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Sample records for failure prevention perspective

  1. Dietary guidance in heart failure: a perspective on needs for prevention and management.

    PubMed

    Ershow, Abby G; Costello, Rebecca B

    2006-03-01

    The role that dietary factors play in preventing heart failure (HF) and in improving prognosis is increasingly recognized, indicating a need for well-grounded guidelines that can provide recommendations for daily nutrient intakes. At present, however, the state of dietary guidance is more satisfactory for persons at risk of HF (Stages A and B) than for those with a diagnosis of HF (Stages C and D). For individuals at risk of HF, a good starting point is provided by governmental and professional society guidance directed at dietary management of cardiovascular risk factors such as hypertension, hyperlipidemia, and obesity. These dietary recommendations are consonant with epidemiologic research suggesting that improving risk factor profiles likely will lower the risk of developing HF. For patients with diagnosed HF, however, little information is available to define optimal nutrient intakes and optimal food patterns. Dietary services have been shown useful in improving clinical outcomes, but nutritional management must be individualized to the patient's needs and must accommodate pharmacologic therapy, multiple co-morbidities, the possible need for nutritional supplements, repeated hospitalizations, salt and fluid retention, voluntary vs. involuntary weight loss, and other nutritional issues relevant to the aged population who comprise the majority of HF patients. Progress in the field will require well-designed clinical investigations addressing nutrient intake, nutrient metabolism, and nutritional status while mindful of the complex pathophysiology of HF.

  2. Preventing Early Learning Failure.

    ERIC Educational Resources Information Center

    Sornson, Bob, Ed.

    Noting that thousands of young children with the capacity to experience school success do not because they are unprepared for school learning activities, have experienced physical or emotional setbacks that cause them to be at risk for early learning failure, have never experienced limits on their behavior, or have mild sensory or motor deficits,…

  3. Early Prevention of School Failure.

    ERIC Educational Resources Information Center

    Anderson, Kent C.

    The Early Prevention of School Failure (EPSF) program developed by Dr. Luceille Werner is presented. The program is designed to identify and remediate developmental deficiencies of four-, five-, and six-year-old children and has been accepted in the National Diffusion Network as a nationally validated program. The main program components are…

  4. Preventing Spacecraft Failures Due to Tribological Problems

    NASA Technical Reports Server (NTRS)

    Fusaro, Robert L.

    2001-01-01

    Many mechanical failures that occur on spacecraft are caused by tribological problems. This publication presents a study that was conducted by the author on various preventatives, analyses, controls and tests (PACTs) that could be used to prevent spacecraft mechanical system failure. A matrix is presented in the paper that plots tribology failure modes versus various PACTs that should be performed before a spacecraft is launched in order to insure success. A strawman matrix was constructed by the author and then was sent out to industry and government spacecraft designers, scientists and builders of spacecraft for their input. The final matrix is the result of their input. In addition to the matrix, this publication describes the various PACTs that can be performed and some fundamental knowledge on the correct usage of lubricants for spacecraft applications. Even though the work was done specifically to prevent spacecraft failures the basic methodology can be applied to other mechanical system areas.

  5. Heart Failure Epidemiology: European Perspective

    PubMed Central

    Guha, K; McDonagh, T

    2013-01-01

    Heart failure poses an increasing problem for global healthcare systems. The epidemiological data which has been accrued over the last thirty years has predominantly been accumulated from experience within North America and Europe. Initial large cohort, prospective longitudinal studies produced the first publications; however latterly the focus has shifted onto epidemiological data governing hospitalisation and mortality. The emphasis behind this shift has been the resource implications with regards to repetitive, costly and prolonged hospitalisation. The European experience in heart failure, though similar to North America has recently demonstrated differences in hospitalisation which may underlie the differences between healthcare system configuration. Heart failure however remains an increasing global problem and the endpoint of a variety of cardiovascular diseases. Allied with the fact of increasingly elderly populations and prior data demonstrating a steep rise in prevalent cases within more elderly populations, it is likely that the increasing burden of disease will continue to pose challenges for modern healthcare. Despite the predicted increase in the number of patients affected by heart failure, over the last thirty years, a clear management algorithm has evolved for the use of pharmacotherapies (neuro-hormonal antagonists), device based therapies (Implantable Cardioverting Defibrillator (ICD) and Cardiac Resynchronisation Therapy (CRT)) and mechanical therapies including left ventricular assist devices and cardiac transplantation. Though the management of such patients has been clearly delineated in national and international guidelines, the underuse of all available and appropriate therapies remains a significant problem. When comparing various epidemiological studies from different settings and timepoints, it should be remembered that rates of prevalence and incidence may vary depending upon the definition used, methods of accumulating information (with

  6. Preventing Early Reading Failure: An Argument

    ERIC Educational Resources Information Center

    Morris, Darrell

    2015-01-01

    Across the pendulum-like changes in beginning reading instruction over the past 30 years, three interrelated ideas emerge as the key to preventing reading failure in kindergarten and first grade: (1) an interesting, carefully-leveled book curriculum; (2) a leveled phonics curriculum; and (3) a well-trained teacher who knows how to integrate guided…

  7. Pyrotechnic system failures: Causes and prevention

    NASA Technical Reports Server (NTRS)

    Bement, Laurence J.

    1988-01-01

    Although pyrotechnics have successfully accomplished many critical mechanical spacecraft functions, such as ignition, severance, jettisoning and valving (excluding propulsion), failures continue to occur. Provided is a listing of 84 failures of pyrotechnic hardware with completed design over a 23-year period, compiled informally by experts from every NASA Center, as well as the Air Force Space Division and the Naval Surface Warfare Center. Analyses are presented as to when and where these failures occurred, their technical source or cause, followed by the reasons why and how these kinds of failures persist. The major contributor is a fundamental lack of understanding of the functional mechanisms of pyrotechnic devices and systems, followed by not recognizing pyrotechnics as an engineering technology, insufficient manpower with hands-on experience, too few test facilities, and inadequate guidelines and specifications for design, development, qualification and acceptance. Recommendations are made on both a managerial and technical basis to prevent failures, increase reliability, improve existing and future designs, and develop the technology to meet future requirements.

  8. Preventing dance injuries: current perspectives.

    PubMed

    Russell, Jeffrey A

    2013-09-30

    Dancers are clearly athletes in the degree to which sophisticated physical capacities are required to perform at a high level. The standard complement of athletic attributes - muscular strength and endurance, anaerobic and aerobic energy utilization, speed, agility, coordination, motor control, and psychological readiness - all are essential to dance performance. In dance, as in any athletic activity, injuries are prevalent. This paper presents the research background of dance injuries, characteristics that distinguish dance and dancers from traditional sports and athletes, and research-based perspectives into how dance injuries can be reduced or prevented, including the factors of physical training, nutrition and rest, flooring, dancing en pointe, and specialized health care access for dancers. The review concludes by offering five essential components for those involved with caring for dancers that, when properly applied, will assist them in decreasing the likelihood of dance-related injury and ensuring that dancers receive optimum attention from the health care profession: (1) screening; (2) physical training; (3) nutrition and rest; (4) specialized dance health care; and (5) becoming acquainted with the nature of dance and dancers.

  9. Preventing dance injuries: current perspectives

    PubMed Central

    Russell, Jeffrey A

    2013-01-01

    Dancers are clearly athletes in the degree to which sophisticated physical capacities are required to perform at a high level. The standard complement of athletic attributes – muscular strength and endurance, anaerobic and aerobic energy utilization, speed, agility, coordination, motor control, and psychological readiness – all are essential to dance performance. In dance, as in any athletic activity, injuries are prevalent. This paper presents the research background of dance injuries, characteristics that distinguish dance and dancers from traditional sports and athletes, and research-based perspectives into how dance injuries can be reduced or prevented, including the factors of physical training, nutrition and rest, flooring, dancing en pointe, and specialized health care access for dancers. The review concludes by offering five essential components for those involved with caring for dancers that, when properly applied, will assist them in decreasing the likelihood of dance-related injury and ensuring that dancers receive optimum attention from the health care profession: (1) screening; (2) physical training; (3) nutrition and rest; (4) specialized dance health care; and (5) becoming acquainted with the nature of dance and dancers. PMID:24379726

  10. Rehospitalization for heart failure: problems and perspectives.

    PubMed

    Gheorghiade, Mihai; Vaduganathan, Muthiah; Fonarow, Gregg C; Bonow, Robert O

    2013-01-29

    With a prevalence of 5.8 million in the United States alone, heart failure (HF) is associated with high morbidity, mortality, and healthcare expenditures. Close to 1 million hospitalizations for heart failure (HHF) occur annually, accounting for over 6.5 million hospital days and a substantial portion of the estimated $37.2 billion that is spent each year on HF in the United States. Although some progress has been made in reducing mortality in patients hospitalized with HF, rates of rehospitalization continue to rise, and approach 30% within 60 to 90 days of discharge. Approximately half of HHF patients have preserved or relatively preserved ejection fraction (EF). Their post-discharge event rate is similar to those with reduced EF. HF readmission is increasingly being used as a quality metric, a basis for hospital reimbursement, and an outcome measure in HF clinical trials. In order to effectively prevent HF readmissions and improve overall outcomes, it is important to have a complete and longitudinal characterization of HHF patients. This paper highlights management strategies that when properly implemented may help reduce HF rehospitalizations and include adopting a mechanistic approach to cardiac abnormalities, treating noncardiac comorbidities, increasing utilization of evidence-based therapies, and improving care transitions, monitoring, and disease management.

  11. Risky business: failure to prevent and failure to communicate.

    PubMed

    Moore, Dorothy L; Ste-Marie, Micheline

    2009-01-01

    Healthcare-associated infections (HAIs), important threats to patient safety, are considered differently from other adverse events. Gardam and his colleagues discuss several reasons for this and outline approaches that may bring about changes in attitudes and enhance HAI prevention. We comment on the potential preventability of HAIs, the need for improved communication strategies and the different vision of the role of infection control personnel suggested by Gardam et al. Recent developments in infection control structure and management and patient safety in Quebec are summarized.

  12. Progress toward a Prevention Perspective

    ERIC Educational Resources Information Center

    Stagner, Matthew W.; Lansing, Jiffy

    2009-01-01

    Matthew Stagner and Jiffy Lansing chart developments in the field of child maltreatment and propose a new framework for preventing child abuse and neglect. They begin by describing the concept of investment-prevention as it has been applied recently in fields such as health care and welfare. They then explain how the new framework applies to…

  13. Failure and preventive costs of mastitis on Dutch dairy farms.

    PubMed

    van Soest, Felix J S; Santman-Berends, Inge M G A; Lam, Theo J G M; Hogeveen, Henk

    2016-10-01

    Mastitis is an important disease from an economic perspective, but most cost assessments of mastitis include only the direct costs associated with the disease (e.g., production losses, culling, and treatment), which we call failure costs (FC). However, farmers also invest time and money in controlling mastitis, and these preventive costs (PC) also need to be taken into account. To estimate the total costs of mastitis, we estimated both FC and PC. We combined multiple test-day milk records from 108 Dutch dairy farms with information on applied mastitis prevention measures and farmers' registration of clinical mastitis for individual dairy cows. The aim was to estimate the total costs of mastitis and to give insight into variations between farms. We estimated the average total costs of mastitis to be €240/lactating cow per year, in which FC contributed €120/lactating cow per year and PC contributed another €120/lactating cow per year. Milk production losses, discarded milk, and culling were the main contributors to FC, at €32, €20, and €20/lactating cow per year, respectively. Labor costs were the main contributor to PC, next to consumables and investments, at €82, €34, and €4/lactating cow per year, respectively. The variation between farmers was substantial, and some farmers faced both high FC and PC. This variation may have been due to structural differences between farms, different mastitis-causing pathogens, the time at which preventive action is initiated, stockmanship, or missing measures in PC estimates. We estimated the minimum FC to be €34 per lactating cow per yr. All farmers initiated some preventive action to control or reduce mastitis, indicating that farmers will always have mastitis-related costs, because mastitis will never be fully eradicated from a farm. Insights into both the PC and FC of a specific farm will allow veterinary advisors and farmers to assess whether current udder health strategies are appropriate or whether there

  14. Utility-scale system preventive and failure-related maintenance

    SciTech Connect

    Jennings, C.; Hutchinson, P.

    1995-11-01

    This paper describes the design and performance background on PVUSA utility-scale systems at Davis and Kerman, California, and reports on a preventative and failure-related maintenance approach and costs.

  15. Expose hidden failures to prevent cascading outages

    SciTech Connect

    Phadke, A.G.; Thorp, J.S.

    1996-07-01

    This article describes how to identify lines and buses that present the greatest hazard to system reliability, and add digital equipment to supervise and control hidden failures of the associated relays. Major blackouts are rare events, but their impact can be catastrophic. A study of significant disturbances reported by NERC in the period from 1984 through 1988 indicates that protective relays are involved in one way or another in 75% of major disturbances. A common scenario is that the relay has an undetected (hidden) defect that was exposed due to the conditions created by other disturbances. For example, near-by faults, overloads, or reverse power flows expose the defective relay and cause a false trip, which exacerbates the situation. Given the importance of hidden failure modes in traditional relaying systems, intervention by computer-based rational control schemes is proposed in this article. Relays with high-vulnerability indices can be identified, and their vulnerable functions and failure modes identified. Countermeasures to reduce or eliminate the likelihood of the hidden failure of key relays can be provided.

  16. Epidemiological Perspectives on Maltreatment Prevention

    ERIC Educational Resources Information Center

    Wulczyn, Fred

    2009-01-01

    Fred Wulczyn explores how data on the incidence and distribution of child maltreatment shed light on planning and implementing maltreatment prevention programs. He begins by describing and differentiating among the three primary sources of national data on maltreatment. Wulczyn then points out several important patterns in the data. The first…

  17. Preventing Heart Failure: The Role of Physical Activity

    PubMed Central

    Nayor, Matthew; Vasan, Ramachandran S.

    2015-01-01

    Purpose of review Heart failure prevention is an important public health goal. Increased physical activity and exercise may help to prevent heart failure, as they are associated with reduced heart failure incidence and potentially act through a variety of mechanisms to slow disease progression. Recent findings Increased physical activity, higher cardiorespiratory fitness, and lower sedentary time are associated with reduced heart failure incidence. These associations are consistent for occurrence of both heart failure with preserved versus reduced ejection fraction, the common subphenotypes of the condition. Physiologic cardiac and vascular remodeling occur across the normal range of physical activity in the community, and regular exercise (4–5 sessions per week) is necessary to mitigate age-associated reductions in ventricular compliance and cardiac mass. Summary Greater physical activity, lesser sedentary time and improved cardiorespiratory fitness are associated with reductions in heart failure risk. Various mechanisms may explain these findings including: reducing the prevalence of standard and novel cardiovascular risk factors, inhibiting pathologic cardiovascular remodeling, promoting physiologic remodeling, and improving cardiac, neurohormonal, skeletal muscle, pulmonary, renal, and vascular performance. Future research is needed to elucidate the optimal timing, duration, and modality of physical activity and exercise training necessary to prevent the development of heart failure. PMID:26154074

  18. Cardiac Cachexia: Perspectives for Prevention and Treatment

    PubMed Central

    Okoshi, Marina Politi; Capalbo, Rafael Verardino; Romeiro, Fernando G; Okoshi, Katashi

    2017-01-01

    Cachexia is a prevalent pathological condition associated with chronic heart failure. Its occurrence predicts increased morbidity and mortality independent of important clinical variables such as age, ventricular function, or heart failure functional class. The clinical consequences of cachexia are dependent on both weight loss and systemic inflammation, which accompany cachexia development. Skeletal muscle wasting is an important component of cachexia; it often precedes cachexia development and predicts poor outcome in heart failure. Cachexia clinically affects several organs and systems. It is a multifactorial condition where underlying pathophysiological mechanisms are not completely understood making it difficult to develop specific prevention and treatment therapies. Preventive strategies have largely focused on muscle mass preservation. Different treatment options have been described, mostly in small clinical studies or experimental settings. These include nutritional support, neurohormonal blockade, reducing intestinal bacterial translocation, anemia and iron deficiency treatment, appetite stimulants, immunomodulatory agents, anabolic hormones, and physical exercise regimens. Currently, nonpharmacological therapy such as nutritional support and physical exercise are considered central to cachexia prevention and treatment. PMID:27812676

  19. Failure Prevention of Hydraulic System Based on Oil Contamination

    NASA Astrophysics Data System (ADS)

    Singh, M.; Lathkar, G. S.; Basu, S. K.

    2012-07-01

    Oil contamination is the major source of failure and wear of hydraulic system components. As per literature survey, approximately 70 % of hydraulic system failures are caused by oil contamination. Hence, to operate the hydraulic system reliably, the hydraulic oil should be of perfect condition. This requires a proper `Contamination Management System' which involves monitoring of various parameters like oil viscosity, oil temperature, contamination level etc. A study has been carried out on vehicle mounted hydraulically operated system used for articulation of heavy article, after making the platform levelled with outrigger cylinders. It is observed that by proper monitoring of contamination level, there is considerably increase in reliability, economy in operation and long service life. This also prevents the frequent failure of hydraulic system.

  20. Preventive strategies of renal failure in the Arab world.

    PubMed

    Shaheen, Faissal A M; Al-Khader, Abdullah A

    2005-09-01

    The prevalence of both acute and chronic renal failure is high in the Arab world. Data available on the exact prevalence of various renal diseases are very limited. Nevertheless, the reported prevalence of chronic renal failure is 80 to 120 per million population (pmp) in the Kingdom of Saudi Arabia and 225 pmp in Egypt. This is in comparison with the reported prevalence of 283 pmp in Europe, 975 pmp in the United States, and 1149 pmp in Japan. Lower prevalence rates reported in this region could be due to underreporting. The economic burden of renal replacement on health care providers is enormous. In the Kingdom of Saudi Arabia, the estimated cost per annum incurred toward maintenance hemodialysis is US 19,400 US dollars and, considering that there are more than 7200 patients on regular dialysis in this country, the total expenditure is enormous. Such large amounts may be beyond the monetary capacity of many countries in this region because of limited financial resources. These figures clearly suggest that there is an urgent need to establish a massive prevention program. The strategy adapted should be innovative and imaginative and should be one that is maximally cost effective. Paradoxically, in the Arab world, we have a good opportunity to reduce the incidence of kidney failure (chronic and acute) substantially by appropriately chosen models. This is because many of the causes of renal failure are eminently preventable. In fact, a rough estimate is that these programs, if successful, can reduce the incidence by as much as 40% (personal communication, Shaheen, 2003). It is worthy of mention that, in the Arab world, the budget for research is about 0.15% of the national domestic product compared with the international average of 1.5%. In this article, we concentrate on some of the main causes of renal failure in the Arab world that we feel can be prevented and suggest ways that can best address this issue.

  1. The Prevention of Hospital Readmissions in Heart Failure

    PubMed Central

    Ziaeian, Boback; Fonarow, Gregg C.

    2016-01-01

    Heart failure (HF) is a growing healthcare burden and one of the leading causes of hospitalizations and readmission. Preventing readmissions for HF patients is an increasing priority for clinicians, researchers, and various stakeholders. The following review will discuss the interventions found to reduce readmissions for patients and improve hospital performance on the 30-day readmission process measure. While evidence-based therapies for HF management have proliferated, the consistent implementation of these therapies and development of new strategies to more effectively prevent readmissions remain areas for continued improvement. PMID:26432556

  2. How to prevent deep-well liner failure

    SciTech Connect

    Durham, K.S.

    1987-11-01

    This article discusses three liner design rules to prevent deep-well liner failure. They are: 1) Always select heavier weight casing, all other things being equal. 2) Always suspect that liner tops and casing shoes will leak. Design accordingly. 3) Liner tension designs should always include ballooning and temperature effects of stimulation. The article also gives some guidelines that will lead to better deep-well liner designs and reduce mechanical risk, according to the author.

  3. When is total hip arthroplasty a failure? The patients' perspective.

    PubMed Central

    Hellman, E. J.; Feinberg, J. R.; Capello, W. N.

    1996-01-01

    Total hip arthroplasty (THA) patients (186 primary, 92 revision) were surveyed regarding their satisfaction, their expectations regarding longevity, of the hip implant, and their perspective on the potential or actual need for revision surgery. The vast majority of patients were glad they had the original THA, would do it again if faced with a similar choice, and would recommend it to others. One-third of patients believed their current implants would last the rest of their life. The most common responses to either potential or actual failure were happiness it lasted as long as it did, accepting it as "one of those things," and disappointment. No primary THA patients and only 7% of revision of THA patients indicated that they would consider the primary THA a failure when revision surgery was indicated. PMID:9129281

  4. Burn prevention mechanisms and outcomes: pitfalls, failures and successes.

    PubMed

    Atiyeh, Bishara S; Costagliola, Michel; Hayek, Shady N

    2009-03-01

    -risk groups. Depending on the population of the country, burns prevention could be a national programme. This can ensure sufficient funds are available and lead to proper coordination of district, regional, and tertiary care centres. It could also provide for compulsory reporting of all burn admissions to a central registry, and these data could be used to evaluate strategies and prevention programmes that should be directed at behavioural and environmental changes which can be easily adopted into lifestyle. Particularly in LMICs, the emphasis in burn prevention should be by advocating change from harmful cultural practices. This needs to be done with care and sensitivity. The present review is a summary of what has already been accomplished in terms of burn prevention highlighting some of the successes but above all the numerous pitfalls and failures. Recognizing these failures is the first step towards development of more effective burn prevention strategies particularly in LMICs in which burn injury remains endemic and associated with a high mortality rate. Burn prevention is not easy, but easy or not, we have no options; burns must be prevented.

  5. Preventive interventions for ADHD: a neurodevelopmental perspective.

    PubMed

    Halperin, Jeffrey M; Bédard, Anne-Claude V; Curchack-Lichtin, Jocelyn T

    2012-07-01

    It is proposed that the time is ripe for the development of secondary preventive interventions for attention-deficit/hyperactivity disorder (ADHD). By targeting preschool children, a developmental stage during which ADHD symptoms first become evident in most children with the disorder, many of the adverse long-term consequences that typify the trajectory of ADHD may be avoided. A dynamic/interactive model of the biological and environmental factors that contribute to the emergence and persistence of ADHD throughout the lifespan is proposed. Based on this model, it is argued that environmental influences and physical exercise can be used to enhance neural growth and development, which in turn should have an enduring and long-term impact on the trajectory of ADHD. Central to this notion are 2 hypotheses: 1) environmental influences can facilitate structural and functional brain development, and 2) changes in brain structure and function are directly related to ADHD severity over the course of development and the degree to which the disorder persists or remits with time. We present experimental and correlational data supporting the first hypothesis and longitudinal data in individuals with ADHD supporting the second. The case is made for initiating such an intervention during the preschool years, when the brain is likely to be more "plastic" and perhaps susceptible to lasting modifications, and before complicating factors, such as comorbid psychiatric disorders, academic failure, and poor social and family relationships emerge, making successful treatment more difficult. Finally, we review recent studies in young children with ADHD that might fall under the umbrella of secondary prevention.

  6. Cachexia in chronic heart failure: endocrine determinants and treatment perspectives.

    PubMed

    Mangner, Norman; Matsuo, Yae; Schuler, Gerhard; Adams, Volker

    2013-04-01

    It is well documented in the current literature that chronic heart failure is often associated with cachexia, defined as involuntary weight loss of 5 % in 12 month or less. Clinical studies unraveled that the presence of cachexia decreases significantly mean survival of the patient. At the molecular level mainly myofibrillar proteins are degraded, although a reduced protein synthesis may also contribute to the loss of muscle mass. Endocrine factors clearly regulate muscle mass and function by influencing the normally precisely controlled balance between protein breakdown and protein synthesis The aim of the present article is to review the knowledge in the field with respect to the role of endocrine factors for the regulation of cachexia in patients with CHF and deduce treatment perspectives.

  7. Right ventricular failure after LVAD implantation: prevention and treatment.

    PubMed

    Meineri, Massimiliano; Van Rensburg, Adriaan E; Vegas, Annette

    2012-06-01

    Right ventricular failure (RVF) complicates 20-50% of left ventricular assist device (LVAD) implantation cases and contributes to increased postoperative morbidity and mortality. Normal LVAD function alters the highly compliant right ventricular (RV) physiology, which may unmask RVF. Risk scores for predicting RVF post-LVAD incorporate multiple risk factors but have not been prospectively validated. Prevention of RVF consists of optimising RV function by modifying RV preload and afterload, providing adequate intra-operative RV protection and minimising blood transfusions. Treatment of RVF relies on inotropic support, decreasing pulmonary vascular resistance and adjusting LVAD flows to minimise distortion of RV geometry. RVAD insertion is a last recourse when RVF is refractory to medical treatment.

  8. Diabetes mellitus and renal failure: Prevention and management

    PubMed Central

    Nasri, Hamid; Rafieian-Kopaei, Mahmoud

    2015-01-01

    Nowadays, diabetes mellitus (DM) and hypertension are considered as the most common causes of end-stage renal disease (ESRD). In this paper, other than presenting the role of DM in ESRD, glucose metabolism and the management of hyperglycemia in these patients are reviewed. Although in several large studies there was no significant relationship found between tight glycemic control and the survival of ESRD patients, it is recommended that glycemic control be considered as the main therapeutic goal in the treatment of these patients to prevent damage to other organs. Glycemic control is perfect when fasting blood sugar is less than 140 mg/dL, 1-h postprandial blood glucose is less than 200 mg/dL, and glycosylated hemoglobin (HbA1c) is 6-7 in patients with type 1 diabetes and 7-8 in patients with type 2 diabetes. Administration of metformin should be avoided in chronic renal failure (CRF) because of lactic acidosis, the potentially fatal complication of metformin, but glipizide and repaglinide seem to be good choices. PMID:26941817

  9. Diabetes mellitus and renal failure: Prevention and management.

    PubMed

    Nasri, Hamid; Rafieian-Kopaei, Mahmoud

    2015-11-01

    Nowadays, diabetes mellitus (DM) and hypertension are considered as the most common causes of end-stage renal disease (ESRD). In this paper, other than presenting the role of DM in ESRD, glucose metabolism and the management of hyperglycemia in these patients are reviewed. Although in several large studies there was no significant relationship found between tight glycemic control and the survival of ESRD patients, it is recommended that glycemic control be considered as the main therapeutic goal in the treatment of these patients to prevent damage to other organs. Glycemic control is perfect when fasting blood sugar is less than 140 mg/dL, 1-h postprandial blood glucose is less than 200 mg/dL, and glycosylated hemoglobin (HbA1c) is 6-7 in patients with type 1 diabetes and 7-8 in patients with type 2 diabetes. Administration of metformin should be avoided in chronic renal failure (CRF) because of lactic acidosis, the potentially fatal complication of metformin, but glipizide and repaglinide seem to be good choices.

  10. Rural Residents' Perspectives on Multiple Morbidity Management and Disease Prevention.

    PubMed

    Bardach, Shoshana H; Schoenberg, Nancy E; Tarasenko, Yelena N; Fleming, Steven T

    2011-12-01

    Middle-aged and older adults often experience several simultaneously occurring chronic conditions or "multiple morbidity" (MM). The task of both managing MM and preventing chronic conditions can be overwhelming, particularly in populations with high disease burdens, low socioeconomic status, and health care provider shortages. This article sought to understand Appalachian residents' perspectives on MM management and prevention. Forty-one rural Appalachian residents aged 50 and above with MM were interviewed about disease management and colorectal cancer (CRC) prevention. Transcripts were examined for overall analytic categories and coded using techniques to enhance transferability and rigor. Participants indicate facing various challenges to prevention due, in part, to conditions within their rural environment. Patients and providers spend significant time and energy on MM management, often precluding prevention activities. This article discusses implications of MM management for CRC prevention and strategies to increase disease prevention among this rural, vulnerable population burdened by MM.

  11. Perspectives for Cancer Prevention With Natural Compounds

    PubMed Central

    Amin, A.R.M. Ruhul; Kucuk, Omer; Khuri, Fadlo R.; Shin, Dong M.

    2009-01-01

    Cancer is the second leading cause of death in the United States. Despite the estimated 565,650 deaths in 2008 of Americans as a result of cancer, it is mostly a preventable disease. Simply by modification of diet, maintenance of optimum body weight, and regular physical activity, 30% to 40% of all instances of cancer could be prevented. Modification of diet alone by increasing vegetable and fruit intake could prevent 20% or more of all cases of cancer and may potentially prevent approximately 200,000 cancer-related deaths annually. Because of their safety, low toxicity, antioxidant properties, and general acceptance as dietary supplements, fruits, vegetables, and other dietary elements (phytochemicals and minerals) are being investigated for the prevention of cancer. Extensive research over the past several decades has identified numerous dietary and botanical natural compounds that have chemopreventive potential. In this review, we discuss promising natural chemopreventive compounds, their molecular targets, and their mechanisms, which may help the further design and conduct of preclinical and clinical trials. PMID:19414669

  12. Violence Prevention and Students with Disabilities: Perspectives from the Field of Youth Violence Prevention

    ERIC Educational Resources Information Center

    Gorman-Smith, Deborah

    2012-01-01

    Much of the work in youth violence prevention has been based in a public health model and guided by a developmental-ecological perspective on risk and prevention (Bronfenbrenner, 1979, 1988). A central tenet of developmental-ecological theory is that individual development is influenced by the ongoing qualities of the social settings in which the…

  13. Some airline experience in preventing engine rotor failures

    NASA Technical Reports Server (NTRS)

    Morelli, J. J.

    1977-01-01

    Methods used by airlines, with the assistance of the engine manufacturers to achieve control over the type of problems which lead to uncontained failure and avoid many potential problems are discussed.

  14. Spacecraft Parachute Recovery System Testing from a Failure Rate Perspective

    NASA Technical Reports Server (NTRS)

    Stewart, Christine E.

    2013-01-01

    Spacecraft parachute recovery systems, especially those with a parachute cluster, require testing to identify and reduce failures. This is especially important when the spacecraft in question is human-rated. Due to the recent effort to make spaceflight affordable, the importance of determining a minimum requirement for testing has increased. The number of tests required to achieve a mature design, with a relatively constant failure rate, can be estimated from a review of previous complex spacecraft recovery systems. Examination of the Apollo parachute testing and the Shuttle Solid Rocket Booster recovery chute system operation will clarify at which point in those programs the system reached maturity. This examination will also clarify the risks inherent in not performing a sufficient number of tests prior to operation with humans on-board. When looking at complex parachute systems used in spaceflight landing systems, a pattern begins to emerge regarding the need for a minimum amount of testing required to wring out the failure modes and reduce the failure rate of the parachute system to an acceptable level for human spaceflight. Not only a sufficient number of system level testing, but also the ability to update the design as failure modes are found is required to drive the failure rate of the system down to an acceptable level. In addition, sufficient data and images are necessary to identify incipient failure modes or to identify failure causes when a system failure occurs. In order to demonstrate the need for sufficient system level testing prior to an acceptable failure rate, the Apollo Earth Landing System (ELS) test program and the Shuttle Solid Rocket Booster Recovery System failure history will be examined, as well as some experiences in the Orion Capsule Parachute Assembly System will be noted.

  15. New Perspectives on Drug Education/Prevention.

    PubMed

    Rosenbaum, Marsha

    2016-01-01

    In 2014, Oregon, Alaska, and the District of Columbia joined Colorado and Washington as voters approved initiatives to legally regulate and tax marijuana for adults. Other states, including California, are likely to follow in 2016. While none of these new laws allow sales to minors, there is widespread concern about the potential impact of these reforms on teenagers. Many worry that legalization will "send the wrong message," and increase access and availability, leading to an escalation in teenage use. This new social, political and cultural context presents a new challenge, as marijuana gradually becomes a normal part of the adult world, akin to alcohol. The movement toward legalization provides an opportunity to re-think our approach to teen drug education/prevention. This is the moment to examine current approaches, and devise innovative, pragmatic strategies for dealing with teens and marijuana (and other drug use). As we examine the issue of drug education/prevention in the context of legalization, we detail efforts that have been tried, and what is realistically possible to accomplish, with the health and safety of teenagers our highest priority. A reality-based approach advocates honest, science-based information; encourages moderation, if experimentation persists; promotes an understanding of the legal consequences and social context of drug use; emphasizes safety through personal responsibility and knowledge; and encourages the delay of experimentation with all intoxicating substances until adulthood.

  16. Preventing Intelligence Failures in an Unpredictable 21st Century

    DTIC Science & Technology

    2012-03-20

    Ultimately, intelligence will always be imperfect and, as history demonstrates, surprise can never be completely prevented. Despite intelligence reform...recurring theme in this paper is that I&W intelligence will always be imperfect and, as history demonstrates, surprise can never be completely prevented... history shows us, surprise can never be completely prevented. Walter Laqueur, Mark Lowenthal, Robert Jervis, and Richard Betts have attributed the

  17. Prevention of mechanical failures in implanted spinal cord stimulation systems.

    PubMed

    Henderson, Jaimie M; Schade, C M; Sasaki, John; Caraway, David L; Oakley, John C

    2006-07-01

    Introduction.  Spinal cord stimulation (SCS) is an effective procedure for the treatment of neuropathic extremity pain, with success rates approaching 70%. However, mechanical failures, including breakage and migration, can significantly limit the long-term effectiveness of SCS. A systematic analysis of surgical techniques was undertaken by a consensus group, coupled with extensive in vivo and in vitro biomechanical testing of system components. Methods.  A computer model based on morphometric data was used to predict movement in a standard SCS system between an anchored lead and pulse generator placed in various locations. These displacements were then used to determine a realistic range of forces exerted on components of the SCS system. Laboratory fixtures were constructed to subject leads and anchors to repetitive stresses until failure occurred. An in vivo sheep model also was used to determine system compliances and failure thresholds in a biologically realistic setting. A panel of experienced implanters then interpreted the results and related them to clinical observations. Results.  Use of a soft silastic anchor pushed through the fascia to provide a larger bend radius for the lead was associated with a time to failure 65 times longer than an anchored but unsupported lead. In addition, failures of surgical paddle leads occurred when used with an anchor, whereas without an anchor, no failures occurred to 1 million cycles. Based on these findings, the panel recommended a paramedian approach, abdominal pulse generator placement, maximizing bend radius by pushing the anchor through the fascia, and anchoring of the extension connector near the lead anchor. Discussion.  Several factors are important in longevity of SCS systems. We discovered that technical factors can make a large difference in SCS reliability and that strict attention to these "best practices" will provide the best chance for maintaining the integrity of SCS systems over the long term.

  18. Perspective on precision medicine in paediatric heart failure.

    PubMed

    Fridman, Michael D; Mital, Seema

    2017-03-01

    In 2015, President Obama launched the Precision Medicine Initiative (PMI), which introduced new funding to a method of research with the potential to study rare and complex diseases. Paediatric heart failure, a heterogeneous syndrome affecting approximately 1 in 100000 children, is one such condition in which precision medicine techniques may be applied with great benefit. Current heart failure therapies target downstream effects of heart failure rather than the underlying cause of heart failure. As such, they are often ineffective in paediatric heart failure, which is typically of primary (e.g. genetic) rather than secondary (e.g. acquired) aetiology. It is, therefore, important to develop therapies that can target the causes of heart failure in children with greater specificity thereby decreasing morbidity, mortality and burden of illness on both patients and their families. The benefits of co-ordinated research in genomics, proteomics, metabolomics, transcriptomics and phenomics along with dietary, lifestyle and social factors have led to novel therapeutic and prognostic applications in other fields such as oncology. Applying such co-ordinated research efforts to heart failure constitutes an important step in advancing care and improving the lives of those affected.

  19. Effectiveness of Additives in Improving Fuel Lubricity and Preventing Pump Failure at High Temperature

    DTIC Science & Technology

    2013-01-01

    the specified 1,700 rpm, the housing pressure on pump No. 1 dropped significantly. Fuel began spewing out of test stand gear box and the pump seized...UNCLASSIFIED EFFECTIVENESS OF ADDITIVES IN IMPROVING FUEL LUBRICITY AND PREVENTING PUMP FAILURE AT HIGH TEMPERATURE INTERIM REPORT TFLRF...UNCLASSIFIED EFFECTIVENESS OF ADDITIVES IN IMPROVING FUEL LUBRICITY AND PREVENTING PUMP FAILURE AT HIGH TEMPERATURE INTERIM REPORT TFLRF No. 437

  20. Rosemary and cancer prevention: preclinical perspectives.

    PubMed

    Ngo, Suong N T; Williams, Desmond B; Head, Richard J

    2011-12-01

    Colorectal cancer is the second leading cause of cancer death in Australia. Nutrition, particularly intake of vegetables and certain plant components, has been reported to have a major role in cancer risk reduction. Recently, there has been a growing research interest in rosemary, a common household plant grown in many parts of the world. This study aims to review scientific evidence from all studies, published from 1996 to March 2010 that examined the protective effects of rosemary on colorectal cancer and other types of cancer. Literature evidence from animal and cell culture studies demonstrates the anticancer potential of rosemary extract, carnosol, carnosic acid, ursolic acid, and rosmarinic acid. No evidence for other rosemary constituents was found. The reported anticancer properties were found to arise through the molecular changes in the multiple-stage process of cancer development, which are dose related and not tissue or species specific. This is evidenced by the ability of rosemary to suppress the development of tumors in several organs including the colon, breast, liver, stomach, as well as melanoma and leukemia cells. The results suggested that the different molecular targets modulated by rosemary and its active constituents are useful indicators of success in clinical cancer chemo-prevention trials.

  1. Volume Overload in Heart Failure: An Evidence-Based Review of Strategies for Treatment and Prevention.

    PubMed

    Houston, Brian A; Kalathiya, Rohan J; Kim, Daniel A; Zakaria, Sammy

    2015-09-01

    Acute decompensated heart failure is the leading cause of hospital admission in the United States, with a high risk of readmission within 30 days. Most acute decompensated heart failure admissions are driven by congestive signs and symptoms resulting from fluid and sodium overload. We reviewed the evidence base addressing the management and prevention of fluid overload in heart failure, focusing on recent clinical trials. All the references in this review were obtained through PubMed and had at least 1 of the following key words: heart failure and volume overload, congestion, loop diuretics, thiazide diuretics, aldosterone antagonists, dopamine, cardiorenal syndrome, nesiritide, vasopressin antagonists, ultrafiltration, sodium restriction, fluid restriction, telemonitoring, and invasive hemodynamic monitoring. We also reviewed relevant references cited in the obtained articles, especially articles addressing methods of treating or preventing volume overload in patients with heart failure.

  2. [Early detection, prevention and management of renal failure in liver transplantation].

    PubMed

    Castells, Lluís; Baliellas, Carme; Bilbao, Itxarone; Cantarell, Carme; Cruzado, Josep Maria; Esforzado, Núria; García-Valdecasas, Juan Carlos; Lladó, Laura; Rimola, Antoni; Serón, Daniel; Oppenheimer, Federico

    2014-10-01

    Renal failure is a frequent complication in liver transplant recipients and is associated with increased morbidity and mortality. A variety of risk factors for the development of renal failure in the pre- and post-transplantation periods have been described, as well as at the time of surgery. To reduce the negative impact of renal failure in this population, an active approach is required for the identification of those patients with risk factors, the implementation of preventive strategies, and the early detection of progressive deterioration of renal function. Based on published evidence and on clinical experience, this document presents a series of recommendations on monitoring RF in LT recipients, as well as on the prevention and management of acute and chronic renal failure after LT and referral of these patients to the nephrologist. In addition, this document also provides an update of the various immunosuppressive regimens tested in this population for the prevention and control of post-transplantation deterioration of renal function.

  3. Young women's perspectives on cervical cancer prevention in Appalachian Kentucky.

    PubMed

    Head, Katharine J; Cohen, Elisia L

    2012-04-01

    Human papillomavirus (HPV) vaccination coupled with routine Papanicolaou (Pap) tests can prevent pervasive HPV infections causing cervical cancer. However, both HPV vaccination rates and Pap testing rates in Appalachian Kentucky are lower among all age groups than the rest of the United States. We recruited 19 young women residing in Appalachian Kentucky from university-based and rural clinical settings for group and individual interviews. After considering an integrated behavioral framework, we illustrate these women's perspectives by detailing five themes, including (a) experiential beliefs pose barriers to performing behaviors, (b) three vaccine doses complicate vaccination intention, (c) women have misunderstandings about HPV and the HPV vaccination function, (d) normative influences cue action (and inaction), and (e) specific environmental and contextual barriers exist to performing cervical cancer prevention behaviors in Appalachian Kentucky. These findings related to cervical cancer prevention in Appalachian Kentucky have implications for health-message design and clinical practice.

  4. Priming as a means of preventing skill failure under pressure.

    PubMed

    Ashford, Kelly J; Jackson, Robin C

    2010-08-01

    The present study examined the effectiveness of a priming paradigm in alleviating skill failure under stress. The priming intervention took the form of a scrambled sentence task. Experiment 1: Thirty-four skilled field-hockey players performed a dribbling task in low- and high-pressure situations under single task, skill-focused, and priming conditions. Results revealed a significant increase in performance time from low to high pressure. In addition, performance in the priming condition was significantly better than in the control and skill-focused conditions. Experiment 2: Thirty skilled field-hockey players completed the same dribbling task as in Experiment 1; however, in addition to the control and skill-focused conditions, participants were allocated to either a positive, neutral, or negative priming condition. Results revealed significant improvements in performance time from the skill focus to the control to the priming condition for the positive and neutral groups. For the negative group, times were significantly slower in the priming condition. Results are discussed in terms of utilizing priming in a sporting context.

  5. Module failure isolation circuit for paralleled inverters. [preventing system failure during power conditioning for spacecraft applications

    NASA Technical Reports Server (NTRS)

    Nagano, S. (Inventor)

    1979-01-01

    A module failure isolation circuit is described which senses and averages the collector current of each paralled inverter power transistor and compares the collector current of each power transistor the average collector current of all power transistors to determine when the sensed collector current of a power transistor in any one inverter falls below a predetermined ratio of the average collector current. The module associated with any transistor that fails to maintain a current level above the predetermined radio of the average collector current is then shut off. A separate circuit detects when there is no load, or a light load, to inhibit operation of the isolation circuit during no load or light load conditions.

  6. Public health and the prevention of obesity: failure or success?

    PubMed

    Aranceta Bartrina, Javier

    2013-09-01

    In recent decades, obesity has become a major public health problem in developed societies and economies in transition. Rapid social changes that have occurred since the mid 20th century prompted major changes in eating habits and lifestyles, with the gradual abandonment of traditional dietary patterns and culinary techniques, significant decrease in physical activity and increased sedentary time, giving as result in an imbalance in the energy balance. Obesity is a risk factor for many chronic diseases. There is evidence that childhood obesity influences adult health condition. Additionally, obesity in children affects their physical, emotional and social wellbeing. According to some estimates the cost of obesity may represent up to 12% of health cost in some countries. Many actions have been developed since around the year 2000 WHO alerted about the problem. The analysis of the factors involved in the origin of the problem have led to recognize the importance of creating supportive environments for healthier food choices and physical activity to be the easiest and accessible options in common everyday environments, such as schools, workplace or community environment. Evidence is long available that the most effective interventions to prevent childhood obesity should consider multiple strategies and last longer. Today it is also recognized the importance of implementing policies that encourage supportive friendly environments for physical activity and help decisions to opt for healthy eating habits.

  7. Older users' perspectives on the benefits of preventive home visits.

    PubMed

    Tøien, Mette; Bjørk, Ida Torunn; Fagerström, Lisbeth

    2015-05-01

    In this article we explore older people's perspectives on the benefits of preventive home visits (PHVs), after long-term follow-up. PHVs are health services intended to promote older people's health and independence, prevent disease, and postpone functional decline. We applied an explorative and descriptive design and analyzed qualitative research interviews of 10 PHV users who had received multiple visits for at least 6 years. We sought manifest and latent content in our analysis. The participants reported benefits falling within four main categories: to feel safe, to manage everyday life, to live well, and to be somebody. Two latent themes emerged: living with an underlying, realistic concern about an uncertain future, and striving to maintain oneself as a person. The perceived benefits of PHVs differed significantly from the outcome measures commonly used in randomized, controlled trials. PHV interventions should have a longitudinal approach and support each person's current needs and valued goals.

  8. Iron deficiency and heart failure: diagnostic dilemmas and therapeutic perspectives.

    PubMed

    Jankowska, Ewa A; von Haehling, Stephan; Anker, Stefan D; Macdougall, Iain C; Ponikowski, Piotr

    2013-03-01

    Iron is a micronutrient essential for cellular energy and metabolism, necessary for maintaining body homoeostasis. Iron deficiency is an important co-morbidity in patients with heart failure (HF). A major factor in the pathogenesis of anaemia, it is also a separate condition with serious clinical consequences (e.g. impaired exercise capacity) and poor prognosis in HF patients. Experimental evidence suggests that iron therapy in iron-deficient animals may activate molecular pathways that can be cardio-protective. Clinical studies have demonstrated favourable effects of i.v. iron on the functional status, quality of life, and exercise capacity in HF patients. It is hypothesized that i.v. iron supplementation may become a novel therapy in HF patients with iron deficiency.

  9. The genetics of premature ovarian failure: current perspectives

    PubMed Central

    Chapman, Chevy; Cree, Lynsey; Shelling, Andrew N

    2015-01-01

    Premature ovarian failure (POF) is a common cause of infertility in women, characterized by amenorrhea, hypoestrogenism, and elevated gonadotropin levels in women under the age of 40. Many genes have been identified over the past few years that contribute to the development of POF. However, few genes have been identified that can explain a substantial proportion of cases of POF. The unbiased approaches of genome-wide association studies and next-generation sequencing technologies have identified several novel genes implicated in POF. As only a small proportion of genes influencing idiopathic POF have been identified thus far, it remains to be determined how many genes and molecular pathways may influence idiopathic POF development. However, owing to POF’s diverse etiology and genetic heterogeneity, we expect to see the contribution of several new and novel molecular pathways that will greatly enhance our understanding of the regulation of ovarian function. Future genetic studies in large cohorts of well-defined, unrelated, idiopathic POF patients will provide a great opportunity to identify the missing heritability of idiopathic POF. The identification of several causative genes may allow for early detection and would provide better opportunity for early intervention, and furthermore, the identification of specific gene defects will help direct potential targets for future treatment. PMID:26445561

  10. [Electrical failure with nerve stimulation: cases report and check list for prevention].

    PubMed

    Choquet, O; Feugeas, J-L; Capdevila, X; Manelli, J-C

    2007-03-01

    Functionality of the nerve stimulator and integrity of the electrical circuit should be verified and confirmed before performing peripheral nerve blockade. The clinical cases reported here demonstrate that electrical disconnection or malfunction during nerve localization can unpredictably occur and a checklist is described to prevent the unknown electrical circuit failure.

  11. Intralipid prevents and rescues fatal pulmonary arterial hypertension and right ventricular failure in rats.

    PubMed

    Umar, Soban; Nadadur, Rangarajan D; Li, Jingyuan; Maltese, Federica; Partownavid, Parisa; van der Laarse, Arnoud; Eghbali, Mansoureh

    2011-09-01

    Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling leading to right ventricular (RV) hypertrophy and failure. Intralipid (ILP), a source of parenteral nutrition for patients, contains γ-linolenic acid and soy-derived phytoestrogens that are protective for lungs and heart. We, therefore, investigated the therapeutic potential of ILP in preventing and rescuing monocrotaline-induced PAH and RV dysfunction. PAH was induced in male rats with monocrotaline (60 mg/kg). Rats then received daily ILP (1 mL of 20% ILP per day IP) from day 1 to day 30 for prevention protocol or from day 21 to day 30 for rescue protocol. Other monocrotaline-injected rats were left untreated to develop severe PAH by day 21 or RV failure by approximately day 30. Saline or ILP-treated rats served as controls. Significant increase in RV pressure and decrease in RV ejection fraction in the RV failure group resulted in high mortality. Therapy with ILP resulted in 100% survival and prevented PAH-induced RV failure by preserving RV pressure and RV ejection fraction and preventing RV hypertrophy and lung remodeling. In preexisting severe PAH, ILP attenuated most lung and RV abnormalities. The beneficial effects of ILP in PAH seem to result from the interplay of various factors, among which preservation and/or stimulation of angiogenesis, suppression and/or reversal of inflammation, fibrosis and hypertrophy, in both lung and RV, appear to be major contributors. In conclusion, ILP not only prevents the development of PAH and RV failure but also rescues preexisting severe PAH.

  12. Design and Rationale of the PREVENT III Clinical Trial: Edifoligide for the Prevention of Infrainguinal Vein Graft Failure

    PubMed Central

    Conte, Michael S.; Lorenz, Todd J.; Bandyk, Dennis F.; Clowes, Alexander W.; Moneta, Gregory L.; Seely, B. Lynn

    2006-01-01

    Surgical bypass of peripheral arterial occlusive disease with autologous vein grafts provides an effective means of restoring blood flow to the lower extremity, and has been a standard therapy for patients with disabling claudication or critical limb ischemia (CLI). However, failure rates may run as high as 50% within 5 years. These graft failures occur as a result of neointimal hyperplasia, a ubiquitous biologic response of blood vessel walls to injury, which is characterized by the migration and proliferation of smooth muscle cells (SMC). The E2F family of transcription factors regulates the expression of genes controlling SMC proliferation. Edifoligide (E2F Decoy) is a novel therapy that inhibits E2F function, thus attenuating neointimal hyperplasia. Its use in conjunction with a patented drug delivery pressurization chamber is under investigation. Using this system, edifoligide is administered to vein grafts in a single, ex vivo treatment following vein harvest and before implantation, resulting in minimal systemic drug exposure and excellent patient compliance. This Phase 3, randomized, double-blind, multicenter clinical trial is designed to evaluate the safety and efficacy of edifoligide in a population of approximately 1400 patients with CLI undergoing infrainguinal bypass for peripheral arterial disease (PAD). The primary outcome measure will be the time to occurrence of non-technical graft failure resulting in either graft revision or major amputation at 12 months after enrollment. A governing Clinical Events Classification committee (CEC) will adjudicate each graft failure to determine its etiology. The PREVENT III trial is the largest multicenter trial ever performed in patients receiving autologous vein bypass grafts for CLI. This landmark study will determine if edifoligide is safe and effective at preventing vein graft failure in patients undergoing lower extremity bypass, but it also provides a unique opportunity to observe current treatment

  13. Predictors of Prevention Failure in College Students Participating in Two Indicated Depression Prevention Programs

    PubMed Central

    Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando L.; Otero, Patricia

    2014-01-01

    The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force. PMID:24714056

  14. Predictors of prevention failure in college students participating in two indicated depression prevention programs.

    PubMed

    Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando L; Otero, Patricia

    2014-04-04

    The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force.

  15. Regulatory perspective for prevention of groundwater pollution. [Monograph

    SciTech Connect

    Dotson, L.J.

    1982-01-01

    This paper attempts to establish a regulatory perspective for preventing groundwater pollution, which is a serious problem in many regions of the country. Historically, pollution-control regulations have been haphazard and uncoordinated. Few have been designed to consider the problems unique to this source. The paper outlines important hydrologic factors to establish a basis for an improved regulatory program for groundwater quality protection. Significant factors include the hydrologic role of ground water, the uses and regional importance of groundwater, and groundwater contamination pathways. A review of past and present trends in regulatory protection includes two regulatory approaches that are generally superior and a listing of key factors that planners should consider when designing land-use regulations. The paper concludes with a discussion of some possible problems of implementing an improved regulatory program, such as limits on our technical or enforcement capabilities. 52 references, 7 figures.

  16. A Perspective on Progress and Gaps in HIV Prevention Science

    PubMed Central

    Mesquita, Pedro M.M.; Herold, Betsy C.

    2012-01-01

    Abstract In the past few years, the transdisciplinary field of HIV prevention has reached several milestones. Topically applied tenofovir gel provided significant protection from sexual transmission of HIV in a large-scale clinical trial and oral Truvada (emtricitabine/tenofovir disoproxil fumarate) was recently approved for preexposure prophylaxis (PrEP) following two successful clinical trials in men and women. These achievements are tempered by the disappointing results of other clinical trials, which highlight the complexities of prevention research. In this perspective, we discuss scientific and developmental gaps for topical chemoprophylaxis of the sexual transmission of HIV, which depends on the complex interactions between the pharmacokinetics and pharmacodynamics of drugs, formulation and delivery systems, anatomic site of transmission, and host mucosal immune defenses. Despite the considerable time and resources devoted to unraveling the initial steps in sexual transmission of HIV, current knowledge is based on animal models and human explanted tissue, which may not fully recapitulate what happens clinically. Understanding these events, including the role that sex hormones, semen, and mucosal secretions play in transmission, and the interplay between innate immunity, the mucosal environment, and drug efficacy is paramount. This drives some of the most pressing questions in the field. PMID:22966871

  17. Liver resection for cancer: New developments in prediction, prevention and management of postresectional liver failure.

    PubMed

    van Mierlo, Kim M C; Schaap, Frank G; Dejong, Cornelis H C; Olde Damink, Steven W M

    2016-12-01

    Hepatic failure is a feared complication that accounts for up to 75% of mortality after extensive liver resection. Despite improved perioperative care, the increasing complexity and extensiveness of surgical interventions, in combination with an expanding number of resections in patients with compromised liver function, still results in an incidence of postresectional liver failure (PLF) of 1-9%. Preventive measures aim to enhance future remnant liver size and function. Numerous non-invasive techniques to assess liver function and predict remnant liver volume are being developed, along with introduction of novel surgical strategies that augment growth of the future remnant liver. Detection of PLF is often too late and treatment is primarily symptomatic. Current therapeutic research focuses on ([bio]artificial) liver function support and regenerative medicine. In this review we discuss the current state and new developments in prediction, prevention and management of PLF, in light of novel insights into the aetiology of this complex syndrome.

  18. Prevention and Treatment of Intestinal Failure-Associated Liver Disease in Children

    PubMed Central

    Raphael, Bram P.; Duggan, Christopher

    2016-01-01

    Intestinal failure-associated liver disease (IFALD), a serious complication occurring in infants, children and adults exposed to long-term parenteral nutrition (PN), causes a wide-spectrum of disease, ranging from cholestasis and steatosis to fibrosis and eventually cirrhosis. Known host risk factors for IFALD include low birth weight, prematurity, short bowel syndrome and recurrent sepsis. The literature suggests that components of PN may also play a part of the multifactorial pathophysiology. Because some intravenous lipid emulsions (ILE) may contribute to inflammation and interfere with bile excretion, treatment with ILE minimization and/or ILEs composed primarily of omega-3 fatty acids can be helpful but requires careful monitoring for growth failure and essential fatty acid deficiency (EFAD). Data from randomized controlled trials are awaited to support widespread use of these approaches. Other IFALD treatments include cycling PN, ursodeoxycholic acid, sepsis prevention, photoprotection and polyvinylchloride-free tubing. Management and prevention of IFALD remains a clinical challenge. PMID:23397535

  19. Lack of prevention of heart failure by serial electrical cardioversion in patients with persistent atrial fibrillation

    PubMed Central

    Tuinenburg, A; Van Gelder, I C; Den Berg, M P V.; Brugemann, J; De Kam, P J; Crijns, H

    1999-01-01

    OBJECTIVE—To investigate the occurrence of heart failure complications, and to identify variables that predict heart failure in patients with (recurrent) persistent atrial fibrillation, treated aggressively with serial electrical cardioversion and antiarrhythmic drugs to maintain sinus rhythm.
DESIGN—Non-randomised controlled trial; cohort; case series; mean (SD) follow up duration 3.4 (1.6) years.
SETTING—Tertiary care centre.
SUBJECTS—Consecutive sampling of 342 patients with persistent atrial fibrillation (defined as > 24 hours duration) considered eligible for electrical cardioversion.
INTERVENTIONS—Serial electrical cardioversions and serial antiarrhythmic drug treatment, after identification and treatment of underlying cardiovascular disease.
MAIN OUTCOME MEASURES—heart failure complications: development or progression of heart failure requiring the institution or addition of drug treatment, hospital admission, or death from heart failure.
RESULTS—Development or progression of heart failure occurred in 38 patients (11%), and 22 patients (6%) died from heart failure. These complications were related to the presence of coronary artery disease (p < 0.001, risk ratio 3.2, 95% confidence interval (CI) 1.6 to 6.5), rheumatic heart disease (p < 0.001, risk ratio 5.0, 95% CI 2.4 to 10.2), cardiomyopathy (p < 0.001, risk ratio 5.0, 95% CI 2.0 to 12.4), atrial fibrillation for < 3 months (p = 0.04, risk ratio 2.0, 95% CI 1.0 to 3.7), and poor exercise tolerance (New York Heart Association class III at inclusion, p < 0.001, risk ratio 3.5, 95% CI 1.9 to 6.7). No heart failure complications were observed in patients with lone atrial fibrillation.
CONCLUSIONS—Aggressive serial electrical cardioversion does not prevent heart failure complications in patients with persistent atrial fibrillation. These complications are predominantly observed in patients with more severe underlying cardiovascular disease. Randomised

  20. The patient perspective: Quality of life in advanced heart failure with frequent hospitalisations.

    PubMed

    Nieminen, Markku S; Dickstein, Kenneth; Fonseca, Cândida; Serrano, Jose Magaña; Parissis, John; Fedele, Francesco; Wikström, Gerhard; Agostoni, Piergiuseppe; Atar, Shaul; Baholli, Loant; Brito, Dulce; Colet, Josep Comín; Édes, István; Gómez Mesa, Juan E; Gorjup, Vojka; Garza, Eduardo Herrera; González Juanatey, José R; Karanovic, Nenad; Karavidas, Apostolos; Katsytadze, Igor; Kivikko, Matti; Matskeplishvili, Simon; Merkely, Béla; Morandi, Fabrizio; Novoa, Angel; Oliva, Fabrizio; Ostadal, Petr; Pereira-Barretto, Antonio; Pollesello, Piero; Rudiger, Alain; Schwinger, Robert H G; Wieser, Manfred; Yavelov, Igor; Zymliński, Robert

    2015-07-15

    End of life is an unfortunate but inevitable phase of the heart failure patients' journey. It is often preceded by a stage in the progression of heart failure defined as advanced heart failure, and characterised by poor quality of life and frequent hospitalisations. In clinical practice, the efficacy of treatments for advanced heart failure is often assessed by parameters such as clinical status, haemodynamics, neurohormonal status, and echo/MRI indices. From the patients' perspective, however, quality-of-life-related parameters, such as functional capacity, exercise performance, psychological status, and frequency of re-hospitalisations, are more significant. The effects of therapies and interventions on these parameters are, however, underrepresented in clinical trials targeted to assess advanced heart failure treatment efficacy, and data are overall scarce. This is possibly due to a non-universal definition of the quality-of-life-related endpoints, and to the difficult standardisation of the data collection. These uncertainties also lead to difficulties in handling trade-off decisions between quality of life and survival by patients, families and healthcare providers. A panel of 34 experts in the field of cardiology and intensive cardiac care from 21 countries around the world convened for reviewing the existing data on quality-of-life in patients with advanced heart failure, discussing and reaching a consensus on the validity and significance of quality-of-life assessment methods. Gaps in routine care and research, which should be addressed, were identified. Finally, published data on the effects of current i.v. vasoactive therapies such as inotropes, inodilators, and vasodilators on quality-of-life in advanced heart failure patients were analysed.

  1. Perspectives of Fijian Policymakers on the Obesity Prevention Policy Landscape

    PubMed Central

    Hendriks, Anna-Marie; Delai, Mere Y.; Thow, Anne-Marie; Gubbels, Jessica S.; De Vries, Nanne K.; Kremers, Stef P. J.; Jansen, Maria W. J.

    2015-01-01

    In Fiji and other Pacific Island countries, obesity has rapidly increased in the past decade. Therefore, several obesity prevention policies have been developed. Studies show that their development has been hampered by factors within Fiji's policy landscape such as pressure from industry. Since policymakers in the Fijian national government are primarily responsible for the development of obesity policies, it is important to understand their perspectives; we therefore interviewed 15 policymakers from nine Fijian ministries. By applying the “attractor landscape” metaphor from dynamic systems theory, we captured perceived barriers and facilitators in the policy landscape. A poor economic situation, low food self-sufficiency, power inequalities, inappropriate framing of obesity, limited policy evidence, and limited resource sharing hamper obesity policy developments in Fiji. Facilitators include policy entrepreneurs and policy brokers who were active when a window of opportunity opened and who strengthened intersectoral collaboration. Fiji's policy landscape can become more conducive to obesity policies if power inequalities are reduced. In Fiji and other Pacific Island countries, this may be achievable through increased food self-sufficiency, strengthened intersectoral collaboration, and the establishment of an explicit functional focal unit within government to monitor and forecast the health impact of policy changes in non-health sectors. PMID:26380307

  2. Ubiquitous protective effects of cyclosporine A in preventing cardiac arrest-induced multiple organ failure.

    PubMed

    Cour, Martin; Abrial, Maryline; Jahandiez, Vincent; Loufouat, Joseph; Belaïdi, Elise; Gharib, Abdallah; Varennes, Annie; Monneret, Guillaume; Thibault, Hélène; Ovize, Michel; Argaud, Laurent

    2014-10-15

    Opening of the mitochondrial permeability transition pore (mPTP) appears to be a pivotal event in myocardial ischemia-reperfusion (I/R) injury. Resuscitated cardiac arrest (CA) leads to the post-CA syndrome that encompasses, not only myocardial dysfunction, but also brain injury, failure of other organs (kidney, liver, or lung), and systemic response to I/R. We aimed to determine whether cyclosporine A (CsA) might prevent multiple organ failure following CA through a ubiquitous mPTP inhibition in each distant vital organ. Anesthetized New Zealand White rabbits were subjected to 15 min of CA and 120 min of reperfusion. At the onset of resuscitation, the rabbits received CsA, its non-immunosuppressive derivative NIM811, or vehicle (controls). Survival, hemodynamics, brain damage, organ injuries, and systemic I/R response were analyzed. Fresh mitochondria were isolated from the brain, heart, kidney, liver, and lung to assess both oxidative phosphorylation and permeability transition. CsA analogs significantly improved short-term survival and prevented multiple organ failure, including brain damage and myocardial dysfunction (P < 0.05 vs. controls). Susceptibility of mPTP opening was significantly increased in heart, brain, kidney, and liver mitochondria isolated from controls, while mitochondrial respiration was impaired (P < 0.05 vs. sham). CsA analogs prevented these mitochondrial dysfunctions (P < 0.05 vs. controls). These results suggest that CsA and NIM811 can prevent the post-CA syndrome through a ubiquitous mitochondrial protective effect at the level of each major distant organ.

  3. Late renal failure due to prostatic outflow obstruction: a preventable disease.

    PubMed

    Sacks, S H; Aparicio, S A; Bevan, A; Oliver, D O; Will, E J; Davison, A M

    1989-01-21

    Nineteen patients presenting with late renal failure due to prostatic outflow obstruction (mean age 68.7 years; mean serum creatinine concentration 1158 mumol/l) were identified from the admission records of two renal units. As late renal failure secondary to prostatic enlargement is preventable case records were analysed retrospectively in an attempt to identify aspects of management in which preventive efforts might be of value. Delays in referral were common, with a mean of 2.8 years between the onset of prostatic symptoms and time of referral, six patients being referred who had had symptoms for more than three years. Four of five patients who had had a prostatectomy were known to be in renal failure at the time of operation but were not referred until 2-13 years later, when prostatic symptoms had recurred and there was evidence of progressive nephropathy with dilatation of the upper urinary tract. Two patients died on admission and eight (47% of survivors) required long term dialysis, most patients (80%) requiring some dialysis support during the initial period. These findings suggest that progressive nephropathy caused by prostatic outflow obstruction might, in part, be averted by more adequate screening of renal function in men with untreated prostatism and closer follow up of patients with uraemia at the time of prostatectomy.

  4. Preventing cerebral oedema in acute liver failure: the case for quadruple-H therapy.

    PubMed

    Warrillow, S J; Bellomo, R

    2014-01-01

    Severe cerebral oedema is a life-threatening complication of acute liver failure. Hyperammonaemia and cerebral hyperaemia are major contributing factors. A multimodal approach, which incorporates hyperventilation, haemodiafiltration, hypernatraemia and hypothermia (quadruple-H therapy), may prevent or attenuate severe cerebral oedema. This approach is readily administered by critical care clinicians and is likely to be more effective than the use of single therapies. Targeting of PaCO2 in the mild hyperventilation range, as seen in acute liver failure patients before intubation, aims to minimise hyperaemic cerebral oedema. Haemodiafiltration aims to achieve the rapid control of elevated blood ammonia concentrations by its removal and to reduce production via the lowering of core temperature. The administration of concentrated saline increases serum tonicity and further reduces cerebral swelling. In addition, the pathologically increased cerebral blood-flow is further attenuated by therapeutic hypothermia. The combination of all four treatments in a multimodal approach may be a safe and effective means of attenuating or treating the cerebral oedema of acute liver failure and preventing death from neurological complications.

  5. A Novel Role of Three Dimensional Graphene Foam to Prevent Heater Failure during Boiling

    PubMed Central

    Ahn, Ho Seon; Kim, Ji Min; Park, Chibeom; Jang, Ji-Wook; Lee, Jae Sung; Kim, Hyungdae; Kaviany, Massoud; Kim, Moo Hwan

    2013-01-01

    We report a novel boiling heat transfer (NBHT) in reduced graphene oxide (RGO) suspended in water (RGO colloid) near critical heat flux (CHF), which is traditionally the dangerous limitation of nucleate boiling heat transfer because of heater failure. When the heat flux reaches the maximum value (CHF) in RGO colloid pool boiling, the wall temperature increases gradually and slowly with an almost constant heat flux, contrary to the rapid wall temperature increase found during water pool boiling. The gained time by NBHT would provide the safer margin of the heat transfer and the amazing impact on the thermal system as the first report of graphene application. In addition, the CHF and boiling heat transfer performance also increase. This novel boiling phenomenon can effectively prevent heater failure because of the role played by the self-assembled three-dimensional foam-like graphene network (SFG). PMID:23743619

  6. Prevention of corrosion-related failures in condensers and feedwater heaters

    SciTech Connect

    Beavers, J.A.; Agrawal, A.K.; Berry, W.E.

    1982-12-01

    The common alloys used for tubing in power plant feedwater heaters and condensers are identified and the major corrosion problems encountered in these components are described. The frequency of failure and failure modes in both components are shown to be alloy specific. Some corrosion problems are shown to be controllable through minor design modifications in the equipment and others through judicious selection of alloys. In condensers, alloy selection is most effective when based on tube location. In feedwater heaters, strict control of water quality is shown to be necessary with most alloys to minimize corrosion problems. Benefits of some auxiliary techniques for preventing corrosion attack include coating and cathodic protection of the tube sheet and cooling water intake screens.

  7. A novel role of three dimensional graphene foam to prevent heater failure during boiling.

    PubMed

    Ahn, Ho Seon; Kim, Ji Min; Park, Chibeom; Jang, Ji-Wook; Lee, Jae Sung; Kim, Hyungdae; Kaviany, Massoud; Kim, Moo Hwan

    2013-01-01

    We report a novel boiling heat transfer (NBHT) in reduced graphene oxide (RGO) suspended in water (RGO colloid) near critical heat flux (CHF), which is traditionally the dangerous limitation of nucleate boiling heat transfer because of heater failure. When the heat flux reaches the maximum value (CHF) in RGO colloid pool boiling, the wall temperature increases gradually and slowly with an almost constant heat flux, contrary to the rapid wall temperature increase found during water pool boiling. The gained time by NBHT would provide the safer margin of the heat transfer and the amazing impact on the thermal system as the first report of graphene application. In addition, the CHF and boiling heat transfer performance also increase. This novel boiling phenomenon can effectively prevent heater failure because of the role played by the self-assembled three-dimensional foam-like graphene network (SFG).

  8. [Current perspectives in telemonitoring and devices in chronic heart failure patients: lights and shadows].

    PubMed

    Mortara, Andrea; Oliva, Fabrizio; Di Lenarda, Andrea

    2010-05-01

    The complexity of an integrated approach, mandatory for chronic diseases such as heart failure, might be simplified by the availability of new technologies for remote data transmission at relatively low costs. Home telemonitoring for complex patients opens new perspectives for the safe discharge of chronically severe patients and intensive surveillance for unstable subjects, and shows potential benefits on patients' quality of life and cost containment. Systematic reviews and meta-analyses document a 30-35% decrease in mortality and a 15-20% reduction in hospital admissions. Critical issues remain the presence of health facilities and professionals both in hospital and in the community adequately prepared for patient management through the telemonitoring tool, the selection of patients who may benefit most from it, and financial reimbursement of remote monitoring. The main indication to telemonitoring is the patient at high risk of short-term hemodynamic deterioration, but psychosocial issues should also be considered. New perspectives for tailored management of heart failure patients come from the recent availability of implantable devices able to record hemodynamic parameters. Current evidence is, however, insufficient to affirm their reliability, efficacy, cost-effectiveness, and management changes that may derive from their use.

  9. Failure Prevention For Nuclear Power Plants Through Proactive Management of Materials Degradation (PMMD)

    SciTech Connect

    Bond, Leonard J.; Doctor, Steven R.; Bruemmer, Stephen M.; Cumblidge, Stephen E.; Hull, Amy; Malik, Shah

    2009-05-01

    Failure prevention is central to the operation of nuclear power plants. To meet this goal there is growing interest in new and improved philosophies and methodologies for plant life management (PLiM), which include the migration from reliance on periodic inservice inspection to include condition-based maintenance. A further step in the development of plant management is the move from reactive responses based on ISI to become proactive, through the investigation of the potential for implementation of a proactive management of materials degradation (PMMD) program and its potential impact on the management of LWRs.

  10. Teacher Perceptions of High School Student Failure in the Classroom: Identifying Preventive Practices of Failure Using Critical Incident Technique

    ERIC Educational Resources Information Center

    Kalahar, Kory G.

    2011-01-01

    Student failure is a prominent issue in many comprehensive secondary schools nationwide. Researchers studying error, reliability, and performance in organizations have developed and employed a method known as critical incident technique (CIT) for investigating failure. Adopting an action research model, this study involved gathering and analyzing…

  11. Suicide Prevention Programs in the Schools: A Review and Public Health Perspective

    ERIC Educational Resources Information Center

    Miller, David N.; Eckert, Tanya L.; Mazza, James J.

    2009-01-01

    The purpose of this article is to provide a comprehensive review of school-based suicide prevention programs from a public health perspective. A literature review of empirical studies examining school-based suicide prevention programs was conducted. Studies were required to contain information pertaining to the implementation and outcomes of a…

  12. Youth and Adult Perspectives on Violence Prevention Strategies: A Community-Based Participatory Study

    ERIC Educational Resources Information Center

    Dodington, James; Mollen, Cynthia; Woodlock, Joseph; Hausman, Alice; Richmond, Therese S.; Fein, Joel A.

    2012-01-01

    This project explores the beliefs and perspectives of urban adults and youth regarding community violence prevention strategies and identifies points of overlap and differences of opinion that can contribute to the development of successful youth violence prevention programs. We coded transcript data from adults and 10-16-year-old youth from the…

  13. Exogenous midkine administration prevents cardiac remodeling in pacing-induced congestive heart failure of rabbits.

    PubMed

    Harada, Masahide; Hojo, Mayumi; Kamiya, Kaichiro; Kadomatsu, Kenji; Murohara, Toyoaki; Kodama, Itsuo; Horiba, Mitsuru

    2016-01-01

    Midkine (MK), a heparin-binding growth factor, has been shown to prevent cardiac remodeling after ischemic injury through its anti-apoptotic effect. Cell apoptosis is central to the pathophysiology of cardiac remodeling in congestive heart failure (CHF) of ischemic as well as non-ischemic origin. We hypothesized that MK exerts the anti-apoptotic cardioprotective effect in CHF of non-ischemic etiology. MK protein or vehicle (normal saline) was subcutaneously administered in tachycardia-induced CHF rabbits (right ventricular pacing, 350 beats/min, 4 weeks). The vehicle-treated rabbits (n = 19, control) demonstrated severe CHF and high mortality rate, whereas MK (n = 16) demonstrated a well-compensated state and a lower mortality rate. In echocardiography, left ventricular (LV) end-diastolic dimension decreased in MK versus control, whereas LV systolic function increased. In histological analysis (picrosirius red staining), MK decreased collagen deposition area compared with control. TUNEL staining showed that MK prevented cell apoptosis and minimized myocyte loss in the CHF rabbit ventricle, associated with activation of PI3-K/Akt signaling, producing a parallel decrease of Bax/Bcl-2 ratio. MK prevented progression of cardiac remodeling in the CHF rabbit, likely by activation of anti-apoptotic signaling. Exogenous MK application might be a novel therapeutic strategy for CHF due to non-ischemic origin.

  14. Finding common ground: perspectives on community-based childhood obesity prevention.

    PubMed

    Porter, Christine M; Pelletier, David L

    2012-11-01

    To support successful and inclusive community organizing for childhood obesity prevention, this research identified stakeholder perspectives on what communities should do to prevent childhood obesity. It employed factor analysis on statement sorts (Q methodology) conducted by 95 people in an upstate New York community. These participants sorted 36 statements about the issue by how much he or she agreed or disagreed with each. Participants were recruited through strategic snowball sampling to sample a variety of perspectives. The four resulting factors, or perspectives, were interpreted in the context of presort demographic surveys and postsort interviews. This research found one stance that fits the environmental perspective common in public health. The other three factors indicate important variations among perspectives centered on individual responsibility, ranging from libertarian to technocratic views. However, overall, results revealed a substantial degree of agreement among the four perspectives, including on providing access to family activities and on making fruits and vegetables more available and affordable, for example, through subsidies. This article points to common ground for community action on childhood obesity prevention, highlights areas likely to generate considerable contention, and shows whose views are not being accounted for in, at least, this community's childhood obesity prevention project.

  15. Prevention strategies for cardioembolic stroke: present and future perspectives.

    PubMed

    Giacalone, Giacomo; Abbas, Mohammed Abballa; Corea, Francesco

    2010-06-15

    Atrial fibrillation (AF) is the most common cause of cardioembolism. An update on secondary prevention strategies, used to protect patients from the risk of stroke in many common cardiac conditions, is presented in the paper. The main line of actions of stroke prevention in cardioembolism is mostly connected with antithrombotic drugs, but also other, more invasive, techniques are quickly emerging. Also the classic pharmacological prevention with coumarins may soon be overcome by new generation anticoagulants. Is an aggressive treatment of Patent Foramen Ovale (PFO) always recommended? One of the main challenges of the future years will be to understand competitiveness between old and new preventive strategies.

  16. Engaging local businesses in HIV prevention efforts: the consumer perspective.

    PubMed

    Phillips-Guzman, Christina M; Martinez-Donate, Ana P; Hovell, Melbourne F; Blumberg, Elaine J; Sipan, Carol L; Rovniak, Liza S; Kelley, Norma J

    2011-07-01

    Participation of different community sectors, including the private business sector, is necessary to fight the HIV/AIDS epidemic. Local businesses may be reluctant to participate in HIV prevention because of fear of negative customer reactions and loss of revenue. This study examines the extent to which residents of two communities in San Diego, California, would support HIV prevention initiatives in local businesses. A population-based household survey (N = 200) is conducted in two communities with higher versus lower risk for HIV. The survey includes questions regarding the acceptability of HIV prevention activities, such as condom and brochure distribution in businesses, and history of exposure to HIV prevention activities in local businesses. Most residents agree that (a) business involvement in prevention activities would reduce HIV (92%), (b) free or low-cost condoms available in businesses could prevent the spread of HIV (90.9%) and increase condom accessibility (87%), and (c) they would prefer to shop at businesses that supported HIV prevention versus those that did not (87.4%). These findings suggest that HIV prevention in local businesses would be supported by residents and would be unlikely to adversely affect business profits. This information could be used to design interventions to engage local businesses in HIV-prevention efforts.

  17. Hepatocyte Growth Factor Prevents Acute Renal Failure of Accelerates Renal Regeneration in mice

    NASA Astrophysics Data System (ADS)

    Kawaida, Kouichi; Matsumoto, Kunio; Shimazu, Hisaaki; Nakamura, Toshikazu

    1994-05-01

    Although acute renal failure is encountered with administration of nephrotoxic drugs, ischemia, or unilateral nephrectomy, there has been no effective drug which can be used in case of acute renal failure. Hepatocyte growth factor (HGF) is a potent hepatotropic factor for liver regeneration and is known to have mitogenic, motogenic, and morphogenic activities for various epithelial cells, including renal tubular cells. Intravenous injection of recombinant human HGF into mice remarkably suppressed increases in blood urea nitrogen and serum creatinine caused by administration of cisplatin, a widely used antitumor drug, or HgCl_2, thereby indicating that HGF strongly prevented the onset of acute renal dysfunction. Moreover, exogenous HGF stimulated DNA synthesis of renal tubular cells after renal injuries caused by HgCl_2 administration and unilateral nephrectomy and induced reconstruction of the normal renal tissue structure in vivo. Taken together with our previous finding that expression of HGF was rapidly induced after renal injuries, these results allow us to conclude that HGF may be the long-sought renotropic factor for renal regeneration and may prove to be effective treatment for patients with renal dysfunction, especially that caused by cisplatin.

  18. Shockwaves prevent from heart failure after acute myocardial ischaemia via RNA/protein complexes.

    PubMed

    Tepeköylü, Can; Primessnig, Uwe; Pölzl, Leo; Graber, Michael; Lobenwein, Daniela; Nägele, Felix; Kirchmair, Elke; Pechriggl, Elisabeth; Grimm, Michael; Holfeld, Johannes

    2017-04-01

    Shock wave treatment (SWT) was shown to induce regeneration of ischaemic myocardium via Toll-like receptor 3 (TLR3). The antimicrobial peptide LL37 gets released by mechanical stress and is known to form complexes with nucleic acids thus activating Toll-like receptors. We suggested that SWT in the acute setting prevents from the development of heart failure via RNA/protein release. Myocardial infarction in mice was induced followed by subsequent SWT. Heart function was assessed 4 weeks later via transthoracic echocardiography and pressure-volume measurements. Human umbilical vein endothelial cells (HUVECs) were treated with SWT in the presence of RNase and proteinase and analysed for proliferation, tube formation and LL37 expression. RNA release and uptake after SWT was evaluated. We found significantly improved cardiac function after SWT. SWT resulted in significantly higher numbers of capillaries and arterioles and less left ventricular fibrosis. Supernatants of treated cells activated TLR3 reporter cells. Analysis of the supernatant revealed increased RNA levels. The effect could not be abolished by pre-treatment of the supernatant with RNase, but only by a sequential digestion with proteinase and RNase hinting strongly towards the involvement of RNA/protein complexes. Indeed, LL37 expression as well as cellular RNA uptake were significantly increased after SWT. We show for the first time that SWT prevents from left ventricular remodelling and cardiac dysfunction via RNA/protein complex release and subsequent induction of angiogenesis. It might therefore develop a potent regenerative treatment alternative for ischaemic heart disease.

  19. Darbepoetin-α prevents progressive left ventricular dysfunction and remodeling in nonanemic dogs with heart failure

    PubMed Central

    Rastogi, Sharad; Imai, Makoto; Sharov, Victor G.; Mishra, Sudhish; Sabbah, Hani N.

    2008-01-01

    In anemic patients with heart failure (HF), erythropoietin-type drugs can elicit clinical improvement. This study examined the effects of chronic monotherapy with darbepoetin-α (DARB) on left ventricular (LV) function and remodeling in nonanemic dogs with advanced HF. HF [LV ejection fraction (EF) ∼25%] was produced in 14 dogs by intracoronary microembolizations. Dogs were randomized to once a week subcutaneous injection of DARB (1.0 μg/kg, n = 7) or to no therapy (HF, n = 7). All procedures were performed during cardiac catheterization under general anesthesia and under sterile conditions. LV end-diastolic volume (EDV), end-systolic volume (ESV), and EF were measured before the initiation of therapy and at the end of 3 mo of therapy. mRNA and protein expression of caspase-3, hypoxia inducible factor-1α, and the bone marrow-derived stem cell marker c-Kit were determined in LV tissue. In HF dogs, EDV and ESV increased and EF decreased after 3 mo of followup. Treatment with DARB prevented the increase in EDV, decreased ESV, and increased EF. DARB therapy also normalized the expression of HIF-1α and active caspase-3 and enhanced the expression of c-Kit. We conclude that chronic monotherapy with DARB prevents progressive LV dysfunction and dilation in nonanemic dogs with advanced HF. These results suggest that DARB elicits beneficial effects in HF that are independent of the presence of anemia. PMID:18952719

  20. Prevention strategies for gastric cancer: a global perspective.

    PubMed

    Park, Jin Young; von Karsa, Lawrence; Herrero, Rolando

    2014-11-01

    Despite the substantial burden of gastric cancer worldwide, population strategies for primary prevention have not been introduced in any country. Recognizing the causal role of Helicobacter pylori infection, there is increasing interest in population-based programs to eradicate the infection to prevent gastric cancer. Nonetheless, the paucity of available evidence on feasibility and effectiveness has prevented implementation of this approach. There are very few secondary prevention programs based on screening with endoscopy or radiography, notably in the Republic of Korea and Japan, two of the countries with the highest incidence rates of gastric cancer. In Korea, where the organized screening program is in place, survival rate of gastric cancer is as high as 67%. More research is needed to quantify the specific contribution of the screening program to observed declines in mortality rates. Gastric cancer screening is unlikely to be feasible in many Low-Middle Income Countries where the gastric cancer burden is high. Prevention strategies are still under development and the optimal approach may differ depending on local conditions and societal values. The present review gives an overview of the etiology and burden of the disease, and possible prevention strategies for countries and regions confronted with a significant burden of disease.

  1. AAV-mediated liver-specific MPV17 expression restores mtDNA levels and prevents diet-induced liver failure.

    PubMed

    Bottani, Emanuela; Giordano, Carla; Civiletto, Gabriele; Di Meo, Ivano; Auricchio, Alberto; Ciusani, Emilio; Marchet, Silvia; Lamperti, Costanza; d'Amati, Giulia; Viscomi, Carlo; Zeviani, Massimo

    2014-01-01

    Mutations in human MPV17 cause a hepatocerebral form of mitochondrial DNA depletion syndrome (MDS) hallmarked by early-onset liver failure, leading to premature death. Liver transplantation and frequent feeding using slow-release carbohydrates are the only available therapies, although surviving patients eventually develop slowly progressive peripheral and central neuropathy. The physiological role of Mpv17, including its functional link to mitochondrial DNA (mtDNA) maintenance, is still unclear. We show here that Mpv17 is part of a high molecular weight complex of unknown composition, which is essential for mtDNA maintenance in critical tissues, i.e. liver, of a Mpv17 knockout mouse model. On a standard diet, Mpv17-/- mouse shows hardly any symptom of liver dysfunction, but a ketogenic diet (KD) leads these animals to liver cirrhosis and failure. However, when expression of human MPV17 is carried out by adeno-associated virus (AAV)-mediated gene replacement, the Mpv17 knockout mice are able to reconstitute the Mpv17-containing supramolecular complex, restore liver mtDNA copy number and oxidative phosphorylation (OXPHOS) proficiency, and prevent liver failure induced by the KD. These results open new therapeutic perspectives for the treatment of MPV17-related liver-specific MDS.

  2. New perspectives on the transition between discrete fracture, fragmentation, and pulverization during brittle failure of rocks

    NASA Astrophysics Data System (ADS)

    Griffith, W. A.; Ghaffari, H.; Barber, T. J.; Borjas, C.

    2015-12-01

    The motions of Earth's tectonic plates are typically measured in millimeters to tens of centimeters per year, seemingly confirming the generally-held view that tectonic processes are slow, and have been throughout Earth's history. In line with this perspective, the vast majority of laboratory rock mechanics research focused on failure in the brittle regime has been limited to experiments utilizing slow loading rates. On the other hand, many natural processes that pose significant risk for humans (e.g., earthquakes and extraterrestrial impacts), as well as risks associated with human activities (blow-outs, explosions, mining and mine failures, projectile penetration), occur at rates that are hundreds to thousands of times faster than those typically simulated in the laboratory. Little experimental data exists to confirm or calibrate theoretical models explaining the connection between these dramatic events and the pulverized rocks found in fault zones, impacts, or explosions; however the experimental data that does exist is thought-provoking: At the earth's surface, the process of brittle fracture passes through a critical transition in rocks at high strain rates (101-103s-1) between regimes of discrete fracture and distributed fragmentation, accompanied by a dramatic increase in strength. Previous experimental works on this topic have focused on key thresholds (e.g., peak stress, peak strain, average strain rate) that define this transition, but more recent work suggests that this transition is more fundamentally dependent on characteristics (e.g., shape) of the loading pulse and related microcrack dynamics, perhaps explaining why for different lithologies different thresholds more effectively define the pulverization transition. In this presentation we summarize some of our work focused on this transition, including the evolution of individual defects at the microscopic, microsecond scale and the energy budget associated with the brittle fragmentation process as a

  3. Teachers' Perspectives on Preventing Suicide in Children and Adolescents in Schools: A Qualitative Study.

    PubMed

    Ross, Victoria; Kõlves, Kairi; De Leo, Diego

    2016-08-31

    Given the important role teachers play as gatekeepers in school suicide prevention, this study explored teachers' perspectives on what should be done to improve current suicide prevention efforts. The study, in Queensland, Australia, was part of a large-scale survey examining teachers' knowledge, attitudes and experience of suicidality. One hundred and fifteen teachers responded to an online survey question regarding their views on the requirements for school suicide prevention. Qualitative analysis identified five themes from teachers' responses: awareness and stigma reduction, support services for students, education and training, bullying and the role of social media. The results of this study provide some profound insights into teachers' perspectives on suicide and highlight the critical need for improved suicide prevention efforts in schools.

  4. Self-Regulation, Cooperative Learning, and Academic Self-Efficacy: Interactions to Prevent School Failure

    PubMed Central

    Fernandez-Rio, Javier; Cecchini, Jose A.; Méndez-Gimenez, Antonio; Mendez-Alonso, David; Prieto, Jose A.

    2017-01-01

    Learning to learn and learning to cooperate are two important goals for individuals. Moreover, self regulation has been identified as fundamental to prevent school failure. The goal of the present study was to assess the interactions between self-regulated learning, cooperative learning and academic self-efficacy in secondary education students experiencing cooperative learning as the main pedagogical approach for at least one school year. 2.513 secondary education students (1.308 males, 1.205 females), 12–17 years old (M = 13.85, SD = 1.29), enrolled in 17 different schools belonging to the National Network of Schools on Cooperative Learning in Spain agreed to participate. They all had experienced this pedagogical approach a minimum of one school year. Participants were asked to complete the cooperative learning questionnaire, the strategies to control the study questionnaire and the global academic self-efficacy questionnaire. Participants were grouped based on their perceptions on cooperative learning and self-regulated learning in their classes. A combination of hierarchical and κ-means cluster analyses was used. Results revealed a four-cluster solution: cluster one included students with low levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster two included students with high levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster three included students with high levels of cooperative learning, low levels of self-regulated learning and intermediate-low levels of academic self-efficacy, and, finally, cluster four included students with high levels of self-regulated learning, low levels of cooperative learning, and intermediate-high levels of academic self-efficacy. Self-regulated learning was found more influential than cooperative learning on students’ academic self-efficacy. In cooperative learning contexts students interact through different types of regulations: self, co, and

  5. Self-Regulation, Cooperative Learning, and Academic Self-Efficacy: Interactions to Prevent School Failure.

    PubMed

    Fernandez-Rio, Javier; Cecchini, Jose A; Méndez-Gimenez, Antonio; Mendez-Alonso, David; Prieto, Jose A

    2017-01-01

    Learning to learn and learning to cooperate are two important goals for individuals. Moreover, self regulation has been identified as fundamental to prevent school failure. The goal of the present study was to assess the interactions between self-regulated learning, cooperative learning and academic self-efficacy in secondary education students experiencing cooperative learning as the main pedagogical approach for at least one school year. 2.513 secondary education students (1.308 males, 1.205 females), 12-17 years old (M = 13.85, SD = 1.29), enrolled in 17 different schools belonging to the National Network of Schools on Cooperative Learning in Spain agreed to participate. They all had experienced this pedagogical approach a minimum of one school year. Participants were asked to complete the cooperative learning questionnaire, the strategies to control the study questionnaire and the global academic self-efficacy questionnaire. Participants were grouped based on their perceptions on cooperative learning and self-regulated learning in their classes. A combination of hierarchical and κ-means cluster analyses was used. Results revealed a four-cluster solution: cluster one included students with low levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster two included students with high levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster three included students with high levels of cooperative learning, low levels of self-regulated learning and intermediate-low levels of academic self-efficacy, and, finally, cluster four included students with high levels of self-regulated learning, low levels of cooperative learning, and intermediate-high levels of academic self-efficacy. Self-regulated learning was found more influential than cooperative learning on students' academic self-efficacy. In cooperative learning contexts students interact through different types of regulations: self, co, and shared

  6. New Prevention Perspectives in Nutrition Services for Children.

    ERIC Educational Resources Information Center

    Weaver, Nancy

    Presentations concerning a variety of special programs operating within the framework of a large comprehensive child care program were discussed. A description is given of how a specialist from a certain discipline functions in the many varied programs aimed at prevention. The specialty is nutrition. Each presentation discussed has opportunities…

  7. USPSTF perspective on evidence-based preventive recommendations for children.

    PubMed

    Melnyk, Bernadette Mazurek; Grossman, David C; Chou, Roger; Mabry-Hernandez, Iris; Nicholson, Wanda; DeWitt, Thomas G; Cantu, Adelita G; Flores, Glenn

    2012-08-01

    The development and use of evidence-based recommendations for preventive care by primary care providers caring for children is an ongoing challenge. This issue is further complicated by the fact that a higher proportion of recommendations by the US Preventive Services Task Force (USPSTF) for pediatric preventive services in comparison with adult services have insufficient evidence to recommend for or against the service. One important root cause for this problem is the relative lack of high quality screening and counseling studies in pediatric primary care settings. The paucity of studies limits the development of additional evidence-based guidelines to enhance best practices for pediatric and adolescent conditions. In this article, we describe the following: (1) evidence-based primary care preventive services as a strategy for addressing important pediatric morbidities, (2) the process of making evidence-based screening recommendations by the USPSTF, (3) the current library of USPSTF recommendations for children and adolescents, and (4) factors influencing the use of USPSTF recommendations and other evidence-based guidelines by clinicians. Strategies to accelerate the implementation of evidence-based services and areas of need for future research to fill key gaps in evidence-based recommendations and guidelines are highlighted.

  8. Theoretical Perspectives on Fishing Vessel Accidents and Their Prevention.

    ERIC Educational Resources Information Center

    Boshier, Roger

    Fishing vessel accidents occur because of complex interactions of human, technical, and environmental factors. Although they usually occur because of human actions, thoughts, or behavior, investigators and prevention educators are preoccupied with technical matters and equipment. Equipment, machinery, weather, and other objective facts are…

  9. Suicide and Suicide Prevention: Greek versus Biblical Perspectives.

    ERIC Educational Resources Information Center

    Kaplan, Kalman J.

    1992-01-01

    Compares suicide in Greek tragedy and Hebrew Bible, concentrating on life situations portrayed in two sets of narratives promoting or preventing suicide. Notes frequency of suicides in Greek tragedy and infrequency of suicides in Bible. Compares stories of Narcissus and Jonah in attempt to pinpoint what is suicide-promoting in Greek narratives and…

  10. A Perspective on Primary Prevention in the Earliest Years.

    ERIC Educational Resources Information Center

    Richmond, Julius B.

    The decade of the 70's has seen significant improvements in child health and dramatic insights into the biological, psychological, and social factors influencing children's growth and development. Four of the six major gains in health status listed in the Surgeon General's Report on Health Promotion and Disease Prevention relate to improvements in…

  11. A Network Perspective on Dropout Prevention in Two Cities

    ERIC Educational Resources Information Center

    Wells, Rebecca; Gifford, Elizabeth; Bai, Yu; Corra, Ashley

    2015-01-01

    Purpose: This exploratory case study examines how school systems and other local organizations have been working within two major U.S. cities to improve high school graduation rates. Systematically assessing active interorganizational dropout prevention networks may reveal characteristics affecting communities' capacity to support school…

  12. Frequency and Predictors of Internal Mammary Artery Graft Failure and Subsequent Clinical Outcomes: Insights From the PREVENT IV Trial

    PubMed Central

    Harskamp, Ralf E.; Alexander, John H.; Ferguson, T. Bruce; Hager, Rebecca; Mack, Michael J.; Englum, Brian; Wojdyla, Daniel; Schulte, Phillip J.; Kouchoukos, Nicholas T.; de Winter, Robbert J.; Gibson, C. Michael; Peterson, Eric D.; Harrington, Robert A.; Smith, Peter K.; Lopes, Renato D.

    2015-01-01

    Background The internal mammary artery (IMA) is the preferred conduit for bypassing the left anterior descending (LAD) artery in patients undergoing coronary artery bypass grafting (CABG). Systematic evaluation of the frequency and predictors of IMA failure and long-term outcomes is lacking. Methods and Results PREVENT IV trial participants who underwent IMA-LAD revascularization and had 12–18-month angiographic follow-up (n=1539) were included. Logistic regression with fast false selection rate methods was used to identify characteristics associated with IMA failure (≥75% stenosis). The relationship between IMA failure and long-term outcomes including death, myocardial infarction, and repeat revascularization was assessed using Cox regression. IMA failure occurred in 132 participants (8.6%). Predictors of IMA graft failure were LAD stenosis <75% (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.19–2.59), additional bypass graft to diagonal branch (OR, 1.92; 95% CI, 1.33–2.76), and not having diabetes (OR, 1.82; 95% CI, 1.20–2.78). LAD stenosis and additional diagonal graft remained predictive of IMA failure in an alternative model that included angiographic failure or death before angiography as the outcome. IMA failure was associated with a significantly higher incidence of subsequent acute (<14 days of angiography) clinical events, mostly due to a higher rate of repeat revascularization. Conclusions IMA failure was common and associated with higher rates of repeat revascularization, and patients with intermediate LAD stenosis or with an additional bypass graft to the diagonal branch had increased risk for IMA failure. These findings raise concerns regarding competitive flow and the benefit of CABG in intermediate LAD stenosis without functional evidence of ischemia. Clinical Trial Registration Information ClinicalTrials.gov. Identifier: NCT00042081. PMID:26647082

  13. Future Issues and Approaches to Health Monitoring and Failure Prevention for Oil-Free Gas Turbines

    NASA Technical Reports Server (NTRS)

    DellaCorte, Christopher

    2004-01-01

    Recent technology advances in foil air bearings, high temperature solid lubricants and computer based modeling has enabled the development of small Oil-Free gas turbines. These turbomachines are currently commercialized as small (<100 kW) microturbine generators and larger machines are being developed. Based upon these successes and the high potential payoffs offered by Oil-Free systems, NASA, industry, and other government entities are anticipating Oil-Free gas turbine propulsion systems to proliferate future markets. Since an Oil-Free engine has no oil system, traditional approaches to health monitoring and diagnostics, such as chip detection, oil analysis, and possibly vibration signature analyses (e.g., ball pass frequency) will be unavailable. As such, new approaches will need to be considered. These could include shaft orbit analyses, foil bearing temperature measurements, embedded wear sensors and start-up/coast down speed analysis. In addition, novel, as yet undeveloped techniques may emerge based upon concurrent developments in MEMS technology. This paper introduces Oil-Free technology, reviews the current state of the art and potential for future turbomachinery applications and discusses possible approaches to health monitoring, diagnostics and failure prevention.

  14. Reduced cardiac remodelling and prevention of glutathione deficiency after omega-3 supplementation in chronic heart failure.

    PubMed

    Fang, Yuehua; Favre, Julie; Vercauteren, Magalie; Laillet, Brigitte; Remy-Jouet, Isabelle; Skiba, Mohamed; Lallemand, Françoise; Dehaudt, Cathy; Monteil, Christelle; Thuillez, Christian; Mulder, Paul

    2011-06-01

    n-3 polyunsaturated fatty acids (omega-3) supplementation is associated with reduced cardiovascular mortality and post-infarction death. However, the impact of omega-3 supplementation in congestive heart failure (CHF) is still unknown. This study assesses the effects of omega-3 supplementation on left ventricular (LV) function and remodelling. We assessed, in rats with CHF induced by left coronary ligation, the effects of a 1-week and a 12-week supplementation with omega-3 (450 mg/kg per day) on LV hemodynamics, function and structure. Chronic omega-3 reduces total peripheral resistance due to an increase in cardiac output without modification of arterial pressure. Only chronic omega-3 reduces LV end-diastolic pressure and LV relaxation constant. Moreover, chronic omega-3 decreases LV systolic and diastolic diameters, LV weight and collagen density. Acute and chronic omega-3 increase LV γ-glutamyl-cysteine synthetase and oppose glutathione deficiency resulting in a reduction of myocardial oxidized glutathione. In experimental CHF, long-term omega-3 supplementation improves LV hemodynamics and function and prevents LV remodelling and glutathione deficiency. The latter might be one of the mechanisms involved, but whether other mechanism, independent of myocardial redox 'status', such as reduced inflammation, are implicated remains to be confirmed.

  15. Metformin prevents the development of chronic heart failure in the SHHF rat model.

    PubMed

    Cittadini, Antonio; Napoli, Raffaele; Monti, Maria Gaia; Rea, Domenica; Longobardi, Salvatore; Netti, Paolo Antonio; Walser, Marion; Samà, Mariateresa; Aimaretti, Gianluca; Isgaard, Jörgen; Saccà, Luigi

    2012-04-01

    Insulin resistance is a recently identified mechanism involved in the pathophysiology of chronic heart failure (CHF). We investigated the effects of two insulin-sensitizing drugs (metformin and rosiglitazone) in a genetic model of spontaneously hypertensive, insulin-resistant rats (SHHF). Thirty SHHF rats were randomized into three treatment groups as follows: 1) metformin (100 mg/kg per day), 2) rosiglitazone (2 mg/kg per day), and 3) no drug. Ten Sprague-Dawley rats served as normal controls. At the end of the treatment period (12 months), the cardiac phenotype was characterized by histology, echocardiography, and isolated perfused heart studies. Metformin attenuated left ventricular (LV) remodeling, as shown by reduced LV volumes, wall stress, perivascular fibrosis, and cardiac lipid accumulation. Metformin improved both systolic and diastolic indices as well as myocardial mechanical efficiency, as shown by improved ability to convert metabolic energy into mechanical work. Metformin induced a marked activation of AMP-activated protein kinase, endothelial nitric oxide synthase, and vascular endothelial growth factor and reduced tumor necrosis factor-α expression and myocyte apoptosis. Rosiglitazone did not affect LV remodeling, increased perivascular fibrosis, and promoted further cardiac lipid accumulation. In conclusion, long-term treatment with metformin, but not with rosiglitazone, prevents the development of severe CHF in the SHHF model by a wide-spectrum interaction that involves molecular, structural, functional, and metabolic-energetic mechanisms.

  16. Application of woven tires waste as soft clay subgrade reinforcement for preventing highway structural failure

    NASA Astrophysics Data System (ADS)

    Apriyono, Arwan; Sumiyanto, Gusmawan, Dadan Deri

    2017-03-01

    This study presents the application of woven waste tires as soft clay subgrade reinforcement for preventing highway structural failure, reducing construction cost and minimizing environmental hazards associated with the increasingly large amount of waste tires in Indonesia. To his end, we performed experiments using five stripe distance variations of woven tires - i.e. 2, 2.5, 3, 3.5 and 4 cm. Five soft clay samples were made and each was reinforced using each of these woven tires. The California Bearing Ratio (CBR) test was conducted on each softclay sample and the CBR value was determined from the stress on the displacement of 0.10 and 0.20 inch. The correlation between CBR value and strip distance was used to infer the optimum woven tires strip distance, indicated by the largest CBR value. The result suggests that the strip distance of 3 cm is optimum with corresponding CBR value of ˜20%, which is 115% increase compared to softclay without reinforcement.

  17. Adolescent Dating Violence Prevention and Intervention in a Community Setting: Perspectives of Young Adults and Professionals

    ERIC Educational Resources Information Center

    Martsolf, Donna S.; Colbert, Crystal; Draucker, Claire B.

    2012-01-01

    Adolescent dating violence (ADV) is a significant community problem. In this study, we examine the perspectives of two groups (young adults who experienced ADV as teens and professionals who work with teens) on ADV prevention/intervention in a community context. We interviewed 88 young adults and 20 professionals. Our research team used Thorne's…

  18. Tobacco Prevention Education in Schools for the Deaf: The Faculty Perspective

    ERIC Educational Resources Information Center

    Berman, Barbara A.; Guthmann, Debra S.; Liu, Weiqing; Streja, Leanne

    2011-01-01

    We report results of a survey of tobacco education practices and perspectives among faculty at four Schools for the Deaf participating in the trial of a tailored tobacco prevention curriculum. Few faculty (20.4%) included tobacco use among the three most important health problems facing their students, although 88.8% considered tobacco education…

  19. Cardiac Implantable Electronic Device Infection: From an Infection Prevention Perspective

    PubMed Central

    Sastry, Sangeeta; Rahman, Riaz; Yassin, Mohamed H.

    2015-01-01

    A cardiac implantable electronic device (CIED) is indicated for patients with severely reduced ejection fraction or with life-threatening cardiac arrhythmias. Infection related to a CIED is one of the most feared complications of this life-saving device. The rate of CIED infection has been estimated to be between 2 and 25; though evidence shows that this rate continues to rise with increasing expenditure to the patient as well as healthcare systems. Multiple risk factors have been attributed to the increased rates of CIED infection and host comorbidities as well as procedure related risks. Infection prevention efforts are being developed as defined bundles in numerous hospitals around the country given the increased morbidity and mortality from CIED related infections. This paper aims at reviewing the various infection prevention measures employed at hospitals and also highlights the areas that have relatively less established evidence for efficacy. PMID:26550494

  20. Stretching and injury prevention in football: current perspectives.

    PubMed

    Stojanovic, Marko D; Ostojic, Sergej M

    2011-04-01

    Stretching exercises are regularly recommended as a part of football-training sessions and in preparation for competition. There is little sound empirical evidence, however, to substantiate the role of stretching exercises and consequently increased flexibility on injury prevention in football. Furthermore, in the last decade or so, fundamental research has shed some light on the biomechanical adaptation of the muscle-tendon unit following different stretching protocols, improving knowledge about the topic and enabling better understanding of the stretching-injury relationship. The purpose of this review is to examine the literature on the role of stretching and/or increased flexibility on injury prevention in football, with presented results analyzed in the context of the up-to-date basic science research evidence.

  1. Food Policy Approaches to Obesity Prevention: An International Perspective.

    PubMed

    Zhang, Qi; Liu, Shiyong; Liu, Ruicui; Xue, Hong; Wang, Youfa

    2014-06-01

    This paper provides a comprehensive overview of the recent obesity prevention-related food policies initiated in countries worldwide. We searched and reviewed relevant research papers and government documents, focusing on those related to dietary guidelines, food labeling, regulation of food marketing, and policies affecting food prices. We also commented on the effects and challenges of some of the related policy options. There are large variations regarding what, when, and how policies have been implemented across countries. Clearly, developed countries are leading the effort, and developing countries are starting to develop some related policies. The encouraging message is that many countries have been adopting policies that might help prevent obesity and that the support for more related initiatives is strong and continues to grow. Communicating information about these practices will help researchers, public health professionals, and policy makers around the world to take action to fight the growing epidemic of obesity and other nutrition-related diseases.

  2. Calorie restriction and cancer prevention: a mechanistic perspective

    PubMed Central

    2013-01-01

    Calorie restriction (CR) is one of the most potent broadly acting dietary interventions for inducing weight loss and for inhibiting cancer in experimental models. Translation of the mechanistic lessons learned from research on CR to cancer prevention strategies in human beings is important given the high prevalence of excess energy intake, obesity, and metabolic syndrome in many parts of the world and the established links between obesity-associated metabolic perturbations and increased risk or progression of many types of cancer. This review synthesizes findings on the biological mechanisms underlying many of the anticancer effects of CR, with emphasis on the impact of CR on growth factor signaling pathways, inflammation, cellular and systemic energy homeostasis pathways, vascular perturbations, and the tumor microenvironment. These CR-responsive pathways and processes represent targets for translating CR research into effective cancer prevention strategies in human beings. PMID:24280167

  3. Diabetes prevention: global health policy and perspectives from the ground

    PubMed Central

    Bergman, Michael; Buysschaert, Martin; Schwarz, Peter EH; Albright, Ann; Narayan, KM Venkat; Yach, Derek

    2015-01-01

    SUMMARY Type 2 diabetes and other noncommunicable diseases are a growing public health challenge globally. An estimated 285 million people, corresponding to 6.4% of the world’s adult population, has diabetes, which is expected to reach 552 million by the International Diabetes Federation in 2030. A much larger segment of the world’s population, approximating 79 million individuals in the USA alone, has prediabetes. Globally, a relatively small percentage of those with diabetes or prediabetes are diagnosed with the potential for developing chronic complications. To address this epidemic, governments, in concert with the private sector, need to set policies that promote healthy nutritional and agricultural policies, favor modifications in the environment that encourage greater physical activity and make prevention affordable for all citizens at high risk. The public health sector has the charge of translating evidence-based findings into practical, accessible and cost-effective programs and monitoring the process to continuously improve prevention initiatives. The clinical sector has the formidable challenge of screening and identifying those at high risk and referring them to accredited intervention programs. There is a need to explore additional cost-effective interventions that are customized to meet individual needs that can be offered at the community and clinical levels. Thus, all three sectors, government, public health and clinical, each have a critical role in this process and by working in a partnership, ought to create the necessary synergies essential for making substantial forays in the prevention of Type 2 diabetes. PMID:26339296

  4. A preventive maintenance policy for a standby system subject to internal failures and external shocks with loss of units

    NASA Astrophysics Data System (ADS)

    Eloy Ruiz-Castro, Juan

    2015-07-01

    In many situations, serious damage and considerable financial losses are caused by non-repairable failures of a system. Redundant systems and maintenance policies are commonly employed to improve reliability. This paper is focused on the modelling of a complex cold standby system by analysing the effectiveness and costs of preventive maintenance, always in an algorithmic form. The online unit of the system is subject to wear failures and external shocks. The online unit can go through an indeterminate number of degradation levels before failure. This one is observed when inspections occur. Inspections are performed at random intervals, and when one takes place, the unit is taken to the preventive maintenance facility if it is necessary. The preventive maintenance time and cost is different depending on the degradation level observed. If only one unit is performing, a minimal maintenance policy is adopted in order to optimise system behaviour. Reliability measures such as the conditional probability of failure are worked out in a well-structured and algebraic form in transient and stationary regimes by using algorithmic methods. The stationary distribution is calculated using matrix analytic methods, and rewards are included in the model. An optimisation example shows the versatility of the model presented.

  5. Preventive Intervention for Early Childhood Behavioral Problems: An Ecological Perspective

    PubMed Central

    Shepard, Stephanie A.; Dickstein, Susan

    2009-01-01

    The purpose of this paper is to highlight the importance of preventive interventions targeting parents when addressing early childhood behavior problems. We briefly review evidence-based parent management training programs (PMT), focusing on one particular program, the Incredible Years Series (IY). Next, we discuss the barriers to embedding evidence-based practice like IY in community contexts, and demonstrate how early childhood mental health consultation can be used to enhance community capacity to adopt evidence-based practice and improve outcomes for the large number of young children and their families in need. PMID:19486845

  6. Psychosocial perspectives and the issue of prevention in childhood obesity.

    PubMed

    Stein, Daniel; Weinberger-Litman, Sarah L; Latzer, Yael

    2014-01-01

    A dramatic increase in childhood overweight/obesity has been recognized globally over the past 50 years. This observed increase may reflect genetic, as well as psychological, environmental, and socio-cultural influences. In the first part of this review, we present an updated summary of the psychosocial factors associated with this change and discuss possible ways in which they operate. Among these factors, lower socio economic status (in both industrialized and non-industrialized countries), being female, belonging to a minority group, and being exposed to adverse life events may all be associated with a greater risk of childhood overweight/obesity. These influences may be mediated via a variety of mechanisms, in particular above-average food intake of low nutritional quality and reduction in physical activity. Other important psychosocial mediators include the influence of the family and peer environment, and exposure to the media. In the second part of the review, we discuss the potential of psychosocial prevention programs to intervene in the processes involved in the rise of childhood overweight/obesity. Two points are emphasized. First, prevention programs should be multidisciplinary, combining the knowledge of experts from different professions, and taking into consideration the important role of the family environment and relevant influential social organizations, particularly school. Second, effective change is unlikely to occur without large-scale programs carried out on a public policy level.

  7. Psychosocial Perspectives and the Issue of Prevention in Childhood Obesity

    PubMed Central

    Stein, Daniel; Weinberger-Litman, Sarah L.; Latzer, Yael

    2014-01-01

    A dramatic increase in childhood overweight/obesity has been recognized globally over the past 50 years. This observed increase may reflect genetic, as well as psychological, environmental, and socio-cultural influences. In the first part of this review, we present an updated summary of the psychosocial factors associated with this change and discuss possible ways in which they operate. Among these factors, lower socio economic status (in both industrialized and non-industrialized countries), being female, belonging to a minority group, and being exposed to adverse life events may all be associated with a greater risk of childhood overweight/obesity. These influences may be mediated via a variety of mechanisms, in particular above-average food intake of low nutritional quality and reduction in physical activity. Other important psychosocial mediators include the influence of the family and peer environment, and exposure to the media. In the second part of the review, we discuss the potential of psychosocial prevention programs to intervene in the processes involved in the rise of childhood overweight/obesity. Two points are emphasized. First, prevention programs should be multidisciplinary, combining the knowledge of experts from different professions, and taking into consideration the important role of the family environment and relevant influential social organizations, particularly school. Second, effective change is unlikely to occur without large-scale programs carried out on a public policy level. PMID:25133140

  8. Youth Sports: A Pediatrician's Perspective on Coaching and Injury Prevention

    PubMed Central

    Koester, Michael C.

    2000-01-01

    Objective: My objective is to review the factors that influence youth participation in sports, to discuss the role coaches may play in youth sports injuries, and to call on athletic trainers and other health professionals to become involved in youth sports in an effort to limit injury risk. Background: Millions of American youths participate in team sports. Their primary motivation to participate is to have fun. Unfortunately, large numbers of participants have sustained correspondingly large numbers of injuries. Many injuries can be attributed to improper technique and conditioning methods taught by volunteer coaches. Although not the only contributors to injuries, these may be the most amenable to preventive measures, such as formal instruction for coaches in the areas of proper biomechanics and player-coach communication. Description: I provide an overview of the reasons why children participate in sports, discuss participation motivation, and review the literature on coaches' communication methods that have been proved effective in maximizing learning and enjoyment for young athletes. Clinical Advantages: This article provides certified athletic trainers with the background knowledge needed to take an active role in youth sports injury prevention at the community level. PMID:16558664

  9. Perspective: Physician education: a promising strategy to prevent adolescent suicide.

    PubMed

    Taliaferro, Lindsay A; Borowsky, Iris Wagman

    2011-03-01

    Many young people who present to primary care providers (PCPs) have high levels of emotional distress and/or suicidal ideation. Therefore, PCPs are in an ideal position to recognize and respond to early symptoms and distress signals that accompany suicide warning signs, yet they underrecognize mood disorders and suicidality among youth. Medical school and residency programs typically provide inadequate training on pediatric mental health and adolescent suicide prevention. Thus, PCPs lack complete knowledge of risk factors and feel unprepared to handle mental health problems among youth. In this article, the authors provide an overview of the epidemiology of adolescent suicide and describe risk factors, protective factors, and warning signs. They propose that physician education represents a promising strategy to prevent adolescent suicide, and they establish the need for improved educational opportunities that would provide PCPs with the necessary skills and supports to identify and respond to psychosocial concerns that may increase suicide risk among youth. They recommend strategies, methods, and content areas for addressing educational gaps, as well as organizational approaches to support enhanced physician education. They also suggest areas for future research.

  10. Hazard report. Shift checks and semiannual preventive maintenance are important in detecting critical failures in Zoll M series defibrillators.

    PubMed

    2009-05-01

    The manufacturer-recommended shift check for Zoll M Series defibrillators cannot detect some critical failures that could inhibit defibrillation or pacing. To improve detection of these failures and to limit their impact on patient care, hospitals should perform not only the routine perform not only the routine shift check, but also the twice-annual preventive maintenance procedure recommended by Zoll. Additionally, units exhibiting an error code--even one that appears to resolve itself--should be immediately removed from service and evaluated by the clinical engineering department.

  11. Client and Provider Perspectives on New HIV Prevention Tools for MSM in the Americas

    PubMed Central

    Lippman, Sheri A.; Koester, Kimberly A.; Amico, K. Rivet; Lama, Javier R.; Martinez Fernandes, Nilo; Gonzales, Pedro; Grinsztejn, Beatriz; Liu, Al; Buchbinder, Susan; Koblin, Beryl A.

    2015-01-01

    Men who have sex with men (MSM) in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP) and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers’ opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM. PMID:25826246

  12. Client and provider perspectives on new HIV prevention tools for MSM in the Americas.

    PubMed

    Lippman, Sheri A; Koester, Kimberly A; Amico, K Rivet; Lama, Javier R; Martinez Fernandes, Nilo; Gonzales, Pedro; Grinsztejn, Beatriz; Liu, Al; Buchbinder, Susan; Koblin, Beryl A

    2015-01-01

    Men who have sex with men (MSM) in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP) and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers' opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM.

  13. Food Policy Approaches to Obesity Prevention: An International Perspective

    PubMed Central

    Zhang, Qi; Liu, Shiyong; Liu, Ruicui; Xue, Hong

    2015-01-01

    This paper provides a comprehensive overview of the recent obesity prevention–related food policies initiated in countries worldwide. We searched and reviewed relevant research papers and government documents, focusing on those related to dietary guidelines, food labeling, regulation of food marketing, and policies affecting food prices. We also commented on the effects and challenges of some of the related policy options. There are large variations regarding what, when, and how policies have been implemented across countries. Clearly, developed countries are leading the effort, and developing countries are starting to develop some related policies. The encouraging message is that many countries have been adopting policies that might help prevent obesity and that the support for more related initiatives is strong and continues to grow. Communicating information about these practices will help researchers, public health professionals, and policy makers around the world to take action to fight the growing epidemic of obesity and other nutrition-related diseases. PMID:25705571

  14. Best practices for preventing musculoskeletal disorders in masonry: stakeholder perspectives.

    PubMed

    Entzel, Pamela; Albers, Jim; Welch, Laura

    2007-09-01

    Brick masons and mason tenders report a high prevalence of work-related musculoskeletal disorders (WMSDs), many of which can be prevented with changes in materials, work equipment or work practices. To explore the use of "best practices" in the masonry industry, NIOSH organized a 2-day meeting of masonry stakeholders. Attendees included 30 industry representatives, 5 health and safety researchers, 4 health/safety specialists, 2 ergonomic consultants, and 2 representatives of state workers' compensation programs. Small groups discussed ergonomic interventions currently utilized in the masonry industry, including factors affecting intervention implementation and ways to promote diffusion of interventions. Meeting participants also identified various barriers to intervention implementation, including business considerations, quality concerns, design issues, supply problems, jobsite conditions and management practices that can slow or limit intervention diffusion. To be successful, future diffusion efforts must not only raise awareness of available solutions but also address these practical concerns.

  15. Environmental vascular risk factors: new perspectives for stroke prevention.

    PubMed

    Bernal-Pacheco, Oscar; Román, Gustavo C

    2007-11-15

    Despite intensive evaluation of acute stroke patients, perhaps only half of the attributable stroke risk is usually identified. In addition to traditional and non-traditional vascular risk factors-including most recently homocysteine, inflammation, and alterations of coagulation-a number of environmental risk factors for stroke have been identified in the last decade. In this update we review the following: lower education and poor socioeconomic status (probable surrogates for exposure to traditional high-risk behaviors such as smoking, poor nutrition, lack of prenatal control, absence of preventive medical and dental care, and non-compliance of treatment of conditions such as hypertension); depression, stress and affective disorders; obstructive sleep apnea; passive smoking and environmental pollution; infections, in particular periodontal diseases that increase C-reactive protein (CRP); raised body mass index (obesity); exercise, and diet. The possible role of high-fructose corn syrup in the epidemic of obesity in the USA is reviewed. Protective diets include higher consumption of fish, olive oil, grains, fruits and vegetables (Mediterranean diet), as well as probiotic bacteria in yogurt and dairy products. Careful attention should be given to the patient's environment looking for modifiable factors. The effects of clean environmental air and water, adequate diet and appropriate nutrition, healthy teeth, exercise, and refreshing sleep in the prevention of stroke and cardiovascular disease appear to be quite compelling. Although some of these modifiable risk factors lack evidence-based information, judicious clinical sense should be used to counteract the potentially damaging effects of adverse environmental vascular risk factors.

  16. Advanced composites: Design and application. Proceedings of the meeting of the Mechanical Failures Prevention Group

    NASA Technical Reports Server (NTRS)

    Shives, T. R.; Willard, W. A.

    1979-01-01

    The design and application of advanced composites is discussed with emphasis on aerospace, aircraft, automotive, marine, and industrial applications. Failure modes in advanced composites are also discussed.

  17. Inhibition of Apoptosis-Regulated Signaling Kinase-1 and Prevention of Congestive Heart Failure by Estrogen

    PubMed Central

    Satoh, Minoru; Matter, Christian M.; Ogita, Hisakazu; Takeshita, Kyosuke; Wang, Chao-Yung; Dorn, Gerald W.; Liao, James K.

    2008-01-01

    Background Epidemiological studies have shown gender differences in the incidence of congestive heart failure (CHF); however, the role of estrogen in CHF is not known. We hypothesize that estrogen prevents cardiomyocyte apoptosis and the development of CHF. Methods and Results 17β-Estradiol (E2, 0.5 mg/60-day release) or placebo pellet was implanted subcutaneously into male Gαq transgenic (Gq) mice. After 8 weeks, E2 treatment decreased the extent of cardiac hypertrophy and dilation and improved contractility in Gq mice. E2 treatment also attenuated nicotinamide adenine dinucleotide phosphate oxidase activity and superoxide anion production via downregulation of Rac1. This correlated with reduced apoptosis in cardiomyocytes of Gq mice. The antioxidative properties of E2 were also associated with increased expression of thioredoxin (Trx), Trx reductases, and Trx reductase activity in the hearts of Gq mice. Furthermore, the activation of apoptosis signal-regulating kinase 1 and its downstream effectors, c-Jun N-terminal kinase and p38 mitogen-activated protein kinase, in the hearts of Gq mice was reduced by long-term E2 treatment. Indeed, E2 (10 nmol/L)-treated cardiomyocytes were much more resistant to angiotensin II–induced apoptosis. These antiapoptotic and cardioprotective effects of E2 were blocked by an estrogen receptor antagonist (ICI 182,780) and by a Trx reductase inhibitor (azelaic acid). Conclusions These findings indicate that long-term E2 treatment improves CHF by antioxidative mechanisms that involve the upregulation of Trx and inhibition of Rac1-mediated attenuated nicotinamide adenine dinucleotide phosphate oxidase activity and apoptosis signal-regulating kinase 1 /c-Jun N-terminal kinase/p38 mitogen-activated protein kinase–mediated apoptosis. These results suggest that estrogen may be a useful adjunctive therapy for patients with CHF. PMID:17562954

  18. Condensin and the spindle midzone prevent cytokinesis failure induced by chromatin bridges in C. elegans embryos

    PubMed Central

    Bembenek, Joshua N.; Verbrugghe, Koen J.C.; Khanikar, Jayshree; Csankovszki, Györgyi; Chan, Raymond C.

    2013-01-01

    Summary Background During cell division, chromosomes must clear the path of the cleavage furrow before the onset of cytokinesis. The abscission checkpoint in mammalian cells stabilizes the cleavage furrow in the presence of a chromatin obstruction. This provides time to resolve the obstruction before the cleavage furrow regresses or breaks the chromosomes, preventing aneuploidy or DNA damage. Two unanswered questions in the proposed mechanistic pathway of the abscission checkpoint concern factors involved in 1) resolving the obstructions, and 2) coordinating obstruction resolution with the delay in cytokinesis. Results We found that the 1-cell and 2-cell C. elegans embryos suppress furrow regression following depletion of essential chromosome segregation factors: topoisomerase IITOP-2, CENP-AHCP-3, cohesin, and to a lesser degree, condensin. Chromatin obstructions activated Aurora BAIR-2 at the spindle midzone, which is needed for the abscission checkpoint in other systems. Condensin I, but not condensin II, localizes to the spindle midzone in anaphase and to the midbody during normal cytokinesis. Interestingly, condensin I is enriched on chromatin bridges and near the midzone/midbody in an AIR-2 dependent manner. Disruption of AIR-2, the spindle midzone or condensin leads to cytokinesis failure in a chromatin-obstruction-dependent manner. Examination of the condensin-deficient embryos uncovered defects in both the resolution of the chromatin obstructions and the maintenance of the stable cleavage furrow. Conclusions We postulate that condensin I is recruited by Aurora BAIR-2 to aid in the resolution of chromatin obstructions and also helps generate a signal to maintain the delay in cytokinesis. PMID:23684975

  19. Supporting Vulnerable Learners in the Primary Grades: Strategies To Prevent Early School Failure.

    ERIC Educational Resources Information Center

    Stormont, Melissa; Espinosa, Linda; Knipping, Nancy; McCathren, Rebecca

    2003-01-01

    This article provides early elementary school teachers with specific strategies to support the diverse needs of children who are vulnerable for failure in school. Children who are vulnerable include those who have an increased risk for failure because of specific characteristics that have been found to predict problems in school, such as poverty.…

  20. Prevention preferable to treatment: 3 case reports of patients experiencing right-sided heart failure after Ebstein anomaly correction

    PubMed Central

    Luo, Ming; Lin, Jing; Qin, Zhen; Du, Lei

    2017-01-01

    Abstract Rationale: Ebstein anomaly is a common congenital heart disease that may induce severe tricuspid regurgitation and dilation of the “atrialized” portion of the right ventricle. Patients who undergo surgery to correct Ebstein anomaly are at high risk of postoperative right-sided heart failure, yet little is known about what pre-, peri-, or postoperative procedures may help reduce this risk. Patient concerns: Here, we describe 3 cases of adults with Ebstein anomaly who underwent corrective surgery and in whom right-sided heart failure occurred with severe tricuspid regurgitation detected by transesophageal echocardiography. Diagnoses: Ebstein anomaly. Intervention: Various approaches were applied to prevent right heart failure: perioperative control of atrial and ventricle arrhythmia, protection of myocardium, reduction of right-side cardiac workload after cardiopulmonary bypass, and mechanical support for right heart. Outcomes: One of the 3 patients died, another experienced kidney failure despite postoperative support on extracorporeal membrane oxygenation, and the third patient survived without complications. Lessons: Our case series suggests that surgical prognosis can be improved through aggressive preoperative treatment, vasoactive and anti-arrhythmia medications, and comprehensive measures designed to reduce myocardial injury, prevent myocardial edema, and reduce pre- and afterload on the right ventricle. PMID:28072699

  1. Caregiver perspectives for the prevention, diagnosis and treatment of childhood giardiasis in Havana City, Cuba. A qualitative study.

    PubMed

    Escobedo, Angel A; Almirall, Pedro; Alfonso, Maydel; Avila, Ivonne; Cimerman, Sérgio; Salazar, Yohana; Dawkins, Isabel V; García, Rosa M

    2011-08-01

    Although long considered a non-pathogenic protozoan, Giardia lamblia is now a well recognized cause of abdominal discomfort, diarrhoea and failure-to-thrive in children. The overall prevalence of this infection in Cuban population is about 7.2%; however, higher prevalences have been found among young children attending day-care centres and primary school in the country. Anecdotally, clinical giardiasis is generally considered to place a large burden on both diagnostic and treatment services in Cuba. In order to gain insight into caregivers' perspectives with respect to this infection in children, a qualitative study was carried out in a paediatric hospital in Cuba. Focus group discussions were conducted to gather information about the awareness of the giardiasis, their mode of transmission and symptoms, diagnosis process, treatment seeking behaviour, possible ways of prevention, and barriers for not adopting preventive behaviours, the source and channels of information about this disease. Caregivers have knowledge of giardiasis, although there were myths and misconceptions regarding giardiasis. Manifestations like diarrhoea, abdominal pain and nausea were cited; however, asymptomatic forms of these infections are hardly accepted. Boiling water and washing hands before eating and after defecation and washing vegetables were mentioned among the principal ways of preventing this infection. The most commonly mentioned reasons for not adopting preventive behaviours included lack of time due to outdoor activities and limitation of combustible distribution. Treatment-seeking behaviour when giardiasis suspected mainly included visiting the nearby family doctor. The findings of this study reveal the need for a health education intervention in areas of misperceptions and confusion.

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

    PubMed Central

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

    2015-01-01

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

  3. The causes and prevention of cancer: gaining perspective.

    PubMed Central

    Ames, B N; Gold, L S

    1997-01-01

    Epidemiological studies have identified several factors that are likely to have a major effect on reducing rates of cancer: reduction of smoking, increased consumption of fruits and vegetables, and control of infections. Other factors include avoidance of intense sun exposure, increased physical activity, and reduced consumption of alcohol and possibly red meat. Risks of many types of cancer can already be reduced, and the potential for further reductions is great. In the United States, cancer death rates for all cancers combined are decreasing, if lung cancer (90% of which is due to smoking), is excluded from the analysis. We review the research on causes of cancer and show why much cancer is preventable. The idea that traces of synthetic chemicals, such as DDT, are major contributors to human cancer is not supported by the evidence, yet public concern and resource allocation for reduction of chemical pollution are very high, in part because standard risk assessment uses linear extrapolation from limited data in high-dose animal cancer tests. These tests are done at the maximum tolerated dose (MTD) and are typically misinterpreted to mean that low doses of synthetic chemicals and industrial pollutants are relevant to human cancer. About half the chemicals tested, whether synthetic or natural, are carcinogenic to rodents at such high doses. Almost all chemicals in the human diet are natural. For example, 99.99% of the pesticides we eat are naturally present in plants to ward off insects and other predators. Half of the natural pesticides that have been tested at the MTD are rodent carcinogens. Cooking food produces large numbers of natural dietary chemicals. Roasted coffee, for example, contains more than 1000 chemicals: of 27 tested, 19 are rodent carcinogens. Increasing evidence supports the idea that the high frequency of positive results in rodent bioassays is due to testing at the MTD, which frequently can cause chronic cell killing and consequent cell

  4. Economic Statistical Design of Integrated X-bar-S Control Chart with Preventive Maintenance and General Failure Distribution

    PubMed Central

    Caballero Morales, Santiago Omar

    2013-01-01

    The application of Preventive Maintenance (PM) and Statistical Process Control (SPC) are important practices to achieve high product quality, small frequency of failures, and cost reduction in a production process. However there are some points that have not been explored in depth about its joint application. First, most SPC is performed with the X-bar control chart which does not fully consider the variability of the production process. Second, many studies of design of control charts consider just the economic aspect while statistical restrictions must be considered to achieve charts with low probabilities of false detection of failures. Third, the effect of PM on processes with different failure probability distributions has not been studied. Hence, this paper covers these points, presenting the Economic Statistical Design (ESD) of joint X-bar-S control charts with a cost model that integrates PM with general failure distribution. Experiments showed statistically significant reductions in costs when PM is performed on processes with high failure rates and reductions in the sampling frequency of units for testing under SPC. PMID:23527082

  5. Economic Statistical Design of integrated X-bar-S control chart with Preventive Maintenance and general failure distribution.

    PubMed

    Caballero Morales, Santiago Omar

    2013-01-01

    The application of Preventive Maintenance (PM) and Statistical Process Control (SPC) are important practices to achieve high product quality, small frequency of failures, and cost reduction in a production process. However there are some points that have not been explored in depth about its joint application. First, most SPC is performed with the X-bar control chart which does not fully consider the variability of the production process. Second, many studies of design of control charts consider just the economic aspect while statistical restrictions must be considered to achieve charts with low probabilities of false detection of failures. Third, the effect of PM on processes with different failure probability distributions has not been studied. Hence, this paper covers these points, presenting the Economic Statistical Design (ESD) of joint X-bar-S control charts with a cost model that integrates PM with general failure distribution. Experiments showed statistically significant reductions in costs when PM is performed on processes with high failure rates and reductions in the sampling frequency of units for testing under SPC.

  6. Role of the family in suicide prevention: an attachment and family systems perspective.

    PubMed

    Lobo Prabhu, Sheila; Molinari, Victor; Bowers, Theron; Lomax, James

    2010-01-01

    Suicide can be an act of despair, anger, or escape from intolerable pain associated with prior bonding disturbances within the family system, interpersonal loss, and current perceived lack of social support. Using a variety of online databases, the authors examined the research on the family's role in preventing suicide from an attachment and family systems perspective. They found relevant articles describing how to make use of family support in suicide prevention. From a study of the literature, the authors outline three new family concepts in suicide prevention: family cohesion, family adhesion, and formation of a new family. Therapists should use every familial resource to avoid premature closure and to expand perception of support options. The authors suggest specific practice recommendations to successfully involve families in suicide prevention based on the outlined family conceptual framework, and they recommend research investigation to determine empirical validation of these tentative formulations.

  7. Aligning product development and user perspectives: social-behavioural dimensions of multipurpose prevention technologies.

    PubMed

    Brady, M; Tolley, E

    2014-10-01

    Multipurpose prevention technologies provide a compelling response to the multiple and reinforcing sexual and reproductive health risks faced by women globally. To ensure that this potential is realised, product-specific characteristics and their social-behavioural correlates must be considered early in the product development process. This paper provides an overview of the key user-related social and behavioural dimensions of three broad categories of multipurpose prevention technologies: 1) sustained release vaginal rings, 2) pericoital vaginal products, and 3) co-formulated or co-administered injectables. The authors build upon the broad parameters of Target Product Profiles for such products, aligning them with user perspective considerations.

  8. A marketing perspective on disseminating evidence-based approaches to disease prevention and health promotion.

    PubMed

    Maibach, Edward W; Van Duyn, Mary Ann S; Bloodgood, Bonny

    2006-07-01

    Evidence-based disease prevention practice guidelines can provide a rationale for health programming decisions, which should, in turn, lead to improved public health outcomes. This logic has stimulated the creation of a growing number of evidence-based prevention practice guidelines, including the Guide to Community Preventive Services. Few systematic efforts have been made to document the degree of adoption and implementation of these approaches, although the evidence on translation of research into practice in other health fields indicates that the adoption and implementation rate is low. Drawing on the marketing literature, we suggest three approaches to enhance the adoption and implementation of evidence-based approaches: 1) conducting consumer research with prospective adopters to identify their perspectives on how evidence-based prevention programs can advance their organization's mission, 2) building sustainable distribution channels to promote and deliver evidence-based programs to prospective adopters, and 3) improving access to easily implemented programs that are consistent with evidence-based guidelines. Newly emerging paradigms of prevention research (e.g., RE-AIM) that are more attuned to the needs of the marketplace will likely yield a new generation of evidence-based preventive approaches that can be more effectively disseminated. We suggest that the public health community prioritize the dissemination of evidence-based prevention approaches, because doing so is a potent environmental change strategy for enhancing health.

  9. F 16915 prevents heart failure-induced atrial fibrillation: a promising new drug as upstream therapy.

    PubMed

    Le Grand, Bruno; Letienne, Robert; Dupont-Passelaigue, Elisabeth; Lantoine-Adam, Frédérique; Longo, Frédéric; David-Dufilho, Monique; Michael, Georghia; Nishida, Kunihiro; Catheline, Daniel; Legrand, Philippe; Hatem, Stéphane; Nattel, Stanley

    2014-07-01

    Atrial fibrillation (AF) is a common complication of heart failure. The aim of the present study was to investigate the effects of a new pure docosahexaenoic acid derivative called F 16915 in experimental models of heart failure-induced atria dysfunction. The atrial dysfunction-induced AF was investigated (1) in a dog model of tachypacing-induced congestive heart failure and (2) in a rat model of heart failure induced by occlusion of left descending coronary artery and 2 months reperfusion. F 16915 (5 g/day for 4 weeks) significantly reduced the mean duration of AF induced by burst pacing in the dog model (989 ± 111 s in the vehicle group to 79 ± 59 s with F 16915, P < 0.01). This dose of F 16915 also significantly reduced the incidence of sustained AF (5/5 dogs in the vehicle group versus 1/5 with F 16915, P < 0.05). In the rat model, the percentage of shortening fraction in the F 16915 group (100 mg/kg p.o. daily) was significantly restored after 2 months (32.6 ± 7.4 %, n = 9 vs 17.6 ± 3.4 %, n = 9 in the vehicle group, P < 0.01). F 16915 also reduced the de-phosphorylation of connexin43 from atria tissue. The present results show that treatment with F 16915 reduced the heart dilation, resynchronized the gap junction activity, and reduced the AF duration in models of heart failure. Thus, F 16915 constitutes a promising new drug as upstream therapy for the treatment of AF in patients with heart failure.

  10. Aircraft Loss-of-Control Accident Prevention: Switching Control of the GTM Aircraft with Elevator Jam Failures

    NASA Technical Reports Server (NTRS)

    Chang, Bor-Chin; Kwatny, Harry G.; Belcastro, Christine; Belcastro, Celeste

    2008-01-01

    Switching control, servomechanism, and H2 control theory are used to provide a practical and easy-to-implement solution for the actuator jam problem. A jammed actuator not only causes a reduction of control authority, but also creates a persistent disturbance with uncertain amplitude. The longitudinal dynamics model of the NASA GTM UAV is employed to demonstrate that a single fixed reconfigured controller design based on the proposed approach is capable of accommodating an elevator jam failure with arbitrary jam position as long as the thrust control has enough control authority. This paper is a first step towards solving a more comprehensive in-flight loss-of-control accident prevention problem that involves multiple actuator failures, structure damages, unanticipated faults, and nonlinear upset regime recovery, etc.

  11. Compliance with infection prevention and control in oral health-care facilities: a global perspective.

    PubMed

    Oosthuysen, Jeanné; Potgieter, Elsa; Fossey, Annabel

    2014-12-01

    Many publications are available on the topic of compliance with infection prevention and control in oral health-care facilities all over the world. The approaches of developing and developed countries show wide variation, but the principles of infection prevention and control are the same globally. This study is a systematic review and global perspective of the available literature on infection prevention and control in oral health-care facilities. Nine focus areas on compliance with infection-control measures were investigated: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; and some special considerations. Various international studies from developed countries have reported highly scientific evidence-based information. In developed countries, the resources for infection prevention and control are freely available, which is not the case in developing countries. The studies in developing countries also indicate serious shortcomings with regard to infection prevention and control knowledge and education in oral health-care facilities. This review highlights the fact that availability of resources will always be a challenge, but more so in developing countries. This presents unique challenges and the opportunity for innovative thinking to promote infection prevention and control.

  12. Primary Prevention of Reading Failure: Effect of Universal Peer Tutoring in the Early Grades

    ERIC Educational Resources Information Center

    Jones, Giavana; Ostojic, Dragana; Menard, Jessica; Picard, Erin; Miller, Carlin J.

    2017-01-01

    Reading is typically considered a survival skill in our technology- and literacy-bound culture. Individuals who struggle with learning to read are at significantly elevated risk for a number of negative outcomes, including school failure, under- and unemployment, and special education placement. Thus, those who do not learn to read fluently will…

  13. High saturated fat feeding prevents left ventricular dysfunction and enhances mitochondrial function in heart failure

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Accumulation of lipids in the heart is associated with contractile dysfunction, and has been proposed to be a causative factor in mitochondrial dysfunction. We have previously shown that administration of a high saturated fat diet in heart failure (HF) increased mitochondrial respiration and ETC com...

  14. ISS Ammonia Pump Failure, Recovery, and Lesson Learned A Hydrodynamic Bearing Perspective

    NASA Technical Reports Server (NTRS)

    Bruckner, Robert J.; Manco, Richard A., II

    2014-01-01

    The design, development, and operation of long duration spaceflight hardware has become an evolutionary process in which meticulous attention to details and lessons learned from previous experiences play a critical role. Invaluable to this process is the ability to retrieve and examine spaceflight hardware that has experienced a premature failure. While these situations are rare and unfortunate, the failure investigation and recovery from the event serve a valuable purpose in advancing future space mechanism development. Such a scenario began on July 31, 2010 with the premature failure of an ammonia pump on the external active thermal control system of the International Space Station. The ground-based inspections of the returned pump and ensuing failure investigation revealed five potential bearing forces that were un-accounted for in the design phase and qualification testing of the pump. These forces could combine in a number of random orientations to overload the pump bearings leading to solid-surface contact, wear, and premature failure. The recovery plan identified one of these five forces as being related to the square of the operating speed of the pump and this fact was used to recover design life through a change in flight rules for the operation of the pump module. Through the course of the failure investigation, recovery, and follow-on assessment of pump wear life, design guidance has been developed to improve the life of future mechanically pumped thermal control systems for both human and robotic exploration missions.

  15. EPA, not DHA, prevents fibrosis in pressure overload-induced heart failure: potential role of free fatty acid receptor 4.

    PubMed

    Eclov, Julie A; Qian, Qingwen; Redetzke, Rebecca; Chen, Quanhai; Wu, Steven C; Healy, Chastity L; Ortmeier, Steven B; Harmon, Erin; Shearer, Gregory C; O'Connell, Timothy D

    2015-12-01

    Heart failure with preserved ejection fraction (HFpEF) is half of all HF, but standard HF therapies are ineffective. Diastolic dysfunction, often secondary to interstitial fibrosis, is common in HFpEF. Previously, we found that supra-physiologic levels of ω3-PUFAs produced by 12 weeks of ω3-dietary supplementation prevented fibrosis and contractile dysfunction following pressure overload [transverse aortic constriction (TAC)], a model that resembles aspects of remodeling in HFpEF. This raised several questions regarding ω3-concentration-dependent cardioprotection, the specific role of EPA and DHA, and the relationship between prevention of fibrosis and contractile dysfunction. To achieve more clinically relevant ω3-levels and test individual ω3-PUFAs, we shortened the ω3-diet regimen and used EPA- and DHA-specific diets to examine remodeling following TAC. The shorter diet regimen produced ω3-PUFA levels closer to Western clinics. Further, EPA, but not DHA, prevented fibrosis following TAC. However, neither ω3-PUFA prevented contractile dysfunction, perhaps due to reduced uptake of ω3-PUFA. Interestingly, EPA did not accumulate in cardiac fibroblasts. However, FFA receptor 4, a G protein-coupled receptor for ω3-PUFAs, was sufficient and required to block transforming growth factor β1-fibrotic signaling in cultured cardiac fibroblasts, suggesting a novel mechanism for EPA. In summary, EPA-mediated prevention of fibrosis could represent a novel therapy for HFpEF.

  16. Psychosis Prevention: A Modified Clinical High Risk Perspective From the Recognition and Prevention (RAP) Program

    PubMed Central

    Cornblatt, Barbara A.; Carrión, Ricardo E.; Auther, Andrea; McLaughlin, Danielle; Olsen, Ruth H.; John, Majnu; Correll, Christoph U.

    2016-01-01

    Objective Early intervention and prevention of psychosis remain a major challenge. Prediction would be greatly advanced with improved ability to identify individuals at true risk, which, at present, is moderate at best. The authors tested a modified strategy to improve prediction by selecting a more homogeneous high-risk sample (attenuated positive symptom criteria only, age range of mid-teens to early 20s) than is currently standard, combined with a systematic selection of neurodevelopmental deficits. Method A sample of 101 treatment-seeking adolescents (mean age, 15.9 years) at clinical high risk for psychosis were followed clinically for up to 5 years (mean follow-up time, 3.0 years, SD=1.6). Adolescents were included only if they exhibited one or more attenuated positive symptoms at moderate to severe, but not psychotic, severity levels. Cox regression was used to derive a risk index. Results The overall conversion rate to psychosis was 28.3%. The final predictor model, with a positive predictive validity of 81.8%, consisted of four variables: disorganized communication, suspiciousness, verbal memory deficits, and decline in social functioning during follow-up. Significant effects also suggest narrowing the risk age range to 15–22 years. Conclusions Clinical high risk criteria that emphasize disorganized communication and suspiciousness while also including compromised verbal memory and declining social functioning have the potential to improve predictive accuracy compared with attenuated positive symptoms used alone. On the resulting risk index (a weighted combination of the predictors), low scores were interpreted as signifying minimal risk, with little treatment necessary, high scores as suggesting aggressive intervention, and intermediate scores, although less informative, as supporting psychosocial treatment. PMID:26046336

  17. Plasmodium vivax infections in U.S. Army troops: failure of primaquine to prevent relapse in studies from Somalia.

    PubMed

    Smoak, B L; DeFraites, R F; Magill, A J; Kain, K C; Wellde, B T

    1997-02-01

    Different strains of Plasmodium vivax vary in their sensitivity to primaquine, the only drug that prevents relapses. Described are the clinical data and relapse pattern for 75 soldiers treated for vivax malaria since returning from Somalia. Following their initial attack of malaria, 60 of the 75 cases received a standard course of primaquine (15 mg base daily for 14 days). Twenty-six of the 60 soldiers subsequently relapsed for a failure rate of 43%. Eight soldiers had a second relapse following primaquine therapy after both the primary attack and first relapse. Three of these soldiers had received a higher dosage of primaquine (30 mg base daily for 14 days) after their second attack. The apparent ineffectiveness of primaquine therapy in preventing relapses suggests the presence of primaquine-resistant P. vivax strains in Somalia.

  18. Success, Failure, and Unfinished Business of Education, Prevention, Policy, and Intervention Programs on Substance Misuse in Brazilian Sport.

    PubMed

    Santos, Azenildo M

    2015-01-01

    The current Brazilian situation is such that it is difficult to obtain a worldwide evaluation of failure in education, intervention, or prevention programs. How fragile Brazil's anti-doping system is, its appropriateness as well as its relevance, with needed policy infrastructures for achieving the selected goals, and how wide the gap is between education and prevention program effectiveness between high-performance athletes and recreational practitioners who just want to look good. An additional concern, and ever present flaw regarding Brazil's "common sportsman" in day-to-day society is their not receiving known and necessary "sports education," enabling the development of an "at-risk" population for self-harm. Reflections on public health policy are noted.

  19. Prevention of Post-Radiotherapy Failure in Prostate Cancer by Vitamin D

    DTIC Science & Technology

    2003-03-01

    failure), hypertension, muscle calcification , muscle weakness, and formation of calcium plaques in the eye. Individuals with known hVpercalcemia, known...survey associated a higher calcium and vitamin D intake with a lower incidence of colon cancer.1 2 Well-designed clinical trials need to be conducted to...of vitamin D. Eur J Clin Nutr 1997;51 Suppl 1:S76-9. 4. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes : Calcium

  20. Reducing risk of Anthracycline-related heart failure after childhood cancer | Division of Cancer Prevention

    Cancer.gov

    DESCRIPTION (provided by applicant): Childhood cancer survivors are at a 15-fold risk of developing heart failure (HF) compared to age-matched controls. There is a strong dose-dependent association between anthracyclines and risk of HF;the incidence approaches 20% at cumulative doses between 300-600 mg/m2, and exceeds 30% for doses >600 mg/m2. Outcome following HF is poor;5-year survival rate is |

  1. A perspective on sympathetic renal denervation in chronic congestive heart failure.

    PubMed

    Madanieh, Raef; El-Hunjul, Mohammed; Alkhawam, Hassan; Kosmas, Constantine E; Madanieh, Abed; Vittorio, Timothy J

    2016-01-01

    Medical therapy has indisputably been the mainstay of management for chronic congestive heart failure. However, a significant percentage of patients continue to experience worsening heart failure (HF) symptoms despite treatment with multiple therapeutic agents. Recently, catheter-based interventional strategies that interrupt the renal sympathetic nervous system have shown promising results in providing better symptom control in patients with HF. In this article, we will review the pathophysiology of HF for better understanding of the interplay between the cardiovascular system and the kidney. Subsequently, we will briefly discuss pivotal renal denervation (RDN) therapy trials in patients with resistant hypertension and then present the available evidence on the role of RDN in HF therapy.

  2. Inhibition of leukotriene B4 synthesis does not prevent development of acute renal failure following storage and transplantation.

    PubMed

    Lane, N J; Thorniley, M S; Manek, S; Fuller, B J; Green, C J

    1994-12-27

    Compound BW B70C, a selective 5-lipoxygenase inhibitor was tested for its ability to reduce inflammatory damage in an in vivo rabbit model of renal storage and transplantation. Kidneys were stored at 0-2 degrees C for 48 hr prior to autografting. In controls, renal vein LTB4 levels rose significantly after 30 min reperfusion but fell after 2 hr to baseline. TxB2 levels remained at baseline for the 6 hr measured. 6-k-PGF1 alpha levels rose significantly after 1 hr of reperfusion and remained elevated thereafter. Histology after 6 hr reperfusion showed moderate-to-severe cortical edema and mild congestion. Infused colloidal carbon was retained in the perivascular area in a narrow band at the corticomedullary junction, indicating a zone of vascular permeability. At 3 days after transplant, kidneys exhibited widespread tubular necrosis and calcification but little inflammation. Serum creatinine and urea peaked between days 3 and 5. 3/6 rabbits showed no symptoms of renal failure after 3 weeks. Pretreatment with BW B70C prevented the increase in LTB4 but had little effect on TxB2 and 6-k-PGF1 alpha levels. Histology showed no amelioration of cortical edema at 6 hr and congestion and hemorrhage were exacerbated. BW B70C had no effect on either colloidal carbon retention or distribution but did significantly reduce tubular necrosis and calcification at day 3. There was very little inflammatory infiltrate. BW B70C treatment did not improve the long-term viability of transplanted kidneys: 2/6 rabbits showed no symptoms of renal failure after 3 weeks. These data indicate that inhibition of LTB4 synthesis by BW B70C does not prevent the development of acute renal failure following 48 hr hypothermic storage and transplantation.

  3. Failure of a novel silicone–polyurethane copolymer (Optim™) to prevent implantable cardioverter-defibrillator lead insulation abrasions

    PubMed Central

    Hauser, Robert G.; Abdelhadi, Raed H.; McGriff, Deepa M.; Kallinen Retel, Linda

    2013-01-01

    Aim The purpose of this study was to determine if Optim™, a unique copolymer of silicone and polyurethane, protects Riata ST Optim and Durata implantable cardioverter-defibrillator (ICD) leads (SJM, St Jude Medical Inc., Sylmar, CA, USA) from abrasions that cause lead failure. Methods and results We searched the US Food and Drug Administration's (FDA's) Manufacturers and User Device Experience (MAUDE) database on 13 April 2012 using the simple search terms ‘Riata ST Optim™ abrasion analysis’ and ‘Durata abrasion analysis’. Lead implant time was estimated by subtracting 3 months from the reported lead age. The MAUDE search returned 15 reports for Riata ST Optim™ and 37 reports for Durata leads, which were submitted by SJM based on its analyses of returned leads for clinical events that occurred between December 2007 and January 2012. Riata ST Optim™ leads had been implanted 29.1 ± 11.7 months. Eight of 15 leads had can abrasions and three abrasions were caused by friction with another device, most likely another lead. Four of these abrasions resulted in high-voltage failures and one death. One failure was caused by an internal insulation defect. Durata leads had been implanted 22.2 ± 10.6 months. Twelve Durata leads had can abrasions, and six leads had abrasions caused by friction with another device. Of these 18 can and other device abrasions, 13 (72%) had electrical abnormalities. Low impedances identified three internal insulation abrasions. Conclusions Riata ST Optim™ and Durata ICD leads have failed due to insulation abrasions. Optim™ did not prevent these abrasions, which developed ≤4 years after implant. Studies are needed to determine the incidence of these failures and their clinical implications. PMID:22915789

  4. Community Perspectives on Communication Strategies for Alcohol Abuse Prevention in Rural Central Kenya.

    PubMed

    Muturi, Nancy

    2016-01-01

    The current study explores community perspectives on alcohol abuse prevention strategies in rural Kenya. Data from focus group discussions with members of community organizations and in-depth interviews with a snowball sample of key informants revealed that rural communities view national alcohol abuse prevention interventions as ineffective and messages as unpersuasive in changing this high-risk behavior. The use of ethnic languages, stronger fear appeals, and visual aids were recommended for alcohol prevention messages aimed at communities with low literacy. Community members favored narratives and entertainment-education strategies, which are more engaging, and print media for their educational value. Health activism, although common, was viewed as less effective in motivating individuals to change drinking behavior but more effective in advocacy campaigns to pressure the government to enforce alcohol regulations. This study suggests further empirical research to inform evidence-based prevention campaigns and to understand how to communicate about alcohol-related health risks within communities that embrace alcohol consumption as a cultural norm.

  5. Financial implications of a model heart failure disease management program for providers, hospital, healthcare systems, and payer perspectives.

    PubMed

    Whellan, David J; Reed, Shelby D; Liao, Lawrence; Gould, Stuart D; O'connor, Christopher M; Schulman, Kevin A

    2007-01-15

    Although heart failure disease management (HFDM) programs improve patient outcomes, the implementation of these programs has been limited because of financial barriers. We undertook the present study to understand the economic incentives and disincentives for adoption of disease management strategies from the perspectives of a physician (group), a hospital, an integrated health system, and a third-party payer. Using the combined results of a group of randomized controlled trials and a set of financial assumptions from a single academic medical center, a financial model was developed to compute the expected costs before and after the implementation of a HFDM program by 3 provider types (physicians, hospitals, and health systems), as well as the costs incurred from a payer perspective. The base-case model showed that implementation of HFDM results in a net financial loss to all potential providers of HFDM. Implementation of HFDM as described in our base-case analysis would create a net loss of US dollars 179,549 in the first year for a physician practice, US dollars 464,132 for an integrated health system, and US dollars 652,643 in the first year for a hospital. Third-party payers would be able to save US dollars 713,661 annually for the care of 350 patients with heart failure in a HFDM program. In conclusion, although HFDM programs may provide patients with improved clinical outcomes and decreased hospitalizations that save third-party payers money, limited financial incentives are currently in place for healthcare providers and hospitals to initiate these programs.

  6. [Efforts to prevent adverse events in the United States--health care risk management and a fresh perspective on adverse events prevention].

    PubMed

    Ayuzawa, J

    2001-03-01

    Not causing adverse events is never-ceasing issue in the health care field. However, the advances and greater specialization of medical technologies and the increasing number of elderly people, are all factors in the occurrence of adverse events. At the same time, greater efficiency is now demanded in the health care field, and the problem of preventing adverse events has become tougher than ever before. Given the situation, a fresh perspective on attempts to prevent adverse events may be important. One hint for such a new perspective is the health care risk management that is widely practiced in the health care field in the United States. This was introduced in the mid-1970s to counter the disputes and lawsuits at the time, but over the years the focus has shifted to the importance of prevention, and is now recognized as a means to work toward the assurance of quality of health care. Hints are also found in the suggestions related to adverse events prevention. In "To Err Is Human," published in November 1999 in the United States, includes proposals to "respect human limits in process design" and "promote effective team functioning," which are just the approaches we should adopt for a new perspective. I would also like to draw attention to the idea that there should be investigations into "developing effective mechanisms for identifying and dealing with unsafe practitioners" and the importance of "protecting voluntary reporting systems" that is mentioned. Adopting American methods unchanged to the health care system in Japan may not be appropriate, but the way of thinking and know-how from health care risk management, as well as the suggestions for adverse events prevention will provide us new perspectives on adverse events prevention, from which we should work toward a system of more efficient, and high-quality adverse events prevention.

  7. Understanding Strategic Success and Tactical Failure in 1973: An Examination from a Spatial-Temporal Perspective

    DTIC Science & Technology

    2013-05-23

    the canal was as much of surmounting a psychological obstacle in the minds of the Egyptians, as it was a physical barrier for the military to cross...temporal perspectives are not new to the arena of anthropological or psychological studies. They are challenging topics to challenge within the... gestalt for the understanding and explanation of present actions.124 As expressed before, a nuanced sense of time is difficult to grasp. To the Western

  8. Adult venovenous extracorporeal membrane oxygenation for severe respiratory failure: Current status and future perspectives.

    PubMed

    Sen, Ayan; Callisen, Hannelisa E; Alwardt, Cory M; Larson, Joel S; Lowell, Amelia A; Libricz, Stacy L; Tarwade, Pritee; Patel, Bhavesh M; Ramakrishna, Harish

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory failure was proposed more than 40 years ago. Despite the publication of the ARDSNet study and adoption of lung protective ventilation, the mortality for acute respiratory failure due to acute respiratory distress syndrome has continued to remain high. This technology has evolved over the past couple of decades and has been noted to be safe and successful, especially during the worldwide H1N1 influenza pandemic with good survival rates. The primary indications for ECMO in acute respiratory failure include severe refractory hypoxemic and hypercarbic respiratory failure in spite of maximum lung protective ventilatory support. Various triage criteria have been described and published. Contraindications exist when application of ECMO may be futile or technically impossible. Knowledge and appreciation of the circuit, cannulae, and the physiology of gas exchange with ECMO are necessary to ensure lung rest, efficiency of oxygenation, and ventilation as well as troubleshooting problems. Anticoagulation is a major concern with ECMO, and the evidence is evolving with respect to diagnostic testing and use of anticoagulants. Clinical management of the patient includes comprehensive critical care addressing sedation and neurologic issues, ensuring lung recruitment, diuresis, early enteral nutrition, treatment and surveillance of infections, and multisystem organ support. Newer technology that delinks oxygenation and ventilation by extracorporeal carbon dioxide removal may lead to ultra-lung protective ventilation, avoidance of endotracheal intubation in some situations, and ambulatory therapies as a bridge to lung transplantation. Risks, complications, and long-term outcomes and resources need to be considered and weighed in before widespread application. Ethical challenges are a reality and a multidisciplinary approach that should be adopted for every case in consideration.

  9. Adult venovenous extracorporeal membrane oxygenation for severe respiratory failure: Current status and future perspectives

    PubMed Central

    Sen, Ayan; Callisen, Hannelisa E.; Alwardt, Cory M.; Larson, Joel S.; Lowell, Amelia A.; Libricz, Stacy L.; Tarwade, Pritee; Patel, Bhavesh M.; Ramakrishna, Harish

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory failure was proposed more than 40 years ago. Despite the publication of the ARDSNet study and adoption of lung protective ventilation, the mortality for acute respiratory failure due to acute respiratory distress syndrome has continued to remain high. This technology has evolved over the past couple of decades and has been noted to be safe and successful, especially during the worldwide H1N1 influenza pandemic with good survival rates. The primary indications for ECMO in acute respiratory failure include severe refractory hypoxemic and hypercarbic respiratory failure in spite of maximum lung protective ventilatory support. Various triage criteria have been described and published. Contraindications exist when application of ECMO may be futile or technically impossible. Knowledge and appreciation of the circuit, cannulae, and the physiology of gas exchange with ECMO are necessary to ensure lung rest, efficiency of oxygenation, and ventilation as well as troubleshooting problems. Anticoagulation is a major concern with ECMO, and the evidence is evolving with respect to diagnostic testing and use of anticoagulants. Clinical management of the patient includes comprehensive critical care addressing sedation and neurologic issues, ensuring lung recruitment, diuresis, early enteral nutrition, treatment and surveillance of infections, and multisystem organ support. Newer technology that delinks oxygenation and ventilation by extracorporeal carbon dioxide removal may lead to ultra-lung protective ventilation, avoidance of endotracheal intubation in some situations, and ambulatory therapies as a bridge to lung transplantation. Risks, complications, and long-term outcomes and resources need to be considered and weighed in before widespread application. Ethical challenges are a reality and a multidisciplinary approach that should be adopted for every case in consideration. PMID:26750681

  10. Assessing Risk and Preventing 30-Day Readmissions in Decompensated Heart Failure: Opportunity to Intervene?

    PubMed

    Dunbar-Yaffe, Richard; Stitt, Audra; Lee, Joseph J; Mohamed, Shanas; Lee, Douglas S

    2015-10-01

    Heart failure (HF) patients are at high risk of hospital readmission, which contributes to substantial health care costs. There is great interest in strategies to reduce rehospitalization for HF. However, many readmissions occur within 30 days of initial hospital discharge, presenting a challenge for interventions to be instituted in a short time frame. Potential strategies to reduce readmissions for HF can be classified into three different forms. First, patients who are at high risk of readmission can be identified even before their initial index hospital discharge. Second, ambulatory remote monitoring strategies may be instituted to identify early warning signs before acute decompensation of HF occurs. Finally, strategies may be employed in the emergency department to identify low-risk patients who may not need hospital readmission. If symptoms improve with initial therapy, low-risk patients could be referred to specialized, rapid outpatient follow-up care where investigations and therapy can occur in an outpatient setting.

  11. Immunotherapeutics to prevent the replication of Brucella in a treatment failure mouse model.

    PubMed

    Jain-Gupta, N; Contreras-Rodriguez, A; Smith, G P; Garg, V K; Witonsky, S G; Isloor, S; Vemulapalli, R; Boyle, S M; Sriranganathan, N

    2014-02-12

    Outer membrane vesicles (OMVs) from Brucella melitensis and irradiated Brucella neotomae have been shown to be effective vaccines against a B. melitensis challenge in a mouse model. The present study evaluates the efficacy of these two vaccines as immuno-therapeutics in combination with conventional antibiotics against a B. melitensis infection. BALB/c mice chronically infected with B. melitensis were treated for 4 weeks with doxycycline and gentamicin and vaccinated twice during the course of therapy. Antibiotics in sub-therapeutic concentrations were chosen in such a way that the treatment would result in a therapeutic failure in mice. Although no additive effect of vaccines and antibiotics was seen on the clearance of B. melitensis, mice receiving vaccines along with antibiotics exhibited no Brucella replication post-treatment compared to mice treated only with antibiotics. Administration of irradiated B. neotomae along with antibiotics led to higher production of IFN-γ ex vivo by splenocytes upon stimulation with heat inactivated B. melitensis while no such effect was seen by splenocytes from mice vaccinated with OMVs. OMV vaccinated mice developed significantly higher anti-Brucella IgG antibody titers at the end of the treatment compared to the mice that received only antibiotics. The mice that received only vaccines did not show any significant clearance of Brucella from spleens and livers compared to non-treated control mice. This study suggests that incorporating OMVs or irradiated B. neotomae along with conventional antibiotics might be able to improve therapeutic efficacy and control the progression of disease in treatment failure cases.

  12. Failure of propranolol to prevent tilt-evoked systemic vasodilatation, adrenaline release and neurocardiogenic syncope.

    PubMed

    Eldadah, Basil A; Pechnik, Sandra L; Holmes, Courtney S; Moak, Jeffrey P; Saleem, Ahmed M; Goldstein, David S

    2006-09-01

    In patients with neurocardiogenic syncope, head-up tilt often evokes acute loss of consciousness accompanied by vasodilatation, increased plasma adrenaline and systemic hypotension. Since hypotension increases adrenaline levels and adrenaline can produce skeletal muscle vasodilatation by activating beta2 receptors, adrenaline might induce a positive feedback loop precipitating circulatory collapse. We hypothesized that propranolol, a non-selective beta-blocker, would prevent adrenaline-induced vasodilatation and thereby prevent syncope. Eight subjects with recurrent neurocardiogenic syncope and previously documented tilt-induced syncope with elevated plasma adrenaline levels participated in the present study. Subjects underwent tilt table testing after receiving oral propranolol or placebo in a double-blind randomized crossover fashion. Haemodynamic and neurochemical variables were measured using intra-arterial monitoring, impedance cardiography, arterial blood sampling and tracer kinetics of simultaneously infused [3H]noradrenaline and [3H]adrenaline. The occurrence of tilt-induced neurally mediated hypotension and syncope, duration of tilt tolerance, extent of the decrease in SVRI (systemic vascular resistance index) and magnitude of plasma adrenaline increases did not differ between the propranolol and placebo treatment phases. SVRI was inversely associated with fractional increase in plasma adrenaline during both phases. One subject did not faint when on propranolol; this subject's response is discussed in the context of central effects of propranolol. In this small, but tightly controlled, study, propranolol did not prevent tilt-induced vasodilatation, syncope or elevated plasma adrenaline.

  13. GPs’ perspectives on secondary cardiovascular prevention in older age: a focus group study in the Netherlands

    PubMed Central

    van Peet, Petra G; Drewes, Yvonne M; Gussekloo, Jacobijn; de Ruijter, Wouter

    2015-01-01

    Background Although guidelines recommend secondary cardiovascular prevention irrespective of age, in older age the uptake of treatment is lower than in younger age groups. Aim To explore the dilemmas GPs in the Netherlands encounter when implementing guidelines for secondary cardiovascular prevention in older age. Design and setting Qualitative study in four focus groups consisting of GPs (n = 23, from the northern part of the province South Holland) and a fifth focus group consisting of GP trainees (n = 4, from the Leiden University Medical Center). Method Focus group discussions were organised to elicit perspectives on the implementation of secondary cardiovascular prevention for older people. The 14 theoretical domains of the refined Theoretical Domains Framework (TDF) were used for (deductive) coding of the focus group discussions. The coded texts were analysed, content was discussed, and barriers and facilitators were identified for each domain of the TDF. Results The main theme that emerged was ‘uncertainty’. Identified barriers were guideline-related, patient-related, and organisation-related. Identified facilitators were doctor-related, patient-related, and organisation-related. The main aim of secondary preventive treatment was improvement in quality of life. Conclusion GPs in the Netherlands are uncertain about many aspects of secondary cardiovascular prevention in older age; the guidelines themselves, their own role, patient factors, and the organisation of care. In view of this uncertainty, GPs consciously weigh all aspects of the situation in close dialogue with the individual patient, with the ultimate aim of improving quality of life. This highly-individualised care may largely explain the reduced prescription rates. PMID:26500321

  14. Electrochemical stabilization as a means of preventing ground failure in railroads

    USGS Publications Warehouse

    Solntzev, D.I.; Sorkov, V.S.; Sokoloff, V.P.

    1947-01-01

    Laboratory and field data on electrochemical stabilization of clays, by three Russian authors, are here presented in translation. Abstracts of the Russian papers were published in May 1947 issue of the Engineering News Record (pp. 100-101). There exists also a small body of literature, in German and English, dealing with the electrochemical stabilization and related subjects. Elements of the electrochemical process were patented by Casagrande in Germany, shortly before the last war. Results of the Russians and of others, including the German patent, appear to be sound and interesting accordingly. Mechanism of the electrochemical stabilization, however, appears to be surmised rather than established. Unless the mechanism of such stabilization is understood in detail, little progress may be expected in field applications of the electrochemical method. Electroosmosis, a poorly reversible coagulation of the soil colloids, and introduction of exchangeable aluminum into the clay complex have been given credit for the ground-stabilizing effects of direct electrical current. Much remains to be done, as the reader may see, in developing further the theory of the method. A critical study is indicated, in this connection, by agencies or individuals qualified and equipped for basic research in soil physics. Optimum schedules for field treatments need be ascertained with particular care, to suit any given kind of material and environment. A wide range of variation in such schedules, is most certainly to be encountered in dealing with materials as diverse in their composition and properties as are clays. Any generalization on relationships between soil, electrolytes, moisture, and current could be premature if based on the Russian work alone. Stabilization of ground is a major engineering geologic problem of national interest. Needless to say, perhaps, that failures are to be expected, in laboratory and in the field, in this as well as in any other kind of research. To minimize

  15. Cancer Therapy-Related Cardiac Dysfunction and Heart Failure: Part 2: Prevention, Treatment, Guidelines, and Future Directions.

    PubMed

    Hamo, Carine E; Bloom, Michelle W; Cardinale, Daniela; Ky, Bonnie; Nohria, Anju; Baer, Lea; Skopicki, Hal; Lenihan, Daniel J; Gheorghiade, Mihai; Lyon, Alexander R; Butler, Javed

    2016-02-01

    Success with oncologic treatment has allowed cancer patients to experience longer cancer-free survival gains. Unfortunately, this success has been tempered by unintended and often devastating cardiac complications affecting overall patient outcomes. Cardiac toxicity, specifically the association of several cancer therapy agents with the development of left ventricular dysfunction and cardiomyopathy, is an issue of growing concern. Although the pathophysiologic mechanisms behind cardiac toxicity have been characterized, there is currently no evidence-based approach for monitoring and management of these patients. In the first of a 2-part review, we discuss the epidemiologic, pathophysiologic, risk factors, and imaging aspects of cancer therapy-related cardiac dysfunction and heart failure. In this second part, we discuss the prevention and treatment aspects in these patients and conclude with highlighting the evidence gaps and future directions for research in this area.

  16. The use of failure mode and effects analysis to construct an effective disposal and prevention mechanism for infectious hospital waste

    SciTech Connect

    Ho, Chao Chung; Liao, Ching-Jong

    2011-12-15

    Highlights: > This study is based on a real case in a regional teaching hospital in Taiwan. > We use Failure mode and effects analysis (FMEA) as the evaluation method. > We successfully identify the risk factors of infectious waste disposal. > We propose plans for the detection of exceptional cases of infectious waste. - Abstract: In recent times, the quality of medical care has been continuously improving in medical institutions wherein patient-centred care has been emphasized. Failure mode and effects analysis (FMEA) has also been promoted as a method of basic risk management and as part of total quality management (TQM) for improving the quality of medical care and preventing mistakes. Therefore, a study was conducted using FMEA to evaluate the potential risk causes in the process of infectious medical waste disposal, devise standard procedures concerning the waste, and propose feasible plans for facilitating the detection of exceptional cases of infectious waste. The analysis revealed the following results regarding medical institutions: (a) FMEA can be used to identify the risk factors of infectious waste disposal. (b) During the infectious waste disposal process, six items were scored over 100 in the assessment of uncontrolled risks: erroneous discarding of infectious waste by patients and their families, erroneous discarding by nursing staff, erroneous discarding by medical staff, cleaning drivers pierced by sharp articles, cleaning staff pierced by sharp articles, and unmarked output units. Therefore, the study concluded that it was necessary to (1) provide education and training about waste classification to the medical staff, patients and their families, nursing staff, and cleaning staff; (2) clarify the signs of caution; and (3) evaluate the failure mode and strengthen the effects.

  17. The redefinition of failure to thrive from a case study perspective.

    PubMed

    Locklin, Maryanne

    2005-01-01

    Explaining failure to thrive (FTT) in dichotomous terms--organic versus non-organic --no longer applies in the context of modern pediatric nursing. FTT has turned out to be much more multifaceted. One infant's story illustrates the complexities and long-term ramifications of a pediatric feeding disorder and the challenges faced by health care professionals and families in their care. The story illustrates how physiologic, sensorimotor, and behavioral issues can all impact a child's inability to gain weight as expected. With greater understanding, pediatric nurses can appreciate their role as members of a multidisciplinary pediatric feeding disorder team.

  18. Rehabilitation practice patterns for patients with heart failure: the Asian perspective.

    PubMed

    Sun, Xing-Guo

    2015-01-01

    More countries around world have begun to use cardiac rehabilitation in patients diagnosed with chronic heart failure (HF). Asia is the largest continent in the world and, depending on its economy, culture, and beliefs, a given Asian country differs from Western countries as well as others in Asia. The cardiac rehabilitation practice patterns for patients with HF are somewhat different in Asia. In addition to the formal pattern of Western practice, it also includes special techniques and skills, such as Taiji, Qigong, and Yoga. This article describes cardiac rehabilitation patterns for patients with HF in most Asian countries and areas.

  19. Civil society perspectives on negative biomedical HIV prevention trial results and implications for future trials.

    PubMed

    Essack, Zaynab; Koen, Jennifer; Slack, Catherine; Lindegger, Graham; Newman, Peter A

    2012-01-01

    Community engagement is crucial to ongoing development and testing of sorely needed new biomedical HIV prevention technologies. Yet, negative trial results raise significant challenges for community engagement in HIV prevention trials, including the early termination of the Cellulose Sulfate microbicide trial and two Phase IIb HIV vaccine trials (STEP and Phambili). The present study aimed to explore the perspectives and experiences of civil society organization (CSO) representatives regarding negative HIV prevention trial results and perceived implications for future trials. We conducted in-depth interviews with 14 respondents from a broad range of South African and international CSOs, and analyzed data using thematic analysis. CSO representatives reported disappointment in response to negative trial results, but acknowledged such outcomes as inherent to clinical research. Respondents indicated that in theory negative trial results seem likely to impact on willingness to participate in future trials, but that in practice people in South Africa have continued to volunteer. Negative trial results were described as having contributed to improving ethical standards, and to a re-evaluation of the scientific agenda. Such negative results were identified as potentially impacting on funding for trials and engagement activities. Our findings indicate that trial closures may be used constructively to support opportunities for reflection and renewed vigilance in strategies for stakeholder engagement, communicating trial outcomes, and building research literacy among communities; however, these strategies require sustained resources for community engagement and capacity-building.

  20. Prevention of perinatal group B streptococcal infections: a review with an Indian perspective.

    PubMed

    Narava, S; Rajaram, G; Ramadevi, A; Prakash, G V; Mackenzie, S

    2014-01-01

    Group B Streptococcus (GBS) is an important cause of maternal and neonatal morbidity and mortality in many parts of the world. Asymptomatic colonisation of the vagina and rectum with Group B streptococci is common in pregnancy. Maternal colonisation of GBS can vary depending on ethnicity and geographical distribution. Vertical transmission of this organism from mother to foetus may lead to neonatal GBS disease. Intra-partum use of antibiotics in these women has led to a decrease in the rate of early onset but not late onset GBS disease. Identification of women with GBS is the key factor in the prevention of perinatal GBS disease. There are different screening strategies available to identify women at risk of perinatal GBS disease. Clinicians continue to face the challenge of choosing between preventive strategies to reduce the impact of perinatal GBS disease. Controversy exists regarding the ideal preventive strategy. In India, the mortality and morbidity associated with the GBS disease remains largely a under-recognised problem. This comprehensive review summarises the salient features of GBS disease and discusses the epidemiology, risk factors, screening strategies, intra-partum antibiotic prophylaxis with an Indian perspective and how it compares with the Western nations.

  1. Roof Deformation, Failure Characteristics, and Preventive Techniques of Gob-Side Entry Driving Heading Adjacent to the Advancing Working Face

    NASA Astrophysics Data System (ADS)

    Bai, Jian-biao; Shen, Wen-long; Guo, Guan-long; Wang, Xiang-yu; Yu, Yang

    2015-11-01

    In mining excavation, the roof bending subsidence of gob-side entry driving heading adjacent to the advancing working face (HAWF) can be considerable. Influenced by the original rock pressure, the front and lateral abutment pressure of the adjacent working face, and the front abutment pressure of the current working face, the support body can easily fail, leading to serious instability of the rock mass surrounding the tunnel. To study the stress state and the deformation failure mechanism of the HAWF roof structure, we use on-site survey data, numerical simulation, and theoretical calculations to fit the spatial distribution law of mining abutment pressure piecewise, and establish a dynamic mechanical model of the roof structure. We then propose a roof failure criterion and examine the roof flexure deformation behavioral pattern. We found that the central part of the roof is the main point that controls the surrounding rock. To prevent the deformation and collapse of the roof and rock surrounding the tunnel, we propose techniques that can be applied to HAWF gob-side entry driving, including setting the coal pillar width, the driving stop and restart timing, and other control concepts.

  2. Metallic wear debris sensors: promising developments in failure prevention for wind turbine gearsets and similar components

    NASA Astrophysics Data System (ADS)

    Poley, Jack; Dines, Michael

    2011-04-01

    Wind turbines are frequently located in remote, hard-to-reach locations, making it difficult to apply traditional oil analysis sampling of the machine's critical gearset at timely intervals. Metal detection sensors are excellent candidates for sensors designed to monitor machine condition in vivo. Remotely sited components, such as wind turbines, therefore, can be comfortably monitored from a distance. Online sensor technology has come of age with products now capable of identifying onset of wear in time to avoid or mitigate failure. Online oil analysis is now viable, and can be integrated with onsite testing to vet sensor alarms, as well as traditional oil analysis, as furnished by offsite laboratories. Controlled laboratory research data were gathered from tests conducted on a typical wind turbine gearbox, wherein total ferrous particle measurement and metallic particle counting were employed and monitored. The results were then compared with a physical inspection for wear experienced by the gearset. The efficacy of results discussed herein strongly suggests the viability of metallic wear debris sensors in today's wind turbine gearsets, as correlation between sensor data and machine trauma were very good. By extension, similar components and settings would also seem amenable to wear particle sensor monitoring. To our knowledge no experiments such as described herein, have previously been conducted and published.

  3. Passive ALWR requirements to prevent containment failure. Advanced Reactor Severe Accident Program

    SciTech Connect

    Additon, S.L.; Blanchard, D.P.; Leaver, D.E.; Persinko, D. |

    1991-12-01

    The purpose of this report is to document a systematic evaluation of the Passive Advanced Light Water Reactor (ALWR) design requirements which address severe accident mitigation. This evaluation was performed concurrent with completion of the ALWR Requirements Document to assure the adequacy of these mitigation requirements. The passive plant approach to containment integrity assurance reflects an expansion of the approach established earlier for evolutionary ALWRs. The report identifies containment challenges that might occur coincident with or result from a core damage event, compiles the set of passive ALWR design requirements which addresses each challenge, and evaluates each set of requirements on an integrated basis to confirm that the requirements provide substantial assurance that coincident core damage and containment failure are precluded. Based on past PRAs, a review of pertinent safety functions, severe accident analyses, current regulatory requirements, and reviews by ALWR design personnel, twenty-three (23) potential containment challenges were identified. The report concludes that the relevant ALWR requirements severe to limit the likelihood and magnitude of the challenges, and to assure the capability of the containment to accommodate all challenges which remain potentially risk-significant.

  4. Passive ALWR requirements to prevent containment failure. [Advanced light water reactors

    SciTech Connect

    Additon, S.L.; Blanchard, D.P.; Leaver, D.E.; Persinko, D. TENERA, L.P., Bethesda, MD )

    1991-12-01

    The purpose of this report is to document a systematic evaluation of the Passive Advanced Light Water Reactor (ALWR) design requirements which address severe accident mitigation. This evaluation was performed concurrent with completion of the ALWR Requirements Document to assure the adequacy of these mitigation requirements. The passive plant approach to containment integrity assurance reflects an expansion of the approach established earlier for evolutionary ALWRs. The report identifies containment challenges that might occur coincident with or result from a core damage event, compiles the set of passive ALWR design requirements which addresses each challenge, and evaluates each set of requirements on an integrated basis to confirm that the requirements provide substantial assurance that coincident core damage and containment failure are precluded. Based on past PRAs, a review of pertinent safety functions, severe accident analyses, current regulatory requirements, and reviews by ALWR design personnel, twenty-three (23) potential containment challenges were identified. The report concludes that the relevant ALWR requirements severe to limit the likelihood and magnitude of the challenges, and to assure the capability of the containment to accommodate all challenges which remain potentially risk-significant.

  5. Preventive effects of eastern medication (Kampo) on the progression of chronic renal failure.

    PubMed

    Mitsuma, T

    1996-01-01

    Twenty-two patients with chronic renal failure (CRF) were investigated. The patients were mainly administered decoctions of rhubarb (symbol in text) for 4 weeks. After that, traditional Chinese (Kampo) prescriptions, most of them involving Wen-Pi-Tang were given for another 4 weeks. Following administration of these prescriptions, the levels of serum methylguanidine (MG), blood urea nitrogen and serum inorganic phosphorus improved significantly, although the values of serum creatinine (Cr) were not changed remarkably. The fact that the serum MG/Cr ratio was reduced after the therapy suggested that rhubarb possessed the potential to scavenge hydroxyl radicals by which MG was produced from Cr through creatol, as reported recently. The serum Cr concentration was determined over an observation period of more than 40 weeks in each of the 7 cases. Evaluation of the progression rate of CRF was made from the slopes of the regression lines. After analysis, 5 of the 7 cases showed significant retardation of progression after the administration of Kampo prescriptions during 106 ± 32 (mean ± SD) weeks. Of the 5 cases, 2 were prescribed Wen-Pi-Tang, another 2 cases were treated with Wen-Pi-Tang and Bu-Zhong-Yi-Qi-Tang and the last was treated with Ba-Wei-Di-Huang-Wan. This study demonstrated that the traditional Chinese prescriptions, most of them comprising Wen-Pi-Tang and/or Bu-Zhong-Yi-Qi-Tang, retarded the progression of CRF.

  6. Becoming a first-class noticer. How to spot and prevent ethical failures in your organization.

    PubMed

    Bazerman, Max H

    2014-01-01

    We'd like to think that no smart, upstanding manager would ever overlook or turn a blind eye to threats or wrongdoing that ultimately imperil his or her business. Yet it happens all the time. We fall prey to obstacles that obscure or drown out important signals that things are amiss. Becoming a "first-class noticer," says Max H. Bazerman, a professor at Harvard Business School, requires conscious effort to fight ambiguity, motivated blindness, conflicts of interest, the slippery slope, and efforts of others to mislead us. As a manager, you can develop your noticing skills by acknowledging responsibility when things go wrong rather than blaming external forces beyond your control. Bazerman also advises taking an outsider's view to challenge the status quo. Given the string of ethical failures of corporations around the world in recent years--from BP to GM to JP Morgan Chase--it's clear that leaders not only need to act more responsibly themselves but also must develop keen noticing skills in their employees and across their organizations.

  7. Cross-border reproductive care: market forces in action or market failure? An economic perspective.

    PubMed

    Connolly, Mark

    2011-12-01

    From an economist's perspective, cross-border reproductive care (CBRC) reflects a global market economy bringing together the needs of patients and skills of doctors at an agreed price. From this perspective CBRC is neither wrong nor right, rather it reflects rational economic behaviour of couples to maximize their wellbeing. The major economic criticism of CBRC relates to the costs and risks of multiple pregnancies, as couples paying out-of-pocket may have more embryos transferred than is desirable to optimize their chances of having a live birth. This criticism is valid, suggesting a need to communicate the hidden costs of failing to adequately fund fertility services. However, under some circumstances health authorities may be willing to bear these additional costs if the savings from not providing fertility services are sufficiently large enough to warrant a no-funding policy. Because infertility is often viewed as a low health priority, the likelihood of CBRC persisting is real, particularly as many health services adjust to the challenges of ageing populations and decreased public financing. To counter funding challenges, there is a need to communicate the medical benefits of assisted reproduction and the economic benefits that these children will offer in an era of austerity and ageing populations.

  8. Perioperative management of left ventricular diastolic dysfunction and heart failure: an anesthesiologist's perspective

    PubMed Central

    2017-01-01

    Anesthesiologists frequently see asymptomatic patients with diastolic dysfunction or heart failure for various surgeries. These patients typically show normal systolic function but abnormal diastolic parameters in their preoperative echocardiographic evaluations. The symptoms that are sometimes seen are similar to those of chronic obstructive pulmonary disease. Patients with diastolic dysfunction, and even with diastolic heart failure, have the potential to develop a hypertensive crisis or pulmonary congestion. Thus, in addition to conventional perioperative risk quantification, it may be important to consider the results of diastolic assessment for predicting the postoperative outcome and making better decisions. If anesthesiologists see female patients older than 70 years of age who have hypertension, diabetes, chronic renal disease, recent weight gain, or exercise intolerance, they should focus on the patient's diastologic echocardiography indicators such as left atrial enlargement or left ventricular hypertrophy. In addition, there is a need for perioperative strategies to mitigate diastolic dysfunction-related morbidity. Specifically, hypertension should be controlled, keeping pulse pressure below diastolic blood pressure, maintaining a sinus rhythm and normovolemia, and avoiding tachycardia and myocardial ischemia. There is no need to classify these diastolic dysfunction, but it is important to manage this condition to avoid worsening outcomes. PMID:28184260

  9. Perioperative management of left ventricular diastolic dysfunction and heart failure: an anesthesiologist's perspective.

    PubMed

    Ryu, Taeha; Song, Seok-Young

    2017-02-01

    Anesthesiologists frequently see asymptomatic patients with diastolic dysfunction or heart failure for various surgeries. These patients typically show normal systolic function but abnormal diastolic parameters in their preoperative echocardiographic evaluations. The symptoms that are sometimes seen are similar to those of chronic obstructive pulmonary disease. Patients with diastolic dysfunction, and even with diastolic heart failure, have the potential to develop a hypertensive crisis or pulmonary congestion. Thus, in addition to conventional perioperative risk quantification, it may be important to consider the results of diastolic assessment for predicting the postoperative outcome and making better decisions. If anesthesiologists see female patients older than 70 years of age who have hypertension, diabetes, chronic renal disease, recent weight gain, or exercise intolerance, they should focus on the patient's diastologic echocardiography indicators such as left atrial enlargement or left ventricular hypertrophy. In addition, there is a need for perioperative strategies to mitigate diastolic dysfunction-related morbidity. Specifically, hypertension should be controlled, keeping pulse pressure below diastolic blood pressure, maintaining a sinus rhythm and normovolemia, and avoiding tachycardia and myocardial ischemia. There is no need to classify these diastolic dysfunction, but it is important to manage this condition to avoid worsening outcomes.

  10. Noninvasive Mechanical Ventilation in Acute Respiratory Failure Patients: A Respiratory Therapist Perspective

    PubMed Central

    Hidalgo, V; Giugliano-Jaramillo, C; Pérez, R; Cerpa, F; Budini, H; Cáceres, D; Gutiérrez, T; Molina, J; Keymer, J; Romero-Dapueto, C

    2015-01-01

    Physiotherapist in Chile and Respiratory Therapist worldwide are the professionals who are experts in respiratory care, in mechanical ventilation (MV), pathophysiology and connection and disconnection criteria. They should be experts in every aspect of the acute respiratory failure and its management, they and are the ones who in medical units are able to resolve doubts about ventilation and the setting of the ventilator. Noninvasive mechanical ventilation should be the first-line of treatment in acute respiratory failure, and the standard of care in severe exacerbations of chronic obstructive pulmonary disease, acute cardiogenic pulmonary edema, and in immunosuppressed patients with high levels of evidence that support the work of physiotherapist. Exist other considerations where most of the time, physicians and other professionals in the critical units do not take into account when checking the patient ventilator synchrony, such as the appropriate patient selection, ventilator selection, mask selection, mode selection, and the selection of a trained team in NIMV. The physiotherapist needs to evaluate bedside; if patients are properly connected to the ventilator and in a synchronously manner. In Chile, since 2004, the physioterapist are included in the guidelines as a professional resource in the ICU organization, with the same skills and obligations as those described in the literature for respiratory therapists. PMID:26312104

  11. Noninvasive Mechanical Ventilation in Acute Respiratory Failure Patients: A Respiratory Therapist Perspective.

    PubMed

    Hidalgo, V; Giugliano-Jaramillo, C; Pérez, R; Cerpa, F; Budini, H; Cáceres, D; Gutiérrez, T; Molina, J; Keymer, J; Romero-Dapueto, C

    2015-01-01

    Physiotherapist in Chile and Respiratory Therapist worldwide are the professionals who are experts in respiratory care, in mechanical ventilation (MV), pathophysiology and connection and disconnection criteria. They should be experts in every aspect of the acute respiratory failure and its management, they and are the ones who in medical units are able to resolve doubts about ventilation and the setting of the ventilator. Noninvasive mechanical ventilation should be the first-line of treatment in acute respiratory failure, and the standard of care in severe exacerbations of chronic obstructive pulmonary disease, acute cardiogenic pulmonary edema, and in immunosuppressed patients with high levels of evidence that support the work of physiotherapist. Exist other considerations where most of the time, physicians and other professionals in the critical units do not take into account when checking the patient ventilator synchrony, such as the appropriate patient selection, ventilator selection, mask selection, mode selection, and the selection of a trained team in NIMV. The physiotherapist needs to evaluate bedside; if patients are properly connected to the ventilator and in a synchronously manner. In Chile, since 2004, the physioterapist are included in the guidelines as a professional resource in the ICU organization, with the same skills and obligations as those described in the literature for respiratory therapists.

  12. The performance efficiency of bioaugmentation to prevent anaerobic digestion failure from ammonia and propionate inhibition.

    PubMed

    Li, Ying; Zhang, Yue; Sun, Yongming; Wu, Shubiao; Kong, Xiaoying; Yuan, Zhenhong; Dong, Renjie

    2017-05-01

    This study aims to investigate the effect of bioaugmentation with enriched methanogenic propionate degrading microbial consortia on propionate fermentation under ammonia stress from total ammonia nitrogen concentration (TAN) of 3.0gNL(-1). Results demonstrated that bioaugmentation could prevent unstable digestion against further deterioration. After 45days of 1dosage (0.3g dry cell weight L(-1)d(-1), DCW L(-1)d(-1)) of bioaugmentation, the average volumetric methane production (VMP), methane recovery rate and propionic acid (HPr) degradation rate was enhanced by 70mLL(-1)d(-1), 21% and 51%, respectively. In contrast, the non-bioaugmentation reactor almost failed. Routine addition of a double dosage (0.6g DCW L(-1)d(-1)) of bioaugmentation culture was able to effectively recover the failing digester. The results of FISH suggested that the populations of Methanosaetaceae increased significantly, which could be a main contributor for the positive effect on methane production.

  13. Acute decompensated heart failure (ADHF): A comprehensive contemporary review on preventing early readmissions and postdischarge death.

    PubMed

    Rocha, Bruno M L; Menezes Falcão, Luiz

    2016-11-15

    Heart failure (HF) is an increasingly prevalent syndrome and a leading cause of both first hospitalization and readmissions. Strikingly, up to 25% of the patients are readmitted within 30 to 60-days, accounting for HF as the primary cause for readmission in the adult population. Given its poor prognosis, one could describe it as a "malignant condition". Acute decompensation is intrinsically related to increased right heart tele-diastolic pressures and often related to congestive symptoms. In-hospital strategies to adequately compensate and timely discharge patients are limited. Conversely, the fragile early postdischarge phase is a vulnerable period when one could potentially intervene cost-effectively to improve survival and to reduce morbidity. Promising transitional hospital-to-home programs may have a broader role in the near future, namely for selected higher risk patients. However, identifying patients at risk for hospital readmission has been challenging. Novel approaches, such as ferric carboxymaltose and valsartan/sacubitril, and reemerging drugs, particularly digoxin, may reduce hospitalizations. Despite this, optimizing the use of "older" therapies is still warranted. Right heart pressures monitoring may provide novel insights into promptly outpatient management. Unfortunately, randomized trials in the specific ADHF population are scarce. A novel paradigmatic approach is needed in order to suitably improve the currently poor prognosis of ADHF. Both improving survival and reducing hospitalizations are, therefore, primordial therapy goals. Lastly, no single drug has consistently proved to improve survival in HF with preserved ejection fraction (HFpEF); yet, some approaches may efficiently reduce hospitalizations. Awareness on HFpEF management beyond the failing heart is imperative.

  14. Neurocognitive monitors: toward the prevention of cognitive performance decrements and catastrophic failures in the operational environment.

    PubMed

    Thomas, Maria L; Russo, Michael B

    2007-05-01

    Network-centric doctrine and the proposed C41SR (command, control, communications, computers, intelligence, surveillance and reconnaissance) distributions to the individual warfighter require that the cognitive performance, judgment, and decision making of warfighters must be sustained and effectively managed in the forward operating environment, where various physiological and psychological stressors abound, in order to reduce human errors and catastrophic failures. The U.S. Army Medical Research and Materiel Command (USAMRMC) established the Cognitive Performance, Judgment, and Decision-Making Research Program (CPJDRP) in 2004 to direct research to this issue. A Neurophysiological Measures and Cognition Focus Team (NMFCT) was formed to work with augmented cognition investigators and to specifically address the development of neurophysiological measures as potential monitors of alertness-cognitive state in warfighters. The USAM-RMC approach complemented the Defense Advanced Research Projects Agency (DARPA) Augmented Cognition approach, which focused on the detection of workload-related impaired cognitive state, and subsequent modification of information flow through automation. In this preface, the premise for neurophysiological measures as neurocognitive monitors is explained using an example of a neurophysiological index: the oculomotor measure, saccadic velocity. The progress of the NMFCT on the development of a neurocognitive monitor is described, as well as the recommendations of a 2005 USAMRMC/Telemedicine and Advanced Technology Research Center (TATRC)-sponsored workshop. Awareness of neurocognitive monitoring is discussed, as are future endeavors related to operational testing and fieldability. Four papers are summarized in this Neurophysiological Monitoring and Augmented Cognition section involving technologies to enhance cognitive performance in the operational environment: one on dynamic cortical electroencephalography, two on oculometrics, and one on a

  15. Current status and perspectives of Clonorchis sinensis and clonorchiasis: epidemiology, pathogenesis, omics, prevention and control.

    PubMed

    Tang, Ze-Li; Huang, Yan; Yu, Xin-Bing

    2016-07-06

    Clonorchiasis, caused by Clonorchis sinensis (C. sinensis), is an important food-borne parasitic disease and one of the most common zoonoses. Currently, it is estimated that more than 200 million people are at risk of C. sinensis infection, and over 15 million are infected worldwide. C. sinensis infection is closely related to cholangiocarcinoma (CCA), fibrosis and other human hepatobiliary diseases; thus, clonorchiasis is a serious public health problem in endemic areas. This article reviews the current knowledge regarding the epidemiology, disease burden and treatment of clonorchiasis as well as summarizes the techniques for detecting C. sinensis infection in humans and intermediate hosts and vaccine development against clonorchiasis. Newer data regarding the pathogenesis of clonorchiasis and the genome, transcriptome and secretome of C. sinensis are collected, thus providing perspectives for future studies. These advances in research will aid the development of innovative strategies for the prevention and control of clonorchiasis.

  16. Getting into trouble: perspectives on stress and suicide prevention among Pacific Northwest Indian youth.

    PubMed

    Strickland, C June; Cooper, Michelle

    2011-07-01

    Suicide rates among Indian youth in the United States are two to three times the national average. Although researchers have identified related risk and protective factors, they have limited understanding of the perspectives of youth at risk. In this descriptive, ethnographic study in a Pacific Northwest tribe, the goal was to gain an understanding of the life experiences of the youth. Focus groups and observations were conducted with 30 Indian youth aged between 14 and 19 years in a Pacific Northwest tribe. Youth were asked to talk about their stressors, sense of family/community support, and hopes for the future. Youth reported major stress and noted that friends and family were both a support and also a source of stress. They hoped for strengthening of cultural values, economic development, and opportunities to give their talents to the tribe. These findings provide further insight about suicide risk among Indian youth and advance the understanding of suicide prevention in a transcultural setting.

  17. Lay health mentors in community-based older adult disability prevention programs: provider perspectives.

    PubMed

    Dossa, Almas; Capitman, John A

    2011-04-01

    In this study, we explored provider perspectives on the benefits of and implementation challenges in using lay health mentor peers in a community-based replication of an efficacious 12-month older adult disability prevention program. In addition, we describe the association of the mentor program with site features and program completion. We conducted semi-structured telephone interviews with nurses, social workers, and site managers and obtained primary data on site features and secondary data on program completion. Major themes included the importance of the health mentor program and implementation challenges. Sites with mentor programs were more likely to have older adults complete the program compared with sites without mentor programs. Rural, small, and less diverse sites were more likely to have health mentor programs than urban, large, and more diverse sites. Implications include a need to fund more lay health mentor programs, obtain adequate staffing including minority staff for health mentor support, and implement strategies to improve program efficiency.

  18. Asbestos contamination in feldspar extraction sites: a failure of prevention? Commentary.

    PubMed

    Cavariani, Fulvio

    2016-01-01

    Fibrous tremolite is a mineral species belonging to the amphibole group. It is present almost everywhere in the world as a natural contaminant of other minerals, like talc and vermiculite. It can be also found as a natural contaminant of the chrysotile form of asbestos. Tremolite asbestos exposures result in respiratory health consequences similar to the other forms of asbestos exposure, including lung cancer and mesothelioma. Although abundantly distributed on the earth's surface, tremolite is only rarely present in significant deposits and it has had little commercial use. Significant presence of amphibole asbestos fibers, characterized as tremolite, was identified in mineral powders coming from the milling of feldspar rocks extracted from a Sardinian mining site (Italy). This evidence raises several problems, in particular the prevention of carcinogenic risks for the workers. Feldspar is widespread all over the world and every year it is produced in large quantities and it is used for several productive processes in many manufacturing industries (over 21 million tons of feldspar mined and marketed every year). Until now the presence of tremolite asbestos in feldspar has not been described, nor has the possibility of such a health hazard for workers involved in mining, milling and handling of rocks from feldspar ores been appreciated. Therefore the need for a wider dissemination of knowledge of these problems among professionals, in particular mineralogists and industrial hygienists, must be emphasized. In fact both disciplines are necessary to plan appropriate environmental controls and adequate protections in order to achieve safe working conditions.

  19. Failure of vaccination to prevent outbreaks of foot-and-mouth disease.

    PubMed Central

    Woolhouse, M. E.; Haydon, D. T.; Pearson, A.; Kitching, R. P.

    1996-01-01

    Outbreaks of foot-and-mouth disease persist in dairy cattle herds in Saudi Arabia despite revaccination at intervals of 4-6 months. Vaccine trials provide data on antibody responses following vaccination. Using this information we developed a mathematical model of the decay of protective antibodies with which we estimated the fraction of susceptible animals at a given time after vaccination. The model describes the data well, suggesting over 95% take with an antibody half-life of 43 days. Farm records provided data on the time course of five outbreaks. We applied a 'SLIR' epidemiological model to these data, fitting a single parameter representing disease transmission rate. The analysis provides estimates of the basic reproduction number R(0), which may exceed 70 in some cases. We conclude that the critical intervaccination interval which would provide herd immunity against FMDV is unrealistically short, especially for heterologous challenge. We suggest that it may not be possible to prevent foot-and-mouth disease outbreaks on these farms using currently available vaccines. PMID:8666082

  20. Preventing low birth weight, child abuse, and school failure: the need for comprehensive, community-wide approaches.

    PubMed

    Chamberlin, R W

    1992-02-01

    Based on numerous examples from this country and abroad, we now have a reasonable idea of how we can reduce substantially the incidence of low-weight births, child abuse, adolescent pregnancy, school failure, and school dropout. The most effective long-term strategy appears to be the development of a comprehensive, coordinated, community-wide approach focused on preventing low- and medium-risk families from becoming high-risk as well as providing intensive services to those who already have reached a high-risk status. The best results can be obtained when all levels of government and the private sector work together. In this partnership, the best outcomes appear to result when the state and federal governments, private corporations, or both provide technical assistance, additional funding as needed, and help in setting program standards, and when the community maintains local control over establishing priorities and implementation strategies. However, to reach these goals and to maintain program support over the long time periods needed to show positive results (4 to 8 years), it is necessary to become skilled in social marketing techniques to turn program need into demand and to develop a strong local and statewide advocacy group to facilitate passage of needed legislation and prevent funding cutbacks. Pediatricians can modify their practices to make them more supportive to families and can work with other community leaders to bring about the changes in attitudes and about the changes in attitudes and funding priorities at the state and community levels that will be necessary to develop more effective preventive programs.

  1. New perspectives on ACL injury: On the role of repetitive sub-maximal knee loading in causing ACL fatigue failure.

    PubMed

    Wojtys, Edward M; Beaulieu, Mélanie L; Ashton-Miller, James A

    2016-12-01

    In this paper, we review a series of studies that we initiated to examine mechanisms of anterior cruciate ligament (ACL) injury in the hope that these injuries, and their sequelae, can be better prevented. First, using the earliest in vitro model of a simulated single-leg jump landing or pivot cut with realistic knee loading rates and trans-knee muscle forces, we identified the worst-case dynamic knee loading that causes the greatest peak ACL strain: Combined knee compression, flexion, and internal tibial rotation. We also identified morphologic factors that help explain individual susceptibility to ACL injury. Second, using the above knee loading, we introduced a possible paradigm shift in ACL research by demonstrating that the human ACL can fail by a sudden rupture in response to repeated sub-maximal knee loading. If that load is repeated often enough over a short time interval, the failure tended to occur proximally, as observed clinically. Third, we emphasize the value of a physical exam of the hip by demonstrating how limited internal axial rotation at the hip both increases the susceptibility to ACL injury in professional athletes, and also increases peak ACL strain during simulated pivot landings, thereby further increasing the risk of ACL fatigue failure. When training at-risk athletes, particularly females with their smaller ACL cross-sections, rationing the number and intensity of worst-case knee loading cycles, such that ligament degradation is within the ACL's ability to remodel, should decrease the risk for ACL rupture due to ligament fatigue failure.© 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:2059-2068, 2016.

  2. The failure of selenium supplementation to prevent copper-induced liver damage in Fischer 344 rats.

    PubMed

    Aburto, E M; Cribb, A; Fuentealba, I C; Ikede, B O; Kibenge, F S; Markham, F

    2001-04-01

    This study evaluates the ability of selenium (Se) supplementation to prevent experimental copper (Cu)-induced hepatocellular damage. Weanling male Fischer 344 rats were randomly assigned to groups of 15, 3 groups (A,B,C) were fed Cu-loaded diets (containing 2000 microg/g copper, added as CuSO4) and different levels of Se (added as Na2SeO3 x 5H2O) as follows: A) Cu-loaded/Se adequate diet (0.4 microg/g Se, fed basis); B) Cu-loaded/Se-supplemented diet (2 microg/g Se); and C) Cu-loaded/Se-deficient diet (< 0.2 microg/g). Three additional groups (D,E,F) were fed diets containing adequate levels of Cu (14 microg/g Cu, fed basis) and different levels of Se as follows: D) Cu-adequate/Se-adequate diet; E) Cu-adequate/Se-supplemented diet (2 microg/g Se); and F) Cu-adequate/Se-deficient (< 0.2 microg/g) diet. After 4, 8, and 12 weeks on the experimental diets, liver samples were processed for histology, histochemistry, metal analysis, glutathione peroxidase (GSH-Px) measurement, and quantification of malondialdehyde (MDA). Morphologic changes characteristic of Cu-associated hepatitis, without an increase in hepatic MDA levels, were seen in all Cu-loaded rats in each sampling. Similar changes occurred in rats fed Se-adequate, Se-supplemented and Se-deficient diets. This study demonstrates that Fischer 344 rats fed 2000 microg/g Cu develop morphologic changes due to Cu toxicity without evidence of lipid peroxidation. Furthermore, Se supplementation does not result in protection against Cu-induced liver injury.

  3. The failure of selenium supplementation to prevent copper-induced liver damage in Fischer 344 rats.

    PubMed Central

    Aburto, E M; Cribb, A; Fuentealba, I C; Ikede, B O; Kibenge, F S; Markham, F

    2001-01-01

    This study evaluates the ability of selenium (Se) supplementation to prevent experimental copper (Cu)-induced hepatocellular damage. Weanling male Fischer 344 rats were randomly assigned to groups of 15, 3 groups (A,B,C) were fed Cu-loaded diets (containing 2000 microg/g copper, added as CuSO4) and different levels of Se (added as Na2SeO3 x 5H2O) as follows: A) Cu-loaded/Se adequate diet (0.4 microg/g Se, fed basis); B) Cu-loaded/Se-supplemented diet (2 microg/g Se); and C) Cu-loaded/Se-deficient diet (< 0.2 microg/g). Three additional groups (D,E,F) were fed diets containing adequate levels of Cu (14 microg/g Cu, fed basis) and different levels of Se as follows: D) Cu-adequate/Se-adequate diet; E) Cu-adequate/Se-supplemented diet (2 microg/g Se); and F) Cu-adequate/Se-deficient (< 0.2 microg/g) diet. After 4, 8, and 12 weeks on the experimental diets, liver samples were processed for histology, histochemistry, metal analysis, glutathione peroxidase (GSH-Px) measurement, and quantification of malondialdehyde (MDA). Morphologic changes characteristic of Cu-associated hepatitis, without an increase in hepatic MDA levels, were seen in all Cu-loaded rats in each sampling. Similar changes occurred in rats fed Se-adequate, Se-supplemented and Se-deficient diets. This study demonstrates that Fischer 344 rats fed 2000 microg/g Cu develop morphologic changes due to Cu toxicity without evidence of lipid peroxidation. Furthermore, Se supplementation does not result in protection against Cu-induced liver injury. Images Figure 3. Figure 4. Figure 5. Figure 6. PMID:11346254

  4. Controversies and unresolved issues in tuberculosis prevention and control: a low-burden-country perspective.

    PubMed

    Abubakar, Ibrahim; Stagg, Helen R; Cohen, Ted; Mangtani, Punam; Rodrigues, Laura C; Pimpin, Laura; Watson, John M; Squire, S Bertel; Zumla, Alimuddin

    2012-05-15

    Despite declining incidence in most high-income countries, tuberculosis shows no signs of disappearing in the near future. Although surveillance data from most Western European countries show relatively stable declines in the rate of tuberculosis over the past several decades, some have reported either an increasing rate or a decelerating pace of reduction in recent years. The burden of disease now disproportionately affects high-risk groups such as migrants, homeless persons, and prisoners. In view of the concentration of cases in urban areas and high-risk deprived groups, interventions that may not be efficient when applied to the general population may be highly cost effective when targeted at high-risk groups. In this article, we examine some controversial elements of tuberculosis prevention and control in low-burden countries and recommend issues for further research. In particular, we assess current evidence on the duration of protection by BCG vaccine, the screening of migrants and hard-to-reach groups, and the use of preventive therapy for contacts of cases of infectious multidrug-resistant tuberculosis. This analysis is presented from the perspective of low-tuberculosis-burden, high-income countries attempting to eliminate tuberculosis.

  5. Resveratrol in primary and secondary prevention of cardiovascular disease: a dietary and clinical perspective.

    PubMed

    Tomé-Carneiro, João; Gonzálvez, Manuel; Larrosa, Mar; Yáñez-Gascón, María J; García-Almagro, Francisco J; Ruiz-Ros, José A; Tomás-Barberán, Francisco A; García-Conesa, María T; Espín, Juan Carlos

    2013-07-01

    Primary prevention of cardiovascular disease (CVD) aims to avoid a first event in subjects that are at risk but have not yet been diagnosed with heart disease. Secondary prevention of CVD aims to avoid new events in patients with established heart disease. Both approaches involve clinical intervention and implementation of healthy lifestyles. The grape and wine polyphenol resveratrol (3,5,4'-trihydroxy-trans-stilbene) has shown cardioprotective benefits in humans. Most of these approaches deal with rather high doses and short follow-ups, and do not address the issue of long-term resveratrol consumption safety, especially in medicated individuals. Here, we review the trials conducted with resveratrol in patients at risk for or with established CVD, focusing on the two longest human clinical trials reported so far (1-year follow-up). We also discuss the expectations for resveratrol from a dietary and clinical perspective in relation to CVD. However, statistically significant changes in CVD-risk markers do not necessarily equal clinical significance in the daily care of patients.

  6. Antiplatelet and anticoagulant agents in heart failure: current status and future perspectives.

    PubMed

    Gurbel, Paul A; Tantry, Udaya S

    2014-02-01

    There has been a 3-fold increase in hospital discharges for heart failure (HF) and also significantly increased mortality rate in HF patients in recent years. A major focus of HF research has been in the area of neurohormonal control and resynchronization therapy. There is a great urgency in better understanding the pathophysiology underlying the exceedingly high mortality and a need for exploration of therapeutic strategies beyond those that influence neurohormonal pathways. The decision to treat patients with HF with antiplatelet therapy remains largely influenced by the presence or absence of concomitant arterial disease. Antithrombotic therapy has been shown to be effective in many forms of cardiac disease, including patients with HF and atrial fibrillation. Although it is clear that platelet activation and hypercoagulability are present in HF, and there is evidence that stroke is reduced by warfarin therapy in the HF patient, the available data suggest that the risk of major bleeding overshadows the antithromboembolic benefit in HF patients in sinus rhythm. The utility of oral anticoagulant and/or antiplatelet therapy has never been evaluated in an adequately powered dedicated clinical trial of HF patients in sinus rhythm. In this state-of-the art paper we explore the evidence for targeting the inhibition of platelet function and coagulation to improve outcomes in the HF patient.

  7. Current Perspectives on Systemic Hypertension in Heart Failure with Preserved Ejection Fraction.

    PubMed

    Tam, Marty C; Lee, Ran; Cascino, Thomas M; Konerman, Matthew C; Hummel, Scott L

    2017-02-01

    Heart failure with preserved ejection fraction (HFpEF) is a prevalent but incompletely understood syndrome. Traditional models of HFpEF pathophysiology revolve around systemic HTN and other causes of increased left ventricular afterload leading to left ventricular hypertrophy (LVH) and diastolic dysfunction. However, emerging models attribute the development of HFpEF to systemic proinflammatory changes secondary to common comorbidities which include HTN. Alterations in passive ventricular stiffness, ventricular-arterial coupling, peripheral microvascular function, systolic reserve, and chronotropic response occur. As a result, HFpEF is heterogeneous in nature, making it difficult to prescribe uniform therapies to all patients. Nonetheless, treating systemic HTN remains a cornerstone of HFpEF management. Antihypertensive therapies have been linked to LVH regression and improvement in diastolic dysfunction. However, to date, no therapies have definitive mortality benefit in HFpEF. Non-pharmacologic management for HTN, including dietary modification, exercise, and treating sleep disordered breathing, may provide some morbidity benefit in the HFpEF population. Future research is need to identify effective treatments, perhaps in more specific subgroups, and focus may need to shift from reducing mortality to improving exercise capacity and symptoms. Tailoring antihypertensive therapies to specific phenotypes of HFpEF may be an important component of this strategy.

  8. Hepatocellular carcinoma: reasons for phase III failure and novel perspectives on trial design.

    PubMed

    Llovet, Josep M; Hernandez-Gea, Virginia

    2014-04-15

    Hepatocellular carcinoma (HCC) is a major health problem. Most patients with HCC experience a recurrence after resection/ablation or are diagnosed at advanced stages. Sorafenib remains the only approved systemic drug for these patients. Molecular therapies targeting signaling cascades involved in hepatocarcinogenesis have been explored in phase III clinical trials. However, none of the drugs tested have shown positive results in the first-line (brivanib, sunitinib, erlotinib, and linifanib) or second-line (brivanib, everolimus) setting after sorafenib progression. Reasons for failure are heterogeneous and include lack of understanding of critical drivers of tumor progression/dissemination, liver toxicity, flaws in trial design, or marginal antitumoral potency. These trials are also challenging time to progression as a surrogate endpoint of survival. Trials ongoing testing drugs head-to-head versus sorafenib in "all comers" might have difficulties in achieving superior results in the first line. Novel trials are also designed testing drugs in biomarker-based subpopulations of patients with HCC. Most common mutations, however, are undruggable, such as p53 and CTNNB1. Two types of studies are proposed: (i) phase II pivotal proof-of-concept studies testing drugs blocking potential oncogenic addiction loops, such as the one testing MEK inhibitors in RAS(+) patients or amplification of FGF19 as a target; and (ii) phase II to III studies using biomarker-based trial enrichment for defining HCC subpopulations, such as the case of enriching for MET-positive tumors. These strategies have been deemed successful in breast, melanoma, and lung cancers, and are expected to change the landscape of trial design of HCC.

  9. A Biochemical Approach to Understanding the Fanconi Anemia Pathway-Regulated Nucleases in Genome Maintenance for Preventing Bone Marrow Failure and Cancer

    DTIC Science & Technology

    2014-04-01

    the Fanconi Anemia Pathway- Regulated Nucleases in Genome Maintenance for Preventing Bone Marrow Failure and Cancer PRINCIPAL INVESTIGATOR...GRANT NUMBER 4. TITLE AND SUBTITLE A Biochemical Approach to Understanding the Fanconi Anemia Pathway-Regulated Nucleases in Genome Maintenance for...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Fanconi anemia is the most prevalent inherited BMF syndromes, caused by mutations in

  10. Dynamic analysis method for prevention of failure in the first-stage low-pressure turbine blade with two-finger root

    NASA Astrophysics Data System (ADS)

    Park, Jung-Yong; Jung, Yong-Keun; Park, Jong-Jin; Kang, Yong-Ho

    2002-05-01

    Failures of turbine blades are identified as the leading causes of unplanned outages for steam turbine. Accidents of low-pressure turbine blade occupied more than 70 percent in turbine components. Therefore, the prevention of failures for low pressure turbine blades is certainly needed. The procedure is illustrated by the case study. This procedure is used to guide, and support the plant manager's decisions to avoid a costly, unplanned outage. In this study, we are trying to find factors of failures in LP turbine blade and to make three steps to approach the solution of blade failure. First step is to measure natural frequency in mockup test and to compare it with nozzle passing frequency. Second step is to use FEM and to calculate the natural frequencies of 7 blades and 10 blades per group in BLADE code. Third step is to find natural frequencies of grouped blade off the nozzle passing frequency.

  11. Saying 'No' to PrEP research in Malawi: what constitutes 'failure' in offshored HIV prevention research?

    PubMed

    Peterson, Kristin; Folayan, Morenike Oluwatoyin; Chigwedere, Edward; Nthete, Evaristo

    2015-12-01

    Between 2004 and 2005, the first multi-sited clinical trial tested whether an existing, marketed antiretroviral drug, Tenofovir (TDF), could prevent HIV transmission. Referred to as pre-exposure prophylaxis (PrEP), most of these trial sites prematurely closed down. Two sites located in Cambodia and Cameroon received international media attention. But little attention was drawn to sites in Malawi and Nigeria, where university ethicists and research scientists extensively debated PrEP. This article focuses on events that took place in Malawi where there was a prolonged dispute over the scientific rationales of PrEP and not trial specific ethics referred to as 'bioethics'. Specifically, the article discusses debates pertaining to three PrEP trial protocols that were refused ethics approval in Malawi between 2004 and 2009. It is argued that HIV science debates in Malawi are embedded in postcolonial politics--geopolitical histories and state and household economic dispossessions that have created the structural possibilities for Malawi to become an offshore destination for HIV clinical research. As such, ethics in this case does not pertain to trial or bioethical 'failures'. Rather, ethics is located at the scale of imperial relations that give rise to multiple, often invisible, research concerns and constraints.

  12. Does Accidental Overcorrection of Symptomatic Hyponatremia in Chronic Heart Failure Require Specific Therapeutic Adjustments for Preventing Central Pontine Myelinolysis?

    PubMed Central

    De Vecchis, Renato; Noutsias, Michel; Ariano, Carmelina; Cesaro, Arturo; Cioppa, Carmela; Giasi, Anna; Maurea, Nicola

    2017-01-01

    This review aims at summarizing essential aspects of epidemiology and pathophysiology of hyponatremia in chronic heart failure (CHF), to set the ground for a practical as well as evidence-based approach to treatment. As a guide through the discussion of the available evidence, a clinical case of hyponatremia associated with CHF is presented. For this case, the severe neurological signs at presentation justified an emergency treatment with hypertonic saline plus furosemide, as indicated. Subsequently, as the neurological emergency began to subside, the reversion of the trend toward hyponatremia overcorrection was realized by continuous infusion of hypotonic solutions, and administration of desmopressin, so as to prevent the very feared risk of an osmotic demyelination syndrome. This very disabling complication of the hyponatremia correction is then briefly outlined. Moreover, the possible advantages related to systematic correction of the hyponatremia that occurs in the course of CHF are mentioned. Additionally, the case of tolvaptan, a vasopressin receptor antagonist, is concisely presented in order to underline the different views that have led to different norms in Europe with respect to the USA or Japan as regards the use of this drug as a therapeutic resource against the hyponatremia. PMID:28270885

  13. Baden-Powell on teeth: a centenary perspective of a pioneer of preventive dental health.

    PubMed

    Pearn, J

    2008-01-12

    In the era when dental care, particularly preventive dental health, did not enjoy a high public profile, Lieut-General (later Lord) Robert Baden-Powell (1857-1941) was an influential advocate for the care of the teeth. He was a pioneer in a targeted outreach to youth, specifically boys and young men, emphasising the importance of dental health as an essential part of total body health and fitness. In his book, Scouting for boys, first published on 1 May 1908, he described personal accounts of the consequences of the neglect of oral hygiene and presented advice on how to make an effective 'camp tooth-brush' in order that dental hygiene would not be compromised even under the exigencies of conditions away from home. Baden-Powell wrote explicitly that daily dental hygiene was the single most important 'one civilised thing [teenage youths] could do', irrespective of one's physical circumstances. Scouting for boys was for more than five decades the world's best seller in English, after the Bible. It has run to, and now surpasses, 60 million copies in 30 languages and has been published in 35 editions. It is believed that Baden-Powell's frank and direct exhortations to preserve the teeth, with simple and direct advice on food and what today would be called oral hygiene, have been read by 350 million people throughout the world. His advocacy reached out to boys and young men as it does today to youths of both sexes in that 'window of opportunity' when life-long habits of healthcare are being inculcated and when important components of secondary dentition are forming. This paper is a centenary perspective of Baden-Powell's pioneering advocacy of modern preventive dental health.

  14. Prevention of unintended pregnancy and HIV/STIs among Latinos in rural communities: perspectives of health care providers.

    PubMed

    Branch, Meredith; Harvey, S Marie; Zukoski, Ann P; Warren, Jocelyn

    2010-08-01

    Latino women in the United States are disproportionately at risk for unintended pregnancy, HIV, and sexually transmitted infections (STIs). We conducted nine focus groups with health care practitioners who provide reproductive health care to Latinos in rural areas of the Northwest. From the practitioner perspective, we explored barriers and facilitators to the acquisition and use of contraceptives and to the prevention of HIV/STIs among rural Latinos. Suggestions for improving reproductive health care included Spanish-language resources/materials and convenient contraceptive methods. Findings provide context to the complex issues related to unintended pregnancy and disease prevention among Latinos residing in rural communities.

  15. Endothelial p53 Deletion Improves Angiogenesis and Prevents Cardiac Fibrosis and Heart Failure Induced by Pressure Overload in Mice

    PubMed Central

    Gogiraju, Rajinikanth; Xu, Xingbo; Bochenek, Magdalena L.; Steinbrecher, Julia H.; Lehnart, Stephan E.; Wenzel, Philip; Kessel, Michael; Zeisberg, Elisabeth M.; Dobbelstein, Matthias; Schäfer, Katrin

    2015-01-01

    Background Cardiac dysfunction developing in response to chronic pressure overload is associated with apoptotic cell death and myocardial vessel rarefaction. We examined whether deletion of tumor suppressor p53 in endothelial cells may prevent the transition from cardiac hypertrophy to heart failure. Methods and Results Mice with endothelial‐specific deletion of p53 (End.p53‐KO) were generated by crossing p53fl/fl mice with mice expressing Cre recombinase under control of an inducible Tie2 promoter. Cardiac hypertrophy was induced by transverse aortic constriction. Serial echocardiography measurements revealed improved cardiac function in End.p53‐KO mice that also exhibited better survival. Cardiac hypertrophy was associated with increased p53 levels in End.p53‐WT controls, whereas banded hearts of End.p53‐KO mice exhibited lower numbers of apoptotic endothelial and non‐endothelial cells and altered mRNA levels of genes regulating cell cycle progression (p21), apoptosis (Puma), or proliferation (Pcna). A higher cardiac capillary density and improved myocardial perfusion was observed, and pharmacological inhibition or genetic deletion of p53 also promoted endothelial sprouting in vitro and new vessel formation following hindlimb ischemia in vivo. Hearts of End.p53‐KO mice exhibited markedly less fibrosis compared with End.p53‐WT controls, and lower mRNA levels of p53‐regulated genes involved in extracellular matrix production and turnover (eg, Bmp‐7, Ctgf, or Pai‐1), or of transcription factors involved in controlling mesenchymal differentiation were observed. Conclusions Our analyses reveal that accumulation of p53 in endothelial cells contributes to blood vessel rarefaction and fibrosis during chronic cardiac pressure overload and suggest that endothelial cells may be a therapeutic target for preserving cardiac function during hypertrophy. PMID:25713289

  16. Use of growth-hormone-releasing peptide-6 (GHRP-6) for the prevention of multiple organ failure.

    PubMed

    Cibrián, Danay; Ajamieh, Hussam; Berlanga, Jorge; León, Olga S; Alba, Jose S; Kim, Micheal J-T; Marchbank, Tania; Boyle, Joseph J; Freyre, Freya; Garcia Del Barco, Diana; Lopez-Saura, Pedro; Guillen, Gerardo; Ghosh, Subrata; Goodlad, Robert A; Playford, Raymond J

    2006-05-01

    Novel therapies for the treatment of MOF (multiple organ failure) are required. In the present study, we examined the effect of synthetic GHRP-6 (growth hormone-releasing peptide-6) on cell migration and proliferation using rat intestinal epithelial (IEC-6) and human colonic cancer (HT29) cells as in vitro models of injury. In addition, we examined its efficacy when given alone and in combination with the potent protective factor EGF (epidermal growth factor) in an in vivo model of MOF (using two hepatic vessel ischaemia/reperfusion protocols; 45 min of ischaemia and 45 min of reperfusion or 90 min of ischaemia and 120 min of reperfusion). In vitro studies showed that GHRP-6 directly influenced gut epithelial function as its addition caused a 3-fold increase in the rate of cell migration of IEC-6 and HT29 cells (P<0.01), but did not increase proliferation ([3H]thymidine incorporation). In vivo studies showed that, compared with baseline values, ischaemia/reperfusion caused marked hepatic and intestinal damage (histological scoring), neutrophilic infiltration (myeloperoxidase assay; 5-fold increase) and lipid peroxidation (malondialdehyde assay; 4-fold increase). Pre-treatment with GHRP-6 (120 microg/kg of body weight, intraperitoneally) alone truncated these effects by 50-85% (all P<0.05) and an additional benefit was seen when GHRP-6 was used in combination with EGF (1 mg/kg of body weight, intraperitoneally). Lung and renal injuries were also reduced by these pre-treatments. In conclusion, administration of GHRP-6, given alone or in combination with EGF to enhance its effects, may provide a novel simple approach for the prevention and treatment of MOF and other injuries of the gastrointestinal tract. In view of these findings, further studies appear justified.

  17. Endovenous administration of bone-marrow-derived multipotent mesenchymal stromal cells prevents renal failure in diabetic mice.

    PubMed

    Ezquer, Fernando; Ezquer, Marcelo; Simon, Valeska; Pardo, Fabian; Yañez, Alejandro; Carpio, Daniel; Conget, Paulette

    2009-11-01

    Twenty-five to 40% of diabetic patients develop diabetic nephropathy, a clinical syndrome that comprises renal failure and increased risk of cardiovascular disease. It represents the major cause of chronic kidney disease and is associated with premature morbimortality of diabetic patients. Multipotent mesenchymal stromal cells (MSC) contribute to the regeneration of several organs, including acutely injured kidney. We sought to evaluate if MSC protect kidney function and structure when endovenously administered to mice with severe diabetes. A month after nonimmunologic diabetes induction by streptozotocin injection, C57BL/6 mice presented hyperglycemia, glycosuria, hypoinsulinemia, massive beta-pancreatic islet destruction, low albuminuria, but not renal histopathologic changes (DM mice). At this stage, one group of animals received the vehicle (untreated) and other group received 2 doses of 0.5 x 10(6) MSC/each (MSC-treated). Untreated DM mice gradually increased urinary albumin excretion and 4 months after diabetes onset, they reached values 15 times higher than normal animals. In contrast, MSC-treated DM mice maintained basal levels of albuminuria. Untreated DM mice had marked glomerular and tubular histopathologic changes (sclerosis, mesangial expansion, tubular dilatation, proteins cylinders, podocytes lost). However, MSC-treated mice showed only slight tubular dilatation. Observed renoprotection was not associated with an improvement in endocrine pancreas function in this animal model, because MSC-treated DM mice remained hyperglycemic and hypoinsulinemic, and maintained few remnant beta-pancreatic islets throughout the study period. To study MSC biodistribution, cells were isolated from isogenic mice that constitutively express GFP (MSC(GFP)) and endovenously administered to DM mice. Although at very low levels, donor cells were found in kidney of DM mice 3 month after transplantation. Presented preclinical results support MSC administration as a cell

  18. Yup'ik culture and context in Southwest Alaska: community member perspectives of tradition, social change, and prevention.

    PubMed

    Ayunerak, Paula; Alstrom, Deborah; Moses, Charles; Charlie, James; Rasmus, Stacy M

    2014-09-01

    This paper provides an introduction to key aspects of Yup'ik Inuit culture and context from both historical and contemporary community member perspectives. Its purpose is to provide a framework for understanding the development and implementation of a prevention initiative centered on youth in two communities in Southwest Alaska as part of collaboration with the University of Alaska Fairbanks and the National Institutes of Health. This paper is written from the perspective of elders and local prevention workers from each of the two prevention communities. The co-authors discuss their culture and their community from their own perspectives, drawing from direct experience and from ancestral knowledge gained through learning and living the Yuuyaraq or the Yup'ik way of life. The authors of this paper identity key aspects of traditional Yup'ik culture that once contributed to the adaptability and survivability of their ancestors, particularly through times of hardship and social disruption. These key processes and practices represent dimensions of culture in a Yup'ik context that contribute to personal and collective growth, protection and wellbeing. Intervention development in Yup'ik communities requires bridging historical cultural frames with contemporary contexts and shifting focus from reviving cultural activities to repairing and revitalizing cultural systems that structure community.

  19. Yup’ik Culture and Context in Southwest Alaska: Community Member Perspectives of Tradition, Social Change, and Prevention

    PubMed Central

    Ayunerak, Paula; Alstrom, Deborah; Moses, Charles; Charlie, James

    2014-01-01

    This paper provides an introduction to key aspects of Yup’ik Inuit culture and context from both historical and contemporary community member perspectives. Its purpose is to provide a framework for understanding the development and implementation of a prevention initiative centered on youth in two communities in Southwest Alaska as part of collaboration with the University of Alaska Fairbanks and the National Institutes of Health. This paper is written from the perspective of elders and local prevention workers from each of the two prevention communities. The co-authors discuss their culture and their community from their own perspectives, drawing from direct experience and from ancestral knowledge gained through learning and living the Yuuyaraq or the Yup’ik way of life. The authors of this paper identity key aspects of traditional Yup’ik culture that once contributed to the adaptability and survivability of their ancestors, particularly through times of hardship and social disruption. These key processes and practices represent dimensions of culture in a Yup’ik context that contribute to personal and collective growth, protection and wellbeing. Intervention development in Yup’ik communities requires bridging historical cultural frames with contemporary contexts and shifting focus from reviving cultural activities to repairing and revitalizing cultural systems that structure community. PMID:24771075

  20. Detection, Diagnosis and Prognosis: Contribution to the energy challenge: Proceedings of the Meeting of the Mechanical Failures Prevention Group

    NASA Technical Reports Server (NTRS)

    Shives, T. R. (Editor); Willard, W. A. (Editor)

    1981-01-01

    The contribution of failure detection, diagnosis and prognosis to the energy challenge is discussed. Areas of special emphasis included energy management, techniques for failure detection in energy related systems, improved prognostic techniques for energy related systems and opportunities for detection, diagnosis and prognosis in the energy field.

  1. Prevention of hospital-acquired thrombosis from a primary care perspective: a qualitative study

    PubMed Central

    Litchfield, Ian; Fitzmaurice, David; Apenteng, Patricia; Harrison, Sian; Heneghan, Carl; Ward, Alison; Greenfield, Sheila

    2016-01-01

    Background Although there is considerable risk for patients from hospital-acquired thrombosis (HAT), current systems for reducing this risk appear inefficient and have focused predominantly on secondary care, leaving the role of primary care underexplored, despite the onset of HAT often occurring post-discharge. Aim To gain an understanding of the perspectives of primary care clinicians on their contribution to the prevention of HAT. Their current role, perceptions of patient awareness, the barriers to better care, and suggestions for how these may be overcome were discussed. Design and setting Qualitative study using semi-structured interviews in Oxfordshire and South Birmingham, England. Method Semi-structured telephone interviews with clinicians working at practices of a variety of size, socioeconomic status, and geographical location. Results A number of factors that influenced the management of HAT emerged, including patient characteristics, a lack of clarity of responsibility, limited communication and poor coordination, and the constraints of limited practice resources. Suggestions for improving the current system include a broader role for primary care supported by appropriate training and the requisite funding. Conclusion The role of primary care remains limited, despite being ideally positioned to either raise patient awareness before admission or support patient adherence to the thromboprophylaxis regimen prescribed in hospital. This situation may begin to be addressed by more robust lines of communication between secondary and primary care and by providing more consistent training for primary care staff. In turn, this relies on the allocation of appropriate funds to allow practices to meet the increased demand on their time and resources. PMID:27266864

  2. Prevention

    MedlinePlus

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

  3. Prevention

    MedlinePlus

    ... Is Strong Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... to avoid secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  4. Focus on Mechanical Failures: Mechanisms and Detection. Proceedings of the Meeting (45th) of the Mechanical Failures Prevention Group Held in Annapolis, Maryland on April 9 - 11, 1999

    DTIC Science & Technology

    1991-04-04

    reproduction is for U.S. Government purposes. Acceslon For NTIS CRA&M DTIC TAB Unannowk’I•.: JustifIcdtiron L Dist ibjtio ! Avaiiobll,ly O’,ale. Avait a...Dickson, S. Lalonde and L . Shiqiong Catastrophic Temperature Increase During the Separation of High Strength Alloys 79 in Tensile Loading D. D. Make/and...Nemarich and W. W. Boblitt S~iii Beyond Failure Avoidance: Evolution of an Expert System of Mechanical Systems 135 Integrity Management R. L . Kincaid

  5. Effects of a catheter-associated urinary tract infection prevention campaign on infection rate, catheter utilization, and health care workers' perspective at a community safety net hospital.

    PubMed

    Gray, Dorinne; Nussle, Richard; Cruz, Abner; Kane, Gail; Toomey, Michael; Bay, Curtis; Ostovar, Gholamabbas Amin

    2016-01-01

    Preventing catheter-associated urinary tract infections is in the forefront of health care quality. However, nurse and physician engagement is a common barrier in infection prevention efforts. After implementation of a multidisciplinary catheter-associated urinary tract infection (CAUTI) prevention campaign, we studied the impact of our campaign and showed its association with reducing the CAUTI rate and catheter utilization and the positive effect on health care workers' engagement and perspectives. CAUTI prevention campaigns can lead to lower infection rates and change health care workers' perspective.

  6. Emerging Ecological Approaches to Prevention, Health Promotion, and Public Health in the School Context: Next Steps from a Community Psychology Perspective

    ERIC Educational Resources Information Center

    Trickett, Edison J.; Rowe, Hillary L.

    2012-01-01

    In recent years, ecological perspectives have become more visible in prevention, health promotion, and public health within the school context. Individually based approaches to understanding and changing behavior have been increasingly challenged by these perspectives because of their appreciation for contextual influences on individual behavior.…

  7. Validation of Heart Failure Events in the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) Participants Assigned to Doxazosin and Chlorthalidone

    PubMed Central

    Piller, Linda B; Davis, Barry R; Cutler, Jeffrey A; Cushman, William C; Wright, Jackson T; Williamson, Jeff D; Leenen, Frans HH; Einhorn, Paula T; Randall, Otelio S; Golden, John S; Haywood, L Julian

    2002-01-01

    Background The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) is a randomized, double-blind, active-controlled trial designed to compare the rate of coronary heart disease events in high-risk hypertensive participants initially randomized to a diuretic (chlorthalidone) versus each of three alternative antihypertensive drugs: alpha-adrenergic blocker (doxazosin), ACE-inhibitor (lisinopril), and calcium-channel blocker (amlodipine). Combined cardiovascular disease risk was significantly increased in the doxazosin arm compared to the chlorthalidone arm (RR 1.25; 95% CI, 1.17–1.33; P < .001), with a doubling of heart failure (fatal, hospitalized, or non-hospitalized but treated) (RR 2.04; 95% CI, 1.79–2.32; P < .001). Questions about heart failure diagnostic criteria led to steps to validate these events further. Methods and Results Baseline characteristics (age, race, sex, blood pressure) did not differ significantly between treatment groups (P < .05) for participants with heart failure events. Post-event pharmacologic management was similar in both groups and generally conformed to accepted heart failure therapy. Central review of a small sample of cases showed high adherence to ALLHAT heart failure criteria. Of 105 participants with quantitative ejection fraction measurements provided, (67% by echocardiogram, 31% by catheterization), 29/46 (63%) from the chlorthalidone group and 41/59 (70%) from the doxazosin group were at or below 40%. Two-year heart failure case-fatalities (22% and 19% in the doxazosin and chlorthalidone groups, respectively) were as expected and did not differ significantly (RR 0.96; 95% CI, 0.67–1.38; P = 0.83). Conclusion Results of the validation process supported findings of increased heart failure in the ALLHAT doxazosin treatment arm compared to the chlorthalidone treatment arm. PMID:12459039

  8. Recruitment and Retention of Participants for an International Type 1 Diabetes Prevention Trial: A Coordinators’ Perspective

    PubMed Central

    Franciscus, Margaret; Nucci, Anita; Bradley, Brenda; Suomalainen, Heli; Greenberg, Ellen; LaForte, Diane; Kleemola, Paivi; Hyytinen, Mila; Salonen, Marja; Martin, Mary Jean; Catte, Daniel; Catteau, Jacki

    2013-01-01

    Background The Trial to Reduce Insulin Dependent Diabetes Mellitus in the Genetically at Risk (TRIGR) is the first multicenter international type 1 diabetes (T1D) prevention trial to be undertaken. A unique feature of TRIGR has been recruitment of eligible pregnant women and enrollment of newborns for long-term follow-up assessments. Purpose Our purpose is to summarize the recruitment and retention strategies used to conduct TRIGR from the perspective of the study coordinators. Methods TRIGR was designed to test whether weaning to formula containing hydrolyzed vs. intact cow’s milk protein would be efficacious in decreasing risk for development of T1D-associated autoantibodies and T1D among infants identified to be at increased risk for T1D based on their human leukocyte antigen (HLA) profile and family history. Multiple strategies tailored to local issues were required to enroll and follow the target number of infants. Results The study was conducted in the United States, Canada, Australia and 12 countries in Europe. Of the 5,606 mothers registered world-wide, 5,000 of their infants were randomized. Of these, 2,159 were HLA eligible and enrolled in the 8-month intervention and 10-year follow-up phases of the study. The TRIGR study met the accrual goal after 4.7 years of recruitment, 2.7 years longer than projected initially. Challenges included difficulty in finding fathers with T1D, a higher than expected rate of premature delivery amongst T1D mothers, and implementation of new privacy regulations mid-trial. The majority of participants were recruited from primary care antenatal clinics located near the study centers and from a general hospital or pediatric center that was affiliated with a TRIGR Study center. Internet and magazine advertisements were found to be useful for recruitment of families. Alternative follow-up strategies are offered to families who wish to reduce or discontinue participation. Limitations Our experience is limited to a single

  9. Prevention of mental disorders, substance abuse, and problem behaviors: a developmental perspective.

    PubMed

    Beardslee, William R; Chien, Peter L; Bell, Carl C

    2011-03-01

    Robust scientific evidence shows that mental, emotional, and behavioral disorders can be prevented before they begin. This article highlights and expands points from a 2009 Institute of Medicine report to provide a concise summary of the literature on preventing mental illness. Because prevention requires intervention before the onset of illness, effective preventive approaches are often interdisciplinary and developmental. Evidence-based preventive strategies are discussed for the different phases of a young person's life. Specific recommendations to focus on parenting, child development, and the prevention of depression are made for a target audience of practicing psychiatrists and mental health professionals. Further systemic recommendations are to prioritize prevention and to coordinate and facilitate research on preventive practices in order to reduce suffering, create healthier families, and save money.

  10. Theoretical Perspectives on Learning for the Prevention of Fishing Vessel Accidents.

    ERIC Educational Resources Information Center

    Boshier, Roger

    2000-01-01

    Outlines a theoretical model for accident prevention education that includes four paradigms: humanism, radical humanism, functionalism, and radical functionalism. Applies the model to fishing boat accidents and derives implications for changing the content and processes of prevention education. (SK)

  11. Family Violence Prevention Programs in Immigrant Communities: Perspectives of Immigrant Men

    ERIC Educational Resources Information Center

    Simbandumwe, Louise; Bailey, Kim; Denetto, Shereen; Migliardi, Paula; Bacon, Brenda; Nighswander, Maggie

    2008-01-01

    The Strengthening Families in Canada Family Violence Prevention Project was aimed at engaging immigrant and refugee communities in family violence prevention. The project, which received support from the Community Mobilization Program, National Crime Prevention Strategy, involved a partnership of four community health and education organizations.…

  12. Working-class Filipino women's perspectives on factors that facilitate or hinder prenatal micronutrients supplementation to prevent congenital anomalies.

    PubMed

    Daack-Hirsch, Sandra; Gamboa, Henrietta

    2012-11-01

    The study was conducted to plan for a community-health campaign to inform working-class Filipinos about the causes and prevention of orofacial clefting. Prenatal micronutrients may play a role in preventing orofacial clefting. Therefore, women's practices and perspectives on barriers to and facilitators of micronutrient supplementation were elicited. A total of 43 women and 22 health care workers were interviewed. Barriers to taking supplements included side effects, late prenatal care, the view that micronutrients are medications, inadequate supply, and health care workers who were unaware that prenatal vitamin supplements prevent congenital anomalies. The main facilitator was women's understanding that prenatal micronutrients improve the physical well-being of both mother and child. Given that women view having healthy babies as a reason to take micronutrients and that the health care workers lacked knowledge related to the use of micronutrients to prevent congenital anomalies, uptake of prenatal micronutrient supplementation programs may improve by specifically promoting the health benefit of preventing congenital anomalies.

  13. Patient barriers to implantable cardioverter defibrillator implantation for the primary prevention of sudden cardiac death in patients with heart failure and reduced ejection fraction

    PubMed Central

    Chan, Laura Lihua; Lim, Choon Pin; Aung, Soe Tin; Quetua, Paul; Ho, Kah Leng; Chong, Daniel; Teo, Wee Siong; Sim, David; Ching, Chi Keong

    2016-01-01

    INTRODUCTION Device therapy is efficacious in preventing sudden cardiac death (SCD) in patients with reduced ejection fraction. However, few who need the device eventually opt to undergo implantation and even fewer reconsider their decisions after deliberation. This is due to many factors, including unresolved patient barriers. This study identified the factors that influenced patients’ decision to decline implantable cardioverter defibrillator (ICD) implantation, and those that influenced patients who initially declined an implant to reconsider having one. METHODS A single-centre survey was conducted among 240 patients who had heart failure with reduced ejection fraction and met the ICD implantation criteria, but had declined ICD implantation. RESULTS Participants who refused ICD implantation were mostly male (84%), Chinese (71%), married (72%), currently employed (54%), and had up to primary or secondary education (78%) and monthly income of < SGD 3,000 (51%). Those who were more likely to reconsider their decision were aware that SCD was a consequence of heart failure with reduced ejection fraction, knowledgeable of the preventive role of ICDs, currently employed and aware that their doctor strongly recommended the implant. Based on multivariate analysis, knowledge of the role of ICDs for primary prophylaxis was the most important factor influencing patient decision. CONCLUSION This study identified the demographic and social factors of patients who refused ICD therapy. Knowledge of the role of ICDs in preventing SCD was found to be the strongest marker for reconsidering ICD implantation. Measures to address this information gap may lead to higher rates of ICD implantation. PMID:27075476

  14. Prevention

    MedlinePlus

    ... Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox Vaccine Guidance Infection Control: Hospital Infection Control: Home ... Mouth Infection) Poxvirus and Rabies Branch Travelers’ Health: Smallpox & Other Orthopoxvirus-Associated Infections Poxvirus Prevention Recommend on ...

  15. Preventable Failure: Improvements in Long-Term Outcomes When High Schools Focused on the Ninth Grade Year. Research Summary

    ERIC Educational Resources Information Center

    Roderick, Melissa; Kelley-Kemple, Thomas; Johnson, David W.; Beechum, Nicole O.

    2014-01-01

    In 2007, spurred by University of Chicago Consortium on Chicago School Research (UChicago CCSR) research reports, leadership at the Chicago Public Schools (CPS) began a new targeted approach to reducing course failure in the ninth grade. The research suggested that the transition between eighth and ninth grade played a critical role in shaping…

  16. A feminist perspective on risk factor research and on the prevention of eating disorders.

    PubMed

    Piran, Niva

    2010-01-01

    This review utilizes a feminist lens to discuss risk factor research and prevention work in the field of eating disorders. The article suggests that feminist informed risk factor research needs to consider gender as it intersects with other social variables as a relevant higher level risk factor and examine its relationship to individual level risk factors such as the internalization of thinness or negative body image. The article also highlights the key elements of participatory approaches and systemic changes to feminist informed prevention work. Prevention work conducted to date suggests the relevance of these elements to achieving behavioral changes in prevention work.

  17. Can oral vitamin D prevent the cardiovascular diseases among migrants in Australia? Provider perspective using Markov modelling.

    PubMed

    Ruwanpathirana, Thilanga; Owen, Alice; Renzaho, Andre M N; Zomer, Ella; Gambhir, Manoj; Reid, Christopher M

    2015-06-01

    The study was designed to model the effectiveness and cost effectiveness of oral Vitamin D supplementation as a primary prevention strategy for cardiovascular disease among a migrant population in Australia. It was carried out in the Community Health Service, Kensington, Melbourne. Best-case scenario analysis using a Markov model was employed to look at the health care providers' perspective. Adult migrants who were vitamin D deficient and free from cardiovascular disease visiting the medical centre at least once during the period from 1 January 2010 to 31 December 2012 were included in the study. The blood pressure-lowering effect of vitamin D was taken from a published meta-analysis and applied in the Framingham 10 year cardiovascular risk algorithm (with and without oral vitamin D supplements) to generate the probabilities of cardiovascular events. A Markov decision model was used to estimate the provider costs associated with the events and treatments. Uncertainties were derived by Monte Carlo simulation. Vitamin D oral supplementation (1000 IU/day) for 10 years could potentially prevent 31 (interquartile range (IQR) 26 to 37) non-fatal and 11 (IQR 10 to 15) fatal cardiovascular events in a migrant population of 10,000 assuming 100% compliance. The provider perspective incremental cost effectiveness per year of life saved was AU$3,992 (IQR 583 to 8558). This study suggests subsidised supplementation of oral vitamin D may be a cost effective intervention to reduce non-fatal and fatal cardiovascular outcomes in high-risk migrant populations.

  18. Practitioners' Perspectives on Cultural Sensitivity in Latina/o Teen Pregnancy Prevention

    ERIC Educational Resources Information Center

    Wilkinson-Lee, Ada M.; Russell, Stephen T.; Lee, Faye C. H.

    2006-01-01

    This study examined practitioners' understandings of cultural sensitivity in the context of pregnancy prevention programs for Latina teens. Fifty-eight practitioners from teen pregnancy prevention programs in California were interviewed in a guided conversation format. Three themes emerged in our analysis. First, practitioners' definitions of…

  19. Public Health and Church-Based Constructions of HIV Prevention: Black Baptist Perspective

    ERIC Educational Resources Information Center

    Roman Isler, Malika; Eng, Eugenia; Maman, Susanne; Adimora, Adaora; Weiner, Bryan

    2014-01-01

    The black church is influential in shaping health behaviors within African-American communities, yet few use evidence-based strategies for HIV prevention (abstinence, monogamy, condoms, voluntary counseling and testing, and prevention with positives). Using principles of grounded theory and interpretive description, we explored the social…

  20. Integrating the Perspective of Vulnerable Heterosexual Male Adolescents to Prevent Premature Paternity and Sexually Transmitted Infection

    ERIC Educational Resources Information Center

    Manseau, Helene; Blais, Martin; Engler, Kim; Bosse, Marie-Andre

    2008-01-01

    This study presents the perspective of vulnerable Canadian (Quebecker) adolescents defined as such on account of their numerous experiences with potential or actual fatherhood or exposure to sexually transmitted infection. The interviews allowed youth to talk about their experiences with paternity, their sex lives and their views on sex education.…

  1. The EARLY ALLIANCE prevention trial: an integrated set of interventions to promote competence and reduce risk for conduct disorder, substance abuse, and school failure.

    PubMed

    Dumas, J E; Prinz, R J; Smith, E P; Laughlin, J

    1999-03-01

    Describes the EARLY ALLIANCE interventions, an integrated set of four programs designed to promote competence and reduce risk for early-onset conduct disorder, substance abuse, and school failure. These interventions are evaluated as part of a prevention trial that begins at school entry and targets child functioning and socializing practices across multiple contexts (school, peer group, family) and multiple domains (affective, social, and achievement coping-competence). The paper presents the conceptual foundation of the four interventions, including a synopsis of the risk and protective factors associated with conduct disorder and related outcomes, and of the coping-competence model driving EARLY ALLIANCE. The developmental rationale, intended impact, and procedures are described for each intervention: a universally administered classroom program and indicated, peer, reading-mentoring, and family programs. Interventions are currently being tested in a prevention trial, which is briefly summarized.

  2. Public health and church-based constructions of HIV prevention: black Baptist perspective

    PubMed Central

    Roman Isler, Malika; Eng, Eugenia; Maman, Susanne; Adimora, Adaora; Weiner, Bryan

    2014-01-01

    The black church is influential in shaping health behaviors within African-American communities, yet few use evidence-based strategies for HIV prevention (abstinence, monogamy, condoms, voluntary counseling and testing, and prevention with positives). Using principles of grounded theory and interpretive description, we explored the social construction of HIV prevention within black Baptist churches in North Carolina. Data collection included interviews with church leaders (n = 12) and focus groups with congregants (n = 7; 36 participants). Analytic tools included open coding and case-level comparisons. Social constructions of HIV/AIDS prevention were influenced by two worldviews: public health and church-based. Areas of compatibility and incompatibility exist between the two worldviews that inform acceptability and adaptability of current evidence-based strategies. These findings offer insight into ways to increase the compatibility of evidence-based HIV prevention strategies within the black Baptist church context. PMID:24643141

  3. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia

    PubMed Central

    Cyril, Sheila; Green, Julie; Nicholson, Jan M.; Agho, Kingsley; Renzaho, Andre M. N.

    2016-01-01

    Background Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers’ perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities’ participation in these services. Methods We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Results Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. Conclusion This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health

  4. Prevention of postpartum hemorrhage in low-resource settings: current perspectives

    PubMed Central

    Prata, Ndola; Bell, Suzanne; Weidert, Karen

    2013-01-01

    Background Postpartum hemorrhage (PPH) is the leading cause of maternal death in low-income countries and is the primary cause of approximately one-quarter of global maternal deaths. The purpose of this paper is to provide a review of PPH prevention interventions, with a particular focus on misoprostol, and the challenges and opportunities that preventing PPH in low-resource settings presents. Methods Using PubMed, we conducted a review of the literature on the randomized controlled trials of interventions to prevent PPH. We then searched PubMed and Google Scholar for nonrandomized field trials of interventions to prevent PPH. We limited our review to interventions that are discussed in the current World Health Organization (WHO) recommendations for PPH prevention and present evidence regarding the use of these interventions. We focused our review on nondrug PPH prevention interventions compared with no intervention and uterotonics versus placebo; this review does not decipher the relative effectiveness of uterotonic drugs. We describe challenges to and opportunities for scaling up PPH prevention interventions. Results Active management of the third stage of labor is considered the “gold standard” strategy for reducing the incidence of PPH. It combines nondrug interventions (controlled cord traction and cord clamping) with the administration of an uterotonic drug, the preferred uterotonic being oxytocin. Unfortunately, oxytocin has limited application in resource-poor countries, due to its heat instability and required administration by a skilled provider. New heat-stable drugs and drug formulations are currently in development that may improve the prevention of PPH; however, misoprostol is a viable option for provision at home by a lay health care worker or the woman herself, in the interim. Conclusion As the main cause of maternal mortality worldwide, PPH prevention interventions need to be prioritized. Increased access to prophylactic uterotonics, regardless

  5. Alternatives to Antibiotics to Prevent Necrotic Enteritis in Broiler Chickens: A Microbiologist's Perspective

    PubMed Central

    Caly, Delphine L.; D'Inca, Romain; Auclair, Eric; Drider, Djamel

    2015-01-01

    Since the 2006 European ban on the use of antibiotics as growth promoters in animal feed, numerous studies have been published describing alternative strategies to prevent diseases in animals. A particular focus has been on prevention of necrotic enteritis in poultry caused by Clostridium perfringens by the use of microbes or microbe-derived products. Microbes produce a plethora of molecules with antimicrobial properties and they can also have beneficial effects through interactions with their host. Here we review recent developments in novel preventive treatments against C. perfringens-induced necrotic enteritis in broiler chickens that employ yeasts, bacteria and bacteriophages or secondary metabolites and other microbial products in disease control. PMID:26648920

  6. [Safety and health in work from the perspective of the Prevention of Occupational Hazards Act].

    PubMed

    Gómez-Hortigüela Amillo, J

    1996-01-01

    The passing of the Prevention of Occupational Hazards Act, (Ley 31/1995), constituted a change in direction in the development of occupational safety and health in Spain. This article describes the most salient points of this new legislation, from the criteria and principles that have to govern preventive activities, to the obligations and rights of both employers and workers, together with the co-operation and co-ordination of the activities of the various Administrations which have jurisdiction and the participation of employers' and workers' organisations, as the backbone of policy in matters concerning the prevention of occupational hazards.

  7. A translational neuroscience perspective on mindfulness meditation as a prevention strategy.

    PubMed

    Tang, Yi-Yuan; Leve, Leslie D

    2016-03-01

    Mindfulness meditation research mainly focuses on psychological outcomes such as behavioral, cognitive, and emotional functioning. However, the neuroscience literature on mindfulness meditation has grown in recent years. This paper provides an overview of relevant neuroscience and psychological research on the effects of mindfulness meditation. We propose a translational prevention framework of mindfulness and its effects. Drawing upon the principles of prevention science, this framework integrates neuroscience and prevention research and postulates underlying brain regulatory mechanisms that explain the impact of mindfulness on psychological outcomes via self-regulation mechanisms linked to underlying brain systems. We conclude by discussing potential clinical and practice implications of this model and directions for future research.

  8. What Prevents Quality Midwifery Care? A Systematic Mapping of Barriers in Low and Middle Income Countries from the Provider Perspective

    PubMed Central

    McConville, Fran; Portela, Anayda

    2016-01-01

    Background Quality of care is essential for further progress in reducing maternal and newborn deaths. The integration of educated, trained, regulated and licensed midwives into the health system is associated with improved quality of care and sustained decreases in maternal and newborn mortality. To date, research on barriers to quality of care for women and newborns has not given due attention to the care provider’s perspective. This paper addresses this gap by presenting the findings of a systematic mapping of the literature of the social, economic and professional barriers preventing midwifery personnel in low and middle income countries (LMICs) from providing quality of care. Methods and Findings A systematic search of five electronic databases for literature published between January 1990 and August 2013. Eligible items included published and unpublished items in all languages. Items were screened against inclusion and exclusion criteria, yielding 82 items from 34 countries. 44% discussed countries or regions in Africa, 38% in Asia, and 5% in the Americas. Nearly half the articles were published since 2011. Data was extracted and presented in a narrative synthesis and tables. Items were organized into three categories; social; economic and professional barriers, based on an analytical framework. Barriers connected to the socially and culturally constructed context of childbirth, although least reported, appear instrumental in preventing quality midwifery care. Conclusions Significant social and cultural, economic and professional barriers can prevent the provision of quality midwifery care in LMICs. An analytical framework is proposed to show how the overlaps between the barriers reinforce each other, and that they arise from gender inequality. Links are made between burn out and moral distress, caused by the barriers, and poor quality care. Ongoing mechanisms to improve quality care will need to address the barriers from the midwifery provider perspective

  9. Assessment of the Broader Economic Consequences of HPV Prevention from a Government-Perspective: A Fiscal Analytic Approach

    PubMed Central

    Setiawan, Didik; Kotsopoulos, Nikolaos; Wilschut, Jan C.; Postma, Maarten J.; Connolly, Mark P.

    2016-01-01

    Background Cervical cancer poses a substantial burden in terms of morbidity, mortality, and economic losses, especially in low/middle-income countries. HPV vaccination and/or cervical cancer screening among females may reduce the burden of HPV-related diseases, including cervical cancer. However, limited funds may impede the implementation of population-based programmes. Governmental investments in the prevention of infectious disease may have broader economic and fiscal benefits, which are not accounted in conventional economic analyses. This study estimates the broader economic and fiscal impacts of implementing HPV vaccination and/or cervical cancer screening in Indonesia from the perspective of the government. Methods A government-perspective quantitative analytic framework was applied to assess the Net Present Value (NPV) of investment on cervical cancer prevention strategies including HPV vaccination, cervical screening and its combination in Indonesia. All monetary values were presented in International Dollars (I$). Results Based on a cohort of 10,000,000 Indonesian 12-year-old females, it was estimated that HPV vaccination and/or cervical cancer screening result in a positive NPV for the Indonesian government. The combination of cervical screening and HPV vaccination generated a substantial reduction of cervical cancer incidence and HPV-related mortality of 87,862 and 19,359, respectively. It was estimated that HPV vaccination in combination with cervical screening is the most favorable option for cervical cancer prevention (NPV I$2.031.786.000), followed by HPV vaccination alone (NPV I$1.860.783.000) and cervical screening alone (NPV I$375.244.000). Conclusion In addition to clinical benefits, investing in HPV vaccination and cervical screening may yield considerable fiscal benefits for the Indonesian governments due to lifelong benefits resulting from reduction of cervical cancer-related morbidity and mortality. PMID:27490258

  10. Real-Time Smart Grids Control for Preventing Cascading Failures and Blackout using Neural Networks: Experimental Approach for N-1-1 Contingency

    NASA Astrophysics Data System (ADS)

    Zarrabian, Sina; Belkacemi, Rabie; Babalola, Adeniyi A.

    2016-12-01

    In this paper, a novel intelligent control is proposed based on Artificial Neural Networks (ANN) to mitigate cascading failure (CF) and prevent blackout in smart grid systems after N-1-1 contingency condition in real-time. The fundamental contribution of this research is to deploy the machine learning concept for preventing blackout at early stages of its occurrence and to make smart grids more resilient, reliable, and robust. The proposed method provides the best action selection strategy for adaptive adjustment of generators' output power through frequency control. This method is able to relieve congestion of transmission lines and prevent consecutive transmission line outage after N-1-1 contingency condition. The proposed ANN-based control approach is tested on an experimental 100 kW test system developed by the authors to test intelligent systems. Additionally, the proposed approach is validated on the large-scale IEEE 118-bus power system by simulation studies. Experimental results show that the ANN approach is very promising and provides accurate and robust control by preventing blackout. The technique is compared to a heuristic multi-agent system (MAS) approach based on communication interchanges. The ANN approach showed more accurate and robust response than the MAS algorithm.

  11. Ammonia tank failure

    SciTech Connect

    Sweat, M.E.

    1983-04-01

    An ammonia tank failure at Hawkeye Chemical of Clinton, Iowa is discussed. The tank was a double-wall, 27,000 metric-ton tank built in 1968 and commissioned in December 1969. The paper presented covers the cause of the failure, repair, and procedural changes made to prevent recurrence of the failure. (JMT)

  12. Heart Failure

    MedlinePlus

    ... version of this page please turn Javascript on. Heart Failure What is Heart Failure? In heart failure, the heart cannot pump enough ... failure often experience tiredness and shortness of breath. Heart Failure is Serious Heart failure is a serious and ...

  13. The immigrant Haitian mother: transcultural nursing perspective on preventive health care for children.

    PubMed

    DeSantis, L; Thomas, J T

    1990-01-01

    Thirty immigrant Haitian mothers in Southeast Florida were interviewed regarding their beliefs and practices about preventive health care (illness prevention and health maintenance measures) for infants and preschool children (up to age 5). All mothers used preventive health care measures from both the Western biomedical and traditional Haitian ethnomedical (folk) systems. Ninety-seven percent used magico-religious measures; 47% administered home remedies; 47% gave children over-the-counter drugs; and 35% utilized a variety of measures to ensure cold air did not enter neonates and cause illness or pain. The Haitian mothers considered the preventive health care measures effective because the children remained healthy and will likely use them again. They sought consultation from a variety of individuals who formed their health management groups and child caretaker networks. Infants and toddlers were considered at higher risk than newborns for illness due to "evil harm" inflicted by other people and/or voodoo spirits. Implications for transcultural nursing practice include developing community outreach programs, implementing nursing interventions that combine biomedical and ethnomedical preventive health care measures, and functioning as part of the health management group. The authors wish to thank Maude Vincent, R.N., for her assistance in data gathering and analysis.

  14. Perspectives

    ERIC Educational Resources Information Center

    Tarone, Elaine

    2013-01-01

    The topic of this "Perspectives" column is "Requiring a Proficiency Level as a Requirement for U.S. K-12 Teacher Licensure." In 1998, the American Council of Teachers of Foreign Languages (ACTFL) began to work with the National Council for Accreditation of Teacher Education (NCATE), which accredits teacher education programs…

  15. Uterine prolapse prevention in Eastern Nepal: the perspectives of women and health care professionals

    PubMed Central

    Radl, Christina M; Rajwar, Ranjita; Aro, Arja R

    2012-01-01

    Uterine prolapse is a major reproductive health issue in Nepal. There is a wide range of literature available on the causes and risk factors of uterine prolapse and on the ways to prevent and treat it. There is still a lack of published evidence on what prevention and treatment services are working well or the attitudes toward them. This paper presents the findings of a qualitative study on primary and secondary prevention of uterine prolapse in Eastern Nepal. Method The study involved eight focus group discussions with 71 women in six villages of the eastern districts of Siraha and Saptari and 14 qualitative interviews with health professionals from the local to central level. The group discussions and interviews covered the awareness levels of uterine prolapse and its prevention and treatment, as well as participants’ opinions on and experiences with the services offered. Results It was found that patriarchy, gender discrimination, and cultural traditions such as early marriage and pregnancy make it difficult for people to discontinue uterine prolapse risk behaviors. Women are aware of risk factors, prevention, and treatment, but are powerless to change their situations. Health professionals and women are fond of surgery as treatment, but opinions on the use of ring pessaries and pelvic floor muscle training are split. Conclusion The main recommendation that can be drawn from this study is that research on the effectiveness of early treatments, such as ring pessaries and exercise, should be conducted. Furthermore, the involvement of other target groups (husbands, adolescents, and mothers-in-law) needs to be increased in order to make it easier for women to adapt low-risk behaviors. Finally, uterine prolapse prevention should be better integrated in national reproductive health services. Enforcing transparency, monitoring systems, and collaborations are important factors that should be considered as well. PMID:22927768

  16. A fresh perspective from immunologists and vaccine researchers: Active vaccination strategies to prevent and reverse Alzheimer’s disease

    PubMed Central

    Agadjanyan, M.G.; Petrovsky, N.; Ghochikyan, A.

    2015-01-01

    Traditional vaccination against infectious diseases relies on generation of cellular and humoral immune responses that act to protect the host from overt disease even although they do not induce sterilizing immunity. More recently, attempts have been made with mixed success to generate therapeutic vaccines against a wide range of non-infectious diseases including neurodegenerative disorders. Following the exciting first report of successful vaccine prevention of progression of an AD animal model in 1999, various epitope-based vaccines targeting beta-amyloid (Aβ) have proceeded to human clinical trials, with varied results. More recently, AD vaccines based on tau protein have advanced into clinical testing too. This review seeks to put perspective to the mixed results obtained so far in clinical trials of AD vaccines, and discuss the many pitfalls and misconceptions encountered on the path to a successful AD vaccine, including better standardization of immunological efficacy measures of antibodies, immunogenicity of platform/carrier and adjuvants. PMID:26192465

  17. No-reflow phenomenon: pathophysiology, diagnosis, prevention, and treatment. A review of the current literature and future perspectives.

    PubMed

    Galasso, Gennaro; Schiekofer, Stephan; D'Anna, Carolina; Gioia, Giuseppe Di; Piccolo, Raffaele; Niglio, Tullio; Rosa, Roberta De; Strisciuglio, Teresa; Cirillo, Plinio; Piscione, Federico; Trimarco, Bruno

    2014-03-01

    No-reflow is responsible for 40% of the primary percutaneous coronary intervention without complete myocardial reperfusion despite successful reopening of the infarct-related artery. This review describes the main pathophysiological mechanisms of no-reflow, its clinical manifestation, including the strong association with increased in-hospital mortality, malignant arrhythmias, and cardiac failure as well as the diagnostic methods. The latter ranges from simple angiographic thrombolysis in myocardial infarction grade score to more complex angiographic indexes, imaging techniques such as myocardial contrast echo or cardiac magnetic resonance, and surrogate clinical end points such as ST-segment resolution. This review also summarizes the strategies of prevention and treatment of no-reflow, considering the most recent studies results regarding medical therapy and devices.

  18. Animal Models and “Omics” Technologies for Identification of Novel Biomarkers and Drug Targets to Prevent Heart Failure

    PubMed Central

    Hou, Yunlong; Adrian-Segarra, Juan M.; Richter, Manfred; Kubin, Natalia; Shin, Jaeyoung; Werner, Isabella; Walther, Thomas; Schönburg, Markus; Pöling, Jochen; Warnecke, Henning; Braun, Thomas; Kostin, Sawa; Kubin, Thomas

    2015-01-01

    It is now accepted that heart failure (HF) is a complex multifunctional disease rather than simply a hemodynamic dysfunction. Despite its complexity, stressed cardiomyocytes often follow conserved patterns of structural remodelling in order to adapt, survive, and regenerate. When cardiac adaptations cannot cope with mechanical, ischemic, and metabolic loads efficiently or become chronically activated, as, for example, after infection, then the ongoing structural remodelling and dedifferentiation often lead to compromised pump function and patient death. It is, therefore, of major importance to understand key events in the progression from a compensatory left ventricular (LV) systolic dysfunction to a decompensatory LV systolic dysfunction and HF. To achieve this, various animal models in combination with an “omics” toolbox can be used. These approaches will ultimately lead to the identification of an arsenal of biomarkers and therapeutic targets which have the potential to shape the medicine of the future. PMID:26236717

  19. Indian students' perspectives on obesity and school-based obesity prevention: a qualitative examination.

    PubMed

    Riggs, Nathaniel; Tewari, Abha; Stigler, Melissa; Rodrigues, Lindsay; Arora, Monika; Khubchandani, Jagdish; Simmons, Rob; Pentz, Mary Ann

    2013-11-01

    Childhood obesity has recently been reported as a growing problem in low- and middle-income countries. One potential prevention strategy is to apply effective obesity prevention approaches from the United States and/or other Western countries into programs that can be implemented in developing countries such as India. The purpose of this study was to explore Indian students' perceptions of social-contextual factors related to obesity and whether they perceived a role for school-based obesity prevention. This study was conducted as a first step in a model to translate interventions from one culture to another. A total of 183 fourth- and fifth-grade students of middle socioeconomic status participated in focus group discussions. Analyses were guided by the essential principles of qualitative research and informed by social cognitive and social ecological theories. Results yielded five relevant themes: (a) student health behavior knowledge, (b) parental influence on health behavior, (c) school influence on health behavior, (d) media influence on health behavior, and (e) contexts for health promotion intervention. We found that students had moderate knowledge related to health behaviors (i.e., food intake and physical activity); that parents, schools, and the media are all important contributors to healthy and unhealthy behavior; and that schools can play an important role in the prevention of obesity. Results suggest that Indian middle socioeconomic status students are already moderately aware of the health benefits to nutritious food intake and physical activity, but parents, schools, and the media can influence unhealthy behaviors.

  20. First-Year Students' Perspectives on Reasons for and Prevention of Their Own Alcohol Overdose

    ERIC Educational Resources Information Center

    Reis, Janet

    2014-01-01

    Two hundred twenty-six first-year students enrolled at a large, public Midwest university and deemed to require an emergency transport for a potential alcohol overdose completed a brief questionnaire on the student's perceptions of why the event occurred, what might have happened to prevent the overdose situation, and personal assessment of…

  1. Substance abuse prevention in Cape Town's peri-urban settlements: local health trainers' perspectives

    PubMed Central

    Puljević, Cheneal; Learmonth, Despina

    2014-01-01

    South Africa currently experiences high levels of alcohol and other drug (AOD) abuse. As a result there is a need for the initiation of regional AOD abuse prevention programmes with a specific focus on youth prevention strategies. The Medical Knowledge Institute (MKI) is a non-profit organisation which develops and facilitates health information workshops to members of disadvantaged peri-urban communities in South Africa. This research investigated the views of eight local MKI health trainers on factors contributing to AOD abuse in their communities. Although the expected focus of the discussion was on prevention strategies and effective interventions, the trainers placed more emphasis on the individual and community factors influencing AOD abuse. The themes which emerged through the research included: status, government, (di)stress, gender, recreation, consequences and community. This research holds significance as it has the potential to assist further development of community-based AOD prevention workshops and to guide public health policy and service development for AOD abuse. PMID:25750776

  2. Facilitators and Barriers to Discussing HIV Prevention With Adolescents: Perspectives of HIV-Infected Parents

    PubMed Central

    Reis, Janet S.; Weber, Kathleen M.

    2013-01-01

    Objectives. We examined HIV-infected parents’ conversations about HIV prevention with their uninfected children, including what facilitated or hindered communication. Methods. Parents with HIV/AIDS (n = 90) who had children aged 10 to 18 years were recruited for a mixed method study from 2009 to 2010. Interviews assessed facilitators and barriers to discussing HIV prevention. A questionnaire identified the frequency and content of conversations, parental confidence level, and perceived importance of discussing preventive topics. Results. Eighty-one percent of parents reported “sometimes” or “often” communicating about HIV prevention. A subset of parents found these conversations difficult; 44% indicated their desire for support. Facilitators to communication included utilizing support, focusing on the benefits of talking, and having a previous relationship with one’s child. Barriers to discussions included fear of negative consequences, living in denial, and lacking a parental role model who discussed safer sex. Parents varied as to how they believed their HIV status affected communication. Those who did not disclose their HIV status to their children reported less frequent communication; self-efficacy partially mediated this relationship. Conclusions. Findings highlighted the need for communication skills training that support HIV-infected parents in their efforts to discuss HIV-related information with adolescents. PMID:23763390

  3. A Preventative Model of School Consultation: Incorporating Perspectives from Positive Psychology

    ERIC Educational Resources Information Center

    Akin-Little, K. Angeleque; Little, Steven G.; Delligatti, Nina

    2004-01-01

    Using the principles of mental health and behavioral consultation, combined with concepts from positive psychology, this paper generates a new preventative model of school consultation. This model has two steps: (1) the school psychologist aids the teacher in the development and use of his/her personal positive psychology (e.g., optimism,…

  4. Prevalence, consequences and prevention of childhood nutritional iron deficiency: a child public health perspective.

    PubMed

    Moy, R J D

    2006-10-01

    The true extent of nutritional iron deficiency (ID) in childhood is unclear because of uncertainty over its definition and the insensitivity of markers of ID. The major cause is likely to be the excessive and early use of cow's milk. Recent neurophysiological observations support the many field studies correlating ID with cognitive developmental delays. Prevention is best sought through supplementation of essential foods.

  5. A Media Campaign Prevention Program for Child Sexual Abuse: Community Members' Perspectives

    ERIC Educational Resources Information Center

    Self-Brown, Shannon; Rheingold, Alyssa A.; Campbell, Carole; de Arellano, Michael A.

    2008-01-01

    This study examines the face validity and feasibility of materials included in a multimedia child sexual abuse (CSA) prevention campaign. A quantitative survey method assessed participants' comfort level, knowledge gain, and likelihood of behavioral change in response to the media campaign. Furthermore, a focus group method explored participants'…

  6. The Prevention of the Workplace Harassment at Japanese Universities:The Perspective of the Research and the Findings from the Complete Count Survey

    ERIC Educational Resources Information Center

    Kawabata, Tomoko

    2014-01-01

    This article shows the perspective of this research and the result of the complete count survey performed from October to November in 2013 to examine the attitude toward the prevention and the resolution of the workplace harassment at the Japanese universities. The questionnaire was distributed to 1131 universities, two years colleges, and…

  7. Germ-line gene modification and disease prevention: some medical and ethical perspectives.

    PubMed

    Wivel, N A; Walters, L

    1993-10-22

    There has been considerable debate about the ethics of human germ-line gene modification. As a result of recent advances in the micromanipulation of embryos and the laboratory development of transgenic mice, a lively discussion has begun concerning both the technical feasibility and the ethical acceptability of human germ-line modification for the prevention of serious disease. This article summarizes some of the recent research on germ-line gene modification in animal models. Certain monogenic deficiency diseases that ultimately might be candidates for correction by germ-line intervention are identified. Several of the most frequently considered ethical issues relative to human germ-line gene modification are considered in the context of professional ethics, parental responsibility, and public policy. Finally, it is suggested that there is merit in continuing the discussion about human germ-line intervention, so that this technique can be carefully compared with alternative strategies for preventing genetic disease.

  8. Violent and aggressive behaviors in youth: a mental health and prevention perspective.

    PubMed

    Osofsky, H J; Osofsky, J D

    2001-01-01

    Aggressive behavior and violence leading to disciplinary and legal difficulties have reached epidemic proportions among our youth. The severity of problems and social and economic costs to society have increased markedly. In this article, the authors review the risk factors, situational concerns, and warning signs that are important in predicting school violence and in designing effective prevention and early intervention efforts. They then describe programs with which they are involved as mental health professionals that appear to be extremely promising and applicable to other communities. The prevention and intervention programs are distinctive in that they involve collaborations with law enforcement, including the police and criminal sheriff, and the juvenile court as well as parents and schools in their efforts to promote positive development. These clinical, educational, and public policy approaches offer mental health professionals increased opportunities to be of help in this critical area.

  9. Parents as health promoters: a theory of planned behavior perspective on the prevention of childhood obesity.

    PubMed

    Andrews, Kyle R; Silk, Kami S; Eneli, Ihuoma U

    2010-01-01

    Childhood obesity is a significant problem in the United States. A number of communication campaigns and interventions have been conducted to combat the problem, with parents being recognized as an important target audience. A critical aspect of involving parents in such campaigns is formative research on parents' perceptions of their role in preventing childhood obesity. To facilitate this process, a study was conducted in which parents (N = 201) responded to Theory of Planned Behavior (TPB) survey items as they relate to providing healthy foods and limiting unhealthy foods for their children. Results indicated support for TPB predictions. Additionally, the degree to which parents viewed providing healthy foods and limiting unhealthy foods as effective in preventing obesity (response efficacy) was predictive of parent tracking of children's unhealthy eating behavior. Finally, parent TV viewing behavior was related to perceived response efficacy of limiting children's TV viewing hours. Practical implications for communication practitioners are discussed.

  10. The role of public schools in HIV prevention: perspectives from African Americans in the rural South.

    PubMed

    Lloyd, Stacey W; Ferguson, Yvonne Owens; Corbie-Smith, Giselle; Ellison, Arlinda; Blumenthal, Connie; Council, Barbara J; Youmans, Selena; Muhammad, Melvin R; Wynn, Mysha; Adimora, Adaora; Akers, Aletha

    2012-02-01

    Though African-American youth in the South are at high risk for HIV infection, abstinence until marriage education continues to be the only option in some public schools. Using community-based participatory research methods, we conducted 11 focus groups with African-American adults and youth in a rural community in North Carolina with high rates of HIV infection with marked racial disparities. Focus group discussions explored participant views on contributors to the elevated rates of HIV and resources available to reduce transmission. Participants consistently identified the public schools' sex education policies and practices as major barriers toward preventing HIV infection among youth in their community. Ideas for decreasing youth's risk of HIV included public schools providing access to health services and sex education. Policymakers, school administrators, and other stakeholders should consider the public school setting as a place to provide HIV prevention education for youth in rural areas.

  11. Using social networks to understand and prevent substance use: a transdisciplinary perspective.

    PubMed

    Valente, Thomas W; Gallaher, Peggy; Mouttapa, Michele

    2004-01-01

    We review findings from research on smoking, alcohol, and other drug use, which show that the network approaCh is instructive for understanding social influences on substance use. A hypothetical network is used throughout to illustrate different network findings and provide a short glossary of terms. We then describe how network analysis can be used to design more effective prevention programs and to monitor and evaluate these programs. The article closes with a discussion of the inherent transdisciplinarity of social network analysis.

  12. Strategies for the prevention of stigma in psychiatry: Perspectives on local Psychiatric Rehabilitation.

    PubMed

    Amorosi, Marilisa

    2014-11-01

    The author, along the many years of her experience about psychiatric clinical cases on the community work, has acquired expertise in the field psychiatric rehabilitation and prevention of psychological discomfort or psychiatric disorder. Particular attention she and har team have always put the issue ok killing of the stigma and prejudice about mental illness, also through an invilment of the general populazion, school and etc. Her Experiences has shown that all of the strategies, as well as drug therapies and psycoterapies, improve recovery.

  13. Prophylactic orthosteric inhibition of leukocyte integrin CD11b/CD18 prevents long-term fibrotic kidney failure in cynomolgus monkeys

    PubMed Central

    Dehnadi, Abbas; Benedict Cosimi, A.; Neal Smith, Rex; Li, Xiangen; Alonso, José L.; Means, Terry K.; Arnaout, M. Amin

    2017-01-01

    Ischaemic acute kidney injury (AKI), an inflammatory disease process, often progresses to chronic kidney disease (CKD), with no available effective prophylaxis. This is in part due to lack of clinically relevant CKD models in non-human primates. Here we demonstrate that inhibition of the archetypal innate immune receptor CD11b/CD18 prevents progression of AKI to CKD in cynomolgus monkeys. Severe ischaemia-reperfusion injury of the right kidney, with subsequent periods of the left ureter ligation, causes irreversible right kidney failure 3, 6 or 9 months after AKI. Moreover, prophylactic inactivation of CD11b/CD18, using the orthosteric CD11b/CD18 inhibitor mAb107, improves microvascular perfusion and histopathology, reduces intrarenal pro-inflammatory mediators and salvages kidney function long term. These studies reveal an important early role of CD11b+ leukocytes in post-ischaemic kidney fibrosis and failure, and suggest a potential early therapeutic intervention to mitigate progression of ischaemic AKI to CKD in humans. PMID:28071653

  14. Predicting outflow induced by moraine failure in glacial lakes: the Lake Palcacocha case from an uncertainty perspective

    NASA Astrophysics Data System (ADS)

    Rivas, D. S.; Somos-Valenzuela, M. A.; Hodges, B. R.; McKinney, D. C.

    2015-06-01

    Moraine dam collapse is one of the causes of glacial lake outburst floods. Available models seek to predict both moraine breach formation and lake outflow. The models depend on hydraulic, erosion, and geotechnical parameters that are mostly unknown or uncertain. This paper estimates the outflow hydrograph caused by a potential erosive collapse of the moraine dam of Lake Palcacocha in Peru and quantifies the uncertainty of the results. The overall aim is to provide a simple yet hydraulically robust approach for calculating the expected outflow hydrographs that is useful for risk assessment studies. To estimate the peak outflow and failure time of the hydrograph, we assessed several available empirical equations based on lake and moraine geometries; each equation has defined confidence intervals for peak flow predictions. Complete outflow hydrographs for each peak flow condition were modeled using a hydraulic simulation model calibrated to match the peak flows estimated with the empirical equations. Failure time and peak flow differences between the simulations, and the corresponding empirical equations were used as error parameters. Along with an expected hydrograph, lower and upper bound hydrographs were calculated for Lake Palcacocha, representing the confidence interval of the results. The approach has several advantages: first, it is simple and robust. Second, it evaluates the capability of empirical equations to reproduce the conditions of the lake and moraine dam. Third, this approach accounts for uncertainty in the hydrographs estimations, which makes it appropriate for risk management studies.

  15. Predicting outflow induced by moraine failure in glacial lakes: the Lake Palcacocha case from an uncertainty perspective

    NASA Astrophysics Data System (ADS)

    Rivas, D. S.; Somos-Valenzuela, M. A.; McKinney, D. C.; Hodges, B. R.

    2014-09-01

    Moraine dam collapse is one of the causes of Glacier Lake Outburst Floods. Available models seek to predict both moraine breach formation and lake outflow. The models depend on hydraulic, erosion, and geotechnical parameters that are mostly unknown or uncertain. This paper estimates the outflow hydrograph caused by a potential collapse of the moraine dam of Lake Palcacocha in Peru and quantifies the uncertainty of the results. The overall aim is to provide a simple and robust method of calculation of the expected outflow hydrographs that is useful for risk assessment studies. To estimate the peak outflow and failure time of the hydrograph, we assessed several available empirical equations based on lake and moraine geometries; each equation has defined confidence intervals for peak flow predictions. Complete outflow hydrographs for each peak flow condition were modeled using a~hydraulic simulation model calibrated to meet the peak flows estimated with the empirical equations. Failure time and peak flow differences between the simulations and the corresponding empirical equations were used as error parameters. Along with an expected hydrograph, lower and upper bound hydrographs were calculated for Lake Palcacocha, representing the confidence interval of the results. The method has several advantages: first, it is simple and robust. Second, it evaluates the capability of empirical equations to reproduce the conditions of the lake and moraine dam. Third, this method accounts for uncertainty in the hydrographs estimations, which makes it appropriate for risk management studies.

  16. The role of the emergency department in the management of acute heart failure: An international perspective on education and research.

    PubMed

    Pang, Peter S; Collins, Sean P; Miró, Òscar; Bueno, Hector; Diercks, Deborah B; Di Somma, Salvatore; Gray, Alasdair; Harjola, Veli-Pekka; Hollander, Judd E; Lambrinou, Ekaterini; Levy, Phillip D; Papa, AnnMarie; Möckel, Martin

    2015-08-11

    Emergency departments are a major entry point for the initial management of acute heart failure (AHF) patients throughout the world. The initial diagnosis, management and disposition - the decision to admit or discharge - of AHF patients in the emergency department has significant downstream implications. Misdiagnosis, under or overtreatment, or inappropriate admission may place patients at increased risk for adverse events, and add costs to the healthcare system. Despite the critical importance of initial management, data are sparse regarding the impact of early AHF treatment delivered in the emergency department compared to inpatient or chronic heart failure management. Unfortunately, outcomes remain poor, with nearly a third of patients dying or re-hospitalised within 3 months post-discharge. In the absence of robust research evidence, consensus is an important source of guidance for AHF care. Thus, we convened an international group of practising emergency physicians, cardiologists and advanced practice nurses with the following goals to improve outcomes for AHF patients who present to the emergency department or other acute care setting through: (a) a better understanding of the pathophysiology, presentation and management of the initial phase of AHF care; (b) improving initial management by addressing knowledge gaps between best practices and current practice through education and research; and (c) to establish a framework for future emergency department-based international education and research.

  17. Review of Matrix Metalloproteinases’ Effect on the Hybrid Dentin Bond Layer Stability and Chlorhexidine Clinical Use to Prevent Bond Failure

    PubMed Central

    Moon, Peter C; Weaver, Jared; Brooks, Carol N

    2010-01-01

    This review describes the relationship between dentin collagen hybrid bond layer degradation and the Matrix Metalloproteinases (MMPs) after their release by acid etch and rinse adhesives and self etching bonding adhesives that can reduce the bond stability over time. MMP-2, MMP-8 and MMP-9 are indicated as the active proteases that breakdown the collagen fibrils in the hybrid bond layer. Phosphoric acid in the acid etch and rinse bonding process and acid primers in the self etch process are implicated in the release of these proteases and their activation by several non-collagen proteins also released from dentin by the etching. MMPs are released in saliva by salivary glands, by cells in the gingival crevices to crevicular fluid and by pulpal odontoblasts cells to the dentinal fluids. These sources may affect the hybrid layer also. Evidence of the bond strength deterioration over time and the ability of Chlorhexidine to prevent bond deterioration by inhibiting MMP action are discussed. Dentin Bonding procedure utilizing Chlorhexidine for different application times and concentrations are being developed. The application of 2% Chlorhexidine to the phosphoric acid etch surface after rinsing off the acid is the only procedure that has been clinically tested for a longer period of time and shown to prevent bond strength degradation so far. The adoption of this procedure is recommended as means of improving bond stability at this time. PMID:21339893

  18. Prevention and Treatment of Flatulence From a Traditional Persian Medicine Perspective

    PubMed Central

    Larijani, Bagher; Esfahani, Mohammad Medhi; Moghimi, Maryam; Shams Ardakani, Mohammad Reza; Keshavarz, Mansoor; Kordafshari, Gholamreza; Nazem, Esmaiel; Hasani Ranjbar, Shirin; Mohammadi Kenari, Hoorieh; Zargaran, Arman

    2016-01-01

    Context The feeling of abdominal fullness, bloating, and movement of gas in the abdomen is a very uncomfortable sensation termed flatulence. Since flatulence is one of the most common gastrointestinal symptoms that is bothersome to patients, it is important to identify effective methods to resolve this issue. In modern medicine, management of flatulence is often not satisfactory. On the other hand, traditional systems of medicine can be considered good potential sources to find new approaches for preventing and treating flatulence. The aim of this study is to review flatulence treatments from a traditional Persian medicine (TPM) viewpoint. Evidence Acquisition In this study, the reasons for flatulence and methods for its prevention and treatment are reviewed in traditional Persian medicine (TPM) texts and then related with evidence from modern medicine by searching in databases, including PubMed, Scopus, Google Scholar, and IranMedex. Results From a traditional Persian scholar viewpoint, one of the most important causes of flatulence is an incorrect manner of eating; valuable advice to correct bad eating habits will be illustrated. In addition, traditional practitioners describe some herbs and vegetables as well as herbal compounds that are effective food additives to relieve flatulence. The anti-flatulent effect of most of these herbs has been experimentally verified using modern medicine. Conclusions Attention to TPM can lead to the identification of new preventive and curative approaches to avoid and treat flatulence. In addition, Persian viewpoints from the medieval era regarding flatulence are historically important. PMID:27275398

  19. Application of environmental sensitivity theories in personalized prevention for youth substance abuse: a transdisciplinary translational perspective.

    PubMed

    Thibodeau, Eric L; August, Gerald J; Cicchetti, Dante; Symons, Frank J

    2016-03-01

    Preventive interventions that target high-risk youth, via one-size-fits-all approaches, have demonstrated modest effects in reducing rates of substance use. Recently, substance use researchers have recommended personalized intervention strategies. Central to these approaches is matching preventatives to characteristics of an individual that have been shown to predict outcomes. One compelling body of literature on person × environment interactions is that of environmental sensitivity theories, including differential susceptibility theory and vantage sensitivity. Recent experimental evidence has demonstrated that environmental sensitivity (ES) factors moderate substance abuse outcomes. We propose that ES factors may augment current personalization strategies such as matching based on risk factors/severity of problem behaviors (risk severity (RS)). Specifically, individuals most sensitive to environmental influence may be those most responsive to intervention in general and thus need only a brief-type or lower-intensity program to show gains, while those least sensitive may require more comprehensive or intensive programming for optimal responsiveness. We provide an example from ongoing research to illustrate how ES factors can be incorporated into prevention trials aimed at high-risk adolescents.

  20. Current Perspectives on Prevention of Mother-to-Child Transmission of Syphilis

    PubMed Central

    2016-01-01

    This article aims to provide an update on the prevention of mother-to-child transmission of syphilis by drawing upon some important basic concepts and reviewing the most recent literature on the diagnosis and treatment of syphilis in pregnancy. New technologies, such as automated and point-of-care immunologic tests, are shifting some paradigms, which will certainly be further investigated in the forthcoming years. This is the time to carefully evaluate traditional as well as new strategies to prevent congenital syphilis. Adverse outcomes of mother-to-child transmission of syphilis can be prevented with antenatal screening and penicillin therapy, which proved to have an excellent cost-benefit ratio even in populations with a low prevalence of syphilis. However, syphilis epidemiology is influenced by socioeconomic and cultural factors, and major challenges are faced by poor and developing countries in which the severity of the problem is extremely alarming. On the other hand, the emergence of new technologies has raised doubts about the best algorithm to be used when proper laboratory resources are available. Conditions are quite heterogeneous across populations, and some procedures should not be generalized while there is no evidence that supports some changes and while in-depth studies about local conditions are not conducted. Official organizations need to be alert in order to avoid isolated decisions and ensure that evidence-based guidelines be used in the management of syphilis in pregnancy. PMID:27081586

  1. Oral administration of both tetrahydrobiopterin and L-arginine prevents endothelial dysfunction in rats with chronic renal failure.

    PubMed

    Yamamizu, Kohei; Shinozaki, Kazuya; Ayajiki, Kazuhide; Gemba, Munekazu; Okamura, Tomio

    2007-03-01

    We examined the mechanism of endothelial dysfunction in chronic renal failure (CRF), with reference to NO synthase. CRF was induced by 5/6 nephrectomy in rats. Either L-arginine (1.25 g/L in drinking water), tetrahydrobiopterin (BH4, 10 mg/kg per day in food), or a combination of the 2 were orally administered to CRF rats for 9 weeks. CRF rats showed elevation of systolic blood pressure compared with sham-operated rats. Endothelium-dependent relaxation induced by acetylcholine or A23187 in the isolated aorta was significantly reduced, and in vitro treatment with L-arginine, BH4, or superoxide dismutase restored the relaxation. Aortic segments from CRF rats showed significantly higher superoxide production in response to A23187, which was inhibited by L-NAME. Plasma concentrations of asymmetric dimethylarginine and symmetric dimethylarginine were higher in CRF rats. These changes in CRF rats were totally or partially decreased by L-arginine or BH4 supplementation in vivo. Interestingly, the combined treatment showed additive effects in certain parameters. These results suggest that vascular disorders in CRF rats may be partly due to NOS uncoupling caused by a relative deficiency of BH4 and partially due to accumulation of endogenous inhibitors of NOS and L-arginine uptake, resulting in the decrease of NO production and the increase of reactive oxygen species.

  2. Infection prevention and control strategies in the era of limited resources and quality improvement: a perspective paper.

    PubMed

    Vandijck, Dominique; Cleemput, Irina; Hellings, Johan; Vogelaers, Dirk

    2013-11-01

    This paper aims to describe, using an evidence-based approach, the importance of and the resources necessary for implementing effective infection prevention and control (IPC) programmes. The intrinsic and explicit values of such strategies are presented from a clinical, health-economic and patient safety perspective. Policy makers and hospital managers are committed to providing comprehensive, accessible, and affordable healthcare of high quality. Changes in the healthcare system over time accompanied with variations in demographics and case-mix have considerably affected the availability, quality and ultimately the safety of healthcare. The main goal of an IPC programme is to prevent and control healthcare-associated infections (HAI). Many patient-, healthcare provider-, and organizational factors are associated with an increased risk for acquiring HAIs and may impact both the quality and outcome of patient care. Evidence has been published in support of having an effective IPC programme. It has been estimated that about one-third of HAIs could be prevented if key elements of the evidence-based recommendations for IPC are adequately introduced and followed. However, several healthcare agencies from over the world have reported deficits in the essential resources and components of current IPC programmes. To meet its main goal, staffing, training, and infrastructure requirements are needed. Nevertheless, and given the economic crisis, policy makers and hospital managers may be tempted to not increase or even to reduce the budget as it consumes resources and does not generate sufficient visible revenue. IPC is a critical issue in patient safety, as HAIs are by far the most common complication affecting admitted patients. The significant clinical and health-economic burden HAIs place on the healthcare system speak to the importance of getting introduced effective IPC programmes.

  3. Tissue factor pathway inhibitor prevents airway obstruction, respiratory failure and death due to sulfur mustard analog inhalation

    SciTech Connect

    Rancourt, Raymond C. Veress, Livia A. Ahmad, Aftab Hendry-Hofer, Tara B. Rioux, Jacqueline S. Garlick, Rhonda B. White, Carl W.

    2013-10-01

    Sulfur mustard (SM) inhalation causes airway injury, with enhanced vascular permeability, coagulation, and airway obstruction. The objective of this study was to determine whether recombinant tissue factor pathway inhibitor (TFPI) could inhibit this pathogenic sequence. Methods: Rats were exposed to the SM analog 2-chloroethyl ethyl sulfide (CEES) via nose-only aerosol inhalation. One hour later, TFPI (1.5 mg/kg) in vehicle, or vehicle alone, was instilled into the trachea. Arterial O{sub 2} saturation was monitored using pulse oximetry. Twelve hours after exposure, animals were euthanized and bronchoalveolar lavage fluid (BALF) and plasma were analyzed for prothrombin, thrombin–antithrombin complex (TAT), active plasminogen activator inhibitor-1 (PAI-1) levels, and fluid fibrinolytic capacity. Lung steady-state PAI-1 mRNA was measured by RT-PCR analysis. Airway-capillary leak was estimated by BALF protein and IgM, and by pleural fluid measurement. In additional animals, airway cast formation was assessed by microdissection and immunohistochemical detection of airway fibrin. Results: Airway obstruction in the form of fibrin-containing casts was evident in central conducting airways of rats receiving CEES. TFPI decreased cast formation, and limited severe hypoxemia. Findings of reduced prothrombin consumption, and lower TAT complexes in BALF, demonstrated that TFPI acted to limit thrombin activation in airways. TFPI, however, did not appreciably affect CEES-induced airway protein leak, PAI-1 mRNA induction, or inhibition of the fibrinolytic activity present in airway surface liquid. Conclusions: Intratracheal administration of TFPI limits airway obstruction, improves gas exchange, and prevents mortality in rats with sulfur mustard-analog-induced acute lung injury. - Highlights: • TFPI administration to rats after mustard inhalation reduces airway cast formation. • Inhibition of thrombin activation is the likely mechanism for limiting casts. • Rats given TFPI

  4. Oleanane triterpenoids in the prevention and therapy of breast cancer: current evidence and future perspectives

    PubMed Central

    Parikh, Nisha R.; Mandal, Animesh; Bhatia, Deepak; Siveen, Kodappully Sivaraman; Sethi, Gautam

    2014-01-01

    Breast cancer is one of the most frequently diagnosed cancers and major cause of death in women in the world. Emerging evidence underscores the value of dietary and non-dietary phytochemicals, including triterpenoids, in the prevention and treatment of breast cancer. Oleanolic acid, an oleanane-type pentacyclic triterpenoid, is present in a large number of dietary and medicinal plants. Oleanolic acid and its derivatives exhibit several promising pharmacological activities, including antioxidant, anti-inflammatory, hepatoprotective, cardioprotective, antipruritic, spasmolytic, antiallergic, antimicrobial and antiviral effects. Numerous studies indicate that oleanolic acid and other oleanane triterpenoids modulate multiple intracellular signaling pathways and exert chemopreventive and antitumor activities in various in vitro and in vivo model systems. A series of novel synthetic oleanane triterpenoids have been prepared by chemical modifications of oleanolic acid and some of these compounds are considered to be the most potent anti-inflammatory and anticarcinogenic triterpenoids. Accumulating studies provide extensive evidence that synthetic oleanane derivatives inhibit proliferation and induce apoptosis of various cancer cells in vitro and demonstrate cancer preventive or antitumor efficacy in animal models of blood, breast, colon, connective tissue, liver, lung, pancreas, prostate and skin cancer. This review critically examines the potential role of oleanolic acid, oleanane triterpenoids and related synthetic compounds in the chemoprevention and treatment of mammary neoplasia. Both in vitro and in vivo studies on these agents and related molecular mechanisms are presented. Several challenges and future directions of research to translate already available impressive preclinical knowledge to clinical practice of breast cancer prevention and therapy are also presented. PMID:25395898

  5. Why Adolescents Fight: A Qualitative Study of Youth Perspectives on Fighting and Its Prevention

    PubMed Central

    Shetgiri, Rashmi; Lee, Simon C.; Tillitski, John; Wilson, Connie; Flores, Glenn

    2014-01-01

    Objective Identify risk factors for fighting, factors that protect against fighting, and strategies to prevent fighting, among adolescents who fight and those uninvolved in fighting. Methods Focus groups were conducted with middle and high-school students, stratified by fighting (fighter/non-fighter) status, race/ethnicity, and gender. Groups were audiotaped, transcribed, and analyzed using margin coding and thematic content analysis. Themes were independently identified by three coders; disagreements were resolved by consensus. Results The 65 participants in the 12 focus groups were 13–17 years old. Reasons for fighting include self-defense, to gain/maintain respect, or due to anger; having goals for the future is protective. Non-fighters state that their parents condone fighting only when physically attacked, and teach adolescents strategies to avoid fighting. Fighters describe mixed messages from parents, and pro-fighting attitudes and modeling of aggressive behavior among some family members. Non-fighters avoid fighting by ignoring insults or walking away. Fighters feel unable to use nonviolent conflict-resolution methods effectively. Peers may instigate or encourage fights. Suggested prevention strategies include anger-management and conflict-resolution programs, relationships with caring adults, and physicians counseling youth about the consequences of fighting. Conclusions Non-fighters use various strategies to avoid fighting, whereas fighters are aware of few alternatives to fighting. Conflicting parental messages about fighting may enhance the likelihood of fighting. Physicians can counsel youth about the negative consequences of fighting. Interventions that teach anger management and conflict resolution, promote adolescent self-efficacy for using non-violent strategies, and address parental attitudes about fighting may be effective in preventing fighting. PMID:25528128

  6. [A 100-year perspective on renal function and hypertension. Anti-renin therapy has made hypertensive renal failure a rarity].

    PubMed

    Bergström, G; Herlitz, H; Himmelmann, A; Ljungman, S; Aurell, M

    1999-11-24

    One hundred years ago, in 1898, Professor Robert Tigerstedt, Karolinska institutet, Sweden, discovered renin. The subsequent elaboration in 1960 of the renin-angiotensin-aldosterone system signalled the start of modern hypertension research. The kidney takes part in blood pressure regulation in a number of ways. Indications are that increased renovascular resistance due to increased renin-angiotensin activity is of importance for the barostatic function of the kidneys and for the pathogenesis of human hypertension. Several commonly used, efficacious and well tolerated antihypertensive agents act by blocking the renin-angiotensin system, thus normalising kidney function. A number of current large-scale trials--utilising ACE inhibitors and angiotensin receptor antagonists--will, it is hoped, elucidate the proper role of 'anti-renin therapy' in the treatment of hypertension. Thanks to effective modern management of hypertension, renal failure due to hypertensive kidney disease is rare in Sweden today.

  7. Nonuremic Indication for Peritoneal Dialysis for Refractory Heart Failure in Cardiorenal Syndrome Type II: Review and Perspective

    PubMed Central

    Nakayama, Masaaki

    2013-01-01

    Cardiorenal syndrome (CRS) type II is a serious condition in which chronic cardiac abnormalities cause worsening kidney function, leading to permanent chronic kidney damage. Management of CRS type II coupled with diuretic-resistant congestive heart failure (CHF) has been an issue of dispute. However, since the early 1990s, reports indicating the clinical usefulness of peritoneal dialysis (PD) as maintenance therapy for intractable CHF in this population have been accumulating. The present manuscript reviews the mechanisms by which kidney dysfunction develops within CHF, and then examines recent experiences of PD as chronic supportive therapy for intractable CRS type II, reviews the contributing mechanisms, and discusses the rationale for using PD as a new therapeutic approach in the nonuremic setting of CHF. PMID:23349193

  8. Strategies to Engage Men and Boys in Violence Prevention: A Global Organizational Perspective

    PubMed Central

    Carlson, Juliana; Casey, Erin; Edleson, Jeffrey L.; Tolman, Richard M.; Neugut, Tova B.; Kimball, Ericka

    2014-01-01

    This study presents descriptive findings from in-depth interviews with 29 representatives of organizations in Africa, Asia, Europe, Oceania, and North and South America that engage men and boys in preventing gender-based violence. In particular, the findings suggest that strategies are responsive to the specific cultural, economic and contextual concerns of the local community, with nuanced messages and appropriate messengers. Additionally, respondents reported key principles informing their organizational strategies to deepen men and boys’ engagement. Attention is also paid to respondents’ caution about the risks of framing of engagement practices as separate from both women's organizations and women and girls themselves. PMID:26202155

  9. Strategies to Engage Men and Boys in Violence Prevention: A Global Organizational Perspective.

    PubMed

    Carlson, Juliana; Casey, Erin; Edleson, Jeffrey L; Tolman, Richard M; Walsh, Tova B; Kimball, Ericka

    2015-11-01

    This study presents descriptive findings from in-depth interviews with 29 representatives of organizations in Africa, Asia, Europe, Oceania, and North and South America that engage men and boys in preventing gender-based violence. In particular, the findings suggest that strategies are responsive to the specific cultural, economic, and contextual concerns of the local community, with nuanced messages and appropriate messengers. In addition, respondents reported key principles informing their organizational strategies to deepen men and boys' engagement. Attention is also paid to respondents' caution about the risks of framing of engagement practices as separate from both women's organizations and women and girls themselves.

  10. Perspectives on marijuana use and abuse and recommendations for preventing abuse.

    PubMed

    Carroll, J F

    1981-01-01

    Survey research on levels of use and attitudes toward marijuana by youth indicate a consistently favorable attitude toward occasional, moderate use. Use of marijuana is contrasted with the use of alcohol and tobacco by youth. Research findings re the dangers of marijuana use are summarized. The inability of legislators and law enforcement personnel to control access to and use of marijuana, coupled with the high cost of our present legal response to the marijuana challenge, leads to recommending legalization of marijuana, as well as, developing a generic primary prevention program for marijuana abuse which features distinguishing "responsible use" from "abuse." Criteria for judging marijuana abuse are provided.

  11. Parent, Teacher, and School Stakeholder Perspectives on Adolescent Pregnancy Prevention Programming for Latino Youth.

    PubMed

    Johnson-Motoyama, Michelle; Moses, Mindi; Kann, Tiffany Koloroutis; Mariscal, E Susana; Levy, Michelle; Navarro, Carolina; Fite, Paula J

    2016-12-01

    Teen pregnancy remains a public health concern particularly among Latinos, whose pregnancy rate of 83.5 per 1000 girls constitutes one of the highest rates of teen pregnancy among all ethnic and racial groups in the United States. To enhance the effectiveness of interventions for diverse Latino populations in the US, it is crucial to assess the community's understanding of the etiology of the problem of adolescent pregnancy and to implement programs that reflect the local community's beliefs and preferences. We present findings from six focus groups held with parents (n = 18), teachers (n = 23) and school stakeholders (n = 8) regarding teen pregnancy prevention among Latino youth at a high school located in a large, Midwestern city. Two investigators analyzed data iteratively using a template organizing approach. A consensus emerged across the groups regarding content that emphasized respect for oneself and one's family, a focus on personal and shared responsibility in reproductive health behavior, information about the "realities" or consequences associated with engaging in sexual activity, and information about contraceptives. The strong request from participants to include a parental education component reflects the community's belief that parents play a crucial, protective role in the socialization and development of adolescent sexual behavior, a view that is supported by empirical research. Findings highlight the importance of involving local school communities in identifying adolescent pregnancy prevention strategies that are responsive to the community's cultural values, beliefs, and preferences, as well as the school's capacity and teacher preferences.

  12. Perspectives of traditional health practitioners on the use of microbicides for the prevention of HIV.

    PubMed

    Walwyn, David; Maitshotlo, Boitumelo

    2012-01-01

    In many South African communities, Traditional Health Practitioners (THPs) are significant participants within a plural health care system. For several years, it has been argued that this role, especially in the context of HIV/AIDS, has not been fully optimised and THPs continue to operate outside the formal biomedical sector, where the latter forms the central means by which public health campaigns are delivered and implemented. In our previous research, we have shown that this separation of the biomedical and traditional sectors perpetuates a low level of understanding of HIV by THPs with adverse consequences for patients and the overall health care system. In this study we investigated whether biomedical/traditional division could be transformed through the involvement of THPs in the distribution of barrier microbicides; the latter are presently under investigation as a means of preventing HIV infection. We concluded that THPs could provide a willing and effective distribution network for the gel-based microbicides; given the large number of THPs and their patients, such a distribution strategy would ensure that microbicides are accessible and adopted relatively quickly within the target communities of the HIV prevention campaigns.

  13. Research perspectives: The 2013 AAOS/ORS research symposium on Bone Quality and Fracture Prevention.

    PubMed

    Donnelly, Eve; Lane, Joseph M; Boskey, Adele L

    2014-07-01

    Bone fracture resistance is determined by the amount of bone present ("bone quantity") and by a number of other geometric and material factors grouped under the term "bone quality." In May 2013, a workshop was convened among a group of clinicians and basic science investigators to review the current state of the art in Bone Quality and Fracture Prevention and to make recommendations for future directions for research. The AAOS/ORS/OREF workshop was attended by 64 participants, including two representatives of the National Institutes of Arthritis and Musculoskeletal and Skin Diseases and 13 new investigators whose posters stimulated additional interest. A key outcome of the workshop was a set of recommendations regarding clinically relevant aspects of both bone quality and quantity that clinicians can use to inform decisions about patient care and management. The common theme of these recommendations was the need for more education of clinicians in areas of bone quality and for basic science studies to address specific topics of pathophysiology, diagnosis, prevention, and treatment of altered bone quality. In this report, the organizers with the assistance of the speakers and other attendees highlight the major findings of the meeting that justify the recommendations and needs for this field.

  14. Cognitive representations of breast cancer, emotional distress and preventive health behaviour: a theoretical perspective.

    PubMed

    Decruyenaere, M; Evers-Kiebooms, G; Welkenhuysen, M; Denayer, L; Claes, E

    2000-01-01

    Individuals at high risk for developing breast and/or ovarian cancer are faced with difficult decisions regarding genetic testing, cancer prevention and/or intensive surveillance. Large interindividual differences exist in the uptake of these health-related services. This paper is aimed at understanding and predicting how people emotionally and behaviourally react to information concerning genetic predisposition to breast/ovarian cancer. For this purpose, the self-regulation model of illness representations is elaborated. This model suggests that health-related behaviour is influenced by a person's cognitive and emotional representation of the health threat. These representations generate coping behaviour aimed at resolving the objective health problems (problem-focussed coping) and at reducing the emotional distress induced by the health threat (emotion-focussed coping). Based on theoretical considerations and empirical studies, four interrelated attributes of the cognitive illness representation of hereditary breast/ovarian cancer are described: causal beliefs concerning the disease, perceived severity, perceived susceptibility to the disease and perceived controllability. The paper also addresses the complex interactions between these cognitive attributes, emotional distress and preventive health behaviour.

  15. African American women's perspectives on 'down low/DL' men: implications for HIV prevention.

    PubMed

    Goparaju, Lakshmi; Warren-Jeanpiere, Lari

    2012-01-01

    African American women are disproportionately affected by HIV. Some research has explored if non-disclosing men who have sex with men and women contribute to women's HIV risk. Popular media discourse tends to refer to these men as 'down low' or 'DL'. Six focus groups were conducted with 36 African American women in Washington, DC, to examine their knowledge, attitudes, beliefs and behaviours regarding DL men. Three of the focus groups were composed of HIV-positive women and three groups were composed of HIV-negative women. Data analysis reveals six central subcategories related to women's perspectives on the DL: awareness, suspicion, coping with partner infidelity (male versus female), sexual health communication, empathy and religion. No major differences were identified between the HIV-positive and HIV-negative focus groups. Findings from this study provide insight into African American women's perceptions of African American male sexuality and how these perceptions serve to influence interpersonal relationship factors and women's exposure to HIV risk.

  16. Anaemia in diabetic renal failure: is there a role for early erythropoietin treatment in preventing cardiovascular mortality?

    PubMed

    Abaterusso, Cataldo; Pertica, Nicoletta; Lupo, Antonio; Ortalda, Vittorio; Gambaro, Giovanni

    2008-09-01

    The mortality rate in diabetics with chronic kidney disease (CKD) is seven times higher than end-stage renal disease mainly because of cardiac causes. Anaemia may have a relevant role in the pathogenesis of cardiovascular (CV) disease in CKD. Anaemia occurs at an earlier stage of CKD in diabetic individuals than in those with other causes of CKD. Observational findings support the unfavourable influence of anaemia on mortality in CKD patients, and the combination of anaemia and CKD in diabetics identifies a group with a particularly high mortality risk. While the effect of erythropoietin on these patients' quality of life is known, its impact on mortality and CV risk is uncertain. The recent Anaemia Correction in Diabetes (ACORD) trial in diabetic CKD patients, which targeted haemoglobin levels of 13-15 mg/dl, disclosed no statistically significant favourable or adverse effects on mortality or morbidity over the 2-year follow-up, while other studies endeavouring to nearly normalize haemoglobin have reportedly proved risky. Even if anaemia is causally involved, the pathogenesis of CV disease in diabetics with CKD is so complex that addressing just one factor (anaemia) may not suffice to prevent CV risk, and normalizing haemoglobin levels may even be harmful.

  17. Repeat HIV Testing at Voluntary Testing and Counseling Centers in Croatia: Successful HIV Prevention or Failure to Modify Risk Behaviors?

    PubMed Central

    Matković Puljić, Vlatka; Kosanović Ličina, Mirjana Lana; Kavić, Marija; Nemeth Blažić, Tatjana

    2014-01-01

    HIV testing plays a critical role in preventing the spread of the virus and identifying infected individuals in need of care. Voluntary counseling and testing centers (VCTs) not only conduct testing but they also provide counseling. Since a proportion of people who test negative for HIV on their previous visit will return for retesting, the frequency of retesting and the characteristics of those who retest may provide insights into the efficacy of testing and counseling strategies. In this cross-sectional, retrospective study of 1,482 VCT clients in Croatia in 2010, 44.3% had been tested for HIV before. The rate of repeat HIV testing is lower in Croatia than in other countries. Men who have sex with men (MSM) clients, those with three or more sexual partners in the last 12 months, consistent condom users with steady partners, and intravenous drug users were more likely to be repeat testers. This finding suggests that clients presenting for repeat HIV testing are those who self-identify as being at a higher risk of infection. Our data showed that testing positive for HIV was not associated with repeat testing. However, the effects of repeat testing on HIV epidemiology needs to be explored. PMID:24705595

  18. Is radiation-induced ovarian failure in rhesus monkeys preventable by luteinizing hormone-releasing hormone agonists?: Preliminary observations

    SciTech Connect

    Ataya, K.; Pydyn, E.; Ramahi-Ataya

    1995-03-01

    With the advent of cancer therapy, increasing numbers of cancer patients are achieving long term survival. Impaired ovarian function after radiation therapy has been reported in several studies. Some investigators have suggested that luteinizing hormone-releasing hormone agonists (LHRHa) can prevent radiation-induced ovarian injury in rodents. Adult female rhesus monkeys were given either vehicle or Leuprolide acetate before, during, and after radiation. Radiation was given in a dose of 200 rads/day for a total of 4000 rads to the ovaries. Frequent serum samples were assayed for estradiol (E{sub 2}) and FSH. Ovariectomy was performed later. Ovaries were processed and serially sectioned. Follicle count and size distribution were determined. Shortly after radiation started, E{sub 2} dropped to low levels, at which it remained, whereas serum FSH level, which was low before radiation, rose soon after starting radiation. In monkeys treated with a combination of LHRHa and radiation, FSH started rising soon after the LHRHa-loaded minipump was removed (after the end of radiation). Serum E{sub 2} increased after the end of LHRHa treatment in the non-irradiated monkey, but not in the irradiated monkey. Follicle counts were not preserved in the LHRHa-treated monkeys that received radiation. The data demonstrated no protective effect of LHRHa treatment against radiation-induced ovarian injury in this rhesus monkey model. 58 refs., 2 figs., 1 tab.

  19. Predicting intentions versus predicting behaviors: domestic violence prevention from a theory of reasoned action perspective.

    PubMed

    Nabi, Robin L; Southwell, Brian; Hornik, Robert

    2002-01-01

    A central assumption of many models of human behavior is that intention to perform a behavior is highly predictive of actual behavior. This article presents evidence that belies this notion. Based on a survey of 1,250 Philadelphia adults, a clear and consistent pattern emerged suggesting that beliefs related to domestic violence correlate with intentions to act with respect to domestic violence but rarely correlate with reported actions (e.g., talking to the abused woman). Numerous methodological and substantive explanations for this finding are offered with emphasis placed on the complexity of the context in which an action to prevent a domestic violence incident occurs. We conclude by arguing that despite the small, insignificant relationships between beliefs and behaviors found, worthwhile aggregate effects on behavior might still exist, thus reaffirming the role of communication campaign efforts.

  20. Optimal dietary approaches for prevention of type 2 diabetes: a life-course perspective.

    PubMed

    Buyken, A E; Mitchell, P; Ceriello, A; Brand-Miller, J

    2010-03-01

    In recent years, several alternative dietary approaches, including high-protein and low-glycaemic-load diets, have produced faster rates of weight loss than traditional low-fat, high-carbohydrate diets. These diets share an under-recognised unifying mechanism: the reduction of postprandial glycaemia and insulinaemia. Similarly, some food patterns and specific foods (potatoes, white bread, soft drinks) characterised by hyperglycaemia are associated with higher risk of adiposity and type 2 diabetes. Profound compensatory hyperinsulinaemia, exacerbated by overweight, occurs during critical periods of physiological insulin resistance such as pregnancy and puberty. The dramatic rise in gestational diabetes and type 2 diabetes in the young may therefore be traced to food patterns that exaggerate postprandial glycaemia and insulinaemia. The dietary strategy with the strongest evidence of being able to prevent type 2 diabetes is not the accepted low-fat, high-carbohydrate diet, but alternative dietary approaches that reduce postprandial glycaemia and insulinaemia without adversely affecting other risk factors.

  1. Payment contracts in a preventive health care system: a perspective from operations management.

    PubMed

    Yaesoubi, Reza; Roberts, Stephen D

    2011-12-01

    We consider a health care system consisting of two noncooperative parties: a health purchaser (payer) and a health provider, where the interaction between the two parties is governed by a payment contract. We determine the contracts that coordinate the health purchaser-health provider relationship; i.e. the contracts that maximize the population's welfare while allowing each entity to optimize its own objective function. We show that under certain conditions (1) when the number of customers for a preventive medical intervention is verifiable, there exists a gate-keeping contract and a set of concave piecewise linear contracts that coordinate the system, and (2) when the number of customers is not verifiable, there exists a contract of bounded linear form and a set of incentive-feasible concave piecewise linear contracts that coordinate the system.

  2. Prevention and management of gastrointestinal infections in infants from a nutritional perspective.

    PubMed

    Purssell, Edward

    2009-01-01

    This article considers infections of the gastrointestinal (GI) tract. This is a complex organ, which exists in a range of environments. Despite containing defence mechanisms against microorganisms, GI infections are common throughout infancy; however, the risk of infection can be reduced through careful hygiene and the encouragement of breast-feeding. Although research into the role of dietary factors in preventing or treating GI infection is in its early days, there is some evidence for the use of prebiotics and probiotics. The role of health care professionals is to give parents and carers advice to manage these infections, and to differentiate those infants at risk of dehydration, or those where diarrhoea and vomiting signifies something more serious. Informing parents and carers about the treatment and management of minor ailments will also help avoid unnecessary demand on the health service associated with regular consultation about these conditions.

  3. A media campaign prevention program for child sexual abuse: community members' perspectives.

    PubMed

    Self-Brown, Shannon; Rheingold, Alyssa A; Campbell, Carole; de Arellano, Michael A

    2008-06-01

    This study examines the face validity and feasibility of materials included in a multimedia child sexual abuse (CSA) prevention campaign. A quantitative survey method assessed participants' comfort level, knowledge gain, and likelihood of behavioral change in response to the media campaign. Furthermore, a focus group method explored participants' attitudes and opinions regarding the campaign and the unique effects of ethnic or cultural norms on participants' acceptance of the media materials. Six groups, established based on participant ethnicity (i.e., three Caucasian groups, two African American groups, one Hispanic group), met at two sites in the Charleston, South Carolina, area. Quantitative data suggest that participants reported increased CSA knowledge and low levels of discomfort or anxiety related to exposure to the materials. Focus group results suggest that study participants, regardless of ethnic background, agreed that the media campaign can have a positive impact on public knowledge of CSA. Implications and directions for future research are discussed.

  4. Rosuvastatin, inflammation, C-reactive protein, JUPITER, and primary prevention of cardiovascular disease--a perspective.

    PubMed

    Kones, Richard

    2010-12-09

    The major public health concern worldwide is coronary heart disease, with dyslipidemia as a major risk factor. Statin drugs are recommended by several guidelines for both primary and secondary prevention. Rosuvastatin has been widely accepted because of its efficacy, potency, and superior safety profile. Inflammation is involved in all phases of atherosclerosis, with the process beginning in early youth and advancing relentlessly for decades throughout life. C-reactive protein (CRP) is a well-studied, nonspecific marker of inflammation which may reflect general health risk. Considerable evidence suggests CRP is an independent predictor of future cardiovascular events, but direct involvement in atherosclerosis remains controversial. Rosuvastatin is a synthetic, hydrophilic statin with unique stereochemistry. A large proportion of patients achieve evidence-based lipid targets while using the drug, and it slows progression and induces regression of atherosclerotic coronary lesions. Rosuvastatin lowers CRP levels significantly. The Justification for Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial was designed after the observation that when both low density lipoprotein and CRP were reduced, patients fared better than when only LDL was lowered. Advocates and critics alike acknowledge that the benefits of rosuvastatin in JUPITER were real. After a review, the US Food and Drug Administration extended the indications for rosuvastatin to include asymptomatic JUPITER-eligible individuals with one additional risk factor. The American Heart Association and Centers of Disease Control and Prevention had previously recognized the use of CRP in persons with "intermediate risk" as defined by global risk scores. The Canadian Cardiovascular Society guidelines went further and recommended use of statins in persons with low LDL and high CRP levels at intermediate risk. The JUPITER study focused attention on ostensibly healthy individuals with

  5. Rosuvastatin, inflammation, C-reactive protein, JUPITER, and primary prevention of cardiovascular disease – a perspective

    PubMed Central

    Kones, Richard

    2010-01-01

    The major public health concern worldwide is coronary heart disease, with dyslipidemia as a major risk factor. Statin drugs are recommended by several guidelines for both primary and secondary prevention. Rosuvastatin has been widely accepted because of its efficacy, potency, and superior safety profile. Inflammation is involved in all phases of atherosclerosis, with the process beginning in early youth and advancing relentlessly for decades throughout life. C-reactive protein (CRP) is a well-studied, nonspecific marker of inflammation which may reflect general health risk. Considerable evidence suggests CRP is an independent predictor of future cardiovascular events, but direct involvement in atherosclerosis remains controversial. Rosuvastatin is a synthetic, hydrophilic statin with unique stereochemistry. A large proportion of patients achieve evidence-based lipid targets while using the drug, and it slows progression and induces regression of atherosclerotic coronary lesions. Rosuvastatin lowers CRP levels significantly. The Justification for Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial was designed after the observation that when both low density lipoprotein and CRP were reduced, patients fared better than when only LDL was lowered. Advocates and critics alike acknowledge that the benefits of rosuvastatin in JUPITER were real. After a review, the US Food and Drug Administration extended the indications for rosuvastatin to include asymptomatic JUPITER-eligible individuals with one additional risk factor. The American Heart Association and Centers of Disease Control and Prevention had previously recognized the use of CRP in persons with “intermediate risk” as defined by global risk scores. The Canadian Cardiovascular Society guidelines went further and recommended use of statins in persons with low LDL and high CRP levels at intermediate risk. The JUPITER study focused attention on ostensibly healthy individuals

  6. Perspectives in Genetics and Sickle Cell Disease Prevention in Africa: Beyond the Preliminary Data from Cameroon.

    PubMed

    Wonkam, Ambroise; Ngo Bitoungui, Valentina Josiane; Ngogang, Jeanne

    2015-01-01

    Management of sickle cell disease (SCD) in Africa needs to be accompanied by various preventive strategies, including early detection via prenatal genetic diagnosis (PND). Contrary to Cameroonian doctors who considered termination of an affected pregnancy (TAP) for SCD in 36.1%, the majority of parents (62.5%) with affected children accepted TAP in principle. In practice, most women opted for TAP (90%), justified by a huge psycho-social burden. The ethical and legal challenges of PND prompted the need to explore the use of genetics for secondary prevention of SCD. In 610 Cameroonian SCD patients, the genomic variations in two principal foetal haemoglobin-promoting loci were significantly associated with foetal haemoglobin levels. In addition, the co-inheritance of a 3.7-kb α-globin gene deletion and SCD was associated with a late disease onset and possibly improved survival: there was a much higher allele frequency of the 3.7-kb α-globin gene deletion in SCD patients (∼ 40%) than in haemoglobin AA controls (∼ 10%). The data indicate the urgent need to develop and implement policy actions in sub-Saharan Africa on at least four levels: (1) the implementation of SCD screening practices and early neonatal follow-up; (2) the development and incorporating of socio-economic support to alleviate the burden of SCD on affected families; (3) the exploration of the appropriateness of the medical abortion laws for SCD, and (4) the development of national plans for genetic medicine, including research on genomic variants that affect the phenotypes of SCD, in order to potentially use them for anticipatory guidance.

  7. Rural perspectives on HIV/AIDS prevention: a comparative study of Thailand and Ghana.

    PubMed

    Aheto, Denis Worlanyo; Gbesemete, Kwame Prosper

    2005-04-01

    The paper compares rural perspectives in Thailand and Ghana on the level of condom acceptance in sexual relations, willingness to test oneself for HIV before and in marriage and sources of information on HIV/AIDS. We also compared the policy approaches to combating HIV/AIDS in both countries. The results indicates that in the villages studied in Thailand, all single men and the majority of the single women were in favour of using condoms in sexual relations. This group also showed a positive attitude to HIV/AIDS test before and in marriage. However, married men in rural Thailand disapproved of the use of condoms with their wives but married women in the sample population were open to the possibility of using condoms. Both married men and women were strongly against HIV/AIDS test in marriage. In contrast to Thailand, most single men in the communities studied in Ghana showed a disapproval to the use of condoms in sexual relations. However, they condoned HIV test before marriage. Married men and women in rural Ghana were against the use of condoms in sexual relations as well as HIV/AIDS test in marriage. In order to mitigate mother-to-child transmission, the Thais applied anti-retroviral drug care for HIV positive pregnant women during pregnancy and after delivery. In Ghana on the other hand, pregnant women were subject to HIV test and counselling. The mode of information acquisition on HIV/AIDS in both countries were through the media, campaigns and village volunteers. Finally, we observed that fighting poverty is a sine qua non for the success of any HIV/AIDS eradication programme.

  8. Alzheimer disease research in the 21st century: past and current failures, new perspectives and funding priorities.

    PubMed

    Pistollato, Francesca; Ohayon, Elan L; Lam, Ann; Langley, Gillian R; Novak, Thomas J; Pamies, David; Perry, George; Trushina, Eugenia; Williams, Robin S B; Roher, Alex E; Hartung, Thomas; Harnad, Stevan; Barnard, Neal; Morris, Martha Clare; Lai, Mei-Chun; Merkley, Ryan; Chandrasekera, P Charukeshi

    2016-06-28

    Much of Alzheimer disease (AD) research has been traditionally based on the use of animals, which have been extensively applied in an effort to both improve our understanding of the pathophysiological mechanisms of the disease and to test novel therapeutic approaches. However, decades of such research have not effectively translated into substantial therapeutic success for human patients. Here we critically discuss these issues in order to determine how existing human-based methods can be applied to study AD pathology and develop novel therapeutics. These methods, which include patient-derived cells, computational analysis and models, together with large-scale epidemiological studies represent novel and exciting tools to enhance and forward AD research. In particular, these methods are helping advance AD research by contributing multifactorial and multidimensional perspectives, especially considering the crucial role played by lifestyle risk factors in the determination of AD risk. In addition to research techniques, we also consider related pitfalls and flaws in the current research funding system. Conversely, we identify encouraging new trends in research and government policy. In light of these new research directions, we provide recommendations regarding prioritization of research funding. The goal of this document is to stimulate scientific and public discussion on the need to explore new avenues in AD research, considering outcome and ethics as core principles to reliably judge traditional research efforts and eventually undertake new research strategies.

  9. Alzheimer disease research in the 21st century: past and current failures, new perspectives and funding priorities

    PubMed Central

    Pistollato, Francesca; Ohayon, Elan L.; Lam, Ann; Langley, Gillian R.; Novak, Thomas J.; Pamies, David; Perry, George; Trushina, Eugenia; Williams, Robin S.B.; Roher, Alex E.; Hartung, Thomas; Harnad, Stevan; Barnard, Neal; Morris, Martha Clare; Lai, Mei-Chun; Merkley, Ryan; Chandrasekera, P. Charukeshi

    2016-01-01

    Much of Alzheimer disease (AD) research has been traditionally based on the use of animals, which have been extensively applied in an effort to both improve our understanding of the pathophysiological mechanisms of the disease and to test novel therapeutic approaches. However, decades of such research have not effectively translated into substantial therapeutic success for human patients. Here we critically discuss these issues in order to determine how existing human-based methods can be applied to study AD pathology and develop novel therapeutics. These methods, which include patient-derived cells, computational analysis and models, together with large-scale epidemiological studies represent novel and exciting tools to enhance and forward AD research. In particular, these methods are helping advance AD research by contributing multifactorial and multidimensional perspectives, especially considering the crucial role played by lifestyle risk factors in the determination of AD risk. In addition to research techniques, we also consider related pitfalls and flaws in the current research funding system. Conversely, we identify encouraging new trends in research and government policy. In light of these new research directions, we provide recommendations regarding prioritization of research funding. The goal of this document is to stimulate scientific and public discussion on the need to explore new avenues in AD research, considering outcome and ethics as core principles to reliably judge traditional research efforts and eventually undertake new research strategies. PMID:27229915

  10. Perspectives from Geriatric In-patients with Heart Failure, and their Caregivers, on Gaps in Care Quality

    PubMed Central

    Azad, Nahid; Lemay, Genevieve; Li, J.; Benzaquen, M.; Khoury, L.

    2016-01-01

    Background Evidence indicates that care experiences for complex HF patients could be improved by simple organizational and process changes, rather than complex clinical mechanisms. This survey identifies care gaps and recommends simple changes. Methods The study utilized both quantitative and qualitative methods at The Ottawa Hospital, Geriatric Medical Unit (GMU) during a three-month period. Results Nineteen patients (average age 85, 12 female) surveyed. Twelve participants lived alone. Fourteen lived in own home. Four patients had formal home-care services. Fifteen relied on family. Gaps were identified in in-patient practice, discharge plan, and discharge summary implementation feedback. Only five participants had seen a cardiologist or a specialist. Half of the patients did not know if they were on a special Heart-Failure (HF) diet. Participants did not recall receiving information on life expectancy but were comfortable discussing EoL care and dying. HF-specific management recommendations were mentioned in only 37% of discharge summaries to primary care providers (PCPs). Conclusion The results provide the starting point for a quality assurance and process re-engineering program in GMU. Organization change is needed to develop and integrate a cardiogeriatric clinical framework to allow the cardiologist, geriatrician, and PCP to actively work as a team with the patient/caregiver to develop the optimal care plan pre- and post-discharge. PMID:28050224

  11. Primary Prevention Is? A Global Perspective on How Organizations Engaging Men in Preventing Gender-Based Violence Conceptualize and Operationalize Their Work.

    PubMed

    Storer, Heather L; Casey, Erin A; Carlson, Juliana; Edleson, Jeffrey L; Tolman, Richard M

    2016-02-01

    Engaging men in addressing violence against women (VAW) has become a strategy in the global prevention of gender-based violence. Concurrently, Western public health frameworks have been utilized to guide prevention agendas worldwide. Using qualitative methods, this study describes how global anti-violence organizations that partner with men conceptualize primary prevention in their work. Findings suggest that "primary prevention" is not a fixed term in the context of VAW and that front-line prevention work challenges rigidly delineated distinctions between levels of prevention. Much can be learned from global organizations' unique and contextualized approaches to the prevention of VAW.

  12. "In reality, it is complex and difficult": UK nurses' perspectives on "treatment as prevention" within HIV care.

    PubMed

    Evans, Catrin; Bennett, Juliet; Croston, Michelle; Brito-Ault, Nathaniel; Bruton, Jane

    2015-01-01

    Globally, clinical guidelines for HIV treatment are being altered to reflect new research showing that successful treatment with antiretroviral therapies (ART) can prevent the onward transmission of HIV. As a result, health care services are being challenged to find ways to roll out "treatment as prevention" (TasP) as a public health measure. In theory, TasP requires individuals to start ART as soon as they are diagnosed - for public health reasons - which may be some time before ART for that individual is required for clinical reasons. There is currently little research on the acceptability of TasP from a patient or provider perspective. This paper reports findings from a qualitative study that sought to explore UK nurses' views and experiences of TasP in HIV care. Ten HIV specialist nurses, purposively selected from across the country, were interviewed. Results suggest that, although positive about TasP in principle, nurses hold several reservations about its implementation in practice. Perceived benefits of TasP include reassurance for patients that their loved ones are protected and that immediate care is available. Concerns include the possibility of sexual dis-inhibition or coercion within sexual relationships. In the UK context, decisions around TasP are still being made on a highly individualised patient by patient basis, within a philosophy of holistic care and partnership working. As such, the research participants called for more resources to support information giving, risk assessment and decision-making. The results show that translating a public health treatment approach into individual patient care is complex, potentially time-consuming and may alter traditional provider-patient dynamics. The findings from this study suggest that in-depth research is needed to understand better the patient, community and provider experience as TasP becomes more widely rolled out.

  13. [Stroke prevention in sickle-cell disease: results, hurdles and future perspectives].

    PubMed

    Bernaudin, Françoise; Verlhac, Suzanne

    2008-10-01

    Sickle cell disease (SCD) is the most frequent cause of stroke during infancy, and stroke is the most serious complication of SCD in children. Sludge-induced distal vasculopathy explains 25% of strokes in SCD, while proximal vasculopathy is responsible for 75% of cases. The stenoses observed in SCD-related proximal vasculopathy are progressive and can be detected by transcranial Doppler (TCD), a reliable, non-invasive and low-cost imaging method. High velocities (> 2 mls) are associated with a 40% risk of stroke within 36 months, but initiation of a transfusion program maintaining the HbS level under 30% reduces the risk to less than 2%. TCD must be performed in all children at 12-18 months of age to detect cerebral vasculopathy and prevent stroke. This approach has been adopted in our institution, based on a cohort of SCD newborns screened at birth: the risk of stroke was reduced from the expected 11% to less than 2% at 18 years. Genoidentical stem cell transplantation, which safely obviates the need for transfusion programs and provides a 95% chance of cure, should be offered early to patients at risk of stroke. When possible, sibling cord blood cryopreservation is recommended

  14. Effectiveness of Palivizumab in Preventing RSV Hospitalization in High Risk Children: A Real-World Perspective.

    PubMed

    Homaira, Nusrat; Rawlinson, William; Snelling, Thomas L; Jaffe, Adam

    2014-01-01

    Infection with respiratory syncytial virus (RSV) is one of the major causes globally of childhood respiratory morbidity and hospitalization. Palivizumab, a humanized monoclonal antibody, has been recommended for high risk infants to prevent severe RSV-associated respiratory illness. This recommendation is based on evidence of efficacy when used under clinical trial conditions. However the real-world effectiveness of palivizumab outside of clinical trials among different patient populations is not well established. We performed a systematic review focusing on postlicensure observational studies of the protective effect of palivizumab prophylaxis for reducing RSV-associated hospitalizations in infants and children at high risk of severe infection. We searched studies published in English between 1 January 1999 and August 2013 and identified 420 articles, of which 20 met the inclusion criteria. This review supports the recommended use of palivizumab for reducing RSV-associated hospitalization rates in premature infants born at gestational age < 33 weeks and in children with chronic lung and heart diseases. Data are limited to allow commenting on the protective effect of palivizumab among other high risk children, including those with Down syndrome, cystic fibrosis, and haematological malignancy, indicating further research is warranted in these groups.

  15. Preventing HIV among Latino and African American Gay and Bisexual Men in a Context of HIV-Related Stigma, Discrimination, and Homophobia: Perspectives of Providers

    PubMed Central

    Brooks, Ronald A.; Etzel, Mark A.; Hinojos, Ernesto; Henry, Charles L.; Perez, Mario

    2005-01-01

    HIV-related stigma, discrimination, and homophobia impede community based efforts to combat HIV disease among Latino and African American gay and bisexual men. This commentary highlights ways to address these social biases in communities of color in Los Angeles from the perspectives of staff from HIV prevention programs. Information was collected from HIV prevention program staff participating in a two-day symposium. The outcomes from the symposium offer strategies for developing and implementing HIV prevention services for Latino and African American gay and bisexual men, which include: 1) addressing social biases present in a community that can hinder, and even prohibit, utilization of effective HIV prevention programs; 2) recasting HIV prevention messages in a broader social or health context; 3) developing culturally appropriate HIV prevention messages; 4) exploring new modalities and venues for delivering HIV prevention messages that are appropriate for gay and bisexual men of color and the communities in which they live; and 5) broadening the target of HIV prevention services to include service providers, local institutions and agencies, and the community at-large. These strategies underscore the need to consider the social and contextual factors of a community when designing and implementing HIV prevention programs. PMID:16283834

  16. [Kinetic therapy for therapy and prevention of post-traumatic lung failure. Results of a prospective study of 111 polytrauma patients].

    PubMed

    Stiletto, R; Gotzen, L; Goubeaud, S

    2000-12-01

    The effects of kinetic therapy on the oxygenation in the injured lung of 111 polytrauma patients were analysed in an open prospective study. The patient collective comprised 82 men and 29 women. For the total group, the average age was 38.3 years (+/- 16.1). The initial ISS was 39.3 points (+/- 18.9), and the APACHE II evaluated 24 h after including the patient into the study was 13.1 (+/- 5.2). The data of 3 treatment groups were evaluated: 1, acute respiratory disease (ARDS, n = 42); 2, acute lung injury (ALI, n = 36); and 3, prophylaxis (n = 33, a group of prophylactically treated patients with a PaO2/FiO2 ratio > or = 300 and an ISS > or = 15). Positioning therapy was administered in group 3 in order to prevent atelectases, and respirator-induced lung injuries during a foreseeable, relatively long period in the intensive care unit in view of the severity of the trauma. The mean treatment time in the kinetic bed was 6.3 days (+/- 3.9), the time on respirator 18.5 days (+/- 15.4). The patients stayed in the ICU 22.4 days (+/- 15.4) and left the hospital after 35.1 days (+/- 27.7). For scoring the severity of respiratory failure, the lung injury score (LIS) according to Murray and the SOFA score lung (sepsis-related organ failure assessment) according to Vincent were evaluated. The LIS at time of recruitment into the study was 2.2 (+/- 1.0), the SOFA score lung 3.0 (+/- 0.9). In the ALI and ARDS groups a significant improvement in oxygenation was observed (p < 0.0001). No patient of the prophylaxis group developed an ALI or ARDS. The mortality rate in the total group of 10.8% was relatively low in comparison with other published data. Consistent kinetic therapy integrated in a standardised treatment regimen contributes towards improving the negative outcome to date of patients with severe respiratory failure after major trauma.

  17. Emergence of Avian Infectious Bronchitis Virus and its variants need better diagnosis, prevention and control strategies: a global perspective.

    PubMed

    Dhama, Kuldeep; Singh, Shambhu Dayal; Barathidasan, Rajamani; Desingu, P A; Chakraborty, Sandip; Tiwari, Ruchi; Kumar, M Asok

    2014-06-01

    Growth in poultry sector is being challenged due to increased incidence and re-emergence of diseases caused due to evolution of several viral pathogens and use of live vaccines. Piles of economic losses are encountered due to these diseases. Avian Infectious Bronchitis (IB), caused by Corona virus, is OIE-listed disease and characterized by respiratory, renal and urogenital involvements, causing high mortality. Economic losses are encountered due to loss of productive performance of both egg and meat-type chickens. Variant viruses evolve due to spontaneous mutations and recombinations, causing disease in vaccinated flocks of all ages. Serotyping and genotyping are the common methods of classification of IBV strains. The virus has 4 clusters, grouped into 7 serotypes and the most important strains are Massachusetts, Connecticut, Arkansas, Gray, Holte and Florida along with numerous others, distributed round the globe. Several conventional and molecular diagnostic methods have been described for the diagnosis of IB in chickens. 'All-in/all-out' operations of rearing along with good biosafety measures forms the basis of prevention, whereas vaccination forms the backbone of IB control programme. Both live and inactivated (oil emulsified) conventional vaccines are available. The new generation vaccines (recombinant and vector-based) developed against locally prevailing IBV strains may be more helpful and avoid the reversion of virulence in live vaccine viruses. The present review deals with all these perspectives of this important emerging poultry pathogen.

  18. Hepatitis C virus in the new era: Perspectives in epidemiology, prevention, diagnostics and predictors of response to therapy

    PubMed Central

    Ansaldi, Filippo; Orsi, Andrea; Sticchi, Laura; Bruzzone, Bianca; Icardi, Giancarlo

    2014-01-01

    Despite the great successes achieved in the fields of virology and diagnostics, several difficulties affect improvements in hepatitis C virus (HCV) infection control and eradication in the new era. New HCV infections still occur, especially in some of the poorest regions of the world, where HCV is endemic and long-term sequelae have a growing economic and health burden. An HCV vaccine is still no available, despite years of researches and discoveries about the natural history of infection and host-virus interactions: several HCV vaccine candidates have been developed in the last years, targeting different HCV antigens or using alternative delivery systems, but viral variability and adaption ability constitute major challenges for vaccine development. Many new antiviral drugs for HCV therapy are in preclinical or early clinical development, but different limitations affect treatment validity. Treatment predictors are important tools, as they provide some guidance for the management of therapy in patients with chronic HCV infection: in particular, the role of host genomics in HCV infection outcomes in the new era of direct-acting antivirals may evolve for new therapeutic targets, representing a chance for modulated and personalized treatment management, when also very potent therapies will be available. In the present review we discuss the most recent data about HCV epidemiology, the new perspectives for the prevention of HCV infection and the most recent evidence regarding HCV diagnosis, therapy and predictors of response to it. PMID:25110404

  19. Causes, treatment and prevention of early childhood caries: a microbiologic perspective.

    PubMed

    Berkowitz, Robert J

    2003-05-01

    Early childhood caries (ECC) is a virulent form of dental caries that can destroy the primary dentition of toddlers and preschool children. It occurs worldwide, afflicting predominantly disadvantaged children. High-risk North American populations include Hispanic and Native American children, as well as children enrolled in Head Start, a federally funded program for preschool children living in poverty. The prevalence of EEC among these children ranges from 11% to 72%. ECC is an infectious disease, and Streptococcus mutans is the most likely causative agent; diet also plays a critical role in the acquisition and clinical expression of this infection. Early acquisition of S. mutans is a key event in the natural history of the disease. Acquisition may occur via vertical or horizontal transmission. Primary oral colonization by S. mutans coupled with caries-promoting feeding behaviours results in accumulation of these organisms to levels exceeding 30% of the total cultivable plaque flora which in turn leads to rapid demineralization of tooth structure. Treatment of ECC is costly because the cooperative capacity of babies and preschool children usually necessitates the use of general anesthesia. Treatment usually consists of restoration or surgical removal of carious teeth along with recommendations regarding feeding habits. However, this approach has resulted in unacceptable clinical outcomes, and relapse rates of approximately 40% have been reported within the first year after dental surgery. Primary prevention of ECC has largely been restricted to counselling parents about caries-promoting feeding behaviours. This approach has also had minimal success. Newer strategies addressing the infectious component through use of topical antimicrobial therapy appear promising.

  20. ACCESS TO TREATMENT IN HIV PREVENTION TRIALS: PERSPECTIVES FROM A SOUTH AFRICAN COMMUNITY

    PubMed Central

    BARSDORF, NICOLA; MAMAN, SUZANNE; KASS, NANCY; SLACK, CATHERINE

    2009-01-01

    Access to treatment, in HIV vaccine trials (HVTs), remains ethically controversial. In most prevention trials, including in South Africa, participants who seroconvert are referred to publicly funded programmes for treatment. This strategy is problematic when there is inadequate and uneven access to public sector antiretroviral therapy (ART) and support resources. The responsibilities, if any, of researchers, sponsors and public health authorities involved in HVTs has been hotly debated among academics, scholars, representatives of international organizations and sponsors. However, there is little published on community perceptions. Recent guidance asserts that communities should make inputs into treatment and care decisions. This qualitative study explored a South African community’s perceptions of who should provide what to HVT participants as well as how and why this should be done. Twenty-nine adults working at or attending five primary health care clinics in two rural areas in KwaZulu-Natal participated in in-depth interviews. Respondents expressed that researchers should ‘help participants to access’ treatment and care ‘because they are in a position to do so’ and ‘are in a relationship with’ trial participants. Respondents suggested that researchers could help by ‘facilitating referral’ until such time that participants can access care and treatment on their own. We highlight a series of implications for researchers in HVTs, including their need to be aware of prospective participants’ considerable trust in and respect for researchers, the responsibility that this places on them, and the need for clear communication with communities so as not to erode community trust. PMID:19793135

  1. PRIMARY PREVENTION IS? A GLOBAL PERSPECTIVE ON HOW ORGANIZATIONS ENGAGING MEN IN PREVENTING GENDER-BASED VIOLENCE CONCEPTUALIZE AND OPERATIONALIZE THEIR WORK

    PubMed Central

    Storer, Heather L.; Casey, Erin A.; Carlson, Juliana; Edleson, Jeffrey L.; Tolman, Richard M.

    2014-01-01

    Engaging men in addressing violence against women (VAW) has become a strategy in the global prevention of gender-based violence. Concurrently, Western public health frameworks have been utilized to guide prevention agendas worldwide. Using qualitative methods, this study describes how global anti-violence organizations that partner with men conceptualize primary prevention in their work. Findings suggest that ‘primary prevention’ is not a fixed term in the context of VAW and that front-line prevention work challenges rigidly delineated distinctions between levels of prevention. Much can be learned from global organizations’ unique and contextualized approaches to the prevention of VAW. PMID:26333283

  2. Use of Q methodology to analyze divergent perspectives on participatory action research as a strategy for HIV/AIDS prevention among Caribbean youth.

    PubMed

    Goto, Keiko; Tiffany, Jennifer; Pelto, Gretel; Pelletier, David

    2008-08-01

    This study used Q methodology to examine perspectives regarding participatory action research (PAR) among participants in a UNICEF initiative aimed at enhancing HIV/AIDS prevention among youth in the Caribbean. We interviewed 20 youth PAR researchers and 12 project managers from youth organizations about their attitudes and experiences. Statements from the interviews were used in a structured ranking task. Q factor analysis of the rankings identified three clusters of respondents with differing viewpoints on PAR. The clusters respectively saw PAR as an effective peer education tool, an empowering process for youth, and a tool for gathering information on the gap between knowledge and behavior. We identified divergent perspectives on the purpose and utility of PAR among participants who received the same orientation, training, and support and who worked in the context of a single initiative. These multiple perspectives present both challenges and resources for health projects.

  3. Preventing passenger vehicle occupant injuries by vehicle design--a historical perspective from IIHS.

    PubMed

    O'Neill, Brian

    2009-04-01

    and chest injury measures recorded on driver and front-seat test dummies. NHTSA later added side crash tests and rollover ratings to the U.S. NCAP. Consumer crash testing spread worldwide in the 1990s. In 1995, the Insurance Institute for Highway Safety (IIHS) began using frontal offset crash tests to rate and compare frontal crashworthiness and later added side and rear crash assessments. Shortly after, Europe launched EuroNCAP to assesses new car performance including front, side, and front-end pedestrian tests. The influence of these consumer-oriented crash test programs on vehicle designs has been major. From the beginning, U.S. NCAP results prompted manufacturers to improve seat belt performance. Frontal offset tests from IIHS and EuroNCAP resulted in greatly improved front-end crumple zones and occupant compartments. Side impact tests have similarly resulted in improved side structures and accelerated the introduction of side impact airbags, especially those designed to protect occupant's heads. Vehicle safety designs, initially driven by regulations and later by consumer demand because of crash testing, have proven to be very successful public health measures. Since they were first introduced in the late 1960s, vehicle safety designs have saved hundreds of thousands of lives and prevented countless injuries worldwide. The designs that improved vehicle crashworthiness have been particularly effective. Some newer crash avoidance designs also have the potential to be effective-e.g., electronic stability control is already saving many lives in single-vehicle crashes. However, determining the actual effectiveness of these new technologies is a slow process and needs real-world crash experience because there are no assessment equivalent of crash tests for crash avoidance designs.

  4. Intravenous renal cell transplantation with SAA1-positive cells prevents the progression of chronic renal failure in rats with ischemic-diabetic nephropathy.

    PubMed

    Kelly, Katherine J; Zhang, Jizhong; Han, Ling; Wang, Mingsheng; Zhang, Shaobo; Dominguez, Jesus H

    2013-12-15

    Diabetic nephropathy, the most common cause of progressive chronic renal failure and end-stage renal disease, has now reached global proportions. The only means to rescue diabetic patients on dialysis is renal transplantation, a very effective therapy but severely limited by the availability of donor kidneys. Hence, we tested the role of intravenous renal cell transplantation (IRCT) on obese/diabetic Zucker/SHHF F1 hybrid (ZS) female rats with severe ischemic and diabetic nephropathy. Renal ischemia was produced by bilateral renal clamping of the renal arteries at 10 wk of age, and IRCT with genetically modified normal ZS male tubular cells was given intravenously at 15 and 20 wk of age. Rats were euthanized at 34 wk of age. IRCT with cells expressing serum amyloid A had strong and long-lasting beneficial effects on renal function and structure, including tubules and glomeruli. However, donor cells were found engrafted only in renal tubules 14 wk after the second infusion. The results indicate that IRCT with serum amyloid A-positive cells is effective in preventing the progression of chronic kidney disease in rats with diabetic and ischemic nephropathy.

  5. Spermatogonial stem cell autotransplantation and germline genomic editing: a future cure for spermatogenic failure and prevention of transmission of genomic diseases

    PubMed Central

    Mulder, Callista L.; Zheng, Yi; Jan, Sabrina Z.; Struijk, Robert B.; Repping, Sjoerd; Hamer, Geert; van Pelt, Ans M.M.

    2016-01-01

    BACKGROUND Subfertility affects approximately 15% of all couples, and a severe male factor is identified in 17% of these couples. While the etiology of a severe male factor remains largely unknown, prior gonadotoxic treatment and genomic aberrations have been associated with this type of subfertility. Couples with a severe male factor can resort to ICSI, with either ejaculated spermatozoa (in case of oligozoospermia) or surgically retrieved testicular spermatozoa (in case of azoospermia) to generate their own biological children. Currently there is no direct treatment for azoospermia or oligozoospermia. Spermatogonial stem cell (SSC) autotransplantation (SSCT) is a promising novel clinical application currently under development to restore fertility in sterile childhood cancer survivors. Meanwhile, recent advances in genomic editing, especially the clustered regulatory interspaced short palindromic repeats-associated protein 9 (CRISPR-Cas9) system, are likely to enable genomic rectification of human SSCs in the near future. OBJECTIVE AND RATIONALE The objective of this review is to provide insights into the prospects of the potential clinical application of SSCT with or without genomic editing to cure spermatogenic failure and to prevent transmission of genetic diseases. SEARCH METHODS We performed a narrative review using the literature available on PubMed not restricted to any publishing year on topics of subfertility, fertility treatments, (molecular regulation of) spermatogenesis and SSCT, inherited (genetic) disorders, prenatal screening methods, genomic editing and germline editing. For germline editing, we focussed on the novel CRISPR-Cas9 system. We included papers written in English only. OUTCOMES Current techniques allow propagation of human SSCs in vitro, which is indispensable to successful transplantation. This technique is currently being developed in a preclinical setting for childhood cancer survivors who have stored a testis biopsy prior to cancer

  6. Primary Care Patients’ Perspectives of Barriers and Enablers of Primary Prevention and Health Promotion—A Meta-Ethnographic Synthesis

    PubMed Central

    Moreno-Peral, Patricia; Conejo-Cerón, Sonia; Fernández, Ana; Berenguera, Anna; Martínez-Andrés, María; Pons-Vigués, Mariona; Motrico, Emma; Rodríguez-Martín, Beatriz; Bellón, Juan A.; Rubio-Valera, Maria

    2015-01-01

    Background Primary care (PC) patients have difficulties in committing to and incorporating primary prevention and health promotion (PP&HP) activities into their long-term care. We aimed to re-interpret, for the first time, qualitative findings regarding factors affecting PC patients' acceptance of PP&HP activities. Methods and Findings A meta-ethnographic synthesis was generated following electronic and manual searches that retrieved 29 articles. Papers were reviewed and translated to produce a re-interpretation of the extracted concepts. The factors affecting PC patients' receptiveness to PP&HP activities were framed in a four-level ecological model (intrapersonal, interpersonal, institutional and environment and society). Intrapersonal factors (patients' beliefs/attitudes, knowledge, skills, self-concept, motivation and resources) were the most numerous, with almost 25 different factors. Public health education to modify erroneous beliefs and values regarding PP&HP could encourage a transition to healthier lifestyles. Health care professionals' abilities to communicate and involve patients in the decision-making process can act as facilitators. Biopsychosocial training (with emphasis on communication skills) for health professionals must start with undergraduates. Increased consultation time, the use of reminders, follow-up visits and tools for communicating risk and motivating patients could be applied at the intrapersonal level. Collaborative care involving other health professionals (nutritionists or psychotherapists) and family and community stakeholders (teachers or gym trainers) was important in developing healthier habits. Patients also cited barriers related to the built environment and socioeconomic difficulties that highlighted the need for policies promoting social justice and equity. Encouraging PP&HP using social marketing strategies and regulating media to control its impact on health were also cited. Only the perspectives of PC patients in the

  7. The Korean perspective of Helicobacter pylori infection: lessons from the Japanese government's policy to prevent gastric cancer.

    PubMed

    Park, Jong-Min; Hahm, Ki Baik

    2014-01-01

    The guideline of the Korean College of Helicobacter and Upper Gastrointestinal Research group for Helicobacter pylori infection was first produced in 1998, when definite indication for H. pylori eradication is early gastric cancer in addition to the previous indications of peptic ulcer (PUD) including scar lesion and marginal zone B cell lymphoma (MALT type). Though treatment is recommended for the relatives of a patient with gastric cancer, unexplained iron deficiency anemia, and chronic idiopathic thrombocytopenic purpura, a consensus treatment guideline is the treatment of PUD, MALToma, and gastric cancer in Korea. One- or 2-week treatment with proton pump inhibitor (PPI)-based triple therapy consisting of one PPI and 2 antibiotics, clarithromycin and amoxicillin, is recommended as the first-line treatment regimen. In the case of treatment failure, one or 2 weeks of quadruple therapy (PPI + metronidazole + tetracycline + bismuth) is recommended, whose eradication regimen was not different between Korea and Japan. Though the treatment regimen was similar between two nations, the Japanese government declared the inclusion of H. pylori eradication in patients with H. pylori-associated chronic gastritis, reaching the conclusion that the treatment guideline became quite different between Korea and Japan from February 21, 2013. The prime rationale of the Japanese extended treatment guideline for H. pylori infection was based on the drastic intention to prevent gastric cancer as well as the improvement of chronic gastritis-associated functional dyspepsia based on their findings that H. pylori eradication might decrease gastric cancer incidence as well as mortality. In this review, the discrepancy between the Korean and Japanese treatment guidelines will be explained; why and how?

  8. Current challenges in palliative care provision for heart failure in the UK: a survey on the perspectives of palliative care professionals

    PubMed Central

    Cheang, Mun Hong; Rose, Gabrielle; Cheung, Chi-Chi; Thomas, Martin

    2015-01-01

    Objective Palliative care (PC) in heart failure (HF) is beneficial and recommended in international HF guidelines. However, there is a perception that PC is underutilised in HF in the UK. This exploratory study aims to investigate, from a PC perspective, this perceived underutilisation and identify problems with current practice that may impact on the provision of PC in HF throughout the UK. Methods A prospective survey was electronically sent to PC doctors and nurses via the UK Association for Palliative Medicine and adult PC teams listed in the UK Hospice directory. Results We received 499 responses (42%—PC consultants). Although PC provision for patients with HF was widespread, burden on PC services was low (47% received less than 10 referrals annually). While PC was acknowledged to have a role in end-stage HF, there were differing views about the optimal model of care. Levels of interdisciplinary collaboration (58%) and mutual education (36%) were low. There were frequent reports that end-of-life matters were not addressed by cardiology prior to PC referral. Moreover, 24% of respondents experienced difficulties with implantable cardioverter defibrillator deactivation. Conclusions Low HF referrals despite widespread availability of PC services and insufficient efforts by cardiology to address PC issues may contribute to the perception that PC is underutilised in HF. The challenges facing PC and HF identified here need to be further investigated and addressed. These findings will hopefully promote awareness of PC issues in HF and encourage debate on how to improve PC support for this population. PMID:25628893

  9. The Public Health Perspective in Health Promotion and Disability Prevention for Older Adults: The Role of the Centers for Disease Control and Prevention.

    ERIC Educational Resources Information Center

    Hennessy, Catherine Hagan; Buchner, David M.; Jordan, Joanne M.; Leveille, Suzanne G.; Shefer, Abigail M.; Stevens, Judy A.

    2001-01-01

    The Centers for Disease Control and Prevention works with public health agencies and other organizations to address chronic disease prevention and risk reduction in older adults. Efforts in the areas of physical activity, osteoarthritis, and chronic illness self-management are described. Other activities include older adult immunization programs…

  10. Prevention--a cost-effective way to fight the non-communicable disease epidemic: an academic perspective of the United Nations High-level NCD Meeting.

    PubMed

    Probst-Hensch, Nicole; Tanner, Marcel; Kessler, Claudia; Burri, Christian; Künzli, Nino

    2011-09-07

    The United Nations General Assembly has convened a Summit on non-communicable diseases (NCDs), an historic moment in the global combat of these disorders. Lifestyles in increasingly urban and globalised environments have led to a steep surge in NCD incidence in low and middle income countries, where two thirds of all NCD deaths occur (most importantly from cancer, cardiovascular and respiratory disease as well as diabetes). Treatment of NCDs is usually long term and expensive, thus threatening patients' and nations' budgets and putting them at high risk for poverty. The NCD Summit offers an opportunity for strengthening and shaping primary prevention, the most cost-effective instrument to fight major risk factors such as tobacco smoking, alcohol abuse, physical inactivity and unhealthy diet. From a Swiss perspective, we also emphasised the efforts for new laws on prevention and diagnosis registration, in accordance with the recommendations of the NCD summit in order to strengthen primary prevention and disease monitoring. In addition, the need for structural prevention across all policy sectors with leadership in environmental policy making to prevent NCDs as well as the need to adapt and strengthen primary health care are equally relevant for Switzerland. To compliment efforts in primary prevention, the field of NCDs requires special R&D platforms for affordable NCD drugs and diagnostics for neglected population segments in both Switzerland and low and middle income countries. Switzerland has a track record in research and development against diseases of poverty on a global scale that now needs to be applied to NCDs.

  11. Heart failure.

    PubMed

    Braunwald, Eugene

    2013-02-01

    Despite major improvements in the treatment of virtually all cardiac disorders, heart failure (HF) is an exception, in that its prevalence is rising, and only small prolongations in survival are occurring. An increasing fraction, especially older women with diabetes, obesity, and atrial fibrillation exhibit HF with preserved systolic function. Several pathogenetic mechanisms appear to be operative in HF. These include increased hemodynamic overload, ischemia-related dysfunction, ventricular remodeling, excessive neurohumoral stimulation, abnormal myocyte calcium cycling, excessive or inadequate proliferation of the extracellular matrix, accelerated apoptosis, and genetic mutations. Biomarkers released as a consequence of myocardial stretch, imbalance between formation and breakdown of extracellular matrix, inflammation, and renal failure are useful in the identification of the pathogenetic mechanism and, when used in combination, may become helpful in estimating prognosis and selecting appropriate therapy. Promising new therapies that are now undergoing intensive investigation include an angiotensin receptor neprilysin inhibitor, a naturally-occurring vasodilator peptide, a myofilament sensitizer and several drugs that enhance Ca++ uptake by the sarcoplasmic reticulum. Cell therapy, using autologous bone marrow and cardiac progenitor cells, appears to be promising, as does gene therapy. Chronic left ventricular assistance with continuous flow pumps is being applied more frequently and successfully as destination therapy, as a bridge to transplantation, and even as a bridge to recovery and explantation. While many of these therapies will improve the care of patients with HF, significant reductions in prevalence will require vigorous, multifaceted, preventive approaches.

  12. Adult Dyslexia and the "Conundrum of Failure"

    ERIC Educational Resources Information Center

    Tanner, Kathleen

    2009-01-01

    While there is a wealth of literature about childhood dyslexia, adult dyslexia remains relatively undocumented, particularly from a lived perspective. This paper focuses on the "deficit perspective of failure", as highlighted in current literature, which addresses issues confronting adults with dyslexia. Within this theme of failure a…

  13. Transitions of Care Between Acute and Chronic Heart Failure: Critical Steps in the Design of a Multidisciplinary Care Model for the Prevention of Rehospitalization.

    PubMed

    Comín-Colet, Josep; Enjuanes, Cristina; Lupón, Josep; Cainzos-Achirica, Miguel; Badosa, Neus; Verdú, José María

    2016-10-01

    Despite advances in the treatment of heart failure, mortality, the number of readmissions, and their associated health care costs are very high. Heart failure care models inspired by the chronic care model, also known as heart failure programs or heart failure units, have shown clinical benefits in high-risk patients. However, while traditional heart failure units have focused on patients detected in the outpatient phase, the increasing pressure from hospital admissions is shifting the focus of interest toward multidisciplinary programs that concentrate on transitions of care, particularly between the acute phase and the postdischarge phase. These new integrated care models for heart failure revolve around interventions at the time of transitions of care. They are multidisciplinary and patient-centered, designed to ensure continuity of care, and have been demonstrated to reduce potentially avoidable hospital admissions. Key components of these models are early intervention during the inpatient phase, discharge planning, early postdischarge review and structured follow-up, advanced transition planning, and the involvement of physicians and nurses specialized in heart failure. It is hoped that such models will be progressively implemented across the country.

  14. Calpastatin overexpression prevents progression of S-1,2-dichlorovinyl-L-cysteine (DCVC)-initiated acute renal injury and renal failure (ARF) in diabetes

    SciTech Connect

    Dnyanmote, Ankur V.; Sawant, Sharmilee P.; Lock, Edward A.; Latendresse, John R.; Warbritton, Alan A.; Mehendale, Harihara M. . E-mail: mehendale@ulm.edu

    2006-09-01

    Previously we have shown that 90% of streptozotocin (STZ)-induced type-1 diabetic (DB) mice survive from acute renal failure (ARF) and death induced by a normally LD{sub 9} dose (75 mg/kg, i.p.) of the nephrotoxicant S-1,2-dichlorovinyl-L-cysteine (DCVC). This remarkable protection is due to a combination of slower progression of DCVC-initiated renal injury and increased compensatory nephrogenic tissue repair in the DB kidneys. BRDU immunohistochemistry revealed that the DB condition led to 4-fold higher number of proximal tubular cells (PTC) entering S-phase of cell cycle. In the present study, we tested the hypothesis that DB-induced augmentation of PTC into S-phase is accompanied by overexpression of the calpain-inhibitor calpastatin, which endogenously prevents the progression of DCVC-initiated renal injury mediated by the calpain escaping out of damaged PTCs. Immunohistochemical detection of renal calpain and its activity in the urine, over a time course after treatment with the LD{sub 9} dose of DCVC, indicated progressive increase in leakage of calpain into the extracellular spaces of the injured PTCs of the non-diabetic (NDB) kidneys as compared to the DB kidneys. Calpastatin expression was minimally detected in the NDB kidneys, using immunohistochemistry, over the time course. On the other hand, consistently higher number of tubules in the DB kidney showed calpastatin expression over the time course. The lower leakage of calpain in the DB kidneys was commensurate with constitutively higher expression of calpastatin in the S-phase-laden PTCs of these mice. To test the protective role of newly divided/dividing PTCs, DB mice were given the anti-mitotic agent colchicine (CLC) (2 mg/kg and 1.5 mg/kg, i.p., on days 8 and 10 after STZ injection) prior to challenge with a LD{sub 9} dose of DCVC, which led to 100% mortality by 48 h. Mortality was due to rapid progression of DCVC-initiated renal injury, suggesting that newly divided/dividing cells are instrumental

  15. X-framework: Space system failure analysis framework

    NASA Astrophysics Data System (ADS)

    Newman, John Steven

    Space program and space systems failures result in financial losses in the multi-hundred million dollar range every year. In addition to financial loss, space system failures may also represent the loss of opportunity, loss of critical scientific, commercial and/or national defense capabilities, as well as loss of public confidence. The need exists to improve learning and expand the scope of lessons documented and offered to the space industry project team. One of the barriers to incorporating lessons learned include the way in which space system failures are documented. Multiple classes of space system failure information are identified, ranging from "sound bite" summaries in space insurance compendia, to articles in journals, lengthy data-oriented (what happened) reports, and in some rare cases, reports that treat not only the what, but also the why. In addition there are periodically published "corporate crisis" reports, typically issued after multiple or highly visible failures that explore management roles in the failure, often within a politically oriented context. Given the general lack of consistency, it is clear that a good multi-level space system/program failure framework with analytical and predictive capability is needed. This research effort set out to develop such a model. The X-Framework (x-fw) is proposed as an innovative forensic failure analysis approach, providing a multi-level understanding of the space system failure event beginning with the proximate cause, extending to the directly related work or operational processes and upward through successive management layers. The x-fw focus is on capability and control at the process level and examines: (1) management accountability and control, (2) resource and requirement allocation, and (3) planning, analysis, and risk management at each level of management. The x-fw model provides an innovative failure analysis approach for acquiring a multi-level perspective, direct and indirect causation of

  16. Failure to thrive.

    PubMed

    Krugman, Scott D; Dubowitz, Howard

    2003-09-01

    Failure to thrive is a condition commonly seen by primary care physicians. Prompt diagnosis and intervention are important for preventing malnutrition and developmental sequelae. Medical and social factors often contribute to failure to thrive. Either extreme of parental attention (neglect or hypervigilance) can lead to failure to thrive. About 25 percent of normal infants will shift to a lower growth percentile in the first two years of life and then follow that percentile; this should not be diagnosed as failure to thrive. Infants with Down syndrome, intrauterine growth retardation, or premature birth follow different growth patterns than normal infants. Many infants with failure to thrive are not identified unless careful attention is paid to plotting growth parameters at routine checkups. A thorough history is the best guide to establishing the etiology of the failure to thrive and directing further evaluation and management. All children with failure to thrive need additional calories for catch-up growth (typically 150 percent of the caloric requirement for their expected, not actual, weight). Few need laboratory evaluation. Hospitalization is rarely required and is indicated only for severe failure to thrive and for those whose safety is a concern. A multidisciplinary approach is recommended when failure to thrive persists despite intervention or when it is severe.

  17. An electrophysiologist perspective on risk stratification in heart failure: can better understanding of the condition of the cardiac sympathetic nervous system help?

    PubMed

    Borgquist, Rasmus; Singh, Jagmeet P

    2015-06-01

    Heart failure is often complicated by arrhythmias that can adversely affect the quality of life and increase the risk for sudden cardiac death. Current risk stratification strategies for sudden cardiac death in the heart failure patient are not ideal, with much potential for further refinement. Overactivation of the sympathetic nervous system has been shown to be associated with worsening heart failure as well as arrhythmic events. Recent advances in our understanding of the autonomic nervous system and new methods for quantification of the pathologic activation of the sympathetic nerves have triggered increasing interest in this field. This viewpoint focuses on the need for and challenges of risk stratification of sudden death in the heart failure patient and discusses the potential value of measuring sympathetic nervous system activity to better stratify risk and to select patients with heart failure for implantable cardioverter defibrillator therapy.

  18. Perspectives on strategies for establishing cancer on the global health agenda: possibilities of creating infrastructure for cancer prevention information using school health classes.

    PubMed

    Kawahara, Norie

    2009-01-01

    The Asia Cancer Forum is a body that is committed to strategic analysis in the area of cancer research. The ultimate objective of the Forum is to achieve the inclusion of cancer in the Millennium Development Goals (MDGs) of the United Nations. The MDGs have a tremendous influence on the setting of the global health agenda and the inclusion of cancer within their scope would be greatly beneficial to the global development of cancer research. Although diseases such as HIV/AIDS and malaria remain priority issues for global health, the time has come for policy transformation. Preventive activities and measures require a long period of time before results become apparent and as the cost-benefit effect of allocated funds cannot be measured in the short-term, preventive activities have therefore tended to be given a low priority in terms of national policy. We must take a long-term perspective that looks ahead to the issues that will face future generations. Transcending challenges presented by cultural diversity, we must work to position cancer as a central theme on the global health agenda, even in the face of limited medical resources. Promoting cancer prevention activities through readily available infrastructure in the form of health classes in schools is also of great significance in terms of setting the agenda for global health. As a joint China-Japan research project, in China a questionnaire survey has been implemented through school pupils, with pupils and parents being asked about health classes implemented in schools. From the perspective of formulating strategy for establishing cancer on the global health agenda we will use the data gained from the surveys to analyze and examine the possibilities and significance of creating an infrastructure for a multilateral information network about cancer prevention.

  19. Needs and Preferences for the Prevention of Intimate Partner Violence among Hispanics: A Community’s Perspective

    PubMed Central

    Gonzalez-Guarda, R.M.; Cummings, A.M.; Becerra, M.; Fernandez, M.C.; Mesa, I.

    2013-01-01

    Research suggest that Hispanics in the U.S. are disproportionately affected by the consequences of intimate partner violence. Nevertheless, few intimate partner violence prevention interventions have been developed to address the unique needs and preferences of this population. The Partnership for Domestic Violence Prevention is a community-based participatory research project that assessed the needs and preferences for prevention programs for Hispanics in Miami-Dade County. Nine focus groups with domestic violence service providers, victims and general community members were conducted (N= 76). Four major themes emerged from the focus groups. These included immigrants and teens as the highest priority groups to target in prevention efforts, culture as a double-edged sword, the system that helps and hurts the victim, and the need for wide-scale prevention programs that would reach Hispanics systematically. The results from this study have important implications for the development of intimate violence prevention interventions targeting Hispanics in the U.S. PMID:23843106

  20. Long-term efficacy of implantable cardiac resynchronization therapy plus defibrillator for primary prevention of sudden cardiac death in patients with mild heart failure: an updated meta-analysis.

    PubMed

    Sun, Wei-Ping; Li, Chun-Lei; Guo, Jin-Cheng; Zhang, Li-Xin; Liu, Ran; Zhang, Hai-Bin; Zhang, Ling

    2016-07-01

    Previous studies of implantable cardiac resynchronization therapy plus defibrillator (CRT-D) therapy used for primary prevention of sudden cardiac death have suggested that CRT-D therapy is less effective in patients with mild heart failure and a wide QRS complex. However, the long-term benefits are variable. We performed a meta-analysis of randomized trials identified in systematic searches of MEDLINE, EMBASE, and the Cochrane Database. Three studies (3858 patients) with a mean follow-up of 66 months were included. Overall, CRT-D therapy was associated with significantly lower all-cause mortality than was implantable cardioverter defibrillator (ICD) therapy (OR, 0.78; 95 % CI, 0.63-0.96; P = 0.02; I (2) = 19 %). However, the risk of cardiac mortality was comparable between two groups (OR, 0.74; 95 % CI, 0.53-1.01; P = 0.06). CRT-D treatment was associated with a significantly lower risk of hospitalization for heart failure (OR, 0.67; 95 % CI, 0.50-0.89; P = 0.005; I (2) = 55 %). The composite outcome of all-cause mortality and hospitalization for heart failure was also markedly lower with CRT-D therapy than with ICD treatment alone (OR, 0.67; 95 % CI, 0.57-0.77; P < 0.0001; I (2) = 0 %). CRT-D therapy decreased the long-term risk of mortality and heart failure events in patients with mild heart failure with a wide QRS complex. However, long-term risk of cardiac mortality was similar between two groups. More randomized studies are needed to confirm these findings, especially in patients with NYHA class I heart failure or patients without LBBB.

  1. Theater of the Oppressed in an After-School Program: Middle School Students' Perspectives on Bullying and Prevention

    ERIC Educational Resources Information Center

    Bhukhanwala, Foram

    2014-01-01

    This article examines students' participation in Boalian Theater activities to role-play, rehearse, and develop strategies to use when bullied or witnessing bullying. One intention of the theater was for students to respond and to engage in perspective-taking and empathy as one of the ways of responding to bullying experiences and making sense of…

  2. Respiratory Failure

    MedlinePlus

    Respiratory failure happens when not enough oxygen passes from your lungs into your blood. Your body's organs, ... brain, need oxygen-rich blood to work well. Respiratory failure also can happen if your lungs can' ...

  3. Heart Failure

    MedlinePlus

    Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... Tiredness and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  4. The C of CHADS: Historical perspective and clinical applications for anticoagulation in patients with non valvular atrial fibrillation and congestive heart failure.

    PubMed

    Chugh, Y; Faillace, R T

    2016-12-01

    The risk stratification of patients with coexisting non valvular atrial fibrillation and congestive heart failure, is often a clinical challenge, as the definitions of congestive heart failure in the popular CHADS2 and CHA2DS2VASc scoring systems, and amongst major clinical trials on Warfarin and Novel Oral Anticoagulants (NOAC) have heterogeneity. Available evidence reveals that any heart failure and/or left ventricular systolic dysfunction is associated with higher rates of stroke/systemic embolism and bleeding in patients with non valvular atrial fibrillation compared to patients without heart failure and normal left ventricular function. Most standard dose NOAC regimens have a better safety and efficacy profile over warfarin in most heart failure sub-group types with a few exceptions including patients with NYHA III/IV on Dabigatran 150mg BID from the RE-LY trial, who had higher major bleeding events, and patients with asymptomatic left ventricular dysfunction (ejection fraction ≤40%) and heart failure with reduced ejection fraction on 20mg of Rivaroxaban in the ROCKET-AF trial, when compared to patients on Warfarin in the corresponding groups. With the gaining popularity and use of NOACs, understanding their safety profile in such situations is paramount.

  5. [Childhood obesity prevention from a community view].

    PubMed

    Ariza, Carles; Ortega-Rodríguez, Eduard; Sánchez-Martínez, Francesca; Valmayor, Sara; Juárez, Olga; Pasarín, M Isabel

    2015-04-01

    The percentage of failure and relapse in the treatment of obesity is high. Where possible, the preferred strategy for preventing obesity is to modify eating habits and lifestyles. This article aims to provide a framework for evidence on the most effective interventions for addressing childhood obesity, both from a prevention point of view, as well as reducing it, when it is already established. After a review of the scientific literature, the issues that must be considered both in the universal and selective prevention of childhood obesity are presented. Also, in light of the controversy over the tools for measuring and controlling the problem, some clarification is provided on the criteria. Finally, the approach to the prevention of overweight and obesity with a community perspective is separated, with two short protocols being offered with diagrams of the basic procedure to follow.

  6. "Please Don't Just Hang a Feather on a Program or Put a Medicine Wheel on Your Logo and Think 'Oh Well, This Will Work'": Theoretical Perspectives of American Indian and Alaska Native Substance Abuse Prevention Programs.

    PubMed

    Walsh-Buhi, Margaret L

    Many current theories guiding substance abuse prevention (SAP) programs stem from Western ideologies, leading to a scarcity of research on theories from, and a disconnect with, Indigenous perspectives. This qualitative research study explored perceptions of theory by SAP researchers (N = 22) working with American Indian and Alaska Native communities. In-depth interviews identified components of Indigenous theoretical perspectives, including cultural elements such as balance, social cohesion, and belonging as being particularly significant and currently absent from many SAP programs. Recommendations for conducting metatheory studies and operationalization of Indigenous perspectives into guiding theoretical underpinnings for future SAP programming are provided.

  7. Early Kidney Allograft Dysfunction (Threatened Allograft): Comparative Effectiveness of Continuing Versus Discontinuation of Tacrolimus and Use of Sirolimus to Prevent Graft Failure: A Retrospective Patient-Centered Outcome Study

    PubMed Central

    Wali, Ravinder K.; Prentice, Heather A.; Reddivari, Venkata; Baffoe-Bonnie, Geroge; Drachenberg, Cinthia I.; Pappadimitriou, John C.; Ramos, Emilio; Cooper, Matthew; Jonsson, Johann; Bartlett, Stephen; Weir, Matthew R.

    2016-01-01

    Background Due to lack of treatment options for early acute allograft dysfunction in the presence of tubular-interstitial injury without histological features of rejection, kidney transplant recipients are often treated with sirolimus-based therapy to prevent cumulative calcineurin inhibitor exposure and to prevent premature graft failure. Methods We analyzed transplant recipients treated with sirolimus-based (n = 220) compared with continued tacrolimus-based (n = 276) immunosuppression in recipients of early-onset graft dysfunction (threatened allograft) with the use of propensity score-based inverse probability treatment weighted models to balance for potential confounding by indication between 2 nonrandomized groups. Results Weighted odds for death-censored graft failure (odds ratio [OR], 1.20; 95% confidence interval [95% CI], 0.66-2.19, P = 0.555) was similar in the 2 groups, but a trend for increased risk of greater than 50% loss in estimated glomerular filtration rate from baseline in sirolimus group (OR, 1.90; 95% CI, 0.96-3.76; P = 0.067) compared with tacrolimus group. Sirloimus group compared with tacrolimus group had increased risk for death with functioning graft (OR, 2.01; 95% CI, 1.29-3.14; P = 0.002) as well as increased risk of late death (death after graft failure while on dialysis) (OR, 2.39; 95% CI, 1.59-3.59; P < 0.001). Analysis of subgroups based on the absence or presence of T cell–mediated rejection or tubulointerstitial inflammation in the index biopsy, or the use of different types of induction agents, and all subgroups had increased risk of death with functioning graft and late death if exposed to sirolimus-based therapy. Conclusions Use of sirolimus compared with tacrolimus in recipients with early allograft dysfunction during the first year of transplant may not prevent worsening of allograft function and could potentially lead to poor survival along with increased risk of late death. PMID:27795990

  8. Reconsidering inequalities in preventive health care: an application of cultural health capital theory and the life-course perspective to the take-up of mammography screening.

    PubMed

    Missinne, Sarah; Neels, Karel; Bracke, Piet

    2014-11-01

    While there are abundant descriptions of socioeconomic inequalities in preventive health care, knowledge about the true mechanisms is still lacking. Recently, the role of cultural health capital in preventive health-care inequalities has been discussed theoretically. Given substantial analogies, we explore how our understanding of cultural health capital and preventive health-care inequalities can be advanced by applying the theoretical principles and methodology of the life-course perspective. By means of event history analysis and retrospective data from the Survey of Health Ageing and Retirement, we examine the role of cultural capital and cultural health capital during childhood on the timely initiation of mammography screening in Belgium (N = 1348). In line with cumulative disadvantage theory, the results show that childhood cultural conditions are independently associated with mammography screening, even after childhood and adulthood socioeconomic position and health are controlled for. Lingering effects from childhood are suggested by the accumulation of cultural health capital that starts early in life. Inequalities in the take-up of screening are manifested as a lower probability of ever having a mammogram, rather than in the late initiation of screening.

  9. The perspectives of in-school youths in Kampala, Uganda, on the role of parents in HIV prevention.

    PubMed

    Löfgren, Johanna; Byamugisha, Josaphat; Tillgren, Per; Rubenson, Birgitta

    2009-06-01

    This qualitative study explores how young Ugandans perceive and experience the role of parents in preventing the spread of HIV among youths. Data were gathered from semi-structured face-to-face interviews with 16 in-school youths, ages 18-20, residing in Kampala. A key finding is that the youths perceived parenting styles as influencing HIV prevention among youths. The participants identified several harmful consequences from a lack of parental guidance or inadequate parenting and they discussed the gains of parental support in terms of assisting HIV prevention among youths. The participants expressed the idea that parents can importantly contribute to preventing the spread of HIV among youths by supporting their own adolescent children and discussing topics like sex, relationships, and HIV in an age-appropriate way. However, the participants also felt that Ugandan parents in general are unable to support and talk to youths about sex and HIV in a way that helps protect them from exposure to HIV. The in-school youths felt that parents are unsupportive in terms of HIV prevention among youths by way of fear of talking about sex, parents' lack of time to engage with their children, and authoritarian or indulgent parenting. The participants also described how parents treat girls and boys differently; however, no significant association was found between how girls and boys conceptualised parents' roles.

  10. Data and Statistics: Heart Failure

    MedlinePlus

    ... this? Submit What's this? Submit Button Related CDC Web Sites Heart Disease Stroke High Blood Pressure Salt ... to Prevent and Control Chronic Diseases Million Hearts® Web Sites with More Information About Heart Failure For ...

  11. Alternative agents versus prophylactic platelet transfusion for preventing bleeding in patients with thrombocytopenia due to chronic bone marrow failure: a network meta-analysis and systematic review

    PubMed Central

    Desborough, Michael; Estcourt, Lise J; Chaimani, Anna; Doree, Carolyn; Hopewell, Sally; Trivella, Marialena; Hadjinicolaou, Andreas V; Vyas, Paresh; Stanworth, Simon J

    2016-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To compare the relative efficacy of different treatments for thrombocytopenia (artificial platelet substitutes, platelet-poor plasma, fibrinogen, rFVIIa, rFXIII, thrombopoietin mimetics, antifibrinolytic drugs or platelet transfusions) in patients with chronic bone marrow failure and to derive a hierarchy of potential alternate treatments to platelet transfusions. PMID:27069420

  12. Running nurse-led secondary prevention clinics for coronary heart disease in primary care: qualitative study of health professionals' perspectives

    PubMed Central

    Murchie, Peter; Campbell, Neil C; Ritchie, Lewis D; Thain, Joan

    2005-01-01

    Background A randomised trial of nurse-led secondary prevention clinics for coronary heart disease resulted in improved secondary prevention and significantly lowered all-cause mortality at 4-year follow-up. This qualitative trial was conducted to explore the experience of health professionals that had been involved in running the clinics. Aim To identify the barriers and facilitators to establishing secondary prevention clinics for coronary heart disease within primary care. Design of study Semi-structured audiotaped telephone interviews with GPs and nurses involved in running clinics. Setting A stratified, random sample of 19 urban, suburban, and rural general practices in north-east Scotland. Method Semi-structured telephone interviews with 19 GPs and 17 practice-based nurses involved in running nurse-led clinics for the secondary prevention of coronary heart disease. Results Eight practices had run clinics continuously and 11 had stopped, with eight subsequently restarting. Participants accounted for these patterns by referring to advantages and disadvantages of the clinics in four areas: patient care, development of nursing skills, team working, and infrastructure. Most practitioners perceived benefits for patients from attending secondary prevention clinics, but some, from small rural practices, thought they were unnecessary. The extended role for nurses was welcomed, but was dependent on motivated staff, appropriate training and support. Clinics relied on, and could enhance, team working, however, some doctors were wary of delegating. With regard to infrastructure, staff shortages (especially nurses) and accommodation were as problematic as lack of funds. Conclusions Nurse-led secondary prevention clinics were viewed positively by most healthcare professionals that had been involved in running them, but barriers to their implementation had led most to stop running them at some point. Lack of space and staff shortages are likely to remain ongoing problems

  13. Usability and perceived usefulness of Personal Health Records for preventive health care: a case study focusing on patients' and primary care providers' perspectives.

    PubMed

    Ant Ozok, A; Wu, Huijuan; Garrido, Melissa; Pronovost, Peter J; Gurses, Ayse P

    2014-05-01

    Personal Health Records (PHR) are electronic applications for individuals to access, manage and share their health information in a secure environment. The goal of this study was to evaluate the usefulness and usability of a Web-based PHR technology aimed at improving preventive care, from both the patients' and primary care providers' perspectives. We conducted a multi-method descriptive study that included direct observations, concurrent think-aloud, surveys, interviews and focus groups in a suburban primary care clinic. Patients found the tailored health recommendations useful and the PHR easy to understand and use. They also reported asking useful health-related questions to their physicians because of using the system. Generally, care providers were interested in using the system due to its useful content and impact on patient activation. Future successful systems should be better integrated with hospital records; put more emphasis on system security; and offer more tailored health information based on comprehensive health databases.

  14. From patient to person: the need for an 'HIV trajectories' perspective in the delivery of prevention of mother-to-child-transmission services.

    PubMed

    Hsieh, Amy; Rodrigues, Jessica; Skovdal, Morten; Melillo, Sara; Walker, Damilola

    2014-07-01

    Accelerated efforts to end vertical HIV transmission have resulted in a 52% decrease in new infections among children since 2001. However, current approaches to prevent mother-to-child-transmission (PMTCT) assume a linearity and universality. These insufficiently guide clinicians and programmes toward interventions that comprehensively address the varying and changing needs of clients. This results in high levels of loss-to-follow-up at each step of the PMTCT cascade. Current PMTCT approaches must be adapted to respond to the different and complex realities of women, children and families affected by HIV. Drawing on the concept of an 'HIV trajectories,' we screened peer-reviewed literature for promising PMTCT approaches and selected 13 articles for qualitative review when the described intervention involved more than a biomedical approach to PMTCT and mother-child HIV treatment and care. Our qualitative analysis revealed that interventions which integrated elements of the 'HIV trajectories' perspective and built on people living with HIV support/network, community health worker, primary healthcare and early childhood development platforms were successful because they recognized that HIV is an illness, experienced, moderated and managed by numerous factors beyond biomedical interventions alone.On the basis of this review, we call for the adoption of an 'HIV trajectories' perspective that can help assess the comprehensiveness of care provided to women, children and families affected by HIV and can inform the planning and delivery of HIV and related services so that they more adequately respond to the varying needs of clients on different 'HIV trajectories'.

  15. Public Policy Failure and Fiasco in Education: Perspectives on the British Examinations Crises of 2000-2002 and Other Episodes since 1975

    ERIC Educational Resources Information Center

    Richardson, William

    2007-01-01

    In recent years there has been a re-appraisal within political science of the characteristics of various kinds of public policy failure. At the same time, the political significance of education has grown in most liberal democracies. The present paper examines public policy in British education since the mid-1970s and asks: What goes wrong in…

  16. Responding to Pacific Islanders: Culturally Competent Perspectives for Substance Abuse Prevention. CSAP Cultural Competence Series 8. Special Collaborative Edition.

    ERIC Educational Resources Information Center

    Mokuau, Noreen; Kameoka, Velma A.; Kupuna, Abbie Napeahi; Kelly, Terry; Burgess, Paula-Ann; Kamiyama, David; Young, Kawen T.; Galea'i, Kenneth Elifasa; Natividad, Lisalinda; Dobbin, Jay; Oneisom, Innocente; Mason, Michael

    This monograph addresses issues of concern to primary health care practitioners, policy makers, and evaluators wishing to broaden access to quality substance abuse prevention services for Pacific Islanders. It is devoted exclusively to health issues affecting Pacific Islanders, who often lack access to comprehensive health care because of…

  17. School Violence Prevention: Climate and Moral Perspectives of Sixth through Eighth Grade Students Attending a Southern California Catholic School

    ERIC Educational Resources Information Center

    Gomez, Diane Diaz

    2010-01-01

    The need for U.S. teachers to better understand School Violence Prevention is growing. Evidence suggests however, that 10 years and 10 billion dollars after the Columbine High School massacre, our public schools are not safer (www.community-matters.org). There has been an "after the fact" approach to the problem of school violence. After…

  18. Preventing Adolescent Risk Behavior in the Rural Context: An Integrative Analysis of Adolescent, Parent, and Provider Perspectives

    ERIC Educational Resources Information Center

    Rishel, Carrie W.; Cottrell, Lesley; Kingery, Tricia

    2012-01-01

    Adolescent risk behavior remains prevalent and contributes to numerous social problems and growing health care costs. Contrary to popular perception, adolescents in rural areas engage in risky behaviors at least as much as youth from urban or suburban settings. Little research, however, focuses on risk behavior prevention in the rural context.…

  19. Health Administrator Perspectives on Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Prevention and Services at Historically Black Colleges and Universities

    ERIC Educational Resources Information Center

    Warren-Jeanpiere, Lari; Jones, Sandra; Sutton, Madeline Y.

    2011-01-01

    Objective: Due to the disproportionate impact of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) among African American young adults, the authors explored (1) number of historically black college and university (HBCU) campuses with existing HIV prevention policies and services and (2) perceived barriers for implementing…

  20. Importance and Satisfaction of Preventive Health Strategies in Institutions for People with Intellectual Disabilities: A Perspective of Institutional Directors

    ERIC Educational Resources Information Center

    Lin, J. D.; Yen, C. F.; Wu, J. L.

    2005-01-01

    Aim: To explore the perceptions of institutional directors on the preventive health strategies for people with intellectual disabilities in institutions. Methods: A structured questionnaire was conducted by a cross-sectional postal survey in all registered institutions in Taiwan in 2002. A total of 157 questionnaires were mailed, of which 121…

  1. No benefits of statins for sudden cardiac death prevention in patients with heart failure and reduced ejection fraction: A meta-analysis of randomized controlled trials

    PubMed Central

    Le, Hai-Ha; Fall, Mor; Gueyffier, François; Burnand, Bernard

    2017-01-01

    Background and objectives Statins showed mixed results in heart failure (HF) patients. The benefits in major HF outcomes, including all-cause mortality and sudden cardiac death (SCD), have always been discordant across systematic reviews and meta-analyses. We intended to systematically identify and appraise the available evidence that evaluated the effectiveness of statins in clinical outcomes for HF patients. Design Systematic review and meta-analysis Data sources We searched, until April 28, 2016: Medline, Embase, ISI Web of Science and EBM reviews (Cochrane DSR, ACP journal club, DARE, CCTR, CMR, HTA, and NHSEED), checked clinicaltrials.gov for ongoing trials and manually searched references of included studies. Eligibility criteria for selecting studies We identified 24 randomized clinical trials that evaluated the efficacy of statins for HF patients. All randomized clinical trials were assessed for risk of bias and pooled together in a meta-analysis. Pre-specified outcomes were sudden cardiac death, all-cause mortality, and hospitalization for worsening heart failure. Results Statins did not reduce sudden cardiac death (SCD) events in HF patients [relative risk (RR) 0.92, 95% confidence interval (CI) 0.70 to 1.21], all-cause mortality [RR 0.88, 95% CI 0.75 to 1.02] but significantly reduced hospitalization for worsening heart failure (HWHF) although modestly [RR 0.79, 95% CI 0.66 to 0.94]. Nevertheless, estimated predictive intervals were insignificant in SCD, all-cause mortality and HWHF [RR, 0.54 to 1.63, 0.64 to 1.19, and 0.54 to 1.15], respectively. An important finding was the possible presence of publication bias, small-study effects and heterogeneity of the trials conducted in HF patients. Conclusions Statins do not reduce sudden cardiac death, all-cause mortality, but may slightly decrease hospitalization for worsening heart failure in HF patients. The evaluation of the risk of biases suggested moderate quality of the published results. Until new

  2. 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.

  3. [Domestic, leisure activity and sports-related accidents in an active population: perspectives for prevention by health education].

    PubMed

    Godard, C; Chevalier, A; Lahon, G

    2002-09-01

    Resulting from the findings of epidemiological surveys on non-work-related accidents conducted in 1996 and 1997 among employees covered by a special health insurance programme for gas and electric company workers, this article identifies avoidable and recurrent accidents that may be targeted by health education interventions. It also emphasizes the importance of considering the needs expressed by the population at large when developing the themes for information campaigns. Finally, it proposes a sequel to the "survey-action plan" released in 1996. The proposed follow-up takes into account the occupational setting and its professionally-related barriers, and includes delivering prevention messages, conducting in-house experimental health promotion activities (and evaluating them), and disseminating intermediary external campaigns aimed at impeding avoidable accidents among adults. The preventable accidents identified in this study are not specific to the employed population group studied here; they may also be targeted by more general health promotion programmes and interventions.

  4. Colorectal cancer prevention: Perspectives of key players from social networks in a low-income rural US region

    PubMed Central

    Schoenberg, Nancy E.; Eddens, Kathryn; Jonas, Adam; Snell-Rood, Claire; Studts, Christina R.; Broder-Oldach, Benjamin; Katz, Mira L.

    2016-01-01

    Social networks influence health behavior and health status. Within social networks, “key players” often influence those around them, particularly in traditionally underserved areas like the Appalachian region in the USA. From a total sample of 787 Appalachian residents, we identified and interviewed 10 key players in complex networks, asking them what comprises a key player, their role in their network and community, and ideas to overcome and increase colorectal cancer (CRC) screening. Key players emphasized their communication skills, resourcefulness, and special occupational and educational status in the community. Barriers to CRC screening included negative perceptions of the colonoscopy screening procedure, discomfort with the medical system, and misinformed perspectives on screening. Ideas to improve screening focused on increasing awareness of women's susceptibility to CRC, providing information on different screening tests, improving access, and the key role of health-care providers and key players themselves. We provide recommendations to leverage these vital community resources. PMID:26905402

  5. Colorectal cancer prevention: Perspectives of key players from social networks in a low-income rural US region.

    PubMed

    Schoenberg, Nancy E; Eddens, Kathryn; Jonas, Adam; Snell-Rood, Claire; Studts, Christina R; Broder-Oldach, Benjamin; Katz, Mira L

    2016-01-01

    Social networks influence health behavior and health status. Within social networks, "key players" often influence those around them, particularly in traditionally underserved areas like the Appalachian region in the USA. From a total sample of 787 Appalachian residents, we identified and interviewed 10 key players in complex networks, asking them what comprises a key player, their role in their network and community, and ideas to overcome and increase colorectal cancer (CRC) screening. Key players emphasized their communication skills, resourcefulness, and special occupational and educational status in the community. Barriers to CRC screening included negative perceptions of the colonoscopy screening procedure, discomfort with the medical system, and misinformed perspectives on screening. Ideas to improve screening focused on increasing awareness of women's susceptibility to CRC, providing information on different screening tests, improving access, and the key role of health-care providers and key players themselves. We provide recommendations to leverage these vital community resources.

  6. Hazard Prevention Regarding Occupational Accidents Involving Blue-Collar Foreign Workers: A Perspective of Taiwanese Manpower Agencies.

    PubMed

    Chang, Huan-Cheng; Wang, Mei-Chin; Liao, Hung-Chang; Cheng, Shu-Fang; Wang, Ya-Huei

    2016-07-13

    Since 1989, blue-collar foreign workers have been permitted to work in Taiwanese industries. Most blue-collar foreign workers apply for jobs in Taiwan through blue-collar foreign workers' agencies. Because blue-collar foreign workers are not familiar with the language and culture in Taiwan, in occupational accident education and hazard prevention, the agencies play an important role in the coordination and translation between employees and blue-collar foreign workers. The purpose of this study is to establish the agencies' role in the occupational accidents education and hazard prevention for blue-collar foreign workers in Taiwan. This study uses a qualitative method-grounded theory-to collect, code, and analyze the data in order to understand the agencies' role in occupational accident education and hazard prevention for blue-collar foreign workers in Taiwan. The results show that the duty of agencies in occupational accident education and hazard prevention includes selecting appropriate blue-collar foreign workers, communicating between employees and blue-collar foreign workers, collecting occupational safety and health information, assisting in the training of occupational safety and health, and helping blue-collar foreign workers adapt to their lives in Taiwan. Finally, this study suggests seven important points and discusses the implementation process necessary to improve governmental policies. The government and employees should pay attention to the education/training of occupational safety and health for blue-collar foreign workers to eliminate unsafe behavior in order to protect the lives of blue-collar foreign workers.

  7. Hazard Prevention Regarding Occupational Accidents Involving Blue-Collar Foreign Workers: A Perspective of Taiwanese Manpower Agencies

    PubMed Central

    Chang, Huan-Cheng; Wang, Mei-Chin; Liao, Hung-Chang; Cheng, Shu-Fang; Wang, Ya-huei

    2016-01-01

    Since 1989, blue-collar foreign workers have been permitted to work in Taiwanese industries. Most blue-collar foreign workers apply for jobs in Taiwan through blue-collar foreign workers’ agencies. Because blue-collar foreign workers are not familiar with the language and culture in Taiwan, in occupational accident education and hazard prevention, the agencies play an important role in the coordination and translation between employees and blue-collar foreign workers. The purpose of this study is to establish the agencies’ role in the occupational accidents education and hazard prevention for blue-collar foreign workers in Taiwan. This study uses a qualitative method—grounded theory—to collect, code, and analyze the data in order to understand the agencies’ role in occupational accident education and hazard prevention for blue-collar foreign workers in Taiwan. The results show that the duty of agencies in occupational accident education and hazard prevention includes selecting appropriate blue-collar foreign workers, communicating between employees and blue-collar foreign workers, collecting occupational safety and health information, assisting in the training of occupational safety and health, and helping blue-collar foreign workers adapt to their lives in Taiwan. Finally, this study suggests seven important points and discusses the implementation process necessary to improve governmental policies. The government and employees should pay attention to the education/training of occupational safety and health for blue-collar foreign workers to eliminate unsafe behavior in order to protect the lives of blue-collar foreign workers. PMID:27420085

  8. Reading--A Perspective on Life.

    ERIC Educational Resources Information Center

    Lowe, Kaye

    A study explored the holistic nature of reading failure from the perspective of those who have endured the emotional and intellectual burden of not being able to read. Reading failure is frequently viewed from a fragmented, reductionist perspective. Getting to know and understand the individual's perception of literacy failure is ignored in the…

  9. Behavioral counseling research and evidence-based practice recommendations: U.S. Preventive Services Task Force perspectives.

    PubMed

    Curry, Susan J; Grossman, David C; Whitlock, Evelyn P; Cantu, Adelita

    2014-03-18

    The U.S. Preventive Services Task Force (USPSTF) makes recommendations on which preventive services to routinely incorporate into primary care for specific populations. Behavioral counseling interventions are preventive services designed to help persons engage in healthy behaviors and limit unhealthy ones. The USPSTF's evaluation of behavioral counseling interventions asks 2 primary questions: Do interventions in the clinical setting influence persons to change their behavior, and does changing health behavior improve health outcomes with minimal harms?This article discusses challenges encountered by the USPSTF in aggregating the behavioral counseling intervention literature to develop guidelines. The challenges relate broadly to study populations, intervention protocols, assessment of outcomes, and linking behavior changes to health outcomes. Recommendations to address these challenges include use of the PRECIS (Pragmatic-Explanatory Continuum Indicator Summary) tool as a guide for the development of feasible, replicable, and generalizable behavioral counseling interventions; improved reporting of study methods and results; consensus measures for key behavioral outcomes; and use of existing data sets to link behavior change and clinical outcomes.

  10. 'It looks like you just want them when things get rough': civil society perspectives on negative trial results and stakeholder engagement in HIV prevention trials.

    PubMed

    Koen, Jennifer; Essack, Zaynab; Slack, Catherine; Lindegger, Graham; Newman, Peter A

    2013-12-01

    Civil society organizations (CSOs) have significantly impacted on the politics of health research and the field of bioethics. In the global HIV epidemic, CSOs have served a pivotal stakeholder role. The dire need for development of new prevention technologies has raised critical challenges for the ethical engagement of community stakeholders in HIV research. This study explored the perspectives of CSO representatives involved in HIV prevention trials (HPTs) on the impact of premature trial closures on stakeholder engagement. Fourteen respondents from South African and international CSOs representing activist and advocacy groups, community mobilisation initiatives, and human and legal rights groups were purposively sampled based on involvement in HPTs. Interviews were conducted from February-May 2010. Descriptive analysis was undertaken across interviews and key themes were developed inductively. CSO representatives largely described positive outcomes of recent microbicide and HIV vaccine trial terminations, particularly in South Africa, which they attributed to improvements in stakeholder engagement. Ongoing challenges to community engagement included the need for principled justifications for selective stakeholder engagement at strategic time-points, as well as the need for legitimate alternatives to CABs as mechanisms for engagement. Key issues for CSOs in relation to research were also raised.

  11. Chinese non-governmental organizations involved in HIV/AIDS prevention and control: Intra-organizational social capital as a new analytical perspective.

    PubMed

    Wang, Danni; Mei, Guangliang; Xu, Xiaoru; Zhao, Ran; Ma, Ying; Chen, Ren; Qin, Xia; Hu, Zhi

    2016-11-15

    HIV/AIDS is a major public health and social problem worldwide, and non-governmental organizations (NGOs) have played an irreplaceable role in HIV/AIDS prevention and control. At the present time, however, NGOs have not fully participated in HIV/AIDS prevention and control in China. As an emerging focus on international academic inquiry, social capital can provide a new perspective from which to promote the growth of NGOs. The Joint United Nations Program on HIV/AIDS (UNAIDS) recommends creating regional policies tailored to multiple and varying epidemics of HIV/AIDS. In order to provide evidence to policymakers, this paper described the basic information on NGOs and their shortage of social capital. This paper also compared the actual NGOs to "government-organized non-governmental organizations" (GONGOs). Results indicated that i) Chinese NGOs working on HIV/AIDS are short of funding and core members. GONGOs received more funding, had more core members, and built more capacity building than actual NGOs; ii) Almost half of the NGOs had a low level of trust and lacked a shared vision, networks, and support. The staff of GONGOs received more support from their organization than the staff of actual NGOs. Existing intra-organizational social capital among the staff of NGOs should be increased. Capacity building and policymaking should differentiate between actual NGOs and GONGOs. The relationship between social capital and organizational performance is a topic for further study.

  12. Decompensated heart failure

    PubMed Central

    Mangini, Sandrigo; Pires, Philippe Vieira; Braga, Fabiana Goulart Marcondes; Bacal, Fernando

    2013-01-01

    ABSTRACT Heart failure is a disease with high incidence and prevalence in the population. The costs with hospitalization for decompensated heart failure reach approximately 60% of the total cost with heart failure treatment, and mortality during hospitalization varies according to the studied population, and could achieve values of 10%. In patients with decompensated heart failure, history and physical examination are of great value for the diagnosis of the syndrome, and also can help the physician to identify the beginning of symptoms, and give information about etiology, causes and prognosis of the disease. The initial objective of decompensated heart failure treatment is the hemodynamic and symptomatic improvement preservation and/or improvement of renal function, prevention of myocardial damage, modulation of the neurohormonal and/or inflammatory activation and control of comorbidities that can cause or contribute to progression of the syndrome. According to the clinical-hemodynamic profile, it is possible to establish a rational for the treatment of decompensated heart failure, individualizing the proceedings to be held, leading to reduction in the period of hospitalization and consequently reducing overall mortality. PMID:24136770

  13. Perspectives on prevention of type 2 diabetes after gestational diabetes: a qualitative study of Hispanic, African-American and White women.

    PubMed

    Tang, Joyce W; Foster, Krys E; Pumarino, Javiera; Ackermann, Ronald T; Peaceman, Alan M; Cameron, Kenzie A

    2015-07-01

    Women with gestational diabetes (GDM) have a fivefold higher risk of developing type 2 diabetes (T2DM). Furthermore, Hispanic and African-American women are disproportionately affected by GDM, but their views on prevention of T2DM after gestational diabetes are largely unknown. We conducted semi-structured interviews with 23 women (8 Hispanic, 8 African-American, 7 non-Hispanic White) from two academic clinics in Chicago, IL. Interview questions elicited perspectives on prevention of T2DM; the interview protocol was developed based on the Health Belief Model. Two investigators applied template analysis to identify emergent themes. Women conceptualized risk for T2DM based on family history, health behaviors, and personal history of GDM. A subgroup of women expressed uncertainty about how GDM influences risk for T2DM. Women who described a strong link between GDM and T2DM often viewed the diagnosis as a cue to action for behavior change. T2DM was widely viewed as a severe condition, and desire to avoid T2DM was an important motivator for behavior change. Children represented both a key motivator and critical barrier to behavior change. Women viewed preventive care as important to alert them to potential health concerns. Identified themes were congruent across racial/ethnic groups. Diagnosis with GDM presents a potent opportunity for engaging women in behavior change. To fully harness the potential influence of this diagnosis, healthcare providers should more clearly link the diagnosis of GDM with risk for future T2DM, leverage women's focus on their children to motivate behavior change, and provide support with behavior change during healthcare visits in the postpartum period and beyond.

  14. Bioactivity of Polyphenols: Preventive and Adjuvant Strategies toward Reducing Inflammatory Bowel Diseases-Promises, Perspectives, and Pitfalls.

    PubMed

    Kaulmann, Anouk; Bohn, Torsten

    2016-01-01

    Inflammatory bowel diseases (IBDs) are characterized by autoimmune and inflammation-related complications of the large intestine (ulcerative colitis) and additional parts of the digestive tract (Crohn's disease). Complications include pain, diarrhoea, chronic inflammation, and cancer. IBD prevalence has increased during the past decades, especially in Westernized countries, being as high as 1%. As prognosis is poor and medication often ineffective or causing side effects, additional preventive/adjuvant strategies are sought. A possible approach is via diets rich in protective constituents. Polyphenols, the most abundant phytochemicals, have been associated with anti-inflammatory, antioxidant, immunomodulatory, and apoptotic properties. Locally reducing oxidative stress, they can further act on cellular targets, altering gene expression related to inflammation, including NF-κB, Nrf-2, Jak/STAT, and MAPKs, suppressing downstream cytokine formation (e.g., IL-8, IL-1β, and TNF-α), and boosting the bodies' own antioxidant status (HO-1, SOD, and GPx). Moreover, they may promote, as prebiotics, healthy microbiota (e.g., Bifidobacteria, Akkermansia), short-chain fatty acid formation, and reduced gut permeability/improved tight junction stability. However, potential adverse effects such as acting as prooxidants, or perturbations of efflux transporters and phase I/II metabolizing enzymes, with increased uptake of undesired xenobiotics, should also be considered. In this review, we summarize current knowledge around preventive and arbitrary actions of polyphenols targeting IBD.

  15. Bioactivity of Polyphenols: Preventive and Adjuvant Strategies toward Reducing Inflammatory Bowel Diseases—Promises, Perspectives, and Pitfalls

    PubMed Central

    Kaulmann, Anouk

    2016-01-01

    Inflammatory bowel diseases (IBDs) are characterized by autoimmune and inflammation-related complications of the large intestine (ulcerative colitis) and additional parts of the digestive tract (Crohn's disease). Complications include pain, diarrhoea, chronic inflammation, and cancer. IBD prevalence has increased during the past decades, especially in Westernized countries, being as high as 1%. As prognosis is poor and medication often ineffective or causing side effects, additional preventive/adjuvant strategies are sought. A possible approach is via diets rich in protective constituents. Polyphenols, the most abundant phytochemicals, have been associated with anti-inflammatory, antioxidant, immunomodulatory, and apoptotic properties. Locally reducing oxidative stress, they can further act on cellular targets, altering gene expression related to inflammation, including NF-κB, Nrf-2, Jak/STAT, and MAPKs, suppressing downstream cytokine formation (e.g., IL-8, IL-1β, and TNF-α), and boosting the bodies' own antioxidant status (HO-1, SOD, and GPx). Moreover, they may promote, as prebiotics, healthy microbiota (e.g., Bifidobacteria, Akkermansia), short-chain fatty acid formation, and reduced gut permeability/improved tight junction stability. However, potential adverse effects such as acting as prooxidants, or perturbations of efflux transporters and phase I/II metabolizing enzymes, with increased uptake of undesired xenobiotics, should also be considered. In this review, we summarize current knowledge around preventive and arbitrary actions of polyphenols targeting IBD. PMID:27478535

  16. Drug abuse, relapse, and prevention education in malaysia: perspective of university students through a mixed methods approach.

    PubMed

    Chie, Qiu Ting; Tam, Cai Lian; Bonn, Gregory; Wong, Chee Piau; Dang, Hoang Minh; Khairuddin, Rozainee

    2015-01-01

    In recent years, there have been increasing accounts of illegal substance abuse among university students and professional groups in Malaysia. This study looks at university students' perceptions about this phenomenon. Students from Malaysian universities were asked for their impressions about drug availability and abuse, as well as factors contributing to drug abuse and relapse. The questionnaire also inquired into their knowledge and views regarding government versus private rehabilitation centers, as well as their exposure to, and views about, school-based drug-prevention education. Participants were 460 university students from five Malaysian states: Penang, Selangor, Kuala Lumpur, Sabah, and Sarawak. Results showed gender differences in perceptions of relapse prevention strategies, as well as factors leading to drug abuse and relapse. Students also believed that drug education would be more effective if initiated between the ages of 11 and 12 years, which is slightly older than the common age of first exposure, and provided suggestions for improving existing programs. Implications of student perceptions for the improvement of current interventions and educational programs are discussed.

  17. Teachers’ and Education Support Professionals’ Perspectives on Bullying and Prevention: Findings From a National Education Association Study

    PubMed Central

    Bradshaw, Catherine P.; Waasdorp, Tracy E.; O'Brennan, Lindsey M.; Gulemetova, Michaela

    2014-01-01

    Given growing concerns regarding the prevalence and seriousness of bullying, the National Education Association recently drew upon its membership to launch a national study of teachers’ and education support professionals’ perceptions of bullying, and need for additional training on bullying prevention efforts and school-wide policies. The data were collected from a representative sample of 5,064 National Education Association members (2,163 teachers and 2,901 education support professionals). Analyses indicated that compared to education support professionals, teachers were more likely to witness students being bullied, more likely to view bullying as a significant problem at their school, and were more likely to have students report bullying to them. Teachers were more likely to be involved in bullying policies at their school, yet both groups reported wanting more training related to cyberbullying and bullying related to students’ sexual orientation, gender issues, and racial issues. Implications for school psychologists and the development of school-wide bullying prevention efforts are discussed. PMID:25414539

  18. Packaging waste prevention in the distribution of fruit and vegetables: An assessment based on the life cycle perspective.

    PubMed

    Tua, Camilla; Nessi, Simone; Rigamonti, Lucia; Dolci, Giovanni; Grosso, Mario

    2017-02-01

    In recent years, alternative food supply chains based on short distance production and delivery have been promoted as being more environmentally friendly than those applied by the traditional retailing system. An example is the supply of seasonal and possibly locally grown fruit and vegetables directly to customers inside a returnable crate (the so-called 'box scheme'). In addition to other claimed environmental and economic advantages, the box scheme is often listed among the packaging waste prevention measures. To check whether such a claim is soundly based, a life cycle assessment was carried out to verify the real environmental effectiveness of the box scheme in comparison to the Italian traditional distribution. The study focused on two reference products, carrots and apples, which are available in the crate all year round. An experience of a box scheme carried out in Italy was compared with some traditional scenarios where the product is distributed loose or packaged at the large-scale retail trade. The packaging waste generation, 13 impact indicators on environment and human health and energy consumptions were calculated. Results show that the analysed experience of the box scheme, as currently managed, cannot be considered a packaging waste prevention measure when compared with the traditional distribution of fruit and vegetables. The weaknesses of the alternative system were identified and some recommendations were given to improve its environmental performance.

  19. Vision Screening for Alzheimer's Disease: Prevention from an Ophthalmologist's Perspective (There is More to Vision than Meets the Eye).

    PubMed

    Rosen, Peter N

    2004-01-01

    Recent evidence suggests that memory impairment and vision impairment are closely linked in Alzheimer's disease and that special testing for vision impairment can improve early detection and treatment of dementia. Visual images, attention, memory, awareness, and salience are tightly bound together in the cerebral cortex; under normal circumstances, these functions perform seamlessly to produce a visual reality of the external world. Alzheimer's disease-now considered a chronic illness-unravels the fabric of reality woven together over a lifetime of experience: The disease produces disconnected threads of visual perception, memory, and cognition. The earliest neuroanatomic manifestations of this process begin in the limbic system and medial temporal lobe of the brain, areas critical for detailed visual perception and memory management. Thus, by using vision tests to detect impaired image formation and memory, vision care specialists can play a valuable role in secondary and tertiary prevention, as well as in early treatment of eye disease and dementia. In addition to reducing health care utilization, prevention can be expected to improve functioning and health-related quality of life.

  20. Tobacco-related disease burden and preventive initiatives in China. Global health and the chronic diseases: perspective, policy and practice.

    PubMed

    Niu, Bolin

    2011-06-01

    The burden of chronic diseases in global health is a surging area of research. The Global Health Initiative at the National Heart, Lung, and Blood Institute brings together investigators from developing countries with those from the developed world to study these diseases. In China, approximately 83 percent of all deaths in 2000 were attributed to chronic illnesses, which are the research focuses of the Chinese center of the Global Health Initiative. Tobacco use as well as passive smoking are modifiable risk factors in a large number of such chronic conditions. The prevalence of smoking in China is extensive and has inseparable ties to the economy, with tobacco taxes making up a large portion of government revenue in poorer provinces. Methods of smoking prevention have been piloted in some Chinese schools, which have mitigated the increase in smoking rate but have not resulted in a primary preventive effect. Efforts by the Yale Global Health Initiative and the Yale-China Association are bringing researchers together to address chronic disease in China as Yale School of Medicine enters its 200th year.

  1. Teachers' and Education Support Professionals' Perspectives on Bullying and Prevention: Findings From a National Education Association Study.

    PubMed

    Bradshaw, Catherine P; Waasdorp, Tracy E; O'Brennan, Lindsey M; Gulemetova, Michaela

    2013-01-01

    Given growing concerns regarding the prevalence and seriousness of bullying, the National Education Association recently drew upon its membership to launch a national study of teachers' and education support professionals' perceptions of bullying, and need for additional training on bullying prevention efforts and school-wide policies. The data were collected from a representative sample of 5,064 National Education Association members (2,163 teachers and 2,901 education support professionals). Analyses indicated that compared to education support professionals, teachers were more likely to witness students being bullied, more likely to view bullying as a significant problem at their school, and were more likely to have students report bullying to them. Teachers were more likely to be involved in bullying policies at their school, yet both groups reported wanting more training related to cyberbullying and bullying related to students' sexual orientation, gender issues, and racial issues. Implications for school psychologists and the development of school-wide bullying prevention efforts are discussed.

  2. Drug Abuse, Relapse, and Prevention Education in Malaysia: Perspective of University Students Through a Mixed Methods Approach

    PubMed Central

    Chie, Qiu Ting; Tam, Cai Lian; Bonn, Gregory; Wong, Chee Piau; Dang, Hoang Minh; Khairuddin, Rozainee

    2015-01-01

    In recent years, there have been increasing accounts of illegal substance abuse among university students and professional groups in Malaysia. This study looks at university students’ perceptions about this phenomenon. Students from Malaysian universities were asked for their impressions about drug availability and abuse, as well as factors contributing to drug abuse and relapse. The questionnaire also inquired into their knowledge and views regarding government versus private rehabilitation centers, as well as their exposure to, and views about, school-based drug-prevention education. Participants were 460 university students from five Malaysian states: Penang, Selangor, Kuala Lumpur, Sabah, and Sarawak. Results showed gender differences in perceptions of relapse prevention strategies, as well as factors leading to drug abuse and relapse. Students also believed that drug education would be more effective if initiated between the ages of 11 and 12 years, which is slightly older than the common age of first exposure, and provided suggestions for improving existing programs. Implications of student perceptions for the improvement of current interventions and educational programs are discussed. PMID:25999867

  3. African American women’s perspectives on “Down Low/DL” men: Implications for HIV Prevention

    PubMed Central

    Goparaju, Lakshmi; Warren-Jeanpiere, Lari

    2012-01-01

    African American women are disproportionately affected by HIV. Some research has explored if non-disclosing men who have sex with men and women (MSMW) contribute to women’s HIV risk. Popular media discourse tends to refer to these men as “Down Low” or “DL”. Six focus groups were conducted with 36 African American women in Washington D.C. to examine their knowledge, attitudes, beliefs, and behaviours regarding “Down Low/DL” men. Three of the focus groups were composed of HIV positive women and three groups were composed of HIV negative women. Data analysis reveals six central subcategories related to women’s perspectives on the “DL”: awareness; suspicion; coping with partner infidelity: male vs. female; sexual health communication; empathy; and religion. No major differences were identified between the HIV positive and HIV negative focus groups. Findings from this study provide insight into African American women’s perceptions of African American male sexuality and how these perceptions serve to influence interpersonal relationship factors and women’s exposure to HIV risk. PMID:22804686

  4. Can clinicians and scientists explain and prevent unexplained underperformance syndrome in elite athletes: an interdisciplinary perspective and 2016 update

    PubMed Central

    Lewis, Nathan A; Collins, Dave; Pedlar, Charles R; Rogers, John P

    2015-01-01

    The coach and interdisciplinary sports science and medicine team strive to continually progress the athlete's performance year on year. In structuring training programmes, coaches and scientists plan distinct periods of progressive overload coupled with recovery for anticipated performances to be delivered on fixed dates of competition in the calendar year. Peaking at major championships is a challenge, and training capacity highly individualised, with fine margins between the training dose necessary for adaptation and that which elicits maladaptation at the elite level. As such, optimising adaptation is key to effective preparation. Notably, however, many factors (eg, health, nutrition, sleep, training experience, psychosocial factors) play an essential part in moderating the processes of adaptation to exercise and environmental stressors, for example, heat, altitude; processes which can often fail or be limited. In the UK, the term unexplained underperformance syndrome (UUPS) has been adopted, in contrast to the more commonly referenced term overtraining syndrome, to describe a significant episode of underperformance with persistent fatigue, that is, maladaptation. This construct, UUPS, reflects the complexity of the syndrome, the multifactorial aetiology, and that ‘overtraining’ or an imbalance between training load and recovery may not be the primary cause for underperformance. UUPS draws on the distinction that a decline in performance represents the universal feature. In our review, we provide a practitioner-focused perspective, proposing that causative factors can be identified and UUPS explained, through an interdisciplinary approach (ie, medicine, nutrition, physiology, psychology) to sports science and medicine delivery, monitoring, and data interpretation and analysis. PMID:27900140

  5. Perspectives on HIV Prevention Among Urban Black Women: A Potential Role for HIV Pre-Exposure Prophylaxis

    PubMed Central

    Stone, Valerie E.; Mitty, Jennifer A.; Mimiaga, Matthew J.; Hall, Kathryn T.; Krakower, Douglas; Mayer, Kenneth H.

    2014-01-01

    Abstract Limited data exist regarding attitudes and acceptability of topical and oral HIV pre-exposure prophylaxis (PrEP) among US black women. This investigation explored interest in HIV chemoprophylaxis and modes of use. Five focus groups enrolled 26 black women recruited from an inner-city community health center and affiliated HIV testing sites. Thematic analysis utilized Atlas.ti. Most women expressed interest in PrEP, as many reported condom failure concerns. Most women preferred a pill formulation to intravaginal gel because of greater perceived privacy and concerns about vaginal side effects and gel leakage. Women who had taken pills previously advocated daily dosing and indicated adherence concerns about episodic or post-coital PrEP. Many women desired prophylactic strategies that included partner testing. Urban black women are interested in utilizing PrEP; however, misgivings exist about gel inconvenience and potential side effects for themselves and their partners. Most women preferred oral PrEP, dosed daily. PMID:25295393

  6. Kidney Failure

    MedlinePlus

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. October 2, 2013 Contact Us Health Information Center Phone: 1-800-860- ...

  7. Heart Failure

    MedlinePlus

    ... for people who can't tolerate ACE inhibitors. Beta blockers. This class of drugs not only slows your ... rhythms and lessen your chance of dying unexpectedly. Beta blockers may reduce signs and symptoms of heart failure, ...

  8. Incidence of vertical phoria on postural control during binocular vision: what perspective for prevention to nonspecific chronic pain management?

    PubMed

    Matheron, Eric; Kapoula, Zoï

    2015-01-01

    Vertical heterophoria (VH) is the latent vertical misalignment of the eyes when the retinal images are dissociated, vertical orthophoria (VO) when there is no misalignment. Studies on postural control, during binocular vision in upright stance, reported that healthy subjects with small VH vs. VO are less stable, but the experimental cancellation of VH with an appropriate prism improves postural stability. The same behavior was recorded in nonspecific chronic back pain subjects, all with VH. It was hypothesized that, without refraction problems, VH indicates a perturbation of the somaesthetic cues required in the sensorimotor loops involved in postural control and the capacity of the CNS to optimally integrate these cues, suggesting prevention possibilities. Sensorimotor conflict can induce pain and modify sensory perception in some healthy subjects; some nonspecific pain or chronic pain could result from such prolonged conflict in which VH could be a sign, with new theoretical and clinical implications.

  9. Adoption of preventive behaviors in response to the 2009 H1N1 influenza pandemic: a multiethnic perspective

    PubMed Central

    SteelFisher, Gillian K; Blendon, Robert J; Kang, Minah; Ward, Johanna R M; Kahn, Emily B; Maddox, Kathryn EW; Lubell, Keri M; Tucker, Myra; Ben-Porath, Eran N

    2015-01-01

    Background As public health leaders prepare for possible future influenza pandemics, the rapid spread of 2009 H1N1 influenza highlights the need to focus on measures the public can adopt to help slow disease transmission. Such measures may relate to hygiene (e.g., hand washing), social distancing (e.g., avoiding places where many people gather), and pharmaceutical interventions (e.g., vaccination). Given the disproportionate impact of public health emergencies on minority communities in the United States, it is important to understand whether there are differences in acceptance across racial/ethnic groups that could lead to targeted and more effective policies and communications. Objectives This study explores racial/ethnic differences in the adoption of preventive behaviors during the 2009 H1N1 influenza pandemic. Patients/Methods Data are from a national telephone poll conducted March 17 to April 11, 2010, among a representative sample of 1123 white, 330 African American, 317 Hispanic, 268 Asian, and 262 American Indian/Alaska Native adults in the USA. Results People in at least one racial/ethnic minority group were more likely than whites to adopt several behaviors related to hygiene, social distancing, and healthcare access, including increased hand washing and talking with a healthcare provider (P-values <0·05). Exceptions included avoiding others with influenza-like illnesses and receiving 2009 H1N1 and seasonal influenza vaccinations. After we controlled the data for socioeconomic status, demographic factors, healthcare access, and illness- and vaccine-related attitudes, nearly all racial/ethnic differences in behaviors persisted. Conclusions Minority groups appear to be receptive to several preventive behaviors, but barriers to vaccination are more pervasive. PMID:25688806

  10. Anemia and heart failure.

    PubMed

    O'Meara, Eileen; Murphy, Clare; McMurray, John J V

    2004-12-01

    Over the past few years, anemia has emerged as a powerful independent predictor of adverse outcomes in chronic heart failure (CHF). It affects up to 50% of patients with CHF, depending on the definition of anemia used and on the population studied. Even small reductions in hemoglobin are associated with worse outcome. However, the causes of anemia in CHF remain unclear, although impairment of renal function and inflammatory cytokines are proposed mechanisms. Both may act through impairment of the synthesis or action of erythropoietin. Preliminary studies have demonstrated improvement in symptoms, exercise tolerance, quality of life, and reductions in hospitalizations when patients with severe CHF were treated with erythropoietin. The benefits and the potential risks of such therapies will be further addressed in upcoming larger randomized trials. The recent interest in anemia reflects a new perspective in heart failure therapy, focusing on non-cardiovascular comorbidities.

  11. Failure of Topical Antibiotics to Prevent Disseminated Borrelia burgdorferi Infection Following a Tick Bite in C3H/HeJ Mice

    PubMed Central

    Daniels, Thomas J.; Bittker, Susan; Cooper, Denise; Wang, Guiqing; Pavia, Charles S.

    2012-01-01

    A prior study in mice has shown that the timely application of topical antibiotics to the skin at the tick bite site could eradicate Borrelia burgdorferi infection. That study, however, did not evaluate antibiotic preparations that are considered suitable for use in humans. In this murine study, topical application of 2% erythromycin and 3% tetracycline preparations that are acceptable for use in humans was found to be ineffective in eliminating B. burgdorferi from the tick bite site or in preventing dissemination to other tissues. Reasons for the discrepant findings are discussed. PMID:21930606

  12. Failure to Return for Posttest Counseling and HIV Test Results at the Prevention and Voluntary Testing and Counseling Centers of Douala, Cameroon: An Evaluation of a Routine Five-Year Program

    PubMed Central

    Ngangue, Patrice; Bedard, Emmanuelle; Ngueta, Gerard; Adiogo, Dieudonné; Gagnon, Marie-Pierre

    2016-01-01

    This study examined the magnitude and time trends in failure to return (FTR) rates and the relation between FTR and individual characteristics, tests procedures, waiting period for the results, and HIV test results among people who were screened for HIV in the prevention and voluntary testing and counseling centers (PVTCCs) of six district hospitals of the city of Douala in Cameroon, between January 2009 and December 2013. It was a retrospective analysis of medical records. Among the 32,020 analyzed records, the failure to return (FTR) rate was 14.3%. Overall, people aged 50 years and over, those tested between 2011 and 2012, and those tested in the PVTCC of Bonassama were less likely to return for their results. Significant factors associated with FTR included being a housewife, having a positive/undetermined/requiring confirmation result, and provider-initiated testing and counseling (PITC). There was an increasing trend for FTR in the PVTCCs of Bonassama, New-Bell, Nylon, and Cité des Palmiers. HIV testing and counseling services in Douala district hospitals must be reorganized such that individuals tested for HIV receive their results on the same day of the test. Also counselors need to better alert clients concerning the importance of returning for their test results. PMID:26925261

  13. Heart failure

    PubMed Central

    2011-01-01

    Introduction Heart failure occurs in 3% to 4% of adults aged over 65 years, usually as a consequence of coronary artery disease or hypertension, and causes breathlessness, effort intolerance, fluid retention, and increased mortality. The 5-year mortality in people with systolic heart failure ranges from 25% to 75%, often owing to sudden death following ventricular arrhythmia. Risks of cardiovascular events are increased in people with left ventricular systolic dysfunction (LVSD) or heart failure. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of multidisciplinary interventions for heart failure? What are the effects of exercise in people with heart failure? What are the effects of drug treatments for heart failure? What are the effects of devices for treatment of heart failure? What are the effects of coronary revascularisation for treatment of heart failure? What are the effects of drug treatments in people at high risk of heart failure? What are the effects of treatments for diastolic heart failure? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 80 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: aldosterone receptor antagonists, amiodarone, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, anticoagulation, antiplatelet agents, beta-blockers, calcium

  14. Long-term use of secondary prevention medications for heart failure in Western Australia: a protocol for a population-based cohort study

    PubMed Central

    Qin, Xiwen; Teng, Tiew-Hwa Katherine; Hung, Joseph; Briffa, Tom

    2016-01-01

    Introduction Heart failure (HF) is a chronic, debilitating and progressive disease associated with high morbidity and mortality. Evidence-based medications (EBMs) are the cornerstone of management of patients with HF. In Australia, these EBMs are subsidised by the Commonwealth Government under the Pharmaceutical Benefits Scheme. Suboptimal dispensing and non-adherence to these EBMs have been observed in patients with HF. Our study will investigate trends in dispensing patterns, as well as adherence and persistence of EBMs for HF. We will also identify factors influencing these patterns and their impact on long-term clinical outcomes. Methods and analysis This whole population-based cohort study will use longitudinal data for people aged 65–84 years who were hospitalised for HF in Western Australia between 2003 and 2008. Linked state-wide and national data will provide patient-level information on medication dispensing, medical visits, hospitalisations and death. Drug dispensing trends will be described, drug adherence and persistence estimated and the association with all-cause/cardiovascular death and hospitalisations reported. Ethics and dissemination This project has received approvals from the Western Australian Department of Health Human Research Ethics Committee and the Western Australian Aboriginal Health Ethics Committee. Results will be published in relevant cardiology journals and presented at national and international conferences. PMID:27803111

  15. Innovative design to prevent reversal of roller blood pump rotation in the event of electromechanical failure: an easy solution to a devastating problem.

    PubMed

    Skoletsky, Jennifer S; White, Brian T; Austin, Jon W

    2007-06-01

    Despite the advanced technologies of battery back-up for heart-lung consoles and the availability of system-wide generators, electromechanical failure is still occurring. Several heart-lung machine manufacturers still provide unsafe handcranking devices to use in the case of an emergency while using a roller blood pump. A new design has been engineered to eliminate safety and quality issues for the perfusionist and the patient when the need for handcranking presents itself. A ratchet-style handcranking device was fabricated by means of a steel plate with adjustable pins. The adjustable pins allow for use with different models of the Cobe, Stockert, and Jostra heart-lung consoles, which contain roller pumps with 1800 roller heads. Additional modifications such as a 1:2 transmission and fluorescent markers are also used in the design. This innovative design is an improvement in safety compared with the current handcrank provided by Cobe, Stockert, and Jostra. With this modified handcranking device, accidental reverse rotation of the roller pump head cannot occur. Fluorescent markers will improve visualization of the pump head in low-light situations. The ergonomic design improves efficiency by reducing fatigue. Most importantly, a "safe" safety device will replace the current design provided by these manufacturers, thus improving the quality of care by health care providers.

  16. Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures.

    PubMed

    Harvey, N C W; McCloskey, E V; Mitchell, P J; Dawson-Hughes, B; Pierroz, D D; Reginster, J-Y; Rizzoli, R; Cooper, C; Kanis, J A

    2017-05-01

    This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into four distinct themes: (1) case finding and management of individuals at high risk of fracture, (2) public awareness of osteoporosis and fragility fractures, (3) reimbursement and health system policy and (4) epidemiology of fracture in the developing world. Findings from cohort studies, randomised controlled trials, systematic reviews and meta-analyses, in addition to current clinical guidelines, position papers and national and international audits, are summarised, with the intention of providing a prioritised approach to delivery of optimal bone health for all. Systematic approaches to case-finding individuals who are at high risk of sustaining fragility fractures are described. These include strategies and models of care intended to improve case finding for individuals who have sustained fragility fractures, those undergoing treatment with medicines which have an adverse effect on bone health and people who have diseases, whereby bone loss and, consequently, fragility fractures are a common comorbidity. Approaches to deliver primary fracture prevention in a clinically effective and cost-effective manner are also explored. Public awareness of osteoporosis is low worldwide. If older people are to be more pro-active in the management of their bone health, that needs to change. Effective disease awareness campaigns have been implemented in some countries but need to be undertaken in many more. A major need exists to improve awareness of the risk that osteoporosis poses to individuals who have initiated treatment, with the intention of improving adherence in the long term. A multisector effort is also required to support patients and their clinicians to have meaningful discussions concerning the risk-benefit ratio of osteoporosis treatment. With regard to

  17. Perspectives of UK Pakistani women on their behaviour change to prevent type 2 diabetes: qualitative study using the theory domain framework

    PubMed Central

    Penn, Linda; Dombrowski, Stephan U; Sniehotta, Falko F; White, Martin

    2014-01-01

    Background Type 2 diabetes (T2D) is a debilitating disease, highly prevalent in UK South Asians, and preventable by lifestyle intervention. The ‘New life, New you’ (NLNY) physical activity (PA) and dietary intervention for T2D prevention was culturally adapted to better engage minority ethnic populations and tested for feasibility. Objectives To investigate Pakistani female participants’ perspectives of their behaviour change and of salient intervention features. Setting A community-based 8-week programme of group delivered PA sessions with behavioural counselling and dietary advice, culturally adapted for ethnic minority populations, in an area of socioeconomic deprivation. Participants to NLNY were recruited through screening events in community venues across the town. Participants Interviews were conducted with 20 Pakistani female NLNY participants, aged 26–45 (mean 33.5) years, from different parts of town. Results Within the a priori Theoretical Domains Framework (intentions and goals, reinforcement, knowledge, nature of the activity, social role and identity, social influences, capabilities and skills, regulation and decision, emotion and environment), we identified the importance of social factors relating to participants’ own PA and dietary behaviour change. We also identified cross-cutting themes as collateral benefits of the intervention including participants’ ‘psychological health’; ‘responsibility’ (for others’ health, especially family members included in the new PA and diet regimes) and ‘inclusion’ (an ethos of accommodating differences). Conclusions Our findings suggest that culturally adapted interventions for Pakistani women at risk of T2D, delivered via group PA sessions with counselling and dietary advice, may encourage their PA and dietary behaviour change, and have collateral health and social benefits. The NLNY intervention appeared to be acceptable. We plan to evaluate recruitment, retention and likely effect of the

  18. Cost-effectiveness of anti-oxidant vitamins plus zinc treatment to prevent the progression of intermediate age-related macular degeneration. A Singapore perspective

    PubMed Central

    Saxena, Nakul; George, Pradeep Paul; Heng, Bee Hoon; Lim, Tock Han; Yong, Shao Onn

    2015-01-01

    Purpose: To determine if providing high dose anti-oxidant vitamins and zinc treatment age-related eye disease study (AREDS formulation) to patients with intermediate age-related macular degeneration (AMD) aged 40–79 years from Singapore is cost-effective in preventing progression to wet AMD. Methods: A hypothetical cohort of category 3 and 4 AMD patients from Singapore was followed for 5 calendar years to determine the number of patients who would progress to wet AMD given the following treatment scenarios: (a) AREDS formulation or placebo followed by ranibizumab (as needed) for wet AMD. (b) AREDS formulation or placebo followed by bevacizumab (monthly) for wet AMD. (c) AREDS formulation or placebo followed by aflibercept (VIEW I and II trial treatment regimen). Costs were estimated for the above scenarios from the providers’ perspective, and cost-effectiveness was measured by cost per disability-adjusted life year (DALY) averted with a disability weight of 0.22 for wet AMD. The costs were discounted at an annual rate of 3%. Results: Over 5400 patients could be prevented from progressing to wet AMD cumulatively if AREDS formulation were prescribed. AREDS formulation followed by ranibizumab was cost-effective compared to placebo-ranibizumab or placebo-aflibercept combinations (cost per DALY averted: SGD$23,662.3 and SGD$21,138.8, respectively). However, bevacizumab (monthly injections) alone was more cost-effective compared to AREDS formulation followed by bevacizumab. Conclusion: Prophylactic treatment with AREDS formulation for intermediate AMD patients followed by ranibizumab or for patients who progressed to wet AMD was found to be cost-effective. These findings have implications for intermediate AMD screening, treatment and healthcare planning in Singapore. PMID:26265643

  19. Economic perspective on strategic human capital management and planning for the Centers for Disease Control and Prevention.

    PubMed

    Roy, Kakoli; Chen, Zhuo Adam; Crawford, Carol A Gotway

    2009-11-01

    An organization's workforce--or human capital--is its most valuable asset. The 2002 President's Management Agenda emphasizes the importance of strategic human capital management by requiring all federal agencies to improve performance by enhancing personnel and compensation systems. In response to these directives, the Centers for Disease Control and Prevention (CDC) drafted its strategic human capital management plan to ensure that it is aligned strategically to support the agency's mission and its health protection goals. In this article, we explore the personnel economics literature to draw lessons from research studies that can help CDC enhance its human capital management and planning. To do so, we focus on topics that are of practical importance and empirical relevance to CDC's internal workforce and personnel needs with an emphasis on identifying promising research issues or methodological approaches. The personnel economics literature is rich with theoretically sound and empirically rigorous approaches for shaping an evidence-based approach to human capital management that can enhance incentives to attract, retain, and motivate a talented federal public health workforce, thereby promoting the culture of high-performance government.

  20. Time to abandon the hygiene hypothesis: new perspectives on allergic disease, the human microbiome, infectious disease prevention and the role of targeted hygiene

    PubMed Central

    Bloomfield, Sally F; Rook, Graham AW; Scott, Elizabeth A; Shanahan, Fergus; Stanwell-Smith, Rosalind; Turner, Paul

    2016-01-01

    Aims: To review the burden of allergic and infectious diseases and the evidence for a link to microbial exposure, the human microbiome and immune system, and to assess whether we could develop lifestyles which reconnect us with exposures which could reduce the risk of allergic disease while also protecting against infectious disease. Methods: Using methodology based on the Delphi technique, six experts in infectious and allergic disease were surveyed to allow for elicitation of group judgement and consensus view on issues pertinent to the aim. Results: Key themes emerged where evidence shows that interaction with microbes that inhabit the natural environment and human microbiome plays an essential role in immune regulation. Changes in lifestyle and environmental exposure, rapid urbanisation, altered diet and antibiotic use have had profound effects on the human microbiome, leading to failure of immunotolerance and increased risk of allergic disease. Although evidence supports the concept of immune regulation driven by microbe–host interactions, the term ‘hygiene hypothesis’ is a misleading misnomer. There is no good evidence that hygiene, as the public understands, is responsible for the clinically relevant changes to microbial exposures. Conclusion: Evidence suggests a combination of strategies, including natural childbirth, breast feeding, increased social exposure through sport, other outdoor activities, less time spent indoors, diet and appropriate antibiotic use, may help restore the microbiome and perhaps reduce risks of allergic disease. Preventive efforts must focus on early life. The term ‘hygiene hypothesis’ must be abandoned. Promotion of a risk assessment approach (targeted hygiene) provides a framework for maximising protection against pathogen exposure while allowing spread of essential microbes between family members. To build on these findings, we must change public, public health and professional perceptions about the microbiome and about

  1. Dietary supplement comprised of β-carotene, vitamin C, vitamin E, and magnesium: failure to prevent music-induced temporary threshold shift

    PubMed Central

    Le Prell, C. G.; Fulbright, A.; Spankovich, C.; Griffiths, S. K.; Lobarinas, E.; Campbell, K. C. M.; Antonelli, P. J.; Green, G. E.; Guire, K.; Miller, J. M.

    2016-01-01

    This study examined potential prevention of music-induced temporary threshold shift (TTS) in normal-hearing participants. A dietary supplement composed of β-carotene, vitamins C and E, and magnesium was assessed using a randomized, placebo-controlled, double-blind study design. Dosing began 3 days prior to the music exposure with the final dose consumed approximately 30-min pre-exposure. There were no group differences in post-exposure TTS or music-induced decreases in distortion product otoacoustic emission (DPOAE) amplitude. Transient tinnitus was more likely to be reported by the treatment group, but there were no group differences in perceived loudness or bothersomeness. All subjects were monitored until auditory function returned to pre-exposure levels. Taken together, this supplement had no effect on noise-induced changes in hearing. Recommendations for future clinical trials are discussed. PMID:27990155

  2. Quality of Anticoagulation Control in Preventing Adverse Events in Heart Failure Patients in Sinus Rhythm: A Warfarin Aspirin Reduced Cardiac Ejection Fraction Trial (WARCEF) Substudy

    PubMed Central

    Homma, Shunichi; Thompson, John L.P.; Qian, Min; Ye, Siqin; Di Tullio, Marco R.; Lip, Gregory Y.H.; Mann, Douglas L.; Sacco, Ralph L.; Levin, Bruce; Pullicino, Patrick M.; Freudenberger, Ronald S.; Teerlink, John R.; Graham, Susan; Mohr, J.P.; Labovitz, Arthur J.; Buchsbaum, Richard; Estol, Conrado J.; Lok, Dirk J.; Ponikowski, Piotr; Anker, Stefan D.

    2015-01-01

    Background The aim of this study is to examine the relationship between time in therapeutic range (TTR) and clinical outcomes in heart failure (HF) patients in sinus rhythm (SR) treated with warfarin. Methods and Results We used data from the Warfarin vs. Aspirin in Reduced Cardiac Ejection Fraction Trial (WARCEF) to assess the relationship of TTR with the WARCEF primary outcome (ischemic stroke, intracerebral hemorrhage, or death); with death alone; ischemic stroke alone; major hemorrhage alone; and net clinical benefit (primary outcome and major hemorrhage combined). Multivariable Cox models were used to examine how the event risk changed with TTR and to compare the high TTR, low TTR, and aspirin patients, with TTR being treated as a time-dependent covariate. 2,217 patients were included in the analyses, among whom 1,067 were randomized to warfarin and 1,150 were randomized to aspirin. The median (IQR) follow-up duration was 3.6 (2.0–5.0) years. Mean (±SD) age was 61±11.3 years, with 80% being men. The mean (±SD) TTR was 57% (±28.5%). Increasing TTR was significantly associated with reduction in primary outcome (adjusted p<0.001), death alone (adjusted p=0.001), and improved net clinical benefit (adjusted p<0.001). A similar trend was observed for the other two outcomes but significance was not reached (adjusted p=0.082 for ischemic stroke, adjusted p=0.109 for major hemorrhage). Conclusions In HF patients in SR, increasing TTR is associated with better outcome and improved net clinical benefit. Patients in whom good quality anticoagulation can be achieved may benefit from the use of anticoagulants. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00041938. PMID:25850425

  3. The risks and prevention of contamination of beef feedlot cattle: the perspective of the United States of America.

    PubMed

    Smith, R A; Griffin, D D; Dargatz, D A

    1997-08-01

    There are currently no scientifically defined critical management points or critical control points to manage foodborne pathogens at the pre-harvest level. Research is ongoing: much of the pre-harvest research is funded by producer organisations. The beef industry has Beef Quality Assurance (BQA) programmes in place and these are dynamic. Groups of cattlemen have made a very strong commitment to reducing foodborne pathogens in beef. Fewer Escherichia coli O157:H7 organisms are shed by feedlot cattle near the end of the feeding period than by newly arrived cattle. Moreover, there is less shedding of the organisms in cattle of slaughter age than in younger cattle. The prevalence of E. coli O157:H7 in feedlot cattle is similar to that in range cattle. This suggests that concentrating cattle in feedlot dirt pens does not increase the risk of shedding E. coli organisms. Pen maintenance, considered a good management practice, appears to be an adequate means of keeping pathogen levels in pens low. It is not likely that pre-harvest food safety programmes will eliminate the threat of pathogens such as E. coli O157:H7 or Salmonella. The management of foodborne pathogens will become part of an integrated programme to enhance food safety which includes the producer, the packer, the distributors, retailers and the consumer. The feedlot industry initiated a residue avoidance programme several years ago. As a result, the risk of chemical residues in beef from feedlots in the United States of America is near zero. Hazard analysis and critical control point-type prevention programmes, using scientifically based critical management points, will help ensure that the risk remains negligible.

  4. What obstetrician-gynecologists should know about Ebola: a perspective from the Centers for Disease Control and Prevention.

    PubMed

    Jamieson, Denise J; Uyeki, Timothy M; Callaghan, William M; Meaney-Delman, Dana; Rasmussen, Sonja A

    2014-11-01

    West Africa is currently in the midst of the largest Ebola outbreak in history. Although there have been no Ebola virus disease cases identified in the United States, two U.S. health care workers with Ebola virus disease were medically evacuated from Liberia to the United States in early August 2014. The Centers for Disease Control and Prevention has been working closely with other U.S. government agencies and international and nongovernmental partners for several months to respond to this global crisis. Limited evidence suggests that pregnant women are at increased risk for severe illness and death when infected with Ebola virus, but there is no evidence to suggest that pregnant women are more susceptible to Ebola virus disease. In addition, pregnant women with Ebola virus disease appear to be at an increased risk for spontaneous abortion and pregnancy-associated hemorrhage. Neonates born to mothers with Ebola virus disease have not survived. Although it is very unlikely that obstetrician-gynecologists (ob-gyns) in the United States will diagnose or treat a patient with Ebola virus disease, it is important that all health care providers are prepared to evaluate and care for these patients. Specifically, U.S. health care providers, including ob-gyns, should ask patients about recent travel and should know the signs and symptoms of Ebola virus disease and what to do if assessing a patient with compatible illness. This article provides general background information on Ebola and specifically addresses what is known about Ebola virus disease in pregnancy and the implications for practicing ob-gyns in the United States.

  5. Heart failure

    PubMed Central

    2010-01-01

    Introduction Heart failure occurs in 3% to 4% of adults aged over 65 years, usually as a consequence of coronary artery disease or hypertension, and causes breathlessness, effort intolerance, fluid retention, and increased mortality. The 5-year mortality in people with systolic heart failure ranges from 25% to 75%, often owing to sudden death following ventricular arrhythmia. Risks of cardiovascular events are increased in people with left ventricular systolic dysfunction (LVSD) or heart failure. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug treatments, and of drug and invasive treatments, for heart failure? What are the effects of angiotensin-converting enzyme inhibitors in people at high risk of heart failure? What are the effects of treatments for diastolic heart failure? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 85 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: aldosterone receptor antagonists, amiodarone, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, anticoagulation, antiplatelet agents, beta-blockers, calcium channel blockers, cardiac resynchronisation therapy, digoxin (in people already receiving diuretics and angiotensin-converting enzyme inhibitors), exercise, hydralazine plus isosorbide dinitrate, implantable cardiac

  6. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention

    PubMed Central

    2010-01-01

    sanctions or foregoing these rewards and thus are most vulnerable to their men folk. We argue that the goals of HIV prevention and optimizing of care can best be achieved through change in gender identities, rather than through a focus on individual sexual behaviours. PMID:20181124

  7. Strategies of learning from failure.

    PubMed

    Edmondson, Amy C

    2011-04-01

    Many executives believe that all failure is bad (although it usually provides Lessons) and that Learning from it is pretty straightforward. The author, a professor at Harvard Business School, thinks both beliefs are misguided. In organizational life, she says, some failures are inevitable and some are even good. And successful learning from failure is not simple: It requires context-specific strategies. But first leaders must understand how the blame game gets in the way and work to create an organizational culture in which employees feel safe admitting or reporting on failure. Failures fall into three categories: preventable ones in predictable operations, which usually involve deviations from spec; unavoidable ones in complex systems, which may arise from unique combinations of needs, people, and problems; and intelligent ones at the frontier, where "good" failures occur quickly and on a small scale, providing the most valuable information. Strong leadership can build a learning culture-one in which failures large and small are consistently reported and deeply analyzed, and opportunities to experiment are proactively sought. Executives commonly and understandably worry that taking a sympathetic stance toward failure will create an "anything goes" work environment. They should instead recognize that failure is inevitable in today's complex work organizations.

  8. Kidney (Renal) Failure

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Kidney Failure Kidney failure, also known as renal failure, ... evaluated? How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain ...

  9. [Premature ovarian failure: present aspects].

    PubMed

    Vilodre, Luiz Cesar; Moretto, Marcelo; Kohek, Maria Beatriz da Fonte; Spritzer, Poli Mara

    2007-08-01

    Premature ovarian failure occurs in approximately 1:1000 women before 30 years, 1:250 by 35 years and 1:100 by the age of 40. It is characterized by primary or secondary amenorrhea and cannot be considered as definitive because spontaneous conception may occur in 5 to 10% of cases. In 95% of cases, premature ovarian failure is sporadic. The known causes of premature ovarian failure include chromosomal defects, autoimmune diseases, exposure to radiation or chemotherapy, surgical procedures, and certain drugs. Frequently, however, the etiology is not clear and these cases are considered to be idiopathic. Premature ovarian failure is defined by gonadal failure and high serum follicle-stimulating hormone (FSH) levels. Clinical approach includes emotional support, hormonal therapy with estrogens and progesterone or progestogens, infertility treatment, and prevention of osteoporosis and potential cardiovascular risk.

  10. What Is Threatening the Effectiveness of Insecticide-Treated Bednets? A Case-Control Study of Environmental, Behavioral, and Physical Factors Associated with Prevention Failure

    PubMed Central

    Obala, Andrew A.; Mangeni, Judith Nekesa; Platt, Alyssa; Aswa, Daniel; Abel, Lucy; Namae, Jane; Prudhomme O'Meara, Wendy

    2015-01-01

    prevention in this community. Behavior change interventions to improve compliance and environmental management of mosquito breeding habitats may greatly enhance ITN efficacy. A better understanding of the relationship between agriculture and mosquito survival and feeding success is needed. PMID:26171962

  11. Community perspectives on parental influence on engagement in multiple concurrent sexual partnerships among youth in Tanzania: implications for HIV prevention programming.

    PubMed

    Fehringer, Jessica A; Babalola, Stella; Kennedy, Caitlin E; Kajula, Lusajo J; Mbwambo, Jessie K; Kerrigan, Deanna

    2013-01-01

    Although concurrent sexual partnerships (CPs) have been hypothesized to be an important risk factor for HIV in sub-Saharan Africa, the social and cultural factors that encourage CPs are not well understood. This study explored the community's perspectives on the role that parents can play in influencing their children's decision to engage in CPs. We conducted 16 in-depth interviews, 32 focus group discussions, and 16 key informant interviews with 280 adult participants in Tanzania. Data were coded; findings and conclusions were developed based on themes that emerged from coding. Three parental influences on CPs emerged: parent-child communication about sex, both silent and explicit encouragement of CPs, and parental behavior modeling. Parents are typically either too busy or too "embarrassed" to talk with their children about sex and CPs. The information parents do give is often confusing, fear-based, inadequate, and/or only focused on daughters. Parents themselves also encourage CPs through complicity of silence when their daughters come home with extra cash or consumer goods. In some cases, parents overtly encourage their children, particularly daughters, to practice CPs due to the promise of money from wealthy partners. Finally, when parents engage in CPs, the children themselves learn to behave similarly. These results suggest that parents can influence their children's decision to engage in CPs. HIV prevention interventions should address this by promoting parent-child communication about sexuality; associated disease risks and gender-equitable relationships; promoting positive parental role modeling; and educating parents on the implications of encouragement of CPs in their children.

  12. Lessons from pandemic H1N1 2009 to improve prevention, detection, and response to influenza pandemics from a One Health perspective.

    PubMed

    Pappaioanou, Marguerite; Gramer, Marie

    2010-01-01

    In April 2009, a novel influenza A subtype H1N1 triple reassortant virus (novel H1N1 2009), composed of genes from swine, avian, and human influenza A viruses, emerged in humans in the United States and Mexico and spread person-to-person around the world to become the first influenza pandemic of the 21st century. The virus is believed to have emerged from a reassortment event involving a swine virus some time in the past 10 to 20 years, but pigs, pork, and pork products have not been involved with infection or spread of the virus to or among people. Because countries quickly implemented recently developed pandemic influenza plans, the disease was detected and reported and public health authorities instituted control measures in a timely fashion. But the news media's unfortunate and inappropriate naming of the disease as the "swine flu" led to a drop in the demand for pork and several countries banned pork imports from affected countries, resulting in serious negative economic impacts on the pork industry. With the continual circulation and interspecies transmission of human, swine, and avian influenza viruses in countries around the world, there are calls for strengthening influenza surveillance in pigs, birds, and other animals to aid in monitoring and assessing the risk of future pandemic virus emergence involving different species. We identify and discuss several lessons to be learned from pandemic H1N1 2009 from a One Health perspective, as stronger collaboration among human, animal, and environmental health sectors is necessary to more effectively prevent or detect and respond to influenza pandemics and thus improve human, animal, and environmental health and well-being.

  13. The lived experience of NCLEX failure.

    PubMed

    Griffiths, Margaret J; Papastrat, Karen; Czekanski, Kathleen; Hagan, Kevin

    2004-07-01

    Educators help coach, focus, and prepare students for the National Council Licensure Examination (NCLEX), but often fall short in providing support when graduates are not successful. Most research to date has focused solely on predicting failure, with little to no attention given to interventions after failure. This study presents the voices of unsuccessful candidates, their responses to failure, their perspectives of the factors that contributed to their failure, and the changes they made that led to subsequent success. The results demonstrate common themes related to the failure experience, successful remediation strategies for retesting, and recommendations for faculty interventions during this vulnerable period. Nurse educators have a responsibility to identify, inform, and intervene with students who are at high risk of failing the NCLEX, and this responsibility is executed capably. However, the role extends beyond graduation. The responsibility to help nursing graduates transition from failure to licensure is the final step of successful undergraduate nursing education.

  14. Heart Failure in North America

    PubMed Central

    Blair, John E. A; Huffman, Mark; Shah, Sanjiv J

    2013-01-01

    better heart failure prevention and treatment. PMID:23597296

  15. Pathogenesis and Prevention of Acute Renal Failure

    DTIC Science & Technology

    1987-12-01

    to other intermediaries that are important. To explore this possibility, fructose- l ,6-diphosphate (FDP), a metabolite in the glycolytic pathway, was...Supported b- this contract. *1. Shapiro JI, Cheung C, Itabashi A , Chan L , Schrier RW: The protective effect of verapamil on renal function after warm and...proximal tubules. Am J Physiol, in press. *8. Shapiro JI, Chan L , Cheung C, Itabashi A , Rossi N, Schrier RW: The effect of ATP depletion in the isolated

  16. Cameras Monitor Spacecraft Integrity to Prevent Failures

    NASA Technical Reports Server (NTRS)

    2014-01-01

    The Jet Propulsion Laboratory contracted Malin Space Science Systems Inc. to outfit Curiosity with four of its cameras using the latest commercial imaging technology. The company parlayed the knowledge gained under working with NASA to develop an off-the-shelf line of cameras, along with a digital video recorder, designed to help troubleshoot problems that may arise on satellites in space.

  17. Cascading failures of interdependent modular small-world networks

    NASA Astrophysics Data System (ADS)

    Zhu, Guowei; Wang, Xianpei; Tian, Meng; Dai, Dangdang; Long, Jiachuan; Zhang, Qilin

    2016-07-01

    Much empirical evidence shows that many real-world networks fall into the broad class of small-world networks and have a modular structure. The modularity has been revealed to have an important effect on cascading failure in isolated networks. However, the corresponding results for interdependent modular small-world networks remain missing. In this paper, we investigate the relationship between cascading failures and the intra-modular rewiring probabilities and inter-modular connections under different coupling preferences, i.e. random coupling with modules (RCWM), assortative coupling in modules (ACIM) and assortative coupling with modules (ACWM). The size of the largest connected component is used to evaluate the robustness from global and local perspectives. Numerical results indicate that increasing intra-modular rewiring probabilities and inter-modular connections can improve the robustness of interdependent modular small-world networks under intra-attacks and inter-attacks. Meanwhile, experiments on three coupling strategies demonstrate that ACIM has a better effect on preventing the cascading failures compared with RCWM and ACWM. These results can be helpful to allocate and optimize the topological structure of interdependent modular small-world networks to improve the robustness of such networks.

  18. Can a combined screening/treatment programme prevent premature failure of renal transplants due to chronic rejection in patients with HLA antibodies: study protocol for the multicentre randomised controlled OuTSMART trial

    PubMed Central

    2014-01-01

    Background Renal transplantation is the best treatment for kidney failure, in terms of length and quality of life and cost-effectiveness. However, most transplants fail after 10 to 12 years, consigning patients back onto dialysis. Damage by the immune system accounts for approximately 50% of failing transplants and it is possible to identify patients at risk by screening for the presence of antibodies against human leukocyte antigens. However, it is not clear how best to treat patients with antibodies. This trial will test a combined screening and treatment protocol in renal transplant recipients. Methods/Design Recipients >1 year post-transplantation, aged 18 to 70 with an estimated glomerular filtration rate >30 mL/min will be randomly allocated to blinded or unblinded screening arms, before being screened for the presence of antibodies. In the unblinded arm, test results will be revealed. Those with antibodies will have biomarker-led care, consisting of a change in their anti-rejection drugs to prednisone, tacrolimus and mycophenolate mofetil. In the blinded arm, screening results will be double blinded and all recruits will remain on current therapy (standard care). In both arms, those without antibodies will be retested every 8 months for 3 years. The primary outcome is the 3-year kidney failure rate for the antibody-positive recruits, as measured by initiation of long-term dialysis or re-transplantation, predicted to be approximately 20% in the standard care group but <10% in biomarker-led care. The secondary outcomes include the rate of transplant dysfunction, incidence of infection, cancer and diabetes mellitus, an analysis of adherence with medication and a health economic analysis of the combined screening and treatment protocol. Blood samples will be collected and stored every 4 months and will form the basis of separately funded studies to identify new biomarkers associated with the outcomes. Discussion We have evidence that the biomarker-led care

  19. "You Can Try, But You Won't Stop It. It'll Always Be There": Youth Perspectives on Violence and Prevention in Schools.

    PubMed

    Sundaram, Vanita

    2016-02-01

    The role of schools in preventing violence among teenagers has been highlighted, as has the development of youth-led prevention initiatives. This article explores how young people's views on violence influence their perceptions of its preventability, drawing on focus group discussions with 14- to 16-year-olds from six schools across the north of England. Young people view violence as a highly individualized phenomenon, and gender norms play an important role in shaping young people's perceptions of the preventability of violence. The findings presented here suggest that school-based violence prevention must fundamentally address gender norms and expectations to challenge young people's acceptance and tolerance of violence.

  20. Wind Turbine Failures - Tackling current Problems in Failure Data Analysis

    NASA Astrophysics Data System (ADS)

    Reder, M. D.; Gonzalez, E.; Melero, J. J.

    2016-09-01

    The wind industry has been growing significantly over the past decades, resulting in a remarkable increase in installed wind power capacity. Turbine technologies are rapidly evolving in terms of complexity and size, and there is an urgent need for cost effective operation and maintenance (O&M) strategies. Especially unplanned downtime represents one of the main cost drivers of a modern wind farm. Here, reliability and failure prediction models can enable operators to apply preventive O&M strategies rather than corrective actions. In order to develop these models, the failure rates and downtimes of wind turbine (WT) components have to be understood profoundly. This paper is focused on tackling three of the main issues related to WT failure analyses. These are, the non-uniform data treatment, the scarcity of available failure analyses, and the lack of investigation on alternative data sources. For this, a modernised form of an existing WT taxonomy is introduced. Additionally, an extensive analysis of historical failure and downtime data of more than 4300 turbines is presented. Finally, the possibilities to encounter the lack of available failure data by complementing historical databases with Supervisory Control and Data Acquisition (SCADA) alarms are evaluated.

  1. Right heart failure: toward a common language.

    PubMed

    Mehra, Mandeep R; Park, Myung H; Landzberg, Michael J; Lala, Anuradha; Waxman, Aaron B

    2014-02-01

    In this perspective, the International Right Heart Foundation Working Group moves a step forward to develop a common language to describe the development and defects that exemplify the common syndrome of right heart failure. We first propose fundamental definitions of the distinctive components of the right heart circulation and provide consensus on a universal definition of right heart failure. These definitions will form the foundation for describing a uniform nomenclature for right heart circulatory failure with a view to foster collaborative research initiatives and conjoint education in an effort to provide insight into echanisms of disease unique to the right heart.

  2. Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC).

    PubMed

    Baldwin, Grant; Breiding, Matt; Sleet, David

    2016-06-30

    Traumatic brain injury (TBI) can have long term effects on mental and physical health, and can disrupt vocational, educational, and social functioning. TBIs can range from mild to severe and their effects can last many years after the initial injury. CDC seeks to reduce the burden of TBI from unintentional injuries through a focus on primary prevention, improved recognition and management, and intervening to improve health outcomes after TBI. CDC uses a 4-stage public health model to guide TBI prevention, moving from 1) surveillance of TBI, 2) identification of risk and protective factors for TBI, 3) development and testing of evidence-based interventions, to 4) bringing effective intervention to scale through widespread adoption. CDC's unintentional injury prevention activities focus on the prevention of sports-related concussions, motor vehicle crashes, and older adult falls. For concussion prevention, CDC developed Heads Up - an awareness initiative focusing on ways to prevent a concussion in sports, and identifying how to recognize and manage potential concussions. In motor vehicle injury prevention, CDC has developed a tool (MV PICCS) to calculate the expected number of injuries prevented and lives saved using various evidence-based motor vehicle crash prevention strategies. To help prevent TBI related to older adult falls, CDC has developed STEADI, an initiative to help primary care providers identify their patients' falls risk and provide effective interventions. In the future, CDC is focused on advancing our understanding of the public health burden of TBI through improved surveillance in order to produce more comprehensive estimates of the public health burden of TBI.

  3. Acute kidney failure

    MedlinePlus

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

  4. What Is Heart Failure?

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Heart Failure? Heart failure is a condition in which the heart can' ... force. Some people have both problems. The term "heart failure" doesn't mean that your heart has stopped ...

  5. Heart failure - medicines

    MedlinePlus

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  6. Pilot Study of Implementation of an Internet-Based Depression Prevention Intervention (CATCH-IT) for Adolescents in 12 US Primary Care Practices: Clinical and Management/Organizational Behavioral Perspectives

    PubMed Central

    Eisen, Jeffrey C.; Marko-Holguin, Monika; Fogel, Joshua; Cardenas, Alonso; Bahn, My; Bradford, Nathan; Fagan, Blake; Wiedmann, Peggy

    2013-01-01

    Objective: To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007. Method: The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention). Results: While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses. Conclusion: Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings. Trial Registration: ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912 PMID:24800110

  7. How To Prevent Roof Abuse.

    ERIC Educational Resources Information Center

    Hutchinson, Thomas W.

    2000-01-01

    Discusses ways to prevent school roofing failure through good maintenance practice and the proper handling of emergency situations. What types of problems show up when roofs are not maintained are highlighted. (GR)

  8. Most Heart Failure Patients Die from Pump Failure: Implications for Therapy.

    PubMed

    Pereira-Barretto, Antonio Carlos; Bacal, Fernando; de Albuquerque, Denilson Campos

    2015-12-01

    Careful review of the literature of the last 20 years since the appearance of the first positive trials in heart failure indicates an evolution in the mode of death moving from sudden death to a predominance of pump failure death (i.e., death due to progression of heart failure). Pump failure is becoming a leading cause of mortality in a range of patient profiles, including patients with newly diagnosed or severe heart failure, patients with devices, and patients with heart failure associated with Chagas' disease. Indeed, the evidence suggests that modern management strategies, such as beta-blockers and devices, are successful in preventing sudden death. However, this means that optimally treated patients are at greater risk for the consequences of pump failure (death, hospitalization, and reduced quality of life). This highlights a new important unmet need in heart failure, and a priority for current research should be therapies that reduce pump failure death and hospitalization for more cost-effective management of the disease. Insofar as one-third of heart failure patients do not survive more than 3 years after diagnosis, properly addressing pump failure is an essential target in heart failure.

  9. Cambodian Bon Om Touk stampede highlights preventable tragedy.

    PubMed

    Hsu, Edbert B; Burkle, Frederick M

    2012-10-01

    The tragic nature of the human stampede that took place in Phnom Penh, Cambodia on November 22, 2010 claimed the lives of 347 people during the three-day-long Water Festival, known as Bon Om Touk. Described as the greatest tragedy that Cambodia has experienced since the collapse of the Khmer Rouge, the Bon Om Touk stampede ranks among the deadliest human stampede disasters during the past 30 years, a Class IV event exceeding 100 fatalities according to a recently proposed scale. 1 From the perspective of global health, the event shares many characteristics with preceding major crowd disasters and failures in event planning. It is essential for the international community to officially monitor human stampedes as it does other major disasters. Additional research on human stampedes is needed to improve our collective understanding of the causes of crowd disasters and how best to prevent them. Hsu EB , Burkle FM Jr . Cambodian Bon Om Touk stampede highlights preventable tragedy.

  10. Advanced Heart Failure

    MedlinePlus

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Advanced Heart Failure Updated:Feb 9,2017 When heart failure (HF) ... content was last reviewed on 04/06/2015. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  11. Student Leadership. Prevention Updates

    ERIC Educational Resources Information Center

    Langford, Linda; DeJong, William

    2010-01-01

    Campus-based efforts to reduce alcohol and other drug abuse and violence (AODV) will be more successful if they involve a wide range of stakeholders--including students--who can contribute to the program's design, implementation, and evaluation. Students provide a unique perspective on AODV prevention, and they can also bring a certain authority…

  12. Combining School and Family Interventions for the Prevention and Early Intervention of Disruptive Behavior Problems in Children: A Public Health Perspective

    ERIC Educational Resources Information Center

    Reinke, Wendy M.; Splett, Joni D.; Robeson, Elise N.; Offutt, Cheryl A.

    2009-01-01

    The prevention or reduction of early aggressive and disruptive behavior has important educational and mental health implications. Disruptive behavior problems contribute to loss of instruction time in the classroom, frustration for children and families, and considerable societal burden associated with antisocial acts, including delinquency and…

  13. The prevention of leprosy related disability as an integral component of the government health delivery programme in Indonesia: perspectives on implementation.

    PubMed

    Cross, Hugh

    2013-09-01

    This paper presents a record of three interviews with groups of Ministry of Health personnel and consultants that took place in Jakarta, Indonesia in May 2012. Those contributing to the first interview were provincial and district supervisors with responsibility for leprosy. Those contributing to the second interview were consultants, three of whom were seconded to the Ministry of Health and one was a WHO consultant. A third interview was conducted with the Head and a technical staff member of the Sub Directorate of Leprosy and Yaws Control Programme, Ministry of Health, Indonesia. Leprosy control in Indonesia had been targeted for further enquiry after it became apparent, through an earlier survey of national programme managers and consultants, that the programme had been relatively successful in integrating POD into the government health delivery programme. The perspectives of significant representatives and actors in the national programme were recorded through the interviews undertaken in Jakarta. Limitations This report does not purport to be a study of integration of leprosy services in Indonesia. The perspectives of representatives and significant actors are offered here to enhance understanding of factors that contributed to POD becoming a routine component of general health care in Indonesia. It is also declared here that no independent verification of statements was undertaken and that the effectiveness of measures taken to integrate leprosy related POD has not been independently evaluated.

  14. An international perspective on using opioid substitution treatment to improve hepatitis C prevention and care for people who inject drugs: structural barriers and public health potential

    PubMed Central

    Perlman, David C.; Jordan, Ashly E.; Uuskula, Anneli; Huong, Duong Thi; Masson, Carmen L.; Schackman, Bruce R.; Des Jarlais, Don C.

    2015-01-01

    People who inject drugs (PWID) are central to the hepatitis C virus (HCV) epidemic. Opioid substitution treatment (OST) of opioid dependence has the potential to play a significant role in the public health response to HCV by serving as an HCV prevention intervention, by treating non-injection opioid dependent people who might otherwise transition to non-sterile drug injection, and by serving as a platform to engage HCV infected PWID in the HCV care continuum and link them to HCV treatment. This paper examines programmatic, structural and policy considerations for using OST as a platform to improve the HCV prevention and care continuum in 3 countries—the United States, Estonia and Viet Nam. In each country a range of interconnected factors affects the use OST as a component of HCV control. These factors include 1) that OST is not yet provided on the scale needed to adequately address illicit opioid dependence, 2) inconsistent use of OST as a platform for HCV services, 3) high costs of HCV treatment and health insurance policies that affect access to both OST and HCV treatment, and 4) the stigmatization of drug use. We see the following as important for controlling HCV transmission among PWID: 1) maintaining current HIV prevention efforts, 2) expanding efforts to reduce the stigmatization of drug use, 3) expanding use of OST as part of a coordinated public health approach to opioid dependence, HIV prevention, and HCV control efforts, 4) reductions in HCV treatment costs and expanded health system coverage to allow population level HCV treatment as prevention and OST as needed. The global expansion of OST and use of OST as a platform for HCV services should be feasible next steps in the public health response to the HCV epidemic, and is likely to be critical to efforts to eliminate or eradicate HCV. PMID:26050614

  15. Chronic activation of peroxisome proliferator-activated receptor-alpha with fenofibrate prevents alterations in cardiac metabolic phenotype without changing the onset of decompensation in pacing-induced heart failure

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Severe heart failure (HF) is characterized by profound alterations in cardiac metabolic phenotype, with down-regulation of the free fatty acid (FFA) oxidative pathway and marked increase in glucose oxidation. We tested whether fenofibrate, a pharmacological agonist of peroxisome proliferator-activat...

  16. Loess failure in northeast Afghanistan

    NASA Astrophysics Data System (ADS)

    Shroder, John F.; Schettler, Megan Jensen; Weihs, Brandon J.

    Mass movements in northeastern Afghanistan include large-scale rockslides and complex slope failures, as well as failures in loess. The loess region in northeastern Afghanistan occurs in the Badakhshan and Takhar provinces and was likely created by dust blown to the east from the Karakum Desert and the alluvial plains of northern Afghanistan. This loessic dust was deposited against the Hindu Kush mountain range which rises up along the eastern half of Afghanistan as a result of transpressional tectonism. It overlies less permeable crystalline and sedimentary bedrocks such as Triassic granite, Proterozoic gneiss, and Miocene and Pliocene clastics in the area with the largest concentration of slope failures. Thirty-four loess slides and flows were mapped and analyzed using remote satellite imagery over digital elevation models on Google Earth™. This source enabled location, classification, and measurement of failures. Findings revealed that most failed slopes faced north, west, and northwest. This trend can be explained possibly as different moisture contents resulting from the primarily westerly wind direction, which may cause more precipitation to be deposited on west-facing slopes, and sun position during the hottest part of the day. Additionally, the easterly rising Hindu Kush range may cause more slope area to face west in the study region. Other contributing factors could be the very high seismicity of the area, which may cause rapid dry fluidized loess flows, and landscape modification by humans. Several loess slope failures appear to be generated by water concentration through irrigation ditches and possible rutted tire tracks, which can create tunneling between the loess and its less permeable bedrock. Causes and effects of loess failure in Afghanistan need to be investigated in more depth. Further study may lead to the adoption of more sustainable and safe farming practices and more informed housing locations, which may prevent loss of property, crop, and

  17. External coating failures in Venezuelan pipelines

    SciTech Connect

    Rodriguez, V.; Paiva, A.; Castaneda, L.

    1994-12-31

    External organic coatings have been used in Venezuelan pipelines to prevent corrosion in different environments. These environments can be considered critical due to the high temperature of the fluid transported or due to the aggressiveness of the surrounding soils and waters. It has also been found that inadequate application of the coating has contributed greatly to a premature failure. An overview of the techniques used to determine the causes of the failures and the interpretation of the failure analysis will be presented in detail in this paper.

  18. Renal failure in burn patients: a review

    PubMed Central

    Emara, S.S.; Alzaylai, A.A.

    2013-01-01

    Summary Burn care providers are usually challenged by multiple complications during the management of acute burns. One of the most common complications worldwide is renal failure. This article reviews the various aspects of renal failure management in burn patients. Two different types of renal failures develop in these patients. The different aetiological factors, incidence, suspected prognosis, ways of diagnosing, as well as prevention methods, and the most accepted treatment modalities are all discussed. A good understanding and an effective assessment of the problem help to reduce both morbidity and mortality in burn management. PMID:23966893

  19. Renal failure in burn patients: a review.

    PubMed

    Emara, S S; Alzaylai, A A

    2013-03-31

    Burn care providers are usually challenged by multiple complications during the management of acute burns. One of the most common complications worldwide is renal failure. This article reviews the various aspects of renal failure management in burn patients. Two different types of renal failures develop in these patients. The different aetiological factors, incidence, suspected prognosis, ways of diagnosing, as well as prevention methods, and the most accepted treatment modalities are all discussed. A good understanding and an effective assessment of the problem help to reduce both morbidity and mortality in burn management.

  20. Valve system incorporating single failure protection logic

    DOEpatents

    Ryan, Rodger; Timmerman, Walter J. H.

    1980-01-01

    A valve system incorporating single failure protective logic. The system consists of a valve combination or composite valve which allows actuation or de-actuation of a device such as a hydraulic cylinder or other mechanism, integral with or separate from the valve assembly, by means of three independent input signals combined in a function commonly known as two-out-of-three logic. Using the input signals as independent and redundant actuation/de-actuation signals, a single signal failure, or failure of the corresponding valve or valve set, will neither prevent the desired action, nor cause the undesired action of the mechanism.

  1. Heart failure in the diabetic population - pathophysiology, diagnosis and management.

    PubMed

    Kasznicki, Jacek; Drzewoski, Jozef

    2014-06-29

    Evidence from clinical trials repeatedly confirms the association of diabetes with heart failure, independent of hypertension, atherosclerosis, coronary artery disease and valvular heart disease. However, the importance of coexistence of diabetes and heart failure is not universally recognized, despite the fact that it may significantly contribute to morbidity and mortality of the diabetic population. It seems that prevention of heart failure, early diagnosis, and appropriate management could improve the outcome. Unfortunately, the etiology of heart failure in diabetic patients is still to be elucidated. It is multifactorial in nature and several cellular, molecular and metabolic factors are implicated. Additionally, there are still no definite guidelines on either the diagnosis and treatment of heart failure in diabetic patients or on the therapy of diabetes in subjects with heart failure. This review focuses on the pathophysiology, diagnosis, and prevention of heart failure in the diabetic population as well as management of both comorbidities.

  2. Recognition Failure: Another Case of Retrieval Failure

    ERIC Educational Resources Information Center

    Rabinowitz, Jan; And Others

    1977-01-01

    A theoretical explanation of the phenomenon of recognition failure and a presentation of seven experiments investigating performance. Recognition failure is reduced when a more stringent recognition criterion is used, essentially eliminated when the proper access test is used and significantly reduced when variability in recognition performance is…

  3. Failure of Non-Circular Composite Cylinders

    NASA Technical Reports Server (NTRS)

    Hyer, M. W.

    2004-01-01

    In this study, a progressive failure analysis is used to investigate leakage in internally pressurized non-circular composite cylinders. This type of approach accounts for the localized loss of stiffness when material failure occurs at some location in a structure by degrading the local material elastic properties by a certain factor. The manner in which this degradation of material properties takes place depends on the failure modes, which are determined by the application of a failure criterion. The finite-element code STAGS, which has the capability to perform progressive failure analysis using different degradation schemes and failure criteria, is utilized to analyze laboratory scale, graphite-epoxy, elliptical cylinders with quasi-isotropic, circumferentially-stiff, and axially-stiff material orthotropies. The results are divided into two parts. The first part shows that leakage, which is assumed to develop if there is material failure in every layer at some axial and circumferential location within the cylinder, does not occur without failure of fibers. Moreover before fibers begin to fail, only matrix tensile failures, or matrix cracking, takes place, and at least one layer in all three cylinders studied remain uncracked, preventing the formation of a leakage path. That determination is corroborated by the use of different degradation schemes and various failure criteria. Among the degradation schemes investigated are the degradation of different engineering properties, the use of various degradation factors, the recursive or non-recursive degradation of the engineering properties, and the degradation of material properties using different computational approaches. The failure criteria used in the analysis include the noninteractive maximum stress criterion and the interactive Hashin and Tsai-Wu criteria. The second part of the results shows that leakage occurs due to a combination of matrix tensile and compressive, fiber tensile and compressive, and inplane

  4. Prediction of Cascading Failures in Spatial Networks.

    PubMed

    Shunkun, Yang; Jiaquan, Zhang; Dan, Lu

    2016-01-01

    Cascading overload failures are widely found in large-scale parallel systems and remain a major threat to system reliability; therefore, they are of great concern to maintainers and managers of different systems. Accurate cascading failure prediction can provide useful information to help control networks. However, for a large, gradually growing network with increasing complexity, it is often impractical to explore the behavior of a single node from the perspective of failure propagation. Fortunately, overload failures that propagate through a network exhibit certain spatial-temporal correlations, which allows the study of a group of nodes that share common spatial and temporal characteristics. Therefore, in this study, we seek to predict the failure rates of nodes in a given group using machine-learning methods. We simulated overload failure propagations in a weighted lattice network that start with a center attack and predicted the failure percentages of different groups of nodes that are separated by a given distance. The experimental results of a feedforward neural network (FNN), a recurrent neural network (RNN) and support vector regression (SVR) all show that these different models can accurately predict the similar behavior of nodes in a given group during cascading overload propagation.

  5. Angiotensin-converting enzyme inhibitors in preventing remodeling and development of heart failure after acute myocardial infarction: results of the German multicenter study of the effects of captopril on cardiopulmonary exercise parameters (ECCE).

    PubMed

    Kleber, F X; Sabin, G V; Winter, U J; Reindl, I; Beil, S; Wenzel, M; Fischer, M; Doering, W

    1997-08-04

    Early action of angiotensin-converting enzyme (ACE) inhibitors after myocardial infarction (MI) has been shown in large scale clinical trials to reduce mortality over the first weeks. However, the mechanisms involved are yet unclear and several trials showed a tendency toward a small, albeit unexpected, rise in cardiogenic shock or mortality. Since cardiopulmonary exercise testing (CPX) has become a "gold standard" in assessing the severity of heart failure, we studied--after finishing a pilot trial--the effect of captopril versus placebo in 208 patients who were individually titrated (titrated dose, mean 46/69 mg/day after 7 days/4 weeks, respectively) in order to preserve their blood pressure in the acute phase of myocardial infarction; we followed the development of congestive heart failure (CHF) over 4 weeks by measuring oxygen consumption. After 4 weeks, overall oxygen consumption at the anaerobic threshold (VO2-AT; 13.7 vs 13.1), maximal oxygen consumption (VO2max 19.3 vs 18.9 mL/kg per min) and exercise duration (896 vs 839 sec) showed a nonsignificant difference in favor of the captopril group. The predefined, categorized, combined endpoint of severe heart failure or death (heart failure necessitating ACE inhibition, VO2max < 10 mL/kg per min, or death) was significantly reduced in the captopril group (n = 7/104) versus placebo (n = 18/104; p = 0.03). Differences were mainly caused by fewer CHF events (delta n = 10). We conclude that ACE inhibition with individualized dose titration markedly reduces the 4-week incidence of severe heart failure or death; > 10 patients per 100 treated gained major benefits from this therapy.

  6. Lox/Gox related failures during Space Shuttle Main Engine development

    NASA Technical Reports Server (NTRS)

    Cataldo, C. E.

    1981-01-01

    Specific rocket engine hardware and test facility system failures are described which were caused by high pressure liquid and/or gaseous oxygen reactions. The failures were encountered during the development and testing of the space shuttle main engine. Failure mechanisms are discussed as well as corrective actions taken to prevent or reduce the potential of future failures.

  7. Insulin Signaling and Heart Failure.

    PubMed

    Riehle, Christian; Abel, E Dale

    2016-04-01

    Heart failure is associated with generalized insulin resistance. Moreover, insulin-resistant states such as type 2 diabetes mellitus and obesity increases the risk of heart failure even after adjusting for traditional risk factors. Insulin resistance or type 2 diabetes mellitus alters the systemic and neurohumoral milieu, leading to changes in metabolism and signaling pathways in the heart that may contribute to myocardial dysfunction. In addition, changes in insulin signaling within cardiomyocytes develop in the failing heart. The changes range from activation of proximal insulin signaling pathways that may contribute to adverse left ventricular remodeling and mitochondrial dysfunction to repression of distal elements of insulin signaling pathways such as forkhead box O transcriptional signaling or glucose transport, which may also impair cardiac metabolism, structure, and function. This article will review the complexities of insulin signaling within the myocardium and ways in which these pathways are altered in heart failure or in conditions associated with generalized insulin resistance. The implications of these changes for therapeutic approaches to treating or preventing heart failure will be discussed.

  8. Failure in glass

    NASA Technical Reports Server (NTRS)

    Keeton, S. C.

    1972-01-01

    Review of state of the art concerning glass failure mechanisms and fatigue theories discusses brittle fracture in glass, fatigue mechanisms, fatigue behavior, environmental effects on failure rate, and aging.

  9. [Understanding heart failure].

    PubMed

    Boo, José Fernando Guadalajara

    2006-01-01

    Heart failure is a disease with several definitions. The term "heart failure" is used by has brougth about confusion in the terminology. For this reason, the value of the ejection fraction (< 0.40 or < 0.35) is used in most meganalyses on the treatment of heart failure, avoiding the term "heart failure" that is a confounding concept. In this paper we carefully analyze the meaning of contractility, ventricular function or performance, preload, afterload, heart failure, compensation mechanisms in heart failure, myocardial oxygen consumption, inadequate, adequate and inappropriate hypertrophy, systole, diastole, compliance, problems of relaxation, and diastolic dysfunction. Their definitions are supported by the original scientific descriptions in an attempt to clarify the concepts about ventricular function and heart failure and, in this way, use the same scientific language about the meaning of ventricular function, heart failure, and diastolic dysfunction.

  10. Failures in psychodynamic psychotherapy.

    PubMed

    Gold, Jerry; Stricker, George

    2011-11-01

    This article addresses the issue of failures in psychodynamic psychotherapy. Drawing on the clinical and research literatures, and utilizing our clinical experiences, we first describe and define criteria for success and failure in treatment. We then review five factors that can lead to failure: client factors, therapist factors, technical factors, relationship factors, and environmental factors. We illustrate our presentation with a case example, and conclude by discussing ways in which the likelihood of failures in psychodynamic treatment can be lowered.

  11. "Learning Perspective" in the Asian Viewpoint.

    ERIC Educational Resources Information Center

    Shinil, Kim

    A "schooling perspective" has become the foundation of the modern educational system. It portrays instruction-centered education in which the instructor is responsible for the success or failure of education. On the other hand, a "learning perspective" characterizes education as the learners' intentional activity to attain new knowledge, ways of…

  12. Cascading failure in the wireless sensor scale-free networks

    NASA Astrophysics Data System (ADS)

    Liu, Hao-Ran; Dong, Ming-Ru; Yin, Rong-Rong; Han, Li

    2015-05-01

    In the practical wireless sensor networks (WSNs), the cascading failure caused by a failure node has serious impact on the network performance. In this paper, we deeply research the cascading failure of scale-free topology in WSNs. Firstly, a cascading failure model for scale-free topology in WSNs is studied. Through analyzing the influence of the node load on cascading failure, the critical load triggering large-scale cascading failure is obtained. Then based on the critical load, a control method for cascading failure is presented. In addition, the simulation experiments are performed to validate the effectiveness of the control method. The results show that the control method can effectively prevent cascading failure. Project supported by the Natural Science Foundation of Hebei Province, China (Grant No. F2014203239), the Autonomous Research Fund of Young Teacher in Yanshan University (Grant No. 14LGB017) and Yanshan University Doctoral Foundation, China (Grant No. B867).

  13. Containment performance perspectives based on IPE results

    SciTech Connect

    Lehner, J.R.; Lin, C.C.; Pratt, W.T.

    1996-12-31

    Perspectives on Containment Performance were obtained from the accident progression analyses, i.e. level 2 PRA analyses, found in the IPE submittals. Insights related to the containment failure modes, the releases associated with those failure modes, and the factors responsible for the types of containment failures and release sizes reported were gathered. The results summarized here are discussed in detail in volumes 1 and 2 of NUREG 1560. 3 refs., 4 figs.

  14. Heart Failure: A Primer.

    PubMed

    Lee, Christopher S; Auld, Jonathan

    2015-12-01

    Heart failure is a complex and multisystem clinical syndrome that results from impaired ventricular contractility and/or relaxation. Hypertension, diabetes mellitus, and coronary artery disease are common antecedents to heart failure. The main pathogenic mechanisms involved in heart failure include sympathetic nervous and renin-angiotensin-aldosterone system activation, as well as inflammation. A detailed history and physical examination and additional diagnostic tests may be needed to diagnose heart failure. Most treatment strategies target neurohormonal systems. Nonpharmacologic interventions and effective engagement in self-care are also important in overall heart failure management. Therapeutic strategies are geared toward prolonging life and optimizing quality of life.

  15. The failure of earthquake failure models

    USGS Publications Warehouse

    Gomberg, J.

    2001-01-01

    In this study I show that simple heuristic models and numerical calculations suggest that an entire class of commonly invoked models of earthquake failure processes cannot explain triggering of seismicity by transient or "dynamic" stress changes, such as stress changes associated with passing seismic waves. The models of this class have the common feature that the physical property characterizing failure increases at an accelerating rate when a fault is loaded (stressed) at a constant rate. Examples include models that invoke rate state friction or subcritical crack growth, in which the properties characterizing failure are slip or crack length, respectively. Failure occurs when the rate at which these grow accelerates to values exceeding some critical threshold. These accelerating failure models do not predict the finite durations of dynamically triggered earthquake sequences (e.g., at aftershock or remote distances). Some of the failure models belonging to this class have been used to explain static stress triggering of aftershocks. This may imply that the physical processes underlying dynamic triggering differs or that currently applied models of static triggering require modification. If the former is the case, we might appeal to physical mechanisms relying on oscillatory deformations such as compaction of saturated fault gouge leading to pore pressure increase, or cyclic fatigue. However, if dynamic and static triggering mechanisms differ, one still needs to ask why static triggering models that neglect these dynamic mechanisms appear to explain many observations. If the static and dynamic triggering mechanisms are the same, perhaps assumptions about accelerating failure and/or that triggering advances the failure times of a population of inevitable earthquakes are incorrect.

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

    ERIC Educational Resources Information Center

    Purvis, Johnny; Leonard, Rex

    1985-01-01

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

  17. Barriers and Facilitators in Implementing “Prevention for Positives” Alcohol Reduction Support: The Perspectives of Directors and Providers in Hospital-Based HIV Care Centers

    PubMed Central

    Strauss, Shiela M.; Munoz-Plaza, Corrine E.; Tiburcio, Nelson J.; Gwadz, Marya

    2011-01-01

    HIV-infected patients have considerable need for alcohol reduction support, and HIV care providers are strategically placed to implement a “prevention for positives” alcohol reduction approach through alcohol screening and brief interventions (SBIs). To facilitate this approach, we provided alcohol SBI education and training to HIV care providers in four hospital-based, New York City HIV Care Centers in 2007. Interviews with the medical directors and 14 of the HIV care providers who attended the training identified barriers to implementing alcohol SBIs. These included limited time for alcohol screening, patients’ incomplete disclosure of alcohol use, providers’ perceptions that alcohol use is not a major problem for their patients, and provider specialization that assigns patients with problematic alcohol use to specifically designated providers. Identified facilitators for alcohol SBI implementation included adequate time to conduct the SBI; availability of information, tools, and key points to emphasize with HIV-infected patients; and use of a brief alcohol screening tool. PMID:21570321

  18. Workplace Interventions to Prevent Disability from Both the Scientific and Practice Perspectives: A Comparison of Scientific Literature, Grey Literature and Stakeholder Observations.

    PubMed

    Williams-Whitt, Kelly; Bültmann, Ute; Amick, Benjamin; Munir, Fehmidah; Tveito, Torill H; Anema, Johannes R

    2016-12-01

    Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by

  19. Economic evaluation of participation in a voluntary Johne's disease prevention and control program from a farmer's perspective--The Alberta Johne's Disease Initiative.

    PubMed

    Wolf, R; Clement, F; Barkema, H W; Orsel, K

    2014-05-01

    The Alberta Johne's Disease Initiative (AJDI) is a Johne's disease (JD) control program with the goal of reducing the spread of Mycobacterium avium ssp. paratuberculosis (MAP) through implementation of best management practices. The objective was to estimate the economic benefit of participation in the AJDI. A decision tree was constructed in which disease prevalence, test characteristics, and probabilities for implementation of best management practices suggested by herd veterinarians were implemented. Analysis was performed using a Markov analysis, and input data were assigned using estimates from the AJDI and published data. A cost-effectiveness analysis was performed and the net benefit of participation (from the perspective of a dairy farmer) in the AJDI compared with no participation was calculated. A series of 1-way sensitivity analyses were used to control for uncertainty. Farms participating in the AJDI were estimated to have a net benefit of Can$74 per cow over the course of 10 yr. If project costs were covered by the participating farm, the net benefit was Can$27. In addition to the effects on MAP infection, a reduction in calf diarrhea was modeled for farms that improved their calf management through the use of pasteurizers. In that case, the additional costs outweighed additional revenues compared with the baseline analysis, resulting in a reduced net benefit of Can$19. Participation would not be cost effective if cows in early stages of MAP infection did not have decreased production and if prevalence of MAP infection did not increase on farms with poor management. A limitation of the study, despite high uncertainty in some input parameters, was the lack of knowledge regarding changes in prevalence on farms with various management strategies. In conclusion, participation in the AJDI was cost effective for the average Alberta dairy farm.

  20. Failure of engineering artifacts: a life cycle approach.

    PubMed

    Del Frate, Luca

    2013-09-01

    Failure is a central notion both in ethics of engineering and in engineering practice. Engineers devote considerable resources to assure their products will not fail and considerable progress has been made in the development of tools and methods for understanding and avoiding failure. Engineering ethics, on the other hand, is concerned with the moral and social aspects related to the causes and consequences of technological failures. But what is meant by failure, and what does it mean that a failure has occurred? The subject of this paper is how engineers use and define this notion. Although a traditional definition of failure can be identified that is shared by a large part of the engineering community, the literature shows that engineers are willing to consider as failures also events and circumstance that are at odds with this traditional definition. These cases violate one or more of three assumptions made by the traditional approach to failure. An alternative approach, inspired by the notion of product life cycle, is proposed which dispenses with these assumptions. Besides being able to address the traditional cases of failure, it can deal successfully with the problematic cases. The adoption of a life cycle perspective allows the introduction of a clearer notion of failure and allows a classification of failure phenomena that takes into account the roles of stakeholders involved in the various stages of a product life cycle.

  1. Addressing Failures in Exascale Computing

    SciTech Connect

    Snir, Marc; Wisniewski, Robert; Abraham, Jacob; Adve, Sarita; Bagchi, Saurabh; Balaji, Pavan; Belak, J.; Bose, Pradip; Cappello, Franck; Carlson, Bill; Chien, Andrew; Coteus, Paul; DeBardeleben, Nathan; Diniz, Pedro; Engelmann, Christian; Erez, Mattan; Fazzari, Saverio; Geist, Al; Gupta, Rinku; Johnson, Fred; Krishnamoorthy, Sriram; Leyffer, Sven; Liberty, Dean; Mitra, Subhasish; Munson, Todd; Schreiber, Rob; Stearley, Jon; Van Hensbergen, Eric

    2014-01-01

    We present here a report produced by a workshop on Addressing failures in exascale computing' held in Park City, Utah, 4-11 August 2012. The charter of this workshop was to establish a common taxonomy about resilience across all the levels in a computing system, discuss existing knowledge on resilience across the various hardware and software layers of an exascale system, and build on those results, examining potential solutions from both a hardware and software perspective and focusing on a combined approach. The workshop brought together participants with expertise in applications, system software, and hardware; they came from industry, government, and academia, and their interests ranged from theory to implementation. The combination allowed broad and comprehensive discussions and led to this document, which summarizes and builds on those discussions.

  2. Addressing failures in exascale computing

    SciTech Connect

    Snir, Marc; Wisniewski, Robert W.; Abraham, Jacob A.; Adve, Sarita; Bagchi, Saurabh; Balaji, Pavan; Belak, Jim; Bose, Pradip; Cappello, Franck; Carlson, William; Chien, Andrew A.; Coteus, Paul; Debardeleben, Nathan A.; Diniz, Pedro; Engelmann, Christian; Erez, Mattan; Saverio, Fazzari; Geist, Al; Gupta, Rinku; Johnson, Fred; Krishnamoorthy, Sriram; Leyffer, Sven; Liberty, Dean; Mitra, Subhasish; Munson, Todd; Schreiber, Robert; Stearly, Jon; Van Hensbergen, Eric

    2014-05-01

    We present here a report produced by a workshop on “Addressing Failures in Exascale Computing” held in Park City, Utah, August 4–11, 2012. The charter of this workshop was to establish a common taxonomy about resilience across all the levels in a computing system; discuss existing knowledge on resilience across the various hardware and software layers of an exascale system; and build on those results, examining potential solutions from both a hardware and software perspective and focusing on a combined approach. The workshop brought together participants with expertise in applications, system software, and hardware; they came from industry, government, and academia; and their interests ranged from theory to implementation. The combination allowed broad and comprehensive discussions and led to this document, which summarizes and builds on those discussions.

  3. Kidney Failure: What to Expect

    MedlinePlus

    ... Kidneys & How They Work Kidney Disease A-Z Kidney Failure What is kidney failure and how is it treated? Kidney failure ... Methods for Kidney Failure: Peritoneal Dialysis . Peritoneal dialysis Kidney Transplant A kidney transplant places a healthy kidney ...

  4. Drug Treatment as HIV Prevention Among Women and Girls Who Inject Drugs From a Global Perspective: Progress, Gaps, and Future Directions

    PubMed Central

    Springer, Sandra A.; Larney, Sarah; Alam-mehrjerdi, Zahra; Altice, Frederick L.; Metzger, David; Shoptaw, Steven

    2015-01-01

    Although there have been significant reductions in the number of new HIV infections globally from 2009 to 2013, incidence remains unacceptably high for persons who use drugs. In many settings, women and girls who inject drugs (WWID) with HIV/AIDS experience poor treatment access, including evidence-based practices like antiretroviral therapy and drug treatment. Medication-assisted therapies (MAT) for substance use disorders are especially inaccessible, which in their absence, increases HIV transmission risk. Irrespective of setting or culture, drug treatment using MAT is not only effective but also cost-effective at reducing opioid use and linked injection and sexual risks. Data presented here for WWID address their access to MAT for opioid addiction and to treatments being developed that address the relationship, family, and vocational needs of this group. The most glaring finding is that globally, WWID frequently are excluded in surveys or studies with an impressive lack of disaggregated data by gender when surveying access to MAT—even in wealthy countries. Despite this, there have been some striking improvements in implementing drug treatment as prevention, notably in Iran and China. Still, real barriers remain for women and girls to accessing drug treatment, other harm reduction services, and antiretroviral therapy. Development and/or implementation of interventions that facilitate women and girls engaging in drug treatment that address their roles within society, work, and family/relationships, and outcome evaluation of these interventions are crucial. PMID:25978482

  5. Drug Treatment as HIV Prevention Among Women and Girls Who Inject Drugs From a Global Perspective: Progress, Gaps, and Future Directions.

    PubMed

    Springer, Sandra A; Larney, Sarah; Alam-Mehrjerdi, Zahra; Altice, Frederick L; Metzger, David; Shoptaw, Steven

    2015-06-01

    Although there have been significant reductions in the number of new HIV infections globally from 2009 to 2013, incidence remains unacceptably high for persons who use drugs. In many settings, women and girls who inject drugs (WWID) with HIV/AIDS experience poor treatment access, including evidence-based practices like antiretroviral therapy and drug treatment. Medication-assisted therapies (MAT) for substance use disorders are especially inaccessible, which in their absence, increases HIV transmission risk. Irrespective of setting or culture, drug treatment using MAT is not only effective but also cost-effective at reducing opioid use and linked injection and sexual risks. Data presented here for WWID address their access to MAT for opioid addiction and to treatments being developed that address the relationship, family, and vocational needs of this group. The most glaring finding is that globally, WWID frequently are excluded in surveys or studies with an impressive lack of disaggregated data by gender when surveying access to MAT—even in wealthy countries. Despite this, there have been some striking improvements in implementing drug treatment as prevention, notably in Iran and China. Still, real barriers remain for women and girls to accessing drug treatment, other harm reduction services, and antiretroviral therapy. Development and/or implementation of interventions that facilitate women and girls engaging in drug treatment that address their roles within society, work, and family/relationships, and outcome evaluation of these interventions are crucial.

  6. An Empirical Approach to Logical Clustering of Software Failure Regions

    DTIC Science & Technology

    1994-03-01

    that study was quite preliminary and local in its investigation. This thesis examines clustering from two other perspectives, taxonomical (type of...clustering was cross-examined across the perspectives. The results show that the studied failure regions have a strong tendency to form taxonornical...propagation of the fault (structural clustering). However, that study was quite preliminary and local in its investigation. This thesis examines clustering

  7. Prevention of Hepatitis B

    PubMed Central

    Chang, Mei-Hwei; Chen, Ding-Shinn

    2015-01-01

    Hepatitis B virus (HBV) causes life-threatening liver disease. It is transmitted through a horizontal route or a mother-to-infant route, and the latter is the major route in endemic areas. Prevention of HBV infection by immunization is the best way to eliminate HBV-related diseases. The HBV vaccine is the first human vaccine using a viral antigen from infected persons, which is safe and effective. Either passive immunization by hepatitis B immunoglobulin (HBIG) or active immunization by HBV vaccine is effective, and a combination of both yields the best efficacy in preventing HBV infection. The impact of universal HBV immunization is huge, with 90%–95% effectiveness in preventing chronic HBV infection. It is the first cancer preventive vaccine with a protective efficacy against hepatocellular carcinoma (HCC) of ∼70%. Nevertheless, further effort is still needed to avoid vaccine failure and to increase the global coverage rate. PMID:25732034

  8. Pathogenesis and clinical presentation of acute heart failure.

    PubMed

    Ponikowski, Piotr; Jankowska, Ewa A

    2015-04-01

    Acute heart failure constitutes a heterogeneous clinical syndrome, whose pathophysiology is complex and not completely understood. Given the diversity of clinical presentations, several different pathophysiological mechanisms along with factors triggering circulatory decompensation are involved. This article discusses the available evidence on the pathophysiological phenomena attributed or/and associated with episodes of acute heart failure and describes different clinical profiles, which, from a clinical perspective, constitute a key element for therapeutic decision-making.

  9. Early complications. Respiratory failure.

    PubMed

    Zwischenberger, J B; Alpard, S K; Bidani, A

    1999-08-01

    Pulmonary complications following thoracic surgery are common and associated with significant morbidity and mortality. Respiratory failure after pneumonectomy occurs in approximately 5% to 15% of cases and significantly increases patient mortality. Strategies for ventilator support are based on the nature of the underlying complication and the pathophysiology of respiratory failure. This article describes the cause and pathophysiology of respiratory failure and pulmonary embolus postpneumonectomy. Diagnosis, management, and innovative therapies are also reviewed.

  10. Education About Dental Hygienists' Roles in Public Dental Prevention Programs: Dental and Dental Hygiene Students' and Faculty Members' and Dental Hygienists' Perspectives.

    PubMed

    Pervez, Anushey; Kinney, Janet S; Gwozdek, Anne; Farrell, Christine M; Inglehart, Marita R

    2016-09-01

    In 2005, Public Act No. 161 (PA 161) was passed in Michigan, allowing dental hygienists to practice in approved public dental prevention programs to provide services for underserved populations while utilizing a collaborative agreement with a supervising dentist. The aims of this study were to assess how well dental and dental hygiene students and faculty members and practicing dental hygienists have been educated about PA 161, what attitudes and knowledge about the act they have, and how interested they are in additional education about it. University of Michigan dental and dental hygiene students and faculty members, students in other Michigan dental hygiene programs, and dental hygienists in the state were surveyed. Respondents (response rate) were 160 dental students (50%), 63 dental hygiene students (82%), 30 dental faculty members (26%), and 12 dental hygiene faculty members (52%) at the University of Michigan; 143 dental hygiene students in other programs (20%); and 95 members of the Michigan Dental Hygienists' Association (10%). The results showed that the dental students were less educated about PA 161 than the dental hygiene students, and the dental faculty members were less informed than the dental hygiene faculty members and dental hygienists. Responding dental hygiene faculty members and dental hygienists had more positive attitudes about PA 161 than did the students and dental faculty members. Most of the dental hygiene faculty members and dental hygienists knew a person providing services in a PA 161 program. Most dental hygiene students, faculty members, and dental hygienists wanted more education about PA 161. Overall, the better educated about the program the respondents were, the more positive their attitudes, and the more interested they were in learning more.

  11. Nutrition and metabolism in sepsis and multisystem organ failure.

    PubMed

    Baue, A E

    1991-06-01

    Sepsis and organ failure produce profound metabolic changes that contribute to hepatic and musculoskeletal failure. When multiple organ failure develops, the mortality rate is high, and therapy is unlikely to be effective unless the causative process (e.g., infection, low cardiac output) can be eliminated. Thus, the prevention of multiple organ failure and the prevention or early treatment of infection are paramount. Organ and nutritional support to prevent complications is necessary. The gastrointestinal tract should be used for nutrition whenever possible with a blenderized regular diet with fiber, glutamine, and short-chain fatty acids to protect and preserve the gut. If parenteral nutrition is necessary, special solutions may be necessary for the liver, kidneys, or lungs. If not, protein with 45% branched-chain amino acid, medium- and short-chain triglycerides, glutamine supplementation, and carbohydrates seem best. Other substances are being evaluated that may be helpful in nutrition and organ support, including arginine, xylitol, growth hormone, and anabolic steroids. Multiple organ failure should be prevented, if at all possible, by stopping or controlling the injury, removing as much necrotic tissue as possible, improving blood flow and oxygen consumption, supporting metabolism, and preventing infection or treating it early and adequately. Nutritional support plays a key role in preventing metabolic failure.

  12. The influence of oral copper-methionine on matrix metalloproteinase-2 gene expression and activation in right-sided heart failure induced by cold temperature: A broiler chicken perspective.

    PubMed

    Bagheri Varzaneh, Mina; Rahmani, Hamidreza; Jahanian, Rahman; Mahdavi, Amir Hossein; Perreau, Corinne; Perrot, Gwenn; Brézillon, Stéphane; Maquart, François-Xavier

    2017-01-01

    This study was designed to investigate the expression, activation and activity of matrix metalloproteinase-2 (MMP-2) in the heart of broiler chickens reared in cold conditions and fed with copper-methionine supplement at different levels. The chickens (n=480) were randomly allotted to six treatments and four replicates. Treatments included two rearing temperatures (i.e. normal and cold temperatures) each combined with three levels of supplemental copper-methionine (i.e. 0, 100 and 200mg/kg). On d 38 and 45 of age, four broilers from each treatment were sacrificed and their hearts were stored at -80°C. Right-sided heart failure, as evident from abdominal and pericardial fluid accumulation, was observed in broilers under cold stress and not receiving supplemental copper. This clinical observation was confirmed at molecular level through increased MMP-2 expression, activation and activity in this group. Birds reared under normal temperature, however, were not involved in right-sided heart failure nor benefitted from copper-methionine supplementation. In contrast, gelatin zymography and real-time PCR demonstrated that dietary supplementation with copper-methionine decreased pro-MMP-2 and MMP-2 in the heart of chickens reared in cold conditions. However, gelatin reverse zymography did not show any difference between treatments in tissue inhibitor of metalloproteinase-2. Level of supplementation showed similar effects on parameters determined. It is concluded that dietary supplementation with copper-methionine reduced right-sided heart failure at clinical and molecular levels in cold-stressed chickens.

  13. Rape prevention

    MedlinePlus

    Date rape - prevention; Sexual assault - prevention ... Centers for Disease Control and Prevention. Sexual assault and abuse and STDs. In: 2015 sexually transmitted diseases treatment guidelines 2015. Updated June 4, 2015. www.cdc.gov/ ...

  14. Perspectives on the ethical concerns and justifications of the 2006 Centers for Disease Control and Prevention HIV testing: HIV screening policy changes

    PubMed Central

    2013-01-01

    Background The 2006 Centers for Disease Control and Prevention (CDC) revised recommendations for HIV testing in clinical settings contained seven specific changes to how health care facilities should provide HIV testing. These seven elements have been both supported and challenged in the lay and medical literature. Our first paper in BMC Medical Ethics presented an analysis of the three HIV testing procedural changes included in the recommendations. In this paper, we address the four remaining elements that concern HIV screening policy changes: (1) nontargeted HIV screening, (2) making HIV screening similar to screening for other treatable conditions, (3) increasing HIV screening without assured additional funding for linkage to care, and (4) making patients bear the costs of increased HIV screening in health care settings. Methods We interviewed 25 members from the fields of US HIV advocacy, care, policy, and research about the ethical merits and demerits of the four changes to HIV screening policies. We performed a qualitative analysis of the participant responses in the interviews and summarized the major themes. Results Participants commented that nontargeted HIV screening and making HIV screening similar to screening for other treatable medical conditions was ethical when it broadened the scope of people being tested for HIV. However, they believed it was unethical when it did not respect the exceptional nature of HIV and HIV testing. Some participants favored more testing regardless if there was assured additional funding for linkage to care or if patients might bear the costs of testing because they believed that merely alerting patients of their status was beneficial and would lead to positive consequences. Other participants found ethical flaws with testing without assured linkage to care and patients bearing the costs of testing, as this could discriminate against those who could not pay. Conclusions Our findings suggest that there are fundamental ethical

  15. Living with Respiratory Failure

    MedlinePlus

    ... smoking. Emotional Issues and Support Living with respiratory failure may cause fear, anxiety, depression, and stress. Talk about how you feel with your health care team. Talking to a professional counselor also can ... to living with respiratory failure. You can see how other people who have ...

  16. Ampoule Failure System

    NASA Technical Reports Server (NTRS)

    Watring, Dale A. (Inventor); Johnson, Martin L. (Inventor)

    1996-01-01

    An ampoule failure system for use in material processing furnaces comprising a containment cartridge and an ampoule failure sensor. The containment cartridge contains an ampoule of toxic material therein and is positioned within a furnace for processing. An ampoule failure probe is positioned in the containment cartridge adjacent the ampoule for detecting a potential harmful release of toxic material therefrom during processing. The failure probe is spaced a predetermined distance from the ampoule and is chemically chosen so as to undergo a timely chemical reaction with the toxic material upon the harmful release thereof. The ampoule failure system further comprises a data acquisition system which is positioned externally of the furnace and is electrically connected to the ampoule failure probe so as to form a communicating electrical circuit. The data acquisition system includes an automatic shutdown device for shutting down the furnace upon the harmful release of toxic material. It also includes a resistance measuring device for measuring the resistance of the failure probe during processing. The chemical reaction causes a step increase in resistance of the failure probe whereupon the automatic shutdown device will responsively shut down the furnace.

  17. Perspective: A defined role for multiple Fanconi anemia gene products in DNA damage associated ubiquitination.

    PubMed

    Tan, Winnie; Deans, Andrew J

    2017-03-15

    Fanconi anemia (FA) is an inherited blood disorder that causes bone marrow failure and high predisposition to cancers. The FA pathway guards the cells' genome stability by orchestrating the repair of interstrand crosslink during S phase of the cell cycle, preventing chromosomal instability that is a key event in the bone marrow failure syndrome. Central to FA pathway is loss of mono-ubiquitinated forms of the Fanconi proteins FANCI and FANCD2, a process that is normally mediated by a "core complex" of seven other Fanconi proteins. Each protein when mutated can cause FA. The FA core complex catalyzed reaction is critical for signalling DNA crosslink damage, such as that induced by chemotherapies. We present a perspective on the current understanding of FANCI and FANCD2 monoubiquitination-mediated DNA repair. Our recent biochemical reconstitution of the monoubiquitination (and deubiquitination) reactions creates a paradigm for understanding FA. Further biochemical analysis will create new opportunities to address the leukemic phenotype of FA patients.

  18. Generalized energy failure criterion.

    PubMed

    Qu, R T; Zhang, Z J; Zhang, P; Liu, Z Q; Zhang, Z F

    2016-03-21

    Discovering a generalized criterion that can predict the mechanical failure of various different structural materials is one of ultimate goals for scientists in both material and mechanics communities. Since the first study on the failure criterion of materials by Galileo, about three centuries have passed. Now we eventually find the "generalized energy criterion", as presented here, which appears to be one universal law for various different kinds of materials. The validity of the energy criterion for quantitatively predicting the failure is experimentally confirmed using a metallic glass. The generalized energy criterion reveals the competition and interaction between shear and cleavage, the two fundamental inherent failure mechanisms, and thus provides new physical insights into the failure prediction of materials and structural components.

  19. Acute Decompensated Heart Failure

    PubMed Central

    Joseph, Susan M.; Cedars, Ari M.; Ewald, Gregory A.; Geltman, Edward M.; Mann, Douglas L.

    2009-01-01

    Hospitalizations for acute decompensated heart failure are increasing in the United States. Moreover, the prevalence of heart failure is increasing consequent to an increased number of older individuals, as well as to improvement in therapies for coronary artery disease and sudden cardiac death that have enabled patients to live longer with cardiovascular disease. The main treatment goals in the hospitalized patient with heart failure are to restore euvolemia and to minimize adverse events. Common in-hospital treatments include intravenous diuretics, vasodilators, and inotropic agents. Novel pharmaceutical agents have shown promise in the treatment of acute decompensated heart failure and may simplify the treatment and reduce the morbidity associated with the disease. This review summarizes the contemporary management of patients with acute decompensated heart failure. PMID:20069075

  20. Generalized energy failure criterion

    PubMed Central

    Qu, R. T.; Zhang, Z. J.; Zhang, P.; Liu, Z. Q.; Zhang, Z. F.

    2016-01-01

    Discovering a generalized criterion that can predict the mechanical failure of various different structural materials is one of ultimate goals for scientists in both material and mechanics communities. Since the first study on the failure criterion of materials by Galileo, about three centuries have passed. Now we eventually find the “generalized energy criterion”, as presented here, which appears to be one universal law for various different kinds of materials. The validity of the energy criterion for quantitatively predicting the failure is experimentally confirmed using a metallic glass. The generalized energy criterion reveals the competition and interaction between shear and cleavage, the two fundamental inherent failure mechanisms, and thus provides new physical insights into the failure prediction of materials and structural components. PMID:26996781

  1. Dimension limit for thermal shock failure

    NASA Astrophysics Data System (ADS)

    Shao, Y. F.; Liu, Q. N.; Tian, H. J.; Lin, Z. K.; Xu, X. H.; Song, F.

    2014-08-01

    We analytically present the characteristic dimensional limit below which the thermal shock failure of ceramics never occurs. This limit, together with the critical temperature difference, separates the state space of the ceramics under thermal shock into two parts - the cracked and the uncracked. Based on the water-quench tests of ceramics, we experimentally proved that when the states of ceramics are in the uncracked region, the ceramics do not produce any cracks during thermal shock. The results provide a guide to prevent thermal shock failure in ceramic.

  2. Sociological Perspectives.

    ERIC Educational Resources Information Center

    Townley, Charles; Middleton, Mike

    This monograph examines sociological perspectives and their applications. It is intended to help the college student coming to sociology for the first time to recognize that there are several perspectives within sociology and to disentangle the mass of terms associated with each. The first distinctive sociological perspective came from the work of…

  3. Common-Cause Failure Analysis in Event Assessment

    SciTech Connect

    D. M. Rasmuson; D. L. Kelly

    2008-06-01

    This paper reviews the basic concepts of modelling common-cause failures (CCFs) in reliability and risk studies and then applies these concepts to the treatment of CCF in event assessment. The cases of a failed component (with and without shared CCF potential) and a component being unavailable due to preventive maintenance or testing are addressed. The treatment of two related failure modes (e.g. failure to start and failure to run) is a new feature of this paper, as is the treatment of asymmetry within a common-cause component group.

  4. Emerging Novel Therapies for Heart Failure

    PubMed Central

    Szema, Anthony M; Dang, Sophia; Li, Jonathan C

    2015-01-01

    Heart function fails when the organ is unable to pump blood at a rate proportional to the body’s need for oxygen or when this function leads to elevated cardiac chamber filling pressures (cardiogenic pulmonary edema). Despite our sophisticated knowledge of heart failure, even so-called ejection fraction-preserved heart failure has high rates of mortality and morbidity. So, novel therapies are sorely needed. This review discusses current standard therapies for heart failure and launches an exploration into emerging novel treatments on the heels of recently-approved sacubitril and ivbradine. For example, Vasoactive Intestinal Peptide (VIP) is protective of the heart, so in the absence of VIP, VIP knockout mice have dysregulation in key heart failure genes: 1) Force Generation and Propagation; 2) Energy Production and Regulation; 3) Ca+2 Cycling; 4) Transcriptional Regulators. VIP administration leads to coronary dilation in human subjects. In heart failure patients, VIP levels are elevated as a plausible endogenous protective effect. With the development of elastin polymers to stabilize VIP and prevent its degradation, VIP may therefore have a chance to satisfy the unmet need as a potential treatment for acute heart failure. PMID:26512208

  5. Growth outcome: nutritionist perspective.

    PubMed

    Agostoni, Carlo; Fattore, Giovanni

    2013-01-01

    Increasing evidence points to a fundamental role of early nutrition on rates of growth and development, and later health. We may identify three major fields of scientific interest and clinical application. (1) In developing countries poor growth is associated with greater risk of morbidity and mortality from infectious diseases, mainly lower respiratory infections and diarrhea. In these settings, failure to promote compensatory growth may have negative short-term consequences, and the nutritionist's task is the primary prevention of nutrient deficiencies to promote the full expression of the individual genetic potential, while allowing for recovery of early secondary functional deficiencies. (2) A second challenge for nutritionists is represented by the approach to growth impairments in rare disorders, ranging from congenital disorders to chronic infections. Most disorders are favorably influenced by improved nutritional status and better growth, and patients may satisfactorily reach adolescence, pubertal and reproductive age, up to ageing. Even for the less positive conditions, an improvement in the quality of life for families is in any case a rewarding aim. (3) A third challenge is represented by the definition of the role of nutrition on growth in physiological conditions for all individuals. Concern has been raised about the potential adverse long-term consequences of accelerated child growth rates, possibly resulting in a predisposition to develop non-communicable chronic diseases in the adult age. Accordingly, this hypothesis might explain the benefits of breastfeeding in terms of slower early growth, and the fetal origins hypothesis in terms of adverse postnatal catch-up growth in infants born small. Therefore, growth as viewed by a pediatric nutritionist perspective is a complex matter, ranging from the early stages of intrauterine development up to adult ages and ageing processes. Cost/benefit analyses of interventions on growth such as cost per DALYs

  6. [Heart failure and comorbidities].

    PubMed

    Boully, Clémence; Hanon, Olivier

    2015-03-01

    Heart failure is a frequent disease in the elderly. Its clinical presentation is less typical and the prognosis more severe than in younger subjects because heart failure occurs in patients with multiple comorbidities. A comprehensive geriatric assessment should therefore be performed to detect the vulnerabilities and manage the comorbidities. The main diseases associated with heart failure are dementia, depression, malnutrition, atrial fibrillation, coronary artery disease, orthostatic hypotension, renal failure, anemia and iron deficiency. Comorbidities worsen heart failure and makes its treatment more difficult. The identification and treatment of comorbidities improve the prognosis in terms of mortality but especially in terms of quality of life. Caution with drugs is necessary because of pharmacokinetic or pharmacodynamic changes related to aging and the comorbidities. In this context, clinical and laboratory monitoring should be increased, mostly during an acute event (acute heart failure, infection, dehydration, fall, new therapy…). Therefore, the follow-up of elderly patients with heart failure requires a multidisciplinary approach that involves close cooperation between cardiologists, geriatricians, general practitioners, nurses, and pharmacists.

  7. Renal Failure Prevalence in Poisoned Patients

    PubMed Central

    Arefi, Mohammad; Taghaddosinejad, Fakhroddin; Salamaty, Peyman; Soroosh, Davood; Ashraf, Hami; Ebrahimi, Mohsen

    2014-01-01

    Background: Renal failure is an important adverse effect of drug poisoning. Determining the prevalence and etiology of this serious side effect could help us find appropriate strategies for the prevention of renal failure in most affected patients. Objectives: The present study is aimed to identify drugs that induce renal failure and also to find the prevalence of renal failure in patients referred to emergency departments with the chief complaint of drug poisoning, in order to plan better therapeutic strategies to minimize the mortality associated with drug poisoning induced renal failure. Patients and Methods: This cross-sectional study surveyed 1500 poisoned patients referred to the Emergency Department of Baharloo Hospital in Tehran during 2010. Demographic data including age and gender as well as clinical data including type of medication, duration of hospital stay, and presence of renal failure were recorded. Mann-Whitney U test and chi-squared statistics were used to analyze the results. Results: A total number of 435 patients were poisoned with several drugs, 118 patients were intoxicated with sedative-hypnotic drugs, 279 patients were exposed to opium, and 478 patients were administered to other drugs. The method of intoxication included oral 84.3%, injective 9%, inhalation 4.3% and finally a combination of methods 2.3%. Laboratory results revealed that 134 cases had renal failure and 242 had rhabdomyolysis. The incidence of rhabdomyolysis and renal failure increased significantly with age, and also with time of admission to the hospital. Renal failure was reported in 25.1% of patients exposed to opium, vs. 18.2% of patients poisoned with aluminum phosphide, 16.7% of those with organophosphate, 8% with multiple drugs, 6.7% with alcohol, heavy metals and acids, and 1.7% with sedative hypnotics. Conclusions: Based on the findings of this study, there is a high probability of renal failure for patients poisoned with drugs such as opium, aluminum phosphide

  8. 16 CFR 1702.5 - Failure to supply adverse information.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Failure to supply adverse information. 1702.5 Section 1702.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT...

  9. 16 CFR 1702.5 - Failure to supply adverse information.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Failure to supply adverse information. 1702.5 Section 1702.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT...

  10. 16 CFR 1702.5 - Failure to supply adverse information.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Failure to supply adverse information. 1702.5 Section 1702.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT...

  11. 16 CFR 1702.5 - Failure to supply adverse information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Failure to supply adverse information. 1702.5 Section 1702.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT...

  12. 16 CFR 1702.5 - Failure to supply adverse information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Failure to supply adverse information. 1702.5 Section 1702.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT...

  13. Liver Failure in Pregnancy.

    PubMed

    Bacak, Stephen J; Thornburg, Loralei L

    2016-01-01

    Acute liver failure is a rare but life-threatening medical emergency in pregnancy whose true incidence remains unknown. Many cases of acute liver failure are caused by pregnancy-related conditions such as acute fatty liver of pregnancy and HELLP syndrome. However, acute deterioration in liver function can also be caused by drug overdose, viral infections, and an exacerbation of underlying chronic liver disease. This article provides an overview of the normal liver changes that occur during pregnancy, and summarizes the most common conditions and general management strategies of liver failure during pregnancy.

  14. Damage mechanics - failure modes

    SciTech Connect

    Krajcinovic, D.; Vujosevic, M.

    1996-12-31

    The present study summarizes the results of the DOE sponsored research program focused on the brittle failure of solids with disordered microstructure. The failure is related to the stochastic processes on the microstructural scale; namely, the nucleation and growth of microcracks. The intrinsic failure modes, such as the percolation, localization and creep rupture, are studied by emphasizing the effect of the micro-structural disorder. A rich spectrum of physical phenomena and new concepts that emerges from this research demonstrates the reasons behind the limitations of traditional, deterministic, and local continuum models.

  15. β-Glucans in the treatment and prevention of allergic diseases.

    PubMed

    Jesenak, Milos; Banovcin, Peter; Rennerova, Zuzana; Majtan, Juraj

    2014-01-01

    β-glucans are a group of biologically active polysaccharides of natural origin with a proven pleiotropic immunomodulation effect. Their efficacy has been confirmed in the therapeutic treatment and prevention of various infectious diseases, secondary immune defects and also of oncologic disorders. Allergic diseases are one of the most frequent diseases and their prevalence continues to increase. They develop as a consequence of dysregulation of the immune system, especially when there is failure in the equilibrium of the response of TH1/TH2 lymphocytes towards TH2. New therapeutic approaches in the treatment of immunopathological conditions (e.g. allergic or oncologic) are directed to restoring the equilibrium among different T lymphocyte subpopulations. Based on in vitro experiments, and also on animal and human clinical studies, there is much evidence for the importance of β-glucans in the treatment and also prevention of allergic diseases; this opens new perspectives on the use of this widespread and popular group of natural substances.

  16. Heart failure - discharge

    MedlinePlus

    ... Heart failure - overview Heart pacemaker High blood pressure Implantable cardioverter-defibrillator Smoking - tips on how to quit ... ask your doctor How to read food labels Implantable cardioverter defibrillator - discharge Low-salt diet Mediterranean diet ...

  17. Heart failure overview

    MedlinePlus

    ... heart failure: Fast or difficult breathing Leg swelling (edema) Neck veins that stick out (are distended) Sounds ( ... pacemaker High blood pressure Implantable cardioverter-defibrillator Pulmonary edema Stable angina Ventricular assist device Patient Instructions ACE ...

  18. Failure to communicate.

    PubMed

    Fiesta, J

    1998-02-01

    When a medication error is coupled with a communication problem, a patient may experience significant injury. Cases involving communication breakdown, i.e, failure to communicate or listen, are discussed.

  19. Triac failure detector

    NASA Technical Reports Server (NTRS)

    Nola, F. J. (Inventor)

    1983-01-01

    A failure detector is provided for detecting unidirectional failures in triacs, particularly as used in power factor controllers for induction motors. In a first embodiment, the triac voltage waveform is sensed and upon detection of an unbalanced signal, corresponding to failure of the triac in either the positive or negative direction, the triac is turned full on in both directions. In a second embodiment, a pair of pulsed signals are derived, the pulse durations of which are proportional to the phase difference between the load current and voltage for each half cycle, and the triac is turned full on responsive to a difference in pulse duration between the half cycle signals. An unidirectional open circuit detector is adapted to use a signal from either of the first and second embodiment to turn the triac off in response to an open circuit failure in either direction.

  20. Inverter ratio failure detector

    NASA Technical Reports Server (NTRS)

    Wagner, A. P.; Ebersole, T. J.; Andrews, R. E. (Inventor)

    1974-01-01

    A failure detector which detects the failure of a dc to ac inverter is disclosed. The inverter under failureless conditions is characterized by a known linear relationship of its input and output voltages and by a known linear relationship of its input and output currents. The detector includes circuitry which is responsive to the detector's input and output voltages and which provides a failure-indicating signal only when the monitored output voltage is less by a selected factor, than the expected output voltage for the monitored input voltage, based on the known voltages' relationship. Similarly, the detector includes circuitry which is responsive to the input and output currents and provides a failure-indicating signal only when the input current exceeds by a selected factor the expected input current for the monitored output current based on the known currents' relationship.

  1. Heart failure - tests

    MedlinePlus

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... An echocardiogram (Echo) is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than a plain ...

  2. Common Cause Failure Modeling

    NASA Technical Reports Server (NTRS)

    Hark, Frank; Britton, Paul; Ring, Robert; Novack, Steven

    2015-01-01

    Space Launch System (SLS) Agenda: Objective; Key Definitions; Calculating Common Cause; Examples; Defense against Common Cause; Impact of varied Common Cause Failure (CCF) and abortability; Response Surface for various CCF Beta; Takeaways.

  3. Evaluation of ultrafiltration failure.

    PubMed

    Korbet, S M

    1998-07-01

    The evaluation of ultrafiltration failure is embarked upon when a patient has persistent problems with symptoms and signs of fluid overload. Fluid overload is a common problem in peritoneal dialysis (PD) patients and the risk of its occurrence increases with time on dialysis. Although often attributed to changes in peritoneal membrane function (membrane failure), there are a number of potential, and frequently more common factors that can contribute to the failure of adequate fluid removal in patients on PD. Many of the causes of ultrafiltration failure may be apparent after an initial informal evaluation. However, if after this the etiology remains unexplained, a systematic approach to the differential diagnosis of this problem can be utilized with the use of the peritoneal equilibration test. Once a diagnosis is confirmed, a logical therapeutic plan can be formulated.

  4. Living with Heart Failure

    MedlinePlus

    ... help you in the future. Follow Your Treatment Plan Treatment can relieve your symptoms and make daily ... or nurse about getting flu and pneumonia vaccines. Plan Ahead If you have heart failure, it's important ...

  5. What Causes Respiratory Failure?

    MedlinePlus

    ... Conditions Causing Respiratory Failure Figure A shows the location of the lungs, airways, diaphragm, rib cage, pulmonary arteries, brain, and spinal cord ... STATEMENT FOIA NO FEAR ACT OIG CONTACT US ...

  6. A modeling framework for system restoration from cascading failures.

    PubMed

    Liu, Chaoran; Li, Daqing; Zio, Enrico; Kang, Rui

    2014-01-01

    System restoration from cascading failures is an integral part of the overall defense against catastrophic breakdown in networked critical infrastructures. From the outbreak of cascading failures to the system complete breakdown, actions can be taken to prevent failure propagation through the entire network. While most analysis efforts have been carried out before or after cascading failures, restoration during cascading failures has been rarely studied. In this paper, we present a modeling framework to investigate the effects of in-process restoration, which depends strongly on the timing and strength of the restoration actions. Furthermore, in the model we also consider additional disturbances to the system due to restoration actions themselves. We demonstrate that the effect of restoration is also influenced by the combination of system loading level and restoration disturbance. Our modeling framework will help to provide insights on practical restoration from cascading failures and guide improvements of reliability and resilience of actual network systems.

  7. A Modeling Framework for System Restoration from Cascading Failures

    PubMed Central

    Liu, Chaoran; Li, Daqing; Zio, Enrico; Kang, Rui

    2014-01-01

    System restoration from cascading failures is an integral part of the overall defense against catastrophic breakdown in networked critical infrastructures. From the outbreak of cascading failures to the system complete breakdown, actions can be taken to prevent failure propagation through the entire network. While most analysis efforts have been carried out before or after cascading failures, restoration during cascading failures has been rarely studied. In this paper, we present a modeling framework to investigate the effects of in-process restoration, which depends strongly on the timing and strength of the restoration actions. Furthermore, in the model we also consider additional disturbances to the system due to restoration actions themselves. We demonstrate that the effect of restoration is also influenced by the combination of system loading level and restoration disturbance. Our modeling framework will help to provide insights on practical restoration from cascading failures and guide improvements of reliability and resilience of actual network systems. PMID:25474408

  8. Common-Cause Failure Analysis in Event Assessment

    SciTech Connect

    Dana L. Kelly; Dale M. Rasmuson

    2008-09-01

    This paper describes the approach taken by the U. S. Nuclear Regulatory Commission to the treatment of common-cause failure in probabilistic risk assessment of operational events. The approach is based upon the Basic Parameter Model for common-cause failure, and examples are illustrated using the alpha-factor parameterization, the approach adopted by the NRC in their Standardized Plant Analysis Risk (SPAR) models. The cases of a failed component (with and without shared common-cause failure potential) and a component being unavailable due to preventive maintenance or testing are addressed. The treatment of two related failure modes (e.g., failure to start and failure to run) is a new feature of this paper. These methods are being applied by the NRC in assessing the risk significance of operational events for the Significance Determination Process (SDP) and the Accident Sequence Precursor (ASP) program.

  9. Impact of Aldosterone Antagonists on Sudden Cardiac Death Prevention in Heart Failure and Post-Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Le, Hai-Ha; El-Khatib, Chadia; Mombled, Margaux; Guitarian, Frédéric; Al-Gobari, Muaamar; Fall, Mor; Janiaud, Perrine; Marchant, Ivanny; Cucherat, Michel; Bejan-Angoulvant, Théodora; Gueyffier, François

    2016-01-01

    Background and Objectives Sudden cardiac death (SCD) is a severe burden of modern medicine. Aldosterone antagonist is publicized as effective in reducing mortality in patients with heart failure (HF) or post myocardial infarction (MI). Our study aimed to assess the efficacy of AAs on mortality including SCD, hospitalization admission and several common adverse effects. Methods We searched Embase, PubMed, Web of Science, Cochrane library and clinicaltrial.gov for randomized controlled trials (RCTs) assigning AAs in patients with HF or post MI through May 2015. The comparator included standard medication or placebo, or both. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Event rates were compared using a random effects model. Prospective RCTs of AAs with durations of at least 8 weeks were selected if they included at least one of the following outcomes: SCD, all-cause/cardiovascular mortality, all-cause/cardiovascular hospitalization and common side effects (hyperkalemia, renal function degradation and gynecomastia). Results Data from 19,333 patients enrolled in 25 trials were included. In patients with HF, this treatment significantly reduced the risk of SCD by 19% (RR 0.81; 95% CI, 0.67–0.98; p = 0.03); all-cause mortality by 19% (RR 0.81; 95% CI, 0.74–0.88, p<0.00001) and cardiovascular death by 21% (RR 0.79; 95% CI, 0.70–0.89, p<0.00001). In patients with post-MI, the matching reduced risks were 20% (RR 0.80; 95% CI, 0.66–0.98; p = 0.03), 15% (RR 0.85; 95% CI, 0.76–0.95, p = 0.003) and 17% (RR 0.83; 95% CI, 0.74–0.94, p = 0.003), respectively. Concerning both subgroups, the relative risks respectively decreased by 19% (RR 0.81; 95% CI, 0.71–0.92; p = 0.002) for SCD, 18% (RR 0.82; 95% CI, 0.77–0.88, p < 0.0001) for all-cause mortality and 20% (RR 0.80; 95% CI, 0.74–0.87, p < 0.0001) for cardiovascular mortality in patients treated with AAs. As well, hospitalizations were significantly reduced

  10. Radiocontrast-Induced Renal Failure

    PubMed Central

    Misson, Robert T.; Cutler, Ralph E.

    1985-01-01

    Review of the literature concerning contrast-induced renal dysfunction shows that the currently used agents are remarkably safe with careful patient selection. Clinically apparent kidney failure after their use is essentially nonexistent in those without preexistent renal insufficiency. The incidence rises rapidly in those with azotemia from any cause, however, and diabetic persons with nephropathy are perhaps at special risk. Vigorous volume expansion is possibly effective as a preventive measure and may attenuate adverse effects in those in whom postcontrast dysfunction occurs. New agents are becoming available. It is not yet known if these will prove safer or cost-effective. They have some experimentally demonstrated and theoretic advantages over the presently used agents. PMID:4013281

  11. Heart Failure Update: Outpatient Management.

    PubMed

    Wojnowich, Katherine; Korabathina, Ravi

    2016-03-01

    Outpatient management of heart failure (HF) is aimed at treating symptoms and preventing hospitalizations and readmissions. Management is initiated in a stepwise approach. Blockade of the renin-angiotensin system is a cornerstone of therapy and should be started, along with beta blockers, as soon as the diagnosis of HF is made. Other drugs, including diuretics, aldosterone antagonists, hydralazine, and nitrates, may be added based on symptoms and American College of Cardiology/American Heart Association stage. Despite a great interest in and theoretical benefit of naturoceutical products in the mitigation of oxidative stress and HF progression, none has been proven to be beneficial, and concerns exist regarding their interactions with standard HF drugs. Other nonpharmacologic interventions, including sodium restriction, regular exercise, and/or cardiac rehabilitation, should be initiated at diagnosis. HF often is progressive, and clinicians should be aware of late stage management options, including implantable devices, cardiac transplantation, and hospice care.

  12. Genesis Failure Investigation Report

    NASA Technical Reports Server (NTRS)

    Klein, John

    2004-01-01

    The-Genesis mission to collect solar-wind samples and return them to Earth for detailed analysis proceeded successfully for 3.5 years. During reentry on September 8, 2004, a failure in the entry, descent and landing sequence resulted in a crash landing of the Genesis sample return capsule. This document describes the findings of the avionics sub-team that supported the accident investigation of the JPL Failure Review Board.

  13. Heart failure in pregnancy.

    PubMed

    Rutherford, John D

    2012-12-01

    With increasing maternal age and the presence of comorbid conditions such as hypertension, cardiovascular assessment and monitoring is the responsibility of all clinicians caring for pregnant patients. Furthermore, there are specific conditions, such as mitral stenosis, peripartum cardiomyopathy, and preeclampsia, that can be associated with heart failure and secondary maternal (and fetal) mortality and morbidity. The important causes of heart failure in pregnancy are discussed.

  14. Acute renal failure.

    PubMed

    Bellomo, Rinaldo

    2011-10-01

    Acute renal failure (now acute kidney injury) is a common complication of critical illness affecting between 30 and 60% of critically ill patients. The development of a consensus definition (RIFLE--risk, injury, failure, loss, end-stage system) has allowed standardization of reporting and epidemiological work. Multicenter multinational epidemiological studies indicate that sepsis is now the most common cause of acute renal failure in the intensive care unit (ICU) followed by cardiac surgery-associated acute kidney injury. Unfortunately, our understanding of the pathogenesis of acute renal failure in these settings remains limited. Because of such limited understanding, no reproducibly effective therapies have been developed. In addition the diagnosis of acute renal failure still rests upon the detection of changes in serum creatinine, which only occur if more than 50% of glomerular filtration is lost and are often delayed by more than 24 hours. Such diagnostic delays make the implementation of early therapy nearly impossible. In response to these difficulties, there has been a concerted effort to use proteomics to identify novel early biomarkers of acute renal failure. The identification and study of neutrophil gelatinase- associated lipocalin has been an important step in this field. Another area of active interest and investigation relates to the role of intravenous fluid resuscitation and fluid balance. Data from large observational studies and randomized, controlled trials consistently indicate that a positive fluid balance in patients with acute renal failure represents a major independent risk factor for mortality and provides no protection of renal function. The pendulum is clearly swinging away from a fluid-liberal approach to a fluid-conservative approach in these patients. Finally, there is a growing appreciation that acute renal failure may identify patients who are at increased risk of subsequent chronic renal dysfunction and mortality, opening the way

  15. Buckling failures in insect exoskeletons.

    PubMed

    Parle, Eoin; Herbaj, Simona; Sheils, Fiona; Larmon, Hannah; Taylor, David

    2015-12-17

    Thin walled tubes are often used for load-bearing structures, in nature and in engineering, because they offer good resistance to bending and torsion at relatively low weight. However, when loaded in bending they are prone to failure by buckling. It is difficult to predict the loading conditions which cause buckling, especially for tubes whose cross sections are not simple shapes. Insights into buckling prevention might be gained by studying this phenomenon in the exoskeletons of insects and other arthropods. We investigated the leg segments (tibiae) of five different insects: the locust (Schistocerca gergaria), American cockroach (Periplaneta americana), death's head cockroach (Blaberus discoidalis), stick insect (Parapachymorpha zomproi) and bumblebee (Bombus terrestris audax). These were tested to failure in cantilever bending and modelled using finite element analysis (FEA). The tibiae of the locust and the cockroaches were found to be approximately circular in shape. Their buckling loads were well predicted by linear elastic FEA, and also by one of the analytical solutions available in the literature for elastic buckling. The legs of the stick insect are also circular in cross section but have several prominent longitudinal ridges. We hypothesised that these ridges might protect the legs against buckling but we found that this was not the case: the loads necessary for elastic buckling were not reached in practice because yield occurred in the material, causing plastic buckling. The legs of bees have a non-circular cross section due to a pollen-carrying feature (the corbicula). We found that this did not significantly affect their resistance to buckling. Our results imply that buckling is the dominant failure mode in the tibia of insects; it likely to be a significant consideration for other arthropods and any organisms with stiff exoskeletons. The interactions displayed here between material properties and cross sectional geometry may provide insights for the

  16. Economic Determinants of Academic Failure and School Desertion in the Guatemala Highlands.

    ERIC Educational Resources Information Center

    Carvajal, Manuel J.; And Others

    1993-01-01

    Explores, from an economic perspective, elementary school system adequacy in the rural, indigenous Guatemalan highlands. Estimates least-squares coefficients and elasticities separately for academic failure and school abandonment for each of four indigenous groups. The model explains academic failure better than school desertion. A national policy…

  17. Failure to Fail in a Final Pre-Service Teaching Practicum

    ERIC Educational Resources Information Center

    Danyluk, Patricia J.; Luhanga, Florence; Gwekwerere, Yovita N.; MacEwan, Leigh; Larocque, Sylvie

    2015-01-01

    This article presents a Canadian perspective on the issue of failure to fail in Bachelor of Education programs. The issue of failure to fail in Bachelor of Education programs is one that had not been explored in any great detail. What literature does exist focuses on the strain that a teacher experiences when s/he mentors a student teacher…

  18. Premature ovarian failure.

    PubMed

    Kalantaridou, S N; Davis, S R; Nelson, L M

    1998-12-01

    In 1% of women, premature ovarian failure develops by 40 years of age, a condition causing amenorrhea, infertility, sex steroid deficiency, and elevated gonadotropins. Early loss of ovarian function has significant psychosocial sequelae and major health implications. These young women have a nearly two-fold age-specific increase in mortality rate. Among women with spontaneous premature ovarian failure who have a normal karyotype, half have ovarian follicles remaining in the ovary that function intermittently. Indeed, pregnancies have occurred after the diagnosis of premature ovarian failure. Thus, premature ovarian failure should not be considered as a premature menopause. Young women with this disorder have a 5% to 10% chance for spontaneous pregnancy. Attempts at ovulation induction using various regimens fail to induce ovulation rates greater than those seen in untreated patients; however, oocyte donation for women desiring fertility is an option. Young women with premature ovarian failure need a thorough assessment, sex steroid replacement, and long-term surveillance to monitor therapy. Estrogen-progestin replacement therapy should be instituted as soon as the diagnosis is made. Androgen replacement should also be considered for women with low libido, persistent fatigue, and poor well-being despite taking adequate estrogen replacement. Women with premature ovarian failure should be followed up for the presence of associated autoimmune endocrine disorders such as hypothyroidism, adrenal insufficiency, and diabetes mellitus.

  19. Heart Failure in South Asia

    PubMed Central

    Sivadasan Pillai, Harikrishnan; Ganapathi, Sanjay

    2013-01-01

    South Asia (SA) is both the most populous and the most densely populated geographical region in the world. The countries in this region are undergoing epidemiological transition and are facing the double burden of infectious and non-communicable diseases. Heart failure (HF) is a major and increasing burden all over the world. In this review, we discuss the epidemiology of HF in SA today and its impact in the health system of the countries in the region. There are no reliable estimates of incidence and prevalence of HF (heart failure) from this region. The prevalence of HF which is predominantly a disease of the elderly is likely to rise in this region due to the growing age of the population. Patients admitted with HF in the SA region are relatively younger than their western counterparts. The etiology of HF in this region is also different from the western world. Untreated congenital heart disease and rheumatic heart disease still contribute significantly to the burden of HF in this region. Due to epidemiological transition, the prevalence of hypertension, diabetes mellitus, obesity and smoking is on the rise in this region. This is likely to escalate the prevalence of HF in South Asia. We also discuss potential developments in the field of HF management likely to occur in the nations in South Asia. Finally, we discuss the interventions for prevention of HF in this region PMID:23597297

  20. The failure of cancer chemoprevention.

    PubMed

    Potter, John D

    2014-05-01

    Chemoprevention is proposed as a clinical analogue of population prevention, aimed at reducing likelihood of disease progression, not across the population, but in identified high-risk individuals and not by behavioral or lifestyle modification, but by the use of pharmaceutical agents. Cardiovascular chemoprevention is successful via control of hyperlipidemias and hypertension. However, chemoprevention of cancer is an almost universal failure: not only are some results null; even more frequently, there is an excess of disease, including disease that the agents were chosen specifically to reduce. A brief introduction is followed by the evidence for a wide variety of agents and their largely deleterious, sometimes null, and in one case, largely beneficial, consequences as possible chemopreventives. The agents include (i) those that are food derived and their synthetic analogues: β-carotene, folic acid, retinol and retinoids, vitamin E, multivitamin supplements, vitamin C, calcium and selenium and (ii) agents targeted at metabolic and hormonal pathways: statins, estrogen and antagonists, 5α-reductase inhibitors. There are two agents for which there is good evidence of benefit when the strategy is focused on those at defined high risk but where wider application is much more problematic: aspirin and tamoxifen. The major problems with cancer chemoprevention are presented. This is followed by a hypothesis to explain the failure of cancer chemoprevention as an enterprise, arguing that the central tenets that underpin it are flawed and showing why, far from doing good, cancer chemoprevention causes harm.