Mexico

ERIC Educational Resources Information Center

Brown, Louis D.; Chilenski, Sarah M.; Ramos, Rebeca; Gallegos, Nora; Feinberg, Mark E.

2016-01-01

Effective planning for community health partnerships requires understanding how initial readiness--that is, contextual factors and capacity--influences implementation of activities and programs. This study compares the context and capacity of drug and violence prevention coalitions in Mexico to those in the United States. Measures of coalition…

The Development of an Instrument to Measure School Readiness for a Prevention Program

ERIC Educational Resources Information Center

Dymnicki, Allison B.; Henry, David B.; Myford, Carol M.

2015-01-01

There is a need to understand how environmental characteristics of a school influence the effectiveness of prevention efforts. Although researchers have discussed the importance of conducting needs assessments before implementing interventions, few of these types of assessments focus on the relational aspect. Furthermore, few assessments have the…

Vandalism Prevention Programs Used in Ontario Schools.

ERIC Educational Resources Information Center

White, James; Fallis, Anita

A self-administered questionnaire was mailed to all school principals in Ontario asking them to indicate which of 55 vandalism prevention measures they had used; how effective each had been in reducing vandalism; the cost of vandalism during 1978; whether they have an alarm system and a vandalism-reporting system; and what community groups the…

Updated assessment of the critical environmental factors involved in the prevention of allergic disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Green, A.R.

1979-06-01

The effects of climate, as well as outdoor and indoor pollution, on allergic respiratory symptoms are herein explored. Also, measures utilized in modifying the susceptible individual's milieu are examined. Finally, the potential for ameliorating or preventing the development of allergies in genetically predisposed children is discussed.

Cost-effectiveness of statins for primary prevention in patients newly diagnosed with type 2 diabetes in the Netherlands.

PubMed

de Vries, Folgerdiena M; Denig, Petra; Visser, Sipke T; Hak, Eelko; Postma, Maarten J

2014-03-01

Statins are lipid-lowering drugs that reduce the risk of cardiovascular events in patients with diabetes. The objective of this study was to determine whether statin treatment for primary prevention in newly diagnosed type 2 diabetes is cost-effective, taking nonadherence, baseline risk, and age into account. A cost-effectiveness analysis was performed by using a Markov model with a time horizon of 10 years. The baseline 10-year cardiovascular risk was estimated in a Dutch population of primary prevention patients with newly diagnosed diabetes from the Groningen Initiative to Analyse Type 2 Diabetes Treatment (GIANTT) database, using the United Kingdom Prospective Diabetes Study risk engine. Statin adherence was measured as pill days covered in the IADB.nl pharmacy research database. Cost-effectiveness was measured in costs per quality-adjusted life-year (QALY) from the health care payers' perspective. For an average patient aged 60 years, the base case, statin treatment was highly cost-effective at €2245 per QALY. Favorable cost-effectiveness was robust in sensitivity analysis. Differences in age and 10-year cardiovascular risk showed large differences in cost-effectiveness from almost €100,000 per QALY to almost being cost saving. Treating all patients younger than 45 years at diabetes diagnosis was not cost-effective (weighted cost-effectiveness of almost €60,000 per QALY). Despite the nonadherence levels observed in actual practice, statin treatment is cost-effective for primary prevention in patients newly diagnosed with type 2 diabetes. Because of large differences in cost-effectiveness according to different risk and age groups, the efficiency of the treatment could be increased by targeting patients with relatively higher cardiovascular risk and higher ages. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Acute kidney injury: Global health alert

PubMed Central

Kam Tao Li, Philip; Burdmann, Emmanuel A; Mehta, Ravindra L

2013-01-01

Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians and other health care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI. PMID:24475433

Acute Kidney Injury: Global Health Alert

PubMed Central

Tao Li, P. K.; Burdmann, E. A.; Mehta, R. L.

2013-01-01

Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians and other health care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI. PMID:25013646

Medical Consequences of Chernobyl with Focus on the Endocrine System - Part 2.

PubMed

Foley, Thomas P; Límanová, Zdeňka; Potluková, Eliška

2015-01-01

In the last 70 years, atomic disasters have occurred several times. The nuclear power plant accident at Chernobyl in 1986 in North-Central Ukraine was a unique experience in population exposures to radiation by all ages, and ongoing studies have brought a large amount of information effects of radiation on human organism. Concerning the deteriorating global security situation and the strong rhetoric of some of the world leaders, the knowledge on the biological effects of ionizing radiation and the preventive measures designed to decrease the detrimental effects of radiation gains a new dimension, and involves all of us. This review focuses on the long-term effects of Chernobyl catastrophe especially on the endocrine system in children and in adults, and includes a summary of preventive measures in case of an atomic disaster.

Medical consequences of Chernobyl with focus on the endocrine system: Part 1.

PubMed

Foley, Thomas P; Límanová, Zdeňka; Potluková, Eliška

2015-01-01

In the last 70 years, atomic disasters have occurred several times. The nuclear power plant accident at Chernobyl in 1986 in North-Central Ukraine was a unique experience in population exposures to radiation by all ages, and ongoing studies have brought a large amount of information on effects of radiation on human organism. Concerning the deteriorating global security situation and the strong rhetoric of some of the world leaders, the knowledge on the biological effects of ionizing radiation and the preventive measures designed to decrease the detrimental effects of radiation gains a new dimension, and involves all of us. This review focuses on the long-term effects of Chernobyl catastrophe especially on the endocrine system in children and in adults, and includes a summary of preventive measures in case of an atomic disaster.

Implementing an Evidence-Based Fall Prevention Intervention in Community Senior Centers.

PubMed

Li, Fuzhong; Harmer, Peter; Fitzgerald, Kathleen

2016-11-01

To evaluate the impact of implementing an evidence-based fall prevention intervention in community senior centers. We used a single-group design to evaluate the Tai Ji Quan: Moving for Better Balance (TJQMBB) program's adoption, population reach, implementation, effectiveness, and maintenance among 36 senior centers in 4 Oregon counties between 2012 and 2016. The primary outcome measure, as part of the effectiveness evaluation, was number of falls as ascertained by self-report. Trained TJQMBB instructors delivered the program to community-dwelling older adults for 48 weeks, with a 6-month postintervention follow-up. TJQMBB was adopted by 89% of the senior centers approached and reached 90% of the target population. The program resulted in a 49% reduction in the total number of falls and improved physical performance. Participation was well maintained after the program's completion. The average cost-effectiveness ratio for the 48-week program implementation was $917 per fall prevented and $676 per fall prevented for multiple falls. TJQMBB is an effective public health program that can be broadly implemented in community senior centers for primary prevention of falls among community-dwelling older adults.

Effect of square stepping exercise for older adults to prevent fall and injury related to fall: systematic review and meta-analysis of current evidences.

PubMed

Fisseha, Berihu; Janakiraman, Balamurugan; Yitayeh, Asmare; Ravichandran, Hariharasudhan

2017-02-01

Falls and fall related injuries become an emerging health problem among older adults. As a result a review of the recent evidences is needed to design a prevention strategy. The aim of this review was to determine the effect of square stepping exercise (SSE) for fall down injury among older adults compared with walking training or other exercises. An electronic database search for relevant randomized control trials published in English from 2005 to 2016 was conducted. Articles with outcome measures of functional reach, perceived health status, fear of fall were included. Quality of the included articles was rated using Physiotherapy Evidence Database (PEDro) scale and the pooled effect of SSE was obtained by Review Manager (RevMan5) software. Significant effect of SSE was detected over walking or no treatment to improve balance as well to prevent fear of fall and improve perceived health status. The results of this systematic review proposed that SSE significantly better than walking or no treatment to prevent fall, prevent fear of fall and improve perceived health status.

[Effect of Visiting and a Smartphone Application Based Infection Prevention Education Program for Child Care Teachers: A Non-Randomized Controlled Trial].

PubMed

Yang, Yun Jeong; Kwon, In Soo

2017-12-01

This study was performed to develop an infection prevention education program for child care teachers and to verify its effects. The study was conducted using a nonequivalent control group with a pretest-posttest design. Four private daycare centers (2 centers per city) that were alike in terms of the number of children by age, number of child care teachers, and child care environment were chosen. Participants were assigned to the experimental group (n=20) or control group (n=20). As a part of the program, visiting education (90 min) was provided in the 1st week, and smartphone application education (10 min) was provided thrice a week, in the 2nd and 3rd weeks. Child care teachers' self-efficacy for infection prevention revealed a significant interaction effect between the group and time of measurement (F=21.62, p<.001). In terms of infection prevention behavior, a significant difference was observed between the experimental and control groups (z=-5.36, p<.001). The program implemented in this study was effective in improving the infection prevention self-efficacy and infection prevention behavior of child care teachers. Thus, this program may be effective in enhancing their infection control. © 2017 Korean Society of Nursing Science

Science from evaluation: testing hypotheses about differential effects of three youth-focused suicide prevention trainings.

PubMed

Coleman, Daniel; Del Quest, Aisling

2015-01-01

As part of an evaluation component of a youth suicide prevention, a quasi-experimental repeated measures design tested hypotheses about two brief suicide prevention gatekeeper trainings (Question, Persuade, Refer [QPR] and RESPONSE) and one longer suicide intervention skills training (Applied Suicide Intervention Skills Training [ASIST]). All three trainings showed large changes in prevention attitudes and self-efficacy, largely maintained at follow-up. ASIST trainees had large increases in asking at-risk youth about suicide at follow-up. Convergent with other research, modeling and role-play in training are crucial to increased prevention behaviors. Practice and research implications are discussed, including social work roles in suicide prevention and research.

Novel Areas for Prevention and Control of Canine Leishmaniosis.

PubMed

Miró, Guadalupe; Petersen, Christine; Cardoso, Luís; Bourdeau, Patrick; Baneth, Gad; Solano-Gallego, Laia; Pennisi, Maria Grazia; Ferrer, Lluís; Oliva, Gaetano

2017-09-01

There have been multiple recent advances regarding tools for the control and prevention of canine leishmaniosis (CanL), including new preventative vaccines. In this review, these advances are evaluated based on control targets, including vector and parasite. Leishvet recommendations are provided for control practices based on the dog's risk of infection. New topical insecticide formulations have proven to be effective in preventing sand fly bites, and subsequently infection. Parasite control occurs through chemotherapeutic or immunologic means, which decrease or prevent transmission to other animals, including humans. Leishmaniosis control programs that include a combination of coordinated measures, either in individuals or for prevention across reservoir populations, are required. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment of Critical Care Provider's Application of Preventive Measures for Ventilator-Associated Pneumonia in Intensive Care Units.

PubMed

Bagheri-Nesami, Masoumeh; Amiri-Abchuyeh, Maryam; Gholipour-Baradari, Afshin; Yazdani-Cherati, Jamshid; Nikkhah, Attieh

2015-08-01

The implementation of guidelines for the prevention of Ventilator-associated pneumonia has been shown to have a significant effect in reducing the incidence of VAP. The aim of the present study was to evaluate the implementation of the preventive strategies for VAP in ICUs of university hospitals of Sari, Iran. This cross-sectional study was carried out in 600 beds/day in the ICUs of university hospitals of Sari from April to June 2012. Sampling was done by availability technique in patients receiving mechanical ventilation in the ICU. The implementation of the preventive measures was assessed by a standard checklist with previously approved validity and reliability. The percentage of implementing each of the measures was as follows: sterile suction, 88.44%; semi-recumbent position, 76.8%; oral hygiene, 58.45%; using heat and moisture exchanges (HMEs), 58%; controlling cuff pressure, 46.8%; hand hygiene, 32.8%; using anti-coagulants, 26.8% and physiotherapy, 25.5%. Closed suction system, continuous drainage of subglottic secretions and kinetic beds were not used at all. The overall mean percentage of implementing preventive measures was low and required designing integrated guidelines by considering the conditions of the ICUs in each country, as well as educating and encouraging the staffs to use the recommended guidelines.

[THE ORGANIZATION OF PREVENTION OF RENAL PATHOLOGY IN PREGNANT WOMEN IN BAKU].

PubMed

Kadimova, Sh G

2015-01-01

Nowadays, increasing of renal pathology, especially of its chronic forms characterized by long clinical duration and frequent exacerbations is observed in pregnant women. The study was carried out to analyze prevalence and structure of renal pathology in pregnant women with further development of social economic basics of its prevention. The epidemiological analysis established that during 2009-2011 in Baku prevalence of renal pathology in pregnant women amounted to 11%. The analysis of structure and dynamics of renal pathology in pregnant women during the same period revealed that leading positions are taken by chronic pyelonephritis (27.2%), hydronephrosis (14.8%) and eclampsia (12%). The percentage of cystitis amounted to 4.8%, urolithiasis - 3.2%, renal colic - 2.4% and renal anomalies - 0.8%. The study established that under application of scientifically valid preventive measures an effective prevention of disease is achieved. In particular risk of morbidity is decreased up to 4.18 times. After 10-12 months after implementation of explanatory work degree of implementation of preventive measures among female patients with close adherence to these measures attained maximal level (88.6±2.8%) and among female patients attaching no importance to them in many ways implementation remained low (41±5.6%). At the same time, organization and implementation of developed complex of preventive measures are available. They have no requirement in an additional manpower and material technical resources and are applied using sanitary agitation among population. The task-oriented and permanent explanatory work increases responsibility of population for one's own health, activates population to implement complex of preventive measure. On the whole, workable premises both to stabilize level of morbidity of renal pathology and its consistent decreasing are established.

Addressing the potential adverse effects of school-based BMI assessments on children's wellbeing.

PubMed

Gibbs, Lisa; O'Connor, Thea; Waters, Elizabeth; Booth, Michael; Walsh, Orla; Green, Julie; Bartlett, Jenny; Swinburn, Boyd

2008-01-01

INTRODUCTION. Do child obesity prevention research and intervention measures have the potential to generate adverse concerns about body image by focussing on food, physical activity and body weight? Research findings now demonstrate the emergence of body image concerns in children as young as 5 years. In the context of a large school-community-based child health promotion and obesity prevention study, we aimed to address the potential negative effects of height and weight measures on child wellbeing by developing and implementing an evidence-informed protocol to protect and prevent body image concerns. fun 'n healthy in Moreland! is a cluster randomised controlled trial of a child health promotion and obesity prevention intervention in 23 primary schools in an inner urban area of Melbourne, Australia. Body image considerations were incorporated into the study philosophies, aims, methods, staff training, language, data collection and reporting procedures of this study. This was informed by the published literature, professional body image expertise, pilot testing and implementation in the conduct of baseline data collection and the intervention. This study is the first record of a body image protection protocol being an integral part of the research processes of a child obesity prevention study. Whilst we are yet to measure its impact and outcome, we have developed and tested a protocol based on the evidence and with support from stakeholders in order to minimise the adverse impact of study processes on child body image concerns.

Translation of clinical practice guidelines for childhood obesity prevention in primary care mobilizes a rural Midwest community.

PubMed

Gibson, S Jo

2016-03-01

The purpose of this project was to implement clinic system changes that support evidence-based guidelines for childhood obesity prevention. Adherence rates for prevention and screening of children in a rural Midwest primary care setting were used to measure the success of the program. Retrospective chart reviews reflected gaps in current practice and documentation. An evidence-based toolkit for childhood obesity prevention was used to implement clinic system changes for the identified gaps. The quality improvement approach proved to be effective in translating knowledge of obesity prevention guidelines into rural clinic practices with significant improvements in documentation of prevention measures that may positively impact the childhood obesity epidemic. Primary care providers, including nurse practitioners (NPs), are at the forefront of diagnosing, educating, and counseling children and families on obesity prevention and need appropriate resources and tools to deliver premier care. The program successfully demonstrated how barriers to practice, even with the unique challenges in a rural setting, can be overcome. NPs fulfill a pivotal primary care role and can provide leadership that may positively impact obesity prevention in their communities. ©2015 American Association of Nurse Practitioners.

Effectiveness of preventative and other surgical measures on hypocalcemia following bilateral thyroid surgery: a systematic review and meta-analysis.

PubMed

Antakia, Ramez; Edafe, Ovie; Uttley, Lesley; Balasubramanian, Saba P

2015-01-01

A variety of measures have been proposed to reduce the incidence of post-thyroidectomy hypocalcemia. The aim of this study was to perform a systematic review and meta-analysis of preventive and other surgical measures on post-thyroidectomy hypocalcemia as reported in the literature. Comprehensive searches of the PubMed, EMBASE, and Cochrane databases were performed, and the quality of included papers was assessed using the Cochrane risk of bias tool or a modified Newcastle-Ottawa Scale (NOS). The results of all included studies were summarized, and meta-analyses were performed where appropriate. Thirty-nine randomized controlled trials (RCTs) and 37 observational studies were included. Measures studied included hemostatic techniques, extent of thyroidectomy and central neck dissection, surgical approach, calcium/vitamin D/thiazide diuretic supplements, parathyroid gland autotransplantation (PGAT) and intraoperative parathyroid gland (PG) identification, truncal ligation of inferior thyroid artery (ITA), preoperative magnesium infusion, and use of magnification loupes and Surgicel. Measures associated with significantly lower rates of transient hypocalcemia in meta-analysis were postoperative calcium and vitamin D supplementation compared to either calcium supplements alone (odds ratio (OR) 0.66; p=0.04) or no supplements (OR 0.34; p=0.007), and bilateral subtotal thyroidectomy (BST) compared to Hartley Dunhill (HD) procedure (OR 0.35; p=0.01). Meta-analyses did not demonstrate any measure to be significantly associated with a reduction in permanent hypocalcemia. This review identified postoperative calcium and vitamin D supplementation and bilateral subtotal thyroidectomy (over HD) as being effective in prevention of transient hypocalcemia. However, the majority of RCTs were of low quality, primarily due to a lack of blinding. The wide variability in study design, definitions of hypocalcemia, and methods of assessment prevented meaningful summation of results for permanent hypocalcemia.

A core outcome set for clinical trials in acute diarrhoea.

PubMed

Karas, Jacek; Ashkenazi, Shai; Guarino, Alfredo; Lo Vecchio, Andrea; Shamir, Raanan; Vandenplas, Yvan; Szajewska, Hania

2015-04-01

Core outcome sets are the baseline for what should be measured in clinical research and, thus, should serve as a guide for what should be collected and reported. The Consensus Group on Outcome Measures Made in Pediatric Enteral Nutrition Clinical Trials, established in 2012, agreed that consensus on a core set of outcomes with agreed-upon definitions that should be measured and reported in clinical trials was needed. To achieve this goal, six working groups (WGs) were setup, including WG on acute diarrhoea, whose main goal was to develop a core outcome set for trials in acute diarrhoea. The first step identified how published outcomes related to acute diarrhoea were reported. The second focused on the methodology for determining which outcomes to measure in clinical trials. The third employed a two-phase questionnaire study using the Delphi technique to define clinically important outcomes to clinicians and parents. For therapeutic studies, the five most important outcome measures were diarrhoea duration, degree of dehydration, need for hospitalisation (or duration of hospitalisation for inpatients), the proportion of patients recovered by 48 h and adverse effects. The prophylactic core outcome set included prevention of diarrhoea, prevention of dehydration, prevention of hospitalisation and adverse effects. The outcome sets for therapy and prevention can be recommended for use in future trials of patients with gastroenteritis. Their envisioned goal is to decrease study heterogeneity and to ease the comparability of studies. WG's next step is to determine how to measure the outcomes included in the core set. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Prevention validation and accounting platform: a framework for establishing accountability and performance measures of substance abuse prevention programs.

PubMed

Kim, S; McLeod, J H; Williams, C; Hepler, N

2000-01-01

The field of substance abuse prevention has neither an overarching conceptual framework nor a set of shared terminologies for establishing the accountability and performance outcome measures of substance abuse prevention services rendered. Hence, there is a wide gap between what we currently have as data on one hand and information that are required to meet the performance goals and accountability measures set by the Government Performance and Results Act of 1993 on the other. The task before us is: How can we establish the accountability and performance measures of substance abuse prevention programs and transform the field of prevention into prevention science? The intent of this volume is to serve that purpose and accelerate the processes of this transformation by identifying the requisite components of the transformation (i.e., theory, methodology, convention on terms, and data) and by introducing an open forum called, Prevention Validation and Accounting (PREVA) Platform. The entire PREVA Platform (for short, the Platform) is designed as an analytic framework, which is formulated by a collectivity of common concepts, terminologies, accounting units, protocols for counting the units, data elements, and operationalizations of various constructs, and other summary measures intended to bring about an efficient and effective measurement of process input, program capacity, process output, performance outcome, and societal impact of substance abuse prevention programs. The measurement units and summary data elements are designed to be measured across time and across jurisdictions, i.e., from local to regional to state to national levels. In the Platform, the process input is captured by two dimensions of time and capital. Time is conceptualized in terms of service delivery time and time spent for research and development. Capital is measured by the monies expended for the delivery of program activities during a fiscal or reporting period. Program capacity is captured by fourteen measurement units, tapping into the dimensions of staff resources and community assets. Staff resources are, in turn, operationalized in terms of staff size, staff certification status, staff turnover rate, and the accreditation status of a provider agency. Community assets are operationalized by the number of community centers accessible to the funded agency, number of formalized teams or antidrug coalitions active in the catchment area, and other social/human services providers with whom the prevention agency has formalized networks. The totality of process output from all sources of program activities is reduced to eighteen classes of measures. These are operationalized by thirty-three summary measures. Some of these include: total count of events facilitated; total number of clients served; average number of clients served per event; clients served by single and multiple program sessions; classification of target population in terms of the severity of risk as defined by the Institute of Medicine; age groups and race/ethnicity of clients served; number of program participants retained by recurring programs; number of clients who have completed the program; penetration rates to the target population; client attrition rates; average referral rates per provider per time interval; referral success rates; and so on. All process output measures specified in the Platform are derived from two broad classes of events classified as either products or services. The collectivity of these measures is expected to present a cost-effective, parsimonious, yet comprehensive picture of the entire spectrum of the process output, i.e., "what came out of the program as program activities". For the measurement of performance outcomes, two types of data are incorporated into the Platform: outcome data from individuals and the behavior (or performance) of social indicators from aggregated data bases. Individual data are used to evaluate the outcome of substance abuse programs

Effectiveness of an intervention for prevention and treatment of burnout in primary health care professionals

PubMed Central

2013-01-01

Background Burnout syndrome is an important health problem that affects many professionals and must be addressed globally, with both organizational measures and personal interventions. Burnout of health professionals can be prevented in order to avoid personal, familial, and social consequences, as well as repercussions for patients. Methods/design This work describes a protocol for a controlled, pragmatic, randomized clinical trial in 2 parallel groups: intervention and control. All health professionals from 7 health care centers will form the intervention group, and all health professionals from 7 different health care centers will form the control group. The intervention group will receive 16 hours of training at their work place. The Maslach's burnout inventory, the Cuestionario de Desgaste Profesional Médico or the Cuestionario de Desgaste Profesional de Enfermería, and the 28-item Goldberg's General Health Questionnaire, validated for our setting, will be used as measurement tools. Change in the average scores from the Maslach's burnout inventory emotional exhaustion scale will be compared between the intervention and control groups, measured as intention-to-treat, and the intervention will be considered effective if a minimum decrease of 20% is achieved. Discussion Due to the deleterious consequences of burnout syndrome for people suffering from it and for the organization where they work, it is necessary to evaluate the effectiveness of certain interventions for its prevention. Organizational measures are important for preventing burnout syndrome, but so is providing professionals with coping strategies, as this group intervention intends to do. Trial registration ClinicalTrials.gov processed this record on June 10, 2013. ClinicalTrials.gov Identifier: NCT01870154. PMID:24237937

A systematic review of controlled clinical trials on the prevention of back pain in industry.

PubMed

van Poppel, M N; Koes, B W; Smid, T; Bouter, L M

1997-12-01

To assess the effectiveness of lumbar supports, education, and exercise in the prevention of back pain in industry. A computerised search for controlled clinical trials was conducted. A criteria list was used to assess the methodological quality of the studies. The available evidence for the effectiveness of the interventions was graded with a rating system for the level of evidence. Effect sizes of individual studies were combined if the studies were sufficiently similar. 11 studies were identified for the review. The methodological quality of all studies was low, with a maximum score of three out of seven for internal validity. There was no evidence for the effectiveness of lumbar supports due to contradictory outcomes of the studies. Five of the six studies on education reported no effect. Thus there is limited evidence that education does not help to prevent back pain. All three studies on exercise reported a positive result, indicating limited evidence for the effectiveness of exercise. The combined effect size for exercise was 0.53, which is a medium sized effect. Although widely used, there is little evaluative research on the preventive measures studied here. The review showed that there is limited evidence that exercise has some effect in the prevention of back pain and that education is not effective. No conclusive evidence was found for or against the effectiveness of lumbar supports. Research of higher methodological quality is needed before firm conclusions on the effectiveness of lumbar supports, education, and exercise in the prevention of back pain in industry can be drawn.

[The effect of daily controlled oral hygiene on the oral health of children in a town with drinking water fluoridation (Karl Marx Stadt)].

PubMed

Georgi, J; Künzel, W

1976-03-01

Under the conditions of an optimized (with regard to caries prevention) fluoride content of the drinking uater, the authors studied (in the framework of an oral hygiene measure covering 32 months) in 149 children 6.5-8 years of age the effects of supervised daily dental and oral care on dental health. The improvement in oral hygiene (OHI) by 33% is in harmony with an additional caries reduction by 33.3% (DMF/S index) and a decrease of the PM index by 47%. A wider use of oral hygiene actions as secondary preventive measures is, therefore, recommended also for towns with fluoridated drinking water.

Research on Chinese Life Cycle-Based Wind Power Plant Environmental Influence Prevention Measures

PubMed Central

Wang, Hanxi; Xu, Jianling; Liu, Yuanyuan; Zhang, Tian

2014-01-01

The environmental impact of wind power plants over their life cycle is divided into three stages: construction period, operation period and retired period. The impact is mainly reflected in ecological destruction, noise pollution, water pollution and the effect on bird migration. In response to these environmental effects, suggesting reasonable locations, reducing plant footprint, optimizing construction programs, shielding noise, preventing pollution of terrestrial ecosystems, implementing combined optical and acoustical early warning signals, making synthesized use of power generation equipment in the post-retired period and using other specific measures, including methods involving governance and protection efforts to reduce environmental pollution, can be performed to achieve sustainable development. PMID:25153474

Detecting selection effects in community implementations of family-based substance abuse prevention programs.

PubMed

Hill, Laura G; Goates, Scott G; Rosenman, Robert

2010-04-01

To calculate valid estimates of the costs and benefits of substance abuse prevention programs, selection effects must be identified and corrected. A supplemental comparison sample is typically used for this purpose, but in community-based program implementations, such a sample is often not available. We present an evaluation design and analytic approach that can be used in program evaluations of real-world implementations to identify selection effects, which in turn can help inform recruitment strategies, pinpoint possible selection influences on measured program outcomes, and refine estimates of program costs and benefits. We illustrate our approach with data from a multisite implementation of a popular substance abuse prevention program. Our results indicate that the program's participants differed significantly from the population at large.

Safety belt usage attitude study

DOT National Transportation Integrated Search

1979-02-01

Despite increasing evidence that occupant restraint laws are effective in getting people to wear safety belts and an extremely cost-effective measure for reducing highway deaths and injuries, strong opposition at the state-level has prevented passage...

[Effects of an Integrated Internet Addiction Prevention Program on Elementary Students' Self-regulation and Internet Addiction].

PubMed

Mun, So Youn; Lee, Byoung Sook

2015-04-01

The purpose of this study was to develop an integrated internet addiction prevention program and test its effects on the self-regulation and internet addiction of elementary students who are at risk for internet addiction. A quasi-experimental study with a nonequivalent control group pretest-posttest design was used. Participants were assigned to the experimental group (n=28) or control group (n=28). Contents of the program developed in this study included provision of information about internet addiction, interventions for empowerment and methods of behavioral modification. A pre-test and two post-tests were done to identify the effects of the program and their continuity. Effects were testified using Repeated measures ANOVA, simple effect analysis, and Time Contrast. The self-regulation of the experimental group after the program was significantly higher than the control group. The score for internet addiction self-diagnosis and the internet use time in the experimental group were significantly lower than the control group. The effects of the integrated internet addiction prevention program for preventing internet addiction in elementary students at risk for internet addiction were validated.

Assessing Interventions to Manage West Nile Virus Using Multi-Criteria Decision Analysis with Risk Scenarios

PubMed Central

Hongoh, Valerie; Campagna, Céline; Panic, Mirna; Samuel, Onil; Gosselin, Pierre; Waaub, Jean-Philippe; Ravel, André; Samoura, Karim; Michel, Pascal

2016-01-01

The recent emergence of West Nile virus (WNV) in North America highlights vulnerability to climate sensitive diseases and stresses the importance of preventive efforts to reduce their public health impact. Effective prevention involves reducing environmental risk of exposure and increasing adoption of preventive behaviours, both of which depend on knowledge and acceptance of such measures. When making operational decisions about disease prevention and control, public health must take into account a wide range of operational, environmental, social and economic considerations in addition to intervention effectiveness. The current study aimed to identify, assess and rank possible risk reduction measures taking into account a broad set of criteria and perspectives applicable to the management of WNV in Quebec under increasing transmission risk scenarios, some of which may be related to ongoing warming in higher-latitude regions. A participatory approach was used to collect information on categories of concern to relevant stakeholders with respect to WNV prevention and control. Multi-criteria decision analysis was applied to examine stakeholder perspectives and their effect on strategy rankings under increasing transmission risk scenarios. Twenty-three preventive interventions were retained for evaluation using eighteen criteria identified by stakeholders. Combined evaluations revealed that, at an individual-level, inspecting window screen integrity, wearing light colored, long clothing, eliminating peridomestic larval sites and reducing outdoor activities at peak times were top interventions under six WNV transmission scenarios. At a regional-level, the use of larvicides was a preferred strategy in five out of six scenarios, while use of adulticides and dissemination of sterile male mosquitoes were found to be among the least favoured interventions in almost all scenarios. Our findings suggest that continued public health efforts aimed at reinforcing individual-level preventive behaviours combined with the application of larvicides to manage the risk of WNV infection are the interventions most acceptable and effective at reaching current management objectives now and under future theoretical transmission risk. PMID:27494136

[Evaluation of the theatre play Have Courage! A powerful play about feelings, boundaries and trust in the frame of the national campaign for the prevention of child sexual abuse].

PubMed

Firnges, Christiane; Amann, Stefanie

2016-01-01

This article reports on the evaluation of the effectiveness of a school-based preventive theatre play. The play is part of a national campaign for the prevention of child sexual abuse called Trau dich! (Have courage!). A total of 639 students in third to sixth grade from Schleswig-Holstein and Saxony participated in the study. Scenarios in the play imparted prevention messages and self-protective skills regarding situations of sexual assault or abuse, targeting children aged 8 to 12. Acquisition of knowledge about access to help systems and children's rights were measured pre- and post viewing as well as at a follow-up point two to six months later. Children estimated their competences regarding sensibility, sensing/setting boundaries, social support/to entrust oneself to somebody and knowledge. Based on cognitive empathy, children suggested self-protective skills for situations of conflict. The theatre play contributed to the acquisition of knowledge and an increase of children's self-assessed knowledge and competences. They estimated their competences of distinguishing between good and bad secrets, safe and unsafe touching, and disclosing oneself to somebody; their suggestions for self-protective skills improved compared to baseline data. The effects were still present at follow-up. Girls estimated their competences and self-protective skills to have improved more than boys. Measured negative effects were only temporary. The results indicate that the interactive educative theatre play contributed effectively to the prevention of child sexual abuse through imparting knowledge, self-protective skills, and sensitization.

A protocol for evidence-based targeting and evaluation of statewide strategies for preventing falls among community-dwelling older people in Victoria, Australia

PubMed Central

Finch, Caroline F; Hill, Keith D; Haines, Terry P; Clemson, Lindy; Thomas, Margaret; Thompson, Catherine

2010-01-01

Background Falls are a significant threat to the safety, health and independence of older citizens. Despite the now substantial evidence about effective falls prevention interventions, translation into falls reductions has not yet been fully realised. While the hip fracture rate is decreasing, the number and rate of fall-related hospital admissions among older people is increasing. The challenge now is to deliver the most effective interventions efficiently at a population level, and for these interventions to be taken up by older people. Objective To support the development, and evaluation of, effective falls prevention policy and practice in the state of Victoria, Australia. Methods The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective programme. Research objectives were developed to support the strategies. These include: (1) identification of subgroups of older people most frequently admitted to hospital for falls; (2) examining the acceptability of established falls interventions; (3) identification of factors that encourage and support relevant lifestyle changes; (4) identifying opportunities to incorporate confirmed interventions in existing programmes and services; (5) developing guidelines for sustainability. The research results will subsequently guide strategy details for the falls prevention plan. RE-AIM will provide the framework for the evaluation structure. Outcome measures Measures to monitor the implementation of the selected interventions will be determined for each intervention, based on the five key factors of the RE-AIM model. The overall effect of the falls prevention plan will be monitored by time series analysis of fall-related hospital admission rates for community-dwelling older people. PMID:21186224

Insights about Fall Prevention of Older Adults in the State of Hawai'i.

PubMed

Yamazaki, Yuka; Hayashida, Cullen T; Yontz, Valerie

2017-01-01

The senior population in Hawai'i is growing at a dramatic pace. In the older population, falls and fall-related injuries are leading causes of morbidity and mortality. Moreover, the health care costs for falls are very high. The State of Hawai'i has taken measures to prevent falls through the promotion of medication reviews, vision checks, home assessments, and exercise. However, current published examinations of fall preventive measures have been insufficient, and more research is needed to confirm risk factors, effectiveness of preventive measures, and to explore future objectives. This paper examined the validity of fall risk factors and fall preventive measures for Hawai'i's seniors by conducting mail questionnaire surveys to a sample of seniors using medical alert services from one company in Hawai'i. The results of chi-square analysis suggest that having reduced ability to perform Activities of Daily Living (ADL) and reduced Instrumental Activities of Daily Living (IADL) were associated with a greater risk of falls ( P < .01). In addition, those who fell were more likely to talk about fall preventions with their family members or friends and health providers compared with those who did not ( P = .048 and .003, respectively). Evidence-based exercise programs for strengthening muscles and controlling physical balance may be needed to improve ADL and IADL. Furthermore, the results suggest that seniors do not accept that they are at risk of falling before they actually fall. Public health providers should consider how they approach seniors, and how they inform them of the importance of fall prevention across the life span.

An implementation science perspective on psychological science and cancer: what is known and opportunities for research, policy, and practice.

PubMed

Rabin, Borsika; Glasgow, Russell E

2015-01-01

We discuss the role of implementation science in cancer and summarize the need for this perspective. Following a summary of key implementation science principles and lessons learned, we review the literature on implementation of cancer prevention and control activities across the continuum from prevention to palliative care. We identified 10 unique relevant reviews, four of which were specific to cancer. Multicomponent implementation strategies were found to be superior to single-component interventions, but it was not possible to draw conclusions about specific strategies or the range of conditions across which strategies were effective. Particular gaps identified include the need for more studies of health policies and reports of cost, cost-effectiveness, and resources required. Following this review, we summarize the types of evidence needed to make research findings more actionable and discuss emerging implementation science opportunities for psychological research on cancer prevention and control. These include innovative study designs (i.e., rapid learning designs, simulation modeling, comparative effectiveness, pragmatic studies, mixed-methods research) and measurement science (i.e., development of context-relevant measures; practical, longitudinal measures to gauge improvement; cost-effectiveness data; and harmonized patient report data). We conclude by identifying a few grand challenges for psychologists that if successfully addressed would accelerate integration of evidence into cancer practice and policy more consistently and rapidly. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Updated Priorities Among Effective Clinical Preventive Services

PubMed Central

Maciosek, Michael V.; LaFrance, Amy B.; Dehmer, Steven P.; McGree, Dana A.; Flottemesch, Thomas J.; Xu, Zack; Solberg, Leif I.

2017-01-01

PURPOSE The Patient Protection and Affordable Care Act’s provisions for first-dollar coverage of evidence-based preventive services have reduced an important barrier to receipt of preventive care. Safety-net providers, however, still serve a substantial uninsured population, and clinician and patient time remain limited in all primary care settings. As a consequence, decision makers continue to set priorities to help focus their efforts. This report updates estimates of relative health impact and cost-effectiveness for evidence-based preventive services. METHODS We assessed the potential impact of 28 evidence-based clinical preventive services in terms of their cost-effectiveness and clinically preventable burden, as measured by quality-adjusted life years (QALYs) saved. Each service received 1 to 5 points on each of the 2 measures—cost-effectiveness and clinically preventable burden—for a total score ranging from 2 to 10. New microsimulation models were used to provide updated estimates of 12 of these services. Priorities for improving delivery rates were established by comparing the ranking with what is known of current delivery rates nationally. RESULTS The 3 highest-ranking services, each with a total score of 10, are immunizing children, counseling to prevent tobacco initiation among youth, and tobacco-use screening and brief intervention to encourage cessation among adults. Greatest population health improvement could be obtained from increasing utilization of clinical preventive services that address tobacco use, obesity-related behaviors, and alcohol misuse, as well as colorectal cancer screening and influenza vaccinations. CONCLUSIONS This study identifies high-priority preventive services and should help decision makers select which services to emphasize in quality-improvement initiatives. PMID:28376457

The relationship between hand hygiene and health care-associated infection: it’s complicated

PubMed Central

McLaws, Mary-Louise

2015-01-01

The reasoning that improved hand hygiene compliance contributes to the prevention of health care-associated infections is widely accepted. It is also accepted that high hand hygiene alone cannot impact formidable risk factors, such as older age, immunosuppression, admission to the intensive care unit, longer length of stay, and indwelling devices. When hand hygiene interventions are concurrently undertaken with other routine or special preventive strategies, there is a potential for these concurrent strategies to confound the effect of the hand hygiene program. The result may be an overestimation of the hand hygiene intervention unless the design of the intervention or analysis controls the effect of the potential confounders. Other epidemiologic principles that may also impact the result of a hand hygiene program include failure to consider measurement error of the content of the hand hygiene program and the measurement error of compliance. Some epidemiological errors in hand hygiene programs aimed at reducing health care-associated infections are inherent and not easily controlled. Nevertheless, the inadvertent omission by authors to report these common epidemiological errors, including concurrent infection prevention strategies, suggests to readers that the effect of hand hygiene is greater than the sum of all infection prevention strategies. Worse still, this omission does not assist evidence-based practice. PMID:25678805

The Cost-Effectiveness of the Kiva Antibullying Program: Results from a Decision-Analytic Model.

PubMed

Persson, Mattias; Wennberg, Linn; Beckman, Linda; Salmivalli, Christina; Svensson, Mikael

2018-05-04

Bullying causes substantial suffering for children and adolescents. A number of bullying prevention programs have been advocated as effective methods for counteracting school bullying. However, there is a lack of economic evaluations of bullying prevention programs assessing the "value for money." The aim of this study was to assess the cost-effectiveness of the Finnish bullying prevention program KiVa in comparison to "status quo" (treatment as usual) in a Swedish elementary school setting (grades 1 to 9). The cost-effectiveness analysis was carried out using a payer perspective based on a Markov cohort model. The costs of the program were measured in Swedish kronor and Euros, and the benefits were measured using two different metrics: (1) the number of victim-free years and (2) the number of quality adjusted life years (QALYs). Data on costs, probability transitions, and health-related quality of life measures were retrieved from published literature. Deterministic and probabilistic sensitivity analyses were carried out to establish the uncertainty of the cost-effectiveness results. The base-case analysis indicated that KiVa leads to an increased cost of €829 for a gain of 0.47 victim-free years per student. In terms of the cost per gained QALY, the results indicated a base-case estimate of €13,823, which may be seen as cost-effective given that it is lower than the typically accepted threshold value in Swedish health policy of around €50,000. Further research is needed to confirm the conclusions of this study, especially regarding the treatment effects of KiVa in different school contexts.

Effects of an emotional intelligence program in variables related to the prevention of violence

PubMed Central

Garaigordobil, Maite; Peña-Sarrionandia, Ainize

2015-01-01

In recent decades, numerous studies have shown a significant increase in violence during childhood and adolescence. These data suggest the importance of implementing programs to prevent and reduce violent behavior. The study aimed to design a program of emotional intelligence (EI) for adolescents and to assess its effects on variables related to violence prevention. The possible differential effect of the program on both genders was also examined. The sample comprised 148 adolescents aged from 13 to 16 years. The study used an experimental design with repeated pretest–posttest measures and control groups. To measure the variables, four assessment instruments were administered before and after the program, as well as in the follow-up phase (1 year after the conclusion of the intervention). The program consisted of 20 one-hour sessions. The pretest–posttest ANCOVAs showed that the program significantly increased: (1) EI (attention, clarity, emotional repair); (2) assertive cognitive social interaction strategies; (3) internal control of anger; and (4) the cognitive ability to analyze negative feelings. In the follow-up phase, the positive effects of the intervention were generally maintained and, moreover, the use of aggressive strategies as an interpersonal conflict-resolution technique was significantly reduced. Regarding the effect of the program on both genders, the change was very similar, but the boys increased assertive social interaction strategies, attention, and emotional clarity significantly more than the girls. The importance of implementing programs to promote socio-emotional development and prevent violence is discussed. PMID:26082743

Effects of an emotional intelligence program in variables related to the prevention of violence.

PubMed

Garaigordobil, Maite; Peña-Sarrionandia, Ainize

2015-01-01

In recent decades, numerous studies have shown a significant increase in violence during childhood and adolescence. These data suggest the importance of implementing programs to prevent and reduce violent behavior. The study aimed to design a program of emotional intelligence (EI) for adolescents and to assess its effects on variables related to violence prevention. The possible differential effect of the program on both genders was also examined. The sample comprised 148 adolescents aged from 13 to 16 years. The study used an experimental design with repeated pretest-posttest measures and control groups. To measure the variables, four assessment instruments were administered before and after the program, as well as in the follow-up phase (1 year after the conclusion of the intervention). The program consisted of 20 one-hour sessions. The pretest-posttest ANCOVAs showed that the program significantly increased: (1) EI (attention, clarity, emotional repair); (2) assertive cognitive social interaction strategies; (3) internal control of anger; and (4) the cognitive ability to analyze negative feelings. In the follow-up phase, the positive effects of the intervention were generally maintained and, moreover, the use of aggressive strategies as an interpersonal conflict-resolution technique was significantly reduced. Regarding the effect of the program on both genders, the change was very similar, but the boys increased assertive social interaction strategies, attention, and emotional clarity significantly more than the girls. The importance of implementing programs to promote socio-emotional development and prevent violence is discussed.

Pre-marital examination as a method of prevention from blood genetic disorders. Community views.

PubMed

El-Hazmi, Mohsen A F

2006-09-01

The Saudi Royal Cabinet issued the Saudi Royal Decree No. 3 dated 11-7-1424, establishing the pre-marital examination as a health preventive measure for all Saudis, and requesting the 2 prospective partners (male and female) to carry out a pre-marital examination and present a certificate of pre-marital examination before the wedding. However, the prospective husband and wife are not obliged to abide by the laboratory results if they so wish. This program started officially on the 1st of Muharram, 1425. As a consequence, the community perception and views on the pre-marital examination program as a preventive measure become crucial. Therefore, this study was organized and conducted to reveal the perception of the community regarding the program, through a purpose-made questionnaire that was distributed during symposia and awareness lectures held throughout the Kingdom (Riyadh, Jeddah, Dammam, Al-Khobar, Al-Ahsa, Al-Qassim, and Madinah). The questionnaire covers the opinions of the participants in various aspects related to genetic diseases including nature of diseases, mode of transmission, affecting factors, complications, management, and prevention. In addition, the questionnaire also covers opinions regarding the pre-marital examination as a preventive measure of blood genetic diseases, and its contribution to the control of these diseases. The questionnaire also covers methods in obtaining information, whether from studies, lectures, information media, and awareness lectures. The results revealed that the majority of the participants (94.3%) were convinced that the pre-marital examination is an effective mean of prevention of blood genetic diseases. The majority (86.9%) of the participants were also convinced that the pre-marital examination should be mandatory. These are indications that the community is aware of the pre-marital examination, and the effectiveness of the awareness program is enriching the knowledge of the citizens.

Uncovering effective strategies for hearing loss prevention

PubMed Central

Morata, Thais C.; Meinke, Deanna

2016-01-01

Occupational health agencies, researchers and policy makers have recognized the need for evidence on the effectiveness of interventions designed to reduce or prevent workplace injuries and illnesses. While many workplaces comply with legal or obligatory requirements and implement recommended interventions, few publications exist documenting the effectiveness of these actions. Additionally, some workplaces have discovered through their own processes, novel ways to reduce the risk of injury. Peer-reviewed information on the effectiveness of the many strategies and approaches currently in use could help correct weaknesses, or further encourage their adoption and expansion. The evaluation of intervention effectiveness would certainly contribute to improved worker health and safety. This need is particularly relevant regarding noise exposure in the workplace and hearing loss prevention interventions. In a 2006 review of the U.S. National Institute for Occupational Safety and Health (NIOSH) Hearing Loss Research Program, the independent National Academies of Sciences recommended that NIOSH place greater emphasis on identifying the effectiveness of hearing loss prevention measures on the basis of outcomes that are as closely related as possible to reducing noise exposure and work related hearing loss (http://www.nap.edu/openbook.php?record_id=11721). NIOSH used two different approaches to address that recommendation: the first one was to conduct research, including broad systematic reviews on the effectiveness of interventions to prevent occupational noise-induced hearing loss. The second was to create an award program, the Safe-In-Sound Excellence in Hearing Loss Prevention Award™, to identify and honor excellent real-world examples of noise control and other hearing loss prevention practices and innovations. PMID:27397968

Online training in sports concussion for youth sports coaches.

PubMed

Glang, Ann; Koester, Michael C; Beaver, Sherry Vondy; Clay, Janet E; McLaughlin, Karen A

2010-03-01

The purpose of this study was to evaluate ACTive: Athletic Concussion Training using Interactive Video Education, an interactive e-learning program designed to train community coaches of youth ages 10-18 in effective sports concussion prevention and management practices. Seventy-five youth sports coaches from across the country completed the study over the Internet. Results of a randomized control trial demonstrated significant differences between treatment and control participants on measures of (a) knowledge about sports concussion, management, and prevention; (b) attitudes about the importance of preventing sports concussion; and (c) intention and self-efficacy in sports concussion management and prevention. The results suggest that ACTive is an effective method of training youth sports coaches who are in an important position to reduce risks associated with sports concussion.

Regulatory focus moderates the relationship between task control and physiological and psychological markers of stress: a work simulation study.

PubMed

Parker, Stacey L; Laurie, Kaitlan R; Newton, Cameron J; Jimmieson, Nerina L

2014-12-01

This experiment examined whether trait regulatory focus moderates the effects of task control on stress reactions during a demanding work simulation. Regulatory focus describes two ways in which individuals self-regulate toward desired goals: promotion and prevention. As highly promotion-focused individuals are oriented toward growth and challenge, it was expected that they would show better adaptation to demanding work under high task control. In contrast, as highly prevention-focused individuals are oriented toward safety and responsibility they were expected to show better adaptation under low task control. Participants (N=110) completed a measure of trait regulatory focus and then three trials of a demanding inbox activity under either low, neutral, or high task control. Heart rate variability (HRV), affective reactions (anxiety & task dissatisfaction), and task performance were measured at each trial. As predicted, highly promotion-focused individuals found high (compared to neutral) task control stress-buffering for performance. Moreover, highly prevention-focused individuals found high (compared to low) task control stress-exacerbating for dissatisfaction. In addition, highly prevention-focused individuals found low task control stress-buffering for dissatisfaction, performance, and HRV. However, these effects of low task control for highly prevention-focused individuals depended on their promotion focus. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

The importance of male partner involvement for women's acceptability and adherence to female-initiated HIV prevention methods in Zimbabwe.

PubMed

Montgomery, Elizabeth T; van der Straten, Ariane; Chidanyika, Agnes; Chipato, Tsungai; Jaffar, Shabbar; Padian, Nancy

2011-07-01

Enlisting male partner involvement is perceived as an important component of women's successful uptake of female-initiated HIV prevention methods. We conducted a longitudinal study among a cohort of 955 Zimbabwean women participating in a clinical trial of the effectiveness of a female-initiated HIV prevention method (the diaphragm and lubricant gel) to: (a) describe the extent to which women involved their male partners in the decision to use the study products, and (b) measure the effect perceived male partner support had on their acceptability and consistent use of these methods. Reported levels of male partner involvement in discussions and decisions regarding: joining the study, study activities, the outcome of HIV/STI test results, and product use were very high. In multivariate analyses, regular disclosure of study product use and partner approval for the diaphragm and gel were significantly associated with women's acceptability and consistent use of the products; an essential component for determining efficacy of investigational prevention methods. These results support the need for more sophisticated measurement of how couples interact to make decisions that impact study participation and investigational product use as well as more rigorous adaptations and evaluations of existing strategies to involve male partners in female-initiated HIV prevention trials.

Implementing and Evaluating School-Based Primary Prevention Programs and the Importance of Differential Effects on Outcomes

ERIC Educational Resources Information Center

Hussey, David L.; Flannery, Daniel J.

2007-01-01

In 2004, Second Step (Committee for Children, 2002), a violence prevention program, was implemented in the Cleveland Heights-University Heights school district for 1,416 K through second grade students. Both process and outcome measures were used to evaluate program impact and examine issues related to the implementation and evaluation of…

A Disaster Preparedness Plan for Small Public Libraries, 2002.

ERIC Educational Resources Information Center

Haines, Jan, Comp.

The State Library of Ohio designed this disaster preparedness plan to assist small libraries in gathering information that will be invaluable in the event of an emergency. This plan, which focuses on fire and water disaster prevention, is devoted to using simple and inexpensive measures to prevent a disaster or to lessen its effect. The plan…

[Vertical integration--an important component of rehabilitation of patients with stroke].

PubMed

Sereda, V G; Drygant, L P; Ingula, N I; Kravchuk, N A; Tkachenko, V V; Babirad, A M; Sizina, A V; Titenko, Iu I; Nedashkovskaia, V A; Andrusenko, A S; Sheremet, A E; Kushpiĭ, O V; Mogorita, O L; Matsikevich, V V; Sukhoruchkin, Iu A; Sachko, Iu Iu

2012-01-01

Today it is proved that the reduction of mortality from cardiovascular disease is achieved through the implementation of a coordinated set of measures, the most important of which is to increase public awareness of the risk factors for cardiovascular diseases and their prevention, implementation of effective prevention programs and improve the system of care for stroke.

Measures of Effective Military Public Health Interventions in Stability Operations

DTIC Science & Technology

2011-06-10

treatment of acute watery diarrhea ( nutritional support and oral rehydration therapy). 5. Prevention/treatment of endemic diseases, targeting...age of 5, targeting immunizations and treatment of acute watery diarrhea ( nutritional support and oral rehydration therapy). -Prevention...Improve care for children under-five targeting immunizations and treatment of acute watery diarrhea ( nutritional support and oral rehydration

The impact of economic recession on infection prevention and control.

PubMed

O'Riordan, M; Fitzpatrick, F

2015-04-01

The economic recession that began in 2007 led to austerity measures and public sector cutbacks in many European countries. Reduced resource allocation to infection prevention and control (IPC) programmes is impeding prevention and control of tuberculosis, HIV and vaccine-preventable infections. In addition, higher rates of infectious disease in the community have a significant impact on hospital services, although the extent of this has not been studied. With a focus on quick deficit reduction, preventive services such IPC may be regarded as non-essential. Where a prevention programme succeeds in reducing disease burden to a low level, its very success can undermine the perceived need for the programme. To mitigate the negative effects of recession, we need to: educate our political leaders about the economic benefits of IPC; better quantify the costs of healthcare-associated infection; and evaluate the effects of budget cuts on healthcare outcomes and IPC activities. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

[A comprehensive evaluation of intervention effects on workplace health promotion in a pharmaceutical company].

PubMed

Li, Shuang; Li, Tao; Li, Jian-guo; Chen, Li; Ren, Jun; Li, Chao-lin

2012-02-01

To evaluate the comprehensive workplace health promotion intervention effect in a pharmaceutical company. The evaluation was conducted by using questionnaires, access to information, on-site surveys, satisfaction surveys and interviews. After the intervention, the awareness rate of the staff on "Occupational Disease Prevention Law", occupational disease prevention measures, the definition of hypertension, HIV transmission and high blood pressure, coronary heart disease preventive measures, have been raised from 72.4%, 13.8%, 67.5%, 45.8%, 51.7% to 97.8%, 19.9%, 82.3%, 94.7%, 53.1% respectively. The lifestyle of the staff has been improved, the improvement rate of smoking, drinking, having breakfast 4 times a week and above are 98.5%, 70.2% and 30.6% separately. Out of the 47 evaluation indicators, 41 meet the requirements, 5 basically meet the requirements. After implementing workplace health promotion activities, the level of occupational safety and health management of the pharmaceutical company has been enhanced, the physical and mental health of the staff have been promoted. The WHP comprehensive interventions are feasible and effective.

Mechanisms and methods for biofouling prevention via aeration

NASA Astrophysics Data System (ADS)

Dickenson, Natasha; Henoch, Charles; Belden, Jesse

2013-11-01

Biofouling is a major problem for the Navy and marine industries, with significant economic and ecological consequences. Specifically, biofouling on immersed hull surfaces generates increased drag and thus requires increased fuel consumption to maintain speed. Considerable effort has been spent developing techniques to prevent and control biofouling, but with limited success. Control methods that have proven to be effective are costly, time consuming, or negatively affect the environment. Recently, aeration via bubble injection along submerged surfaces has been shown to achieve long-lasting antifouling effects, and is the only effective non-toxic method available. An understanding of the basic mechanisms by which bubble-induced flow impedes biofouling is lacking, but is essential for the design of large-scale systems. We present results from an experimental investigation of several bubble induced flow fields over an inclined plate with simultaneous measurements of the fluid velocity and bubble characteristics using Digital article Image Velocimetry and high speed digital video. Trajectories of representative larval organisms are also resolved and linked with the flow field measurements to determine the mechanisms responsible for biofouling prevention.

Trauma Center Based Youth Violence Prevention Programs: An Integrative Review.

PubMed

Mikhail, Judy Nanette; Nemeth, Lynne Sheri

2016-12-01

Youth violence recidivism remains a significant public health crisis in the United States. Violence prevention is a requirement of all trauma centers, yet little is known about the effectiveness of these programs. Therefore, this systematic review summarizes the effectiveness of trauma center-based youth violence prevention programs. A systematic review of articles from MEDLINE, CINAHL, and PsychINFO databases was performed to identify eligible control trials or observational studies. Included studies were from 1970 to 2013, describing and evaluating an intervention, were trauma center based, and targeted youth injured by violence (tertiary prevention). The social ecological model provided the guiding framework, and findings are summarized qualitatively. Ten studies met eligibility requirements. Case management and brief intervention were the primary strategies, and 90% of the studies showed some improvement in one or more outcome measures. These results held across both social ecological level and setting: both emergency department and inpatient unit settings. Brief intervention and case management are frequent and potentially effective trauma center-based violence prevention interventions. Case management initiated as an inpatient and continued beyond discharge was the most frequently used intervention and was associated with reduced rearrest or reinjury rates. Further research is needed, specifically longitudinal studies using experimental designs with high program fidelity incorporating uniform direct outcome measures. However, this review provides initial evidence that trauma centers can intervene with the highest of risk patients and break the youth violence recidivism cycle. © The Author(s) 2015.

Bisphosphonates as a Countermeasure to Space Flight Induced Bone Loss

NASA Technical Reports Server (NTRS)

LeBlanc, Adrian; Matsumoto, Toshio; Jones, Jeff; Shapiro, Jay; Lang, Tom; Smith, Scott M.; Shackelford, Linda C.; Sibonga, Jean; Evans, Harlan; Spector, Elisabeth;

Development and Prevention of Running-Related Osteoarthritis.

PubMed

Ni, Guo-Xin

2016-01-01

Studies investigating the effect of running on risk for developing osteoarthritis at weight-bearing joints have reported with conflicting results. Generally, moderate-level running is not likely detrimental to joint health. However, many factors may be associated with the increased risk of developing osteoarthritis in runners. Factors often implicated in the development of osteoarthritis comprise those that increase joint vulnerability and those which increase joint loading. It is therefore suggested that running has different effects on different people. Efforts should be made to identify those with joint vulnerability and joint loading, and measures should be taken to have those factors and/or their running programs modified to run safely. Further investigations are needed to examine the effect of running on joint health under different conditions to confirm the association between exposure to risk factors and development of osteoarthritis, as well as to validate the effectiveness of measures for preventing running-related osteoarthritis.

Prediction impact curve is a new measure integrating intervention effects in the evaluation of risk models.

PubMed

Campbell, William; Ganna, Andrea; Ingelsson, Erik; Janssens, A Cecile J W

2016-01-01

We propose a new measure of assessing the performance of risk models, the area under the prediction impact curve (auPIC), which quantifies the performance of risk models in terms of their average health impact in the population. Using simulated data, we explain how the prediction impact curve (PIC) estimates the percentage of events prevented when a risk model is used to assign high-risk individuals to an intervention. We apply the PIC to the Atherosclerosis Risk in Communities (ARIC) Study to illustrate its application toward prevention of coronary heart disease. We estimated that if the ARIC cohort received statins at baseline, 5% of events would be prevented when the risk model was evaluated at a cutoff threshold of 20% predicted risk compared to 1% when individuals were assigned to the intervention without the use of a model. By calculating the auPIC, we estimated that an average of 15% of events would be prevented when considering performance across the entire interval. We conclude that the PIC is a clinically meaningful measure for quantifying the expected health impact of risk models that supplements existing measures of model performance. Copyright © 2016 Elsevier Inc. All rights reserved.

Health Benefits and Cost-Effectiveness of Asymptomatic Screening for Hypertension and High Cholesterol and Aspirin Counseling for Primary Prevention.

PubMed

Dehmer, Steven P; Maciosek, Michael V; LaFrance, Amy B; Flottemesch, Thomas J

2017-01-01

Our aim was to update estimates of the health and economic impact of clinical services recommended for the primary prevention of cardiovascular disease (CVD) for the comparative rankings of the National Commission on Prevention Priorities, and to explore differences in outcomes by sex and race/ethnicity. We used a single, integrated, microsimulation model to generate comparable results for 3 services recommended by the US Preventive Services Task Force: aspirin counseling for the primary prevention of CVD and colorectal cancer, screening and treatment for lipid disorders (usually high cholesterol), and screening and treatment for hypertension. Analyses compare lifetime outcomes from the societal perspective for a US-representative birth cohort of 100,000 persons with and without access to each clinical preventive service. Primary outcomes are health impact, measured by the net difference in lifetime quality-adjusted life years (QALYs), and cost-effectiveness, measured in incremental cost per QALY or cost savings per person in 2012 dollars. Results are also presented for population subgroups defined by sex and race/ethnicity. Health impact is highest for hypertension screening and treatment (15,600 QALYs), but is closely followed by cholesterol screening and treatment (14,300 QALYs). Aspirin counseling has a lower health impact (2,200 QALYs) but is found to be cost saving ($31 saved per person). Cost-effectiveness for cholesterol and hypertension screening and treatment is $33,800 per QALY and $48,500 per QALY, respectively. Findings favor hypertension over cholesterol screening and treatment for women, and opportunities to reduce disease burden across all services are greatest for the non-Hispanic black population. All 3 CVD preventive services continue to rank highly among other recommended preventive services for US adults, but individual priorities can be tailored in practice by taking a patient's demographic characteristics and clinical objectives into account. © 2017 Annals of Family Medicine, Inc.

Estimating effectiveness in HIV prevention trials with a Bayesian hierarchical compound Poisson frailty model

PubMed Central

Coley, Rebecca Yates; Browna, Elizabeth R.

2016-01-01

Inconsistent results in recent HIV prevention trials of pre-exposure prophylactic interventions may be due to heterogeneity in risk among study participants. Intervention effectiveness is most commonly estimated with the Cox model, which compares event times between populations. When heterogeneity is present, this population-level measure underestimates intervention effectiveness for individuals who are at risk. We propose a likelihood-based Bayesian hierarchical model that estimates the individual-level effectiveness of candidate interventions by accounting for heterogeneity in risk with a compound Poisson-distributed frailty term. This model reflects the mechanisms of HIV risk and allows that some participants are not exposed to HIV and, therefore, have no risk of seroconversion during the study. We assess model performance via simulation and apply the model to data from an HIV prevention trial. PMID:26869051

Prevention of generalized anxiety disorder using a web intervention, iChill: randomized controlled trial.

PubMed

Christensen, Helen; Batterham, Philip; Mackinnon, Andrew; Griffiths, Kathleen M; Kalia Hehir, Kanupriya; Kenardy, Justin; Gosling, John; Bennett, Kylie

2014-09-02

Generalized Anxiety Disorder (GAD) is a high prevalence, chronic disorder. Web-based interventions are acceptable, engaging, and can be delivered at scale. Few randomized controlled trials evaluate the effectiveness of prevention programs for anxiety, or the factors that improve effectiveness and engagement. The intent of the study was to evaluate the effectiveness of a Web-based program in preventing GAD symptoms in young adults, and to determine the role of telephone and email reminders. A 5-arm randomized controlled trial with 558 Internet users in the community, recruited via the Australian Electoral Roll, was conducted with 6- and 12-month follow-up. Five interventions were offered over a 10-week period. Group 1 (Active website) received a combined intervention of psycho-education, Internet-delivered Cognitive Behavioral Therapy (ICBT) for anxiety, physical activity promotion, and relaxation. Group 2 (Active website with telephone) received the identical Web program plus weekly telephone reminder calls. Group 3 (Active website with email) received the identical Web program plus weekly email reminders. Group 4 (Control) received a placebo website. Group 5 (Control with telephone) received the placebo website plus telephone calls. Main outcome measures were severity of anxiety symptoms as measured by the GAD 7-item scale (GAD-7) (at post-test, 6, and 12 months). Secondary measures were GAD caseness, measured by the Mini International Neuropsychiatric Interview (MINI) at 6 months, Centre for Epidemiologic Studies-Depression scale (CES-D), Anxiety Sensitivity Index (ASI), Penn State Worry Questionnaire (PSWQ), and Days out of Role. GAD-7 symptoms reduced over post-test, 6-month, and 12-month follow-up. There were no significant differences between Group 4 (Control) and Groups 1 (Active website), 2 (Active website with telephone), 3 (Active website with email), or 5 (Control with telephone) at any follow-up. A total of 16 cases of GAD were identified at 6 months, comprising 6.7% (11/165) from the Active groups (1, 2, 3) and 4.5% (5/110) from the Control groups (4, 5), a difference that was not significant. CES-D, ASI, and PSWQ scores were significantly lower for the active website with email reminders at post-test, relative to the control website condition. Indicated prevention of GAD was not effective in reducing anxiety levels, measured by GAD-7. There were significant secondary effects for anxiety sensitivity, worry, and depression. Challenges for indicated prevention trials are discussed. International Standard Randomized Controlled Trial Number (ISRCTN): 76298775; http://www.controlled-trials.com/ISRCTN76298775 (Archived by WebCite at http://www.webcitation.org/6S9aB5MAq).

State of condom use in HIV prevention science and practice.

PubMed

Crosby, Richard A

2013-03-01

Condom use remains as the frontline defense against the HIV/AIDS pandemic. Fortunately, an ever-expanding body of empirical literature is currently guiding improvements in use of this prevention strategy. Recent advances include improved measurement of condom use behaviors, advances in condom effectiveness research, innovations in the design of condoms, and greater intervention efficiency for high-risk populations. After reviewing each of these four areas of research, this article will offer speculation about the future of condom use for HIV prevention.

Does a fall prevention educational programme improve knowledge and change exercise prescribing behaviour in health and exercise professionals? A study protocol for a randomised controlled trial.

PubMed

Tiedemann, A; Sturnieks, D L; Hill, A-M; Lovitt, L; Clemson, L; Lord, S R; Harvey, L; Sherrington, C

2014-11-19

Falling in older age is a serious and costly problem. At least one in three older people fall annually. Although exercise is recognised as an effective fall prevention intervention, low numbers of older people engage in suitable programmes. Health and exercise professionals play a crucial role in addressing fall risk in older adults. This trial aims to evaluate the effect of participation in a fall prevention educational programme, compared with a wait-list control group, on health and exercise professionals' knowledge about fall prevention and the effect on fall prevention exercise prescription behaviour and confidence to prescribe the exercises to older people. A randomised controlled trial involving 220 consenting health and exercise professionals will be conducted. Participants will be individually randomised to an intervention group (n=110) to receive an educational workshop plus access to internet-based support resources, or a wait-list control group (n=110). The two primary outcomes, measured 3 months after randomisation, are: (1) knowledge about fall prevention and (2) self-perceived change in fall prevention exercise prescription behaviour. Secondary outcomes include: (1) participants' confidence to prescribe fall prevention exercises; (2) the proportion of people aged 60+ years seen by trial participants in the past month who were prescribed fall prevention exercise; and (3) the proportion of fall prevention exercises prescribed by participants to older people in the past month that comply with evidence-based guidelines. Outcomes will be measured with a self-report questionnaire designed specifically for the trial. The trial protocol was approved by the Human Research Ethics Committee, The University of Sydney, Australia. Trial results will be disseminated via peer reviewed journals, presentations at international conferences and participants' newsletters. Trial protocol was registered with the Australian and New Zealand Clinical Trials Registry (Number ACTRN12614000224628) on 3 March 2014. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

What proportion of congenital abnormalities can be prevented?

PubMed Central

Czeizel, A E; Intôdy, Z; Modell, B

1993-01-01

OBJECTIVE--To estimate the proportion of preventable congenital abnormalities in Hungary. DESIGN--Analysis of available Hungarian data-bases and of the effectiveness of primary, secondary, and tertiary preventive methods. SETTING--Databases of ad hoc epidemiological studies and of the Hungarian congenital abnormality registry. MAIN OUTCOME MEASURES--Prevalence at birth and prevalence after prevention in 73 congenital abnormality types or groups. RESULTS--Preventive methods are available for 51 (70%) of the 73 congenital abnormality types or groups evaluated. The birth prevalence of all congenital abnormalities could be reduced from 65 to 26 per 1000; thus 39 per 1000 (60%) are preventable. Without congenital dislocation of the hip, which is unusually common in Hungary, the preventable proportion of congenital abnormalities is 52%. CONCLUSION--Many congenital abnormalities can be prevented, but as they do not represent a single pathological category there is no single strategy for their prevention. Images p502-a p503-a PMID:8448464

[Hazard assessment and occupational safety measures in surgery : Relevant knowledge on occupational medicine].

PubMed

Darius, S; Meyer, F; Böckelmann, I

2016-11-01

Surgeons routinely work in an environment with occupational risks and hazards about which they are often uninformed. Based on the currently available scientific literature this review article describes the various hazards in the operating theater and their effects on personnel, particularly from the surgical perspective. A further aim of this article is to describe the occupational safety measures to reduce the burdens and to maintain the long-term health of personnel. Ultimately, surgeons should be equipped with the necessary knowledge for implementing hazard assessments according to the German Occupational Health and Safety Act. Surgeons are exposed to increased risks and hazards by working in awkward positions with a high risk for musculoskeletal pain and injuries. They are also commonly exposed to inhalational anesthetics, surgical smoke, radiation, noise and infectious agents. Furthermore, the mental and emotional stress associated with these activities is also high. Meaningful occupational safety measures for reduction of burdens are from a technical aspect the installation of effective air extraction systems, measures to reduce exposure to radiation and noise and the use of safer instruments to prevent needle stick injuries. Furthermore, individual occupational safety measures, such as the use of personal protective equipment (e.g. radiation protective clothing and double gloves) must be observed. The consistent implementation and also adherence to these described occupational safety measures and regulations can reduce the burden on operating theater personnel and contribute to maintaining health. Furthermore, periodic preventive healthcare controls and health checks by the company medical officer and individually initiated additional prevention measures can be a sensible augmentation to these safety measures.

[Effects of prevention education on Human Papillomavirus linked to cervix cancer for unmarried female university students].

PubMed

Kim, Hae Won

2009-08-01

This study was done to identify the effects of a Human Papillomavirus (HPV) linked to cervix cancer prevention education program for unmarried university female students. A new model in the cervix cancer prevention is provided. The research design was a nonequivalent control group pretest-posttest design. Participants were 63 female students in one of two university in an experimental group (29 students) and control group (34 students). After 4 weeks education, the differences between the two groups in the measurement variables were compared. Twelve weeks later, a follow-up test was done for experimental group only. After the education, experimental group showed significantly higher scores in all variables, the intention for Pap test (Z=-3.73, p<.001), intention for HPV vaccination (Z=-3.14, p=.002), general cancer prevention behavior (Z=-2.20, p=.028), attitudes to Pap (Z=-3.23, p=.001), benefits of cancer prevention behavior (Z=-3.97, p<.001), and HPV linked to cervix cancer knowledge (Z=-5.40, p<.001). In the follow-up study, the experimental group showed intermediate effects in intention for Pap test, intention of HPV vaccination and HPV linked to cervix cancer knowledge as well as short term effects in general cancer prevention behavior, attitudes to Pap and benefits of cancer prevention behavior. The program developed for this study on prevention education of HPV linked to cervix cancer was effective for unmarried university students in the short term and intermediate duration. Other educational approaches should be developed and short term effects and longitudinal changes of the education should be assessed. This education program should also be replicated for other female groups including unmarried working women or female adolescents.

[EFFECTIVE EDUCATIONAL INTERVENTIONS IN HIV FOR WOMEN].

PubMed

Miner, Sarah; Poupin, Lauren; Bernales, Margarita; Ferrer, Lilian; Cianelli, Rosina

In Chile, it is estimated that over 38,000 people live with Human Immunodeficiency Virus [HIV]. In 2001, there were 1092 Chilean women living with HIV, and in 2006 there were 7,600, further affecting low income populations. These findings reveal the necessity to create prevention strategies directed towards Chilean women. the purpose of this revision is to analyze studies of prevention programs in HIV in order to determine what aspects should be included in successful HIV prevention programs with women. a literature review was carried out using searches done in the databases Proquest and CINAHL, Pubmed and Scielo. The search was limited by the criteria of full text only, within the last ten years and free access, written in Spanish or English. Fifteen articles were selected for the following revision. all of the selected articles measured the effect of an intervention on knowledge and behaviours related to HIV/AIDS. Fourteen articles produced significant changes in positive behaviours or knowledge related to the prevention of HIV. prevention programs in HIV with socially disadvantaged women can be effective in provoking changes in behaviours and knowledge associated with HIV. Successful interventions were those based on prevention theories or models of behavior change and adapted to the culture of the sample.

Education on tick bite and Lyme borreliosis prevention, aimed at schoolchildren in the Netherlands: comparing the effects of an online educational video game versus a leaflet or no intervention.

PubMed

Beaujean, D J M A; Gassner, F; Wong, A; Steenbergen, J E; Crutzen, R; Ruwaard, D

2016-11-16

Lyme disease or Lyme borreliosis (LB) is the most common tick-borne disease both in the United States and Europe. Children, in particular, are at high risk of contracting LB. Since child-specific educational tools on ticks, tick bites and LB are lacking, we developed an online educational video game. In this study, we compared the effectiveness of an online educational video game versus a newly developed leaflet aimed to improve prevention of tick bites and LB among Dutch schoolchildren. A total of 887 children, aged 9-13 years and attending the two final years of primary schooling, were recruited from 25 primary schools in June and July 2012. They were assigned through cluster randomization to one of three intervention groups: 'game' (22.4%), 'leaflet' (35.6%) or 'control' (41.9%). Prior to and directly following intervention, the children were asked to complete a short questionnaire. The main outcome measures were knowledge, perception (perceived susceptibility and importance) and preventive behavior in relation to tick bites and LB. Generalized linear mixed models were used to analyze the data. In the game group, the leaflet group and the control group, knowledge about ticks and tick bites improved significantly. The game was also an effective tool for improving preventive behavior; the frequency of checking for ticks increased significantly. However, there were no significant differences in knowledge improvement between the interventions. The game outperformed the leaflet in terms of improving preventive behavior, whereas the frequency of tick checks increased significantly. But this frequency didn't increase more than in the control group. The positive knowledge effects observed in the control group suggests the presence of a mere measurement effect related to completion of the questionnaire. The game did not outperform the leaflet or control group on all outcome measures. Therefore, the game may be of value as a complementary role, in addition to other media, in child-specific public health education programs on ticks and LB. This trial was retrospectively registered on October 21, 2016 (trial registration number: ISRCTN15142369).

Lung cancer deaths from indoor radon and the cost effectiveness and potential of policies to reduce them.

PubMed

Gray, Alastair; Read, Simon; McGale, Paul; Darby, Sarah

2009-01-06

To determine the number of deaths from lung cancer related to radon in the home and to explore the cost effectiveness of alternative policies to control indoor radon and their potential to reduce lung cancer mortality. Cost effectiveness analysis. United Kingdom. Epidemiological data on risks from indoor radon and from smoking, vital statistics on deaths from lung cancer, survey information on effectiveness and costs of radon prevention and remediation. Estimated number of deaths from lung cancer related to indoor radon, lifetime risks of death from lung cancer before and after various potential interventions to control radon, the cost per quality adjusted life year (QALY) gained from different policies for control of radon, and the potential of those policies to reduce lung cancer mortality. The mean radon concentration in UK homes is 21 becquerels per cubic metre (Bq/m(3)). Each year around 1100 deaths from lung cancer (3.3% of all deaths from lung cancer) are related to radon in the home. Over 85% of these arise from radon concentrations below 100 Bq/m(3) and most are caused jointly by radon and active smoking. Current policy requiring basic measures to prevent radon in new homes in selected areas is highly cost effective, and such measures would remain cost effective if extended to the entire UK, with a cost per QALY gained of pound11,400 ( euro12 200; $16,913). Current policy identifying and remediating existing homes with high radon levels is, however, neither cost effective (cost per QALY gained pound36,800) nor effective in reducing lung cancer mortality. Policies requiring basic preventive measures against radon in all new homes throughout the UK would be cost effective and could complement existing policies to reduce smoking. Policies involving remedial work on existing homes with high radon levels cannot prevent most radon related deaths, as these are caused by moderate exposure in many homes. These conclusions are likely to apply to most developed countries, many with higher mean radon concentrations than the UK.

Moldy buildings, health of their occupants and fungal prevention.

PubMed

Mihinova, D; Pieckova, E

2012-01-01

Microscopic fungi are important biological pollutants in the indoor environment, they are spread generally: on building materials, carpets, ceiling tiles, insulations, any surfaces, wallpapers, or in heating, ventilation, and air conditioning systems. Molds are able to grow on any materials, as long as moisture and oxygen are available. Exposure to fungi in indoor environments (esp. in water-damaged buildings) can cause adverse health effects, such as allergy, asthma, hypersensitivity pneumonia, mucous membrane irritation, different toxic effects, or even mycoses (in immunocompromised individuals) - alone or in combination. As serious adverse health effects could be caused antifungal prevention is an absolute need.This review article summarizes the occurrence of fungi in the indoor environment of buildings and their contribution to occupants´ health problems, and preventive measures against molds (Tab. 1, Fig. 1, Ref. 48).

Communicating the threat of emerging infections to the public.

PubMed Central

Freimuth, V.; Linnan, H. W.; Potter, P.

2000-01-01

Communication theory and techniques, aided by the electronic revolution, provide new opportunities and challenges for the effective transfer of laboratory, epidemiologic, surveillance, and other public health data to the public who funds them. We review the applicability of communication theory, particularly the audience-source-message-channel meta-model, to emerging infectious disease issues. Emergence of new infectious organisms, microbial resistance to therapeutic drugs, and increased emphasis on prevention have expanded the role of communication as a vital component of public health practice. In the absence of cure, as in AIDS and many other public health problems, an effectively crafted and disseminated prevention message is the key control measure. Applying communication theory to disease prevention messages can increase the effectiveness of the messages and improve public health. PMID:10905966

Advancing HIV/AIDS prevention among American Indians through capacity building and the community readiness model.

PubMed

Thurman, Pamela Jumper; Vernon, Irene S; Plested, Barbara

2007-01-01

Although HIV/AIDS prevention has presented challenges over the past 25 years, prevention does work! To be most effective, however, prevention must be specific to the culture and the nature of the community. Building the capacity of a community for prevention efforts is not an easy process. If capacity is to be sustained, it must be practical and utilize the resources that already exist in the community. Attitudes vary across communities; resources vary, political climates are constantly varied and changing. Communities are fluid-always changing, adapting, growing. They are "ready" for different things at different times. Readiness is a key issue! This article presents a model that has experienced a high level of success in building community capacity for effective prevention/intervention for HIV/AIDS and offers case studies for review. The Community Readiness Model provides both quantitative and qualitative information in a user-friendly structure that guides a community through the process of understanding the importance of the measure of readiness. The model identifies readiness- appropriate strategies, provides readiness scores for evaluation, and most important, involves community stakeholders in the process. The article will demonstrate the importance of developing strategies consistent with readiness levels for more cost-effective and successful prevention efforts.

Effects of complex interventions in 'skin cancer prevention and treatment': protocol for a mixed-method systematic review with qualitative comparative analysis.

PubMed

Beifus, Karolina; Breitbart, Eckhard; Köberlein-Neu, Juliane

2017-09-05

Occurring from ultraviolet radiation combined with impairing ozone levels, uncritical sun exposure and use of tanning beds an increasing number of people are affected by different types of skin cancer. But preventive interventions like skin cancer screening are still missing the evidence for effectiveness and therefore are criticised. Fundamental for an appropriate course of action is to approach the defined parameters as measures for effectiveness critically. A prerequisite should be the critical application of used parameter that are defined as measures for effectiveness. This research seeks to establish, through the available literature, the effects and conditions that prove the effectiveness of prevention strategies in skin cancer. A mixed-method approach is employed to combine quantitative to qualitative methods and answer what effects can display effectiveness considering time horizon, perspective and organisational level and what are essential and sufficient conditions to prove effectiveness and cost-effectiveness in skin cancer prevention strategies. A systematic review will be performed to spot studies from any design and assess the data quantitatively and qualitatively. Included studies from each key question will be summarised by characteristics like population, intervention, comparison, outcomes, study design, endpoints, effect estimator and so on. Beside statistical relevancies for a systematic review the qualitative method of qualitative comparative analysis (QCA) will be performed. The estimated outcomes from this review and QCA are the accomplishment and absence of effects that are appropriate for application in effectiveness assessments and further cost-effectiveness assessment. Formal ethical approval is not required as primary data will not be collected. International Prospective Register for Systematic Reviews number CRD42017053859. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ensuring Effective Prevention of Iodine Deficiency Disorders.

PubMed

Völzke, Henry; Caron, Philippe; Dahl, Lisbeth; de Castro, João J; Erlund, Iris; Gaberšček, Simona; Gunnarsdottir, Ingibjörg; Hubalewska-Dydejczyk, Alicja; Ittermann, Till; Ivanova, Ludmila; Karanfilski, Borislav; Khattak, Rehman M; Kusić, Zvonko; Laurberg, Peter; Lazarus, John H; Markou, Kostas B; Moreno-Reyes, Rodrigo; Nagy, Endre V; Peeters, Robin P; Pīrāgs, Valdis; Podoba, Ján; Rayman, Margaret P; Rochau, Ursula; Siebert, Uwe; Smyth, Peter P; Thuesen, Betina H; Troen, Aron; Vila, Lluís; Vitti, Paolo; Zamrazil, Vaclav; Zimmermann, Michael B

2016-02-01

Programs initiated to prevent iodine deficiency disorders (IDD) may not remain effective due to changes in government policies, commercial factors, and human behavior that may affect the efficacy of IDD prevention programs in unpredictable directions. Monitoring and outcome studies are needed to optimize the effectiveness of IDD prevention. Although the need for monitoring is compelling, the current reality in Europe is less than optimal. Regular and systematic monitoring surveys have only been established in a few countries, and comparability across the studies is hampered by the lack of centralized standardization procedures. In addition, data on outcomes and the cost of achieving them are needed in order to provide evidence of the beneficial effects of IDD prevention in countries with mild iodine deficiency. Monitoring studies can be optimized by including centralized standardization procedures that improve the comparison between studies. No study of iodine consumption can replace the direct measurement of health outcomes and the evaluation of the costs and benefits of the program. It is particularly important that health economic evaluation should be conducted in mildly iodine-deficient areas and that it should include populations from regions with different environmental, ethnic, and cultural backgrounds.

[Passive smoking--health consequences and effects of exposure prevention].

PubMed

Raupach, T; Radon, K; Nowak, D; Andreas, S

2008-01-01

Passive smoking is the third leading but preventable cause of death worldwide. It is associated with an elevated risk of developing acute respiratory diseases, obstructive lung disorders, lung cancer, and cardiovascular disease. Whereas the dose-response relationship between second-hand smoke exposure and respiratory diseases is likely to be linear, a non-linear dose-response curve has been observed with respect to acute cardiovascular events. This explains the disproportionately high risk of myocardial infarction among passive smokers as compared to unexposed individuals. Over the last ten years, exposure to second-hand smoke has declined in Germany, but it is still substantial. With passive smoking in the home being a difficult target for preventive measures, public smoking bans have recently been shown to greatly reduce second-hand smoke-related morbidity and mortality. In addition, such measures are usually well tolerated and highly relevant regarding legal aspects related to workplace issues. This article summarises the current evidence on the health consequences of passive smoking and on the favourable effects of public smoking bans.

Effectiveness Trial of Community-Based I Choose Life-Africa Human Immunodeficiency Virus Prevention Program in Kenya

PubMed Central

Adam, Mary B.

2014-01-01

We measured the effectiveness of a human immunodeficiency virus (HIV) prevention program developed in Kenya and carried out among university students. A total of 182 student volunteers were randomized into an intervention group who received a 32-hour training course as HIV prevention peer educators and a control group who received no training. Repeated measures assessed HIV-related attitudes, intentions, knowledge, and behaviors four times over six months. Data were analyzed by using linear mixed models to compare the rate of change on 13 dependent variables that examined sexual risk behavior. Based on multi-level models, the slope coefficients for four variables showed reliable change in the hoped for direction: abstinence from oral, vaginal, or anal sex in the last two months, condom attitudes, HIV testing, and refusal skill. The intervention demonstrated evidence of non-zero slope coefficients in the hoped for direction on 12 of 13 dependent variables. The intervention reduced sexual risk behavior. PMID:24957544

Effectiveness trial of community-based I Choose Life-Africa human immunodeficiency virus prevention program in Kenya.

PubMed

Adam, Mary B

2014-09-01

We measured the effectiveness of a human immunodeficiency virus (HIV) prevention program developed in Kenya and carried out among university students. A total of 182 student volunteers were randomized into an intervention group who received a 32-hour training course as HIV prevention peer educators and a control group who received no training. Repeated measures assessed HIV-related attitudes, intentions, knowledge, and behaviors four times over six months. Data were analyzed by using linear mixed models to compare the rate of change on 13 dependent variables that examined sexual risk behavior. Based on multi-level models, the slope coefficients for four variables showed reliable change in the hoped for direction: abstinence from oral, vaginal, or anal sex in the last two months, condom attitudes, HIV testing, and refusal skill. The intervention demonstrated evidence of non-zero slope coefficients in the hoped for direction on 12 of 13 dependent variables. The intervention reduced sexual risk behavior. © The American Society of Tropical Medicine and Hygiene.

Occupational hazards to health of port workers.

PubMed

Wang, Yukun; Zhan, Shuifen; Liu, Yan; Li, Yan

2017-12-01

The aim of this article is to reduce the risk of occupational hazards and improve safety conditions by enhancing hazard knowledge and identification as well as improving safety behavior for freight port enterprises. In the article, occupational hazards to health and their prevention measures of freight port enterprises have been summarized through a lot of occupational health evaluation work, experience and understanding. Workers of freight port enterprises confront an equally wide variety of chemical, physical and psychological hazards in production technology, production environment and the course of labor. Such health hazards have been identified, the risks evaluated, the dangers to health notified and effective prevention measures which should be put in place to ensure the health of the port workers summarized. There is still a long way to go for the freight port enterprises to prevent and control the occupational hazards. Except for occupational hazards and their prevention measures, other factors that influence the health of port workers should also be paid attention to, such as age, work history, gender, contraindication and even the occurrence and development rules of occupational hazards in current production conditions.

Effects of Chronic Social Stress and Maternal Intranasal Oxytocin and Vasopressin on Offspring Interferon-γ and Behavior

PubMed Central

Murgatroyd, Christopher A.; Hicks-Nelson, Alexandria; Fink, Alexandria; Beamer, Gillian; Gurel, Kursat; Elnady, Fawzy; Pittet, Florent; Nephew, Benjamin C.

2016-01-01

Recent studies support the hypothesis that the adverse effects of early-life adversity and transgenerational stress on neural plasticity and behavior are mediated by inflammation. The objective of the present study was to investigate the immune and behavioral programing effects of intranasal (IN) vasopressin (AVP) and oxytocin (OXT) treatment of chronic social stress (CSS)-exposed F1 dams on F2 juvenile female offspring. It was hypothesized that maternal AVP and OXT treatment would have preventative effects on social stress-induced deficits in offspring anxiety and social behavior and that these effects would be associated with changes in interferon-γ (IFNγ). Control and CSS-exposed F1 dams were administered IN saline, AVP, or OXT during lactation and the F2 juvenile female offspring were assessed for basal plasma IFNγ and perseverative, anxiety, and social behavior. CSS F2 female juvenile offspring had elevated IFNγ levels and exhibited increased repetitive/perseverative and anxiety behaviors and deficits in social behavior. These effects were modulated by AVP and OXT in a context- and behavior-dependent manner, with OXT exhibiting preventative effects on repetitive and anxiety behaviors and AVP possessing preventative effects on social behavior deficits and anxiety. Basal IFNγ levels were elevated in the F2 offspring of OXT-treated F1 dams, but IFNγ was not correlated with the behavioral effects. These results support the hypothesis that maternal AVP and OXT treatment have context- and behavior-specific effects on peripheral IFNγ levels and perseverative, anxiety, and social behaviors in the female offspring of early-life social stress-exposed dams. Both maternal AVP and OXT are effective at preventing social stress-induced increases in self-directed measures of anxiety, and AVP is particularly effective at preventing impairments in overall social contact. OXT is specifically effective at preventing repetitive/perseverative behaviors, yet is ineffective at preventing deficits in overall social behavior. PMID:28018290

[Medical and biological assessment of preventive drinks use among workers exposed to adverse working conditions].

PubMed

Nikanov, A N; Markova, O L; Frolova, N M; Kulikova, K S

2013-01-01

Studies on the assessment of the effect of treatment-and-preventive drinks, i.e. "Leovit" dietary kissels, and "Zosterin-Ultra" biologically active food additive, on copper, nickel and cobalt ion concentrations in urine and on lead blood concentrations in workers employed at the "Kola Mining Company" limited liability joint-stock company and exposed to long-term metal aerosol effects, were carried out. Dependence of ion concentrations of these metals in biological media on exposure duration was reported. The study findings reveal the advisability of use of the above-mentioned food additives, having detoxication properties, while carrying out preventive measures among workers exposed to heavy metals.

[Prevention of gastroesophageal reflux and aspiration in neonates by holding with hands immediately after delivery by cesarean section].

PubMed

Guo, Hui-Ping; Li, Hui; Guo, Jing; Li, Yan-Wen

2002-04-01

To evaluate the clinical effect of preventing gastroesophageal reflux (GER) and aspiration in neonates delivered by elective cesarean section with hand immediately after birth. On the basis of the principles for drowning resuscitation and evaluation of the principal factors causing GER and aspiration, the author adopted immediate manual management to promote emptying of gastroesophageal and airway contents in 496 newborns delivered by elective cesarean section. No GER and aspiration occurred in the babies receiving the management, and no complication was recorded. As an early preventive measure, manual management is effective in clearing gastroesophageal and airway contents against GER and aspiration, and Apgar scoring can be readily conducted.

Implementation of a guideline for pressure ulcer prevention in home care: pretest-post-test study.

PubMed

Paquay, Louis; Verstraete, Sabine; Wouters, Renild; Buntinx, Frank; Vanderwee, Katrien; Defloor, Tom; Van Gansbeke, Hendrik

2010-07-01

To investigate the effect of the implementation of a patient and family education programme for pressure ulcer prevention in an organisation for home care nursing on guideline adherence and on prevalence and severity of pressure ulcers and to examine the determining factors for the application of measures for pressure ulcer prevention. Quality improvement programmes in pressure ulcer prevention are not always successful. Implementation study using a pretest-post-test design. Data were collected in three probability samples. The first post-test data collection was held after six months, the second after 18 months. Statistical analysis was used, comparing the pretest sample and the second post-test sample. After 18 months, the proportion of subjects with adherent measures had increased from 10·4-13·9%, the proportion of subjects with non-adherent measures decreased from 45·7-36·0%, the proportion of subjects without pressure ulcer prevention increased from 43·9-50·1% (p<0·0001, Chi-square test). Sub-analysis revealed that a positive change in guideline adherence was observed principally in the group at risk. Better process-of-care indicators were associated by lower pressure ulcer prevalence and less severe skin lesions. The nurses' judgement of a patient risk status was the most important factor for applying preventive measures. Furthermore, application of pressure ulcer prevention was determined by higher age (from the age category of 70-79 years), higher dependency for the activities of daily living, higher than baseline mobility score and the presence of a pressure ulcer. Guideline adherence in pressure ulcer prevention changed significantly after implementation of the education programme. There might have been inconsistencies in the nurses' risk judgement. Quality of pressure ulcer prevention improved, but several items for improvement remain. Adaptation of risk assessment procedures is needed. © 2010 Blackwell Publishing Ltd.

Mediational Effects of Self-Efficacy Dimensions in the Relationship between Knowledge of Dengue and Dengue Preventive Behaviour with Respect to Control of Dengue Outbreaks: A Structural Equation Model of a Cross-Sectional Survey

PubMed Central

Isa, Affendi; Loke, Yoon K.; Smith, Jane R.; Papageorgiou, Alexia; Hunter, Paul R.

2013-01-01

Background Dengue fever is endemic in Malaysia, with frequent major outbreaks in urban areas. The major control strategy relies on health promotional campaigns aimed at encouraging people to reduce mosquito breeding sites close to people's homes. However, such campaigns have not always been 100% effective. The concept of self-efficacy is an area of increasing research interest in understanding how health promotion can be most effective. This paper reports on a study of the impact of self-efficacy on dengue knowledge and dengue preventive behaviour. Methods and Findings We recruited 280 adults from 27 post-outbreak villages in the state of Terengganu, east coast of Malaysia. Measures of health promotion and educational intervention activities and types of communication during outbreak, level of dengue knowledge, level and strength of self-efficacy and dengue preventive behaviour were obtained via face-to-face interviews and questionnaires. A structural equation model was tested and fitted the data well (χ2 = 71.659, df = 40, p = 0.002, RMSEA = 0.053, CFI = 0.973, TLI = 0.963). Mass media, local contact and direct information-giving sessions significantly predicted level of knowledge of dengue. Level and strength of self-efficacy fully mediated the relationship between knowledge of dengue and dengue preventive behaviours. Strength of self-efficacy acted as partial mediator in the relationship between knowledge of dengue and dengue preventive behaviours. Conclusions To control and prevent dengue outbreaks by behavioural measures, health promotion and educational interventions during outbreaks should now focus on those approaches that are most likely to increase the level and strength of self-efficacy. PMID:24086777

Mechanism of aquaporin 4 (AQP 4) up-regulation in rat cerebral edema under hypobaric hypoxia and the preventative effect of puerarin.

PubMed

Wang, Chi; Yan, Muyang; Jiang, Hui; Wang, Qi; He, Shang; Chen, Jingwen; Wang, Chengbin

2018-01-15

We aim to investigate the mechanism of aquaporin 4 (AQP 4) up-regulation during high-altitude cerebral edema (HACE) in rats under hypobaric hypoxia and preventative effect of puerarin. Rats were exposed to a hypobaric chamber with or without the preventative treatment of puerarin or dexamethasone. Morriz water maze was used to evaluate the spatial memory injury. HE staining and W/D ratio were used to evaluate edema injury. Rat astrocytes and microglia were co-cultured under the condition of hypoxia with the administration of p38 inhibitor, NF-κB inhibitor or puerarin. Interleukin 6 (IL-6) and tumor necrosis factor α (TNF α) of cortex and culture supernatant were measured with ELISA. AQP4, phosphorylation of MAPKs, NF-κB pathway of cortex and astrocytes were measured by Western blot. Weakened spatial memory and cerebral edema were observed after hypobaric hypoxia exposure. AQP4, phosphorylation of NF-κB and MAPK signal pathway of cortex increased after hypoxia exposure and decreased with preventative treatment of puerarin. Hypoxia increased TNF-α and IL-6 levels in cortex and microglia and puerarin could prevent the increase of them. AQP4 of astrocytes increased after co-cultured with microglia when both were exposed to hypoxia. AQP4 showed a decrease after administered with p38 inhibitor, NF-κB inhibitor or puerarin. Hypoxia triggers inflammatory response, during which AQP4 of astrocytes can be up regulated through the release of TNF-α and IL-6 from microglia. Puerarin can exert a preventative effect on the increase of AQP4 through inhibiting the release of TNF-α and phosphorylation of NF-κB, MAPK pathway. Copyright © 2017 Elsevier Inc. All rights reserved.

Mediational effects of self-efficacy dimensions in the relationship between knowledge of dengue and dengue preventive behaviour with respect to control of dengue outbreaks: a structural equation model of a cross-sectional survey.

PubMed

Isa, Affendi; Loke, Yoon K; Smith, Jane R; Papageorgiou, Alexia; Hunter, Paul R

2013-01-01

Dengue fever is endemic in Malaysia, with frequent major outbreaks in urban areas. The major control strategy relies on health promotional campaigns aimed at encouraging people to reduce mosquito breeding sites close to people's homes. However, such campaigns have not always been 100% effective. The concept of self-efficacy is an area of increasing research interest in understanding how health promotion can be most effective. This paper reports on a study of the impact of self-efficacy on dengue knowledge and dengue preventive behaviour. We recruited 280 adults from 27 post-outbreak villages in the state of Terengganu, east coast of Malaysia. Measures of health promotion and educational intervention activities and types of communication during outbreak, level of dengue knowledge, level and strength of self-efficacy and dengue preventive behaviour were obtained via face-to-face interviews and questionnaires. A structural equation model was tested and fitted the data well (χ(2) = 71.659, df = 40, p = 0.002, RMSEA = 0.053, CFI = 0.973, TLI = 0.963). Mass media, local contact and direct information-giving sessions significantly predicted level of knowledge of dengue. Level and strength of self-efficacy fully mediated the relationship between knowledge of dengue and dengue preventive behaviours. Strength of self-efficacy acted as partial mediator in the relationship between knowledge of dengue and dengue preventive behaviours. To control and prevent dengue outbreaks by behavioural measures, health promotion and educational interventions during outbreaks should now focus on those approaches that are most likely to increase the level and strength of self-efficacy.

An Evaluation of Two Dating Violence Prevention Programs on a College Campus.

PubMed

Peterson, Kerry; Sharps, Phyllis; Banyard, Victoria; Powers, Ráchael A; Kaukinen, Catherine; Gross, Deborah; Decker, Michele R; Baatz, Carrie; Campbell, Jacquelyn

2016-03-13

Dating violence is a serious and prevalent public health problem that is associated with numerous negative physical and psychological health outcomes, and yet there has been limited evaluation of prevention programs on college campuses. A recent innovation in campus prevention focuses on mobilizing bystanders to take action. To date, bystander programs have mainly been compared with no treatment control groups raising questions about what value is added to dating violence prevention by focusing on bystanders. This study compared a single 90-min bystander education program for dating violence prevention with a traditional awareness education program, as well as with a no education control group. Using a quasi-experimental pre-test/post-test design with follow-up at 2 months, a sample of predominately freshmen college students was randomized to either the bystander (n = 369) or traditional awareness (n = 376) dating violence education program. A non-randomized control group of freshmen students who did not receive any education were also surveyed (n = 224). Students completed measures of attitudes, including rape myth acceptance, bystander efficacy, and intent to help as well as behavioral measures related to bystander action and victimization. Results showed that the bystander education program was more effective at changing attitudes, beliefs, efficacy, intentions, and self-reported behaviors compared with the traditional awareness education program. Both programs were significantly more effective than no education. The findings of this study have important implications for future dating violence prevention educational programming, emphasizing the value of bystander education programs for primary dating violence prevention among college students. © The Author(s) 2016.

A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries.

PubMed

Liu, Liang Qin; Moody, Julie; Traynor, Michael; Dyson, Sue; Gall, Angela

2014-11-01

Electrical stimulation (ES) can confer benefit to pressure ulcer (PU) prevention and treatment in spinal cord injuries (SCIs). However, clinical guidelines regarding the use of ES for PU management in SCI remain limited. To critically appraise and synthesize the research evidence on ES for PU prevention and treatment in SCI. Review was limited to peer-reviewed studies published in English from 1970 to July 2013. Studies included randomized controlled trials (RCTs), non-RCTs, prospective cohort studies, case series, case control, and case report studies. Target population included adults with SCI. Interventions of any type of ES were accepted. Any outcome measuring effectiveness of PU prevention and treatment was included. Methodological quality was evaluated using established instruments. Twenty-seven studies were included, 9 of 27 studies were RCTs. Six RCTs were therapeutic trials. ES enhanced PU healing in all 11 therapeutic studies. Two types of ES modalities were identified in therapeutic studies (surface electrodes, anal probe), four types of modalities in preventive studies (surface electrodes, ES shorts, sacral anterior nerve root implant, neuromuscular ES implant). The methodological quality of the studies was poor, in particular for prevention studies. A significant effect of ES on enhancement of PU healing is shown in limited Grade I evidence. The great variability in ES parameters, stimulating locations, and outcome measure leads to an inability to advocate any one standard approach for PU therapy or prevention. Future research is suggested to improve the design of ES devices, standardize ES parameters, and conduct more rigorous trials.

A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries

PubMed Central

Liu, Liang Qin; Moody, Julie; Traynor, Michael; Dyson, Sue; Gall, Angela

2014-01-01

Context Electrical stimulation (ES) can confer benefit to pressure ulcer (PU) prevention and treatment in spinal cord injuries (SCIs). However, clinical guidelines regarding the use of ES for PU management in SCI remain limited. Objectives To critically appraise and synthesize the research evidence on ES for PU prevention and treatment in SCI. Method Review was limited to peer-reviewed studies published in English from 1970 to July 2013. Studies included randomized controlled trials (RCTs), non-RCTs, prospective cohort studies, case series, case control, and case report studies. Target population included adults with SCI. Interventions of any type of ES were accepted. Any outcome measuring effectiveness of PU prevention and treatment was included. Methodological quality was evaluated using established instruments. Results Twenty-seven studies were included, 9 of 27 studies were RCTs. Six RCTs were therapeutic trials. ES enhanced PU healing in all 11 therapeutic studies. Two types of ES modalities were identified in therapeutic studies (surface electrodes, anal probe), four types of modalities in preventive studies (surface electrodes, ES shorts, sacral anterior nerve root implant, neuromuscular ES implant). Conclusion The methodological quality of the studies was poor, in particular for prevention studies. A significant effect of ES on enhancement of PU healing is shown in limited Grade I evidence. The great variability in ES parameters, stimulating locations, and outcome measure leads to an inability to advocate any one standard approach for PU therapy or prevention. Future research is suggested to improve the design of ES devices, standardize ES parameters, and conduct more rigorous trials. PMID:24969965

Successful factors to prevent pressure ulcers - an interview study.

PubMed

Hommel, Ami; Gunningberg, Lena; Idvall, Ewa; Bååth, Carina

2017-01-01

To explore successful factors to prevent pressure ulcers in hospital settings. Pressure ulcer prevalence has been recognised as a quality indicator for both patient safety and quality of care in hospital and community settings. Most pressure ulcer can be prevented if effective measures are implemented and evaluated. The Swedish Association of Local Authorities and Regions initiated nationwide pressure ulcer prevalence studies in 2011. In 2014, after four years of measurement, the prevalence was still unacceptably high on a national level. The mean prevalence of pressure ulcer in the spring of 2014 was 14% in hospital settings with a range from 2·7-36·4%. Qualitative semistructured interviews were conducted. A qualitative content analysis, in addition to Promoting Action on Research Implementation in Health Services frameworks, was used in the analysis of the data text. Individual interviews and focus groups were used to create opportunities for both individual responses and group interactions. The study was conducted at six hospitals during the fall of 2014. Three main categories were identified as successful factors to prevent pressure ulcer in hospitals: creating a good organisation, maintaining persistent awareness and realising the benefits for patients. The goal for all healthcare personnel must be delivering high-quality, sustainable care to patients. Prevention of pressure ulcer is crucial in this work. It seems to be easier for small hospitals (with a low number of units/beds) to develop and sustain an effective organisation in prevention work. The nurse managers' attitude and engagement are crucial to enable the personnel to work actively with pressure ulcer prevention. Strategies are proposed to advance clinical leadership, knowledge, skills and abilities for the crucial implementation of pressure ulcer prevention. © 2016 John Wiley & Sons Ltd.

Prevention of infectious diseases in aquaculture

USGS Publications Warehouse

Ahne, W.; Winton, J.R.; Kimura, T.

1989-01-01

Infectious diseases remain one of the most important limitations to the successful propagation of aquatic animals. Most of the losses caused by pathogens in aquaculture could be prevented by health inspection, adequate environment and sound management practices. Effective control measures, mainly based upon 1) avoidance of pathogens 2) modification of the environment 3) improvement of host resistance 4) vaccination and 5) chemoprophylaxis are described.

Exposure with response prevention versus habit reversal in Tourettes's syndrome: a controlled study.

PubMed

Verdellen, Cara W J; Keijsers, Ger P J; Cath, Danielle C; Hoogduin, Cees A L

2004-05-01

The intentional nature of tics provides the opportunity to apply behavioural interventions aimed at tic reduction through interruption of stimulus-response sequences. The aim of this study has been to evaluate the effect of exposure and response prevention (ER) versus habit reversal (HR) in 43 Tourette's syndrome (TS) patients. The three outcome measures were: the Yale Global Tic Severity Scale (YGTSS), 15-min tic frequency registrations monitored at the institute and 15-min home tic frequency registrations. Both treatment conditions resulted in statistically significant improvements on all outcome measures (p < 0.001). No significant differences were found between the treatment conditions on any of the outcome measures, although there was a tendency in favour of ER on the YGTSS (p = 0.05). These results suggest that, at least in the short term, TS tic symptoms can be treated effectively with both types of treatment.

Primary prevention of dental erosion by calcium and fluoride: a systematic review.

PubMed

Zini, A; Krivoroutski, Y; Vered, Y

2014-02-01

Overviews of the current literature only provide summaries of existing relevant preventive strategies for dental erosion. To perform a systematic review according to the quantitative meta-analysis method of the scientific literature on prevention of dental erosion. The focused question will address primary prevention of dental erosion by calcium and fluoride. Randomized clinical trials (RCTs) regarding dental erosion prevention. The search included five databases: Embase, Cochrane database of systematic reviews, PubMed (MEDLINE), FDA publication and Berman medical library of the Hebrew University. The search included data in the English language, with effect on preventing dental erosion always presented as mean enamel loss and measured by profilometer. Statistical meta-analysis was performed by StatsDirect program and PEPI statistical software. Fixed- and random-effect models were used to analyse the data. Heterogeneity tests were employed to validate the fixed-effect model assumption. A total of 475 articles on dental erosion prevention were located. A four-stage selection process was employed, and 10 RCT articles were found to be suitable for meta-analysis. The number of studies on prevention of dental erosion maintaining standards of evidence-based dentistry remains insufficient to reach any definite conclusions. The focused questions of this review cannot be addressed according to the existing literature. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Measure for Evaluating the Effectiveness of Teen Pregnancy Prevention Programs.

ERIC Educational Resources Information Center

Somers, Cheryl L.; Johnson, Stephanie A.; Sawilowksy, Shlomo S.

2002-01-01

The Teen Attitude Pregnancy Scale (TAPS) was developed to measure teen attitudes and intentions regarding teenage pregnancy. The model demonstrated good internal consistency and concurrent validity for the samples in this study. Analysis revealed evidence of validity for this model. (JDM)

Implementation of electronic medical records

PubMed Central

Greiver, Michelle; Barnsley, Jan; Glazier, Richard H.; Moineddin, Rahim; Harvey, Bart J.

2011-01-01

Abstract Objective To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario’s pay-for-performance program. Design Prospective double-cohort study. Participants Twenty-seven community-based family physicians. Setting Toronto, Ont. Intervention Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records. Main outcome measure Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation. Results After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval −2.8 to 3.9). Conclusion When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied. PMID:21998246

Cholera: foodborne transmission and its prevention.

PubMed

Estrada-García, T; Mintz, E D

1996-10-01

The last several years have witnessed a tremendous increase in reported cholera cases across the globe. The explosive arrival of the seventh cholera pandemic in Latin American in 1991, dramatic epidemics of cholera on the Indian subcontinent and in Southeast Asia due to the newly recognized Vibrio cholerae O139 strain, and the often deadly presence of cholera among populations affected by political and social upheaval in Africa and Eastern Europe are evidence that many countries have failed to adopt effective measures for cholera prevention and control. Foodborne transmission of cholera has been well documented by epidemiologic investigations in nearly every continent, and its interruption is a critical component to any integrated programme for cholera prevention and control. We emphasize clear and effective guidelines for the prevention of foodborne cholera transmission that are drawn from a comprehensive review of relevant epidemiologic and laboratory data.

Interventions for preventing eating disorders in children and adolescents.

PubMed

Pratt, B M; Woolfenden, S R

2002-01-01

Eating disorders represent an extremely difficult condition to treat and patients consume an enormous amount of mental health energy and resources. Being young, female, and dieting are some of the few identified risk factors that have been reliably linked to the development of eating disorders, and several prevention eating disorder prevention programs have been developed and trialed with children and adolescents. The purpose of this systematic review is to evaluate the effectiveness of eating disorder prevention programs for children and adolescents both in the general population and those determined to be at risk. 1. To determine if eating disorder prevention programs are effective in promoting healthy eating attitudes and behaviours in children and adolescents; 2. To determine if eating disorder prevention programs are effective in promoting psychological factors that protect children and adolescents from developing eating disorders; 3. To determine if eating disorder prevention programs are effective in promoting satisfactory physical health in children and adolescents; 4. To determine if eating disorder prevention programs have a long-term, sustainable, and positive impact on the mental and physical health of children and adolescents; and, 5. To determine the safety of eating disorder prevention programs in terms of possible harmful consequences on the mental or physical health of children and adolescents. Relevant trials are identified through searching the Cochrane Controlled Trial Register (CCTR) and relevant biomedical and social science databases. All terms necessary to detect prevention programs and the participant groups are used. A strategy to locate randomised controlled trials is used. Other sources of information are the bibliographies of systematic and non-systematic reviews and reference lists from articles identified through the search strategy. In order to identify unpublished studies, experts in the field are contacted by letter and/or electronic mail. Randomised controlled trials (RCT) with a major focus on eating disorder prevention programs for children and adolescents, where there is no known DSM-IV diagnosis of an eating disorder, are eligible for inclusion in the review. Trials must include a control group and at least one objective outcome measure (eg. BMI) or a standardised psychological measure used with the intervention and control group, pre- and post-intervention. A total of 1379 titles have been identified through the search to date. 13 studies were located that reported use of a randomised controlled trial methodology and were critically appraised by two independent reviewers. Five (5) studies were excluded as data were not reported in a useable form or useable data could not be obtained from the trial authors, one dissertation could not be obtained, one study had no "true" no-treatment or usual treatment control group, and one study did not use a pre-test outcome measure. Eight (8) studies met the selection criteria outlined above. Only one of eight pooled comparisons of two or more studies using similar outcome measures and similar intervention types demonstrated the statistically significant effect of a particular type of eating disorder prevention program for children and adolescents. Combined data from two eating disorder prevention programs based on a media literacy and advocacy approach indicate a reduction in the internalisation or acceptance of societal ideals relating to appearance at a 3- to 6-month follow-up (Kusel, unpublished; Neumark-Sztainer2000) [SMD -0.28, -0.51 to -0.05, 95% CI]. However, there is insufficient evidence to conclude that this approach also demonstrated a significant impact on awareness of societal standards relating to appearance. There is insufficient evidence to support the effect of four programs designed to address eating attitudes and behaviours and other adolescent issues on body weight, eating disorder symptoms, associated eating disorder psychopathology or general psychological and physical well-being in the general sample or those classified as being at high risk for eating disorder (Buddeberg-F 1998; Killen 1993/1996; Santonastaso 1999; Zanetti 1999). Given only one program used a psychoeducation approach to prevent bulimia nervosa (Jerome, unpublished) and only one program adopted a focus on self-esteem (O'Dea 2000), the effect of these approaches could not be evaluated via meta-analyses. In relation to potential harmful effects, there is not sufficient evidence to suggest that harm resulted from any of the prevention programs included in the review. The one significant pooled effect in the current review does not allow for any firm conclusions to be made about the impact of prevention programs for eating disorders in children and adolescents, although none of the pooled comparisons indicated evidence of harm. From a clinical perspective, the development and refinement of prevention programs is complicated by a lack of knowledge about risk factors associated with eating disorders and the need to strike a balance between delivering preventive interventions for eating disorders and considering the potential to cause harm. From a research perspective, the idea of "thresholds" for identifying young people at risk of developing eating disorders has been raised, and denial of concern or denial of illness represents a further issue complicating early identification in relation to eating disorder symptomatology. Longer-term effects of the intervention approaches will need to be monitored across development in order to demonstrate a decline in the incidence of eating disorders and associated risk factors.

Analysis of waste hierarchy in the European waste directive 2008/98/EC.

PubMed

Gharfalkar, Mangesh; Court, Richard; Campbell, Callum; Ali, Zulfiqur; Hillier, Graham

2015-05-01

Loss of recoverable resources in linear resource flow systems is likely to contribute to the depletion of natural resources and environmental degradation. The 'waste hierarchy' in the European Commission's latest Waste Framework Directive 2008/98/EC (WFD2008) makes recommendations on how to address this issue. The WFD2008 is analysed in this work for its adequacy in ensuring return of 'recoverable waste' as a 'resource' into the productive system. Despite the release of guidance documents by the DG Environment, DEFRA and WRAP UK on the interpretation of key provisions of the WFD2008, lack of clarity still exists around the WFD2008 'waste hierarchy'. There is also an overlap between measures such as 'prevention' and 'reduction', 'preparing for reuse' and 'reuse' and lack of clarity on why the measure of 'reuse' is included in the WFD2008 definition of 'prevention'. Finally, absence of the measures of 'recovery' and 'reuse' from the WFD2008 'waste hierarchy' reduces its effectiveness as a resource efficiency tool. Without clarity on the WFD2008 'waste hierarchy', it is challenging for decision makers to take direct action to address inefficiencies existing within their operations or supply chains. This paper proposes the development of an alternative 'hierarchy of resource use' and alternative 'definitions' that attempt to fill identified gaps in the WFD2008 and bring clarity to the key measures of waste prevention, reduction and recovery. This would help the key stakeholders in driving resource effectiveness, which in turn would assist in conservation of natural resources and prevention of environmental degradation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Efficacy of homocysteine lowering therapy with folic acid in stroke prevention: a meta-analysis

PubMed Central

Lee, Meng; Hong, Keun-Sik; Chang, Shen-Chih; Saver, Jeffrey L.

2010-01-01

Background and Purpose Although lower serum homocysteine concentration is associated with a reduced risk of stroke in epidemiologic studies, randomized controlled trials (RCTs) have yielded mixed findings regarding the effect of therapeutic homocysteine lowering on stroke prevention. We performed a meta-analysis of RCTs to assess the efficacy of folic acid supplementation in the prevention of stroke. Methods Salient trials were identified by formal literature search. Relative risk (RR) with 95% confidence interval (CI) was used as a measure of the association between folic acid supplementation and risk of stroke, pooling data across trials using a fixed-effects model. Results The search identified 13 RCTs of folic acid therapy to reduce homocysteine, enrolling 39,005 participants, in which stroke was reported as an outcome measure. Across all trials, folic acid supplementation was associated with a trend toward mild benefit that did not reach statistical significance in reducing the risk of stroke (RR 0.93, 95% CI 0.85-1.03; p=0.16). The RR for non-secondary prevention trials was 0.89 (95% CI 0.79-0.99; p=0.03). In stratified analyses, a greater beneficial effect was seen in the trials testing combination therapy of folic acid plus vitamins B6 and B12 (RR 0.83, 0.71-0.97; p=0.02) and in the trials which disproportionately enrolled male patients (men/women > 2, RR 0.84, 0.74-0.94; p=0.003). Conclusions Folic acid supplementation did not demonstrate a major effect in averting stroke. However, potential mild benefits in primary stroke prevention, especially when folate is combined with B vitamins and in male patients, merit further investigation. PMID:20413740

Stress-induced structural remodeling in hippocampus: Prevention by lithium treatment

NASA Astrophysics Data System (ADS)

Wood, Gwendolyn E.; Young, L. Trevor; Reagan, Lawrence P.; Chen, Biao; McEwen, Bruce S.

2004-03-01

Chronic restraint stress, psychosocial stress, as well as systemic or oral administration of the stress-hormone corticosterone induces a morphological reorganization in the rat hippocampus, in which adrenal steroids and excitatory amino acids mediate a reversible remodeling of apical dendrites on CA3 pyramidal cell neurons of the hippocampus. This stress-induced neuronal remodeling is accompanied also by behavioral changes, some of which can be prevented with selective antidepressant and anticonvulsive drug treatments. Lithium is an effective treatment for mood disorders and has neuroprotective effects, which may contribute to its therapeutic properties. Thus, we wanted to determine whether lithium treatment could prevent the effects of chronic stress on CA3 pyramidal cell neuroarchitecture and the associated molecular and behavioral measures. Chronic lithium treatment prevented the stress-induced decrease in dendritic length, as well as the stress-induced increase in glial glutamate transporter 1 (GLT-1) mRNA expression and the phosphorylation of cAMP-response element binding in the hippocampus. Lithium treatment, however, did not prevent stress effects on behavior in the open field or the plus-maze. These data demonstrate that chronic treatment with lithium can protect the hippocampus from potentially deleterious effects of chronic stress on glutamatergic activation, which may be relevant to its therapeutic efficacy in the treatment of major depressive disorder and bipolar disorder.

From Brochures to Videos to Counseling: Exposure to HIV-Prevention Programs

PubMed Central

Albarracín, Dolores; Leeper, Joshua; Earl, Allison; Durantini, Marta R.

2013-01-01

This research tested the prediction that reading a preventive brochure leads people to watch a preventive video, and that watching this video in turn leads to an increase in the likelihood of participating in a preventive counseling session. A sample of men and women from a southeastern community in the United States was recruited for a general health survey with the objective of examining participation in HIV-prevention interventions. Unobtrusive measures of exposure to HIV-prevention brochures, an HIV-prevention video, and an HIV-prevention counseling session were obtained. Findings indicated that reading the brochures increased watching the video and that watching the video increased participation in the counseling session. The association between exposure to the video and exposure to the counseling was mediated by expectations that the counseling would be useful. Findings are discussed in terms of the need to ensure exposure to interventions to achieve intervention effectiveness. PMID:17985230

The impact of automation on workload and dispensing errors in a hospital pharmacy.

PubMed

James, K Lynette; Barlow, Dave; Bithell, Anne; Hiom, Sarah; Lord, Sue; Pollard, Mike; Roberts, Dave; Way, Cheryl; Whittlesea, Cate

2013-04-01

To determine the effect of installing an original-pack automated dispensing system (ADS) on dispensary workload and prevented dispensing incidents in a hospital pharmacy. Data on dispensary workload and prevented dispensing incidents, defined as dispensing errors detected and reported before medication had left the pharmacy, were collected over 6 weeks at a National Health Service hospital in Wales before and after the installation of an ADS. Workload was measured by non-participant observation using the event recording technique. Prevented dispensing incidents were self-reported by pharmacy staff on standardised forms. Median workloads (measured as items dispensed/person/hour) were compared using Mann-Whitney U tests and rate of prevented dispensing incidents were compared using Chi-square test. Spearman's rank correlation was used to examine the association between workload and prevented dispensing incidents. A P value of ≤0.05 was considered statistically significant. Median dispensary workload was significantly lower pre-automation (9.20 items/person/h) compared to post-automation (13.17 items/person/h, P < 0.001). Rate of prevented dispensing incidents was significantly lower post-automation (0.28%) than pre-automation (0.64%, P < 0.0001) but there was no difference (P = 0.277) between the types of dispensing incidents. A positive association existed between workload and prevented dispensing incidents both pre- (ρ = 0.13, P = 0.015) and post-automation (ρ = 0.23, P < 0.001). Dispensing incidents were found to occur during prolonged periods of moderate workload or after a busy period. Study findings suggest that automation improves dispensing efficiency and reduces the rate of prevented dispensing incidents. It is proposed that prevented dispensing incidents frequently occurred during periods of high workload due to involuntary automaticity. Prevented dispensing incidents occurring after a busy period were attributed to staff experiencing fatigue after-effects. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial.

PubMed

Fernández, Anna; Mendive, Juan M; Conejo-Cerón, Sonia; Moreno-Peral, Patricia; King, Michael; Nazareth, Irwin; Martín-Pérez, Carlos; Fernández-Alonso, Carmen; Rodríguez-Bayón, Antonina; Aiarzaguena, Jose Maria; Montón-Franco, Carmen; Serrano-Blanco, Antoni; Ibañez-Casas, Inmaculada; Rodríguez-Sánchez, Emiliano; Salvador-Carulla, Luis; Garay, Paola Bully; Ballesta-Rodríguez, María Isabel; LaFuente, Pilar; Del Mar Muñoz-García, María; Mínguez-Gonzalo, Pilar; Araujo, Luz; Palao, Diego; Gómez, María Cruz; Zubiaga, Fernando; Navas-Campaña, Desirée; Aranda-Regules, Jose Manuel; Rodriguez-Morejón, Alberto; de Dios Luna, Juan; Bellón, Juan Ángel

2018-02-23

Depression is viewed as a major and increasing public health issue, as it causes high distress in the people experiencing it and considerable financial costs to society. Efforts are being made to reduce this burden by preventing depression. A critical component of this strategy is the ability to assess the individual level and profile of risk for the development of major depression. This paper presents the cost-effectiveness of a personalized intervention based on the risk of developing depression carried out in primary care, compared with usual care. Cost-effectiveness analyses are nested within a multicentre, clustered, randomized controlled trial of a personalized intervention to prevent depression. The study was carried out in 70 primary care centres from seven cities in Spain. Two general practitioners (GPs) were randomly sampled from those prepared to participate in each centre (i.e. 140 GPs), and 3326 participants consented and were eligible to participate. The intervention included the GP communicating to the patient his/her individual risk for depression and personal risk factors and the construction by both GPs and patients of a psychosocial programme tailored to prevent depression. In addition, GPs carried out measures to activate and empower the patients, who also received a leaflet about preventing depression. GPs were trained in a 10- to 15-h workshop. Costs were measured from a societal and National Health care perspective. Qualityadjustedlife years were assessed using the EuroQOL five dimensions questionnaire. The time horizon was 18 months. With a willingness-to-pay threshold of €10,000 (£8568) the probability of cost-effectiveness oscillated from 83% (societal perspective) to 89% (health perspective). If the threshold was increased to €30,000 (£25,704), the probability of being considered cost-effective was 94% (societal perspective) and 96%, respectively (health perspective). The sensitivity analysis confirmed these results. Compared with usual care, an intervention based on personal predictors of risk of depression implemented by GPs is a cost-effective strategy to prevent depression. This type of personalized intervention in primary care should be further developed and evaluated. ClinicalTrials.gov, NCT01151982. Registered on June 29, 2010.

Rationale and design of the PREDICE project: cost-effectiveness of type 2 diabetes prevention among high-risk Spanish individuals following lifestyle intervention in real-life primary care setting.

PubMed

Costa, Bernardo; Cabré, Joan J; Sagarra, Ramon; Solà-Morales, Oriol; Barrio, Francisco; Piñol, Josep L; Cos, Xavier; Bolíbar, Bonaventura; Castell, Conxa; Kissimova-Skarbek, Katarzyna; Tuomilehto, Jaakko

2011-08-04

Type 2 diabetes is an important preventable disease and a growing public health problem. Based on information provided by clinical trials, we know that Type 2 diabetes can be prevented or delayed by lifestyle intervention. In view of translating the findings of diabetes prevention research into real-life it is necessary to carry out community-based evaluations so as to learn about the feasibility and effectiveness of locally designed and implemented programmes. The aim of this project was to assess the effectiveness of an active real-life primary care strategy in high-risk individuals for developing diabetes, and then evaluate its efficiency. Cost-Effectiveness analysis of the DE-PLAN (Diabetes in Europe - Prevention using Lifestyle, physical Activity and Nutritional intervention) project when applied to a Mediterranean population in Catalonia (DE-PLAN-CAT). Multicenter, longitudinal cohort assessment (4 years) conducted in 18 primary health-care centres (Catalan Health Institute). Individuals without diabetes aged 45-75 years were screened using the Finnish Diabetes Risk Score - FINDRISC - questionnaire and a 2-h oral glucose tolerance test. All high risk tested individuals were invited to participate in either a usual care intervention (information on diet and cardiovascular health without individualized programme), or the intensive DE-PLAN educational program (individualized or group) periodically reinforced. Oral glucose tolerance test was repeated yearly to determine diabetes incidence. Besides measuring the accumulated incidence of diabetes, information was collected on economic impact of the interventions in both cohorts (using direct and indirect cost questionnaires) and information on utility measures (Quality Adjusted Life Years). A cost-utility and a cost-effectiveness analysis will be performed and data will be modelled to predict long-term cost-effectiveness. The project was intended to evidence that a substantial reduction in Type 2 diabetes incidence can be obtained at a reasonable cost-effectiveness ratio in real-life primary health care setting by an intensive lifestyle intervention. As far as we know, the DE-PLAN-CAT/PREDICE project represents the first assessment of long-term effectiveness and cost-effectiveness of a public healthcare strategy to prevent diabetes within a European primary care setting.

Ankles back in randomized controlled trial (ABrCt): braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial.

PubMed

Janssen, Kasper W; van Mechelen, Willem; Verhagen, Evert Alm

2011-09-27

Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training) against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care. This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention. The ABrCt is the first randomized controlled trial to directly compare the secondary preventive effect of the combined use of braces and neuromuscular training, against the use of either braces or neuromuscular training as separate secondary preventive measures. This study expects to identify the most effective and cost-efficient secondary preventive measure for ankle sprains. The study results could lead to changes in the clinical guidelines on the prevention of ankle sprains, and they will become available in 2012. Netherlands Trial Register (NTR): NTR2157.

The effect of oral rehydration solution and recommended home fluids on diarrhoea mortality

PubMed Central

Munos, Melinda K.; Walker, Christa L Fischer; Black, Robert E

2010-01-01

Background Most diarrhoeal deaths can be prevented through the prevention and treatment of dehydration. Oral rehydration solution (ORS) and recommended home fluids (RHFs) have been recommended since 1970s and 1980s to prevent and treat diarrhoeal dehydration. We sought to estimate the effects of these interventions on diarrhoea mortality in children aged <5 years. Methods We conducted a systematic review to identify studies evaluating the efficacy and effectiveness of ORS and RHFs and abstracted study characteristics and outcome measures into standardized tables. We categorized the evidence by intervention and outcome, conducted meta-analyses for all outcomes with two or more data points and graded the quality of the evidence supporting each outcome. The CHERG Rules for Evidence Review were used to estimate the effectiveness of ORS and RHFs against diarrhoea mortality. Results We identified 205 papers for abstraction, of which 157 were included in the meta-analyses of ORS outcomes and 12 were included in the meta-analyses of RHF outcomes. We estimated that ORS may prevent 93% of diarrhoea deaths. Conclusions ORS is effective against diarrhoea mortality in home, community and facility settings; however, there is insufficient evidence to estimate the effectiveness of RHFs against diarrhoea mortality. PMID:20348131

[HIV prevention program for young people--the WYSH Project as a model of "combination prevention"].

PubMed

Ono-Kihara, Masako

2010-03-01

In face of the HIV pandemic that still grows, unsuccessful efforts of developing biomedical control measures or the failure of cognitive-behavioral approach to show sustained social level effectiveness, behavioral strategy is now expected to evolve into a structural prevention ("combination prevention") that involves multiple behavioral goals and multilevel approaches. WYSH Project is a combination prevention project for youth developed through socio-epidemiological approach that integrates epidemiology with social science such as social marketing and mixed method. WYSH Project includes mass education programs for youth in schools and programs for out-of-school youth through cyber network and peer communication. Started in 2002, it expanded nationwide with supports from related ministries and parent-teacher associations and has grown into a single largest youth prevention project in Japan.

Effectiveness of artichoke extract in preventing alcohol-induced hangovers: a randomized controlled trial

PubMed Central

Pittler, Max H.; White, Adrian R.; Stevinson, Clare; Ernst, Edzard

2003-01-01

Background Extract of globe artichoke (Cynara scolymus) is promoted as a possible preventive or cure for alcohol-induced hangover symptoms. However, few rigorous clinical trials have assessed the effects of artichoke extract, and none has examined the effects in relation to hangovers. We undertook this study to test whether artichoke extract is effective in preventing the signs and symptoms of alcohol-induced hangover. Methods We recruited healthy adult volunteers between 18 and 65 years of age to participate in a randomized double-blind crossover trial. Participants received either 3 capsules of commercially available standardized artichoke extract or indistinguishable, inert placebo capsules immediately before and after alcohol exposure. After a 1-week washout period the volunteers received the opposite treatment. Participants predefined the type and amount of alcoholic beverage that would give them a hangover and ate the same meal before commencing alcohol consumption on the 2 study days. The primary outcome measure was the difference in hangover severity scores between the artichoke extract and placebo interventions. Secondary outcome measures were differences between the interventions in scores using a mood profile questionnaire and cognitive performance tests administered 1 hour before and 10 hours after alcohol exposure. Results Fifteen volunteers participated in the study. The mean number (and standard deviation) of alcohol units (each unit being 7.9 g, or 10 mL, of ethanol) consumed during treatment with artichoke extract and placebo was 10.7 (3.1) and 10.5 (2.4) respectively, equivalent to 1.2 (0.3) and 1.2 (0.2) g of alcohol per kilogram body weight. The volume of nonalcoholic drink consumed and the duration of sleep were similar during the artichoke extract and placebo interventions. None of the outcome measures differed significantly between interventions. Adverse events were rare and were mild and transient. Interpretation Our results suggest that artichoke extract is not effective in preventing the signs and symptoms of alcohol-induced hangover. Larger studies are required to confirm these findings. PMID:14662662

The public health value of vaccines beyond efficacy: methods, measures and outcomes.

PubMed

Wilder-Smith, A; Longini, I; Zuber, P L; Bärnighausen, T; Edmunds, W J; Dean, N; Spicher, V Masserey; Benissa, M R; Gessner, B D

2017-07-26

Assessments of vaccine efficacy and safety capture only the minimum information needed for regulatory approval, rather than the full public health value of vaccines. Vaccine efficacy provides a measure of proportionate disease reduction, is usually limited to etiologically confirmed disease, and focuses on the direct protection of the vaccinated individual. Herein, we propose a broader scope of methods, measures and outcomes to evaluate the effectiveness and public health impact to be considered for evidence-informed policymaking in both pre- and post-licensure stages. Pre-licensure: Regulatory concerns dictate an individually randomised clinical trial. However, some circumstances (such as the West African Ebola epidemic) may require novel designs that could be considered valid for licensure by regulatory agencies. In addition, protocol-defined analytic plans for these studies should include clinical as well as etiologically confirmed endpoints (e.g. all cause hospitalisations, pneumonias, acute gastroenteritis and others as appropriate to the vaccine target), and should include vaccine-preventable disease incidence and 'number needed to vaccinate' as outcomes. Post-licensure: There is a central role for phase IV cluster randomised clinical trials that allows for estimation of population-level vaccine impact, including indirect, total and overall effects. Dynamic models should be prioritised over static models as the constant force of infection assumed in static models will usually underestimate the effectiveness and cost-effectiveness of the immunisation programme by underestimating indirect effects. The economic impact of vaccinations should incorporate health and non-health benefits of vaccination in both the vaccinated and unvaccinated populations, thus allowing for estimation of the net social value of vaccination. The full benefits of vaccination reach beyond direct prevention of etiologically confirmed disease and often extend across the life course of a vaccinated person, prevent outcomes in the wider community, stabilise health systems, promote health equity, and benefit local and national economies. The degree to which vaccinations provide broad public health benefits is stronger than for other preventive and curative interventions.

Oral literacy demand of preventive dental visits in a pediatric medical office: a pilot study.

PubMed

Kranz, Ashley M; Pahel, Bhavna T; Rozier, R Gary

2013-01-01

The purpose of this study was to examine the oral literacy demands placed on parents of young children during preventive dental visits in a pediatric medical office. Transcripts of audio recordings for 15 pediatric medical visits were analyzed to assess the oral literacy demand of the visit, as measured by use of terminology, language complexity, and structural characteristics of the dialogue. Parent-completed surveys were used to determine recall of dental concepts discussed during the visit. Pearson's correlation coefficients were calculated to identify relationships among these measures and parental recall of the visit. Visits were interactive and used limited jargon and uncomplicated language. Oral literacy demand measures were associated with each other. Parental recall of the visit was associated with measures of high oral literacy demand. Assessing measures of oral literacy demand is a novel method for examining provider communication used during preventive dental visits in a pediatric medical office. Providers displayed low oral literacy demand when communicating with parents. Parental recall of dental concepts, however, was associated unexpectedly with higher oral literacy demand. Further research should examine a larger sample size and the effect of measures of oral literacy demand among low- and high-literacy patients.

Consideration of the effect for enhancing the disaster prevention awareness by visualization of the tsunami lore

NASA Astrophysics Data System (ADS)

Chiharu, M.

2017-12-01

One effective measure for enhancing the residents' disaster prevention awareness is to know the natural hazard which has occurred in the past at residence. Mie Disaster Mitigation Center had released the digital archive for promoting an understanding of disaster prevention on April 28, 2015. This archive is recording the past disaster information as digital catalog. An effective contribution to enhancement of the inhabitants' disaster prevention awareness is expected. It includes the following contents (1) The interview with disaster victim (the 1944 Tonankai Earthquake, The Ise Bay Typhoon and so on) (2) The information on "monument of Tsunami" (3) The description of disaster on the local history material (the school history books, municipal history books, and so on). These contents are being dropped on a map and it is being shown clearly geographically. For all age groups, this way makes it easy to understand that the past disaster information relates to their residence address.

Prevention of Rheumatic Diseases: Strategies, Caveats and Future Directions

PubMed Central

Finckh, Axel

2014-01-01

Rheumatic diseases affect a significant portion of the population and lead to increased health care costs, disability and even premature mortality; as such, effective preventive measures for these diseases could lead to substantial improvements in public health. Importantly, established and emerging data from natural history studies show that for most rheumatic diseases there is a period of ‘preclinical’ disease development during which abnormal biomarkers or other processes can be detected. These changes are useful to understand mechanisms of disease pathogenesis; in addition, they may be applied to estimate a personal risk of future disease, while individuals are still relatively asymptomatic. Based on this, a hope is to implement effective screening and preventive approaches for some rheumatic diseases, perhaps in the near future. However, a key part of such approaches is a deep understanding of the mechanisms of disease development as well as evidence-based and effective screening and preventive interventions that incorporate disease biology as well as ethical and public health concerns. PMID:25437291

Cynodon dactylon extract as a preventive and curative agent in experimentally induced nephrolithiasis.

PubMed

Atmani, F; Sadki, C; Aziz, M; Mimouni, M; Hacht, B

2009-04-01

Cynodon dactylon (Poaceae family) decoction was used in the treatment of kidney stones. However, no scientific study was undertaken so far to demonstrate the beneficial effect of the plant. Thus, the aim of the current study is to evaluate the effect of Cynodon aqueous extract as a preventive and curative agent in experimentally induced nephrolithiasis in a rat model. Ethylene glycol (EG) was used in the experiment to induce calcium oxalate (CaOx) deposition into kidneys. In preventive protocol, Cynodon decoction was administered in the same day with EG to evaluate the ability of the extract to prevent crystal deposition. However, in curative protocol, rats were first rendered nephrolithiasic and then the extract was administered to assess the ability of the plant to eliminate the pre-existing crystal deposition. In both protocols, urinary biochemical and other variables were measured during the course of the study. Crystalluria and renal histology were examined as well. The results showed that, in both protocols, all measured variables were similar for both the rat groups. Nevertheless, urinary biochemical analysis was apparently unaffected by the extract except oxalate in preventive protocol, and calcium, sodium, and potassium in curative protocol which were significantly highly excreted in treated rats compared to untreated animals. Crystalluria was characterized mostly by the presence of large quantities of CaOx monohydrate and CaOx dihydrate particles in untreated rats. However, crystalluria was mainly dominated by the presence of CaOx dihydrate particles with reduced size. The most apparent beneficial effect of Cynodon extract was seen in kidney tissues where reduced levels of CaOx deposition have been noticed especially in medullary and papillary sections from treated rats. We concluded that C. dactylon extract has beneficial effect in preventing and eliminating CaOx deposition into kidneys. Such findings provide a scientific explanation for its use in the treatment of kidneys stones.

Cost-effectiveness of prevention strategies for American tegumentary leishmaniasis in Argentina.

PubMed

Orellano, Pablo Wenceslao; Vazquez, Nestor; Salomon, Oscar Daniel

2013-12-01

The aim of this study was to estimate the cost-effectiveness of reducing tegumentary leishmaniasis transmission using insecticide-impregnated clothing and curtains, and implementing training programs for early diagnosis. A societal perspective was adopted, with outcomes assessed in terms of costs per disability adjusted life years (DALY). Simulation was structured as a Markov model and costs were expressed in American dollars (US$). The incremental cost-effectiveness ratio of each strategy was calculated. One-way and multivariate sensitivity analyses were performed. The incremental cost-effectiveness ratio for early diagnosis strategy was estimated at US$ 156.46 per DALY averted, while that of prevention of transmission with insecticide-impregnated curtains and clothing was US$ 13,155.52 per DALY averted. Both strategies were more sensitive to the natural incidence of leishmaniasis, to the effectiveness of mucocutaneous leishmaniasis treatment and to the cost of each strategy. Prevention of vectorial transmission and early diagnosis have proved to be cost-effective measures.

Educational intervention and functional decline among older people: the modifying effects of social capital.

PubMed

Poulsen, Tine; Siersma, Volkert Dirk; Lund, Rikke; Christensen, Ulla; Vass, Mikkel; Avlund, Kirsten

2014-05-01

To analyse if social capital modifies the effect of educational intervention of home visitors on mobility disability. Earlier studies have found that educational intervention of home visitors has a positive effect of older peoples' functional decline, but how social capital might modify this effect is still unknown. We used the Danish Intervention Study on Preventive Home Visits - a prospective cohort study including 2863 75-year-olds and 1171 80-year-olds in 34 Danish municipalities - to analyse the modifying effect of different aspects of social capital on the effect of educational intervention of home visitors on functional decline. The three measures of social capital (bonding, bridging, and linking) were measured at contextual level. Data was analysed with multivariate linear regression model using generalised estimating equations to account for repeated measurements. We found that 80-year-olds living in municipalities with high bonding (B=0.089, p=0.0279) and high linking (B=0.0929; p=0.0217) had significant better mobility disability in average at 3-year follow up if their municipality had received intervention. With the unique design of the Danish Intervention Study on Preventive Home Visits and with theory-based measures of social capital that distinguish between three aspects of social capital with focus on older people, this study contributes to the literature about the role of social capital for interventions on mobility disability.

Strategies for the prevention of MP3-induced hearing loss among adolescents: expert opinions from a Delphi study.

PubMed

Vogel, Ineke; Brug, Johannes; van der Ploeg, Catharina P B; Raat, Hein

2009-05-01

To identify parties involved in the prevention of MP3-induced hearing loss among adolescents and potentially effective prevention strategies and interventions. Thirty experts in fields such as scientific research, medical practice, community health professions, education, youth work, music entertainment, and enforcement authorities participated in a qualitative, electronic, 3-round, Web-based Delphi study. Multiple parties involved in the prevention of MP3-induced hearing loss among adolescents were identified; the most relevant are the adolescents themselves, their parents, manufacturers of MP3 players and earphones, and the authorities. The experts did not expect that adolescents in general would perform the necessary protective behaviors to prevent MP3-induced hearing loss. Two environmental health protection measures were identified as both relevant and feasible to be implemented (ie, authorities encourage manufacturers to produce safer products, and public health campaigns will be held to improve knowledge of the risks of high-volume music, possible protective measures, and consequences of hearing loss). Authorities, the music industry in general, and especially manufacturers of MP3 players and earphones should recognize their responsibility and create a safer MP3-listening environment by taking measures to protect today's youth from the dangers of listening to high-volume music on MP3 players.

Water fluoridation: a critical review of the physiological effects of ingested fluoride as a public health intervention.

PubMed

Peckham, Stephen; Awofeso, Niyi

2014-01-01

Fluorine is the world's 13th most abundant element and constitutes 0.08% of the Earth crust. It has the highest electronegativity of all elements. Fluoride is widely distributed in the environment, occurring in the air, soils, rocks, and water. Although fluoride is used industrially in a fluorine compound, the manufacture of ceramics, pesticides, aerosol propellants, refrigerants, glassware, and Teflon cookware, it is a generally unwanted byproduct of aluminium, fertilizer, and iron ore manufacture. The medicinal use of fluorides for the prevention of dental caries began in January 1945 when community water supplies in Grand Rapids, United States, were fluoridated to a level of 1 ppm as a dental caries prevention measure. However, water fluoridation remains a controversial public health measure. This paper reviews the human health effects of fluoride. The authors conclude that available evidence suggests that fluoride has a potential to cause major adverse human health problems, while having only a modest dental caries prevention effect. As part of efforts to reduce hazardous fluoride ingestion, the practice of artificial water fluoridation should be reconsidered globally, while industrial safety measures need to be tightened in order to reduce unethical discharge of fluoride compounds into the environment. Public health approaches for global dental caries reduction that do not involve systemic ingestion of fluoride are urgently needed.

Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention

PubMed Central

2014-01-01

Fluorine is the world's 13th most abundant element and constitutes 0.08% of the Earth crust. It has the highest electronegativity of all elements. Fluoride is widely distributed in the environment, occurring in the air, soils, rocks, and water. Although fluoride is used industrially in a fluorine compound, the manufacture of ceramics, pesticides, aerosol propellants, refrigerants, glassware, and Teflon cookware, it is a generally unwanted byproduct of aluminium, fertilizer, and iron ore manufacture. The medicinal use of fluorides for the prevention of dental caries began in January 1945 when community water supplies in Grand Rapids, United States, were fluoridated to a level of 1 ppm as a dental caries prevention measure. However, water fluoridation remains a controversial public health measure. This paper reviews the human health effects of fluoride. The authors conclude that available evidence suggests that fluoride has a potential to cause major adverse human health problems, while having only a modest dental caries prevention effect. As part of efforts to reduce hazardous fluoride ingestion, the practice of artificial water fluoridation should be reconsidered globally, while industrial safety measures need to be tightened in order to reduce unethical discharge of fluoride compounds into the environment. Public health approaches for global dental caries reduction that do not involve systemic ingestion of fluoride are urgently needed. PMID:24719570

A history of fish vaccination: science-based disease prevention in aquaculture.

PubMed

Gudding, Roar; Van Muiswinkel, Willem B

2013-12-01

Disease prevention and control are crucial in order to maintain a sustainable aquaculture, both economically and environmentally. Prophylactic measures based on stimulation of the immune system of the fish have been an effective measure for achieving this goal. Immunoprophylaxis has become an important part in the successful development of the fish-farming industry. The first vaccine for aquaculture, a vaccine for prevention of yersiniosis in salmonid fish, was licensed in USA in 1976. Since then the use of vaccines has expanded to new countries and new species simultaneous with the growth of the aquaculture industry. This paper gives an overview of the achievements in fish vaccinology with particular emphasis on immunoprophylaxis as a practical tool for a successful development of bioproduction of aquatic animals. Copyright © 2013 Elsevier Ltd. All rights reserved.

An interactive multimedia program to prevent HIV transmission in men with intellectual disability.

PubMed

Wells, Jennifer; Clark, Khaya; Sarno, Karen

2014-05-01

The efficacy of a computer-based interactive multimedia HIV/AIDS prevention program for men with intellectual disability (ID) was examined using a quasi-experimental within-subjects design. Thirty-seven men with mild to moderate intellectual disability evaluated the program. The pretest and posttest instruments assessed HIV/AIDS knowledge (high-risk fluids, HIV transmission, and condom facts) and condom application skills. All outcome measures showed statistically significant gains from pretest to posttest, with medium to large effect sizes. In addition, a second study was conducted with twelve service providers who work with men with ID. Service providers reviewed the HIV/AIDS prevention program, completed a demographics questionnaire, and a program satisfaction survey. Overall, service providers rated the program highly on several outcome measures (stimulation, relevance, and usability).

[Development and Effects of a Drinking Prevention Program for Preschool Children].

PubMed

Kim, Younkyoung; Lee, Chong Mi; Park, Jong

2016-04-01

The purpose of this study was to identify the effects of the program to promote drinking knowledge, attitudes, and coping behavior in preschool children. A quasi-experimental with non-equivalent control group pretest-posttest design was conducted. The participants were 123 five year old children from G city. They were assigned to the experimental group (n=77) or the control group (n=46). A pretest and posttest were conducted to measure main variables. For the experimental group, the drinking prevention program was given for 6 weeks. Data were analyzed using χ²-test, t-test, and ANCOVA. After the intervention, preschool children in the experimental group reported significant differences in drinking knowledge (F=9.25, p=.003), drinking attitudes (F=19.57, p<.001), and coping behavior (F=16.38, p<.001) compared to preschool children in the control group. The results of this study indicate that a drinking prevention program for preschool children is effective in increasing drinking knowledge, attitudes, and coping behavior. This drinking prevention program is recommended as an effective intervention for preschool age children to postpone an early introduction to drinking.

Interventions for Preventing Childhood Obesity with Smartphones and Wearable Device: A Protocol for a Non-Randomized Controlled Trial

PubMed Central

Yang, Hye Jung; Kang, Jae-Heon; Kim, Ok Hyun; Choi, Mona; Oh, Myungju; Nam, Jihyun; Sung, Eunju

2017-01-01

Background: Childhood obesity is a critical health issue, both currently and for the foreseeable future. To prevent obesity, behavior changes are essential. Smartphones can be a good tool, as the number of child smartphone users is rapidly increasing. We have developed a mobile platform system named “HAPPY ME,” which is a smartphone application coupled with a wearable device, designed to improve healthy behaviors to prevent childhood obesity. This study aimed to evaluate the effectiveness of obesity prevention among children 10–12 years of age using HAPPY ME. Methods: A total of 1000 participants, all fifth and sixth graders from four schools, were assigned to either control or intervention groups by school. Students in the intervention group used HAPPY ME. The study comprises a safety test, a 12-week efficacy test, and a six-month follow-up test to determine the long-term effects of preventive intervention via the integrated service platform. The integrated service platform aims to facilitate child-parent-school participation, involving the child-parent mobile application, a child-teacher mobile web, and a school website. Primary outcome measures are behavioral changes, including healthy eating, increased physical activity, and fitness. Secondary outcome measures are changes in anthropometric parameters (body weight, height, body mass index z-score, and waist circumference), body mass index (BMI) percentiles (obesity rate), and psychological perceptions among participants. Conclusions: The results of this study will offer evidence of the effectiveness of a mobile platform service with a multi-component intervention program based on a comprehensive approach. PMID:28208839

The phosphatase inhibitor menadione (vitamin K3) protects cells from EGFR inhibition by erlotinib and cetuximab.

PubMed

Perez-Soler, Roman; Zou, Yiyu; Li, Tianhong; Ling, Yi He

2011-11-01

Skin toxicity is the main side effect of epidermal growth factor receptor (EGFR) inhibitors, often leading to dose reduction or discontinuation. We hypothesized that phosphatase inhibition in the skin keratinocytes may prevent receptor dephosphorylation caused by EGFR inhibitors and be used as a new potential strategy for the prevention or treatment of this side effect. Menadione (Vitamin K3) was used as the prototype compound to test our hypothesis. HaCat human skin keratinocyte cells and A431 human squamous carcinoma cells were used. EGFR inhibition was measured by Western blotting and immunofluorescence. Phosphatase inhibition and reactive oxygen species (ROS) generation were measured by standard ELISA and fluorescence assays. Menadione caused significant and reversible EGFR activation in a dose-dependent manner starting at nontoxic concentrations. EGFR activation by menadione was associated with reversible protein tyrosine phosphatase inhibition, which seemed to be mediated by ROS generation as exposure to antioxidants prevented both menadione-induced ROS generation and phosphatase inhibition. Short-term coincubation of cells with nontoxic concentrations of menadione and the EGFR inhibitors erlotinib or cetuximab prevented EGFR dephosphorylation. Seventy-two-hour coincubation of cells with the highest nontoxic concentration of menadione and erlotinib provided for a fourfold cell growth inhibitory protection in HaCat human keratinocyte cells. Menadione at nontoxic concentrations causes EGFR activation and prevents EGFR dephosphorylation by erlotinib and cetuximab. This effect seems to be mediated by ROS generation and secondary phosphatase inhibition. Mild oxidative stress in skin keratinocytes by topical menadione may protect the skin from the toxicity secondary to EGFR inhibitors without causing cytotoxicity. ©2011 AACR

Interventions for Preventing Childhood Obesity with Smartphones and Wearable Device: A Protocol for a Non-Randomized Controlled Trial.

PubMed

Yang, Hye Jung; Kang, Jae-Heon; Kim, Ok Hyun; Choi, Mona; Oh, Myungju; Nam, Jihyun; Sung, Eunju

2017-02-13

Childhood obesity is a critical health issue, both currently and for the foreseeable future. To prevent obesity, behavior changes are essential. Smartphones can be a good tool, as the number of child smartphone users is rapidly increasing. We have developed a mobile platform system named "HAPPY ME," which is a smartphone application coupled with a wearable device, designed to improve healthy behaviors to prevent childhood obesity. This study aimed to evaluate the effectiveness of obesity prevention among children 10-12 years of age using HAPPY ME. A total of 1000 participants, all fifth and sixth graders from four schools, were assigned to either control or intervention groups by school. Students in the intervention group used HAPPY ME. The study comprises a safety test, a 12-week efficacy test, and a six-month follow-up test to determine the long-term effects of preventive intervention via the integrated service platform. The integrated service platform aims to facilitate child-parent-school participation, involving the child-parent mobile application, a child-teacher mobile web, and a school website. Primary outcome measures are behavioral changes, including healthy eating, increased physical activity, and fitness. Secondary outcome measures are changes in anthropometric parameters (body weight, height, body mass index z-score, and waist circumference), body mass index (BMI) percentiles (obesity rate), and psychological perceptions among participants. The results of this study will offer evidence of the effectiveness of a mobile platform service with a multi-component intervention program based on a comprehensive approach.

[Development and effect analysis of web-based instruction program to prevent elementary school students from safety accidents].

PubMed

Chung, Eun-Soon; Jeong, Ihn-Sook; Song, Mi-Gyoung

2004-06-01

This study was aimed to develop a WBI(Web Based Instruction) program on safety for 3rd grade elementary school students and to test the effects of it. The WBI program was developed using Macromedia flash MX, Adobe Illustrator 10.0 and Adobe Photoshop 7.0. The web site was http://www.safeschool.co.kr. The effect of it was tested from Mar 24, to Apr 30, 2003. The subjects were 144 students enrolled in the 3rd grade of an elementary school in Gyungju. The experimental group received the WBI program lessons while each control group received textbook-based lessons with visual presenters and maps, 3 times. Data was analyzed with descriptive statistics, and chi2 test, t-test, and repeated measure ANOVA. First, the WBI group reported a longer effect on knowledge and practice of accident prevention than the textbook-based lessons, indicating that the WBI is more effective. Second, the WBI group was better motivated to learn the accident prevention lessons, showing that the WBI is effective. As a result, the WBI group had total longer effects on knowledge, practice and motivation of accident prevention than the textbook-based instruction. We recommend that this WBI program be used in each class to provide more effective safety instruction in elementary schools.

Objective measures of adoption of patient lift and transfer devices to reduce nursing staff injuries in the hospital setting.

PubMed

Schoenfisch, Ashley L; Pompeii, Lisa A; Myers, Douglas J; James, Tamara; Yeung, Yeu-Li; Fricklas, Ethan; Pentico, Marissa; Lipscomb, Hester J

2011-12-01

Interventions to reduce patient-handling injuries in the hospital setting are often evaluated based on their effect on outcomes such as injury rates. Measuring intervention adoption could address how and why observed trends in the outcome occurred. Unit-level data related to adoption of patient lift equipment were systematically collected at several points in time over 5 years on nursing units at two hospitals, including hours of lift equipment use, equipment accessibility, and supply purchases and availability. Various measures of adoption highlighted the adoption process' gradual nature and variability by hospital and between units. No single measure adequately assessed adoption. Certain measures appear well-correlated. Future evaluation of primary preventive efforts designed to prevent patient-handling injuries would be strengthened by objective data on intermediate measures that reflect intervention implementation and adoption. Copyright © 2011 Wiley Periodicals, Inc.

Probiotics and prevention of Clostridium difficile infection.

PubMed

Goldstein, E J C; Johnson, S J; Maziade, P-J; Evans, C T; Sniffen, J C; Millette, M; McFarland, L V

2017-06-01

The role of probiotics as adjunctive measures in the prevention of Clostridium difficile infection (CDI) has been controversial. However, a growing body of evidence has suggested that they have a role in primary prevention of CDI. Elements of this controversy are reviewed and the proposed mechanisms of action, the value and cost effectiveness of probiotics are addressed with a focus on three agents, Saccharomyces boulardii, Lactobacillus rhamnosus GG and the combination of Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R, Lactobacillus rhamnosus CLR2 (Bio-K+). Copyright © 2016 Elsevier Ltd. All rights reserved.

Pushing the Boundaries of Education: Evaluating the "Impact of Second Step[R]--A Violence Prevention Curriculum" with Psychosocial and Non-Cognitive Measures

ERIC Educational Resources Information Center

Neace, William P.; Munoz, Marco A.

2012-01-01

The "Second Step"[R] violence prevention curriculum was implemented in a large urban school district as part of a comprehensive three-year initiative to impact students at-risk for violence and substance abuse. An outcome evaluation was conducted to assess the intervention's effectiveness on students' attitudes and on behaviors important for…

Indicated Prevention and Early Intervention for Childhood Anxiety: A Randomized Trial with Caucasian and Hispanic/Latino Youth

ERIC Educational Resources Information Center

Pina, Armando A.; Zerr, Argero A.; Villalta, Ian K.; Gonzales, Nancy A.

2012-01-01

Objective: This trial of a randomized indicated anxiety prevention and early intervention explored initial program effects as well as the role of ethnicity and language on measured outcomes. Method: A total of 88 youth (M = 10.36 years; 45 girls, 52 Latino) received 1 of 2 protocols with varying degrees of parent involvement, and response was…

Surgical fires: perioperative communication is essential to prevent this rare but devastating complication.

PubMed

Bruley, M E

2004-12-01

A fire on or within a surgical patient is a continuing risk in modern surgery. Unfortunately, the sensitivity of surgical and anaesthesia staff to this hazard has waned over the past 25 years with cessation of the use of flammable anaesthetic agents. Prevention of surgical fires requires understanding the risks and effective communication between surgical, anaesthesia, and operating nursing staffs. Preventive measures exist but have yet to diffuse sufficiently across professional boundaries. Based on a review of relevant databases, decades of experience from field investigations, and a review of the medical literature, this paper discusses the incidence of surgical fires, the responsibility for prevention in the perioperative setting, and the procedures for surgical fire prevention and extinguishment.

Surgical fires: perioperative communication is essential to prevent this rare but devastating complication

PubMed Central

Bruley, M

2004-01-01



 A fire on or within a surgical patient is a continuing risk in modern surgery. Unfortunately, the sensitivity of surgical and anaesthesia staff to this hazard has waned over the past 25 years with cessation of the use of flammable anaesthetic agents. Prevention of surgical fires requires understanding the risks and effective communication between surgical, anaesthesia, and operating nursing staffs. Preventive measures exist but have yet to diffuse sufficiently across professional boundaries. Based on a review of relevant databases, decades of experience from field investigations, and a review of the medical literature, this paper discusses the incidence of surgical fires, the responsibility for prevention in the perioperative setting, and the procedures for surgical fire prevention and extinguishment. PMID:15576710

Forest Practice Rules and cumulative watershed impacts in California

Treesearch

L. M. Reid

1999-01-01

Response to the following questions, "As currently implemented, are existing California forest practice rules effective in preventing cumulative watershed impacts, including flooding?" and "What kind of measures might improve the effectiveness of forest practices rules for avoiding forestry-related cumulative watershed impacts

The prevention of canine leishmaniasis and its impact on public health.

PubMed

Otranto, Domenico; Dantas-Torres, Filipe

2013-07-01

Canine leishmaniasis (CanL) caused by Leishmania infantum is a vector-borne disease of great veterinary and medical significance. Prevention of CanL requires a combined approach including measures focused on dogs and the environment where the vectors perpetuate. Over past decades, considerable effort has been put towards developing novel and cost-effective strategies against CanL. Vaccination is considered among the most promising tools for controlling CanL, and synthetic pyrethroids are useful and cost-effective in reducing risk of L. infantum infection in dogs. The effectiveness of the use of vaccines plus repellents in preventing L. infantum infection and subsequent disease development should be assessed by means of large-scale, randomized controlled field trials because this combined strategy may become the next frontier in the control of CanL. Copyright © 2013 Elsevier Ltd. All rights reserved.

Preventing unsafe abortion and limiting its consequences: what can be done?

PubMed

Misago, C

1994-12-01

The continued illegality of induced abortion in Latin America has led to substantial, preventable maternal mortality and morbidity. The first strategy for preventing unsafe clandestine abortion is to reduce the incidence of unwanted pregnancy through measures such as improved access to effective contraception, post-abortion family planning counseling, health education campaigns aimed at promoting condom use among young people, involvement of men in family planning decision making, biomedical research on safer and more effective male and female contraceptive methods, and empowering women to demand the use of condoms or avoid unwanted intercourse. The second strategy is to reduce abortion-related mortality and morbidity through more effective clinical management of incomplete illegal abortions, introduction of menstrual regulation services, formation of women's solidarity groups aimed at discouraging the practice of self-induced abortion, and, ultimately, abortion legalization.

Effectiveness of preventive medicine education and its determinants among medical students in Malaysia.

PubMed

Anil, Shirin; Zawahir, Mohamed Shukry; Al-Naggar, Redhwan Ahmed

2016-03-01

Preventive medicine has been incorporated in the medical school curriculum, but its effectiveness and the factors that affect it are yet to be widely looked into in the context of Malaysia. We aimed to measure the familiarity with, perception about the importance to learn, and the ability to practice preventive medicine as well as its determinants among the medical students in Malaysia. Thus, a cross sectional study was conducted through an anonymous online survey among 387 randomly selected final year medical students of four large public medical schools in Malaysia from March to September 2014. Of the total sample, 340 (response rate 87.8%) gave a written informed consent and took part in the survey. The familiarity of the sample with preventive medicine was measured in 19 preventive medicine areas, and their perception about the importance of preventive medicine and their ability to practice it were gauged on a Likert scale (low score indicates disagreement and high indicates agreement). Descriptive statistical analysis was performed, followed by logistic regression. The mean age of the respondents was 23.7 (SD 0.77) years, and 61.2% (n = 208) of them were females. Results showed that 22.9% of the sample (n = 78) had a low familiarity with preventive medicine, whereas 76.8% (n = 261) had a high familiarity. The study sample specified that among all the preventive medicine subjects, screening and control as well as smoking cessation and immunization are "extremely important to learn." In univariable analysis, being a female, medical school, family size, and perception about the importance to learn preventive medicine were associated with the ability to practice it. In multivariable analysis, the perception towards the importance to learn preventive medicine was the only significant determinant: aOR (adjusted odds ratio) for those who "agreed" 17.28 (95% CI aOR 4.44-67.26, P < 0.001) and for "strongly agreed" 35.87 (95% CI aOR 8.04-159.87, P < 0.001). Considering these findings, the familiarity of medical students with preventive medicine should be increased. The perception about the importance to learn preventive medicine is a strong determinant for the ability to practice it.

Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

PubMed Central

Schwalm, Jon-David; McKee, Martin; Huffman, Mark D.; Yusuf, Salim

2016-01-01

Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality. PMID:26903017

Translation of an Effective Tai Chi Intervention Into a Community-Based Falls-Prevention Program

PubMed Central

Li, Fuzhong; Harmer, Peter; Glasgow, Russell; Mack, Karin A.; Sleet, David; Fisher, K. John; Kohn, Melvin A.; Millet, Lisa M.; Mead, Jennifer; Xu, Junheng; Lin, Mei-Li; Yang, Tingzhong; Sutton, Beth; Tompkins, Yvaughn

2008-01-01

Tai Chi—Moving for Better Balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the RE-AIM framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, and participants showed significant improvements in health-related outcome measures. This evidence-based tai chi program is practical to disseminate and can be effectively implemented and maintained in community settings. PMID:18511723

Online versus conventional shopping: consumers' risk perception and regulatory focus.

PubMed

van Noort, Guda; Kerkhof, Peter; Fennis, Bob M

2007-10-01

In two experiments, the impact of shopping context on consumers' risk perceptions and regulatory focus was examined. We predicted that individuals perceive an online (vs. conventional) shopping environment as more risky and that an online shopping environment, by its risky nature, primes a prevention focus. The findings in Study 1 demonstrate these effects by using self-report measures for risk perception and prevention focus. In Study 2, we replicated these findings and demonstrated that the effect of an online shopping environment carries over to behavior in a domain unrelated to shopping.

"Tap and twist": preventing deep vein thrombosis in neuroscience patients through foot and ankle range-of-motion exercises.

PubMed

Palamone, Janet; Brunovsky, Susan; Groth, Matt; Morris, Linda; Kwasny, Mary

2011-12-01

Neurosurgical patients tend to have the highest rate of deep vein thrombosis (DVT) rate among other postsurgical patients. The methods and timing of DVT prevention and treatment continue to be debated among neurointensivists. The greatest opportunity to intervene is early during the stay in the intensive care unit. There are many factors, however, that can make this the most neglected time for aggressive prevention measures. For large university teaching hospitals, the target of the University Health System Consortium is to achieve an average DVT rate at or below half that of previous reported rates. The current recommendations are effective only if there is compliance with these measures during the majority of the patients' hospitalization. Our hypothesis states that without changing any of the current measures to prevent DVT, a structured program of foot and ankle range-of-motion (ROM) exercises will decrease the incidence of DVT in the neuroscience intensive care patient population. This quasi-experimental study was a quality improvement project examining 315 individuals over the age of 18 years, who were admitted to the neurospine intensive care unit and who received a new program of foot exercises as a method of DVT prevention. Data for the outcome measures were derived from bedside measurement of lower extremity doppler, the percentage of time the exercises were performed, patient history, and standard DVT prevention measures. Overall, there was no difference in DVT rates for those receiving the foot ROM intervention during the study period in 2008-2009 compared with the usual nursing practice for the previous year. However, during the study period, those who developed DVT had a significantly lower compliance rate with the ROM exercises (38.7%) than did those who did not develop DVT (58.4%; p < .001). Therefore, foot and ankle ROM exercises may have a promising role in reducing the incidence of DVT in neuroscience intensive care patients when there is diligent performance of the exercises.

The effect of preventive oral care on treatment outcomes of a cohort of oral cancer patients.

PubMed

Morais, Marilia Oliveira; Elias, Marcela Ramos Abrahão; Leles, Cláudio Rodrigues; Dourado Pinezi, Juliana Castro; Mendonça, Elismauro Francisco

2016-04-01

The purpose of this study was to assess patient adherence to an oral preventive measures (OPM) protocol and its impact on cancer treatment outcomes. A retrospective cohort of oral cancer of 133 patients submitted to radiotherapy (RT) was selected, excluding those with metastasis. Patients were grouped according to their local tumor response after finishing RT (favorable or unfavorable) and adherence to an OPM (none, ≤6 months, and >6 months). OPM included education and counseling about adverse effects, elimination of infection foci, restorative procedures, fluoride therapy, oral rehydration, and maintenance and supervision of oral hygiene throughout treatment. Clinical and pathological characteristics were recorded, and patient outcomes (frequency of adverse effects, RT interruption, and overall survival) were analyzed. Patients with higher adherence to the OPM had greater occurrence of RT interruption as a consequence of symptoms (p = 0.01); however, these patients were more likely to complete the established RT protocol (p = 0.02). Overall survival (p = 0.01) was higher in the group with higher adherence. This study suggests that the implementation of oral preventive measures may contribute to improving the prognosis of squamous cell carcinoma (SCC) treatment by reducing the negative impact of oral complications.

Prevention of Disease in Travel from the Perspective of Iranian Traditional Medicine.

PubMed

Motavasselian, Fatemeh; Hashemi, Monireh Seyed; Emtiazy, Majid

2016-05-01

Due to the high volume of travel and the spread of various diseases as well as disorders during a trip, one of the major concerns for travelers is the issues related to disease spread, control, and prevention. The approach of philosophers and traditional physicians along with hygiene measures were noted as trip recommendations in their textbooks. Considering negligence in disease prevention and the lack of dedicated and systematic discussion on this topic, this article aims at collecting their experiences as a practical reference point. This qualitative study, review articles in the field of traditional medicine and search in authentic books on traditional medicine. The gathered data were initially analyzed and then categorized. Results were described in several sub-categories, including general recommendation, food and drinking recommendations during travel, prevention of dehydration in warm and cold conditions, poisoned and polluted air recommendations, management of sea passengers, fatigue due to travel, and the prevention of skin diseases. These measures are efficient interventions and cost-effective, which provide guidelines for traveler's health during a trip.

Targeting students, teachers and parents in a wellness-based prevention program in schools.

PubMed

Russell-Mayhew, Shelly; Arthur, Nancy; Ewashen, Carol

2007-01-01

This study examines the effectiveness of a wellness-based prevention program on elementary and junior high students' body image, personal attitudes, and eating behaviors. Group differences in measures of student attitudes and eating behaviors are examined to determine the effect of targeting different participant combinations (students, parents, and teachers) in 10 groups. For elementary schools, student participants consisted of control (no intervention) (n = 36), student only (n = 81), student/parent (n = 124), student/parent/teacher (n = 103), and parent/teacher (n = 149). For junior high schools, student participants consisted of control (n = 143), student only (n=215), student/parent (n=65), student/parent/teacher (n = 14), and parent/teacher (n = 177). Overall, complete data was available for 1,095 students, 114 parents and 92 teachers. Results indicate that self-concept and eating attitudes and behaviors were positively affected by participation in the program. For example, in elementary schools posttest scores on the behavior subscale of the self-concept measure are significantly higher for the student/parent/teacher group than for the control group. Results indicate that a one-time wellness-based eating disorder prevention program with students, which have in the past shown to be minimally effective, may be more effective in changing attitudes and behaviors when teachers and parents are involved.

Independent Evaluation of Middle School-Based Drug Prevention Curricula: A Systematic Review.

PubMed

Flynn, Anna B; Falco, Mathea; Hocini, Sophia

2015-11-01

Lack of robust program evaluation has hindered the effectiveness of school-based drug abuse prevention curricula overall. Independently evaluated randomized controlled trials (RCTs) of universal, middle school-based drug abuse prevention curricula are the most useful indicators of whether such programs are effective or ineffective. To conduct a systematic review identifying independently evaluated RCTs of universal, middle school-based drug abuse prevention curricula; extract data on study quality and substance use outcomes; and assess evidence of program effectiveness. PsycInfo, Educational Resources Information Center, Science Citation Index, Social Science Citation Index, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews were searched between January 1, 1984, and March 15, 2015. Search terms included variations of drug, alcohol, tobacco, and marijuana use, as well as school, prevention, and effectiveness. Studies included in the review were RCTs carried out by independent evaluators of universal school-based drug prevention curricula available for dissemination in the United States that reported alcohol, tobacco, marijuana, or other drug use outcomes. Two researchers extracted data on study quality and outcomes independently using a data extraction form and met to resolve disagreements. A total of 5071 publications were reviewed, with 13 articles meeting final inclusion criteria. Of the 13 articles, 6 RCTs of 4 distinct school-based curricula were identified for inclusion. Outcomes were reported for 42 single-drug measures in the independent RCTs, with just 3 presenting statistically significant (P < .05) differences between the intervention group and the control group. One program revealed statistically significant positive effects at final follow-up (Lions-Quest Skills for Adolescence). The results of our review demonstrate the dearth of independent research that appropriately evaluates the effectiveness of universal, middle school-based drug prevention curricula. Independent evaluations show little evidence of effectiveness for widely used programs. New methods may be necessary to approach school-based adolescent drug prevention.

Effectiveness of a multifactorial falls prevention program in community-dwelling older people when compared to usual care: study protocol for a randomised controlled trial (Prevquedas Brazil).

PubMed

de Negreiros Cabral, Kelem; Perracini, Monica Rodrigues; Soares, Aline Thomaz; de Cristo Stein, Francine; Sera, Celisa Tiemi Nakagawa; Tiedemann, Anne; Sherrington, Cathie; Filho, Wilson Jacob; Paschoal, Sérgio Márcio Pacheco

2013-03-15

Falling in older age is a major public health concern due to its costly and disabling consequences. However very few randomised controlled trials (RCTs) have been conducted in developing countries, in which population ageing is expected to be particularly substantial in coming years. This article describes the design of an RCT to evaluate the effectiveness of a multifactorial falls prevention program in reducing the rate of falls in community-dwelling older people. Multicentre parallel-group RCT involving 612 community-dwelling men and women aged 60 years and over, who have fallen at least once in the previous year. Participants will be recruited in multiple settings in Sao Paulo, Brazil and will be randomly allocated to a control group or an intervention group. The usual care control group will undergo a fall risk factor assessment and be referred to their clinicians with the risk assessment report so that individual modifiable risk factors can be managed without any specific guidance. The intervention group will receive a 12-week Multifactorial Falls Prevention Program consisting of: an individualised medical management of modifiable risk factors, a group-based, supervised balance training exercise program plus an unsupervised home-based exercise program, an educational/behavioral intervention. Both groups will receive a leaflet containing general information about fall prevention strategies. Primary outcome measures will be the rate of falls and the proportion of fallers recorded by monthly falls diaries and telephone calls over a 12 month period. Secondary outcomes measures will include risk of falling, fall-related self-efficacy score, measures of balance, mobility and strength, fall-related health services use and independence with daily tasks. Data will be analysed using the intention-to-treat principle.The incidence of falls in the intervention and control groups will be calculated and compared using negative binomial regression analysis. This study is the first trial to be conducted in Brazil to evaluate the effectiveness of an intervention to prevent falls. If proven to reduce falls this study has the potential to benefit older adults and assist health care practitioners and policy makers to implement and promote effective falls prevention interventions. ClinicalTrials.gov (NCT01698580).

Methods to measure sedimentation of spawning gravels

Treesearch

Thomas E. Lisle; Rand E. Eads

1991-01-01

Sediment transport occurring after spawning can cause scour of incubating embryos and infiltration of fine sediment into spawning gravel, decreasing intergravel flow and preventing hatched fry from emerging from the gravel. Documentation of these effects requires measuring gravel conditions before and after high flow periods and combining methods to record scour and...

Noninvasive quantification of human brain antioxidant concentrations after an intravenous bolus of vitamin C

USDA-ARS?s Scientific Manuscript database

Background: Until now, antioxidant based initiatives for preventing dementia have lacked a means to detect deficiency or measure pharmacologic effect in the human brain in situ. Objective: Our objective was to apply a novel method to measure key human brain antioxidant concentrations throughout the ...

The Effect of Empowerment and Self-Determination on Health Outcomes

ERIC Educational Resources Information Center

Garces-Ozanne, Arlene; Kalu, Edna Ikechi; Audas, Richard

2016-01-01

There remains a persistent gap in health outcomes between wealthy and poor countries. Basic measures such as life expectancy and infant and under-five mortality remain divergent, with preventable deaths being unacceptably high, despite significant efforts to reduce these disparities. We examine the impact of empowerment, measured by Freedom…

A specific hygiene hypothesis.

PubMed

Shunsheng Han, Cliff

2016-08-01

Allergic diseases have reached epidemic proportions in Western populations in the last several decades. The hygiene hypothesis proposed more than twenty years ago has helped us to understand the epidemic and has been verified with numerous studies. However, translational measures deduced from these studies to prevent allergic diseases have not proven effective. Recent studies on immigrants' allergies and any potential association between oral infection and allergic diseases prompt me to propose a specific hygiene hypothesis to explain how oral hygiene practices might have contributed to the uprising of hay fever, the most common allergic disease. The historic oral hygiene level in US is closely associated with the emerging allergic epidemic. Future studies to test the hypothesis are needed and verification of the hypothesis can potentially yield highly effective measures to prevent allergic diseases. Published by Elsevier Ltd.

Gaining perspective: the effects of message frame on viewer attention to and recall of osteoporosis prevention print advertisements.

PubMed

O'Malley, Deborah A; Latimer-Cheung, Amy E

2013-11-01

This study examined how framed messages affect viewer attention to and cognitive processing of osteoporosis prevention print ads. Attention was measured with eye tracking technology. Cognitive processing was assessed through masked recall. A total of 60 college-aged women viewed 12 gain-framed, 12 loss-framed, and 12 neutral-framed ads. Number of fixations, dwell time, and recall of gain-framed osteoporosis prevention ads were higher than loss-framed or neutral-framed ads, p < .01. Message recall was positively correlated with the number of fixations and dwell time for the gain-framed and neutral-framed messages, p < .01. These findings provide preliminary insight into potential mechanisms underlying message framing effects.

Epidemiology & preventive aspects of railway suicides and fatalities related to trespassing accidents.

PubMed

Kumar, Sachil; Verma, Anoop K; Bhattacharya, Sandeep; Singh, Uma Shankar

2013-11-01

Suicide and trespass are major contributors to risk on the railway, resulting in around 170-180 fatalities per year in Lucknow region, as well as associated major disruption to the rail network. Lucknow is the capital city of the state of Uttar Pradesh in India. The analysis included train-pedestrian fatalities during 2007-2012. The data for 2007-2012 were collected from the autopsy reports of the university, case sheets from the hospital, the general prosecutor's investigations report and the inquest reports from police. The results show that the majority of victims were males. Half of the suicide victims were 20-39 years old. Accidents happened most frequently in situations when a person was walking on the tracks/in front of train (22.7%) or were crossing the tracks illegally (20.9%). Among all train-pedestrian fatalities, about half of the victims (42.8%) were intoxicated by alcohol. Female suicide victims suffered from mental health problems more frequently (55.8%) than male suicide victims. Overall, there is no reason to believe that train-pedestrian fatalities are unavoidable. By contrast, the effective prevention of railway suicides and accidents should be based on a systems approach involving effective measures introduces by several organisations such as government, railway organisations, various authorities (such as public health, education, enforcement, urban planning) and communities. Same measures can often be used to prevent both trespassing and suicides, even though their effectiveness may depend on the target group. In addition, there are measures specifically targeted to prevent either trespassing or suicides. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

A Meta-Intervention to Increase Completion of an HIV-Prevention Intervention: Results from a Randomized Controlled Trial in the State of Florida

PubMed Central

Albarracín, Dolores; Wilson, Kristina; Durantini, Marta R.; Sunderrajan, Aashna; Livingood, William

2016-01-01

Objective A randomized control trial with 722 eligible clients from a health department in the State of Florida was conducted to identify a simple, effective meta-intervention to increase completion of an HIV-prevention counseling program. Method The overall design involved two factors representing an empowering and instrumental message, as well as an additional factor indicating presence or absence of expectations about the counseling. Completion of the three-session counseling was determined by recording attendance. Results A logistic regression analysis with the three factors of empowering message, instrumental message, and presence of mediator measures, as well as all interactions, revealed significant interactions between instrumental and empowering messages and between instrumental messages and presence of mediator measures. Results indicated that (a) the instrumental message alone produced most completion than any other message, and (b) when mediators were not measured, including the instrumental message led to greater completion. Conclusions The overall gains in completion as a result of the instrumental message were 16%, implying success in the intended facilitation of counseling completion. The measures of mediators did not detect any experimental effects, probably because the effects were happening without much conscious awareness. PMID:27786499

Maintenance of Fish Health in Aquaculture: Review of Epidemiological Approaches for Prevention and Control of Infectious Disease of Fish.

PubMed

Assefa, Ayalew; Abunna, Fufa

2018-01-01

Aquaculture is rapidly growing part of agriculture worldwide. It makes up around 44 percent of total fish production globally. This increased growth of production is achieved despite facing many challenges in the aquaculture environment. Among production limiting challenges, the infectious disease takes the lion share by causing multibillion-dollar loss annually. To reduce the impact of the fish disease, it is necessary to address health constraints based on scientifically proven and recommended ways. This review aims at pointing out some of the best approaches to prevention and control of infectious disease in aquaculture. Among the effective prevention and control strategies, vaccination is one of the key practices. Types of vaccines for use in fish include killed vaccines, attenuated vaccines, DNA vaccines, recombinant technology vaccines, and synthetic peptide vaccines. Administration techniques of vaccines in fish include oral, injection, or immersion methods. Antibiotics are also in use in aquaculture despite their side effects in the development of drug resistance by microorganisms. Biological and chemical disease control strategies such as using probiotics, prebiotics, and medicinal plants are widely in use. Biosecurity measures in aquaculture can keep the safety of a facility from certain disease-causing agents that are absent in particular system. Farm-level biosecurity measures include strict quarantine measures, egg disinfection, traffic control, water treatments, clean feed, and disposal of mortalities. In conclusion, rather than trying to treat every disease case, it advisable to follow a preventive approach before the event of any disease outbreaks.

Interventions addressing general parenting to prevent or treat childhood obesity.

PubMed

Gerards, Sanne M P L; Sleddens, Ester F C; Dagnelie, Pieter C; de Vries, Nanne K; Kremers, Stef P J

2011-06-01

Observational studies increasingly emphasize the impact of general parenting on the development of childhood overweight and obesity. The aim of the current literature review was to provide an overview of interventions addressing general parenting in order to prevent or treat childhood obesity. Electronic literature databases were systematically searched for relevant studies. Seven studies were eligible for inclusion. The studies described four different general parenting programs, which were supplemented with lifestyle components (i.e., physical activity and nutrition). All studies showed significant small to moderate intervention effects on at least one weight-related outcome measure. The current review shows that despite the emerging observational evidence for the role of parenting in children's weight-related outcomes, few interventions have been developed that address general parenting in the prevention of childhood obesity. These interventions provide evidence that the promotion of authoritative parenting is an effective strategy for the prevention and management of childhood obesity.

Effect of food additives on egg yolk gelation induced by freezing.

PubMed

Primacella, Monica; Fei, Tao; Acevedo, Nuria; Wang, Tong

2018-10-15

This study demonstrates technological advances in preventing yolk gelation during freezing and thawing. Gelation negatively affects yolk functionality in food formulation. Preventing gelation using 10% salt or sugar limits the application of the yolk. Novel food additives were tested to prevent gelation induced by freezing. Significant reduction (p < 0.05) in gel hardness of frozen-thawed yolk (45 h freezing at -20 °C) indicates that hydrolyzed carboxymethyl cellulose (HCMC), proline, and hydrolyzed egg white and yolk (HEW and HEY) are effective gelation inhibitors. The mechanisms in which these additives prevented gelation were further studied through measuring the changes in the amount of freezable water, lipoprotein particle size, and protein surface hydrophobicity. Overall, this study provides several alternatives of gelation inhibitor that have great potentials in replacing the use of salt or sugar in commercial operation of freezing egg yolk for shelf-life extension. Copyright © 2018 Elsevier Ltd. All rights reserved.

Strategies for prevention of ventilator-associated pneumonia: bundles, devices, and medications for improved patient outcomes.

PubMed

Alroumi, Fahad; Sarwar, Akmal; Grgurich, Philip E; Lei, Yuxiu; Hudcova, Jana; Craven, Donald E

2012-02-01

Ventilator-associated pneumonia is associated with significant patient morbidity, mortality, and increased health care costs. In the current economic climate, it is crucial to implement cost-effective prevention strategies that have proven efficacy. Multiple prevention measures have been proposed by various expert panels. Global strategies have focused on infection control, and reduction of lower airway colonization with bacterial pathogens, intubation, duration of mechanical ventilation, and length of stay in the intensive care unit. Routine use of the Institute for Healthcare Improvement ventilator care bundle is widespread, and has been clearly demonstrated to be an effective method for reducing the incidence of ventilator-associated pneumonia. In this article, we examine specific aspects of the Institute for Healthcare Improvement bundle, better-designed endotracheal tubes, use of antibiotics and probiotics, and treatment of ventilator-associated tracheobronchitis to prevent ventilator-associated pneumonia.

[Prevention of hand dermatoses in small catering enterprises].

PubMed

Kurpiewska, Joanna; Liwkowicz, Jolanta; Padlewska, Kamila

2013-01-01

Work in catering and food processing is mostly performed by hands. Mechanical, thermal and chemical agents, as well as damp working conditions and frequent hand washing aggravate skin irritation. The aim of the study was to test the efficacy of hydrophobic skin protection measure at these workplaces. We recommended the prevention of contact skin disorders by using hydrophobic skin protection measure. The study was conducted in a group of 20 food service sector workers, They were interviewed about skin problems and skin protection measures. Tolb assess the effect of the protective preparation on the skin dermatological test procedures, corneometry and sebumetry, were applied, as well as the level of transepidermal water loss (TEWL) was measured. The same survey was performed in the control group composed of 10 workers who used and 10 who did not use barrier preparation. The respondents declared dryness, roughness, peeling, burning, redness, erythema of the skin. All who had applied barrier cream observed a significant improvement of the skin hydration increased by about 30%, and lubrication of the skin - by 11 times on average. Also the level of TEWL decreased by about 25%. The improvement of skin conditions and reduction of skin disorders were observed confirming the effectiveness of the protection of the skin from exposure to harmful factors. Knowledge about prevention of skin diseases should be promoted among employees of catering enterprises.

Understanding the role of waste prevention in local waste management: A literature review.

PubMed

Zacho, Kristina O; Mosgaard, Mette A

2016-10-01

Local waste management has so far been characterised by end-of-pipe solutions, landfilling, incineration, and recycling. End-of-pipe solutions build on a different mind-set than life cycle-based approaches, and for this reason, local waste managers are reluctant to consider strategies for waste prevention. To accelerate the transition of waste and resource management towards a more integrated management, waste prevention needs to play a larger role in the local waste management. In this review article, we collect knowledge from the scientific community on waste prevention of relevance to local waste management. We analyse the trends in the waste prevention literature by organising the literature into four categories. The results indicate an increasing interest in waste prevention, but not much literature specifically concerns the integration of prevention into the local waste management. However, evidence from the literature can inform local waste management on the prevention potential; the environmental and social effects of prevention; how individuals in households can be motivated to reduce waste; and how the effects of prevention measures can be monitored. Nevertheless, knowledge is still lacking on local waste prevention, especially regarding the methods for monitoring and how local waste management systems can be designed to encourage waste reduction in the households. We end the article with recommendations for future research. The literature review can be useful for both practitioners in the waste sector and for academics seeking an overview of previous research on waste prevention. © The Author(s) 2016.

A trial of a job-specific workers' health surveillance program for construction workers: study protocol

PubMed Central

2011-01-01

Background Dutch construction workers are offered periodic health examinations. This care can be improved by tailoring this workers health surveillance (WHS) to the demands of the job and adjust the preventive actions to the specific health risks of a worker in a particular job. To improve the quality of the WHS for construction workers and stimulate relevant job-specific preventive actions by the occupational physician, we have developed a job-specific WHS. The job-specific WHS consists of modules assessing both physical and psychological requirements. The selected measurement instruments chosen, are based on their appropriateness to measure the workers' capacity and health requirements. They include a questionnaire and biometrical tests, and physical performance tests that measure physical functional capabilities. Furthermore, our job-specific WHS provides occupational physicians with a protocol to increase the worker-behavioural effectiveness of their counselling and to stimulate job-specific preventive actions. The objective of this paper is to describe and clarify our study to evaluate the behavioural effects of this job-specific WHS on workers and occupational physicians. Methods/Design The ongoing study of bricklayers and supervisors is a nonrandomised trial to compare the outcome of an intervention (job-specific WHS) group (n = 206) with that of a control (WHS) group (n = 206). The study includes a three-month follow-up. The primary outcome measure is the proportion of participants who have undertaken one or more of the preventive actions advised by their occupational physician in the three months after attending the WHS. A process evaluation will be carried out to determine context, reach, dose delivered, dose received, fidelity, and satisfaction. The present study is in accordance with the TREND Statement. Discussion This study will allow an evaluation of the behaviour of both the workers and occupational physician regarding the preventive actions undertaken by them within the scope of a job-specific WHS. Trial registration NTR3012 PMID:21958019

Factors That Drive Dentists towards or Away from Dental Caries Preventive Measures: Systematic Review and Metasummary

PubMed Central

Suga, Uhana Seifert Guimarães; Terada, Raquel Sano Suga; Ubaldini, Adriana Lemos Mori; Fujimaki, Mitsue; Pascotto, Renata Corrêa; Batilana, Adelia Portero; Pietrobon, Ricardo; Vissoci, João Ricardo N.; Rodrigues, Clarissa G.

2014-01-01

Background Dental caries is a serious public health concern. The high cost of dental treatment can be avoided by effective preventive measures, which are dependent on dentists’ adherence. This study aimed to evaluate the factors that drive dentists towards or away from dental caries preventive measures. Methods and Findings This systematic review was registered in PROSPERO (CRD42012002235). Several databases as well as the reference lists and citations of the included publications were searched according to PRISMA guidelines, yielding 18,276 titles and abstracts, which were assessed to determine study eligibility. Seven qualitative studies and 41 surveys (36,501 participants) remained after data extraction and interpretation. A total of 43 findings were abstracted from the reports and were grouped together into 6 categories that were judged to be topically similar: education and training, personal beliefs, work conditions, remuneration, gender, place of residence and patients. The main findings for adherence based on their calculated frequency effect sizes (ES) were teamwork (21%) and post-graduation (12%), while for non-adherence were biologicism (27%), and remuneration for preventive procedures (25%). Intensity ES were also calculated and demonstrated low prevalence of the findings. Quality assessment of the studies demonstrated that the methodological quality, particularly of surveys, varied widely among studies. Conclusions Despite the questionable quality of the included reports, the evidence that emerged seems to indicate that further education and training coupled with a fairer pay scheme would be a reasonable approach to change the balance in favor of the provision of dental caries preventive measures by dentists. The results of this review could be of value in the planning and decision making processes aimed at encouraging changes in professional dental practice that could result in the improvement of the oral health care provided to the population in general. PMID:25296335

Advances in Statistical Methods for Substance Abuse Prevention Research

PubMed Central

MacKinnon, David P.; Lockwood, Chondra M.

2010-01-01

The paper describes advances in statistical methods for prevention research with a particular focus on substance abuse prevention. Standard analysis methods are extended to the typical research designs and characteristics of the data collected in prevention research. Prevention research often includes longitudinal measurement, clustering of data in units such as schools or clinics, missing data, and categorical as well as continuous outcome variables. Statistical methods to handle these features of prevention data are outlined. Developments in mediation, moderation, and implementation analysis allow for the extraction of more detailed information from a prevention study. Advancements in the interpretation of prevention research results include more widespread calculation of effect size and statistical power, the use of confidence intervals as well as hypothesis testing, detailed causal analysis of research findings, and meta-analysis. The increased availability of statistical software has contributed greatly to the use of new methods in prevention research. It is likely that the Internet will continue to stimulate the development and application of new methods. PMID:12940467

Recruitment into diabetes prevention programs: what is the impact of errors in self-reported measures of obesity?

PubMed

Hernan, Andrea; Philpot, Benjamin; Janus, Edward D; Dunbar, James A

2012-07-08

Error in self-reported measures of obesity has been frequently described, but the effect of self-reported error on recruitment into diabetes prevention programs is not well established. The aim of this study was to examine the effect of using self-reported obesity data from the Finnish diabetes risk score (FINDRISC) on recruitment into the Greater Green Triangle Diabetes Prevention Project (GGT DPP). The GGT DPP was a structured group-based lifestyle modification program delivered in primary health care settings in South-Eastern Australia. Between 2004-05, 850 FINDRISC forms were collected during recruitment for the GGT DPP. Eligible individuals, at moderate to high risk of developing diabetes, were invited to undertake baseline tests, including anthropometric measurements performed by specially trained nurses. In addition to errors in calculating total risk scores, accuracy of self-reported data (height, weight, waist circumference (WC) and Body Mass Index (BMI)) from FINDRISCs was compared with baseline data, with impact on participation eligibility presented. Overall, calculation errors impacted on eligibility in 18 cases (2.1%). Of n = 279 GGT DPP participants with measured data, errors (total score calculation, BMI or WC) in self-report were found in n = 90 (32.3%). These errors were equally likely to result in under- or over-reported risk. Under-reporting was more common in those reporting lower risk scores (Spearman-rho = -0.226, p-value < 0.001). However, underestimation resulted in only 6% of individuals at high risk of diabetes being incorrectly categorised as moderate or low risk of diabetes. Overall FINDRISC was found to be an effective tool to screen and recruit participants at moderate to high risk of diabetes, accurately categorising levels of overweight and obesity using self-report data. The results could be generalisable to other diabetes prevention programs using screening tools which include self-reported levels of obesity.

Effects of Sex Composition on Group Processes in Alcohol Prevention Groups for Teens

PubMed Central

Garcia, Tracey A.; Bacio, Guadalupe A.; Tomlinson, Kristin; Ladd, Benjamin O.; Anderson, Kristen G.

2015-01-01

Although most alcohol and other drug prevention programs for adolescents are offered in group settings, little is known about the possible effects of sex composition on group processes and mechanisms of change. Using the Group Actor-Partner Interdependence Model framework, we examined how the sex constellation of adolescent prevention group members influenced youth satisfaction, engagement, and endorsement of healthy behavior during group. Participants in Project Options (N = 379; 61.8% girls; Mage = 16.1; SD = 1.4), a voluntary school-based alcohol prevention program, completed measures of satisfaction at each prevention session and observers rated engagement and change talk for each group. When analyses were oriented towards girls, their personal satisfaction, group-rated satisfaction, and group-level engagement were positively related to having more girls in the group. Similarly, in boys, personal satisfaction, satisfaction of the group as a whole, and engagement in groups improved when groups were composed of more girls. Statements supportive of healthy alcohol/drug-related decision making were unrelated to group composition. The findings suggest that the composition of girls and boys in groups has differential effects on some group processes. This avenue of research has merit for the understanding the mechanisms associated with satisfaction and engagement in adolescent substance use prevention programs. PMID:26237325

Industry sponsored anti-smoking ads and adolescent reactance: test of a boomerang effect.

PubMed

Henriksen, L; Dauphinee, A L; Wang, Y; Fortmann, S P

2006-02-01

To examine whether adolescents' exposure to youth smoking prevention ads sponsored by tobacco companies promotes intentions to smoke, curiosity about smoking, and positive attitudes toward the tobacco industry. A randomised controlled experiment compared adolescents' responses to five smoking prevention ads sponsored by a tobacco company (Philip Morris or Lorillard), or to five smoking prevention ads sponsored by a non-profit organisation (the American Legacy Foundation), or to five ads about preventing drunk driving. A large public high school in California's central valley. A convenience sample of 9th and 10th graders (n = 832) ages 14-17 years. Perceptions of ad effectiveness, intention to smoke, and attitudes toward tobacco companies measured immediately after exposure. As predicted, adolescents rated Philip Morris and Lorillard ads less favourably than the other youth smoking prevention ads. Adolescents' intention to smoke did not differ as a function of ad exposure. However, exposure to Philip Morris and Lorillard ads engendered more favourable attitudes toward tobacco companies. This study demonstrates that industry sponsored anti-smoking ads do more to promote corporate image than to prevent youth smoking. By cultivating public opinion that is more sympathetic toward tobacco companies, the effect of such advertising is likely to be more harmful than helpful to youth.

Effectiveness of skin protection measures in prevention of occupational hand eczema: results of a prospective randomized controlled trial over a follow-up period of 1 year.

PubMed

Kütting, B; Baumeister, T; Weistenhöfer, W; Pfahlberg, A; Uter, W; Drexler, H

2010-02-01

We recently found a very low adherence to a generally recommended skin protection regimen in a sample of 1355 metalworkers. The present study assessed the effectiveness of skin protection as presently recommended, especially the differential contribution of skin care and skin protection, to the prevention of occupational hand eczema. Methods Of 1355 metalworkers screened, 1020 male volunteers, all fit for work, were recruited for a prospective intervention study with four arms (skin care, skin protection, both combined, and control group, i.e. no recommendation). The study was performed from winter 2006/2007 to spring 2008, following each subject for up for 12 months. Both hands were examined using a quantitative skin score, and a standardized personal interview was performed three times. The change of the objective skin score from baseline to 12 months was used as primary outcome measure. After 12 months 800 subjects were included (78.4% of those recruited). The compliance to follow the randomized measure depended on the recommended measure and ranged from 73.7% to 88.7%. While in the control group a significant deterioration was found, the largest and significant improvement was noted in the group following the generally recommended skin protection programme (skin care + skin protection) followed by skin protection alone as second best. The generally recommended skin protection regimen seems to provide effective prevention of occupational skin disease. Therefore, the compliance to follow the skin protection regimen, especially the use of skin protection, should be enhanced.

DOSE RESPONSE MODELING FOR 2, 3, 7, 8-TETRACHLORODIBENZO-P-DIOXIN

EPA Science Inventory

As science continues to appreciate the prevalence and power of dioxins, so it learns more about the harmful effects and effective preventive measures regarding these chemicals. Updating the acclaimed First Edition, Dioxins and Health, Second Edition covers the latest major scient...

The comparative effectiveness of two digit-sucking deterrent methods.

PubMed

Bourne, C O

2005-09-01

A study was conducted to compare the effectiveness of the crib and positive reinforcement in eliminating anterior open bites and increased overjets caused by digit-sucking. The overjet and overbite were measured using an overjet ruler at the start and end of the seventeen-week observation period. Forty patients consented to participate but measurements were only obtained for 11 subjects. The trend in this study is that the crib is more effective than positive reinforcement in preventing digit-sucking.

Effect of supervised brushing with fluoride gel during primary school, taking into account the group prevention schedule in kindergarten.

PubMed

Winter, Julia; Jablonski-Momeni, Anahita; Ladda, Annett; Pieper, Klaus

2017-07-01

In one region of Germany, a group of children took part in regular fluoride gel applications during primary school following intensified prevention in kindergarten. This observational study aimed to ascertain whether the dental health of primary school children can be improved by introducing a group prevention program based on applications of fluoride gel. The subjects were distributed among six groups with varying preventive measures in kindergarten and at school. The basis for determining caries experience and calculating the caries increment consisted of dental findings gathered in the second and fourth grade. While second graders without professionally supported daily toothbrushing in kindergarten exhibited an average d 3 -6 mft of 2.17, in those who had enjoyed intensive dental prevention, the corresponding value was 19% lower (d 3-6 mft = 1.74). The caries increment was significantly lower mainly among children who had received the maximum of group prevention (intensive prevention in kindergarten and gel program at school). The results show that intensified preventive programs in kindergartens and schools, based mainly on supervised toothbrushing, have a positive effect on the dental health of primary school children. Such programs are efficient in reducing caries experience especially in socially deprived areas.

Respiratory health of elite athletes – preventing airway injury: a critical review

PubMed Central

Kippelen, Pascale; Fitch, Kenneth D; Anderson, Sandra Doreen; Bougault, Valerie; Boulet, Louis-Philippe; Rundell, Kenneth William; Sue-Chu, Malcolm; McKenzie, Donald C

2012-01-01

Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established. PMID:22522585

Meeting report on the Bellagio Conference 'prevention of vascular diseases in the emerging world: An approach to global health equity'.

PubMed

Dirks, J H; Robinson, S W; Alderman, M; Couser, W G; Grundy, S M; Smith, S C; Remuzzi, G; Unwin, N

2006-10-01

Representatives from five international organizations (International Society of Nephrology, World Heart Federation, International Diabetes Federation, International Atherosclerosis Federation, and International Society of Hypertension) participated in a strategic planning workshop in December 2005 in Bellagio, Italy sponsored by the Rockefeller Foundation. There were equal representatives from developed and developing countries. Global perspectives on diabetes and cardiovascular and renal diseases were presented, with special emphasis on China, India, Latin America, and Africa. The rationale and effectiveness of preventive measures were discussed. It was apparent that measures for primary prevention and early intervention for all the chronic vascular diseases are similar. The five organizations agreed that an integrated global approach to chronic vascular diseases is needed. They resolved to collaborate and work towards an integrated approach to chronic vascular diseases with the establishment of a 5-year plan for the prevention and treatment of chronic vascular diseases, including public advocacy, advising international and national agencies, and improving education and the practice of established approaches.

Youth misperceptions of peer substance use norms: a hidden risk factor in state and community prevention.

PubMed

Wambeam, Rodney A; Canen, Eric L; Linkenbach, Jeff; Otto, Jay

2014-02-01

Effective community prevention of substance abuse involves the integration of policies and programs to address many different risk and protective factors across the social ecology. This study sought to examine whether youth perceptions of peer substance use norms were operating as a risk factor at the same level as other known risk factors in a statewide community prevention effort. Several different analytical techniques were employed to examine the self-reported data from a sample of over 8,000 students in grades 6, 8, 10, and 12 from across Wyoming using a survey based on a risk and protective factor model. The findings of this study revealed that youth misperception of peer substance use norms operate at a level of significance similar to other known risk factors, and these misperceptions are a risk factor that should be measured in order to estimate its relationship with substance use. The measurement of this risk factor has important strategic implications for community prevention.

A study of passive safety features by utilizing intra-subassembly-equipped self-actuated shutdown mechanism for future large fast breeder reactors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Uto, N.; Niwa, H.; Ieda, Y.

1996-08-01

Passive prevention of core disruptive accidents (CDAs) is desired in terms of enhancement of safety for future fast breeder reactors. In addition, mitigation of CDA`s consequences should be required because mitigation measures have a potential of applying to all accidents, while prevention measures are prepared for specific accident initiators. In this paper, the Intra-Subassembly-equipped Self-Actuated Shutdown System (IS-SASS) , which is considered effective on passive prevention and mitigation of CDAs, is described. The IS-SASS is introduced in a fuel subassembly and consists of absorber materials at the top of the active core and an inner duct through which molten fuelmore » can be excluded out of the core. The determination of the appropriate number of the IS-SASS units, their arrangement in the core and their suitable structure are found to be suited to prevention and mitigation of CDAs for liquid metal-cooled large fast breeder reactors.« less

The value of reducing hospital-acquired pressure ulcer prevalence: an illustrative analysis.

PubMed

Spetz, Joanne; Brown, Diane S; Aydin, Carolyn; Donaldson, Nancy

2013-04-01

The aim of this study was to assess the cost savings associated with implementing nursing approaches to prevent hospital-acquired pressure ulcers (HAPU). Hospitals face substantial costs associated with the treatment of HAPUs. Interventions have been demonstrated as effective for HAPU prevention and management, but it is widely perceived that preventative measures are expensive and, thus, may not be a good use of resources. A return-on-investment (ROI) framework from the Agency for Healthcare Research and Quality (AHRQ) Quality Indicators Toolkit was used for this study. The researchers identified achievable improvements in HAPU rates from data from the Collaborative Alliance for Nursing Outcomes and measured costs and savings associated with HAPU reduction from published literature. The analysis produced a baseline ROI ratio of 1.61 and net savings of $127.51 per patient. Hospital-acquired pressure ulcer surveillance and prevention can be cost saving for hospitals and should be considered by nurse executives as a strategy to support quality outcomes.

[Techniques for Preventing Postoperative Complication in Esophageal Salvage Surgery].

PubMed

Iwama, Mitsuru; Yasuda, Takushi; Shiraishi, Osamu; Kato, Hiroaki; Hiraki, Yoko; Tanaka, Yumiko; Yasuda, Atsushi; Shinkai, Masayuki; Imano, Motohiro; Kimura, Yutaka; Imamoto, Haruhiko

2017-07-01

Patients with esophageal cancer are often treated with definitive chemoradiotherapy (dCRT). Regardless of arrival at dCRT, the risk of local/regional recurrence during follow-up is significant. Many patient are faced with limited options for therapy once dCRT has failed. Salvage surgery is the only way for complete cure of patients with local/regional recurrent esophageal cancer after dCRT. However, salvage surgery has a significant high risk of fatal complications. We examine our preventive measures to reduce the incidence of postoperative complications after salvage surgery for thoracic esophageal cancer. The points of our preventive measures are them; I. the ingenuity of surgery, II. the securement of blood supply for the respiratory tract, III. standard lymphadenectomy, IV. countermeasures of anastomotic failure, V. countermeasures of dead space, VI. countermeasures of respiratory complications, VII. perioperative managements. Salvage surgery is a reasonable option to treat patients with local/regional recurrence after failed dCRT. Our preventive mesures are effective, therefore, we have to make the further technological developments and the safety of salvage surgery.

Respiratory health of elite athletes - preventing airway injury: a critical review.

PubMed

Kippelen, Pascale; Fitch, Kenneth D; Anderson, Sandra Doreen; Bougault, Valerie; Boulet, Louis-Philippe; Rundell, Kenneth William; Sue-Chu, Malcolm; McKenzie, Donald C

2012-06-01

Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.

Phylogenetic studies of transmission dynamics in generalized HIV epidemics: An essential tool where the burden is greatest?

PubMed Central

Dennis, Ann M.; Herbeck, Joshua T.; Brown, Andrew Leigh; Kellam, Paul; de Oliveira, Tulio; Pillay, Deenan; Fraser, Christophe; Cohen, Myron S.

2014-01-01

Efficient and effective HIV prevention measures for generalized epidemics in sub-Saharan Africa have not yet been validated at the population-level. Design and impact evaluation of such measures requires fine-scale understanding of local HIV transmission dynamics. The novel tools of HIV phylogenetics and molecular epidemiology may elucidate these transmission dynamics. Such methods have been incorporated into studies of concentrated HIV epidemics to identify proximate and determinant traits associated with ongoing transmission. However, applying similar phylogenetic analyses to generalized epidemics, including the design and evaluation of prevention trials, presents additional challenges. Here we review the scope of these methods and present examples of their use in concentrated epidemics in the context of prevention. Next, we describe the current uses for phylogenetics in generalized epidemics, and discuss their promise for elucidating transmission patterns and informing prevention trials. Finally, we review logistic and technical challenges inherent to large-scale molecular epidemiological studies of generalized epidemics, and suggest potential solutions. PMID:24977473

[Clinical effectiveness and economical evaluation of preventive vaccination].

PubMed

Vaz Carneiro, António; Belo, Ana Isabel; Gouveia, Miguel; Costa, João; Borges, Margarida

2011-01-01

The value of mass vaccination as a preventive measure for infectious diseases is one of the most important advances of modern Medicine. The impact on incidence of several infectious diseases, until recently responsible for significant morbidity and mortality at world level, is well proved in a series of high quality epidemiological studies. In this scientific review we aimed firstly to briefly resume the history of mass vaccination and its scientists, responsible for synthesis and marketing of these drugs. In second place we present a group of a few disease preventable by vaccines as well as the Portuguese National Vaccination Plan and its benefits. In third place we identified groups of subjects in which a well structured vaccination plan is particularly important, as well as the correspondent diseases to be covered by vaccination. Fourthly, we discussed the ethical considerations of vaccination, and its tensions between subject autonomy and society advantages in com pulsive programs. Fifthly, we analyzed clinical effectiveness of vaccines through the concept of herd immunity, clinical evaluation of immune response to vaccines and some examples of systematic reviews on three relevant diseases (influenza, meningococcal and pneumococcal infections). In sixth place we discussed vaccine safety presenting monitoring methods of vaccination risks, as well as discussing the public myths concerning vaccines. Finally we present a economic analysis of preventive vaccination with a review of some published literature on specific diseases. We conclude that mass vaccination is a efficacious preventive measure, as well as a economic rational choice, and that this public health intervention should be a pillar of a modern preventive system.

The 'Sequence of Prevention' for musculoskeletal injuries among recreational basketballers: a systematic review of the scientific literature.

PubMed

Kilic, Özgür; Van Os, Vivian; Kemler, Ellen; Barendrecht, Maarten; Gouttebarge, Vincent

2018-05-01

Currently, there is no overview of the incidence and (basketball-specific) risk factors of musculoskeletal injuries among recreational basketball players, nor any insight into the effect of preventive measures on the incidence of basketball injuries. This study aimed to gather systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures for musculoskeletal injuries among recreational basketball players. Highly sensitive search strategies were built based on three groups of keywords (and related search terms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The incidence of musculoskeletal injuries among recreational basketball players ranged from 0.0047 injuries per 1,000 athlete-exposures (AE) for dental injuries to 10.1 injuries per 1000 AE for overall injuries during match play. Significant risk factors for injuries were defending, postural sway, high vertical ground reaction force during jumping and weight >75 kg. All prevention studies have shown to have a significant effect on reducing the risk of injury ranging from an odds ratio (95% confidence interval (CI)) of 0.175 (0.049-0.626) for training injuries and a relative risk (95% CI) of 0.83 (0.57-1.19) achieved with FIFA 11+ prevention exercises and sport-specific balance training, relatively. In order to gain insight in the aetiology of basketball-specific injuries and consequently facilitate the development of preventive strategies, more high quality basketball-specific and injury-specific studies among recreational basketball players are needed.

The effectiveness of policy and health education strategies for reducing adolescent smoking: a review of the evidence.

PubMed

Willemsen, M C; De Zwart, W M

1999-10-01

This paper identifies the most effective measures to prevent smoking among adolescents. A review was made of the international literature concerning a ban on tobacco advertising, restrictions on sales to youth, product regulation, price increase of cigarettes and educational strategies. It is concluded that isolated measures produce little effect. Most effect may be expected from a combination of a complete ban on tobacco advertising, increasing prices, restricting tobacco product sales to tobacconists, mass media education aimed at youth and intensifying school education. A less effective measure is limiting the age at which adolescents are allowed to buy cigarettes. Copyright 1999 The Association for Professionals in Services for Adolescents.

Dynamics of pregnant women's oral health status during preventive programme.

PubMed

Vasiliauskiene, Ingrida; Milciuviene, Simona; Bendoraitiene, Egle; Narbutaite, Julija; Slabsinskiene, Egle; Andruskeviciene, Vilija

2007-01-01

The aim of the study was to determine the efficiency of the applied preventive measures during pregnancy and to improve oral health status to pregnant women. Oral health status of 180 pregnant women was determined according to WHO criteria (WHO: Basic methods, 1997). Dental caries prevalence, DMF-T and DMF-S were evaluated. Gingival status was estimated according to Silness-Loe (GI) index. Women were asked about tooth brushing frequency; oral hygiene was evaluated according to Green-Vermilion (OHI-S) index. Participants were divided into test (89) and control (91) groups. During pregnancy, the following preventive measures were applied to the test group: fluoride varnish applications, mouthrinsing with 0.12% chlorhexine digluconate, professional oral hygiene. Oral health status was evaluated three times during pregnancy. Reduction in dental caries increment of the test group was 56.25% in comparison with the control group. The periodontal status has improved, oral hygiene index (OHI-S) has decreased from 1.48+/-0.05 to 0.94+/-0.06 in the test group, and from 1.49+/-0.06 to 1.9+/-0.06 in the control group. Results of the study showed that selected dental caries preventive measures were effective and significantly improved women's oral health during pregnancy.

Child maltreatment prevention: a systematic review of reviews.

PubMed

Mikton, Christopher; Butchart, Alexander

2009-05-01

To synthesize recent evidence from systematic and comprehensive reviews on the effectiveness of universal and selective child maltreatment prevention interventions, evaluate the methodological quality of the reviews and outcome evaluation studies they are based on, and map the geographical distribution of the evidence. A systematic review of reviews was conducted. The quality of the systematic reviews was evaluated with a tool for the assessment of multiple systematic reviews (AMSTAR), and the quality of the outcome evaluations was assessed using indicators of internal validity and of the construct validity of outcome measures. The review focused on seven main types of interventions: home visiting, parent education, child sex abuse prevention, abusive head trauma prevention, multi-component interventions, media-based interventions, and support and mutual aid groups. Four of the seven - home-visiting, parent education, abusive head trauma prevention and multi-component interventions - show promise in preventing actual child maltreatment. Three of them - home visiting, parent education and child sexual abuse prevention - appear effective in reducing risk factors for child maltreatment, although these conclusions are tentative due to the methodological shortcomings of the reviews and outcome evaluation studies they draw on. An analysis of the geographical distribution of the evidence shows that outcome evaluations of child maltreatment prevention interventions are exceedingly rare in low- and middle-income countries and make up only 0.6% of the total evidence base. Evidence for the effectiveness of four of the seven main types of interventions for preventing child maltreatment is promising, although it is weakened by methodological problems and paucity of outcome evaluations from low- and middle-income countries.

Association between knowledge of caries preventive practices, preventive oral health habits of parents and children and caries experience in children resident in sub-urban Nigeria.

PubMed

Folayan, Morenike O; Kolawole, Kikelomo A; Oyedele, Titus; Chukwumah, Nneka M; Chukumah, Nneka M; Onyejaka, Nneka; Agbaje, Hakeem; Oziegbe, Elizabeth O; Oshomoji, Olusegun V; Osho, Olusegun V

2014-12-16

The objectives of this study were to assess the association between children and parents' knowledge of caries preventive practices, the parents' caries preventive oral health behaviours and children's caries preventive oral health behaviour and caries experience. Three hundred and twenty four participants aged 8-12 years, 308 fathers and 318 mothers were recruited through a household survey conducted in Suburban Nigeria. A questionnaire was administered to generate information on fathers, mothers and children's knowledge of caries prevention measures and their oral health behaviour. Clinical examination was conducted on the children to determine their dmft/DMFT. Analysis was conducted to determine the predictors of the children's good oral health behaviour. The mothers' oral health behaviours were significant predictors of the children's oral health behaviours. Children who had good knowledge of caries prevention measures had significant increased odds of brushing their teeth twice daily or more. The children's caries prevalence was 13.9%, the mean dmft was 0.2 and the mean DMFT was 0.09. None of the dependent variables could predict the presence of caries in children. The study highlights the effect of maternal oral health behaviour on the oral health behaviour of children aged 8 years to 12 years in suburban Nigeria. A pilot study is needed to evaluate how enhanced maternal preventive oral health practices can improve the oral health preventive practices of children.

[Do breast-feeding and "diet" milks have any preventive or curative effect in the management of atopic dermatitis in children?].

PubMed

de Boissieu, D

2005-01-01

A) The preventive interest of infants' food in the onset of atopic dermatitis. Measures of prevention of atopic dermatitis concern predisposed children. Most studies agree on the protective effect of breast feeding for at least 3 to 4 months, compared with industrial milk products, on the onset of atopic dermatitis. Partial breast feeding is not protective. There is no preventive effect of breast feeding on the onset of atopic dermatitis in the absence of a family history of atopy. However, a few studies have raised the question of the aggravation of eczema during prolonged breast feeding. The "breast fed" group is probably not a homogenous group. Mothers' milk contains IgA, TGFb-type cytokines and long-chain polyinsaturated fatty acids that may play an important part in the acquisition of tolerance to food and the prevention of atopic dermatitis. The administration of a protein hydrolysate is preferable in terms of prevention of an allergy to a formula based on cow's milk, but does not provide any benefit compared with breast feeding. The preventive effect on atopic dermatitis of a casein hydrolysate is greater than that of a partial hydrolysate, which itself is greater than a formula based on cow's milk. In conclusion, the first preventive measure is breast feeding for 3 to 4 months, associated with intensive protein hydrolysate in the case of mixed feeding. In the absence of breast feeding, intensive hydrolysate is recommended in children at high risk. B) The curative interest of infants' food in the management of atopic dermatitis. The curative interest implies the responsibility of food in the triggering-off or maintenance of atopic dermatitis. This concerns non-diversified infants exhibiting severe or moderate eczema concomitant to digestive disorders. In such cases, the diagnosis of food allergy should be evoked. If the infant is fed on industrial milk, a test diet should be proposed with a hydrolysate or based on amino acids, followed by the re-introduction of the formula used previously. If the infant is exclusively breast fed, diagnosis of an allergy to one of the foodstuffs ingested by the mother should be searched for and treated. Early diagnosis of food allergy in infants, before diversification, is the optimal factor of prognosis.

EPA blocks TNF-α-induced inhibition of sugar uptake in Caco-2 cells via GPR120 and AMPK.

PubMed

Castilla-Madrigal, Rosa; Barrenetxe, Jaione; Moreno-Aliaga, María J; Lostao, María Pilar

2018-03-01

The aim of the present work was to investigate in Caco-2 cells whether eicosapentaenoic acid (EPA), an omega-3 polyunsaturated fatty acid, could block the inhibitory effect of tumor necrosis factor-α (TNF-α) on sugar transport, and identify the intracellular signaling pathways involved. After pre-incubation of the Caco-2 cells with TNF-α and EPA for 1 hr, EPA prevented the inhibitory effect of the cytokine on α-methyl-d-glucose (αMG) uptake (15 min) and on SGLT1 expression at the brush border membrane, measured by Western blot. The ERK1/2 inhibitor PD98059 and the AMPK activator AICAR also prevented the inhibitory effect of TNF-α on both αMG uptake and SGLT1 expression. Interestingly, the AMPK inhibitor, Compound C, abolished the ability of EPA to prevent TNF-α-induced reduction of sugar uptake and transporter expression. The GPR120 antagonist, AH7614, also blocked the preventive effect of EPA on TNF-α-induced decrease of αMG uptake and AMPK phosphorylation. In summary, TNF-α inhibits αMG uptake by decreasing SGLT1 expression in the brush border membrane through the activation of ERK1/2 pathway. EPA prevents the inhibitory effect of TNF-α through the involvement of GPR120 and AMPK activation. © 2017 Wiley Periodicals, Inc.

An Evidence-Based Multidisciplinary Practice Guideline to Reduce the Workload due to Lifting for Preventing Work-Related Low Back Pain

PubMed Central

2014-01-01

We developed an evidence-based practice guideline to support occupational safety and health (OSH) professionals in assessing the risk due to lifting and in selecting effective preventive measures for low back pain (LBP) in the Netherlands. The guideline was developed at the request of the Dutch government by a project team of experts and OSH professionals in lifting and work-related LBP. The recommendations for risk assessment were based on the quality of instruments to assess the risk on LBP due to lifting. Recommendations for interventions were based on a systematic review of the effects of worker- and work directed interventions to reduce back load due to lifting. The quality of the evidence was rated as strong (A), moderate (B), limited (C) or based on consensus (D). Finally, eight experts and twenty-four OSH professionals commented on and evaluated the content and the feasibility of the preliminary guideline. For risk assessment we recommend loads heavier than 25 kg always to be considered a risk for LBP while loads less than 3 kg do not pose a risk. For loads between 3–25 kg, risk assessment shall be performed using the Manual handling Assessment Charts (MAC)-Tool or National Institute for Occupational Safety and Health (NIOSH) lifting equation. Effective work oriented interventions are patient lifting devices (Level A) and lifting devices for goods (Level C), optimizing working height (Level A) and reducing load mass (Level C). Ineffective work oriented preventive measures are regulations to ban lifting without proper alternatives (Level D). We do not recommend worker-oriented interventions but consider personal lift assist devices as promising (Level C). Ineffective worker-oriented preventive measures are training in lifting technique (Level A), use of back-belts (Level A) and pre-employment medical examinations (Level A). This multidisciplinary evidence-based practice guideline gives clear criteria whether an employee is at risk for LBP while lifting and provides an easy-reference for (in)effective risk reduction measures based on scientific evidence, experience, and consensus among OSH experts and practitioners. PMID:24999432

An Evidence-Based Multidisciplinary Practice Guideline to Reduce the Workload due to Lifting for Preventing Work-Related Low Back Pain.

PubMed

Kuijer, P Paul Fm; Verbeek, Jos Ham; Visser, Bart; Elders, Leo Am; Van Roden, Nico; Van den Wittenboer, Marion Er; Lebbink, Marian; Burdorf, Alex; Hulshof, Carel Tj

2014-01-01

We developed an evidence-based practice guideline to support occupational safety and health (OSH) professionals in assessing the risk due to lifting and in selecting effective preventive measures for low back pain (LBP) in the Netherlands. The guideline was developed at the request of the Dutch government by a project team of experts and OSH professionals in lifting and work-related LBP. The recommendations for risk assessment were based on the quality of instruments to assess the risk on LBP due to lifting. Recommendations for interventions were based on a systematic review of the effects of worker- and work directed interventions to reduce back load due to lifting. The quality of the evidence was rated as strong (A), moderate (B), limited (C) or based on consensus (D). Finally, eight experts and twenty-four OSH professionals commented on and evaluated the content and the feasibility of the preliminary guideline. For risk assessment we recommend loads heavier than 25 kg always to be considered a risk for LBP while loads less than 3 kg do not pose a risk. For loads between 3-25 kg, risk assessment shall be performed using the Manual handling Assessment Charts (MAC)-Tool or National Institute for Occupational Safety and Health (NIOSH) lifting equation. Effective work oriented interventions are patient lifting devices (Level A) and lifting devices for goods (Level C), optimizing working height (Level A) and reducing load mass (Level C). Ineffective work oriented preventive measures are regulations to ban lifting without proper alternatives (Level D). We do not recommend worker-oriented interventions but consider personal lift assist devices as promising (Level C). Ineffective worker-oriented preventive measures are training in lifting technique (Level A), use of back-belts (Level A) and pre-employment medical examinations (Level A). This multidisciplinary evidence-based practice guideline gives clear criteria whether an employee is at risk for LBP while lifting and provides an easy-reference for (in)effective risk reduction measures based on scientific evidence, experience, and consensus among OSH experts and practitioners.

Ultrasonic Guided Wave Technology for Non-Invasive Assessment of Corrosion-Induced Damage in Piping for Pollution Prevention in DOD Fuel Storage Facilities

DTIC Science & Technology

2011-08-01

using a mixture of rock salt and tap water. A combination of lacquer and duct tape was used to mask the desired corrosion areas and to prevent excessive...Corrosion Measurements," NDT efT E International, Vol. 37, No.3, 2004, pp. 167-180. Demma, A, P. Cawley, M. Lowe and B. Pavlakovic, "The Effect of

The management of work-related asthma guidelines: a broader perspective.

PubMed

Baur, Xaver; Aasen, Tor Brøvig; Burge, P Sherwood; Heederik, Dick; Henneberger, Paul K; Maestrelli, Piero; Schlünssen, Vivi; Vandenplas, Olivier; Wilken, Dennis

2012-06-01

The aim of the European Respiratory Society work-related asthma guidelines is to present the management and prevention options of work-related asthma and their effectiveness. Work-related asthma accounts for 5-25% of all adult asthma cases and is responsible for a significant socioeconomic burden. Several hundred occupational agents, mainly allergens but also irritants and substances with unknown pathological mechanisms, have been identified as causing work-related asthma. The essential message of these guidelines is that the management of work-related asthma can be considerably optimised based on the present knowledge of causes, risk factors, pathomechanisms, and realistic and effective interventions. To reach this goal we urgently require greatly intensified primary preventive measures and improved case management. There is now a substantial body of evidence supporting the implementation of comprehensive medical surveillance programmes for workers at risk. Those workers who fail surveillance programmes need to be referred to a clinician who can confirm or exclude an occupational cause. Once work-related asthma is confirmed, a revised risk assessment in the workplace is needed to prevent further cases. These new guidelines confirm and extend already existing statements and recommendations. We hope that these guidelines will initiate the much-needed research that is required to fill the gaps in our knowledge and to initiate substantial improvements in preventative measures.

Methylene blue prevents surgery-induced peritoneal adhesions but impairs the early phase of anastomotic wound healing

PubMed Central

Dinc, Soykan; Ozaslan, Cihangir; Kuru, Bekir; Karaca, Sefa; Ustun, Huseyin; Alagol, Haluk; Renda, Nurten; Oz, Murat

2006-01-01

Objectives Adhesion formation continues to be an important problem in gastrointestinal surgery. In recent years, methylene blue (MB) has been reported to be an effective agent for preventing peritoneal adhesions. However, its effects on the wound healing process are unknown. In the present study, we investigated the effects of MB on the early and late phases of anastomotic wound healing and on adhesion formation. Methods We randomly categorized 92 rats into 2 groups in bursting pressure measurements and 50 rats into 3 groups in the adhesion model. We divided the animals into saline-treated (n = 46) or MB-treated (n = 46) groups. Bursting pressures of the anastomoses were measured on postoperative days 3 and 7. In biochemical studies, tissue hydroxyproline levels, total nitrite/nitrate levels and nitric oxide synthase activity were measured on postoperative days 3 and 7. In the adhesion model, we randomly categorized rats into sham (n = 10), saline-treated (n = 20) and MB-treated (n = 20) groups, and the formation of intraperitoneal adhesions was scored on postoperative day 14. We compared the measurement of bursting pressure and biochemical measurements of tissue hydroxyproline levels, total nitrite/nitrate levels and nitric oxide synthase activity. Histopathological findings of specimens were presented. Results During the early phase of wound healing (postoperative day 3), bursting pressures, tissue hydroxyproline, total nitrite/nitrate levels and nitric oxide synthase activity in the MB-treated group were significantly lower than those of the saline-treated group. On postoperative day 7, there was no significant difference in these parameters between MB and saline-treated groups. In the adhesion model, MB caused a significant reduction in the formation of peritoneal adhesions. Conclusion MB prevents peritoneal adhesions but causes a significant impairment of anastomotic bursting pressure during the early phase of the wound healing process by its transient inhibitory effect on the nitric oxide pathway. PMID:17152569

The role of risk perception in making flood risk management more effective

NASA Astrophysics Data System (ADS)

Buchecker, M.; Salvini, G.; Di Baldassarre, G.; Semenzin, E.; Maidl, E.; Marcomini, A.

2013-11-01

Over the last few decades, Europe has suffered from a number of severe flood events and, as a result, there has been a growing interest in probing alternative approaches to managing flood risk via prevention measures. A literature review reveals that, although in the last decades risk evaluation has been recognized as key element of risk management, and risk assessment methodologies (including risk analysis and evaluation) have been improved by including social, economic, cultural, historical and political conditions, the theoretical schemes are not yet applied in practice. One main reason for this shortcoming is that risk perception literature is mainly of universal and theoretical nature and cannot provide the necessary details to implement a comprehensive risk evaluation. This paper therefore aims to explore a procedure that allows the inclusion of stakeholders' perceptions of prevention measures in risk assessment. It proposes to adopt methods of risk communication (both one-way and two-way communication) in risk assessment with the final aim of making flood risk management more effective. The proposed procedure not only focuses on the effect of discursive risk communication on risk perception, and on achieving a shared assessment of the prevention alternatives, but also considers the effects of the communication process on perceived uncertainties, accepted risk levels, and trust in the managing institutions. The effectiveness of this combined procedure has been studied and illustrated using the example of the participatory flood prevention assessment process on the Sihl River in Zurich, Switzerland. The main findings of the case study suggest that the proposed procedure performed well, but that it needs some adaptations for it to be applicable in different contexts and to allow a (semi-) quantitative estimation of risk perception to be used as an indicator of adaptive capacity.

[Exercise. Prevention and health promotion--pathways to innovation in public health?].

PubMed

Scriba, P C; Schwartz, F W

2004-02-01

Besides appropriate nutrition, adequate exercise is the universal remedy. Regular endurance training elicits positive effects in numerous organs and tissue systems in the sense of primary prevention. Nevertheless, a lack of exercise and obesity are widespread among the German population. In addition to the individual's own responsibility, measures for disease-oriented prevention as well as for preserving health should be improved based on broad social consensus. To begin with, improved research on treatment and prevention should be required. This national challenge should not only be financed by health insurance funds but also by taxes and levies (e.g., tobacco tax). Only then can the constantly spiralling costs of public health be met.

Principles for designing randomized preventive trials in mental health: an emerging developmental epidemiology paradigm.

PubMed

Brown, C H; Liao, J

1999-10-01

An emerging population-based paradigm is now being used to guide the design of preventive trials used to test developmental models. We discuss elements of the designs of several ongoing randomized preventive trials involving reduction of risk for children of divorce, for children who exhibit behavioral or learning problems, and for children whose parents are being treated for depression. To test developmental models using this paradigm, we introduce three classes of design issues: design for prerandomization, design for intervention, and design for postintervention. For each of these areas, we present quantitative results from power calculations. Both scientific and cost implications of these power calculations are discussed in terms of variation among subjects on preintervention measures, unit of intervention, assignment, balancing, number of pretest and posttest measures, and the examination of moderation effects.

Household Obesity Prevention: Take Action—a Group-Randomized Trial

PubMed Central

French, Simone A.; Gerlach, Anne F.; Mitchell, Nathan R.; Hannan, Peter J.; Welsh, Ericka M.

2018-01-01

The purpose of the present study was to evaluate an intervention to prevent weight gain among households (HHs) in the community. Ninety HHs were randomized to intervention or control group for 1 year. Intervention consisted of six face-to-face group sessions, placement of a television (TV) locking device on all home TVs, and home-based intervention activities. Measures were collected in person at baseline and 1 year. Weight, height, eating behaviors, physical activity (PA), and TV viewing were measured among HH members ages ≥12 years. Follow-up rate at 1 year was 96%. No significant intervention effects were observed for change in HH BMI-z score. Intervention HHs significantly reduced TV viewing, snacks/sweets intake, and dollars per person spent eating out, and increased (adults only) PA and self-weighing frequency compared with control HHs. A 1 year obesity prevention intervention targeting entire HHs was effective in reducing TV viewing, snack/sweets intake and eating out purchases. Innovative methods are needed to strengthen the home food environment intervention component. Longer intervention durations also need to be evaluated. PMID:21212771

Household obesity prevention: Take Action--a group-randomized trial.

PubMed

French, Simone A; Gerlach, Anne F; Mitchell, Nathan R; Hannan, Peter J; Welsh, Ericka M

2011-10-01

The purpose of the present study was to evaluate an intervention to prevent weight gain among households (HHs) in the community. Ninety HHs were randomized to intervention or control group for 1 year. Intervention consisted of six face-to-face group sessions, placement of a television (TV) locking device on all home TVs, and home-based intervention activities. Measures were collected in person at baseline and 1 year. Weight, height, eating behaviors, physical activity (PA), and TV viewing were measured among HH members ages ≥ 12 years. Follow-up rate at 1 year was 96%. No significant intervention effects were observed for change in HH BMI-z score. Intervention HHs significantly reduced TV viewing, snacks/sweets intake, and dollars per person spent eating out, and increased (adults only) PA and self-weighing frequency compared with control HHs. A 1 year obesity prevention intervention targeting entire HHs was effective in reducing TV viewing, snack/sweets intake and eating out purchases. Innovative methods are needed to strengthen the home food environment intervention component. Longer intervention durations also need to be evaluated.

Cardioprotective effect of virgin coconut oil in heated palm oil diet-induced hypertensive rats.

PubMed

Kamisah, Yusof; Periyah, Vengadesh; Lee, Kee Tat; Noor-Izwan, Norrashid; Nurul-Hamizah, Amran; Nurul-Iman, Badlishah Sham; Subermaniam, Kogilavani; Jaarin, Kamsiah; Azman, Abdullah; Faizah, Othman; Qodriyah, Hj Mohd Saad

2015-01-01

Virgin coconut oil (VCO) contains high antioxidant activity which may have protective effects on the heart in hypertensive rats. The study investigated the effects of VCO on blood pressure and cardiac tissue by measuring angiotensin-converting enzyme (ACE) activity and its histomorphometry in rats fed with a heated palm oil (HPO) diet. Thirty-two male Sprague-Dawley rats were randomly divided into four groups: (i) control, (ii) orally given VCO (1.42 ml/kg), (iii) fed with a HPO (15%) diet, and (iv) fed with a HPO diet and supplemented with VCO (1.42 ml/kg, po) (HPO+VCO) for 16 weeks. Blood pressure was measured monthly. After 16 weeks, rat hearts were dissected for lipid peroxidation (TBARS) and ACE activity measurement and histomorphometric study. Systolic blood pressure was significantly increased in the HPO group compared with the control starting at week eight (112.91 ± 1.32 versus 98.08 ± 3.61 mmHg, p < 0.05) which was prevented by VCO supplementation (91.73 ± 3.42 mmHg). The consumption of HPO increased TBARS and ACE activity in heart, which were inhibited by VCO supplementation. The increases in the myofiber width and area as well as nuclear size reduction in the HPO group were significantly prevented by VCO supplementation. These results suggested that VCO supplementation possesses a cardioprotective effect by preventing the increase in blood pressure via an antioxidant mechanism and remodeling in rats fed repeatedly with a HPO diet.

THE EFFECT OF A CULTURALLY TAILORED SUBSTANCE ABUSE PREVENTION INTERVENTION WITH PLAINS INDIAN ADOLESCENTS.

PubMed

Patchell, Beverly A; Robbins, Leslie K; Lowe, John A; Hoke, Mary M

2015-01-01

To examine the effects of incorporating tribal specific cultural beliefs into a tailored substance abuse prevention intervention for at risk rural Oklahoma Native American Indian (NAI) Plains adolescents. The 10 hour Native American Talking Circle Intervention, a school-based, group substance abuse prevention program, was implemented over a 8.5 week period and evaluated using a one group, pretest-posttest design. Measurements were from the Native Self-Reliance Questionnaire and the Substance Problems Scale from Global Appraisal of Individual Needs-Quick (GAIN-Q). One-tailed, paired sample t-tests demonstrated significant increase in self-reliance, from 86.227 to 92.204 (t (43) = -2.580, p = .007) and a decrease in substance abuse/use, from 2.265 to 1.265 (t (33) = 1.844, p = .007). The Native Talking Circle Intervention based on tribal-specific values and beliefs was shown to be effective with substance abuse/use at-risk NAI Plains tribal adolescents.

Introduction to the Special Series: Current Directions for Measuring Parenting Constructs to Inform Prevention Science.

PubMed

Lindhiem, Oliver; Shaffer, Anne

2017-04-01

Parenting behaviors are multifaceted and dynamic and therefore challenging to quantify. Measurement methods have critical implications for study results, particularly for prevention trials designed to modify parenting behaviors. Although multiple approaches can complement one another and contribute to a more complete understanding of prevention trials, the assumptions and implications of each approach are not always clearly addressed. Greater attention to the measurement of complex constructs such as parenting is needed to advance the field of prevention science. This series examines the challenges of measuring changes in parenting behaviors in the context of prevention trials. All manuscripts in the special series address measurement issues and make practical recommendations for prevention researchers. Manuscripts in this special series include (1) empirical studies that demonstrate novel measurement approaches, (2) re-analyses of prevention trial outcome data directly comparing and contrasting two or more methods, and (3) a statistical primer and practical guide to analyzing proportion data.

Evaluating the effectiveness of common disinfectants at preventing the propagation of Mycobacterium spp. isolated from zebrafish

PubMed Central

Chang, Carolyn T.; Colicino, Erica G.; DiPaola, Elizabeth J.; Al-Hasnawi, Hadi Jabbar; Whipps, Christopher M.

2016-01-01

Mycobacteriosis is a bacterial disease that is common in captive, wild and research fish. There is no one causative agent of mycobacteriosis, as several strains and species of Mycobacterium have been identified in zebrafish. With increased usage and investment in wild-type and mutant zebrafish strains, considerable value is placed on preserving zebrafish health. One control measure used to prevent mycobacterial spread within and between zebrafish facilities is egg disinfection. Here we investigate the effectiveness of three disinfectants [chlorine bleach, hydrogen peroxide, and povidone iodine (PVPI)] commonly included in egg disinfection protocols for laboratory fish as well as aquaculture fish and compare the knockdown effect of these treatments on Mycobacterium spp. in vitro. Despite current usage, comparison of these disinfection regimes’ abilities to prevent mycobacterial growth has not been tested. We found that the germicidal effect of different disinfectants vary by Mycobacterium spp.. Hydrogen peroxide was the least effective disinfectant, followed by unbuffered chlorine bleach, which is commonly used to disinfect embryos in zebrafish facilities. Disinfection with 25 ppm PVPI for 5 min was very effective, and may be an improved alternative to chlorine bleach for embryo disinfection. Results from this study can be utilized by laboratory fish facilities in order to prevent the spread of mycobacteriosis in research fish. PMID:26423444

Randomized controlled trial comparing tailoring methods of multimedia-based fall prevention education for community-dwelling older adults.

PubMed

Schepens, Stacey L; Panzer, Victoria; Goldberg, Allon

2011-01-01

We attempted to determine whether multimedia fall prevention education using different instructional strategies increases older adults' knowledge of fall threats and their fall prevention behaviors. Fifty-three community-dwelling older adults were randomized to iwo educational groups or a control group. Multimedia-based educational interventions to increase fall threats knowledge and encourage fall prevention behaviors had two tailoring strategies: (1) improve content realism for individual learners (authenticity group) and (2) highlight program goals and benefits while using participants' content selections (motivation group). Knowledge was measured at baseline and 1-mo follow-up. Participants recorded prevention behaviors for 1 mo. Intervention group participants showed greater knowledge gains and posttest knowledge than did control group participants. The motivation group engaged in more prevention behaviors over 1 mo than did the other groups. Tailoring fall prevention education by addressing authenticity and motivation successfully improved fall threats knowledge. Combining motivational strategies with multimedia education increased the effectiveness of the intervention in encouraging fall prevention behaviors.

The Development of a School-Based Measure of Child Mental Health

ERIC Educational Resources Information Center

Deighton, Jessica; Tymms, Peter; Vostanis, Panos; Belsky, Jay; Fonagy, Peter; Brown, Anna; Martin, Amelia; Patalay, Praveetha; Wolpert, Miranda

2013-01-01

Early detection of child mental health problems in schools is critical for implementing strategies for prevention and intervention. The development of an effective measure of mental health and well-being for this context must be both empirically sound and practically feasible. This study reports the initial validation of a brief self-report…

Radon measurement and mitigation activity in Finland.

PubMed

Valmari, T; Arvela, H; Reisbacka, H; Holmgren, O

2014-07-01

Radon prevention, measurement and mitigation activities have been increasing in Finland during the 2000s. Nowadays, many municipal authorities, especially those located in high-radon areas, require radon prevention measures. This has activated radon measurements. Owners of new houses having radon piping installed under the floor slab are the most active group to measure and reduce the found high-radon values. Their radon awareness is apparently better than on the average, and the existing piping makes it easier and cheaper to reduce the radon levels. Local campaigns involving invitation flyers mailed to the residents have been a cost-effective means to activate measurements of older houses. So far 116,611 dwellings in low-rise residential buildings have been measured. At least 15% of the 16,860 dwellings found to exceed the reference level of 400 Bq m(-3) had their indoor radon level reduced below that. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Lifestyle and Metformin Treatment Favorably Influence Lipoprotein Subfraction Distribution in the Diabetes Prevention Program

PubMed Central

Temprosa, M.; Otvos, J.; Brunzell, J.; Marcovina, S.; Mather, K.; Arakaki, R.; Watson, K.; Horton, E.; Barrett-Connor, E.

2013-01-01

Context: Although intensive lifestyle change (ILS) and metformin reduce diabetes incidence in subjects with impaired glucose tolerance (IGT), their effects on lipoprotein subfractions have not been studied. Objective: The objective of the study was to characterize the effects of ILS and metformin vs placebo interventions on lipoprotein subfractions in the Diabetes Prevention Program. Design: This was a randomized clinical trial, testing the effects of ILS, metformin, and placebo on diabetes development in subjects with IGT. Participants: Selected individuals with IGT randomized in the Diabetes Prevention Program participated in the study. Interventions: Interventions included randomization to metformin 850 mg or placebo twice daily or ILS aimed at a 7% weight loss using a low-fat diet with increased physical activity. Main Outcome Measures: Lipoprotein subfraction size, density, and concentration measured by magnetic resonance and density gradient ultracentrifugation at baseline and 1 year were measured. Results: ILS decreased large and buoyant very low-density lipoprotein, small and dense low-density lipoprotein (LDL), and small high-density lipoprotein (HDL) and raised large HDL. Metformin modestly reduced small and dense LDL and raised small and large HDL. Change in insulin resistance largely accounted for the intervention-associated decreases in large very low-density lipoprotein, whereas changes in body mass index (BMI) and adiponectin were strongly associated with changes in LDL. Baseline and a change in adiponectin were related to change in large HDL, and BMI change associated with small HDL change. The effect of metformin to increase small HDL was independent of adiponectin, BMI, and insulin resistance. Conclusion: ILS and metformin treatment have favorable effects on lipoprotein subfractions that are primarily mediated by intervention-related changes in insulin resistance, BMI, and adiponectin. Interventions that slow the development of diabetes may also retard the progression of atherosclerosis. PMID:23979954

A cluster randomised controlled trial evaluating the effectiveness and cost-effectiveness of the daily mile on childhood obesity and wellbeing; the Birmingham daily mile protocol.

PubMed

Breheny, Katie; Adab, Peymane; Passmore, Sandra; Martin, James; Lancashire, Emma; Hemming, Karla; Frew, Emma

2018-01-11

Childhood obesity prevention is a public health priority. Children spend a large proportion of their waking time in school; therefore this is an appropriate setting to implement obesity prevention initiatives. Anecdotal reports suggest that implementing The Daily Mile in schools has had positive effects on childhood obesity, academic attainment and wellbeing. This trial aims to measure the effectiveness of The Daily Mile for improving health and wellbeing. This protocol describes a cluster randomised controlled trial (RCT) in 40 primary schools located in Birmingham, UK. Eligible participants are children in years 3 (aged 7-8) and 5 (aged 9-10). The study compares The Daily Mile (intervention) to usual practice (control) in relation to health and wellbeing. The Daily Mile intervention involves an additional 15 min of running or walking integrated into the school day, throughout a 12 month study period. The primary clinical outcome is body mass index (BMI) z-scores at 12 months following introduction of the intervention. The cost per Quality Adjusted Life Year (QALY) is the primary outcome of the economic evaluation. Secondary outcomes include wellbeing, physical fitness and teacher reported academic attainment. This study is the first RCT investigating the clinical and cost-effectiveness of The Daily Mile. A range of outcomes will be measured to evaluate the broader wellbeing and academic benefits in addition to clinical outcomes typically measured in childhood obesity prevention trials. The intervention is simple and low-cost, therefore if the benefits are demonstrated it has enormous potential to influence future policy. ISRCTN: 12698269 . Date protocol registered 27th October 2016.

FUEL Your Life: A Translation of the Diabetes Prevention Program to Worksites.

PubMed

Wilson, Mark G; DeJoy, David M; Vandenberg, Robert; Padilla, Heather; Davis, Marsha

2016-01-01

To evaluate the effectiveness of FUEL Your Life, a translation of the Diabetes Prevention Program for worksites. A randomized control group design was conducted in five worksites of a large transportation company. Measures were collected pretest, posttest (6 months), and follow-up (12 months). Railroad maintenance facilities of Union Pacific Railroad. Participants consisted of 362 workers (227 treatment, 135 control). FUEL Your Life was translated from the Diabetes Prevention Program to better fit within the context of the worksite. The primary difference was the use of peer health coaches to provide social support and reinforcement and an occupational nurse to provide lesson content (six sessions of 10 minutes) to participants instead of the lifestyle coaches employed by the Diabetes Prevention Program, resulting in a less structured meeting schedule. The primary outcomes were weight and body mass index (BMI), with secondary outcomes including eating behaviors, physical activity, and social support. Latent growth modeling was used to measure changes in the outcomes over time. Participants in the intervention group maintained weight/BMI (-.1 pounds/-.1 BMI), whereas the control participants gained weight/BMI (+2.6 pounds/+.3 BMI), resulting in a statistically significant difference between groups. Fifty-five percent of intervention participants lost some weight, whereas only 35% of the control group lost weight. FUEL Your Life, a low intensity intervention, was not effective for promoting weight loss, but was effective for helping workers maintain weight over a 12-month period.

Garlic extracts prevent oxidative stress, hypertrophy and apoptosis in cardiomyocytes: a role for nitric oxide and hydrogen sulfide

PubMed Central

2012-01-01

Background In ancient times, plants were recognized for their medicinal properties. Later, the arrival of synthetic drugs pushed it to the backstage. However, from being merely used for food, plants are now been widely explored for their therapeutic value. The current study explores the potential of skin and flesh extracts from a hard-necked Rocambole variety of purple garlic in preventing cardiomyocyte hypertrophy and cell death. Methods Norepinephrine (NE) was used to induce hypertrophy in adult rat cardiomyocytes pretreated with garlic skin and flesh extracts. Cell death was measured as ratio of rod to round shaped cardiomyocytes. Fluorescent probes were used to measure apoptosis and oxidative stress in cardiomyocytes treated with and without extracts and NE. Pharmacological blockade of nitric oxide (NO) and hydrogen sulfide (H2S) were used to elucidate the mechanism of action of garlic extracts. Garlic extract samples were also tested for alliin and allicin concentrations. Results Exposure of cardiomyocytes to NE induced an increase in cell size and cell death; this increase was significantly prevented upon treatment with garlic skin and flesh extracts. Norepinephrine increased apoptosis and oxidative stress in cardiomyocytes which was prevented upon pretreatment with skin and flesh extracts; NO, and H2S blockers significantly inhibited this beneficial effect. Allicin and alliin concentration were significantly higher in garlic flesh extract when compared to the skin extract. Conclusion These results suggest that both skin and flesh garlic extracts are effective in preventing NE induced cardiomyocyte hypertrophy and cell death. Reduction in oxidative stress may also play an important role in the anti-hypertrophic and anti-apoptotic properties of garlic extracts. These beneficial effects may in part be mediated by NO and H2S. PMID:22931510

The Australasian Society of Clinical Immunology and Allergy position statement: Summary of allergy prevention in children.

PubMed

Prescott, Susan L; Tang, Mimi L K

2005-05-02

A family history of allergy and asthma identifies children at high risk of allergic disease. Dietary restrictions in pregnancy are not recommended. Avoiding inhalant allergens during pregnancy has not been shown to reduce allergic disease, and is not recommended. Breastfeeding should be recommended because of other beneficial effects, but if breast feeding is not possible, a hydrolysed formula is recommended (rather than conventional cow's milk formulas) in high-risk infants only. Maternal dietary restrictions during breastfeeding are not recommended. Soy formulas and other formulas (eg, goat's milk) are not recommended for reducing food allergy risk. Complementary foods (including normal cow's milk formulas) should be delayed until a child is aged at least 4-6 months, but a preventive effect from this measure has only been demonstrated in high-risk infants. There is no evidence that an elimination diet after age 4-6 months has a protective effect, although this needs additional investigation. Further research is needed to determine the relationship between house dust mite exposure at an early age and the development of sensitisation and disease; no recommendation can yet be made about avoidance measures for preventing allergic disease. No recommendations can be made about exposure to pets in early life and the development of allergic disease. If a family already has pets it is not necessary to remove them, unless the child develops evidence of pet allergy (as assessed by an allergy specialist). Women should be advised not to smoke while pregnant, and parents should be advised not to smoke. No recommendations can be made on the use of probiotic supplements (or other microbial agents) for preventing allergic disease at this time. Immunotherapy may be considered as a treatment option for children with allergic rhinitis, and may prevent the subsequent development of asthma.

Correlation between practice location as a surrogate for UV exposure and practice patterns to prevent corneal haze after photorefractive keratectomy (PRK).

PubMed

Al-Sharif, Eman M; Stone, Donald U

2016-01-01

PRK is a refractive surgery that reshapes the corneal surface by excimer laser photoablation to correct refractive errors. The effect of increased ultraviolet (UV) exposure on promoting post-PRK corneal haze has been reported in the literature; however, information is lacking regarding the effect of ambient UV exposure on physician practice patterns. The aim of this study was to evaluate the effect of ophthalmologists' practice location on their reported practice patterns to prevent post-PRK corneal haze. A cross-sectional observational study was conducted through an online survey sent to ophthalmologists performing PRK. The survey recorded the primary city of practice from which the two independent variables, latitude and average annual sunshine days, were determined. It also measured the frequency of use of postoperative preventive interventions (dependent variables) which are as follows: intraoperative Mitomycin-C, oral vitamin C, sunglasses, topical corticosteroids, topical cyclosporine, oral tetracyclines and amniotic membrane graft. Fifty-one ophthalmologists completed the survey. Practice locations' mean latitude was 36.4 degrees north, and average sunshine days annually accounted for 60% of year days. There was no significant relation between latitude/average annual sunshine days and usual post-PRK prophylactic treatments ( P  > 0.05). The commonest protective maneuvers were sunglasses (78%), prolonged topical corticosteroids (57%), Mitomycin-C (39%) and oral vitamin C (37%). We found no significant difference in ophthalmologists' practice patterns to prevent post-PRK corneal haze in relation to practice location latitude and average sunshine days. Moreover, the results demonstrated that the most widely used postoperative measures to prevent post-PRK haze are sunglasses, Mitomycin-C, topical corticosteroids, and oral Vitamin C.

16 CFR 1500.90 - Procedures and requirements for exclusions from lead limits under section 101(b) of the Consumer...

Code of Federal Regulations, 2014 CFR

2014-01-01

... inaccessible to a child or prevent the absorption of any lead in the human body through normal and reasonably...) Measurement. For purposes of paragraph (b)(1)(i)(C) of this section, there is no measurable adverse effect on... method of measurement other than blood lead levels if it determines, after notice and a hearing, that...

Effectiveness and cost-effectiveness of a guided Internet- and mobile-based intervention for the indicated prevention of major depression in patients with chronic back pain-study protocol of the PROD-BP multicenter pragmatic RCT.

PubMed

Sander, L; Paganini, S; Lin, J; Schlicker, S; Ebert, D D; Buntrock, C; Baumeister, H

2017-01-21

Reducing the disease burden of major depressive disorder (MDD) is of major public health relevance. The prevention of depression is regarded as one possible approach to reach this goal. People with multiple risk factors for MDD such as chronic back pain and subthreshold depressive symptoms may benefit most from preventive measures. The Internet as intervention setting allows for scaling up preventive interventions on a public mental health level. This study is a multicenter pragmatic randomized controlled trial (RCT) of parallel design aiming to investigate the (cost-) effectiveness of an Internet- and mobile-based intervention (IMI) for the prevention of depression in chronic back pain patients (PROD-BP) with subthreshold depressive symptoms. eSano BackCare-DP is a guided, chronic back pain-specific depression prevention intervention based on cognitive behavioral therapy (CBT) principles comprising six weekly plus three optional modules and two booster sessions after completion of the intervention. Trained psychologists provide guidance by sending feedback messages after each module. A total of 406 patients with chronic back pain and without a depressive disorder at baseline will be recruited following orthopedic rehabilitation care and allocated to either intervention or treatment-as-usual (TAU). Primary patient-relevant endpoint of the trial is the time to onset of MDD measured by the telephone-administered Structured Clinical Interview for DSM (SCID) at baseline and 1-year post-randomization. Key secondary outcomes are health-related quality of life, depression severity, pain intensity, pain-related disability, ability to work, intervention satisfaction and adherence as well as side effects of the intervention. Online assessments take place at baseline and 9 weeks as well as 6 and 12 months post-randomization. Cox regression survival analysis will be conducted to estimate hazard ratio at 12-month follow-up. Moreover, an economic analysis will be conducted from a societal and public health perspective. This is the first study examining an IMI for depression prevention in a sample of chronic pain patients. If this implementation of a depression prevention IMI into orthopedic aftercare proves effective, the intervention could be integrated into routine care with minimal costs and extended for use with other chronic diseases. Results will have implications for researchers, health care providers and public health policy makers. The trial is registered at the WHO International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (DRKS): DRKS00007960 . Registered 12 August 2015.

[Pollution prevention and control of aqueous extract of astragali radix processed with ZrO2 inorganic ceramic membrane micro-filtration].

PubMed

Pan, Lin-Men; Huang, Min-Yan; Guo, Li-Wei

2012-11-01

To study the measures for preventing and controlling the pollution of aqueous extract of Astragali Radix proceeded with inorganic ceramic membrane micro-filtration, in order to find effective measures for preventing and controlling the membrane pollution. The resistance distribution, polymer removal and changes in physical and chemical parameters of the zirconium oxide film of different pore diameters were determined to analyze the state or location of pollutants as well as the regularity of formation. Meanwhile, recoil and ultrasonic physical measures were adopted to strengthen the membrane process, in order to explore the methods for preventing and controlling the membrane pollution. When 0.2 microm of ZrO2 micro-filtrated aqueous extract of Astragali Radix, the rate of pollution was as high as 44.9%. The hole blocking resistance and the concentration polarization resistance were the main filtration resistances, while the surface deposit resistance decreased with the increase in the membrane's hold diameter; after micro-filtration, the liquid turbidity significantly reduced, with slight changes in both pH and viscosity. The 0.2 microm ZrO2 micro-filtration membrane performed better than the 0.05 microm pore size membrane in terms of conductivity. The 0. 2 microm and 0.05 microm pore diameter membranes showed better performance in the removal of pectin. The ultrasonic measure to strengthen membranes is more suitable to this system, with a flux rate up by 41.7%. The membrane optimization process adopts appropriate measures for preventing and controlling the membrane pollution, in order to reduce the membrane pollution, recover membrane performance and increase filtration efficiency.

Cost-Effectiveness of Cranberry Capsules to Prevent Urinary Tract Infection in Long-Term Care Facilities: Economic Evaluation with a Randomized Controlled Trial

PubMed Central

van den Hout, Wilbert B; Caljouw, Monique A A; Putter, Hein; Cools, Herman J M; Gussekloo, Jacobijn

2014-01-01

Objectives To investigate whether the preventive use of cranberry capsules in long-term care facility (LTCF) residents is cost-effective depending on urinary tract infection (UTI) risk. Design Economic evaluation with a randomized controlled trial. Setting Long-term care facilities. Participants LTCF residents (N = 928, 703 female, median age 84), stratified according to UTI risk. Measurements UTI incidence (clinically or strictly defined), survival, quality of life, quality-adjusted life years (QALYs), and costs. Results In the weeks after a clinical UTI, participants showed a significant but moderate deterioration in quality of life, survival, care dependency, and costs. In high-UTI-risk participants, cranberry costs were estimated at €439 per year (1.00 euro = 1.37 U.S. dollar), which is €3,800 per prevented clinically defined UTI (95% confidence interval = €1,300–infinity). Using the strict UTI definition, the use of cranberry increased costs without preventing UTIs. Taking cranberry capsules had a 22% probability of being cost-effective compared with placebo (at a willingness to pay of €40,000 per QALY). In low-UTI-risk participants, use of cranberry capsules was only 3% likely to be cost-effective. Conclusion In high-UTI-risk residents, taking cranberry capsules may be effective in preventing UTIs but is not likely to be cost-effective in the investigated dosage, frequency, and setting. In low-UTI-risk LTCF residents, taking cranberry capsules twice daily is neither effective nor cost-effective. PMID:25180379

Prevention of catheter-associated urinary tract infection

PubMed Central

Trautner, Barbara W.; Hull, Richard A.; Darouiche, Rabih O.

2010-01-01

Purpose of review The underlying cause of catheter-associated urinary tract infection is biofilm formation by uropathogens on the urinary catheter. Biofilm is a relatively new concept in medicine, and current measures to prevent biofilm formation are inadequate. Considerable work is being done in this area, but little clinical progress has been made. The purpose of this review is to analyze recent publications concerning prevention of catheter-associated urinary tract infection. Recent findings Several recent studies have elucidated aspects of biofilm formation in catheter-associated urinary tract infection. Other researchers are working on methods to disrupt biofilm formation on catheter surfaces. At the same time, the magnitude of the problem of catheter-associated urinary tract infection has increased awareness of the effectiveness of basic infection control measures. A modern approach to infection control may include computerized ordering systems that minimize unnecessary days of catheterization. Finally, consumption of cranberry juice products and bacterial interference are two novel approaches to urinary tract infection prevention. Summary Biofilm-disrupting strategies offer promise for the future but have little immediate applicability. Implementation of infection control measures to improve catheter function and remove unnecessary catheters can be done at the present time. In general, prevention of catheter-associated urinary tract infection remains an elusive goal. More basic research at the level of pathogenesis is needed so that novel strategies can be designed. PMID:15647698

The children of mentally ill parents.

PubMed

Mattejat, Fritz; Remschmidt, Helmut

2008-06-01

The children of mentally ill parents have a higher risk of developing mental illnesses themselves over the course of their lives. This known risk must be taken into account in the practical provision of health care. Selective literature review. The increased psychiatric risk for children of mentally ill parents is due partly to genetic influences and partly to an impairment of the parent-child interaction because of the parent's illness. Furthermore, adverse factors are more frequent in these families, as well as a higher risk for child abuse. Genetic and psychosocial factors interact with one another. For example, genetic factors moderate environmental effects; that is, the effect of adverse environmental factors depends on the genetic substrate. Preventive measures for children of mentally ill parents urgently need improvement. In this article, positively evaluated programs of preventive measures are discussed. Essential prerequisites for success include appropriate, specialized treatment of the parental illness, psychoeducative measures, and special support (e.g. self-help groups) as indicated by the family's particular needs.

Guidelines for reporting methodological challenges and evaluating potential bias in dementia research

PubMed Central

Weuve, Jennifer; Proust-Lima, Cécile; Power, Melinda C.; Gross, Alden L.; Hofer, Scott M.; Thiébaut, Rodolphe; Chêne, Geneviève; Glymour, M. Maria; Dufouil, Carole

2015-01-01

Clinical and population research on dementia and related neurologic conditions, including Alzheimer’s disease, faces several unique methodological challenges. Progress to identify preventive and therapeutic strategies rests on valid and rigorous analytic approaches, but the research literature reflects little consensus on “best practices.” We present findings from a large scientific working group on research methods for clinical and population studies of dementia, which identified five categories of methodological challenges as follows: (1) attrition/sample selection, including selective survival; (2) measurement, including uncertainty in diagnostic criteria, measurement error in neuropsychological assessments, and practice or retest effects; (3) specification of longitudinal models when participants are followed for months, years, or even decades; (4) time-varying measurements; and (5) high-dimensional data. We explain why each challenge is important in dementia research and how it could compromise the translation of research findings into effective prevention or care strategies. We advance a checklist of potential sources of bias that should be routinely addressed when reporting dementia research. PMID:26397878

[Prevention of venous thromboembolic disease in general surgery].

PubMed

Arcelus, Juan Ignacio; Lozano, Francisco S; Ramos, José L; Alós, Rafael; Espín, Eloy; Rico, Pedro; Ros, Eduardo

2009-06-01

Postoperative venous thromboembolic disease (VTED) affects approximately one in four general surgery patients who do not receive preventive measures. In addition to the risk of pulmonary embolism, which is often fatal, patients with VTED may develop long-term complications such as post-thrombotic syndrome or chronic pulmonary hypertension. In addition, postoperative VTED is usually asymptomatic or produces clinical manifestations that are attributed to other processes and consequently this complication is often unnoticed by the surgeon who performed the procedure. Thus, the most effective strategy consists of effective prevention of VTED using the most appropriate prophylactic measures against the patient's thromboembolic risk. There is sufficient evidence that VTED can be prevented by pharmacological methods, especially heparin and its derivatives and with mechanical methods such as support tights or intermittent pneumatic compression of the lower extremities. To reduce the incidence of VTED as far as possible, strategies have been proposed that include a combination of drugs and mechanical methods, new antithrombotic drugs, or prolonging the duration of prophylaxis in patients at very high risk, such as those who have undergone surgery for cancer. Another important aspect is the optimal moment to initiate prophylaxis with anticoagulant drugs with the aim of achieving an adequate equilibrium between antithrombotic efficacy and the risk of hemorrhagic complications. The present article reviews the available evidence to attempt to optimize prevention of VTED in general surgery and in some special groups, such as laparoscopic surgery, short-stay surgery and obesity.

Oxidative stress as a mechanism of diabetes in diabetic BB prone rats: effect of secoisolariciresinol diglucoside (SDG).

PubMed

Prasad, K

2000-06-01

Secoisolariciresinol diglucoside (SDG) isolated from flaxseed has antioxidant activity and has been shown to prevent hypercholesterolemic atherosclerosis. An investigation was made of the effects of SDG on the development of diabetes in diabetic prone BioBreeding rats (BBdp rats), a model of human type I diabetes [insulin dependent diabetes mellitus (IDDM)] to determine if this type of diabetes is due to oxidative stress and if SDG can prevent the incidence of diabetes. The rats were divided into three groups: Group I, BioBreeding normal rats (BBn rats) (n = 10); group II, BBdp untreated (n = 11); and group III, BBdp treated with SDG 22 mg/kg body wt, orally) (n = 14). Oxidative stress was determined by measuring lipid peroxidation product malondialdehyde (MDA) an index of level of reactive oxygen species in blood and pancreas; and pancreatic chemiluminescence (Pancreatic-CL), a measure of antioxidant reserve. Incidence of diabetes was 72.7% in untreated and 21.4% in SDG-treated group as determined by glycosuria and hyperglycemia. SDG prevented the development of diabetes by approximately 71%. Development of diabetes was associated with an increase in serum and pancreatic MDA and a decrease in antioxidant reserve. Prevention in development of diabetes by SDG was associated with a decrease in serum and pancreatic-MDA and an increase in antioxidant reserve. These results suggest that IDDM is mediated through oxidative stress and that SDG prevents the development of diabetes.

Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania.

PubMed

Ngalesoni, Frida; Ruhago, George; Mayige, Mary; Oliveira, Tiago Cravo; Robberstad, Bjarne; Norheim, Ole Frithjof; Higashi, Hideki

2017-01-01

Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost. We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD) in Tanzania. A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs) averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters. Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of US$5 and US$267, respectively. Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government's ability to implement these interventions.

Childhood injury: a status report, part 2.

PubMed

Crawley-Coha, Teri

2002-04-01

The October issue of The Journal of Pediatric Nursing carried the first of two parts on childhood injury. That article reviewed the importance of prevention, the short- and long-term effects of injury on the child and the family, and how to incorporate prevention strategies at home and at work. Also reviewed were three of the most common mechanisms of injury, motor vehicle crashes, bicycle crashes, and pool drowning, and prevention measures. In this second part, the remaining primary areas of concern for common pediatric injuries are addressed: poisoning, fires and burns, and firearms. Copyright 2002, Elsevier Science (USA). All rights reserved.

Results of reflective crack questionnaire survey.

DOT National Transportation Integrated Search

1973-01-01

Department engineers were surveyed to obtain their opinions on the potential detrimental effects of transverse reflective cracks through the surface course of bituminous pavements and the costs of preventive measures. The majority of respondents (67%...

N-acetylcysteine prevents ketamine-induced adverse effects on development, heart rate and monoaminergic neurons in zebrafish.

PubMed

Robinson, Bonnie; Dumas, Melanie; Gu, Qiang; Kanungo, Jyotshna

2018-06-08

N-acetylcysteine, a precursor molecule of glutathione, is an antioxidant. Ketamine, a pediatric anesthetic, has been implicated in cardiotoxicity and neurotoxicity including modulation of monoaminergic systems in mammals and zebrafish. Here, we show that N-acetylcysteine prevents ketamine's adverse effects on development and monoaminergic neurons in zebrafish embryos. The effects of ketamine and N-acetylcysteine alone or in combination were measured on the heart rate, body length, brain serotonergic neurons and tyrosine hydroxylase-immunoreactive (TH-IR) neurons. In the absence of N-acetylcysteine, a concentration of ketamine that produces an internal embryo exposure level comparable to human anesthetic plasma concentrations significantly reduced heart rate and body length and those effects were prevented by N-acetylcysteine co-treatment. Ketamine also reduced the areas occupied by serotonergic neurons in the brain, whereas N-acetylcysteine co-exposure counteracted this effect. TH-IR neurons in the embryo brain and TH-IR cells in the trunk were significantly reduced with ketamine treatment, but not in the presence of N-acetylcysteine. In our continued search for compounds that can prevent ketamine toxicity, this study using specific endpoints of developmental toxicity, cardiotoxicity and neurotoxicity, demonstrates protective effects of N-acetylcysteine against ketamine's adverse effects. This is the first study that shows the protective effects of N-acetylcysteine on ketamine-induced developmental defects of monoaminergic neurons as observed in a whole organism. Published by Elsevier B.V.

Partnership, knowledge translation, and substance abuse prevention with a First Nations community.

PubMed

Baydala, Lola; Fletcher, Fay; Worrell, Stephanie; Kajner, Tania; Letendre, Sherry; Letendre, Liz; Rasmussen, Carmen

2014-01-01

Having identified substance abuse as an issue of concern in their community, the Alexis Nakota Sioux Nation invited University of Alberta researchers to partner on the cultural adaptation, delivery, and evaluation of a school-based drug and alcohol abuse prevention program. Researchers conducted a literature review of available drug and alcohol prevention programs for children and youth, identifying the Life Skills Training (LST) program as a viable model for cultural adaptation. Four program objectives were developed: (1) Review and cultural adaptation of the elementary and junior high LST programs, (2) delivery of the adapted programs, (3) measurement of changes in students' knowledge of the negative effects of drug and alcohol use, attitudes toward drugs and alcohol, drug and alcohol refusal and life skills, and changes in self-esteem/self-concept, and (4) documentation of the community's experience of the project. Using the principles of community-based participatory research (CBPR), we employed both qualitative and quantitative methods to evaluate the impact of the project. Qualitative evaluation of the program adaptation and implementation were both positive. Qualitative measures of program impact on students revealed a positive effect, whereas results of the quantitative measures were mixed. Culturally adapted, evidence-based programs can have a positive effect on Aboriginal youth and their communities. Strategies to expand knowledge translation (KT) when working with Aboriginal communities include working to create an "ethical space" that draws on the strengths of both Western and Indigenous worldviews.

Prevention of railway trespassing by automatic sound warning-A pilot study.

PubMed

Kallberg, Veli-Pekka; Silla, Anne

2017-04-03

The objective of this study was to investigate the effects of a sound warning system on the frequency of trespassing at 2 pilot test sites in Finland. The effect of automatic prerecorded sound warning on the prevention of railway trespassing was evaluated based on observations at 2 test sites in Finland. At both sites an illegal footpath crossed the railway, and the average daily number of trespassers before implementation of the measures was about 18 at both sites. The results showed that trespassing was reduced at these sites by 18 and 44%, respectively. Because of the lack of proper control sites, it is possible that the real effects of the measure are somewhat smaller. The current study concludes that automatic sound warning may be efficient and cost effective at locations where fencing is not a viable option. However, it is not likely to be a cost-effective panacea for all kinds of sites where trespassing occurs, especially in countries like Finland where trespassing is scattered along the railway network rather than concentrated to a limited number of sites.

Awareness on causes, consequences and preventive measures of obesity among urban married women in India.

PubMed

Agrawal, Praween; Gupta, Kamla; Mishra, Vinod; Agrawal, Sutapa

2013-10-01

In spite of the numerous chronic diseases that have been linked to obesity, studies focusing on the awareness regarding causes, consequences and strategies to prevent and control of obesity among women are lacking in the literature, especially in developing countries such as India, where obesity is culturally accepted and nurtured and women bearded the highest weight gain in the recent decade. We explored the awareness regarding causes, consequences and preventive measures of obesity among 325 ever-married aged 20-54 years women with different levels of body mass index (BMI) in the national capital territory of Delhi representing urban India. A population based follow-up survey of women systematically selected from the second round of National Family Health Survey (NFHS-2, 1998-99) samples who were re-interviewed after four years in 2003. As a part of qualitative data collection, the respondents were asked to free list open-ended questions on causes, consequences and preventive measures of obesity. Responses were analyzed through Anthropac software package. Over eating was reported as the most important cause of obesity by normal and overweight women whereas obese women reported fried food consumption as the most important cause of weight gain. A few women from each group reported changing lifestyle as a cause of obesity. Also, there were lots of misconceptions about the cause of obesity among women (such as no tension in life, more tension, happiness, constipation, problem in Delhi's water etc.). In terms of the consequences of obesity, the participants were well aware of the common physical consequences. Normal and obese women reported breathlessness as the most important consequence whereas overweight women reported problem in standing and sitting. Regarding preventive measures, overweight and obese women reported 'walking' as most important preventive measure of obesity whereas normal women reported 'doing exercise'. In addition, 'dieting' was reported as the next important preventive measures of obesity by all groups of women. Our study of a fairly large, community-based sample of women has shown that women were aware of the complex nature of obesity in terms of causes, consequences and a range of potential solutions. The findings are important for public health interventions in obesity care in India. Implementation of health promotion and health education in the community should use effective school education and mass media programme to raise more awareness of the causes, consequences and preventive measures and hammer misconceptions, to combat the growing level of obesity among Indian women.

Awareness on causes, consequences and preventive measures of obesity among urban married women in India

PubMed Central

Agrawal, Praween; Gupta, Kamla; Mishra, Vinod; Agrawal, Sutapa

2017-01-01

Background In spite of the numerous chronic diseases that have been linked to obesity, studies focusing on the awareness regarding causes, consequences and strategies to prevent and control of obesity among women are lacking in the literature, especially in developing countries such as India, where obesity is culturally accepted and nurtured and women bearded the highest weight gain in the recent decade. Objective We explored the awareness regarding causes, consequences and preventive measures of obesity among 325 ever-married aged 20-54 years women with different levels of body mass index (BMI) in the national capital territory of Delhi representing urban India. Materials and Methods A population based follow-up survey of women systematically selected from the second round of National Family Health Survey (NFHS-2, 1998-99) samples who were re-interviewed after four years in 2003. As a part of qualitative data collection, the respondents were asked to free list open-ended questions on causes, consequences and preventive measures of obesity. Responses were analyzed through Anthropac software package. Results Over eating was reported as the most important cause of obesity by normal and overweight women whereas obese women reported fried food consumption as the most important cause of weight gain. A few women from each group reported changing lifestyle as a cause of obesity. Also, there were lots of misconceptions about the cause of obesity among women (such as no tension in life, more tension, happiness, constipation, problem in Delhi’s water etc.). In terms of the consequences of obesity, the participants were well aware of the common physical consequences. Normal and obese women reported breathlessness as the most important consequence whereas overweight women reported problem in standing and sitting. Regarding preventive measures, overweight and obese women reported ‘walking’ as most important preventive measure of obesity whereas normal women reported ‘doing exercise’. In addition, ‘dieting’ was reported as the next important preventive measures of obesity by all groups of women. Conclusion Our study of a fairly large, community-based sample of women has shown that women were aware of the complex nature of obesity in terms of causes, consequences and a range of potential solutions. The findings are important for public health interventions in obesity care in India. Implementation of health promotion and health education in the community should use effective school education and mass media programme to raise more awareness of the causes, consequences and preventive measures and hammer misconceptions, to combat the growing level of obesity among Indian women. PMID:28856116

Pulmonary atelectasis: a pathogenic perioperative entity.

PubMed

Duggan, Michelle; Kavanagh, Brian P

2005-04-01

Atelectasis occurs in the dependent parts of the lungs of most patients who are anesthetized. Development of atelectasis is associated with decreased lung compliance, impairment of oxygenation, increased pulmonary vascular resistance, and development of lung injury. The adverse effects of atelectasis persist into the postoperative period and can impact patient recovery. This review article focuses on the causes, nature, and diagnosis of atelectasis. The authors discuss the effects and implications of atelectasis in the perioperative period and illustrate how preventive measures may impact outcome. In addition, they examine the impact of atelectasis and its prevention in acute lung injury.

Side effects in preventive maintenance therapy with neuroleptics with special emphasis on tardive dyskinesia.

PubMed

Logothetis, J; Paraschos, A; Frangos, E

1981-01-01

Neuroleptics induce hypersensitivity reactions, and toxic, systemic and extrapyramidal manifestations. The latter mainly include acute dystonic reactions, other early dyskinesias, akathisia, parkinsonism and TD. These drugs have been implicated for DA antagonism exerted by an adenylate cyclase inhibition. Prolonged blockade of DA receptors is considered as the motivation for a counterbalancing mechanism inducing the DA supersensitivity from which TD results. Recent reports suggest cholinergic and GABA ergic insufficiency as secondary participants. The increasing frequency of TD calls for prevention by modifying treatment practices and searching for effective measures to combat the symptoms.

Effectiveness of Residence Restrictions in Preventing Sex Offense Recidivism

ERIC Educational Resources Information Center

Nobles, Matt R.; Levenson, Jill S.; Youstin, Tasha J.

2012-01-01

Many municipalities have recently extended residence restrictions for sex offenders beyond the provisions of state law, although the efficacy of these measures in reducing recidivism has not been empirically established. This study used arrest histories in Jacksonville, Florida, to assess the effects of a recently expanded municipal 2,500-foot…

School Security and Student Misbehavior: A Multi-Level Examination

ERIC Educational Resources Information Center

Servoss, Timothy J.

2017-01-01

Despite a nationwide trend to increase security measures in schools, their effectiveness in reducing or preventing student misbehavior remains largely unexamined. In addition, there is concern that increased security may have unintended negative side effects and is applied inequitably across students of disparate racial/ethnic backgrounds. The…

Effects of Stress Inoculation Training on Anxiety, Stress, and Academic Performance among Adolescents.

ERIC Educational Resources Information Center

Kiselica, Mark S.; And Others

1994-01-01

Examined effectiveness of preventive stress inoculation program for adolescents (n=48) that consisted of progressive muscle relaxation, cognitive restructuring, and assertiveness training. Compared with control subjects, trainees showed significantly greater improvements on self-report measures of trait anxiety and stress-related symptoms at…

Strategies for improving safety performance in construction firms.

PubMed

Alarcón, Luis Fernando; Acuña, Diego; Diethelm, Sven; Pellicer, Eugenio

2016-09-01

Over the years many prevention management practices have been implemented to prevent and mitigate accidents at the construction site. However, there is little evidence of the effectiveness of individual or combined practices used by companies to manage occupational health and safety issues. The authors selected a sample of 1180 construction firms and 221 individual practices applied in these companies to analyze their effectiveness reducing injury rates over a period of four years in Chile. Different methods were used to study this massive database including: visual analyses of graphical information, statistical analyses and classification techniques. Results showed that practices related to safety incentives and rewards are the most effective from the accident rate viewpoint, even though they are seldom used by companies; on the other hand, practices related to accidents and incidents investigation had a slight negative impact on the accident rate because they are frequently used as a reactive measure. In general, the higher the percentage of prevention practices implemented in a strategy, the lower the accident rate. However, the analysis of the combined effect of prevention practices indicated that the choice of the right combination of practices was more important than just the number of practices implemented. Copyright © 2016 Elsevier Ltd. All rights reserved.

Scavenging of reactive oxygen species and prevention of oxidative neuronal cell damage by a novel gallotannin, pistafolia A.

PubMed

Wei, Taotao; Sun, Handong; Zhao, Xingyu; Hou, Jingwu; Hou, Aijun; Zhao, Qinshi; Xin, Wenjuan

2002-03-08

Pistafolia A is a novel gallotannin isolated from the leaf extract of Pistacia weinmannifolia. In the present investigation, the ability of Pistafolia A to scavenge reactive oxygen species including hydroxyl radicals and superoxide anion was measured by ESR spin trapping technique. The inhibition effect on iron-induced lipid peroxidaiton in liposomes was studied. The protective effects of Pistafolia A against oxidative neuronal cell damage and apoptosis induced by peroxynitrite were also assessed. The results showed that Pistafolia A could scavenge both hydroxyl radicals and superoxide anion dose-dependently and inhibit lipid peroxidation effectively. In cerebellar granule cells pretreated with Pistafolia A, peroxynitrite-induced oxidative neuronal damage and apoptosis were prevented markedly. The antioxidant capacity of Pistafolia A was much more potent then that of the water-soluble analog of vitamin E, Trolox. The results suggested that Pistafolia A might be used as an effective natural antioxidant for the prevention and cure of neuronal diseases associated with the production of peroxynitrite and related reactive oxygen species.

Measuring the burden of preventable diabetic hospitalisations in the Mexican Institute of Social Security (IMSS).

PubMed

Lugo-Palacios, David G; Cairns, John; Masetto, Cynthia

2016-08-02

The prevalence of diabetes among adults in Mexico has increased markedly from 6.7 % in 1994 to 14.7 % in 2015. Although the main diabetic complications can be prevented or delayed with timely and effective primary care, a high percentage of diabetic patients have developed them imposing an important preventable burden on Mexican society and on the health system. This paper estimates the financial and health burden caused by potentially preventable hospitalisations due to diabetic complications in hospitals operated by the largest social security institution in Latin America, the Mexican Institute of Social Security (IMSS), in the period 2007-2014. Hospitalisations in IMSS hospitals whose main cause was a diabetic complication were identified. The financial burden was estimated using IMSS diagnostic-related groups. To estimate the health burden, DALYs were computed under the assumption that patients would not have experienced complications if they had received timely and effective primary care. A total of 322,977 hospitalisations due to five diabetic complications were identified during the period studied, of which hospitalisations due to kidney failure and diabetic foot represent 78 %. The financial burden increased by 8.4 % in real terms between 2007 and 2014. However, when measured as cost per IMSS affiliate, it decreased by 11.3 %. The health burden had an overall decrease of 13.6 % and the associated DALYs in 2014 reached 103,688. Resources used for the hospital treatment of diabetic complications are then not available for other health care interventions. In order to prevent these hospitalisations more resources might need to be invested in primary care; the first step could be to consider the financial burden of these hospitalisations as a potential target for switching resources from hospital care to primary care services. However, more evidence of the effectiveness of different primary care interventions is needed to know how much of the burden could be prevented by better primary care.

BSN723T Prevents Atherosclerosis and Weight Gain in ApoE Knockout Mice Fed a Western Diet.

PubMed

Williams, Jarrod; Ensor, Charles; Gardner, Scott; Smith, Rebecca; Lodder, Robert

This study tests the hypothesis that BSN723T can prevent the development of hyperlipidemia and atherosclerosis in ApoE -/- knockout mice fed a Western (high fat, high cholesterol, and high sucrose) diet. BSN723T is a combination drug therapy consisting of D-tagatose and dihydromyricetin (BSN723). D-tagatose has an antihyperglycemic effect in animal and human studies and shows promise as a treatment for type 2 diabetes and obesity. Many claims regarding BSN723's pharmacological activities have been made including anti-cancer, anti-diabetic, anti-hypertensive, anti-inflammatory, and anti-atherosclerotic effects. To our knowledge this is the first study that combines D-tagatose and BSN723 for the treatment of hyperlipidemia and the prevention of atherosclerosis. ApoE-deficient mice were randomized into five groups with equivalent mean body weights. The mice were given the following diets for 8 weeks: Group 1 - Standard diet; Group 2 - Western diet; Group 3 - Western diet formulated with D-tagatose; Group 4 - Western diet formulated with BSN723; Group 5 - Western diet formulated with BSN723T. Mice were measured for weight gain, tissue and organ weights, total serum cholesterol and triglycerides and formation of atherosclerosis. The addition of D-tagatose, either alone or in combination with BSN723, prevented the increase in adipose tissue and weight gain brought on by the Western diet. Both D-tagatose and BSN723 alone reduced total cholesterol and the formation of atherosclerosis in the aorta compared to mice on the Western diet. Addition of BSN723 to D-tagatose (BSN723T) did not increase efficacy in prevention of increases in cholesterol or atherosclerosis compared to D-tagatose alone. Addition of either D-tagatose or BSN723 alone to a Western diet prevented weight gain, increases in total serum cholesterol and triglycerides, and the formation of atherosclerosis. However, there was no additive or synergistic effect on the measured parameters with the combination BSN723T treatment.

What is the effect of a combined physical activity and fall prevention intervention enhanced with health coaching and pedometers on older adults' physical activity levels and mobility-related goals? Study protocol for a randomised controlled trial.

PubMed

Tiedemann, Anne; Paul, Serene; Ramsay, Elisabeth; O'Rourke, Sandra D; Chamberlain, Kathryn; Kirkham, Catherine; Merom, Dafna; Fairhall, Nicola; Oliveira, Juliana S; Hassett, Leanne; Sherrington, Catherine

2015-05-09

Physical inactivity and falls in older people are important public health problems. Health conditions that could be ameliorated with physical activity are particularly common in older people. One in three people aged 65 years and over fall at least once annually, often resulting in significant injuries and ongoing disability. These problems need to be urgently addressed as the population proportion of older people is rapidly rising. This trial aims to establish the impact of a combined physical activity and fall prevention intervention compared to an advice brochure on objectively measured physical activity participation and mobility-related goal attainment among people aged 60+. A randomised controlled trial involving 130 consenting community-dwelling older people will be conducted. Participants will be individually randomised to a control group (n = 65) and receive a fall prevention brochure, or to an intervention group (n = 65) and receive the brochure plus physical activity promotion and fall prevention intervention enhanced with health coaching and a pedometer. Primary outcomes will be objectively measured physical activity and mobility-related goal attainment, measured at both six and 12 months post randomisation. Secondary outcomes will include: falls, the proportion of people meeting the physical activity guidelines, quality of life, fear of falling, mood, and mobility limitation. Barriers and enablers to physical activity participation will be measured 6 months after randomisation. General linear models will be used to assess the effect of group allocation on the continuously-scored primary and secondary outcome measures, after adjusting for baseline scores. Between-group differences in goal attainment (primary outcome) will be analysed with ordinal regression. The number of falls per person-year will be analysed using negative binomial regression models to estimate the between-group difference in fall rates after one year (secondary outcome). Modified Poisson regression models will compare groups on dichotomous outcome measures. Analyses will be pre-planned, conducted while masked to group allocation and will use an intention-to-treat approach. This trial will address a key gap in evidence regarding physical activity and fall prevention for older people and will evaluate a program that could be directly implemented within Australian health services. ACTRN12614000016639, 7/01/2014.

Parents' Attitude towards the Use of Fluorides and Fissure Sealants and its Effect on their Children's Oral Health.

PubMed

Blumer, Sigalit; Ratson, Tal; Peretz, Benjamin; Dagon, Nurit

To characterize the attitudes of Israeli parents towards caries preventive measures. participating parents completed a 21-item questionnaire on their demographics, dental history, attitudes and satisfaction from fluorides and fissure sealants. One hundred parents (average age 41.62±4.9 years, 85 females) participated. Most of the parents (88% of the mothers and 84% of the fathers) had an academic education. Most of the parents (54%) had a favorable attitude towards the use of fluoridated gels, while only 37% of them had a positive opinion regarding fluoridated water. The satisfaction levels were very high regarding fissure sealants, fluoridated mouth rinses and fluoridated gels (78.1%, 73.6% and 72.5% respectively). The satisfaction from fluoridated water was split almost equally (50.8% were 'pleased' and 49.2% 'not pleased'). The main source for parental oral health knowledge was the dentist (83%). Parents' attitude towards caries preventive measures was significantly correlated to their gender, dental experience, level of education and the number of children in the family. positive attitude towards caries preventive measures was found among parents with higher awareness for preventive oral health measures and among bigger families. Mothers were more positive about fissure sealants than fathers. Mothers with up to 12 years of education tended to have a positive opinion regarding water fluoridation.

Cost-Effectiveness of a Chemoprophylactic Intervention with Single Dose Rifampicin in Contacts of New Leprosy Patients

PubMed Central

Idema, Willemijn J.; Majer, Istvan M.; Pahan, David; Oskam, Linda; Polinder, Suzanne; Richardus, Jan Hendrik

2010-01-01

Background With 249,007 new leprosy patients detected globally in 2008, it remains necessary to develop new and effective interventions to interrupt the transmission of M. leprae. We assessed the economic benefits of single dose rifampicin (SDR) for contacts as chemoprophylactic intervention in the control of leprosy. Methods We conducted a single centre, double blind, cluster randomised, placebo controlled trial in northwest Bangladesh between 2002 and 2007, including 21,711 close contacts of 1,037 patients with newly diagnosed leprosy. We gave a single dose of rifampicin or placebo to close contacts, with follow-up for four years. The main outcome measure was the development of clinical leprosy. We assessed the cost effectiveness by calculating the incremental cost effectiveness ratio (ICER) between the standard multidrug therapy (MDT) program with the additional chemoprophylaxis intervention versus the standard MDT program only. The ICER was expressed in US dollars per prevented leprosy case. Findings Chemoprophylaxis with SDR for preventing leprosy among contacts of leprosy patients is cost-effective at all contact levels and thereby a cost-effective prevention strategy. In total, $6,009 incremental cost was invested and 38 incremental leprosy cases were prevented, resulting in an ICER of $158 per one additional prevented leprosy case. It was the most cost-effective in neighbours of neighbours and social contacts (ICER $214), slightly less cost-effective in next door neighbours (ICER $497) and least cost-effective among household contacts (ICER $856). Conclusion Chemoprophylaxis with single dose rifampicin given to contacts of newly diagnosed leprosy patients is a cost-effective intervention strategy. Implementation studies are necessary to establish whether this intervention is acceptable and feasible in other leprosy endemic areas of the world. PMID:21072235

Stratified prevention: opportunities and limitations. Report on the 1st interdisciplinary cardiovascular workshop in Augsburg.

PubMed

Kirchhof, Gregor; Lindner, Josef Franz; Achenbach, Stephan; Berger, Klaus; Blankenberg, Stefan; Fangerau, Heiner; Gimpel, Henner; Gassner, Ulrich M; Kersten, Jens; Magnus, Dorothea; Rebscher, Herbert; Schunkert, Heribert; Rixen, Stephan; Kirchhof, Paulus

2018-03-01

Sufficient exercise and sleep, a balanced diet, moderate alcohol consumption and a good approach to handle stress have been known as lifestyles that protect health and longevity since the Middle Age. This traditional prevention quintet, turned into a sextet by smoking cessation, has been the basis of the "preventive personality" that formed in the twentieth century. Recent analyses of big data sets including genomic and physiological measurements have unleashed novel opportunities to estimate individual health risks with unprecedented accuracy, allowing to target preventive interventions to persons at high risk and at the same time to spare those in whom preventive measures may not be needed or even be harmful. To fully grasp these opportunities for modern preventive medicine, the established healthy life styles require supplementation by stratified prevention. The opportunities of these developments for life and health contrast with justified concerns: A "surveillance society", able to predict individual behaviour based on big data, threatens individual freedom and jeopardises equality. Social insurance law and the new German Disease Prevention Act (Präventionsgesetz) rightly stress the need for research to underpin stratified prevention which is accessible to all, ethical, effective, and evidence based. An ethical and acceptable development of stratified prevention needs to start with autonomous individuals who control and understand all information pertaining to their health. This creates a mandate for lifelong health education, enabled in an individualised form by digital technology. Stratified prevention furthermore requires the evidence-based development of a new taxonomy of cardiovascular diseases that reflects disease mechanisms. Such interdisciplinary research needs broad support from society and a better use of biosamples and data sets within an updated research governance framework.

Cost-effective and robust mitigation of space debris in low earth orbit

NASA Astrophysics Data System (ADS)

Walker, R.; Martin, C.

It is predicted that the space debris population in low Earth orbit (LEO) will continue to grow and in an exponential manner in the long-term due to an increasing rate of collisions between large objects, unless internationally-accepted space debris mitigation measures are adopted soon. Such measures are aimed at avoiding the future generation of space debris objects and primarily need to be effective in preventing significant long-term growth in the debris population, even in the potential scenario of an increase in future space activity. It is also important that mitigation measures can limit future debris population levels, and therefore the underlying collision risk to space missions, to the lowest extent possible. However, for their wide acceptance, the cost of implementation associated with mitigation measures needs to be minimised as far as possible. Generally, a lower collision risk will cost more to achieve and vice versa, so it is necessary to strike a balance between cost and risk in order to find a cost-effective set of mitigation measures. In this paper, clear criteria are established in order to assess the cost-effectiveness of space debris mitigation measures. A full cost-risk-benefit trade-off analysis of numerous mitigation scenarios is presented. These scenarios consider explosion prevention and post-mission disposal of space systems, including de-orbiting to limited lifetime orbits and re-orbiting above the LEO region. The ESA DELTA model is used to provide long-term debris environment projections for these scenarios as input to the benefit and risk parts of the trade-off analysis. Manoeuvre requirements for the different post-mission disposal scenarios were also calculated in order to define the cost-related element. A 25-year post-mission lifetime de-orbit policy, combined with explosion prevention and mission-related object limitation, was found to be the most cost-effective solution to the space debris problem in LEO. This package would also remain effective after a significant increase in future launch traffic. It was found that the re-orbiting of space systems above the LEO region would not lead to significant collision activity there over the next century. However, above-LEO disposal should be used sparingly because the disposal region could become unstable after a limited number of explosions or collisions due to a lack of air drag to remove the resulting fragments.

Comparing 2 methods of assessing 30-day readmissions: what is the impact on hospital profiling in the veterans health administration?

PubMed

Mull, Hillary J; Chen, Qi; O'Brien, William J; Shwartz, Michael; Borzecki, Ann M; Hanchate, Amresh; Rosen, Amy K

2013-07-01

The Centers for Medicare and Medicaid Services' (CMS) all-cause readmission measure and the 3M Health Information System Division Potentially Preventable Readmissions (PPR) measure are both used for public reporting. These 2 methods have not been directly compared in terms of how they identify high-performing and low-performing hospitals. To examine how consistently the CMS and PPR methods identify performance outliers, and explore how the PPR preventability component impacts hospital readmission rates, public reporting on CMS' Hospital Compare website, and pay-for-performance under CMS' Hospital Readmission Reduction Program for 3 conditions (acute myocardial infarction, heart failure, and pneumonia). We applied the CMS all-cause model and the PPR software to VA administrative data to calculate 30-day observed FY08-10 VA hospital readmission rates and hospital profiles. We then tested the effect of preventability on hospital readmission rates and outlier identification for reporting and pay-for-performance by replacing the dependent variable in the CMS all-cause model (Yes/No readmission) with the dichotomous PPR outcome (Yes/No preventable readmission). The CMS and PPR methods had moderate correlations in readmission rates for each condition. After controlling for all methodological differences but preventability, correlations increased to >90%. The assessment of preventability yielded different outlier results for public reporting in 7% of hospitals; for 30% of hospitals there would be an impact on Hospital Readmission Reduction Program reimbursement rates. Despite uncertainty over which readmission measure is superior in evaluating hospital performance, we confirmed that there are differences in CMS-generated and PPR-generated hospital profiles for reporting and pay-for-performance, because of methodological differences and the PPR's preventability component.

[Application of health education of house-to-house visit in malaria prevention and control].

PubMed

Zhou, Wen-gang; Qu, Yan; Wang, Wen-guang; Tang, Song-yuan

2014-10-01

To evaluate the effects of health education of house-to-house visit in malaria prevention and control in the border and minority areas. A health education of house-to-house visit in malaria prevention and control was carried out, and baseline and follow up surveys were conducted by qualitative and quantitative methods to document the changes of local villagers' knowledge, attitudes and behaviors (KAP) of malaria prevention and control in 2 counties of Yunnan Province, and the results before and after the interventions were analyzed and compared. After the intervention, the cognition rates about malaria symptoms and signs, transmission mode, preventive measures and health-seeking behaviors were 99.3%, 98.9%, 79.9% and 99.3% respectively in the local residents, and those were 39.2%, 8.2%, 47.0% and 49.9% respectively before the intervention, and all the differences were statistically significant (P all < 0.01). KAP related to malaria among the targeting population has improved after the interventions and the house-to-house visit is an effective community-based health education approach.

Prevention and dental health services.

PubMed

Widström, Eeva

2004-01-01

There has been, and still is a firm belief that regular use of dental services is beneficial for all. Thus governments in most European countries have shown some interest in training oral health care professionals, distributing the dental workforce and cost sharing. Constantly evolving treatment options and the introduction of new methods make dental clinicians feel uncertain as to which treatments are most useful, who would benefit from them, and which treatments will achieve cost-effective health gain. Although there is a considerable quantity of scientific literature showing that most available preventive measures are effective, and the number of sensible best-practice guidelines in prevention is growing, there are few studies on cost-efficiency of different methods and, secondly, the prevention and treatment guidelines are poorly known among general practitioners. In the eyes of the public, it is obvious that preventive methods practised by patients at home have been eclipsed by clinical procedures performed in dental clinics. Reliance on an increasingly individualistic approach to health care leads to the medicalisation of issues that are not originally health or medical problems. It is important to move general oral disease prevention back to the people who must integrate this in their daily routines. Prevention primarily based on healthy lifestyles, highlighted in the new public health strategy of the European Union (EU), is the key to future health policy.

Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians.

PubMed

Portincasa, Piero; Di Ciaula, Agostino; Grattagliano, Ignazio

2016-07-01

Gallstone formation is the result of a complex interaction between genetic and nongenetic factors. We searched and reviewed the available literature to define how the primary prevention of gallstones (cholesterol gallstones in particular) could be applied in general practice. Electronic bibliographical databases were searched. Prospective and retrospective cohort studies and case-controlled studies were analyzed and graded for evidence quality. The epidemiological data confirmed that genetic factors are estimated to account for only approximately 25% of the overall risk of gallstones, while metabolic/environmental factors are at least partially modifiable in stone-free risk groups, and are thus modifiable by primary prevention measures related to diet, lifestyle, and environmental factors (i.e., rapid weight loss, bariatric surgery, somatostatin or analogues therapy, transient gallbladder stasis, and hormone therapy). There is no specific recommendation for the secondary prevention of recurrent gallstones. Family physicians can contribute to preventing gallstones due to their capability to identify and effectively manage several risk factors discussed in this study. Although further studies are needed to better elucidate the involvement of epigenetic factors that may regulate the effect of environment and lifestyle on gene expression in the primary prevention of gallstone formation, preventive interventions are feasible and advisable in the general practice setting.

Carbetocin versus oxytocin for prevention of postpartum hemorrhage in obese nulliparous women undergoing emergency cesarean delivery.

PubMed

El Behery, Manal M; El Sayed, Gamal Abbas; El Hameed, Azza A Abd; Soliman, Badeea S; Abdelsalam, Walid A; Bahaa, Abeer

2016-01-01

To assess and compare the effectiveness and safety of single IV polus dose of carbetocin, versus IV oxytocin infusion in the prevention of PPH in obese nulliparous women undergoing emergency Cesarean Delivery. A double-blinded randomized-controlled trial was conducted on 180 pregnant women with BMI >30. Women were randomized to receive either oxytocin or carbetocin during C.S. The primary outcome measure was major primary PPH >1000 ml within 24 h of delivery as per the definition of PPH by the World Health Organization Secondary outcome measures were hemoglobin and hematocrit changes pre- and post-delivery, use of further ecobolics, uterine tone 2 and 12-h postpartum and adverse effects. A significant difference in the amount of estimated blood loss or the incidence of primary postpartum haemorrhage (>1000 ml) in both groups. Haemoglobin levels before and 24-h postpartum was similar. None from the carbetocin group versus 71.5% in oxytocin group needed additional utrotonics (p < 0.01). The uterine contractility was better in the carbetocin group at 2, and 12-h postpartum (p < 0.05). A single 100-µg IV carbetocin is more effective than IV oxytocin infusion for maintaining adequate uterine tone and preventing postpartum bleeding in obese nulliparous women undergoing emergency cesarean delivery, both has similar safety profile and minor hemodynamic effect.

Shiftwork, work-family conflict among Italian nurses, and prevention efficacy.

PubMed

Camerino, Donatella; Sandri, Marco; Sartori, Samantha; Conway, Paul Maurice; Campanini, Paolo; Costa, Giovanni

2010-07-01

Shiftwork may be a demanding situation because it raises problems for reconciling work and nonwork activities; as such, this conflict may be mitigated by designing and implementing effective preventative actions at the workplace. There is a paucity of research directly examining the impact of work schedules and preventative measures at work on work-family conflict. Hence, the authors posed the following questions in their study: What is the impact of different work schedules on work-family conflict? Is a preventative culture associated with less work-family conflict? Is work-family conflict associated with specific health and well-being indicators and if so, how does work-family conflict affect well-being as compared with other potential determinants? A subset of 750 nurses ( approximately 10% of total workforce) were randomly selected from a larger sample. Nurses completed the Italian version of the NEXT questionnaire plus newly developed items to create an index on occupational safety and health prevention at work. Data were explored using two data mining techniques, Random Forests and Bayesian Networks, and modeled using hierarchical linear regression models. In all, 664 (88.5% of sample) nurses answered the questionnaire. The authors found that different work schedules had a differential impact on work-family conflict. In addition, effective risk communication between workers and people in charge of safety and health, and participation in preventative activities, quantitative workload, performing tasks not belonging to the nursing profession, and the number of weekends/month spent at work were all strongly associated with work-family conflict. The variable "time schedules" also acted as an effect modifier in the relationship between effective communication and participation in preventative activities and work-family conflict. In addition, quantitative demands played a role as a mediator (30% of total effect) in the relationship between effective communication and participation in preventative activities and work-family conflict. Work-family conflict was significantly associated with burnout, sleep, and presenteeism; its association with burnout was higher than other precursors. Shift schedules that involved night work implied different workload demands, less effective communication, and participation in preventative activities than the other work schedules considered. The presence of a preventative culture directly reduced work-family conflict and indirectly via reduction of work demands. The authors conclude that the development of a preventative culture among irregular and night shiftworkers can be effective in reducing work-family conflict, while positively increasing well-being and job performance.

Analysis of Q fever in Dutch dairy goat herds and assessment of control measures by means of a transmission model.

PubMed

Bontje, D M; Backer, J A; Hogerwerf, L; Roest, H I J; van Roermund, H J W

2016-01-01

Between 2006 and 2009 the largest human Q fever epidemic ever described occurred in the Netherlands. The source of infection was traced back to dairy goat herds with abortion problems due to Q fever. The first aim of control measures taken in these herds was the reduction of human exposure. To analyze Q fever dynamics in goat herds and to study the effect of control measures, a within-herd model of Coxiella burnetii transmission in dairy goat herds was developed. With this individual-based stochastic model we evaluated six control strategies and three herd management styles and studied which strategy leads to a lower Q fever prevalence and/or to disease extinction in a goat herd. Parameter values were based on literature and on experimental work. The model could not be validated with independent data. The results of the epidemiological model were: (1) Vaccination is effective in quickly reducing the prevalence in a dairy goat herd. (2) When taking into account the average time to extinction of the infection and the infection pressure in a goat herd, the most effective control strategy is preventive yearly vaccination, followed by the reactive strategies to vaccinate after an abortion storm or after testing BTM (bulk tank milk) positive. (3) As C. burnetii in dried dust may affect public health, an alternative ranking method is based on the cumulative amount of C. burnetii emitted into the environment (from disease introduction until extinction). Using this criterion, the same control strategies are effective as when based on time to extinction and infection pressure (see 2). (4) As the bulk of pathogen excretion occurs during partus and abortion, culling of pregnant animals during an abortion storm leads to a fast reduction of the amount of C. burnetii emitted into the environment. However, emission is not entirely prevented and Q fever will not be eradicated in the herd by this measure. (5) A search & destroy (i.e. test and cull) method by PCR of individual milk samples with a detection probability of 50% of detecting and culling infected goats - that excrete C. burnetii intermittently - will not result in eradication of Q fever in the herd. This control strategy was the least effective of the six evaluated strategies. Subject to model limitations, our results indicate that only vaccination is capable of preventing and controlling Q fever outbreaks in dairy goat farms. Thus, preventive vaccination should be considered as an ongoing control measure. Copyright © 2015 Elsevier B.V. All rights reserved.

Cost-effectiveness of active-passive prophylaxis and antiviral prophylaxis during pregnancy to prevent perinatal hepatitis B virus infection.

PubMed

Fan, Lin; Owusu-Edusei, Kwame; Schillie, Sarah F; Murphy, Trudy V

2016-05-01

In an era of antiviral treatment, reexamination of the cost-effectiveness of strategies to prevent perinatal hepatitis B virus (HBV) transmission in the United States is needed. We used a decision tree and Markov model to estimate the cost-effectiveness of the current U.S. strategy and two alternatives: (1) Universal hepatitis B vaccination (HepB) strategy: No pregnant women are screened for hepatitis B surface antigen (HBsAg). All infants receive HepB before hospital discharge; no infants receive hepatitis B immunoglobulin (HBIG). (2) Current strategy: All pregnant women are screened for HBsAg. Infants of HBsAg-positive women receive HepB and HBIG ≤12 hours of birth. All other infants receive HepB before hospital discharge. (3) Antiviral prophylaxis strategy: All pregnant women are screened for HBsAg. HBsAg-positive women have HBV-DNA load measured. Antiviral prophylaxis is offered for 4 months starting in the third trimester to women with DNA load ≥10(6) copies/mL. HepB and HBIG are administered at birth to infants of HBsAg-positive women, and HepB is administered before hospital discharge to infants of HBsAg-negative women. Effects were measured in quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICER). Compared to the universal HepB strategy, the current strategy prevented 1,006 chronic HBV infections and saved 13,600 QALYs (ICER: $6,957/QALY saved). Antiviral prophylaxis dominated the current strategy, preventing an additional 489 chronic infections, and saving 800 QALYs and $2.8 million. The results remained robust over a wide range of assumptions. The current U.S. strategy for preventing perinatal HBV remains cost-effective compared to the universal HepB strategy. An antiviral prophylaxis strategy was cost saving compared to the current strategy and should be considered to continue to decrease the burden of perinatal hepatitis B in the United States. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Air travellers' awareness of the preventability of otic barotrauma.

PubMed

Mitchell-Innes, A; Young, E; Vasiljevic, A; Rashid, M

2014-06-01

Otic barotrauma is common among air travellers and can cause severe otalgia, perforation of the tympanic membrane and hearing loss. Many prevention measures exist, with varying evidence to support their use. There are no data to establish if air travellers are aware of them or indeed use them. We aimed to establish air travellers' knowledge of such prevention measures. We surveyed air travellers at two UK airports by means of a questionnaire. Answers to the questionnaire were collected over a two-week period. Overall, 179 air travellers with a mean age of 28 years (range: 15-72 years) completed the questionnaire. There were 66 female and 113 male air travellers. The majority (84 per cent) complained of symptoms while flying and 30 per cent were not aware of any prevention measures. Barotrauma-related symptoms were reported in 25 per cent of air travellers who were unaware of any prevention measures. Nearly all air travellers (86 per cent) indicated that more information regarding prevention measures would be useful. Air travellers are often not aware of prevention measures to avoid otic barotrauma, and the majority suffer as a result. Increasing public awareness of simple prevention measures would have a significant impact on air travellers.

The effectiveness of jewelweed, Impatiens capensis, the related cultivar I. balsamina and the component, lawsone in preventing post poison ivy exposure contact dermatitis.

PubMed

Abrams Motz, Vicki; Bowers, Christopher P; Mull Young, Linda; Kinder, David H

2012-08-30

Impatiens capensis (jewelweed) is native to the Eastern and Midwestern US and Canada. Many Native American tribes used I. capensis and its close relatives to treat/prevent rash from plant sources particularly Toxicodendron radicans and Urtica dioica. I. balsamina (garden balsam) a native of China was used by the indigenous people of Asia for similar purposes. This study aims to validate ethnopharmacological use of jewelweed in poison ivy (PI) dermatitis prevention and to refute scientific papers denying this efficacy. Additionally, the content of lawsone, the purported effective agent in jewelweed preparations, was measured to see if its concentration correlated with jewelweed preparation efficacy. Poison ivy was brushed onto forearms of volunteers in 6 locations and exposed areas were treated with jewelweed extracts, fresh plant mashes, soaps made of plant extracts, water and Dawn® dish soap. Rash development was scored on a scale of 0-14. Jewelweed mash was effective in reducing poison ivy dermatitis, supporting ethnobotanical use. However, jewelweed extracts were not effective; and soaps made of these extracts were effective but no more so than jewelweed-free soaps. Lawsone content varied with harvest season and did not appear to affect rash development. Jewelweed is an efficacious plant for preventing development of dermatitis following poison ivy contact, but soap is more effective. Lawsone content does not correlate with PI rash prevention. Perhaps saponins, the soapy component of jewelweed are the effective agents. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

[Effect of measures for the detection and long-term drug therapy of arterial hypertension on the morbidity and work capacity of industrial workers].

PubMed

Evdakov, V A; Baĭda, S M; Britov, A N; Safronova, M B; Grigor'eva, N V

1985-01-01

The article contains data on preliminary evaluation of the efficacy of secondary prevention of arterial hypertension among industrial workers of "Avto ZIL" amalgamation. Population studies to reveal major cardiovascular diseases show a certain increase of arterial hypertension and other disease morbidity accompanied by temporary disability. A considerable positive effect is observed in groups of hypertensives undergoing regular and effective anti-hypertension preventive treatment. Long-term regular hypotensive treatment of hypertensive subjects and the lowering of blood pressure to less than 160/90 mm Hg contributes to the decrease in labour and economic losses and to increased labour productivity of industrial workers.

Cholera - management and prevention.

PubMed

Davies, Hannah G; Bowman, Conor; Luby, Stephen P

2017-06-01

Cholera is an acute secretory diarrhoeal infection caused by the bacterium Vibrio cholerae. It is likely to have originated in the Indian sub-continent; however, it spread to cause six worldwide pandemics between 1817-1923. The ongoing seventh worldwide pandemic of cholera began in 1961. The intensity, duration and severity of cholera epidemics have been increasing, signaling the need for more effective control and prevention measures. The response to the cholera pandemics of the 19th century led to the development of safe and effective sanitation and water systems which have effectively removed the risk of cholera in many settings. However, such systems are not in place to protect billions of people worldwide. Although some progress has been made in expanding access to water in recent years, achieving optimal infrastructure will, in the most optimistic scenario, take decades. Climate change, extreme weather events and rapid urbanisation suggests that alternatives to the current paradigm of providing large centralised water and sanitation systems should be considered, including smaller decentralised systems. The aim of this review paper is to provide an overview of current knowledge regarding management of cholera with a focus on prevention measures including vaccination and water and sanitation interventions. © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Prophylactic isopropyl alcohol inhalation and intravenous ondansetron versus ondansetron alone in the prevention of postoperative nausea and vomiting in high-risk patients.

PubMed

Radford, Kennett D; Fuller, Thomas N; Bushey, Brent; Daniel, Carole; Pellegrini, Joseph E

2011-08-01

Patients identified as high risk for postoperative nausea and vomiting (PONV) are often treated prophylactically with intravenous (IV) ondansetron and an additional agent. Limited options exist for a second agent with no adverse effects. The purpose of this investigation was to determine if combining the prophylactic inhalation of isopropyl alcohol (IPA) vapors, an agent with no adverse effects, with IV ondansetron would be more effective than IV ondansetron alone in the prevention of PONV in high-risk patients. A total of 76 patients at high risk for PONV were randomized into control (n = 38) and experimental (n = 38) groups. All patients received IV ondansetron before emergence from general anesthesia. In addition, the experimental group inhaled IPA vapors before induction. Severity of PONV was measured using a 0 to 10 verbal numeric rating scale. Other measured variables included time to onset and incidence of PONV, 24-hour composite nausea score, and satisfaction with nausea control. No significant differences in demographics, surgical or anesthesia time, number of risk factors, severity or incidence of PONV, or satisfaction scores were noted. Prophylactic inhalation of IPA vapors in combination with IV ondansetron was no more efficacious than IV ondansetron alone in the prevention of PONV in a high-risk population.

TakeCARE, a Video Bystander Program to Help Prevent Sexual Violence on College Campuses: Results of Two Randomized, Controlled Trials

PubMed Central

Jouriles, Ernest N.; McDonald, Renee; Rosenfield, David; Levy, Nicole; Sargent, Kelli; Caiozzo, Christina; Grych, John H.

2015-01-01

Objective The present research reports on two randomized controlled trials evaluating TakeCARE, a video bystander program designed to help prevent sexual violence on college campuses. Method In Study 1, students were recruited from psychology courses at two universities. In Study 2, first-year students were recruited from a required course at one university. In both studies, students were randomly assigned to view one of two videos: TakeCARE or a control video on study skills. Just before viewing the videos, students completed measures of bystander behavior toward friends and ratings of self-efficacy for performing such behaviors. The efficacy measure was administered again after the video, and both the bystander behavior measure and the efficacy measure were administered at either one (Study 1) or two (Study 2) months later. Results In both studies, students who viewed TakeCARE, compared to students who viewed the control video, reported engaging in more bystander behavior toward friends and greater feelings of efficacy for performing such behavior. In Study 1, feelings of efficacy mediated effects of TakeCARE on bystander behavior; this result did not emerge in Study 2. Conclusions This research demonstrates that TakeCARE, a video bystander program, can positively influence bystander behavior toward friends. Given its potential to be easily distributed to an entire campus community, TakeCARE might be an effective addition to campus efforts to prevent sexual violence. PMID:27867694

Preventing falls in older multifocal glasses wearers by providing single-lens distance glasses: the protocol for the VISIBLE randomised controlled trial

PubMed Central

Haran, Mark J; Lord, Stephen R; Cameron, Ian D; Ivers, Rebecca Q; Simpson, Judy M; Lee, Bonsan B; Porwal, Mamta; Kwan, Marcella MS; Severino, Connie

2009-01-01

Background Recent research has shown that wearing multifocal glasses increases the risk of trips and falls in older people. The aim of this study is to determine whether the provision of single-lens distance glasses to older multifocal glasses wearers, with recommendations for wearing them for walking and outdoor activities, can prevent falls. We will also measure the effect of the intervention on health status, lifestyle activities and fear of falling, as well as the extent of adherence to the program. Methods/Design Approximately 580 older people who are regular wearers of multifocal glasses people will be recruited. Participants will be randomly allocated to either an intervention group (provision of single lens glasses, with counselling and advice about appropriate use) or a control group (usual care). The primary outcome measure will be falls (measured with 13 monthly calendars). Secondary measures will be quality of life, falls efficacy, physical activity levels and adverse events. Discussions The study will determine the impact of providing single-lens glasses, with advice about appropriate use, on preventing falls in older regular wearers of multifocal glasses. This pragmatic intervention, if found to be effective, will guide practitioners with regard to recommending appropriate glasses for minimising the risk of falls in older people. Trial Registration The protocol for this study was registered with the Clinical Trials.gov Protocol Registration System on June 7th 2006 (#350855). PMID:19321012

HbA1c as a Predictor of Diabetes and as an Outcome in the Diabetes Prevention Program: A Randomized Clinical Trial

PubMed Central

2015-01-01

OBJECTIVE Glycated hemoglobin (HbA1c), a standard measure of chronic glycemia for managing diabetes, has been proposed to diagnose diabetes and identify people at risk. The Diabetes Prevention Program (DPP) was a 3.2-year randomized clinical trial of preventing type 2 diabetes with a 10-year follow-up study, the DPP Outcomes Study (DPPOS). We evaluated baseline HbA1c as a predictor of diabetes and determined the effects of treatments on diabetes defined by an HbA1c ≥6.5% (48 mmol/mol). RESEARCH DESIGN AND METHODS We randomized 3,234 nondiabetic adults at high risk of diabetes to placebo, metformin, or intensive lifestyle intervention and followed them for the development of diabetes as diagnosed by fasting plasma glucose (FPG) and 2-h postload glucose (2hPG) concentrations (1997 American Diabetes Association [ADA] criteria). HbA1c was measured but not used for study eligibility or outcomes. We now evaluate treatment effects in the 2,765 participants who did not have diabetes at baseline according to FPG, 2hPG, or HbA1c (2010 ADA criteria). RESULTS Baseline HbA1c predicted incident diabetes in all treatment groups. Diabetes incidence defined by HbA1c ≥6.5% was reduced by 44% by metformin and 49% by lifestyle during the DPP and by 38% by metformin and 29% by lifestyle throughout follow-up. Unlike the primary DPP and DPPOS findings based on glucose criteria, metformin and lifestyle were similarly effective in preventing diabetes defined by HbA1c. CONCLUSIONS HbA1c predicted incident diabetes. In contrast to the superiority of the lifestyle intervention on glucose-defined diabetes, metformin and lifestyle interventions had similar effects in preventing HbA1c-defined diabetes. The long-term implications for other health outcomes remain to be determined. PMID:25336746

Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: guidance from the European Centre for Disease Prevention and Control.

PubMed

Magiorakos, A P; Burns, K; Rodríguez Baño, J; Borg, M; Daikos, G; Dumpis, U; Lucet, J C; Moro, M L; Tacconelli, E; Simonsen, G Skov; Szilágyi, E; Voss, A; Weber, J T

2017-01-01

Infections with carbapenem-resistant Enterobacteriaceae (CRE) are increasingly being reported from patients in healthcare settings. They are associated with high patient morbidity, attributable mortality and hospital costs. Patients who are "at-risk" may be carriers of these multidrug-resistant Enterobacteriaceae (MDR-E).The purpose of this guidance is to raise awareness and identify the "at-risk" patient when admitted to a healthcare setting and to outline effective infection prevention and control measures to halt the entry and spread of CRE. The guidance was created by a group of experts who were functioning independently of their organisations, during two meetings hosted by the European Centre for Disease Prevention and Control. A list of epidemiological risk factors placing patients "at-risk" for carriage with CRE was created by the experts. The conclusions of a systematic review on the prevention of spread of CRE, with the addition of expert opinion, were used to construct lists of core and supplemental infection prevention and control measures to be implemented for "at-risk" patients upon admission to healthcare settings. Individuals with the following profile are "at-risk" for carriage of CRE: a) a history of an overnight stay in a healthcare setting in the last 12 months, b) dialysis-dependent or cancer chemotherapy in the last 12 months, c) known previous carriage of CRE in the last 12 months and d) epidemiological linkage to a known carrier of a CRE.Core infection prevention and control measures that should be considered for all patients in healthcare settings were compiled. Preliminary supplemental measures to be implemented for "at-risk" patients on admission are: pre-emptive isolation, active screening for CRE , and contact precautions. Patients who are confirmed positive for CRE will need additional supplemental measures. Strengthening the microbiological capacity, surveillance and reporting of new cases of CRE in healthcare settings and countries is necessary to monitor the epidemiological situation so that, if necessary, the implemented CRE prevention strategies can be refined in a timely manner. Creating a large communication network to exchange this information would be helpful to understand the extent of the CRE reservoir and to prevent infections in healthcare settings, by applying the principles outlined here.This guidance document offers suggestions for best practices, but is in no way prescriptive for all healthcare settings and all countries. Successful implementation will result if there is local commitment and accountability. The options for intervention can be adopted or adapted to local needs, depending on the availability of financial and structural resources.

Safety measures to prevent workplace violence in emergency primary care centres--a cross-sectional study.

PubMed

Morken, Tone; Johansen, Ingrid H

2013-10-03

Employees in emergency primary care centres (EPCC) have raised personal safety as an issue. Despite a high risk of experiencing workplace violence at EPCCs in Norway, knowledge regarding applied preventive measures is limited. The description of existing safety measures is an important prerequisite to evaluate and make guidelines for the improvement of preventive practices on a national level. The objective of this study was to investigate to which extent general practitioners work alone in EPCCs in Norway, and to estimate the prevalence of other preventive measures against workplace violence. A survey was sent to the managers of all 210 registered EPCCs in Norway. The questionnaire included 22 items on safety measures, including available staff, architecture and outfitting of the reception and consulting rooms, and the availability of electronic safety systems and training or monitoring systems. The data were analysed using descriptive statistics. Differences between EPCCs staffed by one general practitioner alone and EPCCs with more health personnel on duty were explored. Sixty-one (30%) of the 203 participating EPCCs had more than one person on duty round-the-clock. These EPCCs reported the application of a significantly higher number of safety measures compared to the EPCCs with only one general practitioner on duty during some or part of the 24 hours. Examples of safety measures being more common in highly staffed EPCCs were automatic door locks (p < 0.001), arrangement of furniture in the consulting room ensuring that the patient is not seated between the clinician and the exit (p = 0.014), the possibility of bringing an extra person on emergency call-outs or home visits when needed for security reasons (p = 0.014), and having organised training regarding violence (p < 0.001). This study shows considerable differences between Norwegian EPCCs regarding applied preventive measures, and a higher prevalence of such measures in EPCCs staffed with several health personnel around-the-clock. More research is needed to understand the reasons for, and the effects of, these differences.

[Status of measures against angiography room infection as determined by questionnaire].

PubMed

Tsukamoto, Atsuko; Ito, Makiko; Takahashi, Kanji; Watanabe, Emi; Kikuchi, Tatsuya; Tajima, Osamu; Masuda, Kazuhiro; Wakamatsu, Osamu; Sato, Tsugio; Nakazawa, Yasuo

2006-11-20

Although the cleanliness of the angiography room and that of the operating room have long been equally attended to, the concept of Standard Precautions (including the basic measures and procedures to prevent infection) of the Centers for Disease Control and Prevention (CDC), 1996, as well as the introduction of transmission-based precautions, have been changing to preventive measures that are based on concrete measures. Therefore, a questionnaire was introduced in order to determine the actual status of countermeasures against infection used in the angiography room. The questionnaire was sent to 530 institutions, and 286 responded, a response rate of 54.0%. Its results significantly revealed the following: 1) unexpectedly low recognition of the need and importance for the CDC preventive measures against infection, 2) a considerable number of institutions continuing to perform the conventional preventive measures, 3) problems with education systems on preventive measures, and 4) handwashing, the most important measure against infection, failing to be adequately carried out noticeably among radiological technologists.

Child maltreatment prevention: a systematic review of reviews

PubMed Central

Butchart, Alexander

2009-01-01

Abstract Objective To synthesize recent evidence from systematic and comprehensive reviews on the effectiveness of universal and selective child maltreatment prevention interventions, evaluate the methodological quality of the reviews and outcome evaluation studies they are based on, and map the geographical distribution of the evidence. Methods A systematic review of reviews was conducted. The quality of the systematic reviews was evaluated with a tool for the assessment of multiple systematic reviews (AMSTAR), and the quality of the outcome evaluations was assessed using indicators of internal validity and of the construct validity of outcome measures. Findings The review focused on seven main types of interventions: home visiting, parent education, child sex abuse prevention, abusive head trauma prevention, multi-component interventions, media-based interventions, and support and mutual aid groups. Four of the seven – home-visiting, parent education, abusive head trauma prevention and multi-component interventions – show promise in preventing actual child maltreatment. Three of them – home visiting, parent education and child sexual abuse prevention – appear effective in reducing risk factors for child maltreatment, although these conclusions are tentative due to the methodological shortcomings of the reviews and outcome evaluation studies they draw on. An analysis of the geographical distribution of the evidence shows that outcome evaluations of child maltreatment prevention interventions are exceedingly rare in low- and middle-income countries and make up only 0.6% of the total evidence base. Conclusion Evidence for the effectiveness of four of the seven main types of interventions for preventing child maltreatment is promising, although it is weakened by methodological problems and paucity of outcome evaluations from low- and middle-income countries. PMID:19551253

Rationale, design, and protocol for the prevention of low back pain in the military (POLM) trial (NCT00373009)

PubMed Central

George, Steven Z; Childs, John D; Teyhen, Deydre S; Wu, Samuel S; Wright, Alison C; Dugan, Jessica L; Robinson, Michael E

2007-01-01

Background There are few effective strategies reported for the primary prevention of low back pain (LBP). Core stabilization exercises targeting the deep abdominal and trunk musculature and psychosocial education programs addressing patient beliefs and coping styles represent the current best evidence for secondary prevention of low back pain. However, these programs have not been widely tested to determine if they are effective at preventing the primary onset and/or severity of LBP. The purpose of this cluster randomized clinical trial is to determine if a combined core stabilization exercise and education program is effective in preventing the onset and/or severity of LBP. The effect of the combined program will be compared to three other standard programs. Methods/Design Consecutive Soldiers participating in advanced individual training (AIT) will be screened for eligibility requirements and consented to study participation, as appropriate. Companies of Soldiers will be randomly assigned to receive the following standard prevention programs; a core stabilization exercise program (CSEP) alone, a CSEP with a psychosocial education (PSEP), a traditional exercise (TEP), or a TEP with a PSEP. Proximal outcome measures will be assessed at the conclusion of AIT (a 12 week training period) and include imaging of deep lumbar musculature using real-time ultrasound imaging and beliefs about LBP by self-report questionnaire. We are hypothesizing that Soldiers receiving the CSEP will have improved thickness of selected deep lumbar musculature (transversus abdominus, multifidi, and erector spinae muscles). We are also hypothesizing that Soldiers receiving the PSEP will have improved beliefs about the management of LBP. After AIT, Soldiers will be followed monthly to measure the distal outcomes of LBP occurrence and severity. This information will be collected during the subsequent 2 years following completion of AIT using a web-based data entry system. Soldiers will receive a monthly email that queries whether any LBP was experienced in the previous calendar month. Soldiers reporting LBP will enter episode-specific data related to pain intensity, pain-related disability, fear-avoidance beliefs, and pain catastrophizing. We are hypothesizing that Soldiers receiving the CSEP and PSEP will report the longest duration to first episode of LBP, the lowest frequency of LBP, and the lowest severity of LBP episodes. Statistical comparisons will be made between each of the randomly assigned prevention programs to test our hypotheses related to determining which of the 4 programs is most effective. Discussion We have presented the design and protocol for the POLM trial. Completion of this trial will provide important information on how to effectively train Soldiers for the prevention of LBP. Trial registration NCT00373009 PMID:17868436

[Pharmacological possibilities for the prevention of complications following myocardial infarction].

PubMed

Szekeres, L

1986-01-01

Sudden cardiac death (SCD) due to acute myocardial infarction (AMI) is mostly the result of ventricular fibrillation (VP) which is an electrical accident appearing on the basis of electrical instability of the myocardium. In addition to the chronic electrical instability predisposing to ventricular arrhythmias the trigger effect of a precipitating factor also seems necessary which may disrupt the normal sequence of cardiac contractions. In view of this hypothesis the following strategy of therapeutic interventions aimed at preventing SCD from AMI seems to be logical: Prophylactic measures to prevent pathological processes underlying chronic electrical instability of the heart i.e. elimination of identified risk factors of ischemic heart disease. Protection from SCD due to AMI: by using drugs which could, prevent further electrical destabilization as shifts in myocardial and plasma ionic balance, in pH, in pCO2, accumulation of potentially arrhythmogenic metabolites: Inhibit the trigger effect of sudden changes: in hemodynamics, in the autonomic nervous outflow and balance. The general supportive measures include therapeutic interventions which are not directly connected with appearance of lethal arrhythmias but may indirectly contribute to their development as pain, arterial Hb desaturation, deep vein thrombosis. Some of the measures listed above are capable of limiting the size of the developing infarct, a major determinant of the future conditions of life and prognosis of the patient. In the prehospital phase of AMI when two thirds of all coronary deaths occur general supportive measures and drug treatment of life threatening arrhythmias should be applied simultaneously. Sedatives and anxiolytics, furthermore analgetics are widely used. They are however often associated with bradycardia and sometimes with hypotension. This latter is dominant in patients with inferior infarction, showing a parasympathetic hyperactivity, when atropine treatment is needed. Sympathetic hyperactivity responds to analgesia and sedation but beta blockers may be required to reduce increased MVO2. These agents belong to the group of anti-ischemic drugs. The beneficial anti-ischemic action of beta-blockers is mostly due to their negative chronotropic and inotropic effect. A direct metabolic action was shown by use as well as the presence of a positive steal phenomenon in the experimental angina model in dogs. Anti-ischemic action of coronary vasodilators. The most reliable drug for preventing or abolishing anginal attack is still the classic nitroglycerin. On the other hand persantine a potent coronary dilator failed to protect against anginal attack in man.

Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India

PubMed Central

2010-01-01

Background Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. Methods Based on data from a representative sample of 128 public-funded HIV prevention programs of 14 types in Andhra Pradesh, we have recently reported the number of HIV infections averted by each type of HIV prevention intervention and their cost. Using estimates of the age of onset of HIV infection, we used standard methods to calculate the cost per Disability Adjusted Life Year (DALY) saved as a measure of cost-effectiveness of each type of HIV prevention intervention. Results The point estimates of the cost per DALY saved were less than US $50 for blood banks, men who have sex with men programmes, voluntary counselling and testing centres, prevention of parent to child transmission clinics, sexually transmitted infection clinics, and women sex worker programmes; between US $50 and 100 for truckers and migrant labourer programmes; more than US $100 and up to US $410 for composite, street children, condom promotion, prisoners and workplace programmes and mass media campaign for the general public. The uncertainty range around these estimates was very wide for several interventions, with the ratio of the high to the low estimates infinite for five interventions. Conclusions The point estimates for the cost per DALY saved from the averted HIV infections for all interventions was much lower than the per capita gross domestic product in this Indian state. While these indicative cost-effectiveness estimates can inform HIV control planning currently, the wide uncertainty range around estimates for several interventions suggest the need for more firm data for estimating cost-effectiveness of HIV prevention interventions in India. PMID:20459755

Systematic review finds that silver diamine fluoride is effective for both root caries prevention and arrest in older adults.

PubMed

McReynolds, David; Duane, Brett

2018-06-01

Data sourcesPubMed, Pubmed Clinical Queries, EMBASE, the American Dental Associations Evidence-Based Dentistry Website, Cochrane Library, Web of Science, repository of the Journal of the American Dental Association and Google Scholar.Study selectionFour authors independently assessed the abstracts of studies resulting from the above searches which compared treatment of root caries in an older population with SDF versus other preventive agents or placebos.Data extraction and synthesisTitles and abstracts of all reports identified through the electronic searches were assessed independently by four authors based on agreed upon inclusion and exclusion criteria. Of the selected studies for final inclusion in the systematic review, study quality was assessed using the critical appraisal worksheet for randomised controlled trials from the Oxford Centre for Evidence-Based Medicine (CEBM 2005). Prevented fraction (PF), number needed to treat (NNT) and relative risk (RR) were calculated as outcome measures in each study. In addition, the published evidence on SDF was reviewed in order to formulate clinical recommendations on safety and effectiveness when treating root or coronal caries in an adult population with SDF, as well as treatment of dental hypersensitivity.ResultsThree randomised controlled trials were identified that addressed the effectiveness of SDF on root caries in older adults, but none addressed coronal caries. Root caries prevented fraction and arrest rate for SDF were significantly higher than placebo. The prevented fraction for caries prevention for SDF compared to placebo was 71% in a three-year study and 25% in a two-year study. The prevented fraction for caries arrest for SDF was 725% greater in a 24-month study and 100% greater than placebo in a 30-month study. No severe adverse effects were observed.ConclusionsExisting reports of SDF trials support effectiveness in root caries prevention and arrest, remineralisation of deep occlusal lesions and treatment of hypersensitive dentine.

Life-Cycle Costing of Food Waste Management in Denmark: Importance of Indirect Effects.

PubMed

Martinez-Sanchez, Veronica; Tonini, Davide; Møller, Flemming; Astrup, Thomas Fruergaard

2016-04-19

Prevention has been suggested as the preferred food waste management solution compared to alternatives such as conversion to animal fodder or to energy. In this study we used societal life-cycle costing, as a welfare economic assessment, and environmental life-cycle costing, as a financial assessment combined with life-cycle assessment, to evaluate food waste management. Both life-cycle costing assessments included direct and indirect effects. The latter are related to income effects, accounting for the marginal consumption induced when alternative scenarios lead to different household expenses, and the land-use-changes effect, associated with food production. The results highlighted that prevention, while providing the highest welfare gains as more services/goods could be consumed with the same income, could also incur the highest environmental impacts if the monetary savings from unpurchased food commodities were spent on goods/services with a more environmentally damaging production than that of the (prevented) food. This was not the case when savings were used, e.g., for health care, education, and insurances. This study demonstrates that income effects, although uncertain, should be included whenever alternative scenarios incur different financial costs. Furthermore, it highlights that food prevention measures should not only demote the purchase of unconsumed food but also promote a low-impact use of the savings generated.

Examining the Effectiveness of the Smoking Prevention Program "I Do Not Smoke, I Exercise" in Elementary and Secondary School Settings.

PubMed

Kolovelonis, Athanasios; Goudas, Marios; Theodorakis, Yannis

2016-11-01

The aim of the study was to examine the effectiveness of the smoking prevention program "I do not smoke, I exercise" implemented with elementary and secondary school students. "I do not smoke, I exercise" is a theory-based smoking prevention program that promotes exercise as an alternative of smoking. The program consists of eight sessions implemented weekly. Participants were 338 Greek students (135 elementary and 203 secondary students) who were pre- and posttested in smoking, program, and exercise-related measures. The results showed that the program had significant effects on elementary students' attitudes toward smoking, intention to smoke, subjective norms, attitudes toward the application of the program, and knowledge about the health consequences of smoking. For secondary students, significant effects were found on students' perceived behavioral control and knowledge about the health consequences of smoking, while very few students reported a smoking experience before and after the intervention. Therefore the program "I do not smoke, I exercise" may have positive effects on variables related with smoking behavior. Differences in the program's impact on elementary and secondary students were identified. All these are discussed with reference to the need of implementing smoking prevention programs in schools contexts. © 2016 Society for Public Health Education.

Soil conservation through sediment trapping: A review

NASA Astrophysics Data System (ADS)

Mekonnen, Mulatie; Keesstra, Saskia; Baartman, Jantiene; Maroulis, Jerry; Stroosnijder, Leo

2014-05-01

Preventing the off-site effects of soil erosion is an essential part of good catchment management. Most efforts are in the form of on-site soil and water conservation measures. However, sediment trapping (ST) can be an alternative (or additional) measure to prevent the negative off-site effects of soil erosion. Therefore, not all efforts should focus solely on on-site soil conservation, but also on the safe routing of sediment-laden flows and on creating sites and conditions where sediment can be trapped, preferably in a cost effective or even profitable way. ST can be applied on-site (in-field) and off-site and involves both vegetative and structural measures. The main vegetative measures include grass strips, tree or bush buffers, grassed waterways and restoration of the waterways and their riparian zone; while structural measures include terraces, ponds and check dams. This paper provides a review of studies that have assessed the sediment trapping efficacy (STE) of such vegetative and structural measures. Vegetation type and integration of two or more measures (vegetative as well as structural) are important factors influencing STE. In this review, the STE of most measures was evaluated either individually or in such combinations. In real landscape situations, it is not only important to select the most efficient erosion control measures, but also to determine their optimum location in the catchment. Hence, there is a need for research that shows a more integrated determination of STE at the catchment scale. If integrated measures are implemented at the most appropriate spatial locations within a catchment where they can disconnect landscape units from each other, they will decrease runoff velocity and sediment transport and, subsequently, reduce downstream flooding and sedimentation problems. KEY WORDS: Integrated sediment trapping, sediment trapping efficacy, vegetative, structural, on-site and off-site measures.

Effectiveness of environmental control measures to decrease the risk of invasive aspergillosis in acute leukaemia patients during hospital building work.

PubMed

Combariza, J F; Toro, L F; Orozco, J J

2017-08-01

Invasive aspergillosis (IA) is a significant problem in acute leukaemia patients. Construction work near hospital wards caring for immunocompromised patients is one of the main risk factors for developing invasive pulmonary aspergillosis (IPA). To assess the impact of environmental control measures used during hospital construction for the prevention of IA in acute leukaemia patients. A retrospective cohort study was developed to evaluate the IA incidence in acute leukaemia patients with different environmental control measures employed during hospital construction. We used European Organisation for the Research and Treatment of Cancer (EORTC) criterial diagnosis parameters for definition of IA. A total of 175 episodes of inpatient care were evaluated, 62 of which did not have any environmental control measures (when an outbreak occurred), and 113 that were subject to environmental control measures directed to preventing IA. The study showed an IA incidence of 25.8% for the group without environmental control measures vs 12.4% for those who did receive environmental control measures (P=0.024). The relative risk for IA was 0.595 (95% confidence interval: 0.394-0.897) for the group with environmental control measures. The current study suggests that the implementation of environmental control measures during a hospital construction has a positive impact for prevention of IA in patients hospitalized with acute leukaemia. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

[Rehabilitation in rheumatology].

PubMed

Luttosch, F; Baerwald, C

2010-10-01

Rehabilitation in rheumatology focuses on prevention of functional disorders of the musculoskeletal system, maintenance of working ability and prevention of care dependency. Drug treatment alone rarely results in long-term remission, therefore rehabilitative measures must be integrated into rheumatic care. Rehabilitative therapy in rheumatology includes physiotherapy, patient education and occupational therapy. Positive effects of physical therapy methods have been proven by various studies. Patient education and occupational therapy are important tools for stabilizing the course of the disease. To maintain positive rehabilitative results patients have to be involved in the selection of treatment measures and should take an active part in the long-term treatment process. Despite proven efficacy of physical measures there is evidence for a lack of utilization of rehabilitative therapy due to increasing cost pressure in the health care system which will further increase over time.

[Strategic framework for cholera prevention and control in Chengdu: construction and effectiveness evaluation].

PubMed

Liang, Xian; Du, Chang-hui; Yang, Lan; Ma, Lin; Huang, Zhong-hang; Tuo, Xiao-Li; Yin, Zhong-liang

2011-02-01

To construct an operable strategic framework for cholera prevention and control which mobilized the advantages of local resources and adapted to social developments in Chengdu, and to evaluate its application effects. (1) After analyzing the local epidemic data of cholera in Chengdu from 1994 to 2004, we determined the main problems of cholera prevention and control works as well as the efficiency and deficiency of employed measures, and then formed a basic strategic framework. (2) After 55 invited experts preliminarily scored the strategic framework, we selected 72 specific measures to establish a measure entry database, and then the importance and operability of each measure were scored by 17 core experts. (3) Finally, the effectiveness of this strategic framework was evaluated according to the analyzing results of infection control, health education and etiological monitoring. (1) The framework took government leadership as main scenario and the informatization as subordination scenario. Meanwhile, it focused on three points: the improvement of social environment, the completion of system and mechanisms for monitoring and early warning, and the enhancement of CDC response to public health emergencies. Total importance score and operability score of 35 specific measures included in this framework was 4.20 ± 0.86 and 4.09 ± 0.87, respectively. (2) Chengdu had maintained zero cholera incidence for five consecutive years from 2005 to 2009 since it gradually began to implement the strategic framework in 2002. There were 19 positive cholera cases detected by etiological monitoring and all of them were seafood or fishery products including soft-shelled turtles, silver carps and bullfrogs. The coverage rate and qualification rate of the training for grassroots cadres, grassroots medical workers, mobile cooks and their assistants was 98.14% (198 452/202 220) and 98.17% (194 820/198 452) in average, respectively. The qualification rate of the training for employees in food industry was over 96.00% (912 470/950 489). The average awareness rate of cholera prevention and cure knowledge in rural residents, grassroots cadres, grassroots medical workers, mobile cooks and their assistants was 93.87% (1653/1761) and the average formation rate of good hygiene habits was 70.58% (1243/1761). A strategic framework suitable for cholera prevention and control in Chengdu has been successfully established in this study. The incidence rate of cholera has maintained zero in Chengdu for five consecutive years under incessant threatening conditions such as the occurrence of cholera cases from time to time in its surrounding areas and the continuous existence of Bacillus comma in seafood or fishery products that entered local markets. Therefore, it demonstrated a good application effects.

Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis

PubMed Central

Niu, Peng-Peng; Guo, Zhen-Ni; Jin, Hang; Xing, Ying-Qi; Yang, Yi

2016-01-01

Objective To examine the comparative efficacy and safety of different antiplatelet regimens in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Design Systematic review and network meta-analysis. Data sources As on 31 March 2015, all randomised controlled trials that investigated the effects of antiplatelet agents in the long-term (≥3 months) secondary prevention of non-cardioembolic transient ischaemic attack or ischaemic stroke were searched and identified. Outcome measures The primary outcome measure of efficacy was serious vascular events (non-fatal stroke, non-fatal myocardial infarction and vascular death). The outcome measure of safety was any bleeding. Results A total of 36 randomised controlled trials (82 144 patients) were included. Network meta-analysis showed that cilostazol was significantly more effective than clopidogrel (OR 0.77, 95% credible interval 0.60–0.98) and low-dose (75–162 mg daily) aspirin (0.69, 0.55–0.86) in the prevention of serious vascular events. Aspirin (50 mg daily) plus dipyridamole (400 mg daily) and clopidogrel reduced the risk of serious vascular events compared with low-dose aspirin; however, the difference was not statistically significant. Furthermore, low-dose aspirin was as effective as higher daily doses. Cilostazol was associated with a significantly lower bleeding risk than most of the other regimens. Moreover, aspirin plus clopidogrel was associated with significantly more haemorrhagic events than other regimens. Direct comparisons showed similar results as the network meta-analysis. Conclusions Cilostazol was significantly more effective than aspirin and clopidogrel alone in the long-term prevention of serious vascular events in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Cilostazol was associated with a significantly lower bleeding risk than low-dose aspirin (75–162 mg daily) and aspirin (50 mg daily) plus dipyridamole (400 mg daily). Low-dose aspirin was as effective as higher daily doses. However, further large, randomised, controlled, head-to-head trials are needed, especially in non-Asian ethnic groups. PMID:26988347

Effectiveness of Psychological and/or Educational Interventions in the Prevention of Anxiety: A Systematic Review, Meta-analysis, and Meta-regression.

PubMed

Moreno-Peral, Patricia; Conejo-Cerón, Sonia; Rubio-Valera, Maria; Fernández, Anna; Navas-Campaña, Desirée; Rodríguez-Morejón, Alberto; Motrico, Emma; Rigabert, Alina; Luna, Juan de Dios; Martín-Pérez, Carlos; Rodríguez-Bayón, Antonina; Ballesta-Rodríguez, María Isabel; Luciano, Juan Vicente; Bellón, Juan Ángel

2017-10-01

To our knowledge, no systematic reviews or meta-analyses have been conducted to assess the effectiveness of preventive psychological and/or educational interventions for anxiety in varied populations. To evaluate the effectiveness of preventive psychological and/or educational interventions for anxiety in varied population types. A systematic review and meta-analysis was conducted based on literature searches of MEDLINE, PsycINFO, Web of Science, EMBASE, OpenGrey, Cochrane Central Register of Controlled Trials, and other sources from inception to March 7, 2017. A search was performed of randomized clinical trials assessing the effectiveness of preventive psychological and/or educational interventions for anxiety in varying populations free of anxiety at baseline as measured using validated instruments. There was no setting or language restriction. Eligibility criteria assessment was conducted by 2 of us. Data extraction and assessment of risk of bias (Cochrane Collaboration's tool) were performed by 2 of us. Pooled standardized mean differences (SMDs) were calculated using random-effect models. Heterogeneity was explored by random-effects meta-regression. Incidence of new cases of anxiety disorders or reduction of anxiety symptoms as measured by validated instruments. Of the 3273 abstracts reviewed, 131 were selected for full-text review, and 29 met the inclusion criteria, representing 10 430 patients from 11 countries on 4 continents. Meta-analysis calculations were based on 36 comparisons. The pooled SMD was -0.31 (95% CI, -0.40 to -0.21; P < .001) and heterogeneity was substantial (I2 = 61.1%; 95% CI, 44% to 73%). There was evidence of publication bias, but the effect size barely varied after adjustment (SMD, -0.27; 95% CI, -0.37 to -0.17; P < .001). Sensitivity analyses confirmed the robustness of effect size results. A meta-regression including 5 variables explained 99.6% of between-study variability, revealing an association between higher SMD, waiting list (comparator) (β = -0.33 [95% CI, -0.55 to -0.11]; P = .005) and a lower sample size (lg) (β = 0.15 [95% CI, 0.06 to 0.23]; P = .001). No association was observed with risk of bias, family physician providing intervention, and use of standardized interviews as outcomes. Psychological and/or educational interventions had a small but statistically significant benefit for anxiety prevention in all populations evaluated. Although more studies with larger samples and active comparators are needed, these findings suggest that anxiety prevention programs should be further developed and implemented.

Root caries prevention via sodium fluoride, chlorhexidine and silver diamine fluoride in vitro.

PubMed

Göstemeyer, Gerd; Kohls, Anna; Paris, Sebastian; Schwendicke, Falk

2018-01-31

Uncertainty exists as to how to best prevent root caries development. The aim of the present study was to compare sodium fluoride (NaF), chlorhexidine (CHX) and silver diamine fluoride (SDF) varnishes (V) and rinses (R) regarding their caries preventive effect in an artificial caries biofilm model. 140 bovine root dentin samples were cut, polished and embedded. Samples were allocated to seven treatment groups (n = 20/group): Four varnishes (applied once prior biofilm challenge): 38% SDF (SDFV), 35% CHX-varnish (CHXV), 22,600 ppm NaF-varnish (NaFV), placebo-varnish (PV); two rinses (applied once daily during biofilm challenge): 500 ppm NaF solution (NaFR), 0.1% CHX solution (CHXR); one untreated group. Caries was induced in a multi-station, continuous-culture Lactobacillus rhamnosus GG (LGG) biofilm model. Bacteria were inoculated 1 × daily, while 2% sucrose was supplied 8 ×/day followed by artificial saliva for 10 min. After 12 days, mineral loss (ΔZ) was measured in the effect area and adjacent to the varnished areas. Bacterial counts were assessed on de-Man-Rogosa-Sharpe agar. ΔZ was significantly lower in the NaFR group compared with all other groups. Varnishes did not significantly prevent mineral loss in adjacent areas. None of the agents had a significant antimicrobial effect on LGG. Regular fluoride rinses showed highest root caries-preventive effect.

Effect of an education program on knowledge, self-care behavior and handwashing competence on prevention of febrile neutropenia among breast cancer patients receiving Doxorubicin and Cyclophosphamide in Chemotherapy Day Centre

PubMed Central

Mak, Wai Chi; Yin Ching, Shirley Siu

2015-01-01

Objective: To evaluate the efficacy of an education program on the prevention of febrile neutropenia (FN) among breast cancer patients receiving AC regimen. Methods: Randomized controlled trial with the repeated-measures design was conducted in a Chemotherapy Day Centre of an acute hospital in Hong Kong. Twenty-five subjects in the intervention group received an individual education session followed by three follow-up sessions and routine care. Twenty-four subjects in the control group received routine care. Primary outcomes included the incidence of admission due to FN, the self-care behavior adherence, the knowledge level on prevention of FN and the self-efficacy in self-management, handwashing competence were assessed by self-designed questionnaires, Chinese version of patient activation measure, and handwashing competence checklist. Results: No statistically significant difference between the intervention group and the control group on the incidence of admission due to FN, the self-efficacy in self-management, and the knowledge on prevention of FN. The self-care behavior adherence was significant at cycle 4 of AC regimen in favor of the intervention group (P = 0.036). Handwashing competence improved more significantly among subjects in the intervention group than the control group (P = 0.009). Conclusions: The education program on the prevention of FN had significantly favorable effects on self-care behavior adherence and handwashing competence across time. However, the intervention did not lead to statistically significant improvement on the incidence of admission due to FN, the self-efficacy in self-management and the knowledge level on prevention of FN. PMID:27981125

The disaster prevention awareness of foreign residents and disaster management of organizations for foreign employees

NASA Astrophysics Data System (ADS)

Xin, Tan Yen; Sugiki, Nao; Matsuo, Kojiro

2017-10-01

Japan is known to have many natural disasters occurrences, especially in recent years, the seismic hazard named "Nankai-trough Disastrous Earthquake" of magnitude 9(M) was predicted and will have caused huge damages. Therefore, disaster management should be well planned and executed to ensure minimal amount of victims and damages from disaster. However, foreign residents are mostly vulnerable and ill-equipped to face such consequences compared to Japanese residents, especially when there is limited information available for foreigners presently. As the influx of foreigner migration has been steadily increasing annually, it is vital for disaster management to be compulsively planned to cope up with the great variety of foreigners' needs from diverse backgrounds accordingly. The purpose of this study is to comprehend foreign residents' disaster prevention awareness, in order to provide a more effective information provision on disaster management, so as to help improve their disaster prevention awareness. Thus, this study is set in Toyohashi city, and the methodology used is by conducting two questionnaires. Firstly, to have an accurate understanding on the awareness of foreign residents towards disasters prevention, the questionnaire is conducted towards foreign university students, on pertinent issues such as on the degree of preparedness and their matters of concern of which is related to natural disasters. Secondly, to comprehend disaster management of organizations, the other focuses on preventive measures adopted by manufacturing industry organizations, such as types of preventive measures as a whole and on the issues and challenges encountered during foreign employee-related enforcement of disaster management. Finally, based both results of the questionnaire, the key factors on effective information provision of disaster management is considered.

[Prevention and handling of missing data in clinical trials].

PubMed

Jiang, Zhi-wei; Li, Chan-juan; Wang, Ling; Xia, Jie-lai

2015-11-01

Missing data is a common but unavoidable issue in clinical trials. It not only lowers the trial power, but brings the bias to the trial results. Therefore, on one hand, the missing data handling methods are employed in data analysis. On the other hand, it is vital to prevent the missing data in the trials. Prevention of missing data should take the first place. From the perspective of data, firstly, some measures should be taken at the stages of protocol design, data collection and data check to enhance the patients' compliance and reduce the unnecessary missing data. Secondly, the causes of confirmed missing data in the trials should be notified and recorded in detail, which are very important to determine the mechanism of missing data and choose the suitable missing data handling methods, e.g., last observation carried forward (LOCF); multiple imputation (MI); mixed-effect model repeated measure (MMRM), etc.

Corneal injury from a metallic foreign body: an occupational hazard.

PubMed

Gumus, Koray; Karakucuk, Sarper; Mirza, Ertugrul

2007-09-01

To describe a patient with a corneal injury from a metallic foreign body caused by negligence, and to highlight the importance of measures that must be taken to prevent corneal injuries. A 21-year-old man experienced a foreign body sensation, pain, and redness in his left eye after he cut some iron material without using any eye protection. Slitlamp examination showed a thin, curled piece of iron material stuck into the cornea horizontally. The nasal part had penetrated the nasal tarsal conjunctiva below the upper lid. After removal of the foreign body, the cornea healed without scarring after a short follow-up. A corneal foreign body is a common cause of ocular morbidity and loss of working hours. Most workers do not use protective eyewear during work. By consistently wearing proper safety eyewear, which is the easiest and most effective preventive measure, loss of sight can easily be prevented after an eye injury.

[Impact of interventions in the pressure ulcer rate].

PubMed

Araya Farías, I; Febré, N

To evaluate the impact of a risk management program for prevention of pressure ulcers (PUs) in an adult Intensive Care Unit (ICU). A quantitative, prospective study performed with a «before and after» evaluation, and designed in three stages: 1) PU incidence study; 2) Intervention by implementing a risk management program, and 3) Assessment of the impact. Adherence to the preventive measures showed a significant increase (11.7%) between the first month of the program and the final month (58.5%) of the assessment. Initial PU rate was 20.9, with a decrease in the rate to 14.0 per 1000 bed occupancy days (P<.05) after the risk management program. The data show that the risk management program, using prevention measures, was effective in reducing the rate of PU in the period under study by more than 33%. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Psychiatric disorders: The psychiatrist's contribution to sport.

PubMed

Currie, Alan; Johnston, Allan

2016-12-01

Athletes experience a range of mental health problems with at least an equivalent prevalence to the general population. This chapter explores the psychiatrist's role in sport, along a pathway of mental healthcare from 'upstream' prevention, screening, and early detection of mental stress to 'downstream' assessment, treatment, rehabilitation, and recovery from mental illness. At each stage on this pathway the psychiatrist has a broad spectrum of bio-psycho-social strategies to employ in clinical practice. Upstream, the importance of psychological resilience is described along with the concept of mental 'pre-habilitation' (a term usually associated with the prevention of physical injury). Alongside these preventative measures, early detection is improved by education, increased awareness, and by the use of effective mental health screening measures. Further downstream ready access to psychiatric expertise and good collaboration between the psychiatrist and the world of sport improve access to treatment, delivery of that treatment, rehabilitation, and return to sport during recovery.

Preventive measures aimed at minimizing the risk of African swine fever virus spread in pig farming systems.

PubMed

Bellini, Silvia; Rutili, Domenico; Guberti, Vittorio

2016-11-29

African swine fever (ASF) is one of the most severe diseases of pigs; it has a drastic impact on the pig industry, causing serious socio-economic consequences to pig farmers and pork producers. In Europe, there are currently two main clusters of infection; one in Sardinia caused by strains of African swine fever virus (ASFV) belonging to genotype I and another in Eastern Europe caused by strains of ASFV belonging to genotype II. The latter is inducing an acute form of ASF and it represents a serious threat to the pig sector. ASF is a disease for which there is no effective vaccine; therefore, prevention has a pivotal role in the control strategy of the disease. This review describes the main preventive measures to adopt to mitigate the risk of ASF spread in pig farming systems.

[Venous catheter-related infections].

PubMed

Ferrer, Carmen; Almirante, Benito

2014-02-01

Venous catheter-related infections are a problem of particular importance, due to their frequency, morbidity and mortality, and because they are potentially preventable clinical processes. At present, the majority of hospitalized patients and a considerable number of outpatients are carriers of these devices. There has been a remarkable growth of knowledge of the epidemiology of these infections, the most appropriate methodology for diagnosis, the therapeutic and, in particular, the preventive strategies. Multimodal strategies, including educational programs directed at staff and a bundle of simple measures for implementation, applied to high-risk patients have demonstrated great effectiveness for their prevention. In this review the epidemiology, the diagnosis, and the therapeutic and preventive aspects of these infections are updated. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Preventing School Bullying: Should Schools Prioritize an Authoritative School Discipline Approach over Security Measures?

ERIC Educational Resources Information Center

Gerlinger, Julie; Wo, James C.

2016-01-01

A common response to school violence features the use of security measures to deter serious and violent incidents. However, a second approach, based on school climate theory, suggests that schools exhibiting authoritative school discipline (i.e., high structure and support) might more effectively reduce school disorder. We tested these approaches…

A Scoping Review of Self-Report Measures of Aggression and Bullying for Use with Preadolescent Children

ERIC Educational Resources Information Center

Nelson, Helen J.; Kendall, Garth E.; Burns, Sharyn K.; Schonert-Reichl, Kimberly A.

2017-01-01

Bullying in schools is a major health concern throughout the world, contributing to poor educational and mental health outcomes. School nurses are well placed to facilitate the implementation and evaluation of bullying prevention strategies. To evaluate the effect of such strategies, it is necessary to measure children's behavior over time. This…

Effects of two-stage and total vs. fence-line weaning on the physiology and performance of beef calves

USDA-ARS?s Scientific Manuscript database

Calves weaned using a two-stage method where nursing is prevented between cow-calf pairs prior to separation (Stage 1) experience less weaning stress after separation (Stage 2) based on behavior and growth measures. The aim of this study was to document changes in various physiological measures of s...

Effects of an Interactive School-Based Program for Preventing Adolescent Sexual Harassment: A Cluster-Randomized Controlled Evaluation Study.

PubMed

de Lijster, Gaby P A; Felten, Hanneke; Kok, Gerjo; Kocken, Paul L

2016-05-01

Many adolescents experience sexual harassment and victims of sexual harassment have higher risks regarding well-being and health behaviors such as higher risks of suicidal thoughts, suicidal ideation and feeling unsafe at school. A peer-performed play and school lessons on preventing sexual harassment behavior were presented to secondary school students. We evaluated its effectiveness, using a cluster-randomized controlled design to assign schools to an experimental condition [n = 14 schools; 431 students (51 % female)] and a control condition [n = 11 schools; 384 students (51 % female)]. To measure the effects of the intervention at first post-test and 6-month follow-up, our multilevel analyses used a two-level random intercept model. Outcome measures were sexual harassment behaviors, behavioral determinants and distal factors influencing these behaviors. At post-test, students in the experimental group reported a reduced intention to commit sexual harassment behavior and higher self-efficacy in rejecting it. At post-test and follow-up there was a significant positive effect on social norms for rejecting sexual harassment behavior. At follow-up, sexual self-esteem was higher in students in the experimental group than in the control group. Effects on these determinants will benefit adolescents' future sexual behaviors. In combination, the play and lessons, possibly together with continued sexual health education and skills programs on social-emotional learning in subsequent school years, have potential for preventing sexual harassment behavior.

Effect of an exercise programme for the prevention of back and neck pain in poultry slaughterhouse workers.

PubMed

Bertozzi, Lucia; Villafañe, Jorge H; Capra, Francesco; Reci, Marsida; Pillastrini, Paolo

2015-03-01

The objectives of this study were to determine the effectiveness of a programme of prevention exercises conducted in a corporate environment in poultry industry slaughterers suffering from musculoskeletal disorders. Forty workers, 70% female (mean ± SD age: 44.4 ± 8.4 years) were consecutively, in an alternative way, assigned to one of two groups receiving either set of 10 sessions (experimental or control group). The experimental group followed an exercise programme for a period of five weeks and a protocol of home exercises. The control group performed the exercise protocol only at home. The Roland Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI) to measure disability, the Visual Analogue Scale (VAS) score and the Pain Drawing to measure pain were used as outcome evaluations. A significant effect of time interaction (all P <0.001 and; F = 40.673; F = 33.907 and F = 25.447) existed for lumbar VAS, RMDQ and ODI immediately after the intervention (all P < 0.006). No significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way. This study shows that a programme of prevention exercises may have a positive effect in improving musculoskeletal disorders of slaughterhouse workers. Pain decreased in the lumbar region, and there was an almost significant reduction in disability. Copyright © 2014 John Wiley & Sons, Ltd.