Baştuğ, Osman; Korkmaz, Levent; Korkut, Sabriye; Halis, Hülya; Güneş, Tamer; Kurtoğlu, Selim
Branding refers to a traditional practice of creating ‘therapeutic’ burns with hot iron rods over the skin in order to treat various diseases. Although branding is a harmful practice for the body, it has been used for various illnesses including physiologic jaundice in newborns, pneumonia, and convulsions. It causes serious morbidity and delays seeking proper medical care in neonates. Innovations of modern medicine and the use of evidence-based medicine should be preferred instead of these traditional practices. We present a branded mature newborn baby who was diagnosed as having adrenocorticotropic hormone resistance syndrome. This problem is very rare in Turkey; however, it is a very important health issue and has social aspects. Therefore, this case is presented to increase awareness. PMID:28123337
Baştuğ, Osman; Korkmaz, Levent; Korkut, Sabriye; Halis, Hülya; Güneş, Tamer; Kurtoğlu, Selim
Branding refers to a traditional practice of creating 'therapeutic' burns with hot iron rods over the skin in order to treat various diseases. Although branding is a harmful practice for the body, it has been used for various illnesses including physiologic jaundice in newborns, pneumonia, and convulsions. It causes serious morbidity and delays seeking proper medical care in neonates. Innovations of modern medicine and the use of evidence-based medicine should be preferred instead of these traditional practices. We present a branded mature newborn baby who was diagnosed as having adrenocorticotropic hormone resistance syndrome. This problem is very rare in Turkey; however, it is a very important health issue and has social aspects. Therefore, this case is presented to increase awareness.
Gebrekirstos, Kahsu; Fantahun, Atsede; Buruh, Gerezgiher
Background. In addition to beneficial traditional practices, there are around 140 harmful traditional practices affecting mothers and children in almost all ethnic groups of Ethiopia. Therefore this study might give a clue about their practice and associated factors. The objective of this study was to assess magnitude of harmful traditional practices among children less than 5 years of age in Axum Town, North Ethiopia. Methods. Community based cross-sectional study was conducted on 752 participants who were selected using multistage sampling. Simple random sampling method was used to select ketenas from all kebelles of Axum Town. After proportional allocation of sample size to eachketena, systematic random sampling method was used to get the study participants. Data was collected using interviewer administered questionnaire; it was entered and analyzed using SPSS version 16 and descriptive statistics was calculated. Results. Majority of the respondents (81.2%) were Orthodox, 78.2% of the mothers had no work, and majority of mothers had no formal education. Among the harmful traditional practices performed on children, uvula cutting alone was performed on 72.8% of children followed by milk teeth extraction and uvula cutting with eyebrow incision. Conclusion. The leading harmful traditional practice performed on children in this study was uvula cutting. PMID:25045359
Background Every social grouping in the world has its own cultural practices and beliefs which guide its members on how they should live or behave. Harmful traditional practices that affect children are Female genital mutilation, Milk teeth extraction, Food taboo, Uvula cutting, keeping babies out of exposure to sun, and Feeding fresh butter to new born babies. The objective of this study was to assess factors associated with harmful traditional practices among children less than 5 years of age in Axum town, North Ethiopia. Methods Community based cross sectional study was conducted in 752 participants who were selected using multi stage sampling; Simple random sampling method was used to select ketenas from all kebelles of Axum town. After proportional allocation of sample size, systematic random sampling method was used to get the study participants. Data was collected using interviewer administered Tigrigna version questionnaire, it was entered and analyzed using SPSS version 16. Descriptive statistics was calculated and logistic regressions were used to analyze the data. Results Out of the total sample size 50.7% children were females, the mean age of children was 26.28 months and majority of mothers had no formal education. About 87.8% mothers had performed at least one traditional practice to their children; uvula cutting was practiced on 86.9% children followed by milk teeth extraction 12.5% and eye borrows incision 2.4% children. Fear of swelling, pus and rapture of the uvula was the main reason to perform uvula cutting. Conclusion The factors associated with harmful traditional practices were educational status, occupation, religion of mothers and harmful traditional practices performed on the mothers. PMID:24952584
The Aboriginal people in Canada have been noted to have low self-esteem, subsequently increasing their risk of HIV. To this effect, two traditional healing practices are being used to help these people avoid HIV infection, and to live more healthily and positively if they are infected. The first method is the Medicine Wheel, which is a traditional model used to represent the complex interrelationship among all living things and show how their immune system is physically affected by their emotions and worries. Many Aboriginal AIDS Organizations, counselors and others are now using this AIDS teaching Wheel model. Meanwhile, the second method is the Sharing Circles, which provide an environment where people feel safe to talk about HIV and give participants a sense of support and a means for expression without stigma or judgement. As a result, many people who attend HIV circles begin to take better care of themselves and of others. Overall, it is emphasized that these traditional healing practices can be effectively adapted for use in HIV counseling and education.
Douwes, Marjolein; de Kraker, Heleen
The Hand Arm Risk Assessment Method (HARM 1.0) has been developed for occupational health officers to perform risk assessments of developing arm, neck or shoulder pain during hand arm tasks. The tool can also help in finding solutions for risk reduction and estimating their effect on the risk level. In this paper the status of affairs and the practical application of HARM is described. The usage of HARM is explained and illustrated with the risk assessment of a specific hand arm task. In addition, the experiences with the application of HARM by a stone factory in The Netherlands are described.
Kelly, Brendan D
There are significant points of similarity between considerations of self-harm and suicide in Buddhist and non-Buddhist traditions, including qualified acceptance of certain forms of self-harm, altruism as a motivation for suicide, and self-immolation as a form of political protest. Differences include specific contexts in which certain forms of self-harm are accepted and the predominant frameworks used to interpret such acts. The integration of Buddhist concepts of dukkha (unsatisfactoriness or suffering) and sati (mindfulness) into Western psychotherapeutic paradigms represents a significant point of convergence between the two traditions, and suggests the possibility of greater dialogue and therapeutic benefit in the future.
Han, Myunghee; Washington, Ernest D.
This study describes traditional Korean child rearing and its relation to personality, social development, and their implications for education. Topics addressed include the family structure, traditional value orientation, the prenatal period, patterns of interaction in infancy, the baby as a vulnerable being, the baby as a spiritual being, the…
Solomon, Eric S; Jones, Daniel L
Current and future dental school graduates are increasingly likely to choose a non-traditional dental practice-a group practice managed by a dental service organization or a corporate practice with employed dentists-for their initial practice experience. In addition, the growth of non-traditional practices, which are located primarily in major urban areas, could accelerate the movement of dentists to those areas and contribute to geographic disparities in the distribution of dental services. To help the profession understand the implications of these developments, the aim of this study was to compare the location characteristics of non-traditional practices and traditional dental practices. After identifying non-traditional practices across the United States, the authors located those practices and traditional dental practices geographically by zip code. Non-traditional dental practices were found to represent about 3.1% of all dental practices, but they had a greater impact on the marketplace with almost twice the average number of staff and annual revenue. Virtually all non-traditional dental practices were located in zip codes that also had a traditional dental practice. Zip codes with non-traditional practices had significant differences from zip codes with only a traditional dental practice: the populations in areas with non-traditional practices had higher income levels and higher education and were slightly younger and proportionally more Hispanic; those practices also had a much higher likelihood of being located in a major metropolitan area. Dental educators and leaders need to understand the impact of these trends in the practice environment in order to both prepare graduates for practice and make decisions about planning for the workforce of the future.
Two recent books, "The Case for Tenure" (Matthew W. Finkin, ed.) and "Promotion and Tenure" (William G. Tierney, Estela Mara Bensimon) are important contributions to the dialog about college faculty tenure. Each contributes to but does not fill the professoriate's need for a defense of tenure that incorporates the tradition of principled support…
Kesterton, Amy J; Cleland, John
Background Every year four million babies die in the first month of life and a quarter of these take place in India. A package of essential newborn care practices exists, which has a proven impact on reducing mortality, and can be implemented in low resource settings. However, childbirth and the neonatal period are culturally important times, during which there is strong adherence to traditional practices. Successful implementation of the package therefore requires in-depth knowledge of the local context and tailored behaviour change communication. Methods This study was carried out in rural Karnataka, India. It uses quantitative data from a prospective survey following mothers through their experience of pregnancy and the postnatal period; and qualitative data from in depth interviews and focus group discussions conducted with mothers, grandmothers and birth attendants. It explores local newborn care practices and beliefs, analyses their harmful or beneficial characteristics and elucidates areas of potential resistance to behaviour change and implementation of the essential newborn care package. Results Findings show that many potentially harmful newborn care practices are being carried out in the study area, such as unhygienic cord cutting, delayed breastfeeding and early bathing. Some are more amenable to change than others, depending on the strength of the underlying beliefs, and acceptability of alternative care. However, movement away from traditional practices is already taking place, particularly amongst the more educated and better off, and there is a clear opportunity to broaden, direct and accelerate this process. Conclusion Community education should be a focus of the National Rural Health Mission (NRHM) and Integrated Management of Neonatal and Childhood Illness (IMNCI) program being implemented in Karnataka. The added capacity of the new Accredited Social Health Activists (ASHAs) could enable more women to be reached. With careful tailoring of
As the population in the United States grows more diverse, nurses caring for childbearing women must be aware of the many cultural traditions and customs unique to their patients. This knowledge and insight supports women and their families with the appropriate care, information, and resources. A supportive relationship builds trust, offers guidance, and allows for the new family to integrate information from nurses and other healthcare providers with the practice of certain perinatal cultural traditions. The Asian Indian culture is rich in tradition, specifically during the perinatal period. To support the cultural beliefs and practices of Asian Indian women during this time, nurses need to be aware of and consider multiple factors. Many women are navigating the new role of motherhood while making sense of and incorporating important cultural rituals. The purpose of this article is to provide an overview of perinatal cultural practices and traditions specific to the Asian Indian culture that perinatal nurses may observe in the clinical setting. Cultural traditions and practices specific to the pregnancy and postpartum period are described together with symbolism and implications for nursing practice. It is important to note that information regarding perinatal customs is provided in an effort to promote culturally sensitive nursing care and may not pertain to all Asian Indian women living in the United States.
Allott, Kelly; Redman, Jennifer
Harm reduction refers to the use of strategies to prevent or reduce harmful consequences associated with illicit drug use. There is a paucity of research concerning the harm reduction practices employed by ecstasy users. This study aimed to explore the prevalence, nature and factors associated with harm reduction practices employed by ecstasy users in Australia, with a specific focus on the practice of preloading and postloading--the use of pharmaceuticals and natural products prior and subsequent to ecstasy use. One hundred and sixteen Australian residents aged 18 years and over who had used ecstasy at least once in their lifetime were recruited via convenience sampling, 'snowballing' and via web-based advertisements and completed an anonymous questionnaire. Participants reported using a wide range of strategies for minimising ecstasy-associated harm. The most common strategies used for reducing negative side effects, 'comedown' or neurotoxicity were drinking water, limiting or reducing ecstasy use, taking breaks and taking vitamins or other natural substances. Forty percent of the sample had tested their ecstasy pills for the presence of MDMA. Forty-one percent and 47% of participants had engaged in pre- and postloading, respectively, with the most common pre- and postloading substances being multivitamins, 5-HTP, magnesium and fruit or fruit juice. Younger mean age and 'high' total occasions of ecstasy use was significantly associated with preloading, and 'high' total use and frequency of use was associated with postloading. The results indicate that ecstasy users are aware of the potential for harm associated with ecstasy use and attempt to minimise harm by actively employing strategies. By exploring the pattern of harm reduction practices among ecstasy users, this study has highlighted the need for further research into the efficacy and potential clinical drug interactions associated with such practices, as well as the need for investigation of how such
Roberts, Ellen Adams
The professional experiences and practices of school counselors and the interventions they employ while working with adolescent students who self-harm is an underrepresented area within current research. This generic qualitative study provides a rich description and a deeper understanding of the professional experiences and practices of school…
Mahalik, James R.; Good, Glenn E.; Tager, David; Levant, Ronald F.; Mackowiak, Christopher
This study drew upon the knowledge base of member practitioners of the American Psychological Association (APA) to develop a taxonomy of helpful and harmful practices for treatment with boys and men. Four hundred seventy-five APA-member practitioners solicited from practice-related divisions provided responses to 4 open-ended questions about…
Gorter, A C; Sánchez, G; Pauw, J; Pérez, R M; Sandiford, P; Smith, G D
traditional treatments should be studied to evaluate their effectiveness and adapt them, to the extent possible, to "modern" medicine. Health services providers should become familiar with traditional nomenclature and beliefs in order to be able to communicate better with mothers and steer them away from harmful practices toward improved results in infant diarrheal disease prevention programs.
"Harm reduction" is a public health model that places emphasis on reducing the negative effects of drug use rather than on eliminating drug use or ensuring abstinence. Based on sixteen months of ethnographic research, this article examines how harm reduction in Argentina is both envisioned and observed as a social practice by analyzing how local harm reductionists position their work in relation to "social context." My informants consider this social emphasis to be characteristic of a "Latin" kind of intervention, which they differentiate from an "Anglo-Saxon" approach focused on individual behavior change. Differentiating between these "cultural" models of intervention helps Argentine harm reductionists guide their social orientation to drug use, risk, and harm by situating interventions in the contexts in which users live and operate. It also allows them to distinguish their social form of harm reduction from a neoliberal one that they associate with the global north. The construction of these distinct cultural models of intervention is a means of critiquing neoliberal approaches to health that advocate technical solutions to changing individual behavior. Ultimately, this construct acts as a political commentary on the limits of an individual-oriented harm reduction project when applied to the "Argentine context."
“Harm reduction” is a public health model that places emphasis on reducing the negative effects of drug use rather than on eliminating drug use or ensuring abstinence. Based on sixteen months of ethnographic research, this article examines how harm reduction in Argentina is both envisioned and observed as a social practice by analyzing how local harm reductionists position their work in relation to “social context.” My informants consider this social emphasis to be characteristic of a “Latin” kind of intervention, which they differentiate from an “Anglo-Saxon” approach focused on individual behavior change. Differentiating between these “cultural” models of intervention helps Argentine harm reductionists guide their social orientation to drug use, risk, and harm by situating interventions in the contexts in which users live and operate. It also allows them to distinguish their social form of harm reduction from a neoliberal one that they associate with the global north. The construction of these distinct cultural models of intervention is a means of critiquing neoliberal approaches to health that advocate technical solutions to changing individual behavior. Ultimately, this construct acts as a political commentary on the limits of an individual-oriented harm reduction project when applied to the “Argentine context.” PMID:27182076
Leitch, Sharon; Wallis, Katharine A; Eggleton, Kyle S; Cunningham, Wayne K; Williamson, Martyn I; Lillis, Steven; McMenamin, Andrew W; Tilyard, Murray W; Reith, David M; Samaranayaka, Ari; Hall, Jason E
Background Knowing where and why harm occurs in general practice will assist patients, doctors, and others in making informed decisions about the risks and benefits of treatment options. Research to date has been unable to verify the safety of primary health care and epidemiological research about patient harms in general practice is now a top priority for advancing health systems safety. Objective We aim to study the incidence, distribution, severity, and preventability of the harms patients experience due to their health care, from the whole-of-health-system lens afforded by electronic general practice patient records. Methods “Harm” is defined as disease, injury, disability, suffering, and death, arising from the health system. The study design is a stratified, 2-level cluster, retrospective records review study. Both general practices and patients will be randomly selected so that the study’s results will apply nationally, after weighting. Stratification by practice size and rurality will allow comparisons between 6 study groups (large, medium-sized, small; urban and rural practices). Records of equal numbers of patients from each study group will be included in the study because there may be systematic differences in patient harms in different types of practices. Eight general practitioner investigators will review 3 years of electronic general practice health records (consultation notes, prescriptions, investigations, referrals, and summaries of hospital care) from 9000 patients registered in 60 general practices. Double-blinded reviews will check the concordance of reviewers’ assessments. Study data will comprise demographic data of all 9000 patients and reviewers’ assessments of whether patients experienced harm arising from health care. Where patient harm is identified, their types, preventability, severity, and outcomes will be coded using the Medical Dictionary for Regulatory Activities (MedDRA) 18.0. Results We have recruited practices and
Thomas, Kyla H; Davies, Neil; Metcalfe, Chris; Windmeijer, Frank; Martin, Richard M; Gunnell, David
Aims The UK Clinical Practice Research Datalink (CPRD) is increasingly being used to investigate suicide-related adverse drug reactions. No studies have comprehensively validated the recording of suicide and nonfatal self-harm in the CPRD. We validated general practitioners' recording of these outcomes using linked Office for National Statistics (ONS) mortality and Hospital Episode Statistics (HES) admission data. Methods We identified cases of suicide and self-harm recorded using appropriate Read codes in the CPRD between 1998 and 2010 in patients aged ≥15 years. Suicides were defined as patients with Read codes for suicide recorded within 95 days of their death. International Classification of Diseases codes were used to identify suicides/hospital admissions for self-harm in the linked ONS and HES data sets. We compared CPRD-derived cases/incidence of suicide and self-harm with those identified from linked ONS mortality and HES data, national suicide incidence rates and published self-harm incidence data. Results Only 26.1% (n = 590) of the ‘true’ (ONS-confirmed) suicides were identified using Read codes. Furthermore, only 55.5% of Read code-identified suicides were confirmed as suicide by the ONS data. Of the HES-identified cases of self-harm, 68.4% were identified in the CPRD using Read codes. The CPRD self-harm rates based on Read codes had similar age and sex distributions to rates observed in self-harm hospital registers, although rates were underestimated in all age groups. Conclusions The CPRD recording of suicide using Read codes is unreliable, with significant inaccuracy (over- and under-reporting). Future CPRD suicide studies should use linked ONS mortality data. The under-reporting of self-harm appears to be less marked. PMID:23216533
Rehman, Laurene; Gahagan, Jacqueline; DiCenso, Anne Marie; Dias, Giselle
Applying the principles of harm reduction within the context of incarcerated populations raises a number of challenges. Although some access to harm reduction strategies has been promoted in general society, a divide between what is available and what is advocated continues to exist within the prison system. This paper explores the perceptions and lived experiences of a sample of nationally incarcerated women in Canada regarding their perceptions and experiences in accessing HIV and Hepatitis C prevention, care, treatment and support. In-depth interviews were conducted with 156 women in Canadian national prisons. Q.S.R. Nudist was used to assist with data management. A constant comparison method was used to derive categories, patterns, and themes. Emergent themes highlighted a gap between access to harm reduction in policy and in practice. Despite the implementation of some harm reduction techniques, women in Canadian prisons reported variable access to both education and methods of reducing HIV/HCV transmission. Concerns were also raised about pre-and post-test counseling for HIV/HCV testing. Best practices are suggested for implementing harm reduction strategies within prisons for women in Canada.
Brocato, Jo; Wagner, Eric F.
Examines how social workers may reduce ethical conflicts associated with efforts to address substance abuse by adopting a harm reduction approach to policy, practice, and research. Also examines current drug policies and their consequences and, in particular, how these policies affect social workers as practitioners, agents of social control, and…
Shugar, Andrea L; Quercia, Nada; Trevors, Christopher; Rabideau, Marina M; Ahmed, Sohnee
With the increasing awareness of genetic contributions to disease in Canada, the availability of and demand for genetic testing has soared. Genetic counseling is becoming a recognized and rapidly growing (yet unregulated) health profession in Canada. We hypothesized that the potential risk for harm to the public posed by genetic counseling practice in the province of Ontario is sufficient to consider regulation. The Ontario Ministry of Health and Long-Term Care (MOHTLC) sets criteria (both primary and secondary) to identify health professional bodies that meet the threshold for regulation in the province. We developed a survey based on the MOHTLC criteria to determine if genetic counselors meet the primary criteria to be considered for health professions regulation in Ontario. We surveyed 120 Ontario genetic counselors about their clinical practice and perceptions of risk for harm to the public. Results indicate that Ontario genetic counselors are highly independent in their clinical practice and are involved in patient care activities, clinical judgement and decision-making that have the potential to harm patients. In particular, cancer genetic counselors were identified as a cohort that practices with relatively high autonomy and low supervision. In summary, our study indicates that genetic counseling practice in Ontario meets the primary criteria to be considered for regulation.
Seader, Mary Beth
In response to complaints by some birthparents who agreed to transfer their parental rights and obligations to adopting parents in the past, agencies and persons interested in adoption have reexamined their practices in an effort to be more responsive to the long-term needs of birthparents and children. Before entering into any discussion of a…
Fronczak, N.; Arifeen, S.E.; Moran, A.C.; Caulfield, L.E.; Baqui, A.H.
This paper describes associations among delivery-location, training of birth attendants, birthing practices, and early postpartum morbidity in women in slum areas of Dhaka, Bangladesh. During November 1993–May 1995, data on delivery-location, training of birth attendants, birthing practices, delivery-related complications, and postpartum morbidity were collected through interviews with 1,506 women, 489 home-based birth attendants, and audits in 20 facilities where the women from this study gave birth. Associations among maternal characteristics, birth practices, delivery-location, and early postpartum morbidity were specifically explored. Self-reported postpartum morbidity was associated with maternal characteristics, delivery-related complications, and some birthing practices. Dais with more experience were more likely to use potentially-harmful birthing practices which increased the risk of postpartum morbidity among women with births at home. Postpartum morbidity did not differ by birth-location. Safe motherhood programmes must develop effective strategies to discourage potentially-harmful home-based delivery practices demonstrated to contribute to morbidity. PMID:18402192
Fronczak, N; Arifeen, S E; Moran, A C; Caulfield, L E; Baqui, A H
This paper describes associations among delivery-location, training of birth attendants, birthing practices, and early postpartum morbidity in women in slum areas of Dhaka, Bangladesh. During November 1993-May 1995, data on delivery-location, training of birth attendants, birthing practices, delivery-related complications, and postpartum morbidity were collected through interviews with 1,506 women, 489 home-based birth attendants, and audits in 20 facilities where the women from this study gave birth. Associations among maternal characteristics, birth practices, delivery-location, and early postpartum morbidity were specifically explored. Self-reported postpartum morbidity was associated with maternal characteristics, delivery-related complications, and some birthing practices. Dais with more experience were more likely to use potentially-harmful birthing practices which increased the risk of postpartum morbidity among women with births at home. Postpartum morbidity did not differ by birth-location. Safe motherhood programmes must develop effective strategies to discourage potentially-harmful home-based delivery practices demonstrated to contribute to morbidity.
Maghuyop-Butalid, Roselyn; Mayo, Norhanifa A; Polangi, Hania T
This study determined the profile and birthing practices in both modern and traditional ways among Maranao traditional birth attendants (TBAs) in Lanao del Norte, Philippines. It employed a descriptive research design. The respondents were 50 Maranao TBAs selected through the snowball sampling technique. A questionnaire was developed by the researchers to identify the respondents' modern birthing practices utilizing the Essential Intrapartum and Newborn Care (EINC) Protocol. To determine their profile and traditional birthing practices, items from a previous study and the respondents' personal claims were adapted. This study shows that Maranao TBAs have less compliance to the EINC Protocol and they often practice the traditional birthing interventions, thus increasing the risk of complications to both mother and newborn.
Lawson, David W.; James, Susan; Ngadaya, Esther; Ngowi, Bernard; Mfinanga, Sayoki G. M.; Borgerhoff Mulder, Monique
Polygyny is cross-culturally common and a topic of considerable academic and policy interest, often deemed a harmful cultural practice serving the interests of men contrary to those of women and children. Supporting this view, large-scale studies of national African demographic surveys consistently demonstrate that poor child health outcomes are concentrated in polygynous households. Negative population-level associations between polygyny and well-being have also been reported, consistent with the hypothesis that modern transitions to socially imposed monogamy are driven by cultural group selection. We challenge the consensus view that polygyny is harmful, drawing on multilevel data from 56 ethnically diverse Tanzanian villages. We first demonstrate the vulnerability of aggregated data to confounding between ecological and individual determinants of health; while across villages polygyny is associated with poor child health and low food security, such relationships are absent or reversed within villages, particularly when children and fathers are coresident. We then provide data indicating that the costs of sharing a husband are offset by greater wealth (land and livestock) of polygynous households. These results are consistent with models of polygyny based on female choice. Finally, we show that village-level negative associations between polygyny prevalence, food security, and child health are fully accounted for by underlying differences in ecological vulnerability (rainfall) and socioeconomic marginalization (access to education). We highlight the need for improved, culturally sensitive measurement tools and appropriate scales of analysis in studies of polygyny and other purportedly harmful practices and discuss the relevance of our results to theoretical accounts of marriage and contemporary population policy. PMID:26504213
The author asks for the attention of leaders and all other stakeholders to calls of the World Health Organization (WHO), the Institute of Medicine (IOM), and the UK National Health Service (NHS) to promote continuous learning to reduce harm to patients. This paper presents a concept for structured bottom-up methodology that enables and empowers all stakeholders to identify, prioritize, and address safety challenges. This methodology takes advantage of the memory of the experiences of all persons involved in providing care. It respects and responds to the uniqueness of each setting by empowering and motivating all team members to commit to harm reduction. It is based on previously published work on “Best Practices Research (BPR)” and on “Systematic Appraisal of Risk and Its Management for Error Reduction (SARAIMER)”. The latter approach, has been shown by the author (with Agency for Healthcare Research and Quality (AHRQ) support), to reduce adverse events and their severity through empowerment, ownership and work satisfaction. The author puts forward a strategy for leaders to implement, in response to national and international calls for Better health, Better care, and Better value (the 3B’s of healthcare) in the US Patient Protection and Affordable Care Act. This is designed to enable and implement “ A promise to learn- a commitment to act”. AHRQ has recently published “A Toolkit for Rapid-Cycle Patient Safety and Quality Improvement” that includes an adapted version of SARAIMER. PMID:24715965
The author asks for the attention of leaders and all other stakeholders to calls of the World Health Organization (WHO), the Institute of Medicine (IOM), and the UK National Health Service (NHS) to promote continuous learning to reduce harm to patients. This paper presents a concept for structured bottom-up methodology that enables and empowers all stakeholders to identify, prioritize, and address safety challenges. This methodology takes advantage of the memory of the experiences of all persons involved in providing care. It respects and responds to the uniqueness of each setting by empowering and motivating all team members to commit to harm reduction. It is based on previously published work on "Best Practices Research (BPR)" and on "Systematic Appraisal of Risk and Its Management for Error Reduction (SARAIMER)". The latter approach, has been shown by the author (with Agency for Healthcare Research and Quality (AHRQ) support), to reduce adverse events and their severity through empowerment, ownership and work satisfaction. The author puts forward a strategy for leaders to implement, in response to national and international calls for Better health, Better care, and Better value (the 3B's of healthcare) in the US Patient Protection and Affordable Care Act. ( )This is designed to enable and implement " A promise to learn- a commitment to act". AHRQ has recently published "A Toolkit for Rapid-Cycle Patient Safety and Quality Improvement" that includes an adapted version of SARAIMER.
Nhalevilo, Emilia Afonso
This paper is a response to Maria Andree's paper. Andree tells in the paper how mistakes in practical lessons may be critical events to change students' attitudes in regard science. While traditionally mistakes in practical lessons could obligate students to repeat the experiment in order to get the `right result' in the paper we have a good example how we can use the incident to potentiate students' participation. In my response I illustrate how transferable is what Andree speaks about but I put forward further reflections about the traditions that may act as impediment for students' participation. I thus suggest that the critical paradigm should be a component in reflecting about science classroom practices in order to alter the traditions.
Maeve, M K; Vaughn, M S
The number of incarcerated persons in the United States has been increasing dramatically over the last two decades. Incarcerated men and women have increased rates of serious and chronic physical and mental illnesses and therefore require substantial health care efforts. Caring for prisoners is a difficult and often unrewarding experience for health care providers, particularly within a social climate that encourages noncaring behaviors. This article critically analyzes three philosophic stances toward nursing care with prisoners and suggests their philosophic commensurability within traditional nursing practice. Implications for nursing practice, research, and education are discussed.
Soltani Arabshahi, SeyyedKamran; Mohammadi Kenari, Hoorieh; Kordafshari, Gholamreza; Shams-Ardakani, MohammadReza; Bigdeli, Shoaleh
The major difference between Iranian traditional medicine and allopathic medicine is in the application of evidence and documents. In this study, criteria for evidence-based practice in Iranian traditional medicine and its rules of practice were studied. The experts' views were investigated through in- depth, semi-structured interviews and the results were categorized into four main categories including Designing clinical questions/clinical question-based search, critical appraisal, resource search criteria and clinical prescription appraisal. Although the application of evidence in Iranian traditional medicine follows Evidence Based Medicine (EBM) principles but it benefits from its own rules, regulations, and criteria that are compatible with EBM.
Intersex people and bodies have been considered incapable of integration into society. Medical interventions on often healthy bodies remain the norm, addressing perceived familial and cultural demands, despite concerns about necessity, outcomes, conduct and consent. A global and decentralised intersex movement pursues simple core goals: the rights to bodily autonomy and self-determination, and an end to stigmatisation. The international human rights system is responding with an array of new policy statements from human rights institutions and a handful of national governments recognising the rights of intersex people. However, major challenges remain to implement those statements. Human rights violations of intersex individuals persist, deeply embedded in a deliberate history of silencing. Rhetoric of change to clinical practices remain unsubstantiated. Policy disjunctions arise in a framing of intersex issues as matters of sexual orientation and gender identity, rather than innate sex characteristics; this has led to a rhetoric of inclusion that is not matched by the reality. This paper provides an overview of harmful practices on intersex bodies, human rights developments, and rhetorics of change and inclusion.
Morris, Jessica L; Short, Samm; Robson, Laura; Andriatsihosena, Mamy Soafaly
Contextualising maternal health in countries with high maternal mortality is vital for designing and implementing effective health interventions. A research project was therefore conducted to explore practices, beliefs and traditions around pregnancy, delivery and postpartum in southeast Madagascar. Interviews and focus groups were conducted with 256 pregnant women, mothers of young children, community members and stakeholders; transcripts were analysed to identify and explore predetermined and emerging themes. A questionnaire was also conducted with 373 women of reproductive age from randomly selected households. Data was analysed using STATA. Results confirmed high local rates of maternal mortality and morbidity and revealed a range of traditional health care practices and beliefs impacting on women's health seeking behaviours. The following socio-cultural barriers to health were identified: 1) lack of knowledge, 2) risky practices, 3) delays seeking biomedical care, and 4) family and community expectations. Recommendations include educational outreach and behaviour change communications targeted for women, their partners and family, increased engagement with traditional midwives and healers, and capacity building of formal health service providers.
Watson, Tara Marie; Strike, Carol; Challacombe, Laurel; Demel, Geoff; Heywood, Diana; Zurba, Nadia
Through promotion of consistent, evidence-based policy and practice, best practice recommendations can improve service delivery. Nationally relevant best practice recommendations, including guidance for programmes that provide service to people who use drugs, are often created and disseminated by government departments or other national organisations. However, funding priorities do not always align with stakeholder- and community-identified needs for such recommendations, particularly in the case of harm reduction. We achieved success in developing and widely disseminating best practice documents for Canadian harm reduction programmes by bringing together a multi-stakeholder, cross-regional team of people with relevant and diverse experience and expertise. In this commentary, we summarise key elements of our experience to contribute to the literature more detailed and transparent dialogue about team processes that hold much promise for developing best practice resources. We describe our project's community-based principles and process of working together (e.g., regularly scheduled teleconferences to overcome geographic distance and facilitate engagement), and integrate post-project insights shared by our team members. Although we missed some opportunities for power-sharing with our community partners, overall team members expressed that the project offered them valuable opportunities to learn from each other. We aim to provide practical considerations for researchers, other stakeholders, and community members who are planning or already engaged in a process of developing best practice recommendations for programmes and interventions that address drug use.
In recent years, a number of researchers and social critics have cautioned against the widespread application of behavioral interventions on the grounds that the philosophy of behaviorism is fundamentally manipulative and damaging to creative and intrinsically motivated behavior. Most central to their arguments are concerns about the harmful effects of "extrinsic" rewards. Though concerns about the allegedly harmful effects of "rewards" on intrinsically motivated actions may have been partially allayed by a recent meta-analysis, proponents of the view that intrinsic interest is eroded by the delivery of contingent rewards will likely continue to attest to the dangers of operant conditioning and its application to human behavior. The present manuscript addresses the content of claims about the harmful effects of extrinsic rewards. While consideration is given to the existing behavior therapy literature and its treatment of "natural" versus "arbitrary" rewards, some surprising convergences between the views of self-determination theorists and behavioral practitioners are noted.
Mitchell, A J; Dennis, M
Self harm is a complex behaviour that can be best thought of as a maladaptive response to acute and chronic stress, often but not exclusively linked with thoughts of dying. Patients presenting with self harm usually have current psychosocial difficulties, are likely to be suffering from mental health problems, and are at significant risk of further self harm and suicide. Recent guidelines suggest that all self harm attendees should receive an initial risk assessment at triage in the emergency department. A more detailed mental health assessment and an assessment of psychological and social needs should then be performed by trained staff, ideally specialist mental professionals experienced in this area. Risk of subsequent suicide is particularly high in those with high unresolved suicidal intent, depressive disorder, chronic alcohol and drug misuse, social isolation, and current physical illness. Patients with one or more of these risk factors should be offered enhanced care that may include inpatient or outpatient follow up care, a list of local support resources, and, where possible, self help material. Frequent repeaters, those with alcohol and substance use problems, those with physical or mental illness, and those who are isolated also require input from specialist mental health professionals. It is also recommended that adolescents and elderly people warrant a mandatory specialist assessment.
Zhang, Chun-hong; Zhao, Zhi-ying; Hasi, Ba-te-er; Li, Zhen-hua; Wu, Mao-mao; Zou, De-zhi; Li, Min-hui
Mongolian folk medicine, the important part of Mongolian medicine, is the main means, method and weapon of disease prevention, treatment and health care. Mongolian materia medicas are the important literatures of guiding the healthy development of the modern Mongolian medicine with a long and dazzling history. Since the founding of new China, a new history chapter of Mongolian folk medicine was opened under the attention and support from all levels of party and government. This paper intends to provide comprehensive insight into the rapid development of Mongolian folk medicine. The resources, phytochemistry, quality standard, pharmacology, dosage forms reform and production were reviewed to expound the process that Mongolian folk medicine was developed from traditional practices to scientific development
Harmful alcohol consumption can have severe consequences for both the individual and society. A review of the six published studies on the effectiveness of general practitioner interventions for individuals with harmful alcohol consumption suggests that between five and 10 minutes of advice leads to reductions of alcohol consumption of around 25-35% at follow up six months or one year later. Two of the three studies which failed to demonstrate an intervention effect had inadequate sample sizes and in two of the studies the control group was a comparison group which received minimal advice to reduce alcohol consumption. There was greater evidence for an intervention effect among men than women. The methodological problems of the studies are discussed. PMID:8251237
Kamarulzaman, A; Saifuddeen, S M
Although drugs are haram and therefore prohibited in Islam, illicit drug use is widespread in many Islamic countries throughout the world. In the last several years increased prevalence of this problem has been observed in many of these countries which has in turn led to increasing injecting drug use driven HIV/AIDS epidemic across the Islamic world. Whilst some countries have recently responded to the threat through the implementation of harm reduction programmes, many others have been slow to respond. In Islam, The Quran and the Prophetic traditions or the Sunnah are the central sources of references for the laws and principles that guide the Muslims' way of life and by which policies and guidelines for responses including that of contemporary social and health problems can be derived. The preservation and protection of the dignity of man, and steering mankind away from harm and destruction are central to the teachings of Islam. When viewed through the Islamic principles of the preservation and protection of the faith, life, intellect, progeny and wealth, harm reduction programmes are permissible and in fact provide a practical solution to a problem that could result in far greater damage to the society at large if left unaddressed.
Proske, Antje; Roscoe, Rod D.; McNamara, Danielle S.
Achieving sustained student engagement with practice in computer-based writing strategy training can be a challenge. One potential solution is to foster engagement by embedding practice in educational games; yet there is currently little research comparing the effectiveness of game-based practice versus more traditional forms of practice. In this…
Liu, Dahui; Huang, Luqi; Guo, Lanping; Shao, Aijuan; Chen, Meilan
The bionic cultivation of medicinal plant is an ecological cultivation pattern, which is adopting ecological engineering and modern agricultural techniques to simulate the natural ecosystem of wild medicinal plant community, and has been given greater attention on the agriculture of traditional Chinese medicine (TCM). It is also the cross subject that combines Chinese traditional medicine, agronomy, horticulture, ecology, agricultural engineering and management. Moreover, it has significant technology advantages of promoting the sustainable utilization of medicinal plant resources, improving the ecological environment and harmonizing man and nature. So it's important to develop the bionic cultivation of TCM.
Varol, Nesrin; Fraser, Ian S; Ng, Cecilia H M; Jaldesa, Guyo; Hall, John
Globally, the prevalence of, and support for, female genital mutilation/cutting (FGM/C) is declining. However, the entrenched sense of social obligation that propagates the continuation of this practice and the lack of open communication between men and women on this sensitive issue are two important barriers to abandonment. There is limited evidence on the role of men and their experiences in FGM/C. Marriageability of girls is considered to be one of the main driving forces for the continuation of this practice. In some countries, more men than women are advocating to end FGM/C. Moreover, men, as partners to women with FGM/C, also report physical and psychosexual problems. The abandonment process involves expanding a range of successful programs, addressing the human rights priorities of communities and providing power over their own development processes. Anecdotal evidence exists that FGM/C is practised amongst African migrant populations in Australia. The Australian Government supports a taskforce to improve community awareness and education, workforce training and evidence building. Internationally, an African Coordinating Centre for abandonment of FGM/C has been established in Kenya with a major global support group to share research, promote solidarity, advocacy and implement a coordinated and integrated response to abandon FGM/C.
Condie, Rae; Livingston, Kay
Considerable claims have been made for the development of e-learning, either as stand-alone programmes or alongside more traditional approaches to teaching and learning, for students across school and tertiary education. National initiatives have improved the position of schools in terms of access to hardware and electronic networking, software…
Chait, Richard P.; Ford, Andrew T.
Based on information gathered in a survey of senior academic administrators and from in-depth, on-site interviews with faculty, staff, and trustees on campuses across the United States, the successes and failures of principal academic personnel--traditional tenure, tenure with modifications, and nontenure term-contract systems--are described.…
Goh, Joel; Pfeffer, Jeffrey; Zenios, Stefanos
The existence of important socioeconomic disparities in health and mortality is a well-established fact. Many pathways have been adduced to explain inequality in life spans. In this article we examine one factor that has been somewhat neglected: People with different levels of education get sorted into jobs with different degrees of exposure to workplace attributes that contribute to poor health. We used General Social Survey data to estimate differential exposures to workplace conditions, results from a meta-analysis that estimated the effect of workplace conditions on mortality, and a model that permitted us to estimate the overall effects of workplace practices on health. We conclude that 10-38 percent of the difference in life expectancy across demographic groups can be explained by the different job conditions their members experience.
Banerjee, Sohini; Chowdhury, Arabinda Narayan; Schelling, Esther; Weiss, Mitchell G.
The toxicological impact and intentional ingestion of pesticides are major public health concerns globally. This study aimed to estimate the extent of deliberate self-harm (DSH) and suicides (suicidal behaviour) and document pesticide practices in Namkhana block of the Sundarban region, India. A cross-sectional study was conducted in 1680 households (21 villages) following a mixed random and cluster design sampling. The survey questionnaire (Household Information on Pesticide Use and DSH) was developed by the research team to elicit qualitative and quantitative information. The Kappa statistic and McNemar's test were used to assess the level of agreement and association between respondents' and investigators' opinions about safe storage of pesticides. Over five years, 1680 households reported 181 incidents of suicidal behaviour. Conflict with family members was the most frequently reported reason for suicidal behaviour (53.6%). The Kappa statistic indicated poor agreement between respondents and investigators about safe storage of pesticides. The pesticide-related annual DSH rate was 158.1 (95% CI 126.2–195.5), and for suicide it was 73.4 (95% CI 52.2–100.3) per 100,000. Unsafe pesticide practice and psychosocial stressors are related to the high rates of suicidal behaviour. An intersectoral approach involving the local governments, agricultural department and the health sector would help to reduce the magnitude of this public health problem. PMID:24224181
Heydarirad, Ghazaleh; Choopani, Rasool; Mehdi, Pasalar; Jafari, Jamileh Mahdavi
Background: Mucilage compounds are pharmaceutically important polysaccharides that have an extensive range of applications, including binding agents, thickeners, water retention agents, emulsion stabilizers, suspending agents, disintegrates, film formers, and gelling agents. A historical approach to medical science written by Iranian scholars could help in identifying excellent ideas and provide valuable information in this field for proper application. The aim of the current study was to introduce some mucilage uses derived from traditional Persian medicine (TPM). Methods: In this literature review, we assessed a few main traditional manuscripts of Iranian medicine, including the books Al Havi, Canon of Medicine, Qarabadine-kabir, Zakhireh-ye Khwarazm shahi, Tuhfat ul-Momineen and Makhzan-ul-Adwiah. The word “loab” in the aforementioned books were searched and all data about mucilage compounds were collected. Results: The use of medicinal plants containing mucilage in Iran dates back to ancient times. In traditional Persian manuscripts, mucilage is one of the most cited applications of medicinal plants for therapeutic objectives. There are various mucilage-producing plants in TPM such as Malva silvestris, Linum usitissimum, Althaea officinalis, Plantago psyllium, Descureania sophia and Ziziphus vulgaris. They have been used traditionally via oral or topical routes for respiratory, gastrointestinal, urinary, musculoskeletal, and genital systems as well as skin disorders. Certain applications are unique and promising for today’s chronic ailments. Conclusion: A scientific assessment of these valuable manuscripts would provide a better insight into the thoughts of the past sages and applicable for clinical use of the mucilage compounds. This may lead to research opportunities in the future. PMID:27840507
Heydarirad, Ghazaleh; Choopani, Rasool; Mehdi, Pasalar; Jafari, Jamileh Mahdavi
Background: Mucilage compounds are pharmaceutically important polysaccharides that have an extensive range of applications, including binding agents, thickeners, water retention agents, emulsion stabilizers, suspending agents, disintegrates, film formers, and gelling agents. A historical approach to medical science written by Iranian scholars could help in identifying excellent ideas and provide valuable information in this field for proper application. The aim of the current study was to introduce some mucilage uses derived from traditional Persian medicine (TPM). Methods: In this literature review, we assessed a few main traditional manuscripts of Iranian medicine, including the books Al Havi, Canon of Medicine, Qarabadine-kabir, Zakhireh-ye Khwarazm shahi, Tuhfat ul-Momineen and Makhzan-ul-Adwiah. The word “loab” in the aforementioned books were searched and all data about mucilage compounds were collected. Results: The use of medicinal plants containing mucilage in Iran dates back to ancient times. In traditional Persian manuscripts, mucilage is one of the most cited applications of medicinal plants for therapeutic objectives. There are various mucilage-producing plants in TPM such as Malva silvestris, Linum usitissimum, Althaea officinalis, Plantago psyllium, Descureania sophia and Ziziphus vulgaris. They have been used traditionally via oral or topical routes for respiratory, gastrointestinal, urinary, musculoskeletal, and genital systems as well as skin disorders. Certain applications are unique and promising for today’s chronic ailments. Conclusion: A scientific assessment of these valuable manuscripts would provide a better insight into the thoughts of the past sages and applicable for clinical use of the mucilage compounds. This may lead to research opportunities in the future. PMID:27516674
Background Bapedi traditional healers play a vital role in the primary health care of rural inhabitants in the Limpopo Province, South Africa. However, literature profiling their social and demographic variables, as well as their traditional healing practices is lacking. Methods Convenience sampling were used to identify and select two traditional healers from 17 municipalities (resulting in 34 healers being used in this pilot survey) of the Limpopo Province in South Africa. Information on the social and demographic variables, and traditional healing practices of these healers was gathered from January 2013 to July 2013, using a semi-structured questionnaire, supplemented by field surveys for plant identification and collection used in the preparation of remedies. Results Males constituted nearly two-thirds of the participants. Forty eight percent of them became healers through the mentoring of another healer, while 38% acquired their traditional healing knowledge from parents and 14% from grandparents. In contrast to this, 62% of the females obtained theirs from their parents, 30% from fellow traditional healers, and 8% from grandparents. A total of 154 plant species were indicated as used by healers in the treatment of 52 health-related problems. A vast majority (89%) of these practitioners reported that prepared herbal remedies do expire, which is a temperature-dependent process. Determinations of the efficacy of remedies by most healers (67%) were via consultation with ancestors (90%). This study also found that none of the interviewees had any knowledge of provincial or national environmental legislation. Conclusions The current study has shown that Bapedi traditional healers could play a leading role in both the preservation of indigenous knowledge and the primary health care sector. However, of concern is the traditional methods (via consulting ancestors) employed by most of these healers in determining efficacy of remedies, thus indicating a need for a
Sorensen, Barbara Ellen
Indigenous people have always created what colonial language labels art. Yet there is no Native word for "art" as defined in a Euro-American sense. Art, as the dominant culture envisions, is mostly ornamental. This is in sharp juxtaposition to a Native perspective, which sees art as integrative, inclusive, practical, and constantly…
Hillman, George Milton, Jr.
The purpose of this study was to determine differences in Leadership Practices Inventory (LPI-Self) scores between masters-level seminary students based on the independent variables of student age, class load, gender, marital status, and parental status. The 1,254 masters-level seminary students enrolled on the main campus of Dallas Theological…
Inuwa, Ibrahim Muhammad; Taranikanti, Varna; Al-Rawahy, Maimouna; Habbal, Omar
Practical examinations in anatomy are usually conducted on specimens in the anatomy laboratory (referred to here as the "traditional" method). Recently, we have started to administer similar examinations online using the quiz facility in Moodle™. In this study, we compare student scores between two assessment environments viz. online and traditional environments. We hypothesized that regardless of the examination medium (traditional or online) overall student performance would not be significantly different. For the online medium, radiological images, prosected specimens, and short video clips demonstrating muscle action were first acquired from resources used for teaching during anatomy practical classes. These were optimized for online viewing and then uploaded onto Moodle learning management software. With regards to the traditional format, actual specimens were usually laid out in a circular stream. Identification tags were then attached to specific spots on the specimens and questions asked regarding those identified spots. A cohort of students taking practical examinations in six courses was studied. The courses were divided into three pairs with each pair credit-weight matched. Each pair consisted of a course where the practical examination was conducted online and the other in the traditional format. There was no significant difference in the mean scores within each course pair. In addition, a significant positive correlation between score in traditional and online formats was found. We conclude that mean grades in anatomy practical examination conducted either online or in the traditional format were comparable. These findings should reassure teachers intending to use either format for their practical examinations.
Snow, Loudell F.
The medical belief system of lower class black Americans reflects their social, political and economic marginality in the larger society. A moderate life-style is regarded as the basis for good health with special emphasis on protecting one's body from cold, keeping it clean inside and out and maintaining a proper diet. Illnesses and other life events are classified as “natural” or “unnatural.” Natural illnesses result from the effects of cold, dirt and improper diet on the body causing changes in the blood. A number of beliefs about blood and its functions have important clinical implications for the treatment of hypertension and venereal disease and for family planning. Natural illnesses also result from divine punishment and serve as an instrument of social control. Unnatural illnesses are the result of witchcraft and reflect conflict in the social network. It is believed that physicians do not understand and cannot effectively treat such illnesses, but a variety of traditional healers offer help to the victims. Physicians must elicit such beliefs if they are to interact effectively and sensitively with black patients. Social change is required, however, to eliminate the feelings of powerlessness at the root of many of the health problems of poor black Americans. PMID:6364570
Hodes, R M; Teferedegne, B
In an attempt to assess concepts of disease, we questioned 33 Ethiopian Jews (Falashas) in Ethiopia about 13 diseases: 8 western and 5 cultural syndromes (in the Amharic language): birrd (cold), wugat (stabbing chest pain), moygnbagegn (neurologic disorder), mitch (sunstroke), and attent hono kere (retained fetus becoming bone). Disease causation was often attributed to spirits and the sun. None of the interviewees understood the cause of: a) epilepsy, most attributing it to spirits and recommending smelling match smoke as treatment, b) prolonged labor, attributed by most to the evil kole spirit and is managed by traditional birth attendants; and c) abortion, believed to be caused by exposure to sun or cold. Less than 20% linked malaria to mosquitoes. Most correlated splenomegaly with malaria. Hepatitis was believed to be caused by a bird or bat flying around the affected person. Multiple factors were linked to diarrhea, including a journey in the sun. Moygnbagegn is the only condition treated by venisection from brachial veins; wugat is treated by "cupping". Modern medicine was recommended by < 30% of those questioned for epilepsy, splenomegaly, hepatitis, and Ethiopian cultural diseases. It was recommended most for malaria (52%), sexually transmitted diseases (55%), and diarrhea (69%).
Rieu, Le Tai
This paper discusses superstitious, folk, traditional, and modern medical practices of Vietnam. Concepts of illness, somatization, behavior labeling, diagnostic attempts, and attitudes toward treatment among Vietnamese are also reviewed. (APM)
Mzimkulu, Kanyiswa G.; Simbayi, Leickness C.
The aim of this study was to investigate perspectives and practices of Xhosa-speaking African traditional healers, known as "amagqirha", in managing psychosis. Four traditional healers, 3 male and one female, were chosen to take part in the study through their association with psychosis patients undergoing treatment at a South African…
Ammons, Michael Edward
This non-experimental, regression study examined the relationship between leadership practices and academic achievement for a non-traditional student population. The study was conducted at a small, four-year private college in Eastern North Carolina. The sample consisted of N = 146 (73 male, 73 female) non-traditional students enrolled in an…
Farooqi, Yasmin Nilofer
This research explored the type of traditional healing practices sought by Muslim psychiatric patients treated at public hospitals of Lahore city, Pakistan. The sample comprised 87 adult psychiatric patients (38% male and 62% female). The patients self-reported on the Case History Interview Schedule that they had sought diverse traditional healing…
Normand, Jacques; Li, Jih-Heng; Thomson, Nicholas; Jarlais, Don Des
The “Harm Reduction” session was chaired by Dr. Jacques Normand, Director of the AIDS Research Program of the U.S. National Institute on Drug Abuse. The three presenters (and their presentation topics) were: Dr. Don Des Jarlais (High Coverage Needle/Syringe Programs for People Who Inject Drugs in Low and Middle Income Countries: A Systematic Review), Dr. Nicholas Thomson (Harm Reduction History, Response, and Current Trends in Asia), and Dr. Jih-Heng Li (Harm Reduction Strategies in Taiwan). PMID:25278732
Buchwald, D.; Panwala, S.; Hooton, T. M.
To determine the prevalence of use of traditional health practices among different ethnic groups of Southeast Asian refugees after their arrival in the United States, we conducted a convenience sample of 80 Cambodian, Lao, Mien, and ethnic Chinese patients (20 each) attending the University of Washington Refugee Clinic for a new or follow-up visit. Interpreters administered a questionnaire that dealt with demographics, medical complaints, traditional health practices, health beliefs, and attitudes toward Western practitioners. In all, 46 (58%) patients had used one or more traditional health practices, but the prevalence varied by ethnic group. Coining and massage were used by all groups except the Mien, whereas moxibustion and healing ceremonies were performed almost exclusively by the Mien. Traditional health practices were used for a variety of symptoms and, in 78% of reported uses, patients reported alleviation of symptoms. The use of traditional health practices is common among Southeast Asian refugees. Clinicians who care for this population should be aware of these practices because they may supersede treatments prescribed by physicians or leave cutaneous stigmata that may be confused with disease or physical abuse. Good patient care may necessitate the use or tolerance of both Western and traditional modalities in many Southeast Asian refugees. Images PMID:1595275
Rovin, S; Nash, J
The traditional and predominant manner of delivering dental care is through a fee-for-service, private practice system. A number of alternative dental care delivery systems have emerged and are being tested, and others are just emerging. These systems include department store practices, hospital dental services, health maintenance organizations, the independent practice of dental hygiene, and denturism. Although it is too soon to draw final conclusions about the efficacy and effectiveness of these systems, we examine them for their potential to compete with and change the way dental care is currently delivered. Using the parameters of cost, accessibility, and quality, we compare these systems to traditional dental practice. Some of these emerging forms clearly have the potential to complete favorably with traditional practice. Other seem less likely to alter the existing system substantially. The system which can best control costs, increase accessibility, and enhance quality will gain the competitive edge. PMID:7091453
Naranjo-Gil, David; Sánchez-Expósito, María Jesús; Gómez-Ruiz, Laura
Public health policies must address multiple goals and complex community health needs. Recently, management control practices have emerged to provide a broader type of information for evaluating the effectiveness of healthcare policies, and relate activities and processes to multiple strategic outcomes. This study compares the effect of traditional and contemporary management control practices on the achievement of public health policies. It is also analyzed how two different uses of such practices (enabling vs. coercive) facilitate the achievement of public health policies. Relationships are explored using data collected from managers from public health agencies and public hospitals in Spain. The findings show that contemporary management control practices are more suitable than traditional practices to achieve public health policies. Furthermore, results show that public health policies are better achieved when managers use management control practices in an enabling way rather than in a coercive way.
Naranjo-Gil, David; Sánchez-Expósito, María Jesús; Gómez-Ruiz, Laura
Public health policies must address multiple goals and complex community health needs. Recently, management control practices have emerged to provide a broader type of information for evaluating the effectiveness of healthcare policies, and relate activities and processes to multiple strategic outcomes. This study compares the effect of traditional and contemporary management control practices on the achievement of public health policies. It is also analyzed how two different uses of such practices (enabling vs. coercive) facilitate the achievement of public health policies. Relationships are explored using data collected from managers from public health agencies and public hospitals in Spain. The findings show that contemporary management control practices are more suitable than traditional practices to achieve public health policies. Furthermore, results show that public health policies are better achieved when managers use management control practices in an enabling way rather than in a coercive way. PMID:27428985
Choudhry, U K
This article describes maternal and child care practices among women from India. As in all cultures, certain beliefs exist surrounding what facilitates a good pregnancy and its outcome, as well as negative sanctions. These practices continue to influence many immigrant women to whom western practices are either unknown or unacceptable. An understanding of the traditional belief system of such women can case their adaptation into the Canadian and U.S. health care systems.
Shin, Hyeun-Kyoo; Jeong, Soo-Jin; Ernst, Edzard
Abstract Objective To investigate adverse events attributed to traditional medical treatments in the Republic of Korea. Methods Adverse events recorded in the Republic of Korea between 1999 and 2010 – by the Food and Drug Administration, the Consumer Agency or the Association of Traditional Korean Medicine – were reviewed. Records of adverse events attributed to the use of traditional medical practices, including reports of medicinal accidents and consumers’ complaints, were investigated. Findings Overall, 9624 records of adverse events attributed to traditional medical practices – including 522 linked to herbal treatments – were identified. Liver problems were the most frequently reported adverse events. Only eight of the adverse events were recorded by the pharmacovigilance system run by the Food and Drug Administration. Of the 9624 events, 1389 – mostly infections, cases of pneumothorax and burns – were linked to physical therapy (n = 285) or acupuncture/moxibustion (n = 1104). Conclusion In the Republic of Korea, traditional medical practices often appear to have adverse effects, yet almost all of the adverse events attributed to such practices between 1999 and 2010 were missed by the national pharmacovigilance system. The Consumer Agency and the Association of Traditional Korean Medicine should be included in the national pharmacovigilance system. PMID:23940404
The health cultivation qigong exercise in traditional Chinese medicine refers to a traditional, integrated method of illness prevention and body strengthening, which promotes the functions of qi and the blood, smooths the meridians (energy channels), and balances the viscera and bowels through the regulation of the mind, the breathing, and the body. The concept of using qi to cultivate human life is part of the health cultivation practices of ancient Chinese codes and of Chinese medicine. This concept includes the principles, methods, essences, and clinical applications of the practice. In addition, traditional health cultivation references the concepts of yinyang, viscera and bowels, qi and blood, meridians, and essential energy spirit theory in order to explain the human biological phenomena, the theoretical and practical perspectives of qigong, and the basis of the treatment principle. The health cultivation qigong exercise of Chinese medicine utilizes the concept of the "unity of nature and human beings" in traditional Chinese thinking in its practice, which emphasizes the conformity to nature and seasons. In order to fully leverage the benefits from the purpose of health cultivation in qigong practice, the priority is to understand the health cultivation mechanism, the essentials/matters, and the precautions of qigong practices. Recently, the evidence regarding both the biological and the psychological benefits of qigong practices have been demonstrated in numbers of research articles. In particular, qigong is currently considered to be one of the best mild exercises that is suited to all age groups. Professional nurses are suggested to include the health cultivation qigong exercise as part of activities that target health improvement and illness prevention. Due to the diversity in qigong as practiced by different health cultivation qigong exercise sects, it is essential to accumulate more clinical evidence by conducting greater numbers of rigorous studies
Inuwa, Ibrahim Muhammad; Taranikanti, Varna; Al-Rawahy, Maimouna; Habbal, Omar
Practical examinations in anatomy are usually conducted on specimens in the anatomy laboratory (referred to here as the "traditional" method). Recently, we have started to administer similar examinations online using the quiz facility in Moodle[TM]. In this study, we compare student scores between two assessment environments viz. online and…
This article explores the practical implication of adopting critical pedagogy, and more specifically critical legal pedagogy, in the teaching of non-traditional students in higher education context. It is based on the teaching of criminal law at Birkbeck School of Law, addressing learning tasks which have been designed to enhance students'…
DeMauro, Tom; Helphrey, Traci; Schram, Greg; Spiekermann, Carrie
This paper describes a program designed to compare students' attitudes towards the use of traditional and alternative assessment practices. The targeted population consisted of a second and third grade general education class, a third grade physical education class, and an eighth grade applied technology class in three communities in northern…
Supriya, K E
In Nigeria since 1987, the National Association of Nigeria Nurses and Midwives (NSNNM) has used traditional medial and traditional health care workers to curtail the practice of female circumcision. Other harmful traditions are being changed also, such as early marriage, taboos of pregnancy and childbirth, and scarification. 30,000 member of NANNM are involved in this effort to halt the harmful practices themselves and to change community opinion. The program involved national and state level workshops on harmful health consequences of traditional practices and instruction on how to conduct focus group discussions to assess women's beliefs and practices. The focus groups were found to be a particularly successful method of opening up discussion of taboo topics and expressing deep emotions. The response to the knowledge that circumcision was not necessary was rage and anger, which was channeled into advocacy roles or change in the practice. The result was the channeled into advocacy roles for change in the practice. The result was the development of books, leaflets and videos. One community group designed a dress with a decorative motif of tatoos and bodily cuts to symbolize circumcision and scarring. Plays and songs were written and performed. Artists provided models of female genitalia both before and after circumcision. The campaign has been successful in bringing this issue to the public attention in prominent ways, such a national television, health talk shows, and women;s magazines. One of the most important results of the effort has been the demonstration that culture and tradition can be changed from within, rather than from outside imposition of values and beliefs.
Pickering, Stephen R
The traditional group practice model can take many forms, including general practitioners, specialists, and combinations, as well as solo practitioners sharing space and staff, partnerships, and other legal entities. These practices may share some or all staff functions, including contracting for some functions. The essential characteristic is that those treating patients also have full control over and often direct management of the business aspects of the practice. The most important requirements for success in this model may be a common philosophy of patient care and mutual trust regarding business matters.
The current emphasis on skilled attendants as a means to reduce maternal mortality contributes to a discouraging policy environment for traditional birth attendants (TBAs). They continue to attend a significant number of births, however, such that their role and the policies and practices affecting their work remain important to understanding maternity health care and maternal health in the global South. In this article, I examine the policies and practices governing community elders practicing as TBAs in rural northern Uganda. This discussion is relevant to health workers in developing countries and to scholars in fields such as women's studies, sociology, and public health.
Background Traditional medicine in India can be classified into codified (Ayurveda, Unani, Siddha, Homeopathy) and non-codified (folk medicine) systems. Both the systems contributing equally to the primary healthcare in India. The present study is aimed to understand the current scenario of medicinal practices of non-codified system of traditional medicine in Belgaum region, India. Methods The study has been conducted as a basic survey of identified non-codified traditional practitioners by convenience sampling with semi structured, open ended interviews and discussions. The learning process, disease diagnosis, treatment, remuneration, sharing of knowledge and socio-demographic data was collected, analysed and discussed. Results One hundred and forty traditional practitioners were identified and interviewed for the present study. These practitioners are locally known as “Vaidya”. The study revealed that the non-codified healthcare tradition is practiced mainly by elderly persons in the age group of 61 years and above (40%). 73% of the practitioners learnt the tradition from their forefathers, and 19% of practitioners developed their own practices through experimentation, reading and learning. 20% of the practitioners follow distinctive “Nadi Pariksha” (pulse examination) for disease diagnosis, while others follow bodily symptoms and complaints. 29% of the traditional practitioners do not charge anything, while 59% practitioners receive money as remuneration. Plant and animal materials are used as sources of medicines, with a variety of preparation methods. The preference ranking test revealed higher education and migration from villages are the main reasons for decreasing interest amongst the younger generation, while deforestation emerged as the main cause of medicinal plants depletion. Conclusion Patrilineal transfer of the knowledge to younger generation was observed in Belgaum region. The observed resemblance in disease diagnosis, plant collection and
Van Schipstal, Inge; Berning, Moritz; Murray, Hayley
This article focuses on how recreational drug users in the Netherlands and in online communities navigate the risks and reduce the harms they associate with psychoactive drug use. To do so, we examined the protective practices they invent, use, and share with their immediate peers and with larger drug experimenting communities online. The labor involved in protective practices and that which ultimately informs harm reduction from below follows three interrelated trajectories: (1) the handling and sharing of drugs to facilitate hassle-free drug use, (2) creating pleasant and friendly spaces that we highlight under the practices of drug use attunements, and (3) the seeking and sharing of information in practices to spread the good high. We focus not only on users’ concerns but also on how these concerns shape their approach to drugs, what young people do to navigate uncertainties, and how they reach out to and create different sources of knowledge to minimize adversities and to improve highs. Harm reduction from below, we argue, can best be seen in the practices of sharing around drug use and in the caring for the larger community of drug-using peers. PMID:27721525
Bourdette, Dennis N.; Hartung, Daniel M.; Whitham, Ruth H.
Abstract The US Food and Drug Administration has registered 13 multiple sclerosis (MS) disease-modifying therapies (DMTs). The medications are not interchangeable as they vary in route of administration, efficacy, and safety profile. Selecting the appropriate MS DMT for individual patients requires shared decision-making between patients and neurologists. To reduce costs, insurance companies acting through pharmacy benefit companies restrict access to MS DMTs through tiered coverage and other regulations. We discuss how policies established by insurance companies that limit access to MS DMTs interfere with the process of shared decision-making and harm patients. We present potential actions that neurologists can take to change how insurance companies manage MS DMTs. PMID:27104069
Wang, Xiao-yun; Liang, Zhao-hui; Huang, Hui-ling; Liang, Wei-xiong
As one of the significant parts of medical science research in China, the research on Chinese medicine (CM) reflects the essence of healthcare tradition in the country both theoretically and clinically, and embodies the values of Chinese culture. Therefore, in the practice of ethics review on CM research protocols, besides abiding by the contemporary prevalent international principles and guidelines on bioethics, which emphasizes the scientific and bioethical value of the study, we should also stress the CM theoretical background and relevant clinical experience in the framework of Chinese culture and values. In this paper, we went over the traits of CM clinical research and the experience from the practice of ethics review by the institution review board for bioethics, and then attempted to summarize the key points for the bioethics review to CM researches in China, so as to serve as reference for the bioethics review to traditional and alternative medicine researches.
Dagnew, M B; Damena, M
A study in 3 villages in northwest Ethiopia was designed to find the type and extent of health damaging traditional child practices. The result of the survey showed high rates of uvulectomy and milk teeth extraction, and low rates of eyelid incision and female circumcision. More than 84.5% and 98.8% of the mothers surveyed, respectively, reported milk teeth extraction as a useful treatment for diarrhea and eyelid incision in the treatment of eye disease. The damage done by milk teeth extraction includes complications from unhygienic conditions (e.g. ostitis and osteomyelitis). Although many children survive these ill advised procedures and their complications, the considerable damage done to some of the children makes these procedures serious health hazards. Intensive health education with relevant health activities to correct the use of these traditional practices is advised.
Blass, Rachel B
In responding to the question of whether truth in psychoanalysis is relevant today, the author presents what she refers to as a traditional Freudian-Kleinian perspective. According to this perspective, truth is not only relevant, but rather the quest for it is the alpha and omega of psychoanalytic practice. The author reviews Freud's approach to truth and then discusses Klein's essential contribution to its understanding, grounding, and enrichment, highlighting Klein's thinking about phantasy and the life and death instincts. Finally, the author contends with the opposing view that the quest for truth is no longer relevant to contemporary analytic practice.
Makanjuola, A B; Adelekan, M L; Morakinyo, O
Twenty-seven traditional mental health practitioners (TMHPs) and 16 patients' relatives (PR) were studied with a view to gaining an understanding of the current status of traditional mental health practice in five local government areas in Ilorin Emirate Council Area, Kwara State, Nigeria. Data was collected using Practitioners' Questionnaire (PQ), Patients' Relatives' Questionnaire (PRQ), Focus Group Discussions (FGDs) and observation of TMHPs in their clinics. Factors which affect utilization of traditional mental health services were also reviewed. We found that TMHPs still enjoy considerable patronage from the populace, are more in numerical strength, and are more widely and evenly dispersed in the community than orthodox mental health practitioners (OMHPs). About 74% of TMHPs expressed interest in attending seminars aimed at improving their skills. Most of the patients' relatives expressed the belief that only traditional healers can understand the supernatural aetiological basis of mental disorders, and can therefore offer more effective care than OMHPs. Some of the negative practices observed were (i) infliction of corporal punishment and physical restraints on patients by some TMHPs resulting in wounds, which often become septic (ii) low level of hygiene at the clinics and (iii) lack of adequate follow-up care. In conclusion, since TMHPs still play a major role in the treatment of the mentally ill in this environment, OMHPs should assist them in improving on some of the negative practices identified. Thus, there is an urgent need to organize a training programme for TMHPs to expose them to the general rules of hygiene in medical care, basic principles of orthodox mental health practice, including human treatment of the mentally ill.
Katisi, Masego; Daniel, Marguerite
Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. Donors like the US Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership (funded by the Gates Foundation) in collaboration with Botswana's Ministry of Health have invested much to encourage HIV-negative men to circumcise. Demand creation strategies make use of media and celebrities. The objective of this paper is to explore responses to SMC in relation to circumcision as part of traditional initiation practices. More specifically, we present the views of two communities in Botswana on SMC consultation processes, implementation procedures and campaign strategies. The methods used include participant observation, in-depth interviews with key stakeholders (donors, implementers and Ministry officials), community leaders and men in the community. We observe that consultation with traditional leaders was done in a seemingly superficial, non-participatory manner. While SMC implementers reported pressure to deliver numbers to the World Health Organization, traditional leaders promoted circumcision through their routine traditional initiation ceremonies at breaks of two-year intervals. There were conflicting views on public SMC demand creation campaigns in relation to the traditional secrecy of circumcision. In conclusion, initial cooperation of local chiefs and elders turned into resistance. PMID:25866013
Katisi, Masego; Daniel, Marguerite
Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. Donors like the US Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership (funded by the Gates Foundation) in collaboration with Botswana's Ministry of Health have invested much to encourage HIV-negative men to circumcise. Demand creation strategies make use of media and celebrities. The objective of this paper is to explore responses to SMC in relation to circumcision as part of traditional initiation practices. More specifically, we present the views of two communities in Botswana on SMC consultation processes, implementation procedures and campaign strategies. The methods used include participant observation, in-depth interviews with key stakeholders (donors, implementers and Ministry officials), community leaders and men in the community. We observe that consultation with traditional leaders was done in a seemingly superficial, non-participatory manner. While SMC implementers reported pressure to deliver numbers to the World Health Organization, traditional leaders promoted circumcision through their routine traditional initiation ceremonies at breaks of two-year intervals. There were conflicting views on public SMC demand creation campaigns in relation to the traditional secrecy of circumcision. In conclusion, initial cooperation of local chiefs and elders turned into resistance.
Sharkey, Siobhan; Jones, Ray; Smithson, Janet; Hewis, Elaine; Emmens, Tobit; Ford, Tamsin; Owens, Christabel
The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a 'report' button for participants, links to online support, and a discussion room for forum moderators. This experience with SharpTalk suggests that an approach to ethics, which recognises the relational aspects of research with vulnerable people, is particularly useful for internet-based health research. The solutions presented here can act as guidance for researchers developing proposals and for ethics committees reviewing them.
Sharma, Ratika; Meurk, Carla; Bell, Stephanie; Ford, Pauline; Gartner, Coral
Reducing the burden of physical illness among people living with severe mental illnesses (SMI) is a key priority. Smoking is strongly associated with SMIs resulting in excessive smoking related morbidity and mortality in smokers with SMI. Smoking cessation advice and assistance from mental health practitioners would assist with reducing smoking and smoking-related harms in this group. This study examined the attitudes and practices of Australian mental health practitioners towards smoking cessation and tobacco harm reduction for smokers with SMI, including adherence to the 5As (ask, assess, advise, assist and arrange follow up) of smoking cessation. We surveyed 267 Australian mental health practitioners using a cross-sectional, online survey. Most practitioners (77.5%) asked their clients about smoking and provided health education (66.7%) but fewer provided direct assistance (31.1-39.7%). Most believed that tobacco harm reduction strategies are effective for reducing smoking related risks (88.4%) and that abstinence from all nicotine should not be the only goal discussed with smokers with SMI (77.9%). Many respondents were unsure about the safety (56.9%) and efficacy (39.3%) of e-cigarettes. Practitioners trained in smoking cessation were more likely (OR: 2.9, CI: 1.5-5.9) to help their clients to stop smoking. Community mental health practitioners (OR: 0.3, CI: 0.1-0.9) and practitioners who were current smokers (OR: 0.3, CI: 0.1-0.9) were less likely to adhere to the 5As of smoking cessation intervention. The results of this study emphasize the importance and need for providing smoking cessation training to mental health practitioners especially community mental health practitioners.
Masterson, Margaret A; Welker, Bimbo; Midla, Lowell T; Meiring, Richard W; Hoblet, Kent H
While many other veterinary schools have moved away from a traditional university-based ambulatory practice, the Ohio State University's Large Animal Practice has continued to provide a cost-effective and valuable method of preparing students for today's careers in veterinary medicine. The practice provides a full array of services to production, equine, and camelid clients, including herd health, individual animal medicine and surgery, and emergency services. Acquiring established practices from alumni has formed the client base. Four full-time veterinarians operate the clinic. While these same clinicians do some classroom teaching, their primary responsibility is devoted to the five to six fourth-year veterinary students who rotate through the clinic every two weeks. Teaching methods and objectives for these students include case discussions, homework, truck quiz books, and practice management issues. Financially, the clinic runs as a private practice, with minimal support from the college (201,000 US dollars per fiscal year) and a gross income of 676,000 US dollars per year. Thus, in a cost-effective manner, this required core ambulatory rotation provides students with a scientific learning experience that exposes them to all aspects of large animal production medicine in a real-world setting.
THATTE, N.; MULLANY, L.C.; KHATRY, S.K.; KATZ, J.; TIELSCH, J.M.; DARMSTADT, G.L.
Efforts to formalize the role of traditional birth attendants (TBAs) in maternal and neonatal health programs have had limited success. TBAs’ continued attendance at home deliveries suggests potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes, and practices of TBAs in rural Nepal. Twenty one trained and untrained TBAs participated in focus groups and in-depth interviews about antenatal care, delivery practices, maternal complications, and newborn care. Antenatal care included advice about nutrition and tetanus toxic (TT) immunization but did not include planning ahead for transport in cases of complications. Clean delivery practices were observed by most TBAs though hand washing practices differed by training status. There was no standard practice to identify maternal complications such as excessive bleeding, prolonged labour, or retained placenta, and most referred outside in the event of such complications. Newborn care practices included breastfeeding with supplemental feeds, thermal care after bathing and mustard seed oil massage. TBAs reported high job satisfaction and desire to improve their skills. Despite uncertainty regarding the role of TBAs to manage maternal complications, TBAs may be strategically placed to make potential contributions to newborn survival. PMID:19431006
Thatte, N; Mullany, L C; Khatry, S K; Katz, J; Tielsch, J M; Darmstadt, G L
Efforts to formalise the role of traditional birth attendants (TBAs) in maternal and neonatal health programmes have had limited success. TBAs' continued attendance at home deliveries suggests the potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes and practices of TBAs in rural Nepal. Twenty-one trained and untrained TBAs participated in focus groups and in-depth interviews about antenatal care, delivery practices, maternal complications and newborn care. Antenatal care included advice about nutrition and tetanus toxoid (TT) immunisation, but did not include planning ahead for transport in cases of complications. Clean delivery practices were observed by most TBAs, though hand-washing practices differed by training status. There was no standard practice to identify maternal complications, such as excessive bleeding, prolonged labour, or retained placenta, and most referred outside in the event of such complications. Newborn care practices included breastfeeding with supplemental feeds, thermal care after bathing, and mustard seed oil massage. TBAs reported high job satisfaction and desire to improve their skills. Despite uncertainty regarding the role of TBAs to manage maternal complications, TBAs may be strategically placed to make potential contributions to newborn survival.
Shankar, Rama; Lavekar, G. S.; Deb, S.; Sharma, B. K.
Assam and Arunachal Pradesh have very rich tradition of herbal medicines used in the treatment of various ailments. Tribal communities practice different types of traditional healing practices. Enough documentation is available on the healing practices in other tribal communities except Mishing community of Assam and foot hill of East Siang district of Arunachal Pradesh hence the attempt was made for the same. A survey on folk medicinal plants and folk healers of Mishing tribe was conducted in few places of Lakhimpur and Dhemaji district of Assam and East Siang district of Arunachal Pradesh, where this ethnic group is living since time immemorial. All information was collected based on interview and field studies with local healers within the community. The identification of medicinal plants collected with help of indigenous healers was done. Such medicines have been shown to have significant healing power, either in their natural state or as the source of new products processed by them. This study is mainly concentrated with plants used to cure diseases and to enquire about different healing systems. Detail note on the method of preparation of precise dose, the part/parts of plants used and method of application is given. PMID:23125508
Patra, Pratap Kumar
Branding is an inhuman traditional practice most commonly employed to treat various disorders in neonates and children in certain community in India. Though stringent law exists to prevent such harmful practices, cases of branding is not uncommon in current era.
Geedh, Smita; Nadgauda, Tejaswini
Khargone district is located at the southwest border of Madhya Pradesh. The district comprises of many archaeological and historical sites viz. Navdatoli, Maheshwar, Kasrawad, Mandleshwar. Archaeological excavations at these sites revealed vast cultural assemblage from Lower Paleolithic to Medieval Period. Pottery plays significant role in the reconstruction and understanding of past technologies and socio-economic-religious life. Present paper endeavors to understand contemporary traditional pottery practices at these sites. Besides documentation of degeneration of technology, authors aim to put forth the survival problems of the potters. Furthermore, an attempt has been made to examine the possible reasons behind their present socio-economic conditions.
Abodunrin, O L; Akande, T M; Musa, I O; Aderibigbe, S A
A sizeable number of deliveries still take place with the assistance of Traditional Birth Attendants in Nigeria. This study aims to determine the factors that determine the referral practices of the TBAs in Ilorin of high risk and complicated pregnancies. This descriptive study was conducted among all the 162 registered TBAs in Ilorin that were traceable using pre-tested semi-structured interviewer-administered questionnaire. About 90%, whose source of skill acquisition was by inheritance did not refer their clients appropriately compared with 48% of those whose source of skill acquisition was through formal training (p<0.05). The more the numbers of trainings, the more appropriate the referral (p<0.05). Having supervisory visit by qualified personnel is associated with appropriate referral practices (p<0.05). Regular training and re-training of TBAs with routine monitoring and supportive supervision will promote prompt referral of high risk and complicated pregnancies and deliveries.
Abbott, P J
The American Indian and Alaska Native population is a culturally diverse population with a current census of 1,959,000. Prior to White contact, there was historically little use of alcoholic beverages except for American Indians in the Southwest. After White contact, use and misuse of alcohol escalated rapidly; however, the prevalence, patterns, and problems of drinking alcoholic beverages vary enormously even in tribes closely linked geographically. American Indians and Alaska Natives have preserved and revitalized a number of traditional healing practices and applied these to the treatment of alcohol-related problems. These healing practices include the following: nativistic movements, sacred dances, sweat lodges, talking circle, four circles, and cultural enhancement programs. Additionally, Western treatment approaches have been applied in the treatment of problems related to alcohol, such as medication for detoxification, disulfiram (Antabuse), Alcoholics Anonymous, and behavioral interventions. Several investigators have completed a small number of naturalistic follow-up studies, but no one has undertaken a randomized controlled trial looking at specific methods of alcohol treatment in American Indians or Alaska Natives. American Indian and Alaska Native communities have adapted and integrated both Traditional and Western approaches to fit their own unique sociocultural needs.
Self-harm refers to a person's harming their own body on purpose. About 1 in 100 people hurts himself ... hurt themselves than males. A person who self-harms usually does not mean to kill himself or ...
Henwood, Benjamin F; Padgett, Deborah K; Tiderington, Emmy
Harm reduction is considered by many to be a legitimate alternative to abstinence-based services for dually diagnosed individuals, yet there is limited understanding of how varying approaches affect front-line practice within services for homeless adults. This paper examines how front-line providers working with individuals who have experienced homelessness, serious mental illness, and addiction view policies of harm reduction versus abstinence within two different approaches to homeless services: the traditional or "treatment first" approach that requires abstinence, and the more recent housing first approach that incorporates harm reduction. As part of a federally funded qualitative study, 129 in-depth interviews conducted with 41 providers were thematically analyzed to understand how providers view harm reduction versus abstinence approaches. Themes included the following: (a) harm reduction as a welcomed alternative, (b) working with ambiguity, and (c) accommodating abstinence. Drawing on recovery principles, the authors consider the broader implications of the findings for behavioral health care with this population.
Ali, A A; Siddig, M F
To identify and understand knowledge and practice among traditional birth attendants (TBAs), a total of 111 TBAs were interviewed at Kassala, Eastern Sudan between March and April 2011. Hand-washing prior to the delivery was a universal practice but only 25.2% of the interviewed TBAs used sterilised equipment. TBAs in this study appeared to have a low level of awareness about when a mother should be referred to hospital, and lacked basic information on family planning and HIV/AIDS. None of these 111 TBAs knew or used equipment for neonatal resuscitation (such as bag, tube and mask) or knew neonatal signs that needed extra attention such as change in skin colour, weak suckling and respiratory distress, and nearly one-third (28.8%) of the respondents believed in a few days delay in milk production. Thus, substantial effort is needed to improve the knowledge and practice among TBAs in Eastern Sudan, including training programmes, and this might be the best hope to achieve the Millennium Development Goals.
Background There is little research on HIV awareness and practices of traditional birth attendants (TBA) in India. This study investigated knowledge and attitudes among rural TBA in Karnataka as part of a project examining how traditional birth attendants could be integrated into prevention-of-mother-to-child transmission of HIV (PMTCT) programs in India. Methods A cross-sectional survey was conducted between March 2008 and January 2009 among TBA in 144 villages in Mysore Taluk, Karnataka. Following informed consent, TBA underwent an interviewer-administered questionnaire in the local language of Kannada on practices and knowledge around birthing and HIV/PMTCT. Results Of the 417 TBA surveyed, the median age was 52 years and 96% were Hindus. A majority (324, 77.7%) had no formal schooling, 88 (21.1%) had up to 7 years and 5 (1%) had more than 7 yrs of education. Only 51 of the 417 TBA (12%) reported hearing about HIV/AIDS. Of those who had heard about HIV/AIDS, only 36 (72%) correctly reported that the virus could be spread from mother to child; 37 (74%) identified unprotected sex as a mode of transmission; and 26 (51%) correctly said healthy looking people could spread HIV. Just 22 (44%) knew that infected mothers could lower the risk of transmitting the virus to their infants. An overwhelming majority of TBA (401, 96.2%) did not provide antenatal care to their clients. Over half (254, 61%) said they would refer the woman to a hospital if she bled before delivery, and only 53 (13%) felt referral was necessary if excessive bleeding occurred after birth. Conclusions Traditional birth attendants will continue to play an important role in maternal child health in India for the foreseeable future. This study demonstrates that a majority of TBA lack basic information about HIV/AIDS and safe delivery practices. Given the ongoing shortage of skilled birth attendance in rural areas, more studies are needed to examine whether TBA should be trained and integrated into PMTCT
Johnstone, Brick; Yoon, Dong Pil; Cohen, Daniel; Schopp, Laura H; McCormack, Guy; Campbell, James; Smith, Marian
To determine: (1) differences in spirituality, religiosity, personality, and health for different faith traditions; and (2) the relative degree to which demographic, spiritual, religious, and personality variables simultaneously predict health outcomes for different faith traditions. Cross-sectional analysis of 160 individuals from five different faith traditions including Buddhists (40), Catholics (41), Jews (22), Muslims (26), and Protestants (31). Brief multidimensional measure of religiousness/spirituality (BMMRS; Fetzer in Multidimensional measurement of religiousness/spirituality for use in health research, Fetzer Institute, Kalamazoo, 1999); NEO-five factor inventory (NEO-FFI; in Revised NEO personality inventory (NEO PI-R) and the NEO-five factor inventory (NEO-FFI) professional manual, Psychological Assessment Resources, Odessa, Costa and McCrae 1992); Medical outcomes scale-short form (SF-36; in SF-36 physical and mental health summary scores: A user's manual, The Health Institute, New England Medical Center, Boston, Ware et al. 1994). (1) ANOVAs indicated that there were no significant group differences in health status, but that there were group differences in spirituality and religiosity. (2) Pearson's correlations for the entire sample indicated that better mental health is significantly related to increased spirituality, increased positive personality traits (i.e., extraversion) and decreased personality traits (i.e., neuroticism and conscientiousness). In addition, spirituality is positively correlated with positive personality traits (i.e., extraversion) and negatively with negative personality traits (i.e., neuroticism). (3) Hierarchical regressions indicated that personality predicted a greater proportion of unique variance in health outcomes than spiritual variables. Different faith traditions have similar health status, but differ in terms of spiritual, religious, and personality factors. For all faith traditions, the presence of positive and
Yasien-Esmael, Hend; Rubin, Simon Shimshon
The grief and mourning of Muslim citizens in Israel are considered. First, a series of mourning customs spanning the period from notification of death until post-mourning are presented from 3 perspectives: (a) the requirements of the Islamic Sunni tradition; (b) the manner in which Islamic mourning rituals are practiced; and (c) the authors' interpretative perspective. Next, a synopsis of the personal experiences of two adult children to the death of their elderly father illustrates Muslim bereavement from a narrative point of view. Lastly, the concluding section continues a consideration of the distinction between the Islamic religious emphasis on return to functioning and the myriad ways in which the memory and relationship to the deceased are experienced. The article demonstrates how belief system, Islamic mourning rituals, and the power of loss create an experiential blend that is neither monolithic nor stereotypical.
Esparza, Eliana; Hadzich, Antonella; Kofer, Waltraud; Mithöfer, Axel; Cosio, Eric G
Maca, Lepidium meyenii Walpers (Brassicaceae), is an annual herbaceous plant native to the high plateaus of the Peruvian central Andes. Its underground storage hypocotyls have been a traditional medicinal agent and dietary staple since pre-Columbian times. Reported properties include energizing and fertility-enhancing effects. Published reports have focused on the benzylalkamides (macamides) present in dry hypocotyls as one of the main bioactive components. Macamides are secondary amides formed by benzylamine and a fatty acid moiety, with varying hydrocarbon chain lengths and degree of unsaturation. Although it has been assumed that they are usually present in fresh undamaged tissues, analyses show them to be essentially absent from them. However, hypocotyls dried by traditional Andean postharvest practices or industrial oven drying contain up to 800μgg(-1) dry wt (2.3μmolg(-1) dry wt) of macamides. In this study, the generation of macamides and their putative precursors were studied during nine-week traditional drying trials at 4200m altitude and in ovens under laboratory conditions. Freeze-thaw cycles in the open field during drying result in tissue maceration and release of free fatty acids from storage and membrane lipids up to levels of 1200μgg(-1) dry wt (4.3μmolg(-1) dry wt). Endogenous metabolism of the isothiocyanates generated from glucosinolate hydrolysis during drying results in maximal benzylamine values of 4300μgg(-1) dry wt (40.2μmolg(-1) dry wt). Pearson correlation coefficients of the accumulation profiles of benzylamine and free fatty acid to that of macamides showed good values of 0.898 and 0.934, respectively, suggesting that both provide sufficient substrate for amide synthesis during the drying process.
Moawad, Eman Mohamed Ibraheim; Abdallah, Enas Abdallah Ali; Ali, Yahia Zakaria Abdelalim
Abstract Neonatal jaundice (NNJ) is one of the most common neonatal disorders worldwide. It is still a main cause of avoidable brain damage, physical and mental impairment, and probable death in newborns. We aimed to assess perceptions, practices, and traditional beliefs among Egyptian mothers toward NNJ that may contribute to delayed presentation and inappropriate management of hyperbilirubinemia. This descriptive, cross-sectional study was conducted from January to May 2015. We interviewed 400 Egyptian mothers who gave birth in <1 month before the study using a structured questionnaire. Participants were recruited from outpatients of Cairo University Teaching Hospital. This study revealed unexpected moderate knowledge and attitude scores of Egyptian mothers in most domains with a mean of 6.6 and 20.6, respectively, although the majority of them were illiterate or had low educational attainment. In terms of knowledge, 52.3% of participants had adequate knowledge about NNJ in the aspects of awareness, risk factors, management, and complications. Almost all participants exhibited moderate (89.8%) and high levels (10%) of positive attitudes toward NNJ. Maternal sociodemographic factors influenced knowledge level, attitudes, and behaviors related to NNJ in Egypt. Working mothers and those residing in urban areas were significantly more knowledgeable (P = 0.023 and 0.021, respectively), and attained higher attitude scores (P < 0.001 and P < 0.001, respectively) than housewives and rural ones. Moreover, significantly higher attitude scores (P < 0.001) were attained by those who had completed their university [22.3 (SD = 3.1)] or postgraduate education [22.2 (SD = 3.6)]. The majority of Egyptian mothers have a satisfactory level of knowledge and attitudes related to NNJ. However, cultural beliefs and traditional infant care practices still have an impact on mothers regardless of their educational level. PMID:27603393
Koole, Heather; Nelson, Nickola W.; Curtis, Amy B.
Purpose: This preliminary investigation examined speech-language pathologists' (SLPs') use of contextualized practices (i.e., functional, personally relevant, nonhierarchical, and collaborative) compared with traditional practices (i.e., clinical, generic, hierarchical, and expert driven) with school-age children and adolescents with traumatic…
Gari, Akawak; Yarlagadda, Raghavendra; Wolde-Mariam, Messay
Background: Traditional medicine (TM) has maintained its popularity in all regions of the developing world. Even though, the wide acceptance of TM is a well-established fact, its status in a population with access to modern health is not well clear in the whole country. This study was carried out to assess the knowledge, attitudes, practice and management of TM among the community of Burka Jato Kebele, West Ethiopia. Methodology: A descriptive cross-sectional study was conducted on a total of 282 sampled individuals’ selected using systematic random sampling from January 28, 2013 to February 8, 2013 in Burka Jato Kebele, Nekemte town, East Wollega Zone, West of Ethiopia. Results: The majority (94.22%) of people in the study area relied on TM. Most of them were aware of medicinal herbs (55.7%). About half (40.79%) of the respondents were aware of the major side-effects of TM such as diarrhea (36.64%). About 31.85% of them prefer traditional medical practices (TMP) because they are cheap. Most (50%) of the species were harvested for their leaves to prepare remedies, followed by seed (21.15%) and root (13.46%) and the methods of preparation were pounding (27.54%), crushing (18.84%), a concoction (15.95%) and squeezing (13.04%). About 53.84% of them were used as fresh preparations. Remedies were reported to be administered through oral (53.85%), dermal or topical (36.54%), buccal (3.85%) and anal (5.77%). Conclusion: The study revealed that the use of TMs were quite popular among the population and a large proportion of the respondents not only preferred, but also used TMs notwithstanding that they lived in the urban communities with better access to modern medical care and medical practitioners. To use TM as a valuable alternative to conventional western medicine, further investigation must be undertaken to determine the validity, efficacy of the plants to make it available as an alternative medicine to human beings. PMID:25883518
Gorla, Lorenzo; Crouzy, Benoît; Perona, Paolo
Water demand for hydropower production is increasing together with the consciousness of the importance of riparian ecosystems and biodiversity. Some Cantons in Switzerland and other alpine regions in Austria and in Süd Tiröl (Italy) started replacing the inadequate concept of Minimum Flow Requirement (MFR) with a dynamic one, by releasing a fix percentage of the total inflow (e.g. 25 %) to the environment. Starting from a model proposed by Perona et al. (2013) and the need of including the environment as an actual water user, we arrived to similar qualitative results, and better quantitative performances. In this paper we explore the space of non-proportional water repartition rules analysed by Gorla and Perona (2013), and we propose new ecological indicators which are directly derived from current ecologic evaluation practices (fish habitat modelling and hydrological alteration). We demonstrate that both MFR water redistribution policy and also proportional repartition rules can be improved using nothing but available information. Furthermore, all water redistribution policies can be described by the model proposed by Perona et al. (2013) in terms of the Principle of Equal Marginal Utility (PEMU) and a suitable class of nonlinear functions. This is particularly useful to highlights implicit assumptions and choosing best-compromise solutions, providing analytical reasons explaining why efficiency cannot be attained by classic repartition rules. Each water repartition policy underlies an ecosystem monetization and a political choice always has to be taken. We explicit the value of the ecosystem health underlying each policy by means of the PEMU under a few assumptions, and discuss how the theoretic efficient redistribution law obtained by our approach is feasible and doesn't imply high costs or advanced management tools. For small run-of-river power plants, this methodology answers the question "how much water should be left to the river?" and is therefore a
Pan, Si-Yuan; Gao, Si-Hua; Zhou, Shu-Feng; Yu, Zhi-Ling; Chen, Hou-Qi; Zhang, Shuo-Feng; Tang, Min-Ke; Sun, Jian-Ning; Ko, Kam-Ming
In recent years, increasing numbers of people have been choosing herbal medicines or products to improve their health conditions, either alone or in combination with others. Herbs are staging a comeback and herbal “renaissance” occurs all over the world. According to the World Health Organization, 75% of the world's populations are using herbs for basic healthcare needs. Since the dawn of mankind, in fact, the use of herbs/plants has offered an effective medicine for the treatment of illnesses. Moreover, many conventional/pharmaceutical drugs are derived directly from both nature and traditional remedies distributed around the world. Up to now, the practice of herbal medicine entails the use of more than 53,000 species, and a number of these are facing the threat of extinction due to overexploitation. This paper aims to provide a review of the history and status quo of Chinese, Indian, and Arabic herbal medicines in terms of their significant contribution to the health promotion in present-day over-populated and aging societies. Attention will be focused on the depletion of plant resources on earth in meeting the increasing demand for herbs. PMID:24872833
Pan, Si-Yuan; Litscher, Gerhard; Gao, Si-Hua; Zhou, Shu-Feng; Yu, Zhi-Ling; Chen, Hou-Qi; Zhang, Shuo-Feng; Tang, Min-Ke; Sun, Jian-Ning; Ko, Kam-Ming
In recent years, increasing numbers of people have been choosing herbal medicines or products to improve their health conditions, either alone or in combination with others. Herbs are staging a comeback and herbal "renaissance" occurs all over the world. According to the World Health Organization, 75% of the world's populations are using herbs for basic healthcare needs. Since the dawn of mankind, in fact, the use of herbs/plants has offered an effective medicine for the treatment of illnesses. Moreover, many conventional/pharmaceutical drugs are derived directly from both nature and traditional remedies distributed around the world. Up to now, the practice of herbal medicine entails the use of more than 53,000 species, and a number of these are facing the threat of extinction due to overexploitation. This paper aims to provide a review of the history and status quo of Chinese, Indian, and Arabic herbal medicines in terms of their significant contribution to the health promotion in present-day over-populated and aging societies. Attention will be focused on the depletion of plant resources on earth in meeting the increasing demand for herbs.
Wilson, L; Rhodes, A P; Dodunski, G
The drivers for anthelmintic use today are substantial and anthelmintic use has become an embedded normalised behaviour. The cheapness and easy availability of anthelmintic products has meant that New Zealand farmers have had access to easy "solutions" for dealing with parasites and minimal forward planning or system redesign has been required. Despite 30 years of messaging about the emerging issue of anthelmintic resistance, management to reduce parasitism and the need to change behaviour, farmer practice has largely remained unchanged. Traditional approaches to extension, particularly around parasite management, appear to have been quite ineffective, apart from encouraging change in anthelmintic products and a switch to use of anthelmintics in combination. More effective approaches are required. The evolving nature of anthelmintic resistance and sustainable management of parasitism require attitudes, knowledge and behaviour to change. This is a challenge for all players in the industry; researchers, manufacturers and sellers, advisors and farmers. Looking beyond agriculture to the health sector provides some insight into models of decision making and behaviour change that can inform future strategies. Features in the health belief model including concepts of self-efficacy and cues to action appear to align with the issues, challenges and culture prevailing in farming, and parasite management in particular. Programmes through which farmers have made substantial beneficial behaviour change and the lessons learnt are discussed. Effecting consistent behaviour change around parasite management will involve new approaches by all participants in the process. And the process itself also needs to change. It requires an understanding of whole-farm systems, and the consideration of all the sources of influence on the farmer and the other participants in the process. The process of knowledge sharing involving the farmer should be based on equality; each person in the process
Broeders, Mireille; Paci, Eugenio
Breast cancer screening programs are still object of harsh debate. In 2012, the Independent UK Panel reviewed the benefits and harms of mammography screening based on randomized trials and the EUROSCREEN Working Group reviewed European observational outcome studies. The conclusion was that screening programs should continue, while acknowledging that harms, such as the occurrence of false-positive results and overdiagnosis, can have a negative impact on a woman's life. Information on the balance sheet of the benefits and harms of breast cancer screening should help women and their physicians to make an informed choice. The future challenge for breast screening programs is to assess the feasibility, acceptability, effectiveness and impact of risk-based screening in order to maximize benefit-to-harm ratios.
Sousa, Paulo; Holbrook, Colin; Piazza, Jared
In this article, we discuss the range of concerns people weigh when evaluating the acceptability of harmful actions and propose a new perspective on the relationship between harm and morality. With this aim, we examine Kelly, Stich, Haley, Eng and Fessler's [Kelly, D., Stich, S., Haley, K., Eng, S., & Fessler, D. (2007). Harm, affect, and the…
Ahmed, O A; Odunukwe, N N; Akinwale, O P; Raheem, T Y; Efienemokwu, C E; Ogedengbe, O; Salako, L A
A questionnaire-based study was conducted on 189 Traditional Birth Attendants (TBAs) on their knowledge and practices in prenatal services. Only 86 (45.5%) of them associated cessation of menstrual period with pregnancy while others use mystic power 46 (24.3%), early morning sickness, pallor of conjunctiva and reaction to herbs 56 (29.6%) to detect pregnancy. Fundal height n=76 (40.2%), palpation n=82 (43.4%), special soaps and soups n=52 (27.5%) and special devices n=8 (4.2%) are used to determine stages of pregnancy. Foetal health status is determined by regular foetal movements n=95 (50.3%), mystic power n=15 (8%), soap n=2 (1.1%), special concoction 9 (4.8%), health status of mother n=67 (35.4%) and foetal heart beat n=24 (12.7%). Ninety seven (51.3%) of them used herbal treatment, 77 (40.7%) used incantations, 189 (100%) used special soaps as their main methods of delivery, while only 18 (9.5%) of respondents refer difficult cases to hospitals. Instruments used for separating cord were blade 123 (65.1%) and scissors 40 (21.1%). Symptoms recognized by the TBAs as signs of complications in pregnancy were dizziness, swollen feet, pallor, tiredness, absent foetal movement, loss of appetite, heaviness, pain in back/stomach/side, weight loss, vomiting, bleeding, fever/malaria, head ache, bad dream, premature or delayed labour. Although some of them recognized some danger signs in pregnancy and labour, only very few would refer difficult cases for emergency obstetric interventions. Clear protocols for management and referral, which are necessary for improved maternal survival, should be provided through regular training of the TBAs.
Ren, Jun; Li, Xun; Sun, Jin; Han, Mei; Yang, Guo-Yan; Li, Wen-Yuan; Robinson, Nicola; Lewith, George; Liu, Jian-Ping
Background Evidence-based medicine promotes and relies on the use of evidence in developing clinical practice guidelines (CPGs). The Chinese healthcare system includes both traditional Chinese medicine (TCM) and Western medicine, which are expected to be equally reflected in Chinese CPGs. Objective To evaluate the inclusion of TCM-related information in Western medicine CPGs developed in China and the adoption of high level evidence. Methods All CPGs were identified from the China Guideline Clearinghouse (CGC), which is the main Chinese organisation maintaining the guidelines issued by the Ministry of Health of China, the Chinese Medical Association and the Chinese Medical Doctors’ Association. TCM-related contents were extracted from all the CPGs identified. Extracted information comprised the institution issuing the guideline, date of issue, disease, recommendations relating to TCM, evidence level of the recommended content and references supporting the recommendations. Results A total of 604 CPGs were identified, only a small number of which (74/604; 12%) recommended TCM therapy and only five guidelines (7%) had applied evidence grading. The 74 CPGs involved 13 disease systems according to the International Classification of Diseases 10th edition. TCM was mainly recommended in the treatment part of the guidelines (73/74, 99%), and more than half of the recommendations (43/74, 58%) were related to Chinese herbal medicine (single herbs or herbal treatment based on syndrome differentiation). Conclusions Few Chinese Western medicine CPGs recommend TCM therapies and very few provide evidence grading for the TCM recommendation. We suggest that future guideline development should be based on systematic searches for evidence to support CPG recommendations and involve a multidisciplinary approach including TCM expertise. PMID:26041487
In this article, I document a series of pedagogical responses in my high school instrumental music classroom following the events of Eric Garner's murder in New York City. Foregrounding traditions of black radical politics and aesthetics originating with the Black Power Movement in the 1960s, I explore their implications for classroom practice in…
Dewhurst, D. G.; And Others
Evaluates the effectiveness of an interactive computer-assisted learning program for undergraduate students that simulates experiments performed using isolated, everted sacs of rat small intestine. The program is designed to offer an alternative student-centered approach to traditional laboratory-based practical classes. Knowledge gain of students…
With the growth of Web 2.0 library intranets in recent years, many libraries are leaving behind legacy, first-generation intranets. As Web 2.0 intranets multiply and mature, how will traditional intranet best practices--especially in the areas of planning, implementation, and evaluation--translate into an existing Web 2.0 intranet infrastructure?…
The history of education, as taught in the United States and in the West generally, has focused primarily on how Western educational tradition emerged. This book provides a brief overview of several non-Western approaches to educational thought and practice. An understanding of how other peoples have educated their children, as well as what…
Shaibah, Hassan Sami; van der Vleuten, Cees P. M.
Traditionally, an anatomy practical examination is conducted using a free response format (FRF). However, this format is resource-intensive, as it requires a relatively large time investment from anatomy course faculty in preparation and grading. Thus, several interventions have been reported where the response format was changed to a selected…
Shaibah, Hassan Sami; van der Vleuten, Cees P M
Traditionally, an anatomy practical examination is conducted using a free response format (FRF). However, this format is resource-intensive, as it requires a relatively large time investment from anatomy course faculty in preparation and grading. Thus, several interventions have been reported where the response format was changed to a selected response format (SRF). However, validity evidence from those interventions has not proved entirely adequate for the practical anatomy examination, and thus, further investigation was required. In this study, the validity evidence of SRF was examined using multiple choice questions (MCQs) constructed according to different levels of Bloom's taxonomy in comparison with the traditional free response format. A group of 100 medical students registered in a gross anatomy course volunteered to be enrolled in this study. The experimental MCQ examinations were part of graded midterm and final steeplechase practical examination. Volunteer students were instructed to complete the practical examinations twice, once in each of two separate examination rooms. The two separate examinations consisted of a traditional free response format and MCQ format. Scores from the two examinations (FRF and MCQ) displayed a strong correlation, even with higher level Bloom's taxonomy questions. In conclusion, the results of this study provide empirical evidence that the SRF (MCQ) response format is a valid method and can be used as an alternative to the traditional FRF steeplechase examination.
Peltzer, K; Mngqundaniso, N; Petros, G
The aim of this study was investigate the HIV/AIDS/STI and TB knowledge, beliefs and practices of traditional healers in South Africa. In a cross-sectional study 233 traditional healers were interviewed in three selected communities in KwaZulu-Natal. Results indicate that the most common conditions seen were STIs, a variety of chronic conditions, HIV/AIDS (20%) and tuberculosis (29%). Although most healers had a correct knowledge of the major HIV transmission routes, prevention methods and ARV treatment, their knowledge was poorer on other HIV transmission routes, and 21% believed that there is a cure for AIDS. A minority reported unsafe practices in terms of reuse of razor blades on more than one patients and the reuse of enema equipment without sterilization, and two-thirds used gloves when carrying out scarifications. Randomized control trials are called for to test the effectiveness of traditional healing for HIV/AIDS, STI and TB prevention and care.
Boyer, E. Marcia
Information is presented on a study designed to gather details about the services provided by clinical dental hygienists in traditional and nontraditional settings. The 10 research topics addressed include: services provided by the clinical RDH in the traditional and nontraditional setting; time allocated for such services; how patients are…
Safe with Self-Injury: A Practical Guide to Understanding, Responding and Harm-reduction Inckle Kay Safe with Self-Injury: A Practical Guide to Understanding, Responding and Harm-reduction 274pp £23.99 PCCS Books 9781910919163 1910919160 [Formula: see text].
The author begins her book with a concise exploration of the stereotypes and truths of self-harm. In the following seven chapters, she sets out a grounded and often challenging view of how self-harm is understood from differing perspectives.
Madejón, P; Barba-Brioso, C; Lepp, N W; Fernández-Caliani, J C
This study relates elemental content of a range of edible crops grown in soils severely polluted by metals and metalloids as affected by traditional smallholder management practices. Five agricultural plots close to a sulfidic waste dump were monitored. Soil analysis demonstrated elevated concentrations of As, Cu, Pb and Zn that were greatly in excess of maximum statutory limits for agricultural soils in the studied region. The main vegetables (lettuce, chard, onion, potatoes) and lemon, together with their associated soils, were measured for elemental content. Extractable soil element concentrations were very low. There were differences in elemental accumulation between crops, but none exceeded statutory concentrations in edible parts. Soil-plant transfer factors were uniformly low for all elements and crops. It is concluded that traditional soil management practices (annual liming and application of animal manures) have created conditions for sustainable long-term safety use, with potential for multiple end-use, of these highly polluted soils.
The purpose of the present study was to examine the influence of a traditional yoga practice approach (morning daily practice, TY) compared to that of a Western yoga practice approach (once-twice weekly, evening practice, WY) on determinants of emotional well-being. To that end, in a pre/posttest between-subject design, measures of positive (PA) and negative affect (NA), mindfulness, perceived stress, and arousal states were taken in 24 healthy participants (20 women; mean age: 30.5, SD = 8.1 years) with an already existing WY practice, who either maintained WY or underwent a 2-week, five-times-per-week morning practice (TY). While WY participants maintained baseline values for all measures taken, TY participants showed significant beneficial changes for PA, NA, and mindfulness and a trend for improved ability to cope with stress at the completion of the intervention. Furthermore, TY participants displayed decreased subjective energy and energetic arousal. Altogether, findings indicate that the 2-week TY is beneficial over WY for improving perceived emotional well-being. The present findings (1) undermine and inspire a careful consideration and utilization of yoga practice approach to elicit the best benefits for emotional well-being and (2) support yoga as an evidence-based practice among healthy yoga practitioners. PMID:27123033
Price, David W.; Felix, Kate G.
Introduction: As small group learning sessions, Journal Clubs (JCs) and Case Conferences (CCs), if structured interactively, have potential as educational formats that can change practice. However, the degree to which these formats, as currently typically structured, lead to practice change is unknown. Methods: We used concepts of communities of…
Odom, Arthur Louis; Marszalek, Jacob M.; Stoddard, Elizabeth R.; Wrobel, Jerzy M.
The purpose of this study was to examine the association of middle school student science achievement and attitudes toward science with student-reported frequency of using computers to learn science and other classroom practices. Baseline comparison data were collected on the frequency of student-centred teaching practices (e.g. the use of group…
The term self-harm is commonly used to describe a wide range of behaviours and intentions including attempted hanging, impulsive self-poisoning, and superficial cutting in response to intolerable tension. As with suicide, rates of self-harm vary greatly between countries. 5-9% of adolescents in western countries report having self-harmed within the previous year. Risk factors include socioeconomic disadvantage, and psychiatric illness--particularly depression, substance abuse, and anxiety disorders. Cultural aspects of some societies may protect against suicide and self-harm and explain some of the international variation in rates of these events. Risk of repetition of self-harm and of later suicide is high. More than 5% of people who have been seen at a hospital after self-harm will have committed suicide within 9 years. Assessment after self-harm includes careful consideration of the patient's intent and beliefs about the lethality of the method used. Strong suicidal intent, high lethality, precautions against being discovered, and psychiatric illness are indicators of high suicide risk. Management after self-harm includes forming a trusting relationship with the patient, jointly identifying problems, ensuring support is available in a crisis, and treating psychiatric illness vigorously. Family and friends may also provide support. Large-scale studies of treatments for specific subgroups of people who self-harm might help to identify more effective treatments than are currently available. Although risk factors for self-harm are well established, aspects that protect people from engaging in self-harm need to be further explored.
Kim, Hye-On; Hoppe-Graff, Siegfried
Compares mothers' roles in socializing their children in traditional South Korean families with that of mothers' in modern families. While Confusion influence remains strong, significant changes in South Korean culture often create complex, ambiguous, and emotionally unstable relationships between mothers and their adolescent children. Discusses…
Deegan, Donna; Wims, Padraig; Pettit, Tony
Purpose: In this article the use of blended learning multimedia materials as an education tool was compared with the traditional approach for skills training. Design/Methodology/Approach: This study was conducted in Ireland using a pre-test, post-test experimental design. All students were instructed on how to complete two skills using either a…
Zhu, Hua-Xu; Duan, Jin-Ao; Guo, Li-Wei; Li, Bo; Lu, Jin; Tang, Yu-Ping; Pan, Lin-Mei
Resource of traditional Chinese medicine residue is an inevitable choice to form new industries characterized of modem, environmental protection and intensive in the Chinese medicine industry. Based on the analysis of source and the main chemical composition of the herb residue, and for the advantages of membrane science and technology used in the pharmaceutical industry, especially membrane separation technology used in improvement technical reserves of traditional extraction and separation process in the pharmaceutical industry, it is proposed that membrane science and technology is one of the most important choices in technological design of traditional Chinese medicine resource industrialization. Traditional Chinese medicine residue is a very complex material system in composition and character, and scientific and effective "separation" process is the key areas of technology to re-use it. Integrated process can improve the productivity of the target product, enhance the purity of the product in the separation process, and solve many tasks which conventional separation is difficult to achieve. As integrated separation technology has the advantages of simplified process and reduced consumption, which are in line with the trend of the modern pharmaceutical industry, the membrane separation technology can provide a broad platform for integrated process, and membrane separation technology with its integrated technology have broad application prospects in achieving resource and industrialization process of traditional Chinese medicine residue. We discuss the principles, methods and applications practice of effective component resources in herb residue using membrane separation and integrated technology, describe the extraction, separation, concentration and purification application of membrane technology in traditional Chinese medicine residue, and systematically discourse suitability and feasibility of membrane technology in the process of traditional Chinese
MacMaster, Samuel A.
This article provides information on harm reduction, a recent development in substance abuse services in response to the HIV/AIDS epidemic. The author outlines abstinence and harm reduction perspectives and the stages of change model and discusses how these perspectives can be integrated in social work practice. He proposes using harm reduction…
Kleinman, Sherryl; Copp, Martha
Students share folk beliefs that make it difficult for them to understand inequality, especially the harmful consequences of social practices they routinely engage in, are attached to, and take for granted. Four of these beliefs include: (a) harm is direct, extreme, and the product of an individual's intentions; (2) harm is the product of the…
Malan, Djah F; Neuba, Danho F R
The use of plants during pregnancy is a common practice in Africa. In Côte d'Ivoire, despite modern antenatal medical prescriptions, most pregnant women resort to traditional medicine to ensure foetus development and facilitate childbirth. Yet, there is not enough research on the African traditional medicine concerning this aspect of health. Therefore, the plants used by pregnant women need to be better known in order to offer integrated antenatal care. This study analyzes the salience of plants used, the associated practices and reasons of such practices by pregnant women in Yakassé-Féyassé, an Anyi-Ndenye town of the Eastern Côte d'Ivoire. Methods include an ethnobotany survey (freelist method, interview with pregnant women during their antenatal consultation and with specialists). The survey led to a list of 75 plants distributed in 3 class of salience. In addition, 90.3 % of pregnant women use these practices which are nevertheless ignored by Midwives during antenatal visits.
Case study of New Tradition Homes who saved 26% over Washington state’s energy code by moving ducts inside conditioned space, upgrading the furnace, increasing attic insulation to R-49, and improving air sealing. This added $3,600 to the initial cost or $290 in increased annual mortgage costs but saved $991 per year for an annual net cash back to the homeowner of $700.
Gmel, Gerhard; Rehm, Jürgen
Alcohol misuse can harm people other than the drinker, and can have negative consequences for society as a whole. It is commonly believed to play a role in decreased worker productivity, increased unintentional injuries, aggression and violence against others, and child and spouse abuse. Research findings support the idea that drinking is involved in or associated with many of these social harms, but do not offer evidence that it causes these effects. Methodological flaws characterize much of the research in this area. Use of better design and statistical methodology is necessary in order to clarify the relationship between drinking and the harmful consequences it is believed to cause.
Stancliff, Sharon; Phillips, Benjamin W; Maghsoudi, Nazlee; Joseph, Herman
Drug use is a public health problem associated with high mortality and morbidity, and is often accompanied by suboptimal engagement in health care. Harm reduction is a pragmatic public health approach encompassing all goals of public health: improving health, social well-being, and quality of life. Harm reduction prioritizes improving the lives of people who use drugs in partnership with those served without a narrow focus on abstinence from drugs. Evidence has shown that harm reduction oriented practice can reduce transmission of blood-borne illnesses, and other injection related infections, as well as preventing fatal overdose.
This article offers a model to assist music teachers in reflecting on their teaching practice in relation to their aims and values. Initially developed as a workshop aid for use on a music education MA program, the model is intended to provoke critical engagement with two prominent tensions in music education: that between mastery and enjoyment,…
Null, J. Wesley
As any glance at contemporary educational literature demonstrates, the concept of "constructivism" carries with it enormous appeal. Contemporary literature also reveals that many current educational reform initiatives encourage teaching practices that many people refer to as constructivist (Brooks and Brooks 1993; Roth 1993; Crawford and Witte…
Haglund, Jesper; Stromdahl, Helge
Nineteen informants (n = 19) were asked to study and comment two computer animations of the Otto combustion engine. One animation was non-interactive and realistic in the sense of depicting a physical engine. The other animation was more idealised, interactive and synchronised with a dynamic PV-graph. The informants represented practical and…
From September 2015, schools in England will be teaching new A-level science specifications that have been developed by examination boards to encompass new higher levels of demand developed by the Department for Education. Integral to these new specifications is a radical change to the contribution of practical science to the A-level grade of the…
Calvo, Carmen Benso
The paper reviews school practice in Spain through the long historic period of the dictatorship of Gen. Francisco Franco between the 1936 Civil War and Franco's death in 1975. For this purpose, an analysis is made of the most relevant documents (school materials, reports, direct testimonies by practising teachers, scientific papers on education…
Yi, Lian-yun; Peng, Jing
The actual effect is a big problem in current school moral education. By analyzing the problems in the theory and practice of the current school moral education, the author points out that the reason is that, for a long time, the meaning of morality has been dissimilated, and moral education is considered as a kind of knowledge input and…
Background The WHO estimates that more than 80% of African populations attend traditional healers for health reasons and that 40%–60% of these have some kind of mental illness. However, little is known about the profiles and outcome of this traditional approach to treatment. Objective The purpose of this study was to describe the profiles and outcome of traditional healing practices for severe mental illnesses in Jinja and Iganga districts in the Busoga region of Eastern Uganda. Methods Four studies were conducted. Study I used focus group discussions (FGDs) with case vignettes with local community members and traditional healers to explore the lay concepts of psychosis. Studies II and III concerned a cross-sectional survey of patients above 18 years at the traditional healer's shrines and study IV was made on a prospective cohort of patients diagnosed with psychosis in study III. Manual content analysis was used in study I; quantitative data in studies II, III, and IV were analyzed at univariate, bivariate, and multivariate levels to determine the association between psychological distress and socio-demographic factors; for study IV, factors associated with outcome were analyzed. One-way ANOVA for independent samples was the analysis used in Study IV. Results The community gave indigenous names to psychoses (mania, schizophrenia, and psychotic depression) and had multiple explanatory models for them. Thus multiple solutions for these problems were sought. Of the 387 respondents, the prevalence of psychological distress was 65.1%, where 60.2% had diagnosable current mental illness, and 16.3% had had one disorder in their lifetime. Over 80% of patients with psychosis used both biomedical and traditional healing systems. Those who combined these two systems seemed to have a better outcome. All the symptom scales showed a percentage reduction of more than 20% at the 3- and 6-month follow-ups. Conclusion Traditional healers shoulder a large burden of care of patients
Flynn-Evans, Erin E.
Fatigue risk management programs provide effective tools to mitigate fatigue among shift workers. Although such programs are effective for typical shiftwork scenarios, where individuals of equal skill level can be divided into shifts to cover 24 hour operations, traditional programs are not sufficient for managing sleep loss among individuals with unique skill sets, in occupations where non-traditional schedules are required. Such operations are prevalent at NASA and in other high stress occupations, including among airline pilots, military personnel, and expeditioners. These types of operations require fatigue risk management programs tailored to the specific requirements of the mission. Without appropriately tailored fatigue risk management, such operations can lead to an elevated risk of operational failure, disintegration of teamwork, and increased risk of accidents and incidents. In order to design schedules for such operations, schedule planners must evaluate the impact of a given operation on circadian misalignment, acute sleep loss, chronic sleep loss and sleep inertia. In addition, individual-level factors such as morningness-eveningness preference and sleep disorders should be considered. After the impact of each of these factors has been identified, scheduling teams can design schedules that meet operational requirements, while also minimizing fatigue.
Osuji, Alice; Pharr, Jennifer R; Nwokoro, Uche; Ike, Anulika; Ali, Christiana; Ejiro, Ogheneaga; Osuyali, John; Obiefune, Michael; Fiscella, Kevin; Ezeanolue, Echezona E
Nigeria is second in the world for the number of people with HIV and has a high rate of mother-to-child transmission (MTCT). Over 60% of births in Nigeria occur outside of health care facilities, and because of this, Traditional Birth Attendants (TBAs) play a significant role in maternal and child health. It is important that TBAs be knowledgeable about HIV prevention. The purpose of this study was to determine the impact of HIV testing and counseling (HTC) knowledge on the HIV prevention practices among TBAs in Nigeria. Five hundred TBAs were surveyed. Chi-square and logistic regression were used to assess differences in HIV prevention practices between TBAs with and without HTC knowledge. TBAs with HTC knowledge are significantly more likely to engage in HIV prevention practices than TBAs without HTC. Prevention practices included: wearing gloves during delivery (p < 0.01), sterilization of delivery equipment (p < 0.01), participation in blood safety training (p < 0.01), and disposal of sharps (p < 0.01). As long as a high percent of births occur outside health care facilities in Nigeria, there will be a need for TBAs. Providing TBAs with HTC training increases HIV prevention practices and can be a key to improve maternal and child health.
Osuji, Alice; Pharr, Jennifer R.; Nwokoro, Uche; Ike, Anulika; Ali, Christiana; Ejiro, Ogheneaga; Osuyali, John; Obiefune, Michael; Fiscella, Kevin; Ezeanolue, Echezona E.
Nigeria is second in the world for the number of people with HIV and has a high rate of mother-to-child transmission (MTCT). Over 60% of births in Nigeria occur outside of health care facilities, and because of this, Traditional Birth Attendants (TBAs) play a significant role in maternal and child health. It is important that TBAs be knowledgeable about HIV prevention. The purpose of this study was to determine the impact of HIV testing and counseling (HTC) knowledge on the HIV prevention practices among TBAs in Nigeria. Five hundred TBAs were surveyed. Chi-square and logistic regression were used to assess differences in HIV prevention practices between TBAs with and without HTC knowledge. TBAs with HTC knowledge are significantly more likely to engage in HIV prevention practices than TBAs without HTC. Prevention practices included: wearing gloves during delivery (p < 0.01), sterilization of delivery equipment (p < 0.01), participation in blood safety training (p < 0.01), and disposal of sharps (p < 0.01). As long as a high percent of births occur outside health care facilities in Nigeria, there will be a need for TBAs. Providing TBAs with HTC training increases HIV prevention practices and can be a key to improve maternal and child health. PMID:25674783
The problem is complex. Excessive nitrogen and phosphorous levels can cause harmful algal blooms. Different algal/cyanobacteria strains bloom under different conditions. Different strains produce different toxins at varying amounts.
Dickerson, Daniel L; Brown, Ryan A; Johnson, Carrie L; Schweigman, Kurt; D'Amico, Elizabeth J
American Indians/Alaska Natives (AI/AN) exhibit high levels of alcohol and drug (AOD) use and problems. Although approximately 70% of AI/ANs reside in urban areas, few culturally relevant AOD use programs targeting urban AI/AN youth exist. Furthermore, federally-funded studies focused on the integration of evidence-based treatments with AI/AN traditional practices are limited. The current study addresses a critical gap in the delivery of culturally appropriate AOD use programs for urban AI/AN youth, and outlines the development of a culturally tailored AOD program for urban AI/AN youth called Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY). We conducted focus groups among urban AI/AN youth, providers, parents, and elders in two urban communities in northern and southern California aimed at 1) identifying challenges confronting urban AI/AN youth and 2) obtaining feedback on MICUNAY program content. Qualitative data were analyzed using Dedoose, a team-based qualitative and mixed methods analysis software platform. Findings highlight various challenges, including community stressors (e.g., gangs, violence), shortage of resources, cultural identity issues, and a high prevalence of AOD use within these urban communities. Regarding MICUNAY, urban AI/AN youth liked the collaborative nature of the motivational interviewing (MI) approach, especially with regard to eliciting their opinions and expressing their thoughts. Based on feedback from the youth, three AI/AN traditional practices (beading, AI/AN cooking, and prayer/sage ceremony) were chosen for the workshops. To our knowledge, MICUNAY is the first AOD use prevention intervention program for urban AI/AN youth that integrates evidence-based treatment with traditional practices. This program addresses an important gap in services for this underserved population.
The value of prenatal care has long been recognized by various cultures. The author's purpose in this article is to propose a framework to conceptualize prenatal care using the traditional Korean practice of prenatal care called Tae-Kyo, which means education for the fetus. The philosophy of Tae-Kyo shows the importance of children's development from the very beginning of life and indicates the moral and social responsibilities of pregnant women, family members, and communities in delivering healthy babies. This comprehensive view implies a framework for conceptualizing prenatal care that encompasses multidimensional aspects of prenatal care.
The purpose of this article is not to affirm or deny particular philosophical positions, but to explore the limits of intelligibility about what post-mortem harm means, especially in the light of improper post-mortem procedures at Bristol and Alder Hey hospitals in the late 1990s. The parental claims of post-mortem harm to dead children at Alder Hey Hospital are reviewed from five different philosophical perspectives, eventually settling on a crucial difference of perspective about how we understand harm to the dead. On the one hand there is the broadly 'analytical' tradition(1) of thinking that predicates the notion of harm on the basis of an existing subject. Since the dead are non-existent persons, it makes little sense to view the dead as being harmed. On the other hand, there is a phenomenological perspective, where the dead, in respect to the experience of grief, are existentially absent. This forms the basis that it is possible to harm grieving parent's experiences of how their dead are treated. The article ends with a short examination of what harming the dead implies for traditional bioethical concerns, namely, obtaining informed consent from significant others when planning medical research on the newly dead.
Pinto, Diana; Ribeiro, Branca Telles; Lopes Dantas, Maria Tereza
In the present article, we investigate the extent to which professional theories that underlie, inform, and guide the interviewing practices of two psychiatrists (a neuropsychiatrist and a psychoanalyst) are discursively displayed in their ways of conducting a psychiatric interview. This study analyses excerpts from two audio-recorded psychiatric interviews held at the Institute of Psychiatry of the Federal University of Rio de Janeiro. It follows theoretical and methodological frameworks derived from interactional sociolinguistics. Ethnographic data and research interviews with both clinicians also ground our discussion. Using frame analysis as a central tool, we found that the psychiatrist who subscribes to a neuropsychiatric orientation displays a concern on assessing the patient's cognitive processes, and shifts topics away from the patient's delusions to (re)introduce the institutional frame of the psychiatric interview. By contrast, the psychiatrist who holds a psychoanalytic orientation towards interviewing not only listens attentively to very personal topics introduced by the patient, but also sustains and develops these topics. Most of all, she proposes and stays within conversational frames. In keeping a dual understanding about their practices in the interview situation, both doctors balance the need to follow the institutional agenda and the need to listen to the patient, despite their different theoretical orientations.
Gurven, Michael; Jaeggi, Adrian V.; von Rueden, Chris; Hooper, Paul L.; Kaplan, Hillard
Sharing and exchange are common practices for minimizing food insecurity in rural populations. The advent of markets and monetization in egalitarian indigenous populations presents an alternative means of managing risk, with the potential impact of eroding traditional networks. We test whether market involvement buffers several types of risk and reduces traditional sharing behavior among Tsimane Amerindians of the Bolivian Amazon. Results vary based on type of market integration and scale of analysis (household vs. village), consistent with the notion that local culture and ecology shape risk management strategies. Greater wealth and income were unassociated with the reliance on others for food, or on reciprocity, but wealth was associated with a greater proportion of food given to others (i.e., giving intensity) and a greater number of sharing partners (i.e., sharing breadth). Across villages, greater mean income was negatively associated with reciprocity, but economic inequality was positively associated with giving intensity and sharing breadth. Incipient market integration does not necessarily replace traditional buffering strategies but instead can often enhance social capital. PMID:26526638
Gurven, Michael; Jaeggi, Adrian V; von Rueden, Chris; Hooper, Paul L; Kaplan, Hillard
Sharing and exchange are common practices for minimizing food insecurity in rural populations. The advent of markets and monetization in egalitarian indigenous populations presents an alternative means of managing risk, with the potential impact of eroding traditional networks. We test whether market involvement buffers several types of risk and reduces traditional sharing behavior among Tsimane Amerindians of the Bolivian Amazon. Results vary based on type of market integration and scale of analysis (household vs. village), consistent with the notion that local culture and ecology shape risk management strategies. Greater wealth and income were unassociated with the reliance on others for food, or on reciprocity, but wealth was associated with a greater proportion of food given to others (i.e., giving intensity) and a greater number of sharing partners (i.e., sharing breadth). Across villages, greater mean income was negatively associated with reciprocity, but economic inequality was positively associated with giving intensity and sharing breadth. Incipient market integration does not necessarily replace traditional buffering strategies but instead can often enhance social capital.
Torri, Maria Costanza
Despite the fact that plants have played an important role in midwifery in many cultures, there are very few in-depth studies on the plants traditionally used by midwives. The aim of this study is to analyse the perceptions and the uses of medicinal plants for reproductive health among indigenous midwives in the city of Otavalo, Ecuador. The article also aims to analyse the perceptions of traditional midwives regarding allopathic drugs for reproductive health and their possible overlapping uses of medicinal plants and allopathic drugs. The data are drawn from an ethnographic study carried out in Ecuador. In total, 20 traditional midwives have been interviewed. Individual and in-depth interviews also took place with a sample of 35 women as well as with five nurses and two doctors working at San Luis Hospital in Otavalo. The study shows that cultural health management and the incorporation of the beliefs and practices relating to women's reproductive health can represent a starting point towards the search for more successful strategies in reproductive health.
Yang, Sienhung; Chen, Hsingyu; Lin, Yihsuan; Chen, Yuchun
Pattern, or “zheng,” differentiation is the essential guide to treatment with traditional Chinese medicine (TCM). However, the considerable variability between TCM patterns complicates evaluations of TCM treatment effectiveness. The aim of this study was to explore and characterize the relationship between patterns and the core patterns of allergic rhinitis. We summarized 23 clinical trials of allergic rhinitis with mention of pattern differentiation; association rule mining was used to analyze TCM patterns of allergic rhinitis. A total of 205 allergic rhinitis patients seen at Chang Gung Memorial Hospital from March to June 2005 were included for comparison. Among the 23 clinical trials evaluated, lung qi deficiency and spleen qi deficiencies were the core patterns of allergic rhinitis, accounting for 29.50% and 28.98% of all patterns, respectively. A higher prevalence of lung or spleen qi deficiency (93.7%) was found in Taiwan. Additionally, patients with lung or spleen qi deficiency were younger (27.99 ± 12.94 versus 58.54 ± 12.96 years) and the severity of nasal stuffiness was higher than among patients with kidney qi deficiency (1.35 ± 0.89 versus 0.62 ± 0.65; P < 0.05). Lung and spleen qi deficiencies are the core patterns of allergic rhinitis and determining the severity of nasal stuffiness is helpful in differentiating the TCM patterns. PMID:22899954
Relun, A; Charrier, F; Trabucco, B; Maestrini, O; Molia, S; Chavernac, D; Grosbois, V; Casabianca, F; Etter, E; Jori, F
Corsica is a French Mediterranean island with traditional extensive pig farming oriented towards the production of high quality cured meat products. The increasing success of these cured products in continental Europe has triggered the development and organisation of an extensive pig farming industry. However, these pig farming practices have seldom been described and analysed to understand the potential risk of introduction and spread of infectious diseases. We conducted a cross-sectional study in Corsica in 2013 to characterise the main pig management practices and to identify groups of farms with similar practices and therefore homogeneous risk of introduction and spread of infectious diseases. We interviewed 68 pig farmers and investigated different farm management practices which could lead to contact between herds, such as trading animals, sharing pastures, feed and reproduction management (direct contacts), slaughtering and carcass waste management, and contacts with people and vehicles (indirect contacts). The practices were described and the farms grouped by multiple factor and hierarchical clustering analyses. Results revealed interesting patterns in the introduction and spread of infectious disease, such as the seasonality of pig production, the potential local spread of diseases in pastures due to the presence of free-ranging boars, carcasses, and animal waste. Multivariate analyses identified four groups of farms with different levels of risk of the spread of infectious disease, illustrating changes in farmers' customs from free-range uncontrolled farming systems to more controlled systems aimed at the production of high quality pork products. These results will be useful to more realistically simulate the spread of infectious diseases among Corsican pig farms and highlight the need for awareness raising campaigns among the stakeholders to reduce risky practices.
Evans, Alexandra; Chow, Sherman; Jennings, Rose; Dave, Jayna; Scoblick, Kathryn; Sterba, Katherine Regan; Loyo, Jennifer
This study aimed to obtain in-depth information from low-income, Spanish-speaking Latino families with young children to guide the development of culturally appropriate nutrition interventions. Focus groups were used to assess parent's knowledge about healthful eating, the home food environment, perceived influences on children's eating habits, food purchasing practices, and commonly used strategies to promote healthful eating among their children. Thirty-four Latino parents (33 women; 27 born in Mexico; 21 food-insecure) of preschool-aged children participated in four focus group discussions conducted in Spanish by a trained moderator. The focus groups were audiotaped, transcribed, translated, and coded by independent raters. Results suggest that in general, parents were very knowledgeable about healthful eating and cited both parents and school as significant factors influencing children's eating habits; at home, most families had more traditional Mexican foods available than American foods; cost and familiarity with foods were the most influential factors affecting food purchasing; many parents had rules regarding sugar intake; and parents cited role modeling, reinforcement, and creative food preparation as ways to encourage children's healthful eating habits. Finally, parents generated ideas on how to best assist Latino families through interventions. Parents indicated that future interventions should be community based and teach skills to purchase and prepare meals that include low-cost and traditional Mexican ingredients, using hands-on activities. In addition, interventions could encourage and reinforce healthy food-related practices that Latino families bring from their native countries.
Embedding environmental education within secondary science curriculum presents both philosophical and practical difficulties for teachers. This ethnographic/narrative study, with its methodology grounded in eco-feminism and realism/constructivism, examines the work of six secondary science teachers as they engage in an action research project focused on merging environmental education in their science lessons. Over the course of several months the teachers examine and discuss their views and their professional development related to the project. In the place of definitive conclusions, eight propositions relating the work of secondary science teachers to environmental education, form the basis for a discussion of the implications of the study. The implications are particularly relevant to secondary schools in Ontario, Canada, where the embedding of environmental education in science studies has been mandated.
Harandi, Mehdi F; Nia, Mahdi G; de Vries, Marc J
Since current water governance patterns mandate cooperation and partnership within and between the actors in the hydrosystems, supplementary models are necessary to distinguish the roles and the rules of indoor actions which is why we extend a theory in the frameworks of philosophy of technology. This analysis is empirically grounded on the problematic hydrosystems of a river in central Iran, Zayandehrud. Following a modernist-holistic-based analysis, it illustrates how values in the water apportionment mechanisms are being reshaped. The article by using the theory of normative practice has scrutinised the tasks and the rules of the old and new water-management systems, Mirab. Subsequently according to such philosophical theory, it has argued that the conflicts over the cases are due to interference of structural and directional norms within them.
Lewis, Lisa McConnell
Few events in the practice of a mental health clinician can be as devastating as the suicide of a client. Although suicide is a rare occurrence, clinicians face assessment of clients' risk for harming themselves on a regular basis. One well-accepted and widely practiced intervention for suicidal ideation is the use of no-harm contracts (NHC),…
Tesfahun, Biruh; Kebede, Kefelegn; Effa, Kefena
This study was carried out to describe goat production system under pastoralists' management in three districts of South Omo zone, southern Ethiopia. The districts were Benatsemay, Hamer, and Dasenech. Questionnaires were developed and used to collect data regarding pastoralists' management practices and production system of goats. A total of 180 households were interviewed to capture relevant information. Data collected through questionnaires were subjected to statistical analysis to generate descriptive statistics. Ranking was explained by calculating indexes. The primary purpose of raising goats was for social prestige in Benatsemay and Hamer but for milk production in Dasenech. Body size was the primary preference in Benatsemay and Hamer while milk yield was preferred most in Dasenech. Rangeland grazing was the major feed source in the study area in both dry and wet seasons. Pond and river were the common sources of water reported by farmers in the study districts but inadequate and poor quality. Disease prevalence was the top major constraint in goat husbandry in the three districts.
... sad Cutting and self-harm Cutting and self-harm Self-harm, sometimes called self-injury, is when a person ... about how one girl helps herself not self-harm. What are signs of self-injury in others? ...
Taylor, Lewis A., III
An accessible business school population of undergraduate students was investigated in three independent, but related studies to determine effects on grades due to cutting class and failing to take advantage of optional reviews and study quizzes. It was hypothesized that cutting classes harms exam scores, attending preexam reviews helps exam…
This project represents the Agency’s first effort to unify harmful algal blooms (HABs) research that had been previously carried out in isolation within various laboratories. A unified program is the most efficient way generate useful results for the Agency’s decision...
King, D. N.; Goff, J. R.
This paper builds upon earlier work that argued the information and experience contained within the knowledge-practice-belief complex of Mātauranga Māori [Māori knowledge] is a valuable and neglected area of information and understanding about past catastrophic events in Aotearoa/New Zealand (A/NZ). Here we map Māori oral traditions (pūrākau) that relate experience with extreme environmental disturbance (in particular, tsunamis) around the A/NZ coast, compare the findings with geo-archaeological evidence, and discuss the scientific benefits to be gained by considering pūrākau as legitimate perspectives on history. Not surprisingly, there are both differences and complementarities between traditional Māori narratives and the available geo-archaeological evidence on extreme coastal disturbances. The findings presented here raise new and important questions about accepted geographies of tsunami risk, the causes and sources of their generation, as well as reasons for the relative paucity and abundance of information in some regions. Ways in which Mātauranga Taiao [Māori environmental knowledge] and contemporary science can be combined to produce new narratives about extreme environmental disturbance along the A/NZ coastline will require not only acceptance of other ways of knowing but also open engagement with Māori that respects their rights to tell their own histories. These efforts are encouraged to revitalise and ground-truth the interpretation of traditional stories, corroborate and/or question previous scientific deductions, and improve our collective understanding of the recurring impact of tectonic, geologic and meteorological-based events across A/NZ.
Ulijaszek, S J
It has been largely accepted that Australian Aboriginal people practicing hunting and gathering traditionally underused their objective economic possibilities by working short hours relative to nonhunter-gatherer populations. However, the possibility that their subsistence quest might have been limited by potential heat strain has not been considered for Australian hunter-gatherers. In this article the influence of work and heat load on the potential for heat strain among adult male Australian Aboriginal people is modelled. The possibility that the short working day of Arnhem Land adults reported in the literature might reflect ecologically limited work scheduling by way of potential heat strain is examined. Three climatic regions of the North of Western Australia and the Northern Territory were identified, using data available from the Australian Bureau of Meteorology. Data from the months of January, April, July, and October were used with the United States Army Heat Strain Model, along with assumptions with respect to work load and time scheduling. Predictive modelling indicates that a late start to the working day could carry considerable risks of potential heat strain during the summer, when humidity and maximum daily temperature are highest for all three climatic regions, but especially in the tropical coastal region. While extended work times may have been needed to acquire adequate food under traditional conditions, work output could have been limited by potential heat strain under some conditions likely to have prevailed.
Paul, Mathilde; Baritaux, Virginie; Wongnarkpet, Sirichai; Poolkhet, Chaithep; Thanapongtharm, Weerapong; Roger, François; Bonnet, Pascal; Ducrot, Christian
In developing countries, smallholder poultry production contributes to food security and poverty alleviation in rural areas. However, traditional poultry marketing chains have been threatened by the epidemics caused by the Highly Pathogenic Avian Influenza (H5N1) virus. The article presents a value chain analysis conducted on the traditional poultry marketing chain in the rural province of Phitsanulok, Thailand. The analysis is based on quantitative data collected on 470 backyard chicken farms, and on qualitative data collected on 28 poultry collectors, slaughterhouses and market retailers, using semi-structured interviews. The article examines the organization of poultry marketing chains in time and space, and shows how this may contribute to the spread of Highly Pathogenic Avian Influenza H5N1 in the small-scale poultry sector. The article also discusses the practices and strategies developed by value chain actors facing poultry mortality, with their economic and social determinants. More broadly, this study also illustrates how value chain analysis can contribute to a better understanding of the complex mechanisms associated with the spread of epidemics in rural communities.
Moawad, Eman Mohamed Ibraheim; Abdallah, Enas Abdallah Ali; Ali, Yahia Zakaria Abdelalim
Neonatal jaundice (NNJ) is one of the most common neonatal disorders worldwide. It is still a main cause of avoidable brain damage, physical and mental impairment, and probable death in newborns.We aimed to assess perceptions, practices, and traditional beliefs among Egyptian mothers toward NNJ that may contribute to delayed presentation and inappropriate management of hyperbilirubinemia.This descriptive, cross-sectional study was conducted from January to May 2015. We interviewed 400 Egyptian mothers who gave birth in <1 month before the study using a structured questionnaire. Participants were recruited from outpatients of Cairo University Teaching Hospital.This study revealed unexpected moderate knowledge and attitude scores of Egyptian mothers in most domains with a mean of 6.6 and 20.6, respectively, although the majority of them were illiterate or had low educational attainment. In terms of knowledge, 52.3% of participants had adequate knowledge about NNJ in the aspects of awareness, risk factors, management, and complications. Almost all participants exhibited moderate (89.8%) and high levels (10%) of positive attitudes toward NNJ. Maternal sociodemographic factors influenced knowledge level, attitudes, and behaviors related to NNJ in Egypt. Working mothers and those residing in urban areas were significantly more knowledgeable (P = 0.023 and 0.021, respectively), and attained higher attitude scores (P < 0.001 and P < 0.001, respectively) than housewives and rural ones. Moreover, significantly higher attitude scores (P < 0.001) were attained by those who had completed their university [22.3 (SD = 3.1)] or postgraduate education [22.2 (SD = 3.6)].The majority of Egyptian mothers have a satisfactory level of knowledge and attitudes related to NNJ. However, cultural beliefs and traditional infant care practices still have an impact on mothers regardless of their educational level.
Background The usage of insect repellent plants (IRPs) is one of the centuries-old practices in Africa. In Ethiopia, malaria remains a leading cause of morbidity and mortality, subsequently the majority of people have a tendency to apply various plants as repellents to reduce or interrupt the biting activity of insects. Accordingly, this survey was undertaken to document and evaluate knowledge and usage practices of the local inhabitants on IRPs in the malaria epidemic-prone setting of Ethiopia. Methods Ethnobotanical survey was conducted between January and May 2013. Selected 309 household members were interviewed by administering pre-tested questionnaire on knowledge and usage practices of repellent plants, in Bechobore Kebele, Jimma Zone, Ethiopia. Results Overall, 70.2% (217/309) and 91.8% (199/217) of the respondents have had ample awareness and usage practices of repellent plants, respectively. Informants cited about twenty-two plant species as repellents and also indicated that these plants are useful(85.5%), accessible(86.8%), and affordable(83.9%) too. Residents mainly applying dried leaves [93.9% (187/199)] by means of burning/smouldering [98.9% (197/199)] with the traditional charcoal stove to repel insects, primarily mosquitoes. About 52.8% (105/199) of the informants using aproximately15g of dried plant-materials every day. A Chi-square analysis shows statistically a significant link between the knowledge on repellent plants and gender as well as average monthly income although not with the age of the respondents. Nevertheless, the repellent plant usage custom was not significantly associated with gender, monthly income, and age of the informants. Conclusion Though most of the people have had an adequate awareness still a sizable faction of society suffers with deprivation of IRPs knowledge and usage practices. Therefore, this study calls for more surveys to conserve the existing indigenous knowledge and cultural practices. It could lay the first stone
Graham, Jennifer L.
What are Harmful Algal Blooms (HABs)? Freshwater and marine harmful algal blooms (HABs) can occur anytime water use is impaired due to excessive accumulations of algae. HAB occurrence is affected by a complex set of physical, chemical, biological, hydrological, and meteorological conditions making it difficult to isolate specific causative environmental factors. Potential impairments include reduction in water quality, accumulation of malodorous scums in beach areas, algal production of toxins potent enough to poison both aquatic and terrestrial organisms, and algal production of taste-and-odor compounds that cause unpalatable drinking water and fish. HABs are a global problem, and toxic freshwater and (or) marine algae have been implicated in human and animal illness and death in over 45 countries worldwide and in at least 27 U.S. States (Yoo and others, 1995; Chorus and Bartram, 1999; Huisman and others, 2005).
Kraft, Rory E
Michigan's Appellate Court ruled in 2004 that a pregnancy that resulted from a rape should be considered a bodily injury for sentencing purposes. Interestingly, all three possible outcomes of a pregnancy-abortion, miscarriage, or childbirth-are considered to bring with them significant and substantial physical, psychological, and emotional changes. While the immediate impact of the ruling in People v. Cathey affected only the guilty individual, there are larger implications for this ruling beyond just sentencing guidelines. The ruling can be considered a step forward in prosecuting rapists, but possibly at the expense of reimagining the female body. This article considers the Cathey ruling itself, the potential benefits and consequences of this understanding on feminist discourse, and, crucially, the impact of this decision on abortion discussions. The central question that emerges is, can we both consider pregnancy a harm and believe that this harm is not always wrong-making?
van Eerdenburg, F J; Bouw, J; Zwart, P
In the Netherlands, several millions of injurious small mammals are killed yearly. This concerns not only mice and rats but also moles, musk-rats and several other species of rodent. At the request of the Netherlands Society for the Protection of Animals, studies were done on the methods in killing these animals, the effectiveness of these methods and the possibilities of reducing the harm done to the animals. The most important results of these investigations are reported in the present paper.
Makhubele, J C
The primary aim of this article is to explore and describe the production and consumption of homemade alcohol and its associated challenges in relation to implications for social work practice. Qualitative, explorative, descriptive, and contextual design was ideal and purposive and snowball sampling methods were used in this research. Data was collected through interviews with brewers and consumers of homemade alcoholic beverages. It was found that foreign substances are put into homemade alcoholic beverages for commercial reasons in an attempt to address social exclusion.
Many couples worldwide practice rituals, herbal approaches, and similar traditional approaches to regulate fertility, but many of them are ineffective at preventing pregnancy and some may even be harmful. Health providers who are familiar with cultural beliefs about fertility may use nonharmful practices (e.g., rituals or storytelling) to teach couples about the fertile period or modern contraception. In fact, providers gain credibility when they teach family planning in ways that include traditional beliefs. In Nigeria, fertility regulation methods were used before modern contraception was introduced. In both Nigeria and Niger, some customs prohibit premarital sexual intercourse. Others promote sexual abstinence for up to three years to promote proper birth spacing. Even though many beliefs do not prevent pregnancy and cause no harm, they can be used to assure women that they are in control of their own fertility. Such beliefs include avoiding the sun or moon at certain times or wearing charms (e.g., dead spiders, children's teeth, or leopard skin bracelets). Providers should discourage dangerous or counterproductive beliefs, however. For example, the Nigerian belief that intercourse during menstruation turns people into albinos (although it is not harmful) may encourage sex during the fertile period. Some harmful beliefs or practices include douching with hot water, salt, vinegar, lemon, or potassium after sex; eating arsenic or castor oil seeds; and drinking water used to wash dead bodies. A 28-bead necklace is being used to help women keep track of their menstrual cycle and know when the risk of pregnancy is greatest. 11 white beads designate the fertile period, with fluorescent beads indicating the peak days of ovulation. In Brazil, the third most popular family planning method is natural family planning (NFP), indicating a clear demand for NFP; yet many couples use NFP incorrectly. In the Philippines, lime juice is used to prevent bean pods from opening and
Magolda, Peter; Weems, Lisa
Explores ethical issues related to doing qualitative research and examines harm as it is conceptualized within the qualitative inquiry literature. Serves as an examination of professional standards, administrative practices, and methodological procedures that reveal the different kinds of harm that are inevitable outcomes of qualitative inquiry.…
Chung, Vincent C. H.; Ma, Polly H. X.; Lau, Chun Hong; Griffiths, Sian M.
In Hong Kong, statutory regulation for traditional Chinese medicine (TCM) practitioners has been implemented in the past decade. Increasing use of TCM on top of biomedicine (BM) services by the population has been followed; but corresponding policy development to integrate their practices has not yet been discussed. Using focus group methodology, we explore policy ideas for integration by collating views from frontline BM (n = 50) and TCM clinicians (n = 50). Qualitative data were analyzed under the guidance of structuration model of collaboration, a theoretical model for understanding interprofessional collaboration. From focus group findings we generated 28 possible approaches, and subsequently their acceptability was assessed by a two round Delphi survey amongst BM and TCM policy stakeholders (n = 12). Consensus was reached only on 13 statements. Stakeholders agreed that clinicians from both paradigms should share common goals of providing patient-centered care, promoting the development of protocols for shared care and information exchange, as well as strengthening interprofessional connectivity and leadership for integration. On the other hand, attitudes amongst policy stakeholders were split on the possibility of fostering trust and mutual learning, as well as on enhancing innovation and governmental support. Future policy initiatives should focus on these controversial areas. PMID:22649469
Patra, Pratap Kumar
Branding is an inhuman traditional practice most commonly employed to treat various disorders in neonates and children in certain community in India. Though stringent law exists to prevent such harmful practices, cases of branding is not uncommon in current era. PMID:27217887
Kamal, Atif; Malik, Riffat Naseem; Martellini, Tania; Cincinelli, Alessandra
The aim of this study was to determine the abundance and distribution of polycyclic aromatic hydrocarbons (PAHs) in dust samples collected from the selected professional cooking workplaces (WCs) and residential household cooking areas (WRs), where traditional and primitive cooking practices are still prevelent. Another aim of this study was to investigate the carcinogenic risk for Pakistani human exposure to dust-bound PAHs via the routes of inhalation, ingestion, and dermal contact. Generally, the concentration of individual congeners of PAHs in surface dust samples of WC sites was higher than those measured in WR sites (p < 0.05). The benzo(a)pyrene (B(a)P), a very high carcinogenic compound, was present in the dust samples from WC sites in the highest mean concentration (630 ng g(-1) dry weight (d.w.)). The BaP mean concentration in WC workplaces was almost eight times higher than the mean value found in WR exposure sites. Moreover, the average concentration of ∑PAHs, combustion origin PAHs (∑COMB) and sum total of 7-carcinogenic PAHs (∑7-carcinogens) were also significantly higher in WC dusts samples than that in WR workplaces. Principal component analysis (PCA) and diagnostic ratios suggested coal/wood combustion as major PAH emission sources in both exposure sites. The average incremental lifetime cancer risk (ILCR) suggested a moderate to potential high cancer risk for adults and children exposed to dust-bound PAHs in both exposure sites, in particular via both dermal and ingestion contact pathways.
Marshall, K; Mtimet, N; Wanyoike, F; Ndiwa, N; Ghebremariam, H; Mugunieri, L; Costagli, R
Somalia, one of the world's poorest countries, has livestock as the mainstay of the economy, with an estimated 65% of the population engaged in the livestock sector. This paper presents a gendered study on the traditional livestock breeding practices of Somali pastoralists for camels, cattle, sheep and goats, with a focus on documenting livestock traits of importance, the criteria used to select male breeding animals and the criteria used to cull female breeding animals. Data for the study were obtained by performing participatory rural appraisals (PRAs) with separate male and female pastoral groups from 20 settlements of the Tog-Dheer region of Somaliland (in north-western Somalia). In total, more than 500 pastoralists were involved. In terms of livestock ownership, goats were the most common species kept (97% of all households), followed by sheep (64%), camels (37%) and cattle (9%), with considerable herd size variation across households. Traits of key importance to the pastoralists varied by species and gender of the PRA group, but included adaptedness to harsh environmental conditions, high market value/high meat production and high milk production. The pastoralists practised sensible criteria for the selection of male breeding animals for all species, capturing aspects of productivity (milk yield, reproduction), adaptedness (good hardiness) and marketability (body size and conformation). Similarly, they practised sensible criteria for culling of female breeding animals, with females removed from the herd primarily for poor performance, but also to meet the livelihood needs of the family. Differences in the selection and culling criteria were noted by species, as well as gender of the pastoralists. On the whole, there was strong alignment between the livestock selection criteria used by the Somali pastoralists, their reasons for keeping livestock and the market requirements. This is not surprising given the intimate and long-standing relationship between Somali
The giant earthworm, Rhinodrilus alatus (Righi 1971), has been captured in the southeastern Brazilian Cerrado biome for approximately 80 years and used as bait for amateur fishing throughout Brazil. Local knowledge and traditional extraction practices are crucial for the establishment of management strategies for the species because, although its extraction involves conflicts and social and environmental impacts, the species is one of the major sources of income for approximately 3,000 people, especially for members of an Afro-descendant community that has approximately 2,000 inhabitants. Participatory tools, such as seasonal calendar, transect walks and participatory maps, were individually or collectively used with extractors and traders (former extractors), and 129 semi-structured and unstructured interviews were conducted with the same individuals between 2005 and 2012. The capture of Rhinodrilus alatus was observed in different seasons and areas of occurrence of the species in 17 municipalities, where this giant earthworm is the only species extracted for trade. All information obtained was verified by community members in 17 meetings. The extractors have an extensive knowledge of the life history, behavior, distribution, and possible impacts of climate change on the species. Different capture techniques, which have different impacts, are used during the dry and rainy seasons and are passed by the extractors through the generations. Local knowledge contributed to the establishment of agreements for the use of capture techniques that have less impact, to the expansion of scientific knowledge and the reassessment of the conservation status of Rhinodrilus alatus. The present study may serve as an example for management projects for other giant earthworm species in other regions of Brazil and in other countries. PMID:25874618
Ponce, Manuel N., Jr.
The purpose of this study was to examine the essential elements of a community of practice intended to increase communication and collaboration between traditional public and charter school leaders. Members of the Los Angeles Cohort of the School Leaders Network participated in this study. This case study triangulated observation, interview, and…
Schlosser, Ralf W.; Wendt, Oliver; Bhavnani, Suresh; Nail-Chiwetalu, Barbara
Background: Efficient library searches for research evidence are critical to practitioners who wish to engage in evidence-based practice (EBP) as well as researchers who seek to develop systematic reviews. Aims: This review will propose the benefits of the search technique "Pearl Growing" ("Traditional Pearl Growing") as well…
Salako, A A; Daniel, O J
With the aid of pre-tested, structured, interview questionnaires, 51 traditional birth attendants (TBAs), identified by their certificate of traditional midwifery, were assessed for their knowledge about the care given in pregnancy, labour, and the postnatal period, beliefs and delivery practices including child care, and their attitude towards orthodox midwifery. A total of 22 (43.1%) so identified were found to be practicing traditional midwifery as a full-time job, while 29 (56.9%) were practising on a part-time basis, doing other jobs such as farming and trading. Twenty-two (51.2%) of the male TBAs practised traditional midwifery as a full-time job, while the remaining 21 (48.8%) practised traditional midwifery part-time, along with farming occupation. All the female TBAs practised traditional midwifery part-time with their main occupation such as trading. There was no significant difference between the mean age of male compared with female respondents (59.3+/-15.1 vs. 54.6+/-15.9 years; P = 0.43). Harmful traditional practices, practices that may need verification and areas where training is needed are highlighted. The importance of registration and active supervision of their practices were discussed. The skills that need to be stressed include identification of danger signs in pregnancy and prompt referral of maternal complications. The essence of registration for monitoring of their activities cannot be overemphasized. Findings also revealed that appropriate training could expand their roles in primary health care programmes.
Cho, Hyun-Woo; Hwang, Eui-Hyoung; Lim, Byungmook; Heo, Kwang-Ho; Liu, Jian-Ping; Tsutani, Kiichiro; Lee, Myeong Soo; Shin, Byung-Cheul
Objectives The aims of this study were to investigate whether there is a gap between evidence of traditional medicine (TM) interventions in East-Asian countries from the current Clinical Practice Guidelines (CPGs) and evidence from current systematic reviews and meta-analyses (SR-MAs) and to analyze the impact of this gap on present CPGs. Methods We examined 5 representative TM interventions in the health care systems of East-Asian countries. We searched seven relevant databases for CPGs to identify whether core CPGs included evidence of TM interventions, and we searched 11 databases for SR-MAs to re-evaluate current evidence on TM interventions. We then compared the gap between the evidence from CPGs and SR-MAs. Results Thirteen CPGs and 22 SR-MAs met our inclusion criteria. Of the 13 CPGs, 7 CPGs (54%) mentioned TM interventions, and all were for acupuncture (only one was for both acupuncture and acupressure). However, the CPGs did not recommend acupuncture (or acupressure). Of 22 SR-MAs, 16 were for acupuncture, 5 for manual therapy, 1 for cupping, and none for moxibustion and herbal medicine. Comparing the evidence from CPGs and SR-MAs, an underestimation or omission of evidence for acupuncture, cupping, and manual therapy in current CPGs was detected. Thus, applying the results from the SR-MAs, we moderately recommend acupuncture for chronic LBP, but we inconclusively recommend acupuncture for (sub)acute LBP due to the limited current evidence. Furthermore, we weakly recommend cupping and manual therapy for both (sub)acute and chronic LBP. We cannot provide recommendations for moxibustion and herbal medicine due to a lack of evidence. Conclusions The current CPGs did not fully reflect the evidence for TM interventions. As relevant studies such as SR-MAs are conducted and evidence increases, the current evidence on acupuncture, cupping, and manual therapy should be rigorously considered in the process of developing or updating the CPG system. PMID:24505363
Lasimbang, Helen Benedict; Shoesmith, Wendy; Mohd Daud, Mohd Nazri Bin; Kaur, Nirmal; Jin, Margaret Chin Pau; Singh, Jaswant; John, Wilfred; Salumbi, Edna; Amir, Lidwina
Alcohol is the number three contributor to the burden of disease worldwide so must remain a priority health promotion issue internationally. Malaysia is a Muslim country and alcohol-related harm was not seen as a priority until recently, because it only affects a minority of the population. Sabah has more than 30 different ethnic groups, and alcohol has a traditional role in the cultural practices of many of these groups. In 2009, the Intervention Group for Alcohol Misuse (IGAM) was formed, under the umbrella of Mercy Malaysia by a group of healthcare workers, academics, members of the Clergy and people who were previously alcohol-dependent concerned about the harmful effects of excessive alcohol consumption. IGAM in collaboration with other bodies have organized public seminars, visited villages and schools, encouraged the formation of a support group and trained healthcare professionals in health promotion intervention. The focus later changed to empowering communities to find solutions to alcohol-related harm in their community in a way which is sensitive to their culture. A standard tool-kit was developed using WHO materials as a guide. Village committees were formed and adapted the toolkit according to their needs. This strategy has been shown to be effective, in that 90% of the 20 committees formed are actively and successfully involved in health promotion to reduce alcohol-related harm in their communities.
Roncarolo, Federico; Adam, Caroline; Bisset, Sherri; Potvin, Louise
Food insecurity is steadily increasing in developed countries. Traditional interventions adopted to tackle food insecurity, like food banks, address the urgent need for food. By contrast, alternative interventions, such as community gardens and kitchens, are oriented towards social integration and the development of mutual aid networks. The objective of this paper is to examine whether the populations served by traditional and alternative interventions in food security differ according to measures of vulnerability. We studied newly registered participants to food security interventions. Participants were selected from a random sample of food security community organizations in a two-stage cluster sampling frame. The categorizing variable was participation in a community organization providing either traditional interventions or alternative interventions. Seven measures of vulnerability were used: food security; perceived health; civic participation; perceived social support of the primary network, social isolation, income and education. Regression multilevel models were used to assess associations. 711 participants in traditional interventions and 113 in alternative interventions were enrolled in the study. Between group differences were found with respect to food insecurity, health status perception, civic participation, education and income, but not with respect to social isolation or perceived social support from primary social network. Traditional and alternative food security interventions seem to reach different populations. Participants in traditional interventions were found to have less access to resources, compared to those in alternative interventions. Thus, new participants in traditional interventions may have higher levers of vulnerability than those in alternative interventions.
Discusses benefits of combining traditional agricultural techniques with the concepts of "permaculture," a framework for revitalizing traditions, culture, and spirituality. Describes school, college, and community projects that have assisted American Indian communities in revitalizing sustainable agricultural practices that incorporate…
Tian, M.; Sun, M.
The traditional features of Chinese villages are facing a crisis of discontinuity. In the meantime, there exists a problem in architectural heritage conservation that while preservation and renovation is being done, local self-help construction still proceeds out of control. Nowadays, an increasing number of architects have noticed these phenomena and participate in the evolution of villages carrying various architectural practices in the countryside, which has certain influence at the place, whether during or after the construction. In many well-evaluated rural practice cases in the world, architects not only choose appropriate materials and crafts for natives, but also renew local traditions by offering skill training to craftsmen. However, in Chinese villages, similar practices do not seem to be that effective. Therefore, through field research and interviews, this article discusses the reasons that relatively successful architectural practices in Chinese villages fail to exert a positive influence to the inheriting and update of local traditions. These causes include the increase of information sources, the different aesthetic manner, the conception differences, the influence of constructors, and the instructor role that architects play.
Selekman, Matthew D.
Approximately 14 to 17 percent of adolescents today self-harm, deliberately cutting, burning, or bruising themselves. Most self-harming adolescents use the behavior as a coping strategy to get immediate relief from emotional distress or other stressors in their lives. Stressors include fitting in with peers, activity and homework overload, fears…
Doherty, Liz; Wilson, Iseult M; McKeown, Laura
Playing-related musculoskeletal disorders (PRMDs) as they affect the Irish traditional music community is a topic which, to date, has received scant attention. This paper draws on data generated through a series of four focus group interview studies conducted at the Universities of Ulster and Limerick and involving 22 musicians. Specifically, this paper looks at the wider issue of identity within the Irish traditional music community and at how the complexities inherent in this have, perhaps, affected musicians in recognizing, relating to, and dealing with PRMDs. Whether or not the injuries affecting Irish traditional musicians are similar to or different from what other musicians experience, what this study shows is that the sense of self and discrete identity among the Irish traditional music community is so very strong that merely a "one size fits all" approach to addressing these issues is not likely to yield positive results. Health professionals therefore need to be sensitive to such factors when considering their management of PRMDs and to develop approaches along with the traditional music community that are cognisant of their identity as well as their needs.
Rhodes, Evelyn L.; Dreibelbis, Robert; Klasen, Elizabeth; Naithani, Neha; Baliddawa, Joyce; Menya, Diana; Khatry, Subarna; Levy, Stephanie; Tielsch, James M.; Miranda, J. Jaime; Kennedy, Caitlin; Checkley, William
Global efforts are underway to develop and promote improved cookstoves which may reduce the negative health and environmental effects of burning solid fuels on health and the environment. Behavioral studies have considered cookstove user practices, needs and preferences in the design and implementation of cookstove projects; however, these studies have not examined the implications of the traditional stove use and design across multiple resource-poor settings in the implementation and promotion of improved cookstove projects that utilize a single, standardized stove design. We conducted in-depth interviews and direct observations of meal preparation and traditional, open-fire stove use of 137 women aged 20–49 years in Kenya, Peru and Nepal prior in the four-month period preceding installation of an improved cookstove as part of a field intervention trial. Despite general similarities in cooking practices across sites, we identified locally distinct practices and norms regarding traditional stove use and desired stove improvements. Traditional stoves are designed to accommodate specific cooking styles, types of fuel, and available resources for maintenance and renovation. The tailored stoves allow users to cook and repair their stoves easily. Women in each setting expressed their desire for a new stove, but they articulated distinct specific alterations that would meet their needs and preferences. Improved cookstove designs need to consider the diversity of values and needs held by potential users, presenting a significant challenge in identifying a “one size fits all” improved cookstove design. Our data show that a single stove design for use with locally available biomass fuels will not meet the cooking demands and resources available across the three sites. Moreover, locally produced or adapted improved cookstoves may be needed to meet the cooking needs of diverse populations while addressing health and environmental concerns of traditional stoves. PMID
Iwaniec, Dorota; Larkin, Emma; McSherry, Dominic
Emotional maltreatment tends to be overshadowed in research and in practice by other forms of maltreatment that present more obvious and explicit evidence and appear to require a more urgent response. This article aims to explore a growing body of research pointing to: (a) ways in which emotional maltreatment may adversely impact upon a child's…
Alabi, E M
Nigeria has a rich cultural heritage. Cultural practices include extended family; adequate care for new mothers for 40 days after delivery; prolonged breastfeeding; and respect for elders. Many negative practices exist, most of them affecting the health of children and women. About 90% of babies are delivered by mostly untrained traditional birth attendants (TBAs) and healers. Child marriage is a common Nigerian practice. This deprives the girl of education and results in teenage pregnancy. Legislation does not seem to be very effective. It is hoped that will education, girls will be allowed to remain in school until the age of 18. Female circumcision and vaginal mutilation and also common in Nigerian culture. TBAs and healers have stated that there is severe bleeding after circumcision, sometimes so severe that it leads to death. Other harmful delivery practices include bathing in boiling water; gishiri cut, a crude local symphysiotomy; and agurya cut--removal of the hymen loop on 7-day-old females. Bathing in boiling water results in many women being burned or disfigured; gishiri cut has resulted in vesicovaginal fistula in many young girls. Other harmful practices are purging of infants to get rid of impurities "they might have swallowed while in the uterus;" uvulectomy in infants, and induction of postpartum hemorrhage to clear the uterus of impure blood. The list goes on and on. Women and children are exposed to many unhealthy practices in the name of tradition or culture.
Whitworth, David E.
Laboratory-based practical classes are a common feature of life science teaching, during which students learn how to perform experiments and generate/interpret data. Practical classes are typically instructional, concentrating on providing topic- and technique-specific skills, however to produce research-capable graduates it is also important to…
Blom, Jan Dirk; Poulina, Igmar T; van Gellecum, Trevor L; Hoek, Hans W
Brua is an Afro-Caribbean religion and healing tradition from the southern part of the former Netherlands Antilles. Like other Caribbean healing traditions, it plays a significant role in shaping how individuals experience and express disorders which Western health professionals consider to require psychiatric care. Because little has been published on Brua, and because patients from Aruba, Bonaire, and Curaçao are often reluctant to discuss their commitment to this tradition, they are often misdiagnosed and either over- or undertreated by biomedically trained health professionals. The present paper provides a review of the literature on Brua and its relation to psychiatry. A systematic search was carried out in PubMed, the Ovid database, Google Scholar, and the historical literature. Our search yielded 35 texts on Brua, including three peer-reviewed scientific papers and eight academic theses. From those texts Brua emerges as a holistic patchwork of creolized beliefs and practices which are considered to be both cause and remedy for a wide variety of ailments. Despite the fact that tension between the Brua discourse and Western-oriented psychiatric practice is significant, adherence to Brua does not seem to cause much patient delay in help-seeking. However, belief in Brua as a possible source of mental and physical complaints, as well as patients' frequent recourse to Brua practices, including the use of hallucinogens, may affect the diagnosis and treatment of mental disorders.
Rivera, Jennifer Hall
An increase in online education is causing science educators to evaluate student cognitive understanding after completing virtual, computer-simulated laboratories. Online education has demonstrated comparable learning gains when analysed to those of the traditional classroom, but research is mixed when reviewing students' ability to manipulate…
Fairbanks-Schutz, Jo-Ellen M.
Superintendent leadership can influence student achievement and with the alarming gap between the academic achievement of traditionally marginalized students and their peers, superintendents have an ethical duty to lead their districts in closing these achievement gaps. Spillane, Halverson, and Diamond (2001) suggested that to have a more complete…
Boulton, Michael J.; Hardcastle, Katryna; Down, James; Fowles, John; Simmonds, Jennifer A.
Prior studies indicate that teachers differ in how they respond to different kinds of traditional bullying, and that their beliefs predict their intervention intentions. The current study provided the first extension of this work into the realm of cyber bullying. Preservice teachers in the United Kingdom ("N" = 222) were presented with…
Maloney, Stephen; Storr, Michael; Paynter, Sophie; Morgan, Prue; Ilic, Dragan
Effective education of practical skills can alter clinician behaviour, positively influence patient outcomes, and reduce the risk of patient harm. This study compares the efficacy of two innovative practical skill teaching methods, against a traditional teaching method. Year three pre-clinical physiotherapy students consented to participate in a…
Certain harmful or problematic materials present in residential buildings may need to be handled differently from general demolition debris. Here is a list of several specific types of materials that may be present in residential buildings.
Drucker, Ernest; Anderson, Kenneth; Haemmig, Robert; Heimer, Robert; Small, Dan; Walley, Alex; Wood, Evan; van Beek, Ingrid
This paper examines the role of clinical practitioners and clinical researchers internationally in establishing the utility of harm-reduction approaches to substance use. It thus illustrates the potential for clinicians to play a pivotal role in health promoting structural interventions based on harm-reduction goals and public health models. Popular media images of drug use as uniformly damaging, and abstinence as the only acceptable goal of treatment, threaten to distort clinical care away from a basis in evidence, which shows that some ways of using drugs are far more harmful than others and that punitive approaches and insistence on total abstinence as the only goal of treatment often increases the harms of drug use rather than reducing drug use. Therefore the leadership and scientific authority of clinicians who understand the health impact of harm-reduction strategies is needed. Through a review of harm-reduction interventions in Canada, the United Kingdom, the United States, Australia, Switzerland, and the Netherlands, we identify three ways that clinicians have helped to achieve a paradigm shift from punitive approaches to harm-reduction principles in clinical care and in drug policy: (1) through clinical research to provide data establishing the effectiveness and feasibility of harm-reduction approaches, (2) by developing innovative clinical programmes that employ harm reduction, and thereby (3) changing the standard of care to include routine use of these evidence-based (but often misunderstood) approaches in their practices. We argue that through promotion of harm-reduction goals and methods, clinicians have unique opportunities to improve the health outcomes of vulnerable populations.
Doruk, Bekir Kürsat
This research aimed to identify the educational approaches that pre-service elementary mathematics teachers adopt for their first teaching practice (TP) and the reasons for their choices. It was carried out with thirteen pre-service teachers (PTs). These PTs were observed during their first TP in a real school setting, and interviews were…
This study was designed to identify and investigate nursing faculty and student perspectives of self-directed learning in a practical nursing program. It also explored the degree to which student's perceptions of self-directed learning exhibited factors consistent with that of critical thinking. This study is important because self-directed…
Lev-Ran, Shaul; Nitzan, Uri; Fennig, Shmuel
Harm reduction is a general term for pragmatic interventions aimed at reducing problematic behaviors. Emerging from addiction treatments, it is based on the understanding that people will continue to behave in ways that pose a risk to them and their communities, and that an important goal of any treatment program is to minimize the harm associated with these behaviors. Despite its evidence based background, harm reduction is not readily applied in general psychiatry. This is mainly due to the complex ethical dilemmas arising within harm reduction practices, as well as a lack of scientific knowledge and theoretical frameworks essential for dealing with such ethical dilemmas. In this paper we introduce the fundamental theoretical and scientific base of harm reduction strategies, and present three clinical examples of the complex ethical dilemmas arising when working within a harm reduction practice. We finally present a theoretical framework for dealing with the ethical dilemmas and argue this may make harm reduction strategies more accessible in general psychiatry.
Owens, Robert C
The US Institute of Medicine's focus on patient safety has motivated hospital administrators to facilitate a culture of safety. As a result, subcommittees of the pharmacy and therapeutics committee have emerged in many hospitals to focus on adverse events and patient safety. Antimicrobial harms have gained the attention of practicing clinicians and hospital formulary committees, because they top the list of drugs that are associated with adverse events and because of certain serious harms that have ultimately led to the withdrawal of some antimicrobial agents. In the near future, several antimicrobials in the late phase of development will become available for clinical use (ceftobiprole, ceftaroline, and telavancin), and others (doripenem and dalbavancin) have recently joined the armamentarium. Because new antimicrobials will become part of the treatment armamentarium, it is important to discuss our current understanding of antimicrobial harms in general. Although not thought of as traditional adverse events, Clostridium difficile infection and development of resistance during therapy are adverse events that occur as a result of antimicrobial exposure and therefore are discussed. In addition, a distillation of our current understanding of β-lactam specific adverse events will be provided. Finally, new methods of administration are being evaluated that may influence peak concentration-related antimicrobial adverse events. PMID:18495060
Gray, Matt J; Maguen, Shira; Litz, Brett T
Nearly everyone will experience emotional and psychological distress in the immediate aftermath of a disaster or other large-scale traumatic event. Although extremely upsetting and disruptive, the reaction is understood best as a human response to inordinate adversity, which in the majority of cases remits over time without formal intervention. Nevertheless, some people experience sustained difficulties. To prevent chronic post-traumatic difficulties, mental health professionals provide early interventions soon after traumatic exposure. These interventions typically take the form of single-session debriefings, which have been applied routinely following disasters. The research bearing on these traditional forms of early crisis interventions has shown that, although well-received by victims, there is no empirical support for their continued use. However, promising evidence-based, early interventions have been developed, which are highlighted. Finally, traumatic bereavement and complicated grief in survivors of disasters, an area largely neglected in the field, is discussed.
Smith, Yda J; Stephenson, Stephanie; Gibson-Satterthwaite, Michelle
This case study sought to understand the meaning of restoring traditional weaving as an occupation among Karen women from Burma who now live in an urban city in the United States and to examine the impact of weaving on their daily lives in terms of identity, empowerment, social support, and opportunities for entrepreneurship. The story of one Karen woman, Paw Law Eh, is described. Her story exemplifies the negative consequences of restricted access to familiar and meaningful daily activities, or "occupations", the relationship between occupation and self-identity, how participation in valued occupations can enhance social networks, and the restorative effects that are possible when engagement in meaningful occupations are maintained or restored. Her story demonstrates that occupational therapists have the skills and opportunity to contribute significantly to the well-being of Karen women by supporting the restoration of the occupation of weaving.
This article investigates music in the concentration camps before the second world war. For the camp authorities, ordering prisoners to sing songs or play in orchestras was an instrument of domination. But for the prisoners, music could also be an expression of solidarity and survival: inmates could retain a degree of their own agency in the pre-war camps, despite the often unbearable living conditions and harsh treatment by guards. The present article emphasizes this ambiguity of music in the early camps. It illustrates the emergence of musical traditions in the pre-war camps which came to have a significant impact on everyday life in the camps. It helps to overcome the view that concentration camp prisoners were simply passive victims.
The practice of self-harm is increasing in the United Kingdom, accounting for the highest number of acute medical admissions for women. The medical and nursing response to repeaters, set within a climate of dwindling emergency and accident resources, has been one of impatience, frustration, and hostile care. The author undertook a correspondence study with 6 women who regularly self-harmed. The women claimed that medical and nursing professionals viewed their self-harm as irrational and illogical. However, a qualitative examination of the motivations and interests of all parties reveals that self-harm acts possess situated internal logic, whereas professionals tend to use rational logic in attempting to understand them.
Lewis, Lisa McConnell
Few events in the practice of a mental health clinician can be as devastating as the suicide of a client. Although suicide is a rare occurrence, clinicians face assessment of clients' risk for harming themselves on a regular basis. One well-accepted and widely practiced intervention for suicidal ideation is the use of no-harm contracts (NHC), although opinions about NHCs range from enthusiasm to apathy. The existing research does not support the use of such contracts as a method for preventing suicide, nor for protecting clinicians from malpractice litigation in the event of a client suicide.
Hao, Yufang; Guo, Hong
Objective. This study was to describe RNs' attitude, knowledge, and practice on evidence-based practice (EBP) in traditional Chinese nursing field and to estimate the related sociodemographic and professional factors. Methods. A multiple institutional cross-sectional survey design with self-reported EBP Questionnaire (EBPQ) and self-designed questionnaires were used. Results. The average scores of the total EBPQ were with a mean of 4.24 (SD = 0.79). The score of attitude was the highest one, followed by the knowledge score, and the lowest one is practice. RNs with longer experience reported stronger EBP knowledge (H = 6.64, P < 0.05). And RNs under higher working pressure reported less positive attitudes (ρ = 0.17, P < 0.001), whereas RNs holding negative professional attitude reported lower scores (Spearman's ρ: 0.12 to 0.15, P < 0.001). Significant statistics were found between RNs with research experience and without in attitude (t = −2.40, P < 0.05) and knowledge (t = −2.43, P < 0.05). Conclusions. Respondents generally viewed EBP positively and their attitudes towards EBP tended to be more positive than knowledge and practice of EBP. Data also showed that longer working experience, having administrative position, research experience, lighter working load, and better professional attitude might facilitate EBP. PMID:27528882
Williamson, Jonathan; Ramirez, Ronald; Wingfield, Tom
There is an urgent need for healthcare research, funding, and infrastructure in the Peruvian Amazon. We performed a descriptive study of health, health knowledge and practice, and healthcare access of 13 remote communities of the Manatí and Amazon Rivers in northeastern Peru. Eighty-five adults attending a medical boat service were interviewed to collect data on socioeconomic position, health, diagnosed illnesses, pain, healthcare access, and traditional versus modern medicine use. In this setting, poverty and gender inequality were prevalent, and healthcare access was limited by long distances to the health post and long waiting times. There was a high burden of reported pain (mainly head and musculoskeletal) and chronic non-communicable diseases, such as hypertension (19%). Nearly all participants felt that they did not completely understand their diagnosed illnesses and wanted to know more. Participants preferred modern over traditional medicine, predominantly because of mistrust or lack of belief in traditional medicine. Our findings provide novel evidence concerning transitional health beliefs, hidden pain, and chronic non-communicable disease prevalence in marginalized communities of the Peruvian Amazon. Healthcare provision was limited by a breach between health education, knowledge, and access. Additional participatory research with similar rural populations is required to inform regional healthcare policy and decision-making.
Williamson, Jonathan; Ramirez, Ronald; Wingfield, Tom
There is an urgent need for healthcare research, funding, and infrastructure in the Peruvian Amazon. We performed a descriptive study of health, health knowledge and practice, and healthcare access of 13 remote communities of the Manatí and Amazon Rivers in northeastern Peru. Eighty-five adults attending a medical boat service were interviewed to collect data on socioeconomic position, health, diagnosed illnesses, pain, healthcare access, and traditional versus modern medicine use. In this setting, poverty and gender inequality were prevalent, and healthcare access was limited by long distances to the health post and long waiting times. There was a high burden of reported pain (mainly head and musculoskeletal) and chronic non-communicable diseases, such as hypertension (19%). Nearly all participants felt that they did not completely understand their diagnosed illnesses and wanted to know more. Participants preferred modern over traditional medicine, predominantly because of mistrust or lack of belief in traditional medicine. Our findings provide novel evidence concerning transitional health beliefs, hidden pain, and chronic non-communicable disease prevalence in marginalized communities of the Peruvian Amazon. Healthcare provision was limited by a breach between health education, knowledge, and access. Additional participatory research with similar rural populations is required to inform regional healthcare policy and decision-making. PMID:25688165
Xing, Xiaoyan; Zhao, Yanling; Kong, Weijun; Jia, Lei; Wang, Jiabo; Yan, Dan; Li, Ruisheng; Xiao, Xiaohe
From the view of macroscopic animal ethology combined with computer and modem image processing technique, by monitoring the temperature tropism of animal affected by traditional Chinese medicine (TCM) with different Cold and Hot natures and obtaining many behavior parameters which were difficult to assess in direct observation, the differences between the Cold and Hot nature of TCM were evaluated and presented. This method could real-time, intuitively and objectively, qualitatively and quantitatively monitor the temperature tropism of experimental animals with no disturbance. Further, the Cold and Hot nature of TCM can be expressed from the whole animal level. This method met to the application peculiarity of TCM and suited for the TCM theoretical system. It is a attempt for the study of drug nature of TCM. It also contributed to elucidate the objective authenticity and scientific connotation of Cold and Hot nature of TCM, and express the inherent connection of this nature and the temperature tropism of animal. In this review, a new point and technology platform was provided for establishing an objective method for evaluating the Cold and Hot nature of TCM, which are corresponding with the feature of the application of TCM.
Lau, Nicholas; Sales, Paloma; Averill, Sheigla; Murphy, Fiona; Sato, Sye-Ok; Murphy, Sheigla
Background Cannabis use is becoming more accepted in mainstream society. In this paper, we use Zinberg’s classic theoretical framework of drug, set, and setting to elucidate how older adult cannabis users managed health, social and legal risks in a context of normalized cannabis use. Methods We present selected findings from our qualitative study of Baby Boomer (born 1946–1964) cannabis users in the San Francisco Bay Area. Data collection consisted of a recorded, in-depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analyzed to discover the factors of cannabis harm reduction from the users’ perspectives. Results Interviewees made harm reduction choices based on preferred cannabis derivatives and routes of administration, as well as why, when, where, and with whom to use. Most interviewees minimized cannabis-related harms so they could maintain social functioning in their everyday lives. Responsible and controlled use was described as moderation of quantity and frequency of cannabis used, using in appropriate settings, and respect for non-users. Users contributed to the normalization of cannabis use through normification. Conclusion Participants followed rituals or cultural practices, characterized by sanctions that helped define “normal” or “acceptable” cannabis use. Users contributed to cannabis normalization through their harm reduction methods. These cultural practices may prove to be more effective than formal legal prohibitions in reducing cannabis-related harms. Findings also suggest that users with access to a regulated market (medical cannabis dispensaries) were better equipped to practice harm reduction. More research is needed on both cannabis culture and alternative routes of administration as harm reduction methods. PMID:25911027
Rozycki, Edward G.
Nietzsche overlooks some possibilities. Something may not kill us, yet leave us sickly or crippled. But he is right, too. It may make us stronger. It is ancient wisdom that we grow through facing adversity: ad astra per aspera?to the stars through adversity. We know, too, that too much of something good may do us harm. One can overstudy, or…
Madge, Nicola; Hewitt, Anthea; Hawton, Keith; de Wilde, Erik Jan; Corcoran, Paul; Fekete, Sandor; van Heeringen, Kees; De Leo, Diego; Ystgaard, Mette
Background: Deliberate self-harm among young people is an important focus of policy and practice internationally. Nonetheless, there is little reliable comparative international information on its extent or characteristics. We have conducted a seven-country comparative community study of deliberate self-harm among young people. Method: Over 30,000…
Giri, Anjana; Katzensteiner, Klaus
Crop production, animal husbandry and forestry are three closely interlinked components of land use systems in the mountains of Nepal. Forests are the major source of fuel wood, construction materials, fodder and litter. The latter is used as a bedding material for livestock and forms an important component of farmyard manure. In addition forest grazing by cattle is a common practice. Excessive extraction of biomass from the forest leads to a decline of soil organic matter and nutrient contents. On the landscape scale these negative effects will partly be compensated by positive effects on soil organic matter and nutrient stocks of arable soils. The experimental data base for a quantification of such effects at the scale of communities is however poor, in particular for Nepal. Understanding the impact of subsistence farming on ecosystems is imperative in order to recommend successful and sustainable land management practices. The aim of our study is to quantify effects of land use on carbon and nitrogen pools and fluxes for mountain communities in Nepal. Results of a case study in the buffer zone area of the Sagarmatha National Park are presented. The potential vegetation comprises mixed forests of Quercus semicarpifolia, Rhododendron arboreum and Tsuga dumosa. Carbon and nitrogen stocks in soil and vegetation were quantified for three different land use types, namely: forest with low human impact, forests with high human impact and agricultural land. The scale of disturbance of the forests has been classified by visual estimation considering the percentage of litter raked, number of lopped trees, and grazing intensity assessed by signs of trampling and the number of trails. After stratification of the community area, 20 plots of 10 m radius were established (17 forest plots, 3 plots for arable land) where biometric data of the vegetation were determined and sub-samples were taken for chemical analyses. Organic layers (litter remaining after litter raking) and soil
Vitale, Maria; Tumino, Giovanni; Partanna, Samanta; La Chiusa, Stella; Mancuso, Giorgio; Giglia, Maria La; Presti, Vincenzo Di Marco Lo
A case of acute toxoplasmosis in an adolescent girl, almost certainly related to the consumption of raw sausage, is described. The girl suffered of fever and weakness and presented a swollen lymph node in the submandibular region. Serology analysis was positive for Toxoplasma gondii and excluded other infections. Further analysis, with avidity test and immunoblot, confirmed the acute toxoplasmosis. She reported that about a month before the appearance of the symptoms, she had eaten a piece of raw sausage while it was being prepared by her father. We analyzed sausage samples prepared from this same batch that had been frozen for later consumption, and they demonstrated evidence of T. gondii DNA when using a specific nested PCR assay. The sausage was prepared from the meat of a pig that had been backyard raised and slaughtered at home, a traditional practice in rural communities in many countries. The tasting of fresh prepared raw sausage is a common practice throughout Italy, and it could be a major cause for toxoplasmosis as suggested by the results of a questionnaire administered in the province of Palermo, Sicily. Contact with cats and, to a lesser extent, raw salad consumption were also referred to as presumptive causes for the symptomatic cases. Two additional cases of acute toxoplasmosis reported during questionnaire administration were alleged to have been caused by the consumption of fresh sausage made with the meat of a pig raised in the yard. Traditional practices in animal farming, and the processing of meat from animals raised in the backyard or meat from wild game animals, might have a big impact on food safety.
Mohamad, Ragaa Hosny; Zekry, Zekry Khalid; Al-Mehdar, Hussain A; Salama, Omar; El-Shaieb, Siad Ebrahim; El-Basmy, Amany A; Al-said, Mohamad Gamil Abdel Monem; Sharawy, Sabry Mohamed
There is a traditional belief in the Middle East that regular consumption of camel milk may aid in prevention and control of diabetes. The aim of this work was to evaluate the efficacy of camel milk as an adjuvant therapy in young type 1 diabetics. This 16-week randomized study enrolled 54 type 1 diabetic patients (average age 20 years) selected from those attending the outpatient diabetes clinic of the Menofia University Hospital, affiliated with Egypt's National Cancer Institute. Subjects were randomly divided into two groups of 27 patients: one received usual management (diet, exercise, and insulin), whereas the other received 500 mL of camel milk daily in addition to standard management. A control group of 10 healthy subjects was also assessed. The following parameters were evaluated at baseline and at 4 and 16 weeks: hemoglobin A1c (HbA1c), human C-peptide, lipid profile, serum insulin, anti-insulin antibodies, creatinine clearance, albumin in 24-hour urine, body mass index, and Diabetes Quality of Life score. The following parameters were significantly different between the usual-management group versus the camel milk group after 16 weeks: fasting blood sugar (227.2 +/- 17.7 vs. 98.9 +/- 16.2 mg/dL), HbA1c (9.59 +/- 2.05[%] vs. 7.16 +/- 1.84[%]), serum anti-insulin antibodies (26.20 +/- 7.69 vs. 20.92 +/- 5.45 microU/mL), urinary albumin excretion (25.17 +/- 5.43 vs. 14.54 +/- 5.62 mg/dL/24 hours), daily insulin dose (48.1 +/- 6.95 vs. 23 +/- 4.05 units), and body mass index (18.43 +/- 3.59 vs. 24.3 +/- 2.95 kg/m(2)). Most notably, C-peptide levels were markedly higher in the camel milk group (0.28 +/- 0.6 vs. 2.30 +/- 0.51 pmol/mL). These results suggest that, as an adjunct to standard management, daily ingestion of camel milk can aid metabolic control in young type 1 diabetics, at least in part by boosting endogenous insulin secretion.
Background Physicians involved in primary prevention are key players in CVD risk control strategies, but the expected reduction in CVD risk that would be obtained if all patients attending primary care had their risk factors controlled according to current guidelines is unknown. The objective of this study was to estimate the excess risk attributable, firstly, to the presence of CVD risk factors and, secondly, to the lack of control of these risk factors in primary prevention care across Europe. Methods Cross-sectional study using data from the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA), which involved primary care and outpatient clinics involved in primary prevention from 12 European countries between May 2009 and January 2010. We enrolled 7,434 patients over 50 years old with at least one cardiovascular risk factor but without CVD and calculated their 10-year risk of CVD death according to the SCORE equation, modified to take diabetes risk into account. Results The average 10-year risk of CVD death in study participants (N = 7,434) was 8.2%. Hypertension, hyperlipidemia, smoking, and diabetes were responsible for 32.7 (95% confidence interval 32.0-33.4), 15.1 (14.8-15.4), 10.4 (9.9-11.0), and 16.4% (15.6-17.2) of CVD risk, respectively. The four risk factors accounted for 57.7% (57.0-58.4) of CVD risk, representing a 10-year excess risk of CVD death of 5.66% (5.47-5.85). Lack of control of hypertension, hyperlipidemia, smoking, and diabetes were responsible for 8.8 (8.3-9.3), 10.6 (10.3-10.9), 10.4 (9.9-11.0), and 3.1% (2.8-3.4) of CVD risk, respectively. Lack of control of the four risk factors accounted for 29.2% (28.5-29.8) of CVD risk, representing a 10-year excess risk of CVD death of 3.12% (2.97-3.27). Conclusions Lack of control of CVD risk factors was responsible for almost 30% of the risk of CVD death among patients participating in the EURIKA Study. PMID:21923932
Martineau, F.P.; Graff, H.; Mitchell, C.; Lock, K.
Background The power to influence many social determinants of health lies within local government sectors that are outside public health's traditional remit. We analyse the challenges of achieving health gains through local government alcohol control policies, where legal and professional practice frameworks appear to conflict with public health action. Methods Current legislation governing local alcohol control in England and Wales is reviewed and analysed for barriers and opportunities to implement effective population-level health interventions. Case studies of local government alcohol control practices are described. Results Addressing alcohol-related health harms is constrained by the absence of a specific legal health licensing objective and differences between public health and legal assessments of the relevance of health evidence to a specific place. Local governments can, however, implement health-relevant policies by developing local evidence for alcohol-related health harms; addressing cumulative impact in licensing policy statements and through other non-legislative approaches such as health and non-health sector partnerships. Innovative local initiatives—for example, minimum unit pricing licensing conditions—can serve as test cases for wider national implementation. Conclusions By combining the powers available to the many local government sectors involved in alcohol control, alcohol-related health and social harms can be tackled through existing local mechanisms. PMID:23933915
... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Reports of harm. 1102.10 Section 1102.10... limited to, local government agencies, school systems, social services, child protective services, state... acupuncturists; (4) Child service providers including, but not limited to, child care centers, child...
... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Reports of harm. 1102.10 Section 1102.10... limited to, local government agencies, school systems, social services, child protective services, state... acupuncturists; (4) Child service providers including, but not limited to, child care centers, child...
... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Reports of harm. 1102.10 Section 1102.10... including, but not limited to, local government agencies, school systems, social services, child protective... acupuncturists; (4) Child service providers including, but not limited to, child care centers, child...
... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Reports of harm. 1102.10 Section 1102.10... limited to, local government agencies, school systems, social services, child protective services, state... acupuncturists; (4) Child service providers including, but not limited to, child care centers, child...
The current anti-doping policy (‘war on doping’) resembles the ‘war on drugs’ in several aspects, including a zero-tolerance approach, ideology encroaching on human rights and public health principles, high cost using public money for repression and control, and attempts to shape internationally harmonized legal frameworks to attain its aim. Furthermore, even if for different reasons, both wars seem not to be able to attain their objectives, and possibly lead to more harm to society than they can prevent. The Olympic buzz is mounting and we can expect multiple headlines in the media on doping and anti-doping stories related to this event. In this article we describe current anti-doping policy, reflect on its multiple unplanned consequences, and end with a discussion, if lessons learned from harm reduction experiences in the illicit drugs field could be applied to anti-doping. PMID:22788912
Doyle, L; Sheridan, A; Treacy, M P
WHAT IS KNOWN ON THE SUBJECT?: Self-harm is a relatively common occurrence in adolescents; however, there remains a lack of understanding about the motivations behind adolescent self-harm, and this poor understanding can have a negative impact on how mental health professionals respond to young people who self-harm. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This paper identifies the reasons for self-harm in a community sample of young people and finds that the functions of self-harm differ for different people and that there may be multiple reasons for self-harm. Findings provide support for the affect-regulation model of self-harm which states that young people self-harm to regulate how they are feeling, but provides little support for the interpersonal influence model which proposes that self-harm is an attempt to influence how other people respond to them. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Self-harm for most young people serves at least one specific function and is an indication of distress. There is a requirement for a non-pathologizing response towards young people who self-harm; self-harm should be understood as a meaningful behaviour rather than a symptom of an illness. Mental health nurses need to understand the multiple functions of self-harm. A better understanding of the individualized meaning behind self-harm can positively impact on attitudes towards young people who self-harm and provide for improved mental health service provision.
Deacon, S. Helene; Campbell, Emily; Tamminga, Meredith; Kirby, John
This study examined morphological processing of inflected and derived words by children in Grades 4, 6, and 8. Participants were shown root forms and inflected, derived, and orthographic control items (e.g., "harm", "harmed", "harmful", or "harmony"), followed by a fragment completion task (e.g., completing "h a_ _"). Participants were equally…
The demand for organs prompted the first use of elective ventilation in the UK in the 1990s. Recently the shortfall in supply of organs has once again prompted calls for elective ventilation to be instituted even in patients who are not brain dead. This paper proposes that the term 'elective' ventilation is a misnomer and the term non-therapeutic ventilation (NTV) should be used instead. It is further argued that the practice of NTV in cases of severe stroke is unethical and has the potential of causing a variety of harms to the patient, their relatives, and the healthcare professionals working in transplant teams and this may result in a backlash of reductions in the number of organ donations.
Pronovost, Peter J; Weaver, Sally J; Berenholtz, Sean M; Lubomski, Lisa H; Maragakis, Lisa L; Marsteller, Jill A; Pham, Julius Cuong; Sawyer, Melinda D; Thompson, David A; Weeks, Kristina; Rosen, Michael A
Purpose The purpose of this paper is to provide a practical framework that health care organizations could use to decrease preventable healthcare-acquired harms. Design/methodology/approach An existing theory of how hospitals succeeded in reducing rates of central line-associated bloodstream infections was refined, drawing from the literature and experiences in facilitating improvement efforts in thousands of hospitals in and outside the USA. Findings The following common interventions were implemented by hospitals able to reduce and sustain low infection rates. Hospital and intensive care unit (ICU) leaders demonstrated and vocalized their commitment to the goal of zero preventable harm. Also, leaders created an enabling infrastructure in the way of a coordinating team to support the improvement work to prevent infections. The team of hospital quality improvement and infection prevention staff provided project management, analytics, improvement science support, and expertise on evidence-based infection prevention practices. A third intervention assembled Comprehensive Unit-based Safety Program teams in ICUs to foster local ownership of the improvement work. The coordinating team also linked unit-based safety teams in and across hospital organizations to form clinical communities to share information and disseminate effective solutions. Practical implications This framework is a feasible approach to drive local efforts to reduce bloodstream infections and other preventable healthcare-acquired harms. Originality/value Implementing this framework could decrease the significant morbidity, mortality, and costs associated with preventable harms.
Graham, Jennifer L.; Dubrovsky, Neil M.; Eberts, Sandra M.
Cyanobacterial harmful algal blooms (CyanoHABs) are increasingly a global concern because CyanoHABs pose a threat to human and aquatic ecosystem health and cause economic damages. Despite advances in scientific understanding of cyanobacteria and associated compounds, many unanswered questions remain about occurrence, environmental triggers for toxicity, and the ability to predict the timing, duration, and toxicity of CyanoHABs. U.S. Geological Survey (USGS) scientists are leading a diverse range of studies to address CyanoHAB issues in water bodies throughout the United States, using a combination of traditional methods and emerging technologies, and in collaboration with numerous partners. By providing practical applications of cutting edge CyanoHAB research, USGS studies have advanced scientific understanding, enabling the development of approaches to help protect ecological and human health.
Fisk, S N
As the epidemic of HIV disease continues to grow among drug users and their sexual partners, new ways must be adopted to do prevention work, outreach, and service delivery to this population. The Harm Reduction Model offers methods of working with drug users, which are in contrast to traditional methods based on confrontation and that require abstinence before change can occur. This position paper examines the Harm Reduction Model and outlines areas in which the Association of Nurses in AIDS Care can play a role in the expansion of harm-reduction-based intervention and policies.
Stuttaford, Maria; Al Makhamreh, Sahar; Coomans, Fons; Harrington, John; Himonga, Chuma; Hundt, Gillian Lewando
Background State parties to human rights conventions and declarations are often faced with the seemingly contradictory problem of having an obligation to protect people from harmful practices while also having an obligation to enable access to culturally appropriate effective healing. As people increasingly migrate across the globe, previous distinctions between ‘traditional’ and ‘complementary and alternative medicine’ practices are being transcended. There are connections across transnational healing pathways that link local, national, and global movements of people and knowledge. Objective This paper contributes to the development of the concept and practice of the right to health in all its forms, exploring the right to traditional, complementary, and alternative health (R2TCAH) across different contexts. Design The paper draws on four settings – England, South Africa, Kenya, and Jordan – and is based on key informant interviews and a literature review undertaken in 2010, and updated in 2013. The paper begins by reviewing the international legal context for the right to health. It then considers legal and professional regulations from the global north and south. Results Additional research is needed to establish the legal basis, compare regulatory frameworks, and explore patient and provider perspectives of regulation. This leads to being able to make recommendations on how to balance protection from harm and the obligation to ensure culturally appropriate services. Such an exploration must also challenge Western theories of human rights. Key concepts, such as individual harm, consent, and respect of the autonomy of the individual already established and recognised in international health law, could be adopted in the development of a template for future comparative research. Conclusions Exploration of the normative content of the right to health in all its forms will contribute to supporting traditional, complementary, and alternative health service
Reid, Robert J.
Harm-reduction interventions and policies have emerged as viable strategies to ameliorate the adverse health, social, or economic consequences associated with injection-related behaviors. Highlights the common principles central to harm- reduction practice, based on a public health model. (Contains 26 references.) (GCP)
van Dam, Frits S A M; Renckens, Cees N M
The Dutch parliament has recently accepted a tax law in which certain groups of alternative therapists can be exempt from VAT. To be eligible for this VAT exemption, the disciplines to which the therapists belong have to meet certain training requirements. In this article it is contended, in agreement with the Royal College of Physicians in the UK, that statutory regulation is inappropriate for disciplines whose therapies are neither of proved benefit nor appropriately tested. It legitimizes harmful therapies. This is illustrated by two serious accidents, previously described in this journal, caused by a chiropractor and a craniosacral therapist.
Yalmadau, Kelly; Maluchmai, Maryann R; Tun, Petra; Yinnifel, Cyril; Hancock, W Thane
Background Death remains one of the most important and significant activities in Yap, an event that involves the entire island. A death of a Yapese not only unites the family, it initiates a complex series of reaffirmed kinship ties, rituals and exchanges that refocus the entire community and create new social identities for the participants. How these ties, exchanges, and identities are changing due to new economic challenges and new social pressures were the focus of this preliminary study, which sought to document the resiliency or fragility of traditional structures, measured in the efforts around death and dying in Yap and to identify ways that the health care system can intervene to improve palliative care. Methods 226 persons (49 on Wa'ab - Yap Proper - and 177 on the Outer Islands) participated in 16 focus groups, of which eight were on Wa'ab and eight on four Outer Islands: Fais, Falalop, Fetherai, and Mogmog. We additionally conducted 6 semi-structured open-ended key informant interviews, added to capture more of Yap's enormous sociocultural diversity. Results The islands of Yap, particularly the Outer Islands, continue to support one of the world's best traditional palliative care involving the immediate family, more distant relatives and in many cases the entire community. However, participants showed considerable concern for ways that this system is weakening and offered numerous suggestions for improving and strengthening palliative care in Yap. Discussion Although caution must be exercised not to undermine the existing system, six recommendations on how the health system can intervene can be identified. These involve identifying a key resource person on each island; supplying small, practical “comfort care” kits; making more pain medication available; conducting regular home visits; improving patient-physician and physician-family communication; designing a suicide intervention strategy; and documenting existing variations of how the dying are
Feldman, Katherine A; Walters, Bettye K
The Virginia-Maryland Regional College of Veterinary Medicine (VMRCVM), a regional veterinary college for Maryland and Virginia, has a long and unique tradition of encouraging careers in public and corporate veterinary medicine. The VMRCVM is home to the Center for Public and Corporate Veterinary Medicine (CPCVM), and each year approximately 10% of the veterinary students choose the public/corporate veterinary medicine track. The faculty of the CPCVM, and their many partners from the veterinary public practice community, teach in the veterinary curriculum and provide opportunities for students locally, nationally, and internationally during summers and the final clinical year. Graduates of the program work for government organizations, including the US Department of Agriculture, the Food and Drug Administration, and the Centers for Disease Control and Prevention, as well as in research, in industry, and for non-governmental organizations. Recent activities include securing opportunities for students, providing career counseling for graduate veterinarians interested in making a career transition, delivering continuing education, and offering a preparatory course for veterinarians sitting the board examination for the American College of Veterinary Preventive Medicine. As the VMRCVM moves forward in recognition of the changing needs of the veterinary profession, it draws on its tradition of partnership and capitalizes on the excellence of its existing program. Future plans for the CPCVM include possible expansion in the fields of public health, public policy, international veterinary medicine, organizational leadership, and the One Health initiative. Quality assurance and evaluation of the program is ongoing, with recognition that novel evaluation approaches will be useful and informative.
Laye-Gindhu, Aviva; Schonert-Reichl, Kimberly A.
This study examines self-harm in a community sample of adolescents. More specifically, the study identifies the prevalence and types of self-harm, elucidates the nature and underlying function of self-harm, and evaluates the relation of psychological adjustment, sociodemographic, and health-risk variables to self-harm. Self-report questionnaires…
McDonald, Katherine E.; Conroy, Nicole E.; Olick, Robert S.
Scientific advances can improve the lives of adults with intellectual disability, yet concerns that research participation may impose harm impede scientific progress. What counts as harmful can be subjective and perceptions of harm may vary among stakeholders. We studied perspectives on the harmfulness of research events among adults with…
Olaoye, Iyiade Olatunde; Adensina, Micheal Dapo
Retained rectal foreign bodies are most commonly seen in homosexuals and after assault. A few have been reported after self-treatment of anorectal conditions and prostatic massage. Harmful traditional medical practices have been reported in many communities in Africa but therapeutic anal insertion of foreign bodies for the management of haemorrhoids is rare. We present a patient with features of peritonitis following insertion of a wine bottle into his rectum in an attempt to manage his prolapsed haemorrhoids.
Will Large DSO-Managed Group Practices Be the Predominant Setting for Oral Health Care by 2025? Two Viewpoints: Viewpoint 1: Large DSO-Managed Group Practices Will Be the Setting in Which the Majority of Oral Health Care Is Delivered by 2025 and Viewpoint 2: Increases in DSO-Managed Group Practices Will Be Offset by Models Allowing Dentists to Retain the Independence and Freedom of a Traditional Practice.
Cole, James R; Dodge, William W; Findley, John S; Young, Stephen K; Horn, Bruce D; Kalkwarf, Kenneth L; Martin, Max M; Winder, Ronald L
This Point/Counterpoint article discusses the transformation of dental practice from the traditional solo/small-group (partnership) model of the 1900s to large Dental Support Organizations (DSO) that support affiliated dental practices by providing nonclinical functions such as, but not limited to, accounting, human resources, marketing, and legal and practice management. Many feel that DSO-managed group practices (DMGPs) with employed providers will become the setting in which the majority of oral health care will be delivered in the future. Viewpoint 1 asserts that the traditional dental practice patterns of the past are shifting as many younger dentists gravitate toward employed positions in large group practices or the public sector. Although educational debt is relevant in predicting graduates' practice choices, other variables such as gender, race, and work-life balance play critical roles as well. Societal characteristics demonstrated by aging Gen Xers and those in the Millennial generation blend seamlessly with the opportunities DMGPs offer their employees. Viewpoint 2 contends the traditional model of dental care delivery-allowing entrepreneurial practitioners to make decisions in an autonomous setting-is changing but not to the degree nor as rapidly as Viewpoint 1 professes. Millennials entering the dental profession, with characteristics universally attributed to their generation, see value in the independence and flexibility that a traditional practice allows. Although DMGPs provide dentists one option for practice, several alternative delivery models offer current dentists and future dental school graduates many of the advantages of DMGPs while allowing them to maintain the independence and freedom a traditional practice provides.
Mbassa Menick, D
Youth-related violence is a frequent topic of press reports and editorial comment. The most disturbing aspects of the phenomenon are the younger and younger age of delinquents and the greater and greater availability of firearms. While the advocates of an American-style approach of absolute repression clash with those of the educative approach to change aggressive attitudes and young people benefit from their "minor" status, the compelling reality is that all preventive programs have failed flatly. This purpose of this study was twofold. The first aim was to highlight the important contribution of tradition and custom to channeling youthful behavior in African society today and yesterday through signification and transmission of law in familial, social, educative and juridical practices. The second goal was to identify and define the psycho-relational elements that can be considered as factors promoting violent and self-destructive tendencies in minors of African origin tempted by migration in a society in which social representations inhibit parents and prevent them from conveying the limits of the law in their children.
Molia, Sophie; Traoré, Idrissa; Kamissoko, Badian; Diakité, Adama; Sidibé, Maimouna Sanogo; Sissoko, Kadiatou Diarra; Pfeiffer, Dirk Udo
We aimed at characterizing commercial and traditional village poultry farming in Mali, with a focus on practices influencing the risk of transmission of avian influenza and Newcastle disease. Surveys were conducted in 2009-2011 in a study area covering approximately 98% of the Malian poultry population. Among the 282 commercial farms investigated, of which 64 had not been known by the government authorities, 83% were located within a 50km radius from the capitals of the country and regions and 54% had low biosecurity standard. Among the 152 randomly selected village household flocks investigated, characteristics were overall similar to those in other African countries but some differences were notable including a large flock size (median 44 poultry), a low presence of ducks and geese (11% and 1.1% of flocks, respectively), vaccination against Newcastle disease being common (49% of flocks), a low proportion of households selling sick and dead birds (0.7% and 0%, respectively) and limited cohabitation between poultry and humans at night. Our recommendations to limit the risk of disease transmission include (1) for commercial farms, to introduce compulsory farm registration and accreditation, to increase technical proficiency and access to credit for farms with low biosecurity, and to support poultry producer associations; (2) for village poultry, to promote better quarantine and management of sick and dead birds. Such detailed knowledge of country-specific characteristics of poultry production systems is essential to be able to develop more efficient disease risk management policies.
Aronoff, J; Lynn, S J; Malinoski, P
This article is the first critical review of research that addresses the question of whether cult membership is psychologically harmful. The available evidence warrants three conclusions: (a) persons entering cults do not necessarily exhibit psychopathology; (b) current cult members appear psychologically well-adjusted generally, and demonstrate few conspicuous symptoms of psychopathology. However, pathology may be masked by conformity pressures and demand characteristics associated with the cultic environment; (c) a small but growing body of research indicates that at least a substantial minority of former cult members experience significant adjustment difficulties. There also are indications that these difficulties cannot be ascribed to demand characteristics. Although the review highlights definitional and methodological issues and problems that temper conclusions that can be drawn from the literature, no evidence indicates that cults improve adjustment after members leave the cultic environment.
Sullivan, Patrick J
This paper considers the ethical justification for the use of harm minimisation approaches with individuals who self-injure. While the general issues concerning harm minimisation have been widely debated, there has been only limited consideration of the ethical issues raised by allowing people to continue injuring themselves as part of an agreed therapeutic programme. I will argue that harm minimisation should be supported on the basis that it results in an overall reduction in harm when compared with more traditional ways of dealing with self-injurious behaviour. It will be argued that this is an example of a situation where healthcare professionals sometimes have a moral obligation to allow harm to come to their patients.
Homsy, Jaco; King, Rachel; Tenywa, Joseph; Kyeyune, Primrose; Opio, Alex; Balaba, Dorothy
In many resource-poor settings of Africa, a majority of people living with HIV/AIDS depend on and choose traditional healers for psychosocial counseling and health care. If the current pan-African prevention and care efforts spurred by the HIV pandemic do not actively engage African Traditional Medicine, they will effectively miss 80%, the vast majority of the African people who, according to the World Health Organization, rely on traditional medicine for their primary health care needs. In 2001, the Ugandan nongovernmental organization, Traditional and Modern Health Practitioners Together Against AIDS and Other Diseases, in Kampala, identified the need for a concerted, systematic, and sustained effort at both local and regional levels to support and validate African Traditional Medicine on several fronts. The Eastern & Southern Africa Regional Initiative on Traditional Medicine and AIDS was borne out of this assessment. It convened a regional consultation in May 2003, which produced a series of proposed standards around six main themes related to traditional medicine and HIV/AIDS: the systematic evaluation of traditional remedies; spiritual aspects of healing; HIV prevention and care; processing and packaging of traditional remedies; protection of indigenous knowledge; and intellectual property rights related to traditional health systems. These standards, summarized in this paper, will be incorporated into programs on traditional medicine and HIV/AIDS by various implementers in the region. A number of strategies to test and implement these recommendations are also defined.
Daly, Robin M.; Ebeling, Peter R.
Most current guidelines recommend that older adults and the elderly strive for a total calcium intake (diet and supplements) of 1,000 to 1,300 mg/day to prevent osteoporosis and fractures. Traditionally, calcium supplements have been considered safe, effective and well tolerated, but their safety has recently been questioned due to potential adverse effects on vascular disease which may increase mortality. For example, the findings from a meta-analysis of randomized controlled trials (currently published in abstract form only) revealed that the use of calcium supplements was associated with an ~30% increased risk of myocardial infarction. If high levels of calcium are harmful to health, this may alter current public health recommendations with regard to the use of calcium supplements for preventing osteoporosis. In this review, we provide an overview of the latest information from human observational and prospective studies, randomized controlled trials and meta-analyses related to the effects of calcium supplementation on vascular disease and related risk factors, including blood pressure, lipid and lipoprotein levels and vascular calcification. PMID:22254038
Daly, Robin M; Ebeling, Peter R
Most current guidelines recommend that older adults and the elderly strive for a total calcium intake (diet and supplements) of 1,000 to 1,300 mg/day to prevent osteoporosis and fractures. Traditionally, calcium supplements have been considered safe, effective and well tolerated, but their safety has recently been questioned due to potential adverse effects on vascular disease which may increase mortality. For example, the findings from a meta-analysis of randomized controlled trials (currently published in abstract form only) revealed that the use of calcium supplements was associated with an ~30% increased risk of myocardial infarction. If high levels of calcium are harmful to health, this may alter current public health recommendations with regard to the use of calcium supplements for preventing osteoporosis. In this review, we provide an overview of the latest information from human observational and prospective studies, randomized controlled trials and meta-analyses related to the effects of calcium supplementation on vascular disease and related risk factors, including blood pressure, lipid and lipoprotein levels and vascular calcification.
MacCoun, R J
This article discusses 3 different strategies for dealing with the harmful consequences of drug use and other risky behaviors: We can discourage people from engaging in the behavior (prevalence reduction), we can encourage people to reduce the frequency or extent of the behavior (quantity reduction), or we can try to reduce the harmful consequences of the behavior when it occurs (harm reduction). These strategies are not mutually exclusive; this article offers a framework for integrating them. The framework is useful for examining frequent claims that harm reduction "sends the wrong message." Opposition to harm reduction is based in part on a recognition of potential trade-offs among the strategies, but it is also fueled by several more symbolic psychological factors. Strategies for successfully integrating prevalence reduction, quantity reduction, and harm reduction are explored.
Peltzer, Karl; Phaswana-Mafuya, Nancy; Treger, Latasha
The aim of this study was as part of a baseline assessment in PMTCT in the traditional health sector: a) to determine the views of women who have used the services of traditional practitioners before, during and/or after pregnancy, and b) to conduct formative research with traditional health practitioners (THPs), i.e. herbalists, diviners and traditional birth attendants (TBAs) on HIV, pregnancy care, delivery and infant care. The sample included a) 181 postnatal care clients with a child less than 12 months interviewed at postnatal clinic visits from 20 primary care clinics in the Kouga Local Service Area (LSA), Cacadu district, Eastern Cape, and b) 54 traditional birth attendants (TBAs) and 47 herbalists and/or diviners were interviewed from Kouga LSA. Results showed that THP (in particular TBAs and to a certain extend herbalists/diviners) play a significant role in pregnancy and postnatal care, and also with the assistance of delivery. Certain HIV risk practices were reported on the practice of TBAs. THPs also seem to have some role in infant feeding and family planning. THPs should be trained in optimising their services in pregnancy and postnatal care, and preparation for health facility delivery. In addition, they should be trained on HIV risk practices, HIV/AIDS, HIV prevention including PMTCT, infant feeding and family planning.
Kiesling, Richard L.; Gary, Robin H.; Gary, Marcus O.
Harmful algal blooms can occur when certain types of microscopic algae grow quickly in water, forming visible patches that might harm the health of the environment, plants, or animals. In freshwater, species of Cyanobacteria (also known as bluegreen algae) are the dominant group of harmful, bloom-forming algae. When Cyanobacteria form a harmful algal bloom, potential impairments include restricted recreational activities because of algal scums or algal mats, potential loss of public water supply because of taste and odor compounds (for example, geosmin), and the production of toxins (for example, microcystin) in amounts capable of threatening human health and wildlife.
Kimergård, Andreas; McVeigh, Jim
Objectives The illicit use of anabolic steroids among the gym population continues to rise, along with the number of steroid using clients attending harm reduction services in the UK. This presents serious challenges to public health. Study objectives were to account for the experiences of anabolic steroid users and investigate how ‘risk environments’ produce harm. Methods Qualitative face-to-face interviews with 24 users of anabolic steroids engaged with harm reduction services in the UK. Results Body satisfaction was an important factor when deciding to start the use of anabolic steroids. Many users were unaware of the potential dangers of using drugs from the illicit market, whereas some had adopted a range of strategies to negotiate the hazards relating to the use of adulterated products, including self-experimentation to gauge the perceived efficacy and unwanted effects of these drugs. Viewpoints, first-hand anecdotes, norms and practices among groups of steroid users created boundaries of ‘sensible’ drug use, but also promoted practices that may increase the chance of harms occurring. Established users encouraged young users to go to harm reduction services but, at the same time, promoted risky injecting practices in the belief that this would enhance the efficacy of anabolic steroids. Conclusions Current steroid-related viewpoints and practices contribute to the risk environment surrounding the use of these drugs and may undermine the goal of current public health strategies including harm reduction interventions. The level of harms among anabolic steroid users are determined by multiple and intertwining factors, in addition to the harms caused by the pharmacological action or injury and illness associated with incorrect injecting techniques. PMID:24898090
Osteoporosis Screening in Male Veterans PRINCIPAL INVESTIGATOR: Cathleen S. Colón-Emeric, MD, MHS CONTRACTING ORGANIZATION: Institute...TYPE Annual 3. DATES COVERED 1 October 2012 – 30 September 2013 4. TITLE AND SUBTITLE Benefits, Costs and Harms of Osteoporosis Screening in...to screen for and treat osteoporosis in men. The recommendations of clinical practice guidelines vary in how to select men to be screened, and the
Education programs are a central element of Australian harm reduction drug policy. Considered less judgmental and more effective than the punitive policies of Australia's past, harm reduction drug education is premised on the goal of reducing 'risks' and harms associated with illicit drug use rather than an elimination of use per se. In this article I analyse two sets of key texts designed to reduce drug related harm in Australia: harm reduction teaching resources designed for classroom use and social marketing campaigns that are targeted to a more general audience. I identify two significant accounts of young people's drug use present in Australian harm reduction drug education: 'damaged mental health' and 'distress'. I then draw on some of Deleuze and Guattari's key concepts to consider the harm reducing potential these accounts may have for young people's drug using experiences. To demonstrate the potential limitations of current drug education, I refer to an established body of work examining young people's experiences of chroming. From here, I argue that the accounts of 'damaged mental health' and 'distress' may work to limit the capacity of young drug users to practice safer drug use. In sum, current Australian harm reduction drug education and social marketing may be producing rather than reducing drug related harm.
Kashyap, C. A.
The supply of good quality food is main necessity for economic and social health of urban and rural population throughout the globe. This study comes to know the severity of As in the west Bengal and north-eastern states of the India. Over the 75% large population of India lives in villages and associated with farming and its related work. West Bengal is the densest populated area of India, fish and rice is the staple food as well as in north-eastern states. For the fulfil demand of fish large population the area are used fisheries as the business. Arsenic contamination in ground water is major growing threat to worldwide drinking water resources. High As contamination in water have been reported in many parts of the world Chandrasekharam et al., 2001; Smedley and Kinniburgh, 2002; Farooq et al., 2010). In context to West Bengal and north-east states of India arsenic is main problem in the food chain. These areas are very rich in arsenic many fold higher concentrations of Arsenic than their respective WHO permissible limits have been reported in the water. Over the 36 million people in Bengal delta are at risk due to drinking of As contaminated water (Nordstrom, 2002). The highest concentration of arsenic (535 μg/L Chandrashekhar et al. 2012) was registered from Ngangkha Lawai Mamang Leikai area of Bishnupur district which is fifty fold of the WHO limit for arsenic and tenfold of Indian permissible limit. With the continuous traditional practicing (As rich water pond) and untreated arsenic rich water in fish industries leads to health hazards. A sustainable development in aquaculture should comprise of various fields including environmental, social, cultural and economic aspects. A scientific study has to be needed for the overcome on this problem and rain harvested water may be used for reduce the arsenic problems in fisheries.
Tanning for cosmetic purposes by sunbathing or by using artificial tanning devices is widespread. The hazards associated with exposure to ultraviolet radiation are of concern to the medical profession. Depending on the amount and form of the radiation, as well as on the skin type of the individual exposed, ultraviolet radiation causes erythema, sunburn, photodamage (photoaging), photocarcinogenesis, damage to the eyes, alteration of the immune system of the skin, and chemical hypersensitivity. Skin cancers most commonly produced by ultraviolet radiation are basal and squamous cell carcinomas. There also is much circumstantial evidence that the increase in the incidence of cutaneous malignant melanoma during the past half century is related to increased sun exposure, but this has not been proved. Effective and cosmetically acceptable sunscreen preparations have been developed that can do much to prevent or reduce most harmful effects to ultraviolet radiation if they are applied properly and consistently. Other safety measures include (1) minimizing exposure to ultraviolet radiation, (2) being aware of reflective surfaces while in the sun, (3) wearing protective clothing, (4) avoiding use of artificial tanning devices, and (5) protecting infants and children.
May-Chahal, Corinne; Humphreys, Leslie; Clifton, Alison; Francis, Brian; Reith, Gerda
Incarcerated populations across the world have been found to be consistently and significantly more vulnerable to problem gambling than general populations in the same countries. In an effort to gain a more specific understanding of this vulnerability the present study applied latent class analysis and criminal career theory to gambling data collected from a sample of English and Scottish, male and female prisoners (N = 1057). Theoretical links between gambling and crime were tested through three hypotheses: (1) that prisoners in the UK would have higher rates of problem gambling behaviour than the national population; (2) that if the link between gambling and crime is coincidental, gambling behaviour would be highly prevalent in an offending population, and (3) if connections between gambling behaviour and offending are co-symptomatic a mediating factor would show a strong association. The first of these was supported, the second was not supported and the third was partially supported. Latent class analysis found six gambling behaviour clusters measured by responses to the Problem Gambling Severity Index, primarily distinguished by loss chasing behaviour. Longitudinal offending data drawn from the Police National Computer database found four criminal career types, distinguished by frequency and persistence over time. A significant association was found between higher level loss chasing and high rate offending in criminal careers suggesting that impulse control may be a mediating factor for both gambling harm and criminal careers.
Gonye, Jairos; Moyo, Nathan
This paper examines the teaching and learning of traditional dance at primary school level in Zimbabwe as a key aspect of postcolonial curriculum reimagination within the broader project of reclaiming a nation's heritage. The paper used the survey design to determine how a cohort of primary school teachers understood traditional dance and how they…
Eversman, Michael H.
Professional social work largely has endorsed the empirically supported paradigm of harm reduction in relation to substance abuse issues. Despite literature detailing similarities between social work and harm reduction, little is known about its presence in MSW substance abuse coursework. A purposive sample of 133 social work faculty from…
Ougrin, Dennis; Tranah, Troy; Leigh, Eleanor; Taylor, Lucy; Asarnow, Joan Rosenbaum
Background: Repeated self-harm in adolescents is common and associated with elevated psychopathology, risk of suicide, and demand for clinical services. Despite recent advances in the understanding and treatment of self-harm there have been few systematic reviews of the topic. Aims: The main aim of this article is to review randomised controlled…
Symonds, Catherine S.; Taylor, Steve; Tippins, Val; Turkington, Douglas
Patients with schizophrenia have a substantial lifetime suicide risk, especially by violent means. Little published work exists on self-harm (SH) in this population. The goal of this study was to examine whether patients with schizophrenia were also more likely to self-harm in a violent manner. A retrospective analysis performed on method, motive,…
... HUMAN SERVICES Food and Drug Administration Harmful and Potentially Harmful Constituents in Tobacco Products and Tobacco Smoke; Established List AGENCY: Food and Drug Administration, HHS. ACTION: Notice; establishment of a list. SUMMARY: The Food and Drug Administration (FDA) is establishing a list of harmful...
Freedman, Aviva, Ed.; Pringle, Ian, Ed.
The 19 conference papers in this collection deal with the relationship of various rhetorical theories and their practical applications to the rhetorical traditions that they are superseding. The papers deal with many topics, including the following: (1) a multidisciplinary approach to writing instruction; (2) the importance of writing as a human…
Harm reduction has been increasingly finding its way into public drug policies and healthcare practices worldwide, with successful intervention measures justifiably focussing on the highest-risk groups, such as injecting drug users. However, there are also other types of drug users in need for harm reduction, even though they pose less, low, or no public health risk. Occasionally, drug users may autonomously organise themselves into groups to provide advocacy, harm reduction, and peer-help services, sometimes online. The http://www.daath.hu website has been operated since 2001 by the “Hungarian Psychedelic Community”, an unorganised drug user group with a special interest in hallucinogenic and related substances. As of today, the website serves about 1200 visitors daily, and the online community comprises of more than 8000 registered members. The Daath community is driven by a strong commitment to the policy of harm reduction in the form of various peer-help activities that aim to expand harm reduction without promoting drug use. Our review comprehensively summarises Daath’s user-led harm reduction services and activities from the last ten years, firstly outlining the history and growth phases of Daath, along with its self-set guidelines and policies. Online services (such as a discussion board, and an Ecstasy pill database) and offline activities (such as Ecstasy pill field testing, and a documentary film about psychedelics) are described. In order to extend its harm reduction services and activities in the future, Daath has several social, commercial, and legislative challenges to face. Starting with a need to realign its focus, outlooks for the upcoming operation of Daath are pondered. Future trends in harm reduction, such as separating harm-decreasing from benefit-increasing, are also discussed. We aim to share these innovative harm reduction measures and good practices in order to be critically assessed, and – if found useful – adapted and applied
Móró, Levente; Rácz, József
Harm reduction has been increasingly finding its way into public drug policies and healthcare practices worldwide, with successful intervention measures justifiably focussing on the highest-risk groups, such as injecting drug users. However, there are also other types of drug users in need for harm reduction, even though they pose less, low, or no public health risk. Occasionally, drug users may autonomously organise themselves into groups to provide advocacy, harm reduction, and peer-help services, sometimes online. The http://www.daath.hu website has been operated since 2001 by the "Hungarian Psychedelic Community", an unorganised drug user group with a special interest in hallucinogenic and related substances. As of today, the website serves about 1200 visitors daily, and the online community comprises of more than 8000 registered members. The Daath community is driven by a strong commitment to the policy of harm reduction in the form of various peer-help activities that aim to expand harm reduction without promoting drug use. Our review comprehensively summarises Daath's user-led harm reduction services and activities from the last ten years, firstly outlining the history and growth phases of Daath, along with its self-set guidelines and policies. Online services (such as a discussion board, and an Ecstasy pill database) and offline activities (such as Ecstasy pill field testing, and a documentary film about psychedelics) are described. In order to extend its harm reduction services and activities in the future, Daath has several social, commercial, and legislative challenges to face. Starting with a need to realign its focus, outlooks for the upcoming operation of Daath are pondered. Future trends in harm reduction, such as separating harm-decreasing from benefit-increasing, are also discussed. We aim to share these innovative harm reduction measures and good practices in order to be critically assessed, and--if found useful--adapted and applied elsewhere.
A very systematic study made in Karjat, Maharasht (a tribal area in India) has found that in comparison with the official health care and primary health centers, the traditional health practices are far more comprehensive. However, although the local traditions are comprehensive in their 'scope', they nevertheless reveal several weaknesses when subjected to critical evaluation by the science of Ayurveda. For example, whereas some remedies are found to be sound, there are others that are incomplete, and some appear to be totally distorted. Similarly, the diagnostic abilities of local practitioners, while sound in some cases, are in several others found to be inadequate. As to the use of local herbs, whereas the local tradition has an amazing knowledge of local flora--the knowledge about properties of plants is in many cases incomplete. There are several reasons that may explain how and why these weaknesses have set in. 1st, the local traditions are 'oral' and in the natural course of things, oral traditions the world over have been found to decay over time. A 2nd, external, reason for the current decay of local traditions is the derision, neglect, and oppression they have suffered due to the intolerance of western scientific tradition. A 3rd reason for weaknesses in the local health stream is the breakdown of active links, during the last few centuries, with the mainstream science of Ayurveda.
Nonhuman animal ("animal") experimentation is typically defended by arguments that it is reliable, that animals provide sufficiently good models of human biology and diseases to yield relevant information, and that, consequently, its use provides major human health benefits. I demonstrate that a growing body of scientific literature critically assessing the validity of animal experimentation generally (and animal modeling specifically) raises important concerns about its reliability and predictive value for human outcomes and for understanding human physiology. The unreliability of animal experimentation across a wide range of areas undermines scientific arguments in favor of the practice. Additionally, I show how animal experimentation often significantly harms humans through misleading safety studies, potential abandonment of effective therapeutics, and direction of resources away from more effective testing methods. The resulting evidence suggests that the collective harms and costs to humans from animal experimentation outweigh potential benefits and that resources would be better invested in developing human-based testing methods.
European literature contains fictional descriptions of self-harm and self-punishment over a time span of almost 2 500 years. This article presents such descriptions, from Sofocles' tragedy about King Oedipus to contemporary literature. Particular interest is dedicated to the Austrian Nobel prize laureate Elfriede Jelinek and the Norwegian author Karl Ove Knausgård. In Jelinek's fictional universe, self-harm is particularly related to the topic of autonomy in a family context; while Knausgård describes the role of shame in triggering and sustaining self-harming behaviour.
Hing, Nerilee; Breen, Helen; Gordon, Ashley; Russell, Alex
This paper aimed to analyze the harms arising from gambling and gambling-related help-seeking behaviour within a large sample of Indigenous Australians. A self-selected sample of 1,259 Indigenous Australian adults completed a gambling survey at three Indigenous sports and cultural events, in several communities and online. Based on responses to the problem gambling severity index (PGSI), the proportions of the sample in the moderate risk and problem gambler groups were higher than those for the population of New South Wales. Many in our sample appeared to face higher risks with their gambling and experience severe gambling harms. From PGSI responses, notable harms include financial difficulties and feelings of guilt and regret about gambling. Further harms, including personal, relationship, family, community, legal and housing impacts, were shown to be significantly higher for problem gamblers than for the other PGSI groups. Most problem gamblers relied on family, extended family and friends for financial help or went without due to gambling losses. Nearly half the sample did not think they had a problem with gambling but the results show that the majority (57.7 %) faced some risk with their gambling. Of those who sought gambling help, family, extended family, friends and respected community members were consulted, demonstrating the reciprocal obligations underpinning traditional Aboriginal culture. The strength of this finding is that these people are potentially the greatest source of gambling help, but need knowledge and resources to provide that help effectively. Local Aboriginal services were preferred as the main sources of professional help for gambling-related problems.
A panel of experts has reviewed the evidence regarding the benefits and harms of screening for lung cancer with low-dose computed tomography (CT) and concluded that the technology may benefit some individuals at high risk for lung cancer. But the panel cautioned that many questions remain about the potential harms of screening and how to translate screening into clinical practice. |
Introduction Communication skills training, responsibility, respect, and self-awareness are important indexes of changing learning behaviours in modern approaches. Aim The aim of this study was to investigate the efficacy of three learning approaches, collaborative, context-based learning (CBL), and traditional, on learning, attitude, and behaviour of undergraduate nursing students. Materials and Methods This study was a clinical trial with pretest and post-test of control group. The participants were senior nursing students. The samples were randomly assigned to three groups; CBL, collaborative, and traditional. To gather data a standard questionnaire of students’ behaviour and attitude was administered prior to and after the intervention. Also, the rate of learning was investigated by a researcher-developed questionnaire prior to and after the intervention in the three groups. Results In CBL and collaborative training groups, the mean score of behaviour and attitude increased after the intervention. But no significant association was obtained between the mean scores of behaviour and attitude prior to and after the intervention in the traditional group. However, the mean learning score increased significantly in the CBL, collaborative, and traditional groups after the study in comparison to before the study. Conclusion Both CBL and collaborative approaches were useful in terms of increased respect, self-awareness, self-evaluation, communication skills and responsibility as well as increased motivation and learning score in comparison to traditional method. PMID:27190926
Harmful algal blooms (HABs) are increasingly becoming a significant ecologic, economic, and social driver in the use of water resources. Cyanobacteria and their toxins play an important role in management decisions for drinking water utilities and public health officials. Online ...
Climate change is predicted to change many environmental conditions that could affect the properties of fresh and marine waters. These changes could favor the growth of harmful algal blooms and habitat changes.
... Interactions Print version Harmful Interactions Mixing Alcohol With Medicines You’ve probably seen this warning on medicines ... falls and serious injuries, especially among older people. Medicines may have many ingredients Some medications—including many ...
... page: https://medlineplus.gov/news/fullstory_164009.html Zika Virus May Also Harm the Heart 8 Venezuelan ... 9, 2017 THURSDAY, March 9, 2017 (HealthDay News) -- Zika may cause heart problems in some people infected ...
EPA supports local, state and tribal efforts to maintain water quality. A key element of its efforts is to reduce excess nutrient pollution and the resulting adverse impacts, including harmful algal blooms.
Lewis, Julia B
A technical expert panel (TEP) was convened to evaluate all available literature in the area of bone and mineral metabolism and advise the Centers for Medicare and Medicaid services on the creation and collection of quality measures. The proposed quality measures were evaluated for importance, usability, feasibility, and scientific acceptability. All are important parameters to avoid unintended harmful consequences of a quality measure causing harm to patients or to the delivery of their health care.
Vidal, Victoria L; Ohaeri, Beatrice M; John, Pamela; Helen, Delles
This quasi-experimental study, with a control group and experimental group, compares the effectiveness of virtual reality simulators on developing phlebotomy skills of nursing students with the effectiveness of traditional methods of teaching. Performance of actual phlebotomy on a live client was assessed after training, using a standardized form. Findings showed that students who were exposed to the virtual reality simulator performed better in the following performance metrics: pain factor, hematoma formation, and number of reinsertions. This study confirms that the use of the virtual reality-based system to supplement the traditional method may be the optimal program for training.
Cystic fibrosis is a serious genetic disease due to mutations in the gene encoding CFTR (Cystic FibrosisTransmembrane conductance Regulator), a protein involved in cellular transmembrane transport, particularly of chloride ions. Ivacaftor is described as a selective potentiator of CFTR protein. It is now licensed for the treatment of cystic fibrosis patients 6 years of age and older who carry the CFTR G551D mutation, which is the case for about 4% to 5% of cystic fibrosis patients. Two randomised placebo-controlled trials of ivacaftor have been carried out in this setting, in a total of 213 patients. The frequency of pulmonary exacerbations fell in one of the two trials during the first 48 weeks of treatment, but there was no impact on the number of hospitalisations or the use of intravenous antibiotics. In both trials, addition of ivacaftor improved FEV1 by an average of about 10% at week 24 and increased body weight by an average of about 2.5 kg after 1 year. Upper respiratory tract infections occurred in the ivacaftor groups during these trials, with more cases of bacterial contamination and, possibly, more pulmonary exacerbations in the longer term. Ivacaftorcarries a risk of numerous pharmacokinetic interactions that can require dose adjustment, particularly for patients with hepatic impairment and those receiving cytochrome P450 isozyme 3A inhibitors or inducers. Given the absence of data, ivacaftor should be avoided during pregnancy. In practice, in 2013, it is not possible to determine the harm-benefit balance of ivacaftor due to the high risk of drug interactions, as well as a possible increased risk of infections and liver toxicity.
Hawton, Keith; Saunders, Kate E A; O'Connor, Rory C
Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage years and suicide being the second most common cause of death in young people worldwide. Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role. Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted initiatives focused on high-risk groups. There is little evidence of effectiveness of either psychosocial or pharmacological treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for suicide is important. Major challenges include the development of greater understanding of the factors that contribute to self-harm and suicide in young people, especially mechanisms underlying contagion and the effect of new media. The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs.
Borschmann, Rohan; Coffey, Carolyn; Moran, Paul; Hearps, Stephen; Degenhardt, Louisa; Kinner, Stuart A; Patton, George
The prevalence and correlates of self-harm and suicidal behavior in 515 young offenders (mean age 17.3 years, SD = 1.7) serving community-based orders (CBOs; n = 242) or custodial sentences (n = 273) in Victoria, Australia, are described. Results from structured interviews showed that 83 (16.1%) participants reported self-harming in the previous 6 months, and this was more common among those serving custodial sentences than those serving CBOs (19.4% vs. 12.4%; OR 3.10, 95% CI: 1.74-5.55). Multiple incidents were more common in females and 24% (95% CI: 19-39) of participants who had self-harmed reported having done so with suicidal intent. Self-harm was associated with recent bullying victimization, expulsion from school, past year violent victimization, cannabis dependence, and risk-taking behavior in the preceding year. The epidemiological profile of self-harm in this population appears to be distinct from that seen in the general population. Young offenders who self-harm are a vulnerable group with high rates of psychiatric morbidity, substance misuse problems, and social risk factors. They may benefit from targeted psychological interventions designed specifically to address impulsivity, delivered both within-and during the transition from-the youth justice system.
Warner, Alfred G.
Traditional classes are typically bound both in the classroom space and scheduled time. In this article, I show how applying an online learning framework called the Community of Inquiry and an organizational architecture of matrixed teams has worked in a face-to-face capstone class and extended those boundaries. These were introduced as an…
Adeniyi, Samuel O.; Olufemi-Adeniyi, Olubukola A.; Erinoso, Sakiru M.
The use of traditional medicine as alternative or complimentary therapy is gaining prominence in primary health care worldwide. This is because of the efficacy in the management of mild, chronic seemingly incurable ailments/diseases. Though the publicity is on the increase from country to country in the world, however, one cannot conclude that the…
This article aims to help resolve the apparent paradox of producers of addictive goods who claim to be socially responsible while marketing a product clearly identified as harmful. It advances that reputation effects are crucial in this issue and that determining whether harm reduction practices are costly or profitable for the producers can help to assess the sincerity of their discourse. An analytical framework based on an epidemic model of addictive consumption that includes a deterrent effect of heavy use on initiation is developed. This framework enables us to establish a clear distinction between a simple responsible discourse and genuine harm reduction practices and, among harm reduction practices, between use reduction practices and micro harm reduction practices. Using simulations based on tobacco sales in France from 1950 to 2008, we explore the impact of three corresponding types of actions: communication on damage, restraining selling practices and development of safer products on total sales and on the social cost. We notably find that restraining selling practices toward light users, that is, preventing light users from escalating to heavy use, can be profitable for the producer, especially at early stages of the epidemic, but that such practices also contribute to increase the social cost. These results suggest that the existence of a deterrent effect of heavy use on the initiation of the consumption of an addictive good can shed new light on important issues, such as the motivations for corporate social responsibility and the definition of responsible actions in the particular case of harm reduction.
Ferrey, Anne E; Hughes, Nicholas D; Simkin, Sue; Locock, Louise; Stewart, Anne; Kapur, Navneet; Gunnell, David; Hawton, Keith
Objectives Little research has explored the full extent of the impact of self-harm on the family. This study aimed to explore the emotional, physical and practical effects of a young person's self-harm on parents and family. Design and participants We used qualitative methods to explore the emotional, physical and practical effects of a young person's self-harm on their parents and family. We conducted a thematic analysis of thirty-seven semistructured narrative interviews with parents of young people who had self-harmed. Results After the discovery of self-harm, parents described initial feelings of shock, anger and disbelief. Later reactions included stress, anxiety, feelings of guilt and in some cases the onset or worsening of clinical depression. Social isolation was reported, as parents withdrew from social contact due to the perceived stigma associated with self-harm. Parents also described significant impacts on siblings, ranging from upset and stress to feelings of responsibility and worries about stigma at school. Siblings had mixed responses, but were often supportive. Practically speaking, parents found the necessity of being available to their child often conflicted with the demands of full-time work. This, along with costs of, for example, travel and private care, affected family finances. However, parents generally viewed the future as positive and hoped that with help, their child would develop better coping mechanisms. Conclusions Self-harm by young people has major impacts on parents and other family members. Clinicians and staff who work with young people who self-harm should be sensitive to these issues and offer appropriate support and guidance for families. PMID:26739734
Hay, Carter; Meldrum, Ryan
Self-harm is widely recognized as a significant adolescent social problem, and recent research has begun to explore its etiology. Drawing from Agnew's (1992) social psychological strain theory of deviance, this study considers this issue by testing three hypotheses about the effects of traditional and cyber bullying victimization on deliberate…
Liang, Dapeng; Wang, Chunli; Duan, Yangyang; Li, Xiaofen; Zhou, Shiyu; Zhao, Mingjie; Li, Yi; He, Yumin; Wang, Shaowu; Kelley, Keith W.; Jiang, Ping; Liu, Quentin
Background Cancer patients suffer from diverse symptoms, including depression, anxiety, pain, and fatigue and lower quality of life (QoL) during disease progression. This study aimed to evaluate the benefits of Traditional Chinese Medicine psycho-behavioral interventions (TCM PBIs) on improving QoL by meta-analysis. Methods Electronic literature databases (PubMed, CNKI, VIP, and Wanfang) were searched for randomized, controlled trials conducted in China. The primary intervention was TCM PBIs. The main outcome was health-related QoL (HR QoL) post-treatment. We applied standard meta analytic techniques to analyze data from papers that reached acceptable criteria. Results The six TCM PBIs analyzed were acupuncture, Chinese massage, Traditional Chinese Medicine five elements musical intervention (TCM FEMI), Traditional Chinese Medicine dietary supplement (TCM DS), Qigong and Tai Chi. Although both TCM PBIs and non-TCM PBIs reduced functional impairments in cancer patients and led to pain relief, depression remission, reduced time to flatulence following surgery and sleep improvement, TCM PBIs showed more beneficial effects as assessed by reducing both fatigue and gastrointestinal distress. In particular, acupuncture relieved fatigue, reduced diarrhea and decreased time to flatulence after surgery in cancer patients, while therapeutic Chinese massage reduced time to flatulence and time to peristaltic sound. Conclusion These findings demonstrate the efficacy of TCM PBIs in improving QoL in cancer patients and establish that TCM PBIs represent beneficial adjunctive therapies for cancer patients. PMID:26498685
Benatar argues that it is better never to have been born because of the harms always associated with human existence. Non‐existence entails no harm, along with no experience of the absence of any benefits that existence might offer. Therefore, he maintains that procreation is morally irresponsible, along with the use of reproductive technology to have children. Women should seek termination if they become pregnant and it would be better for potential future generations if humans become extinct as soon as humanely possible. These views are challenged by the argument that while decisions not to procreate may be rational on the grounds of the harm that might occur, it may equally rational to gamble under certain circumstances that future children would be better‐off experiencing the harms and benefits of life rather than never having the opportunity of experiencing anything. To the degree that Benatar's arguments preclude the potential rationality of any such gamble, their moral relevance to concrete issues concerning human reproduction is weakened. However, he is right to emphasise the importance of foreseen harm when decisions are made to attempt to have children. PMID:17906053
Wilson, Robert S; Buchman, Aron S; Arnold, Steven E; Shah, Raj C; Tang, Yuxiao; Bennett, David A
The relation of personality to disability in old age is not well understood. The authors examined the relation of harm avoidance, a trait indicating a tendency to worry, fear uncertainty, be shy, and tire easily, to disability in a group of 474 older persons without dementia. Participants completed the 35-item Harm Avoidance scale. Disability was assessed with the Rosow-Breslau scale, a self-report measure of physical mobility. Performance-based tests of lower limb functions were also administered from which composite measures of gait, balance, and strength were derived. In a logistic regression model controlled for age, sex, education, and lower limb function, persons with high levels of harm avoidance were nearly three times as likely to report mobility limitations as persons with low levels, and these effects largely reflected fatigability and fear of uncertainty. The association of harm avoidance with disability was not explained or modified by frailty, physical activity, depressive symptoms, neuroticism, extraversion, or cognition. The results suggest that harm avoidance is associated with disability in old age.
Background and rationale The HIV epidemic in Vietnam has from its start been concentrated among injecting drug users. Vietnam instituted the 2006 HIV/AIDS Law which includes comprehensive harm reduction measures, but these are unevenly accepted and inadequately implemented. Ward police are a major determinant of risk for IDUs, required to participate in drug control practices (especially meeting quotas for detention centres) which impede support for harm reduction. We studied influences on ward level police regarding harm reduction in Hanoi to learn how to better target education and structural change. Methods After document review, we interviewed informants from government, NGOs, INGOs, multilateral agencies, and police, using semi-structured guides. Topics covered included perceptions of harm reduction and the police role in drug law enforcement, and harm reduction training and advocacy among police. Results Police perceive conflicting responsibilities, but overwhelmingly see their responsibility as enforcing drug laws, identifying and knowing drug users, and selecting those for compulsory detention. Harm reduction training was very patchy, ward police not being seen as important to it; and understanding of harm reduction was limited, tending to reflect drug control priorities. Justification for methadone was as much crime prevention as HIV prevention. Competing pressures on ward police create much anxiety, with performance measures based around drug control; recourse to detention resolves competing pressures more safely. There is much recognition of the importance of discretion, and much use of it to maintain good social order. Policy dissemination approaches within the law enforcement sector were inconsistent, with little communication about harm reduction programs or approaches, and an unfounded assumption that training at senior levels would naturally reach to the street. Discussion Ward police have not been systematically included in harm reduction advocacy
Korner, Anthony; Gerull, Friederike; Stevenson, Janine; Meares, Russell
This article investigates the pattern of temperament for patients with borderline personality disorder and the impact of psychotherapeutic treatment on temperamental variables. A cohort of patients treated in the Westmead Borderline Personality Disorder Psychotherapy research project completed the Tridimensional Personality Questionnaire. All patients had a diagnosis of borderline personality disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, criteria. This group scored highly on novelty-seeking and harm avoidance scales and moderately on reward dependence. There was a significant reduction in harm avoidance after 12 months of psychotherapy with a further reduction after 2 years in therapy. Although at variance with Cloninger's original prediction of low harm avoidance in histrionic and borderline patients, results are consistent with other studies in this patient group. The paradox of "self-harmers" scoring highly on harm avoidance may be explained by recognition of the intensity of "psychic pain" in this group. Self-harming behaviors may frequently be motivated by avoidance of a "greater harm" in terms of the inner psychic reality for these patients. Reduction in harm avoidance with psychotherapy could suggest an impact of treatment on temperament or may indicate that the harm avoidance construct is influenced by state variables such as mood.
Grenville, Jeffrey; Goodman, Deborah; Macpherson, Alison K.
The objective of this study was to describe deliberate self-harming (DSH) characteristics in a child-welfare population identified as having threatened or completed self-harm. Secondary data from 621 serious occurrence reports (SOR) that documented 2004-2007 DSH incidents and DSH threats with 252 Canadian youth in care (Y-INC) of the Children's…
... HUMAN SERVICES Food and Drug Administration Harmful and Potentially Harmful Constituents in Tobacco Products and Tobacco Smoke; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice... tobacco products and tobacco smoke. This information will assist the Agency in establishing a list...
Pasupathi, Monisha; Billitteri, Jacob; Mansfield, Cade D.; Wainryb, Cecilia; Hanley, Grace E.; Taheri, Kiana
This study examined how narration of harm experiences can regulate self and emotions in ways relevant to well-being. Participants (n = 88, 65% female) were asked to provide 6 narratives about instances when they were victims of harm and 6 narratives about instances when they were perpetrators of harm. Narratives were coded for extent of exploration, growth, damage conclusions and resolution. Participants drew damage conclusions more frequently in victim narratives and growth conclusions more frequently in perpetrator narratives. Both the type of experience (victim or perpetrator) and the way the experience was narrated (references to damage conclusions and resolution) predicted emotion and identity implications, which were, in turn, related to well-being. Implications for narrative approaches to self-regulation are discussed. PMID:26392641
Patil, Indrajeet; Calò, Marta; Fornasier, Federico; Young, Liane; Silani, Giorgia
Mature moral judgments rely on the consideration of a perpetrator’s mental state as well as harmfulness of the outcomes produced. Prior work has focused primarily on the functional correlates of how intent information is neurally represented for moral judgments, but few studies have investigated whether individual differences in neuroanatomy can also explain variation in moral judgments. In the current study, we conducted voxel-based morphometry analyses to address this question. We found that local grey matter volume in the left anterior superior temporal sulcus, a region in the functionally defined theory of mind or mentalizing network, was associated with the degree to which participants relied on information about innocent intentions to forgive accidental harms. Our findings provide further support for the key role of mentalizing in the forgiveness of accidental harms and contribute preliminary evidence for the neuroanatomical basis of individual differences in moral judgments. PMID:28382935
Karaganis, Sandra, Ed.
When the Winnetka public school system reexamined its philosophy, questions were raised about the alignment between theory and practice. This sourcebook represents the thinking of teachers about how the validity of their philosophy of education rests on their ability to analyze what they are, discover how they came to be what they are, and imagine…
This study examined a unique professional development model and its contribution to teachers' practice. The study also sought to understand the process of teacher learning as teachers made fundamental changes in their teaching. The new model of professional development was implemented in the context of the Social Forestry, Education and…
Barnes, M C; Gunnell, D; Davies, R; Hawton, K; Kapur, N; Potokar, J; Donovan, J L
Objective Self-harm and suicide increase in times of economic recession, but little is known about why people self-harm when in financial difficulty, and in what circumstances self-harm occurs. This study aimed to understand events and experiences leading to the episode of self-harm and to identify opportunities for prevention or mitigation of distress. Setting Participants’ homes or university rooms. Participants 19 people who had attended hospital following self-harm in two UK cities and who specifically cited job loss, economic hardship or the impact of austerity measures as a causal or contributory factor. Primary and secondary outcome measures Semistructured, in-depth interviews. Interviews were audio recorded, transcribed and analysed cross-sectionally and as case studies. Results Study participants described experiences of severe economic hardship; being unable to find employment or losing jobs, debt, housing problems and benefit sanctions. In many cases problems accumulated and felt unresolvable. For others an event, such as a call from a debt collector or benefit change triggered the self-harm. Participants also reported other current or past difficulties, including abuse, neglect, bullying, domestic violence, mental health problems, relationship difficulties, bereavements and low self-esteem. These contributed to their sense of despair and worthlessness and increased their vulnerability to self-harm. Participants struggled to gain the practical help they felt they needed for their economic difficulties or therapeutic support that might have helped with their other co-existing or historically damaging experiences. Conclusions Economic hardships resulting from the recession and austerity measures accumulated or acted as a ‘final straw’ to trigger self-harm, often in the context of co-existing or historically damaging life-experiences. Interventions to mitigate these effects should include providing practical advice about economic issues before
Rosenkoetter, Lawrence I.; Rosenkoetter, Sharon E.; Ozretich, Rachel A.; Acock, Alan C.
In an effort to minimize the harmful effects of violent TV, a yearlong intervention was undertaken with children in Grades 1 through 3 (N = 177). The classroom-based intervention consisted of 31 brief lessons that emphasized the many ways in which television distorts violence. As hypothesized, the intervention resulted in a reduction in children's…
As the commercial success of electronic cigarettes offers the opportunity to study harm reduction by replacement therapy, the UK government steers in the opposite direction and plans to expand the 'war on drugs' with a blanket ban on all psychoactive substances. Michael Gross reports.
McCormick, Alexander C.
The author expresses concern that launching an accountability initiative without careful consideration may do more harm than good. A well-designed accountability system, writes McCormick, motivates substantive change and useful diagnostic tools must not be undermined in the name of accountability. Several new college-quality initiatives offer…
Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon.
Ruiz-Colmenero, Marta; Bienes, Ramon; Marques, Maria-Jose
Land degradation control is crucial in croplands located in semiarid lands, due to its low soil formation rate, above all in slope fields. This study is located in the South East of Madrid (Spain), in a vineyard at 800 masl under Mediterranean semiarid climatic conditions, with an average slope of 14%. We studied the impact of traditional tillage measuring runoff and soil loss in plots in two critical moments of the vineyard crop: summer with dry soil, and fall when tillage is done in order to facilitate the infiltration of winter rainfalĺs water. Three treatments were tested in nine erosion plots (4m x 0,5m): traditional tillage ("till"); Brachypodium distachyon (L.) ("bra") allowing self-sowing; Secale cereale ("sec"), mown in early spring. Short (15 minutes) but intense (2,16 mm/min) simulated rainfalls were carried out at each plot: The simulated rainfalls made in summer over the vineyard tilled in spring ("till") produced little runoff (41 ml min-1; erosion rate of 0.24 g m-2) and it lasted 6 min from the start of the shower, it was due to the roughness and because the soil was near its wilting point. The low erosion rate is attributable to the sealing of soil after the rains occurred in spring. In treatments with plant cover runoff began earlier, at the 3rd minute. The average runoff was 516 and 730 ml min-1 and erosion rates were 3.04 g m-2 and 1.41 g m-2 in "bra" and "sec" respectively. There were significant differences (F = 31.6, P <0.001) in runoff coefficient between the three treatments with the highest ratio shown in "sec". The average runoff coefficients obtained were 16% in "sec", 13% in "bra" and 1.4% in "till". Moreover two simulated rainfalls were carried out in autumn in order to test the effect of the autumnal traditional tillage. The plant cover treatments were efficient controlling the erosion (sediment yield were in "till"; "sec" and "bra" respectively 2.66, 0. 29, 0. 11 g m-2 in the first simulation, and 11.67, 0.66, 0.14 g m-2 in the
Souleymanov, Rusty; Allman, Dan
In this paper, we argue for the importance of unsettling dominant narratives in the current terrain of harm-reduction policy, practice and research. To accomplish this, we trace the historical developments regarding the Human Immunodeficiency Virus (HIV), the Hepatitis C Virus (HCV) and harm-reduction policies and practice. We argue that multiple historical junctures rather than single causes of social exclusion engender the processes of marginalisation, propelled by social movements, institutional interests, state legislation, community practices, neo-liberalism and governmentality techniques. We analyse interests (activist, lay expert, institutional and state) in the harm-reduction field, and consider conceptualisations of risk, pleasure, stigma, social control and exclusionary moral identities. Based on our review of the literature, this paper provides recommendations for social workers and others delivering health and social care interested in the fields of substance use, HIV prevention and harm reduction.
Souleymanov, Rusty; Allman, Dan
In this paper, we argue for the importance of unsettling dominant narratives in the current terrain of harm-reduction policy, practice and research. To accomplish this, we trace the historical developments regarding the Human Immunodeficiency Virus (HIV), the Hepatitis C Virus (HCV) and harm-reduction policies and practice. We argue that multiple historical junctures rather than single causes of social exclusion engender the processes of marginalisation, propelled by social movements, institutional interests, state legislation, community practices, neo-liberalism and governmentality techniques. We analyse interests (activist, lay expert, institutional and state) in the harm-reduction field, and consider conceptualisations of risk, pleasure, stigma, social control and exclusionary moral identities. Based on our review of the literature, this paper provides recommendations for social workers and others delivering health and social care interested in the fields of substance use, HIV prevention and harm reduction. PMID:27559236
Løberg, Magnus; Lousdal, Mette Lise; Bretthauer, Michael; Kalager, Mette
Mammography screening for breast cancer is widely available in many countries. Initially praised as a universal achievement to improve women's health and to reduce the burden of breast cancer, the benefits and harms of mammography screening have been debated heatedly in the past years. This review discusses the benefits and harms of mammography screening in light of findings from randomized trials and from more recent observational studies performed in the era of modern diagnostics and treatment. The main benefit of mammography screening is reduction of breast-cancer related death. Relative reductions vary from about 15 to 25% in randomized trials to more recent estimates of 13 to 17% in meta-analyses of observational studies. Using UK population data of 2007, for 1,000 women invited to biennial mammography screening for 20 years from age 50, 2 to 3 women are prevented from dying of breast cancer. All-cause mortality is unchanged. Overdiagnosis of breast cancer is the main harm of mammography screening. Based on recent estimates from the United States, the relative amount of overdiagnosis (including ductal carcinoma in situ and invasive cancer) is 31%. This results in 15 women overdiagnosed for every 1,000 women invited to biennial mammography screening for 20 years from age 50. Women should be unpassionately informed about the benefits and harms of mammography screening using absolute effect sizes in a comprehensible fashion. In an era of limited health care resources, screening services need to be scrutinized and compared with each other with regard to effectiveness, cost-effectiveness and harms.
Rodu, Brad; Godshall, William T
According to the Centers for Disease Control and Prevention, about 45 million Americans continue to smoke, even after one of the most intense public health campaigns in history, now over 40 years old. Each year some 438,000 smokers die from smoking-related diseases, including lung and other cancers, cardiovascular disorders and pulmonary diseases. Many smokers are unable – or at least unwilling – to achieve cessation through complete nicotine and tobacco abstinence; they continue smoking despite the very real and obvious adverse health consequences. Conventional smoking cessation policies and programs generally present smokers with two unpleasant alternatives: quit, or die. A third approach to smoking cessation, tobacco harm reduction, involves the use of alternative sources of nicotine, including modern smokeless tobacco products. A substantial body of research, much of it produced over the past decade, establishes the scientific and medical foundation for tobacco harm reduction using smokeless tobacco products. This report provides a description of traditional and modern smokeless tobacco products, and of the prevalence of their use in the United States and Sweden. It reviews the epidemiologic evidence for low health risks associated with smokeless use, both in absolute terms and in comparison to the much higher risks of smoking. The report also describes evidence that smokeless tobacco has served as an effective substitute for cigarettes among Swedish men, who consequently have among the lowest smoking-related mortality rates in the developed world. The report documents the fact that extensive misinformation about ST products is widely available from ostensibly reputable sources, including governmental health agencies and major health organizations. The American Council on Science and Health believes that strong support of tobacco harm reduction is fully consistent with its mission to promote sound science in regulation and in public policy, and to assist
Jiang, Zhou; Pang, Yaqiong; Yu, Xiaobo; Zhou, Suxia; Qian, Jun; Zheng, Ning; Dong, Haiyan; Shi, Qing; Kuo, Minliang; Jia, Lee
Recent large epidemiological studies demonstrated benefit of oral contraceptives in reducing cancer risk, and our analysis also showed molecular and cellular similarities between embryo implantation and CTCs adhesion-invasion to endothelium. We here hypothesize that abortion traditional Chinese medicine (TCM) may serve well for pre-metastatic chemoprevention. To test the hypothesis, we selected the safe and well-known abortifacient TCM Murraya paniculata and identified a most-promising extracted fraction G (containing flavonoids and coumarins) from its many raw ethanol/dichloromethane extracts by using the bioactivity-guided fast screen assay. G showed free radical scavenging effect, and specifically inhibited both embryo implantation to human endometrial bed and cancer HT29 cells to human endothelium in a concentration-dependent manner (1-30 μg/mL) without significant cytotoxicity demonstrated by its high adhesion inhibition ratio. The inhibition may result from its down-regulation on expression of integrin β1 and α6, and CD44 on HT29 cells, as well as E-selectin on endothelial cells. Furthermore, G inhibited invasion and migration of HT29 cells. Pretreatment followed by one-month oral administration of G to the immunocompetent mice inoculated with mouse melanoma cells produced significant inhibition on lung metastasis without marked side effects. Collectively, this paradigm-shifting study provides, for the first time, a new strategy to discover safe and effective pre-metastatic chemopreventives from abortion TCM.
Zhou, Suxia; Qian, Jun; Zheng, Ning; Dong, Haiyan; Shi, Qing; Kuo, Minliang; Jia, Lee
Recent large epidemiological studies demonstrated benefit of oral contraceptives in reducing cancer risk, and our analysis also showed molecular and cellular similarities between embryo implantation and CTCs adhesion-invasion to endothelium. We here hypothesize that abortion traditional Chinese medicine (TCM) may serve well for pre-metastatic chemoprevention. To test the hypothesis, we selected the safe and well-known abortifacient TCM Murraya paniculata and identified a most-promising extracted fraction G (containing flavonoids and coumarins) from its many raw ethanol/dichloromethane extracts by using the bioactivity-guided fast screen assay. G showed free radical scavenging effect, and specifically inhibited both embryo implantation to human endometrial bed and cancer HT29 cells to human endothelium in a concentration-dependent manner (1–30 μg/mL) without significant cytotoxicity demonstrated by its high adhesion inhibition ratio. The inhibition may result from its down-regulation on expression of integrin β1 and α6, and CD44 on HT29 cells, as well as E-selectin on endothelial cells. Furthermore, G inhibited invasion and migration of HT29 cells. Pretreatment followed by one-month oral administration of G to the immunocompetent mice inoculated with mouse melanoma cells produced significant inhibition on lung metastasis without marked side effects. Collectively, this paradigm-shifting study provides, for the first time, a new strategy to discover safe and effective pre-metastatic chemopreventives from abortion TCM. PMID:26959747
Shawyer, Frances; Mackinnon, Andrew; Farhall, John; Sims, Eliza; Blaney, Simone; Yardley, Priscilla; Daly, Maree; Mullen, Paul; Copolov, David
Although harmful command hallucinations have been linked to violent behavior, few studies have examined factors mediating this relationship. The principal aim of this study was to examine a range of factors potentially associated with acting on harmful command hallucinations using a multivariate approach. The sample comprised 75 participants drawn from community and forensic services. Measures assessing characteristics of the command hallucination and the hallucinator, including forensic risk factors, were administered. Using ordinal logistic regression, we found compliance to be associated with increasing age, viewing the command hallucination as positive, congruent delusions, and reporting low maternal control in childhood. Antipsychotic medication was protective while, contrary to expectations, traditional predictors of violence reduced the odds of compliance with command hallucinations viewed as threatening. The findings suggest that compliance with harmful commands is driven by a complex interaction between beliefs related to the command hallucination and personal characteristics, with risk of compliance increasing with age.
Jørgensen, Karsten Juhl
The rationale for breast cancer screening with mammography is deceptively simple: catch it early and reduce mortality from the disease and the need for mastectomies. But breast cancer is a complex problem, and complex problems rarely have simple solutions. Breast screening brings forward the time of diagnosis only slightly compared to the lifetime of a tumour, and screen-detected tumours have a size where metastases are possible. A key question is if screening can prevent metastases, and if the screen-detected tumours are small enough to allow breast conserving surgery rather than mastectomy. A mortality reduction can never justify a medical intervention in its own right, but must be weighed against the harms. Overdiagnosis is the most important harm of breast screening, but has gained wider recognition only in recent years. Screening leads to the detection and treatment of breast cancers that would otherwise never have been detected because they grow very slowly or not at all and would not have been detected in the woman's lifetime in the absence of screening. Screening therefore turns women into cancer patients unnecessarily, with life-long physical and psychological harms. The debate about the justification of breast screening is therefore not a simple question of whether screening reduces breast cancer mortality. This dissertation quantifies the primary benefits and harms of screening mammography. Denmark has an unscreened "control group" because only two geographical regions offered screening over a long time-period, which is unique in an international context. This was used to study breast cancer mortality, overdiagnosis, and the use of mastectomies. Also, a systematic review of overdiagnosis in five other countries allowed us to show that about half of the screen-detected breast cancers are overdiagnosed. An effect on breast cancer mortality is doubtful in today's setting, and overdiagnosis causes an increase in the use of mastectomies. These findings are
Wilson, David P; Donald, Braedon; Shattock, Andrew J; Wilson, David; Fraser-Hurt, Nicole
HIV prevalence worldwide among people who inject drugs (PWID) is around 19%. Harm reduction for PWID includes needle-syringe programs (NSPs) and opioid substitution therapy (OST) but often coupled with antiretroviral therapy (ART) for people living with HIV. Numerous studies have examined the effectiveness of each harm reduction strategy. This commentary discusses the evidence of effectiveness of the packages of harm reduction services and their cost-effectiveness with respect to HIV-related outcomes as well as estimate resources required to meet global and regional coverage targets. NSPs have been shown to be safe and very effective in reducing HIV transmission in diverse settings; there are many historical and very recent examples in diverse settings where the absence of, or reduction in, NSPs have resulted in exploding HIV epidemics compared to controlled epidemics with NSP implementation. NSPs are relatively inexpensive to implement and highly cost-effective according to commonly used willingness-to-pay thresholds. There is strong evidence that substitution therapy is effective, reducing the risk of HIV acquisition by 54% on average among PWID. OST is relatively expensive to implement when only HIV outcomes are considered; other societal benefits substantially improve the cost-effectiveness ratios to be highly favourable. Many studies have shown that ART is cost-effective for keeping people alive but there is only weak supportive, but growing evidence, of the additional effectiveness and cost-effectiveness of ART as prevention among PWID. Packages of combined harm reduction approaches are highly likely to be more effective and cost-effective than partial approaches. The coverage of harm reduction programs remains extremely low across the world. The total annual costs of scaling up each of the harm reduction strategies from current coverage levels, by region, to meet WHO guideline coverage targets are high with ART greatest, followed by OST and then NSPs. But
Gerlock, April A; Buccheri, Robin; Buffum, Martha D; Trygstad, Louise; Dowling, Glenna A
Command hallucinations are relatively common in voice hearers and are taken seriously because of the potential threat to self and others. Many variables mediate the relationship between hearing commands and acting on them. This article describes the implementation of the Harm Command Safety Protocol and the Unpleasant Voices Scale to respond to command hallucinations to harm in the context of the dissemination of a multisite, evidence-based behavioral management course for patients with auditory hallucinations.
Pauly, Bernadette Bernie; Reist, Dan; Belle-Isle, Lynne; Schactman, Chuck
Homelessness and drug use often overlap and the harms of substance use are exacerbated by homelessness. Responding to the twin problems of homelessness and substance use is an important aspect of strategies to end homelessness. The introduction and development of ten year plans to end homelessness in North America heralds a new era of systemic responses to homelessness. Central to many of these plans is the adoption of 'Housing First' as a policy response. Housing First focuses directly on housing people regardless of current patterns of substance use. As such, harm reduction is a key principle of Housing First. In this paper, we examine Housing First as an example of the integration of housing and harm reduction and then put forth a community level policy framework to further promote the integration of harm reduction as part of a response to homelessness. Drawing on Rhodes' risk environment framework and current evidence of Housing First and harm reduction, we describe four key policy areas for action: (1) social inclusion policies; (2) adequate and appropriate supply of housing; (3) on demand harm reduction services and supports and (4) systemic and organizational infrastructure. We conclude by identifying areas for future research.
Hutton, Linda; Whyte, Bill
Despite a growing awareness and acknowledgement of the incidence of sexually harmful behaviour by children and young people, research on this group remains limited. A number of recent publications have reviewed UK systems and practice and suggest that the issue is better appreciated than a decade ago. To date, however, there is no published…
Cruit, W.; Schutzenhofer, S.; Goldberg, B.; Everhart, K.
Methodology developed to provide guidance for replacement of industrial chemicals that must be phased out by law because they are toxic and/or affect environment adversely. Chemicals and processes ranked numerically. Applies mostly to chemicals contributing to depletion of ozone in upper atmosphere; some other harmful chemicals included. Quality function deployment matrix format provides convenient way to compare alternative processes and chemicals. Overall rating at bottom of each process-and-chemical column indicates relative advantage.
Snyder, Darrel E.
Electrofishing, a valuable sampling technique in North America for over half a century, involves a very dynamic and complex mix of physics, physiology, and behavior that remains poorly understood. New hypotheses have been advanced regarding "power transfer" to fish and the epileptic nature of their responses to electric fields, but these too need to be more fully explored and validated. Fishery researchers and managers in the Colorado River Basin, and elsewhere, are particularly concerned about the harmful effects of electrofishing on fish, especially endangered species. Although often not externally obvious or fatal, spinal injuries and associated hemorrhages sometimes have been documented in over 50% of fish examined internally. Such injuries can occur anywhere in the electrofishing field at or above the intensity threshold for twitch. These injuries are believed to result from powerful convulsions of body musculature (possibly epileptic seizures) caused mostly by sudden changes in voltage as when electricity is pulsed or switched on or off. Significantly fewer spinal injuries are reported when direct current, low-frequency pulsed direct current (<30 Hz), or specially designed pulse trains are used. Salmoniae are especially susceptible. Endangered cyprinids of the Colorado River Basin are generally much less susceptible, enough so to allow cautious use of less harmful currents for most recovery monitoring and research. However, the endangered catostomid Xyrauchen texanus appears sufficiently susceptible to warrant a continued minimal-use policy. Other harmful effects, such as bleeding at gills or vent and excessive physiological stress, are also of concern. Mortality, usually by asphyxiation, is a common result of excessive exposure to tetanizing intensities near electrodes or poor handling of captured specimens. Reported effects on reproduction are contradictory, but electrofishing over spawning grounds can harm embryos. Electrofishing is often considered the
Gernsbacher, Morton Ann; Dawson, Michelle; Mottron, Laurent
We assert that one of the examples used by Keller & Miller (K&M), namely, autism, is indeed common, and heritable, but we question whether it is harmful. We provide a brief review of cognitive science literature in which autistics perform superiorly to non-autistics in perceptual, reasoning, and comprehension tasks; however, these superiorities are often occluded and are instead described as dysfunctions. PMID:25506106
Lomba, Angela; Alves, Paulo; Jongman, Rob H G; McCracken, David I
Agriculture constitutes a dominant land cover worldwide, and rural landscapes under extensive farming practices acknowledged due to high biodiversity levels. The High Nature Value farmland (HNVf) concept has been highlighted in the EU environmental and rural policies due to their inherent potential to help characterize and direct financial support to European landscapes where high nature and/or conservation value is dependent on the continuation of specific low-intensity farming systems. Assessing the extent of HNV farmland by necessity relies on the availability of both ecological and farming systems' data, and difficulties associated with making such assessments have been widely described across Europe. A spatially explicit framework of data collection, building out from local administrative units, has recently been suggested as a means of addressing such difficulties. This manuscript tests the relevance of the proposed approach, describes the spatially explicit framework in a case study area in northern Portugal, and discusses the potential of the approach to help better inform the implementation of conservation and rural development policies. Synthesis and applications: The potential of a novel approach (combining land use/cover, farming and environmental data) to provide more accurate and efficient mapping and monitoring of HNV farmlands is tested at the local level in northern Portugal. The approach is considered to constitute a step forward toward a more precise targeting of landscapes for agri-environment schemes, as it allowed a more accurate discrimination of areas within the case study landscape that have a higher value for nature conservation. PMID:25798221
Sun, Xiao-Xia; Han, Kyung-Nam; Choi, Joong-Ki; Kim, Eun-Ki
Screening experiments were conducted in order to find promising synthetic surfactants for harmful algal blooms (HABs) mitigation. The chemically synthesized surfactant cocamidopropyl betaine (CAPB) showed characteristics of relatively high inhibition efficiency, high biodegradability and low cost. The motility inhibition ratios of 10 mg/L CAPB on Cochlodinium polykrikoides and Alexandrium tamarense were about 60% after 5 min. The biodegradation test indicated that the half-life of CAPB in seawater was shorter than one day and 90% was biodegraded after five days under the initial concentration of 100 mg/L at 25 degrees C. Further cell lysis experiments revealed the selective lysis effect of CAPB on different HAB organisms. More than 90% of C. polykrikoides lysed at the concentration of 10 mg/L CAPB after 24 h and at 15 mg/L CAPB after 4 h, whereas the lysis effect of CAPB on A. tamarense was slight, no more than 10% after 2 h interaction with 50 mg/L CAPB. This research provided preliminary data for CAPB as a candidate in harmful algal blooms mitigation and pointed out unresolved problems for its practical application in the meantime.
The Harmful Algal Blooms – Special Sampling and Response Actions webpage contains information about Background on Harmful Algae in Surface Waters and What to Do if Your System Has Indicators of an Algal Bloom.
... html Even Small Rise in Blood Pressure Can Harm Black Patients Study shows higher early death and ... These findings provide further evidence of the potential harms in terms of increased risk of heart attacks, ...
Chamberlain, Samuel R; Leppink, Eric W.; Redden, Sarah A.; Grant, Jon E.
Objective Self-harm is common and is of considerable public health concern. There is an ongoing debate regarding how self-harm should be classified. The aim of this study was to characterize associations between self-harm and impulsivity, including from the perspective of formal mental disorders and neuropsychological functioning. Method Total 333 adults (mean [SD] age 22.6 (3.6) years, 61% male) were recruited from the general community, and undertook detailed clinical and cognitive assessments. History of self-harm was quantified using the Self-Harm Inventory (SHI), which asks about 22 self-harm behaviors (classic self-harm behaviors as well as broader types of behavior that may be relevant, such as engaging in emotionally abusive relationships). Principal components analysis was used to identify latent dimensions of self-harming behaviors. Relationships between self-harm dimensions and other measures were characterized using ordinary least squares regression. Results Principal Components Analysis yielded a three factor solution, corresponding to self-injurious self-harm (e.g. cutting, overdoses, burning), interpersonal related self-harm (e.g. engaging in emotionally or sexually abusive relationships), and reckless self-harm (e.g. losing one’s job deliberately, driving recklessly, abusing alcohol). Regression modelling showed that all three dimensions of self-harm were associated with lower quality of life. Classic and interpersonal self-harm dimensions were associated with impulse control disorders (ICDs) whereas reckless self-harm was associated with other mainstream mental disorders besides ICDs. Only interpersonal self-harm was significantly associated with other impulsive measures ( less risk adjustment on the Cambridge Gambling Task). Conclusions This study suggests the existence of three distinct subtypes or ‘latent factors’ of self-harm: all three appear clinically important in that they are linked with worse quality of life. Clinicians should
Tupper, Kenneth W
Ayahuasca is a tea made from two plants native to the Amazon, Banisteriopsis caapi and Psychotria viridis, which, respectively, contain the psychoactive chemicals harmala alkaloids and dimethyltryptamine. The tea has been used by indigenous peoples in countries such as Brazil, Ecuador and Peru for medicinal, spiritual and cultural purposes since pre-Columbian times. In the 20th century, ayahuasca spread beyond its native habitat and has been incorporated into syncretistic practices that are being adopted by non-indigenous peoples in modern Western contexts. Ayahuasca's globalization in the past few decades has led to a number of legal cases which pit religious freedom against national drug control laws. This paper explores some of the philosophical and policy implications of contemporary ayahuasca use. It addresses the issue of the social construction of ayahuasca as a medicine, a sacrament and a "plant teacher." Issues of harm reduction with respect to ayahuasca use are explored, but so too is the corollary notion of "benefit maximization."
Weirich, Chelsea A; Miller, Todd R
Massive accumulations of cyanobacteria (a.k.a. "blue-green algae"), known as freshwater harmful algal blooms (FHABs), are a common global occurrence in water bodies used for recreational purposes and drinking water purification. Bloom prevalence is increased due to anthropogenic changes in land use, agricultural activity, and climate change. These photosynthetic bacteria produce a range of toxic secondary metabolites that affect animals and humans at both chronic and acute dosages. Children are especially at risk because of their lower body weight, behavior, and toxic effects on development. Here we review common FHAB toxins, related clinical symptoms, acceptable concentrations in drinking water, case studies of children's and young adults' exposures to FHAB toxins through drinking water and food, methods of environmental and clinical detection in potential cases of intoxication, and best practices for FHAB prevention.
Nurwidya, Fariz; Takahashi, Fumiyuki; Baskoro, Hario; Hidayat, Moulid; Yunus, Faisal; Takahashi, Kazuhisa
Tobacco consumption is a major causative agent for various deadly diseases such as coronary artery disease and cancer. It is the largest avoidable health risk in the world, causing more problems than alcohol, drug use, high blood pressure, excess body weight or high cholesterol. As countries like Indonesia prepare to develop national policy guidelines for tobacco harm reduction, the scientific community can help by providing continuous ideas and a forum for sharing and distributing information, drafting guidelines, reviewing best practices, raising funds, and establishing partnerships. We propose several strategies for reducing tobacco consumption, including advertisement interference, cigarette pricing policy, adolescent smoking prevention policy, support for smoking cessation therapy, special informed consent for smokers, smoking prohibition in public spaces, career incentives, economic incentives, and advertisement incentives. We hope that these strategies would assist people to avoid starting smoking or in smoking cessation.
Miao, Chunguang; Tang, Yi; Zhang, Hong; Wu, Zhengyan; Wang, Xiangqin
Vermiculite and vermiculite modified with hydrochloric acid were investigated to evaluate their flocculation efficiencies in freshwater containing harmful algae blooms (HABs) (Microcystis aeruginosa). Scanning electron microscope, Fourier transform infrared spectroscopy, X-ray diffraction, converted fluorescence microscope, plasma-atomic emission spectrometry, and Zetasizer were used to study the flocculation mechanism of modified vermiculite. It was found that the vermiculite modified with hydrochloric acid could coagulate algae cells through charge neutralization, chemical bridging, and netting effect. The experimental results show that the efficiency of flocculation can be notably improved by modified vermiculite. Ninety-eight per cent of algae cells in algae solution could be removed within 10 min after the addition ofmodified vermiculite clay. The method that removal of HABs with modified vermiculite is economical with high efficiency, and more research is needed to assess their ecological impacts before using in practical application.
Dimidjian, Sona; Hollon, Steven D.
Patients can be harmed by treatment or by the decisions that are made about those treatments. Although dramatic examples of harmful effects of psychotherapy have been reported, the full scope of the problem remains unclear. The field currently lacks consensus about how to detect harm and what to do about it when it occurs. In this article, we…
Jambon, Marc; Smetana, Judith G.
We assessed 5-to 11-year-olds' (N = 76) judgments of straightforward moral transgressions (prototypical harm) as well as their evaluations of complex, hypothetical scenarios in which an actor transgresses in order to prevent injury (necessary harm). The nature of the actor's transgression (psychological or physical harm) varied across…
Benedek, E P; Brown, C F
All youngsters are at some risk from exposure to televised pornography, as described above. At particular risk for harm, however, are the most vulnerable children in our society--children in single-parent homes, children with mental and emotional disturbances, mentally challenged children, children who have been physically and/or sexually abused, and children in dysfunctional families. Youngsters for whom television serves as a babysitter or parental surrogate unfortunately are exposed to few competing influences to television viewing. In addition, parents in such homes are least likely to know what their children are viewing and to be able to pass on their own values about sex and sexual behavior. The main possible effects of televised pornography that must concern us as clinicians, educators, and parents are modeling and imitation of language heard and behaviors observed in televised pornography; negative interference with children's normal sexual development; emotional reactions such as nightmares and feelings of anxiety, guilt, confusion, and/or shame; stimulation of premature sexual activity; development of unrealistic, misleading, and/or harmful attitudes toward sex and adult male-female relationships; and undermining of family values with resultant conflict between parents and children. Much more research is clearly needed on this topic. Because of the ethical and procedural problems surrounding research on children exposed to pornography, ideal research designs may never be possible. Nonetheless, we hope that this article will stimulate further discussion and work. To devise public policy that protects children from potentially harmful material while at the same time respecting the media's First Amendment rights, such public discourse and responsible research are essential.
Switzer, S; Guta, A; de Prinse, K; Chan Carusone, S; Strike, C
The use of visual methods is becoming increasingly common and accepted in health research. This paper explores the opportunities and constraints of using photo-based methods in the context of a community-based participatory research study on how to engage people living with HIV in conversations about a hospital's recently introduced harm reduction policy. Using a blended approach of photovoice and photo-elicited interviews, we provided participants (n = 16) with cameras and asked them to take a series of photos that "show how you feel about or have experienced harm reduction as a Casey House client." We reflect on methodological insights from the study to think through the process of doing photo-based work on a stigmatized topic in a small hospital setting by foregrounding: 1) how the act of taking photos assisted participants in visualizing connections between space, harm reduction, and substance use; 2) expectations of participation and navigating daily health realities; and 3) issues of confidentiality, anonymity and stigma in clinical settings. These reflections provide a case study on the importance of critically examining the process of engaging with photo-based methods. We conclude the paper by re-thinking issues of context and photo-based methods. Rather than viewing context as a neutral backdrop to apply a method, context should be viewed as an active force in shaping what can or cannot be done or produced within the space. Photo-based methods may offer an effective community-engagement strategy but may require modification for use in a clinical setting when working on a stigmatized topic with individuals with complex health care needs. Given the potential of visual methods as a community engagement strategy, research teams are advised to understand the entire process as a data collection opportunity so that these methods can be further explored in a variety of contexts.
Lam, Catherine K; Van der Vegt, Gerben S; Walter, Frank; Huang, Xu
This study developed a multilevel model of the interpersonal harming behavior associated with social comparison processes in work teams. We tested this model using temporally lagged data from a sample of student teams (Study 1) and cross-sectional data from a sample of work teams in a telecommunication services company (Study 2). In both studies, social relations analyses revealed that in teams with less cooperative goals, comparison to a higher performing team member was positively associated with interpersonal harming behavior, but only when expectations of future performance similarity to that member were low. The interactive relationship of social comparison and expected future performance similarity with interpersonal harming was buffered, however, in teams with more cooperative goals.
Bender, Filitsa H
This review is focused on minimizing complications and avoiding harm in peritoneal dialysis (PD) patients. Issues related to planning for PD are covered first, with emphasis on PD versus hemodialysis outcomes. Catheter types and insertion techniques are described next, including relevant recommendations by the International Society for Peritoneal Dialysis. A brief review of both noninfectious and infectious complications follows, with emphasis on cardiovascular and metabolic complications. Finally, recommendations for preventing PD-related infections are provided. In conclusion, with proper catheter insertion technique, good training, and attention to detail during the tenure in PD, excellent outcomes can be obtained in a well-informed motivated patient.
Touzeau, Didier; Courty, Pascal
Opioid dependence is a chronic metabolic brain disease and several individual, sociological and biological factors are implicated in its development. Program (needle exchange, low threshold access to treatment) prevent harms associated with opioid use (HIV, overdose…). Effective treatment involves a set of pharmacological and psychosocial interventions. The benefits of maintenance programmes increase as long as the person remains in treatment (many years). Relapse is a symptom of the disorder or a sign of abstinence failure. Treatment aims to improve quality of life in a comprehensive and individualised assessment.
For over 15 years the Australian Agency for International Development (AusAID) has been a leading donor for harm reduction projects in Southeast Asia. The recent AusAID-supported harm reduction projects of greatest significance have included the Asia Regional HIV/AIDS Project (AHRP), from 2002 until 2007,1 and the HIV/AIDS Asia Regional Program (HAARP), from 2007 until 2015.2 Both projects included in their design specific strategies for engaging with law enforcement agencies at country level. The main focus of these strategies has been to develop law enforcement harm reduction policy and curriculum, and the design and implementation of specific harm reduction training for law enforcement officers. In July 2008, the Australian Development Research Awards (ADRA) funded the Nossal Institute for Global Health at the University of Melbourne to establish a research project created to assess the influence of harm reduction programs on the policy and operational practices of law enforcement agencies in Southeast Asia, known as the LEHRN Project (Law Enforcement, Harm Reduction, Nossal Institute Project). The ADRA is a unique grant research mechanism that specifically funds development research to improve the understanding and informed decision making of the implementation of Australian aid effectiveness. While the need to engage law enforcement when establishing harm reduction programs was well documented, little was known about the impact or influence of harm reduction programs on policy and practices of law enforcement agencies. The LEHRN Project provided the opportunity to assess the impact of harm reduction programs on law enforcement in Southeast Asia, with a focus on Vietnam, Cambodia and Lao PDR. PMID:22769050
Thomson, Nick; Moore, Tim; Crofts, Nick
For over 15 years the Australian Agency for International Development (AusAID) has been a leading donor for harm reduction projects in Southeast Asia. The recent AusAID-supported harm reduction projects of greatest significance have included the Asia Regional HIV/AIDS Project (AHRP), from 2002 until 2007,1 and the HIV/AIDS Asia Regional Program (HAARP), from 2007 until 2015.2 Both projects included in their design specific strategies for engaging with law enforcement agencies at country level. The main focus of these strategies has been to develop law enforcement harm reduction policy and curriculum, and the design and implementation of specific harm reduction training for law enforcement officers.In July 2008, the Australian Development Research Awards (ADRA) funded the Nossal Institute for Global Health at the University of Melbourne to establish a research project created to assess the influence of harm reduction programs on the policy and operational practices of law enforcement agencies in Southeast Asia, known as the LEHRN Project (Law Enforcement, Harm Reduction, Nossal Institute Project). The ADRA is a unique grant research mechanism that specifically funds development research to improve the understanding and informed decision making of the implementation of Australian aid effectiveness.While the need to engage law enforcement when establishing harm reduction programs was well documented, little was known about the impact or influence of harm reduction programs on policy and practices of law enforcement agencies. The LEHRN Project provided the opportunity to assess the impact of harm reduction programs on law enforcement in Southeast Asia, with a focus on Vietnam, Cambodia and Lao PDR.
Joseph, M Lindell; Fowler, Debra
The evolving and complex practice environment calls for new mindsets among nurse leaders, academics, and nurse innovators to envision innovative ways to manage and optimize traditional tasks and processes in nursing administration. The purpose of this article is to present 3 case studies that used linear programming and simulation to innovate staffing enterprises, financial management of healthcare systems, and curricula development.
Fresh from teaching his first full school year the author reflects on his traditional teacher preparation path into the classroom and finds he was instilled with a common sense of ethics, compassion, a demand for reflective practice, and a robust guiding philosophy. As a college student, he learned theory and was able to augment that with…
Washington, Siemthlut Michelle
The purpose of this article is to examine how our Kootegan Yix Meh Towlth (traditional governance) might contribute to the development and implementation of a culturally relevant Sliammon governance model. Our Uk woom he heow (ancestors) lived their everyday lives guided by a complex system of practices and beliefs based on our Ta-ow (traditional…
Williams, Huw; Edwards, Adrian; Hibbert, Peter; Rees, Philippa; Prosser Evans, Huw; Panesar, Sukhmeet; Carter, Ben; Parry, Gareth; Makeham, Meredith; Jones, Aled; Avery, Anthony; Sheikh, Aziz; Donaldson, Liam; Carson-Stevens, Andrew
Background Discharge from hospital presents significant risks to patient safety, with up to one in five patients experiencing adverse events within 3 weeks of leaving hospital. Aim To describe the frequency and types of patient safety incidents associated with discharge from secondary to primary care, and commonly described contributory factors to identify recommendations for practice. Design and setting A mixed methods analysis of 598 patient safety incident reports in England and Wales related to ‘Discharge’ from the National Reporting and Learning System. Method Detailed data coding (with 20% double-coding), data summaries generated using descriptive statistical analysis, and thematic analysis of special-case sample of reports. Incident type, contributory factors, type, and level of harm were described, informing recommendations for future practice. Results A total of 598 eligible reports were analysed. The four main themes were: errors in discharge communication (n = 151; 54% causing harm); errors in referrals to community care (n = 136; 73% causing harm); errors in medication (n = 97; 87% causing harm); and lack of provision of care adjuncts such as dressings (n = 62; 94% causing harm). Common contributory factors were staff factors (not following referral protocols); and organisational factors (lack of clear guidelines or inefficient processes). Improvement opportunities include developing and testing electronic discharge methods with agreed minimum information requirements and unified referrals systems to community care providers; and promoting a safety culture with ‘safe discharge’ checklists, discharge coordinators, and family involvement. Conclusion Significant harm was evident due to deficits in the discharge process. Interventions in this area need to be evaluated and learning shared widely. PMID:26622036
Ougrin, Dennis; Boege, Isabel
The Self Harm Questionnaire (SHQ) aiming at identification of self-harm in adolescents has been developed and piloted in a sample of 12-17 year olds (n = 100). The adolescents were recruited from both in- and outpatient psychiatric services. Concurrent validity of the SHQ was evaluated by comparing the SHQ results with recorded self harm in the…
Marshall, Brandon D L; Green, Traci C; Yedinak, Jesse L; Hadland, Scott E
Extra-medical prescription opioid (EMPO) use - intentional use without a prescription or outside of prescribed parameters - is a public health crisis in the United States and around the world. Epidemiological evidence suggests that the prevalence of EMPO use and adverse sequelae, including opioid overdose and hepatitis C infection, are elevated among people aged 18-25. Despite these preventable health risks, many harm reduction interventions are underutilized by, or inaccessible to, EMPO-using youth. In this commentary, we describe key harm reduction strategies for young people who use prescription opioids. We examine individual, social, and policy-level barriers to the implementation of evidence-based approaches that address EMPO use and related harms among young people. We highlight the need for expanded services and new interventions to engage this diverse and heterogeneous at-risk population. A combination of medical, social, and structural harm reduction interventions are recommended. Furthermore, research to inform strategies that mitigate particularly high-risk practices (e.g., polysubstance use) is warranted. Finally, we discuss how the meaningful involvement of youth in the implementation of harm reduction strategies is a critical component of the public health response to the prescription opioid epidemic.
Li, En; Browne, Matthew; Rawat, Vijay; Langham, Erika; Rockloff, Matthew
This article examines gambling harms from both gamblers and affected others' perspectives. Participants (3076 gamblers and 2129 affected others) completed a retrospective survey that elicited information on harms they experienced from gambling across their lifetime. Their responses were analyzed through testing measurement invariance, estimating item-response theoretic parameters, calculating percentages, confidence intervals, and correlations, as well as regressions. The results indicated large commonalities in the experience of harms reported by gamblers and affected others. Further, gamblers appeared to 'export' about half of the harms they experienced to those around them. The findings also provided detailed profiles of evolving harms as problem gambling severity varies.
Paerl, Hans W; Otten, Timothy G
Cyanobacteria are the Earth's oldest oxygenic photoautotrophs and have had major impacts on shaping its biosphere. Their long evolutionary history (≈ 3.5 by) has enabled them to adapt to geochemical and climatic changes, and more recently anthropogenic modifications of aquatic environments, including nutrient over-enrichment (eutrophication), water diversions, withdrawals, and salinization. Many cyanobacterial genera exhibit optimal growth rates and bloom potentials at relatively high water temperatures; hence global warming plays a key role in their expansion and persistence. Bloom-forming cyanobacterial taxa can be harmful from environmental, organismal, and human health perspectives by outcompeting beneficial phytoplankton, depleting oxygen upon bloom senescence, and producing a variety of toxic secondary metabolites (e.g., cyanotoxins). How environmental factors impact cyanotoxin production is the subject of ongoing research, but nutrient (N, P and trace metals) supply rates, light, temperature, oxidative stressors, interactions with other biota (bacteria, viruses and animal grazers), and most likely, the combined effects of these factors are all involved. Accordingly, strategies aimed at controlling and mitigating harmful blooms have focused on manipulating these dynamic factors. The applicability and feasibility of various controls and management approaches is discussed for natural waters and drinking water supplies. Strategies based on physical, chemical, and biological manipulations of specific factors show promise; however, a key underlying approach that should be considered in almost all instances is nutrient (both N and P) input reductions; which have been shown to effectively reduce cyanobacterial biomass, and therefore limit health risks and frequencies of hypoxic events.
Young, Liane; Bechara, Antoine; Tranel, Daniel; Damasio, Hanna; Hauser, Marc; Damasio, Antonio
Summary Moral judgments, whether delivered in ordinary experience or in the courtroom, depend on our ability to infer intentions. We forgive unintentional or accidental harms and condemn failed attempts to harm. Prior work demonstrates that patients with damage to the ventromedial prefrontal cortex (VMPC) deliver abnormal judgments in response to moral dilemmas, and that these patients are especially impaired in triggering emotional responses to inferred or abstract events (e.g., intentions), as opposed to real or actual outcomes. We therefore predicted that VMPC patients would deliver abnormal moral judgments of harmful intentions in the absence of harmful outcomes, as in failed attempts to harm. This prediction was confirmed in the current study: VMPC patients judged attempted harms including attempted murder as more morally permissible relative to controls. These results highlight the critical role of the VMPC in processing harmful intent for moral judgment. PMID:20346759
Greenhouse Gas Emissions and Global Warming Potential of Traditional and Diversified Tropical Rice Rotation Systems including Impacts of Upland Crop Management Practices i.e. Mulching and Inter-crop Cultivation
Janz, Baldur; Weller, Sebastian; Kraus, David; Wassmann, Reiner; Butterbach-Bahl, Klaus; Kiese, Ralf
Paddy rice cultivation is increasingly challenged by irrigation water scarcity, while at the same time changes in demand (e.g. changes in diets or increasing demand for biofuels) will feed back on agricultural practices. These factors are changing traditional cropping patterns from flooded double-rice systems to the introduction of well-aerated upland crop systems in the dry season. Emissions of methane (CH4) are expected to decrease, while emissions of nitrous oxide (N2O) will increase and soil organic carbon (SOC) stocks will most likely be volatilized in the form of carbon dioxide (CO2). We measured greenhouse gas (GHG) emissions at the International Rice Research Institute (IRRI) in the Philippines to provide a comparative assessment of the global warming potentials (GWP) as well as yield scaled GWPs of different crop rotations and to evaluate mitigation potentials or risks of new management practices i.e. mulching and inter-crop cultivation. New management practices of mulching and intercrop cultivation will also have the potential to change SOC dynamics, thus can play the key role in contributing to the GWP of upland cropping systems. To present, more than three years of continuous measurement data of CH4 and N2O emissions in double-rice cropping (R-R) and paddy rice rotations diversified with either maize (R-M) or aerobic rice (R-A) in upland cultivation have been collected. Introduction of upland crops in the dry season reduced irrigation water use and CH4 emissions by 66-81% and 95-99%, respectively. Moreover, for practices including upland crops, CH4 emissions in the subsequent wet season with paddy rice were reduced by 54-60%. Although annual N2O emissions increased twice- to threefold in the diversified systems, the strong reduction of CH4 led to a significantly lower (p<0.05) annual GWP (CH4+ N2O) as compared to the traditional double-rice cropping system. Measurements of soil organic carbon contents before and three years after introduction of upland
Marshall, K G
Harm caused by preventive programs may be physical, psychological, social or, if informed consent has not been obtained, ethical. Adverse effects of preventive screening programs may occur at any of the three levels of the "screening cascade", the screening procedure itself, the investigation of abnormal results of screening tests or the treatment of detected abnormalities or diseases. The greatest harm occurs at the second and third levels. Examples of procedures that may cause physical harm are venipuncture, mammography, colonoscopy, breast biopsy, transrectal ultrasonography, prostate biopsy, weight-reducing and cholesterol-lowering diets and radical prostatectomy. The psychological and social harm of preventive programs involves anticipated discomfort or perception of adverse effects of preventive interventions; unpleasant interactions with health care workers, time required for preventive programs, excessive overall awareness of health, anxiety over the results of a screening test implications of a positive screening test, consequences of being labelled as "sick" or "at risk," psychopathologic effects induced directly by preventive programs and, in the case of a false-negative test result, false assurance of disease-free status. Since the positive predictive value of screening tests in the general population is always low, most abnormal test results are "false-positive," these engender a great deal of psychological discuss among patients. PMID:8800074
Naisteter, Michal A.; Sitron, Justin A.
This article explores the potential for introducing harm reduction into sexuality education. When the goal of sexuality education is on prevention and focuses on risk and public health concerns, a discussion of pleasure is rendered problematic, as many pleasurable behaviors are inherently "unsafe" or "risky" when considered using a safe-sex lens.…
Dollar, Katherine M; Mix, Jacqueline M; Kozlowski, Lynn T
We conducted a comparative analysis of "harm," "harm reduction," and "little cigar" information about cigars on 10 major English-language health Web sites. The sites were from governmental and nongovernmental organizations based in seven different countries and included "harm" and "harm reduction" information, discussions of little cigars, quantitative estimates of health risks, and qualifying behavioral characteristics (inhalation, number per day). Of the 10 Web sites, 7 offered statements explicitly indicating that cigars may be safer than cigarettes. None of the Web sites reviewed described that little cigars are likely as dangerous as cigarettes. Some Web sites provided quantitative estimates of health risks and extensive discussions of qualifying factors. Reading grade levels were higher than desirable. Extensive and complex information on the reduced risks of cigars compared with cigarettes is available on Web sites affiliated with prominent health organizations. Yet these sites fail to warn consumers that popular cigarette-like little cigars and cigarillos are likely to be just as dangerous as cigarettes, even for those who have never smoked cigarettes. Improvement of these Web sites is urgently needed to provide the public with high-quality health information.
Kiser, William S.
Navajo trading has been a crucial component of that tribe's localized economy for generations and has been the subject of much scholarship over the years. The role of the Navajo trader in influencing the types and styles of crafts that Navajos created as well as providing tribal members with an outlet for those items remains important to their…
Background The UK continues to experience a rise in the number of anabolic steroid-using clients attending harm reduction services such as needle and syringe programmes. Methods The present study uses interviews conducted with harm reduction service providers as well as illicit users of anabolic steroids from different areas of England and Wales to explore harm reduction for this group of drug users, focussing on needle distribution policies and harm reduction interventions developed specifically for this population of drug users. Results The article addresses the complexity of harm reduction service delivery, highlighting different models of needle distribution, such as peer-led distribution networks, as well as interventions available in steroid clinics, including liver function testing of anabolic steroid users. Aside from providing insights into the function of interventions available to steroid users, along with principles adopted by service providers, the study found significant tensions and dilemmas in policy implementation due to differing perspectives between service providers and service users relating to practices, risks and effective interventions. Conclusion The overarching finding of the study was the tremendous variability across harm reduction delivery sites in terms of available measures and mode of operation. Further research into the effectiveness of different policies directed towards people who use anabolic steroids is critical to the development of harm reduction. PMID:24986546
Maloney, Stephen; Storr, Michael; Paynter, Sophie; Morgan, Prue; Ilic, Dragan
Effective education of practical skills can alter clinician behaviour, positively influence patient outcomes, and reduce the risk of patient harm. This study compares the efficacy of two innovative practical skill teaching methods, against a traditional teaching method. Year three pre-clinical physiotherapy students consented to participate in a randomised controlled trial, with concealed allocation and blinded participants and outcome assessment. Each of the three randomly allocated groups were exposed to a different practical skills teaching method (traditional, pre-recorded video tutorial or student self-video) for two specific practical skills during the semester. Clinical performance was assessed using an objective structured clinical examination (OSCE). The students were also administered a questionnaire to gain the participants level of satisfaction with the teaching method, and their perceptions of the teaching methods educational value. There were no significant differences in clinical performance between the three practical skill teaching methods as measured in the OSCE, or for student ratings of satisfaction. A significant difference existed between the methods for the student ratings of perceived educational value, with the teaching approaches of pre-recorded video tutorial and student self-video being rated higher than 'traditional' live tutoring. Alternative teaching methods to traditional live tutoring can produce equivalent learning outcomes when applied to the practical skill development of undergraduate health professional students. The use of alternative practical skill teaching methods may allow for greater flexibility for both staff and infrastructure resource allocation.
Grattan, Lynn M.; Holobaugh, Sailor; Morris, J. Glenn
The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels. PMID:27616971
Miller, Karen L; Baraldi, Carole A
Age increases vulnerability, commonly accompanied by greater reliance on others and susceptibility to maltreatment. Physiologic processes become less resilient; the potential for harm from medical care increases. Awareness of frailty, functional, social, and potential maltreatment issues enables early referrals to help the patient maintain her independence. Health issues that may impede both gynecologic care and self-sufficiency include sensory deficits, physical disability, and cognitive impairment. Speaking slowly and providing contextual information enhance patient comprehension. Cancer screening depends on life expectancy. Osteoporosis treatment requires managing fall risk. Gynecologic symptoms more likely have multiple contributing factors than one etiology. Incontinence is a particularly complex issue, but invariably includes bladder diary assessment and pelvic floor muscle training. Function and frailty measures best predict perioperative morbidity. Communication with the patient, her family, other providers, and health care organizations is an important frontier in avoiding errors and adverse outcomes.
Hall, E. J.
Radiation therapy confers enormous benefits that must be balanced against the possibilities for harm including late toxicity in normal tissues and radiation-induced second malignancies. A small percentage of patients experience severe late complications. The question is, do these late sequelae occur randomly, or are they confined to individuals who are genetically predisposed to radiosensitivity. Experiments with knockout mice and with patients demonstrate that individuals heterozygous for a number of genes appear to be radiosensitive. If radiosensitive patients were identified prospectively by genetic analysis, they could be spared the trauma of late sequelae. Several large studies have shown a statistically significant excess of radiation-induced malignancies in radiotherapy patients. Most second cancers are carcinomas, developing in the lining cells of the body often remote from the treatment site. Radiation-induced sarcomas appear only in the heavily irradiated areas. These are small in number but appear with a very high relative risk.
Grattan, Lynn M; Holobaugh, Sailor; Morris, J Glenn
The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels.
Bernal-Delgado, Enrique; Fisher, Elliot S
Background To describe how frequently harm is reported in the abstract of high impact factor medical journals. Methods Design and population: We carried out a blinded structured review of a random sample of 363 Randomised Controlled Trials (RCTs) carried out on human beings, and published in high impact factor medical journals in 2003. Main endpoint: 1) Proportion of articles reporting harm in the abstract; and 2) Proportion of articles that reported harm in the abstract when harm was reported in the main body of the article. Analysis: Corrected Prevalence Ratio (cPR) and its exact confidence interval were calculated. Non-conditional logistic regression was used. Results 363 articles and 407 possible comparisons were studied. Overall, harm was reported in 135 abstracts [37.2% (CI95%:32.2 to 42.4)]. Harm was reported in the main text of 243 articles [66.9% (CI95%: 61.8 to 71.8)] and was statistically significant in 54 articles [14.9% (CI95%: 11.4 to 19.0)]. Among the 243 articles that mentioned harm in the text, 130 articles [53.5% (CI95% 47.0 to 59.9)] reported harm in the abstract; a figure that rose to 75.9% (CI95%: 62.4 to 86.5) when the harm reported in the text was statistically significant. Harm in the abstract was more likely to be reported when statistically significant harm was reported in the main body of the article [cPR = 1.70 (CI95% 1.47 to 1.92)] and when drug companies (not public institutions) funded the RCTs [cPR = 1.29 (CI95% 1.03 to 1.67)]. Conclusion Abstracts published in high impact factor medical journals underreport harm, even when harm is reported in the main body of the article. PMID:18371200
Namdar, Hasan; Emaratkar, Elham; Hadavand, Mohammad Bagher
The Persian Traditional Medicine (PTM) system pays special attention to disease prevention. In PTM, physicians believe that overeating may cause accumulation of unhealthy substances in the body and diseases called “Emtela.” With respect to ocular health, foods can be categorized as beneficial and harmful. Harmful foods such as beef, geese, eggplant, cauliflower, and cheese can cause reduced vision. Dehydrating foods such as walnut and salty fish and hot foods such as garlic, onion, and pepper can cause dry eye. Food items that have beneficial effects on ocular health include thyme and saffron and fruits such as grape, fig, apple, plum, and berries. PTM stipulates that one should not drink water with meals or immediately afterwards, since drinking cold (icy) water causes difficulty in absorption of nutrients. Gulping water may have harmful effects on the eyes; therefore, PTM physicians recommend drinking water at a suitable temperature. It is not safe to drink water first at the morning. Sleeping right after eating is harmful too. Avicenna believes that sleeping on one’s belly after a full meal is very harmful for the eyes. Galen says that old people need deep and continuous sleep more than others. From the view of PTM, moving eyes in different directions, making delicate expressions, trying to look at delicate and find pictures and reading small letters would remove ocular fatigue. There have been mentions of local medicine for improving vision as well; for instance, fennel extracts, pomegranate juice, and honey which are suitable for vision improvement. Local administration of pomegranate blossoms is suitable for treating inflammatory reactions. PMID:27800504
Jankunis, F. J.; Peacock, K.
We define geoengineering (GE) as the intentional use of technology to change the planet's climate. Many people believe GE is different in kind rather than degree from any other organized activity in human history. In fact, humans caused changes in the planet's climate long before the industrial age, and all organisms engineer their environments directly or indirectly. The relevant difference between this cumulative and generally inadvertent activity and GE is the presence of intention. Now that science has revealed the extent to which humans can change the climate, however, even the continuance of Business as Usual (BAU) is, in effect, a form of intentional GE, albeit one that will cause significant climate harm, defined as effects such as sea level rise that will impact human well-being. But as with all forms of engineering, the devil is in the details: what forms of GE should be tried first? Some methods, such as large-scale afforestation, are low risk but have long-term payoffs; others, such as aerosol injection into the stratosphere, could help buy time in a warming crisis but have unknown side-effects and little long-term future. Climate change is a world-wide, inter-generational tragedy of the commons. Rational choice theory, the spatial and temporal extension of the problem, poorly fitted moral frameworks, and political maneuvering are all factors that inhibit solutions to the climate tragedy of the commons. The longer that such factors are allowed to dominate decision-making (or the lack thereof) the more likely it is that humanity will be forced to resort to riskier and more drastic forms of GE. We argue that this fact brings an additional measure of urgency to the search for ways to engineer the climate differently so as to avoid climate harm in the most lasting and least risky way.
The benzodiazepines (BZDs) are anxiolytics, hypnotics, anticonvulsants, muscle-relaxants and induce anaesthesia. Adverse effects comprise sedation subjectively and cognitive and psychomotor impairment objectively. Complex skills such as driving can be compromised. Paradoxical excitement can have forensic implications. Long term use beyond the licensed durations is common but both efficacy and adverse effects associated with this have been poorly documented. Withdrawal and dependence have excited particular concern, and even polemic. Perhaps a third of long term (beyond 6 months) users experience symptoms and signs on attempting to withdraw – anxiety, insomnia, muscle spasms and tension and perceptual hypersensitivity. Uncommonly, fits or a psychosis may supervene. The patterns following withdrawal vary widely. The usual method of withdrawal is slow tapering but it may not obviate the problems completely. BZDs are also drugs of abuse either on their own or in conjunction with opioids and stimulants. Claims have been made that the use of BZDs is associated with increased mortality. This is a concern in view of the widespread usage of these drugs, particularly in the elderly. All of these factors impinge on the risk : benefit ratio and the severity of the indications. Harm reduction should focus on choice of alternative treatments both psychological and pharmacological. Guidelines emphasise that BZDs are not drugs of first choice and should only be used short term. Schedules are available to educate about methods of withdrawal in current users, emphasising the slow rate of taper. General principles of harm minimization in the addiction field are appropriate to BZD abuse. PMID:22882333
Lekouch, N; Sedki, A; Nejmeddine, A; Gamon, S
The use of traditional cosmetics and remedies such as kohl and henna is very common in Morocco, especially among women, children and babies. Kohl is a dangerous eye cosmetic. It is usually mixed with other harmful substances, then applied on women's eyebrows and used in skin treatments for infants. Henna is another traditional product, with religious associations, which has been widely used over the centuries for cosmetic and medical purposes. Many people add various herbs or other substances to the henna in order to strengthen it or to give it a stronger colour. Our results were reassuring in that the concentrations of lead found in non-elaborate (henna only) samples of henna were low. However, when henna was mixed with other products (elaborate henna), these concentrations increased. Lead concentrations in kohl were very high however, unlike henna, were lower in mixed kohl as mixing with other products diluted the concentration of lead. Nevertheless, in both types of kohl, lead concentrations were very high and consequently constitute a risk for public health, particularly for children.
Wendt, Dennis C.; Gone, Joseph P.; Nagata, Donna K.
In recent years psychologists have been increasingly concerned about potentially harmful therapy, yet this recent discourse has not addressed issues that have long been voiced by the multicultural counseling and psychotherapy movement. We aim to begin to bring these seemingly disparate discourses of harm into greater conversation with one another, in the service of placing the discipline on a firmer foothold in its considerations of potentially harmful therapy. After reviewing the two discourses and exploring reasons for their divergence, we argue that they operate according to differing assumptions pertaining to the sources, objects, and scope of harm. We then argue that these differences reveal the discipline’s need to better appreciate that harm is a social construct, that psychotherapy may be inherently ethnocentric, and that strategies for collecting evidence of harm should be integrated with a social justice agenda. PMID:26339075
Wendt, Dennis C; Gone, Joseph P; Nagata, Donna K
In recent years psychologists have been increasingly concerned about potentially harmful therapy, yet this recent discourse has not addressed issues that have long been voiced by the multicultural counseling and psychotherapy movement. We aim to begin to bring these seemingly disparate discourses of harm into greater conversation with one another, in the service of placing the discipline on a firmer foothold in its considerations of potentially harmful therapy. After reviewing the two discourses and exploring reasons for their divergence, we argue that they operate according to differing assumptions pertaining to the sources, objects, and scope of harm. We then argue that these differences reveal the discipline's need to better appreciate that harm is a social construct, that psychotherapy may be inherently ethnocentric, and that strategies for collecting evidence of harm should be integrated with a social justice agenda.
Babor, T F
Recent advances in the technology of behavioural interventions for harmful drinkers have created a new role for clinical practice and new challenges for medical education. Several reports from expert committees have recommended new initiatives in the secondary prevention of alcohol problems through physician-based interventions at the primary care level. The conceptual and scientific bases for these recommendations are discussed in terms of recent studies of harmful and hazardous drinkers. The behavioural principles thought to account for the effectiveness of brief interventions are explained. Despite these promising developments, difficulties are inherent in the introduction of new technologies, especially behavioural technologies, into medical practice. A major challenge to medical education will be the development of academic programs that not only teach skills and competencies in secondary prevention but also deal with the socialization of physicians as behavioural practitioners. PMID:2224675
Lockwood, Joanna; Daley, David; Townsend, Ellen; Sayal, Kapil
Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11-25 years and aims to integrate findings according to differing concepts and methods. Electronic searches of EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed and The Cochrane Library, and manual searches of reference lists of relevant reviews identified 4496 articles published up to July 2015, of which 28 met inclusion criteria. Twenty-four of the studies reported an association between broadly specified impulsivity and self-harm. However, findings varied according to the conception and measurement of impulsivity and the precision with which self-harm behaviours were specified. Specifically, lifetime non-suicidal self-injury was most consistently associated with mood-based impulsivity-related traits. However, cognitive facets of impulsivity (relating to difficulties maintaining focus or acting without forethought) differentiated current self-harm from past self-harm. These facets also distinguished those with thoughts of self-harm (ideation) from those who acted on thoughts (enaction). The findings suggested that mood-based impulsivity is related to the initiation of self-harm, while cognitive facets of impulsivity are associated with the maintenance of self-harm. In addition, behavioural impulsivity is most relevant to self-harm under conditions of negative affect. Collectively, the findings indicate that distinct impulsivity facets confer unique risks across the life-course of self-harm. From a clinical perspective, the review suggests that interventions focusing on reducing rash reactivity to emotions or improving self-regulation and decision making may offer most benefit in supporting those who self-harm.
Dawis, Rene V.
Traces historical development from individual differences psychology through psychological testing, vocational counseling, and student personnel work, to counseling psychology. Describes individual differences tradition in counseling psychology research and practice. Discusses how individual differences psychology has influenced counseling…
Therapies with increasing specificity against pathogens follow the immune system's evolutionary course in maximizing host defence while minimizing self-harm. Nevertheless, even completely non-specific stressors, such as reactive molecular species, heat, nutrient and oxygen deprivation, and acidity can be used to preferentially harm pathogens. Strategic use of non-specific stressors requires exploiting differences in stress vulnerability between pathogens and hosts. Two basic vulnerabilities of pathogens are: (i) the inherent vulnerability to stress of growth and replication (more immediately crucial for pathogens than for host cells) and (ii) the degree of pathogen localization, permitting the host's use of locally and regionally intense stress. Each of the various types of non-specific stressors is present during severe infections at all levels of localization: (i) ultra-locally within phagolysosomes, (ii) locally at the infected site, (iii) regionally around the infected site and (iv) systemically as part of the acute-phase response. We propose that hosts strategically use a coordinated system of non-specific stressors at local, regional and systemic levels to preferentially harm the pathogens within. With the rising concern over emergence of resistance to specific therapies, we suggest more scrutiny of strategies using less specific therapies in pathogen control. Hosts' active use of multiple non-specific stressors is likely an evolutionarily basic defence whose retention underlies and supplements the well-recognized immune defences that directly target pathogens. PMID:27075254
LeGrand, Edmund K; Day, Judy D
Therapies with increasing specificity against pathogens follow the immune system's evolutionary course in maximizing host defence while minimizing self-harm. Nevertheless, even completely non-specific stressors, such as reactive molecular species, heat, nutrient and oxygen deprivation, and acidity can be used to preferentially harm pathogens. Strategic use of non-specific stressors requires exploiting differences in stress vulnerability between pathogens and hosts. Two basic vulnerabilities of pathogens are: (i) the inherent vulnerability to stress of growth and replication (more immediately crucial for pathogens than for host cells) and (ii) the degree of pathogen localization, permitting the host's use of locally and regionally intense stress. Each of the various types of non-specific stressors is present during severe infections at all levels of localization: (i) ultra-locally within phagolysosomes, (ii) locally at the infected site, (iii) regionally around the infected site and (iv) systemically as part of the acute-phase response. We propose that hosts strategically use a coordinated system of non-specific stressors at local, regional and systemic levels to preferentially harm the pathogens within. With the rising concern over emergence of resistance to specific therapies, we suggest more scrutiny of strategies using less specific therapies in pathogen control. Hosts' active use of multiple non-specific stressors is likely an evolutionarily basic defence whose retention underlies and supplements the well-recognized immune defences that directly target pathogens.
Traditional African healing has been in existence for many centuries yet many people still seem not to understand how it relates to God and religion/spirituality. Some people seem to believe that traditional healers worship the ancestors and not God. It is therefore the aim of this paper to clarify this relationship by discussing a chain of communication between the worshipers and the Almighty God. Other aspects of traditional healing namely types of traditional healers, training of traditional healers as well as the role of traditional healers in their communities are discussed. In conclusion, the services of traditional healers go far beyond the uses of herbs for physical illnesses. Traditional healers serve many roles which include but not limited to custodians of the traditional African religion and customs, educators about culture, counselors, social workers and psychologists. PMID:26594664
Although the environmentally harmful effects of widespread dichlorodiphenyltrichloroethane (DDT) use became well-known following Rachel Carson’s Silent Spring (1962), its human health effects have more recently become clearer. A ban on the use of DDT has been in place for over 30 years, but recently DDT has been used for malaria control in areas such as Africa. Recent work shows that DDT has transgenerational effects in progeny and generations never directly exposed to DDT. These effects have health implications for individuals who are not able to have any voice in the decision to use the pesticide. The transgenerational effects of DDT are considered in light of some widely accepted ethical principles. We argue that this reframes the decision to use DDT, requiring us to incorporate new considerations, and new kinds of decision making, into the deliberative process that determines its ongoing use. Ethical considerations for intergenerational environmental justice are presented that include concern and respect for autonomy, nonmaleficence, and justice. Here, we offer a characterization of the kinds of ethical considerations that must be taken into account in any satisfactory decisions to use DDT. PMID:25086599
Mcintosh, S. C., Jr.; Weynand, M. E.
The purpose of this project was to investigate the use of optimization techniques to improve the flutter margins of the HARM AGM-88A wing. The missile has four cruciform wings, located near mid-fuselage, that are actuated in pairs symmetrically and antisymmetrically to provide pitch, yaw, and roll control. The wings have a solid stainless steel forward section and a stainless steel crushed-honeycomb aft section. The wing restraint stiffness is dependent upon wing pitch amplitude and varies from a low value near neutral pitch attitude to a much higher value at off-neutral pitch attitudes, where aerodynamic loads lock out any free play in the control system. The most critical condition for flutter is the low-stiffness condition in which the wings are moved symmetrically. Although a tendency toward limit-cycle flutter is controlled in the current design by controller logic, wing redesign to improve this situation is attractive because it can be accomplished as a retrofit. In view of the exploratory nature of the study, it was decided to apply the optimization to a wing-only model, validated by comparison with results obtained by Texas Instruments (TI). Any wing designs that looked promising were to be evaluated at TI with more complicated models, including body modes. The optimization work was performed by McIntosh Structural Dynamics, Inc. (MSD) under a contract from TI.
Kabasenche, William P; Skinner, Michael K
Although the environmentally harmful effects of widespread dichlorodiphenyltrichloroethane (DDT) use became well-known following Rachel Carson's Silent Spring (1962), its human health effects have more recently become clearer. A ban on the use of DDT has been in place for over 30 years, but recently DDT has been used for malaria control in areas such as Africa. Recent work shows that DDT has transgenerational effects in progeny and generations never directly exposed to DDT. These effects have health implications for individuals who are not able to have any voice in the decision to use the pesticide. The transgenerational effects of DDT are considered in light of some widely accepted ethical principles. We argue that this reframes the decision to use DDT, requiring us to incorporate new considerations, and new kinds of decision making, into the deliberative process that determines its ongoing use. Ethical considerations for intergenerational environmental justice are presented that include concern and respect for autonomy, nonmaleficence, and justice. Here, we offer a characterization of the kinds of ethical considerations that must be taken into account in any satisfactory decisions to use DDT.
This paper considers whether existing law could potentially be used to criminalize the transmission of genetic disease. The paper argues that even if an offence could be made out, the criminal law should not be involved in this context for many reasons, including the need to protect reproductive liberty and pregnant women's rights. The paper also examines whether there might be scope for civil claims between reproductive partners for a 'failure to warn' of potential genetic harm and argues there are strong policy grounds for resisting such claims. If such a duty were to exist, there might, in the future, be scope for a child to bring a claim under the Congenital Disabilities (Civil Liability Act) 1976. Such a claim could be for the failure by the child's father to warn her mother, which in turn led to the loss of opportunity to have treatment in utero which could have prevented the disability. It is suggested that the same arguments which supported granting maternal immunity under the Act would also support paternal immunity and that, therefore the issue of the lack of paternal immunity under the Act should be revisited.
Harris, Jennifer L; Munsell, Christina R
Concerns about potential dangers from energy drink consumption by youth have been raised by health experts, whereas energy drink manufacturers claim these products are safe and suitable for marketing to teens. This review summarizes the evidence used to support both sides of the debate. Unlike most beverage categories, sales of energy drinks and other highly caffeinated products continue to grow, and marketing is often targeted to youth under the age of 18 years. These products pose a risk of caffeine toxicity when consumed by some young people, and there is evidence of other troubling physiological and behavioral effects associated with their consumption by youth. The US Food and Drug Administration has indicated it will reexamine the safety of caffeine in the food supply; however, more research is needed to better understand youth consumption of energy drinks and caffeine in general, as well as the long-term effects on health. Meanwhile, policymakers and physician groups have called on energy drink manufacturers to take voluntary action to reduce the potential harm of their products, including placing restrictions on marketing to youth under the age of 18 years. Additional regulatory and legislative options are also being discussed.
The response to drug use in Laos has focused on reducing opium supply (supply reduction) and rates of drug use (demand reduction). However, recently there is increased interest among government counterparts to discuss and develop broader responses to injecting drug use (IDU) including the introduction of harm reduction programs. The concept of harm reduction has just been introduced to Lao PDR and as yet there is no agreement on a definition of the concept. We highlight here a range of issues that remain controversial in Lao PDR in the HIV, drug use and harm reduction discourse, the definition of 'harm reduction' and related terms; and the scope of harm reduction. This was a qualitative study, consisting of in-depth interviews with 27 law enforcement and 8 health officers who work in the fields of HIV and/or drug control about their understanding of HIV related to drug use, and concepts of harm reduction. Content analysis was performed to identify the coding, categories and themes. We found that law enforcement officers in particular had limited understanding about harm reduction and the feasibility and appropriateness of harm reduction services in the Lao context. Harm reduction should be a core element of a public health response to HIV where drug use and IDU exists. Recommendations include the necessity of increasing the awareness of harm reduction among law enforcement officers and providing appropriate evidence to support the needs of harm reduction policy and programs. HIV prevention and treatment strategies should be integrated within existing social and cultural frameworks, working with the task force for HIV/IDU and other government counterparts. PMID:22769736
Sychareun, Vanphanom; Hansana, Visanou; Phommachanh, Sysavanh; Somphet, Vathsana; Phommavongsa, Phouthong; Tenni, Brigitte; Moore, Timothy; Crofts, Nick
The response to drug use in Laos has focused on reducing opium supply (supply reduction) and rates of drug use (demand reduction). However, recently there is increased interest among government counterparts to discuss and develop broader responses to injecting drug use (IDU) including the introduction of harm reduction programs. The concept of harm reduction has just been introduced to Lao PDR and as yet there is no agreement on a definition of the concept. We highlight here a range of issues that remain controversial in Lao PDR in the HIV, drug use and harm reduction discourse, the definition of 'harm reduction' and related terms; and the scope of harm reduction.This was a qualitative study, consisting of in-depth interviews with 27 law enforcement and 8 health officers who work in the fields of HIV and/or drug control about their understanding of HIV related to drug use, and concepts of harm reduction. Content analysis was performed to identify the coding, categories and themes.We found that law enforcement officers in particular had limited understanding about harm reduction and the feasibility and appropriateness of harm reduction services in the Lao context.Harm reduction should be a core element of a public health response to HIV where drug use and IDU exists. Recommendations include the necessity of increasing the awareness of harm reduction among law enforcement officers and providing appropriate evidence to support the needs of harm reduction policy and programs. HIV prevention and treatment strategies should be integrated within existing social and cultural frameworks, working with the task force for HIV/IDU and other government counterparts.
Wakefield, Jerome C; First, Michael B
The In Review articles in this issue on normality and disorder by Dr Rachel Cooper and Dr Derek Bolton explore the importance of a value component of harm in the concept of mental disorder. They focus on the Diagnostic and Statistical Manual of Mental Disorder's clinical significance criterion, requiring that symptoms cause significant distress or role impairment, as the expression of the harm component. As Dr Bolton argues, harm in the form of distress or role impairment has always been intimately tied to the concept of disorder and treatment decisions; as Dr Cooper argues, without the harm requirement, any disliked anomaly may be labelled a disorder. Moreover, as Cooper argues, a harm requirement is not incompatible with a natural kinds approach to distinguishing among disorders or to a categorical approach to disorder; the lack of zones of rarity on the harm continuum does not preclude categorical underlying causal processes. However, neither paper systematically develops arguments regarding the other component of disorder, the requirement that the harm must be caused by underlying dysfunction. The dysfunction component distinguishes disorders from the many other negative conditions in life. Cooper's identification of dysfunction with symptom severity ignores the fact that normal suffering can be severe, and Bolton's attempt to encompass risk of harm within harm yields an implausibly expansive conception of disorder. While the harm component is essential, clarification of the dysfunction component of the concept of disorder, pursued in part 2 of this In Review in the December 2013 issue, is also essential to establishing a coherent and plausibly limited domain of psychiatric disorder within the broader arena of harmful conditions.
Gilles, Jere L.; Thomas, Justin L.; Valdivia, Corinne; Yucra, Edwin S.
Many sustainable agricultural practices are based on local and traditional farming knowledge. This article examines the conservation and loss of three traditional practices in the Bolivian Altiplano that agronomic research has shown increase the resiliency of small farmers in the face of climate-related risks. These practices are the use of…
Castonguay, Louis G.; Boswell, James F.; Constantino, Michael J.; Goldfried, Marvin R.; Hill, Clara E.
The goal of this article is to delineate training implications regarding harmful effects associated with psychotherapy. The authors strongly recommend that trainees be made aware of (and encouraged to examine carefully) the potentially harmful treatments that have been recently identified (Lilienfeld, 2007). Consistent with a broad perspective on…
Congress of the U.S., Washington, DC. Office of Technology Assessment.
Non-indigenous species (NIS) are common in the United States landscape. While some are beneficial, others are harmful and can cause significant economic, environmental, and health damage. This study, requested by the U.S. House Merchant Marine and Fisheries Committee, examined State and Federal policies related to these harmful NIS. The report is…
Jambon, Marc; Smetana, Judith G
We assessed 5- to 11-year-olds' (N = 76) judgments of straightforward moral transgressions (prototypical harm) as well as their evaluations of complex, hypothetical scenarios in which an actor transgresses in order to prevent injury (necessary harm). The nature of the actor's transgression (psychological or physical harm) varied across participants. Moral judgments and justifications, knowledge of the actor's psychological experience, and their associations were examined. At all ages, children negatively evaluated prototypical harm; judgments of necessary harm became increasingly more forgiving with age as justifications pertaining to the actor's harm decreased. References to the actor's positive actions and children's tendency to coordinate conflicting concerns increased with age, but only when evaluating psychological harm. Across conditions, older children viewed transgressors as holding increasingly more positive attitudes toward their own actions, and this was uniquely associated with more forgiving moral judgments and justifications of necessary but not prototypical harm. Findings are discussed in relation to the emergence of more flexible and nuanced moral evaluations during middle childhood.
Almond, Louise; Canter, David
This study investigates the variations in behaviour displayed by young people who sexually harm, as previous research has shown that they are not a homogeneous sample. Three conceptually distinct sets of behaviour were hypothesized, relating to various modes of interaction between the young people with harmful sexual behaviour (HSB) and their…
Pritchard, Duncan; Graham, Nicola; Ikin, Annette; Penney, Heather; Kovacs, Lisa; Mercer, Dawn; Edwards, Richard; Jones, Dylan; Mace, Floyd Charles
Children and young people with learning disabilities who present sexually harmful behaviour are marginalised and do not always participate in community activities. This case study describes a multi-component intervention that successfully reduced the sexually harmful behaviour of a 16-year-old boy with a mild learning disability. The intervention…
... HOUSING AND URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Multifamily Accelerated Processing (MAP): MAP Lender Quality Assurance Enforcement § 200.1540 Imminent harm notice of action. The Board may issue an imminent harm notice of action to terminate a MAP lender, or to place a MAP lender on...
... HOUSING AND URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Multifamily Accelerated Processing (MAP): MAP Lender Quality Assurance Enforcement § 200.1540 Imminent harm notice of action. The Board may issue an imminent harm notice of action to terminate a MAP lender, or to place a MAP lender on...
... HOUSING AND URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Multifamily Accelerated Processing (MAP): MAP Lender Quality Assurance Enforcement § 200.1540 Imminent harm notice of action. The Board may issue an imminent harm notice of action to terminate a MAP lender, or to place a MAP lender on...
Straiton, Melanie L.; Hjelmeland, Heidi; Grimholt, Tine K.; Dieserud, Gudrun
A total of thirty-two women admitted to a general hospital for medical treatment after self-harming completed measures of conventional positive and negative masculinity and femininity. Comparisons were made with two control groups with no self-harm history; 33 women receiving psychiatric outpatient treatment and a nonclinical sample of 206 women.…
Zhang, Shirui; Dong, Daming; Zheng, Wengang; Wang, Jihua
Animal facilities produce large amounts of harmful gases such as ammonia, hydrogen sulfide, and methane, many of which have a pungent odor. The harmful gases produced by animal housing not only affect the health of people and livestock but also pollute the air. The detection of the harmful gases can effectively improve efficiency of livestock production and reduce environmental pollution. More and more optical detection methods are applied to the detection of the harmful gases produced by animal housing. This summarizes optical detection methods for monitoring the harmful gases in animal housing recently, including nondispersive infrared gas analyzer, ultraviolet differential optical absorption spectroscopy, Fourier transform infrared spectroscopy, and tunable diode laser absorption spectroscopy. The basic principle and the characteristics of these methods are illustrated and the applications on the detection of harmful gases in animal housing are described. Meanwhile, the research of harmful gases monitoring for livestock production based on these methods were listed. The current situation and future development of the detection methods for harmful gases generated by animal housing were summarized by comparing the advantages and disadvantages of each method.
... REGULATIONS PUBLICLY AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Procedural Requirements § 1102.28... publish reports of harm that meet the requirements for publication in the Database. The Commission will... Commission may publish a report of harm that meets the requirements of § 1102.10(d) in the Database...
... REGULATIONS PUBLICLY AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Procedural Requirements § 1102.28... publish reports of harm that meet the requirements for publication in the Database. The Commission will... Commission may publish a report of harm that meets the requirements of § 1102.10(d) in the Database...
... REGULATIONS PUBLICLY AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Procedural Requirements § 1102.28... publish reports of harm that meet the requirements for publication in the Database. The Commission will... Commission may publish a report of harm that meets the requirements of § 1102.10(d) in the Database...
Wang, Hua; Zhang, Zhizhang; Liang, Dongfang; du, Hanbei; Pang, Yong; Hu, Kaimin; Wang, Jianjian
Wind is an important physical factor involved in Harmful Cyanobacterial blooms (CyanoHABs). Its integrated influence was separated to three components: (a) Direct Disturbance Impact (DDI) on cyanbacterial proliferation, (b) Indirect Nutrient Impact (INI) by sediment release and (c) Direct Transportation Impact (DTI) by both gentle wind-induced surface drift and wave-generated Stokes drift. By the combination of field investigation, laboratory experiment and numerical simulation their individual contributions to the severe bloom event in May 2007 in Meiliang Bay, Lake Taihu, was explored. Wind synthetically made 10.5 percent promotion to the bloom on May 28, 2007, but the impact varied with locations. DTI was featured with the strongest contribution of wind's impacts on CyanoHABs, while INI stood at the lowest level and DDI played an intermediate role. From the point of whole Meiliang Bay, the influencing weights of DTI, DDI and INI were approximately 48.55%, 32.30% and 19.15% respectively. DTI exerted the higher promotion in the regions of middle-east (ME), southwest (SW) and southeast (SE), and its actual contribution rate on CyanoHABs ranged from 6.41% to 7.46%. Due to the background nutrient load, INI was characterized by a tiny effect with the contribution rate being 2.18% on average. From the south bay to the north, DDI was detected with a decreasing tendency, with the practical contribution rate generally falling from 4.13% to 2.7%.
Sarasa-Renedo, Ana; Sordo, Luis; Molist, Gemma; Hoyos, Juan; Guitart, Anna M; Barrio, Gregorio
Alcohol affects the brain and most organs and systems, and its use is related to a large number of health problems. These include mental, neurological, digestive, cardiovascular, endocrine, metabolic, perinatal, cancerous, and infectious diseases, as well as intentional and non-intentional injuries. Physiopathological mechanisms still remain unraveled, though direct toxicity of ethanol and its metabolites, nutritional deficit and intestinal microbial endotoxin absorption have been suggested, all of which would be further modulated by use patterns and genetic and environmental factors. Individually it is difficult to precisely predict who will or will not suffer health consequences. At population level several disorders show a linear or exponential dose-response relationship, as is the case with various cancer types, hepatopathies, injuries, and probably risky behaviors such as unsafe sex. Other health problems such as general mortality in people above 45 years of age, ischemic disease or diabetes mellitus show a J-shaped relationship with alcohol use. The overall effect of alcohol on the global burden of disease is highly detrimental, despite the possible beneficial effect on cardiovascular disease. Large differences are found by country, age, gender, socioeconomic and other factors. Disease burden is mostly related with alcohol's capacity to produce dependence and with acute intoxication. Often alcohol also produces negative consequences for other people (violence, unattended family or work duties, etc) which are generally not taken into account when evaluating burden of disease. The aim of this study was to describe the main alcohol-related social and health harms, as well as their generating mechanisms, using secondary data sources.
Pawa, Duangta; Areesantichai, Chitlada
Background People who inject drugs (PWID) in Thailand reported unsafe injection practices resulting in injection-related health consequences. Harm reduction self-efficacy plays an important role and could be improved to reduce harm associated with injecting drugs. Evidence-based interventions targeting PWID are needed. This study sought to evaluate the effectiveness of the behavior change intervention within the PWID population. Methods The behavior change intervention, Triple-S, was designed to improve harm reduction self-efficacy among PWID. This quasi-experimental study was a pre- and post-comparison with a control group design. Participants were PWID, aged 18–45 years, and located in Bangkok. Changes in harm reduction self-efficacy of the intervention group were compared with the control group using paired and independent t-test. Results Most of PWID were male (84%), had a secondary school and lower education (71%), were single, and had a mean age of 41 years. They had been injecting drugs for an average of 20 years, and the median of drug injections per week was ten times in the past month. Pre- and post-intervention effects were measured and results showed that the intervention group reported improvement in harm reduction self-efficacy in negative emotional conditions (P=0.048). Conclusion Our findings suggest that Triple-S intervention can significantly improve harm reduction self-efficacy in negative emotional conditions. The results may suggest the importance of behavior change intervention, especially when integrated with services provided by drop-in centers. The intervention can be further developed to cover other harm reduction behaviors and improve harm reduction self-efficacy. PMID:27660503
Grading is one of the most enduring features of schooling. No matter what other reforms occur in a school, grading remains as one of the cornerstones of educational practice. But recently this long-standing tradition has come under scrutiny with some alarming results. Many traditional grading practices actually "depress" achievement, and may, in…
O'Reilly, M; Kiyimba, N; Karim, K
WHAT IS KNOWN ON THE SUBJECT?: An essential part of the mental health assessment is to evaluate the risk of harm to self. Fundamentally this involves asking directly about self-harming behaviour and suicidal thoughts or urges, but practitioners often find it difficult to open up these conversations. This evaluation of risk is particularly important as self-harm and suicidal thoughts are frequently found in young people who attend mental health services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Young people are not always routinely asked directly about self-harm or suicidal thoughts when they are assessed. There are two ways that mental health practitioners introduce this topic: first, by building up to it by initially asking about general feelings, and second by stating that it is a requirement to ask everyone. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: These questions should not be avoided by mental health practitioners just because they are difficult. We offer suggestions as to how to ask questions about self-harm and suicide based on real-world practice.
Hackett, Simon; Carpenter, John; Patsios, Demi; Szilassy, Eszter
This study evaluates the outcomes of short interagency training courses provided by six Local Safeguarding Children Boards in England. The aim was to develop practical skills in recognising and responding to the needs of children with harmful sexual behaviour in an interagency context. The courses all employed interactive learning and teaching…
Shakerimova, Zere S.; Nussupova, Aizada S.; Burambaeva, Maryam N.; Yermanov, Zhanat R.; Emreyeva, Akmaral E.; Janseitova, Sveta S.
This article considers the psychotherapeutic parameters of traditional Kazakh music, best practices that were achieved in practical psychology. From the one hand, it allows us to see the music features in a new light, and from the other hand--to identify the ethnic psychology of the Kazakh nation. An important step in the study of the…
Guo, Chunfeng; Zheng, Haiyong; Ji, Guangrong; Lv, Liang
According to the shortcomings which are time consuming and laborious of the traditional HAB (Harmful Algal Bloom) diagnosis by the experienced experts using microscope, all kinds of methods and technologies to identify HAB emerged such as microscopic images, molecular biology, characteristics of pigments analysis, fluorescence spectra, inherent optical properties, etc. This paper proposes the design and implementation of a web-based diagnosis system integrating the popular methods for HAB identification. This system is designed with J2EE platform based on MVC (Model-View-Controller) model as well as technologies such as JSP, Servlets, EJB and JDBC.
Quigley, Jody; Rasmussen, Susan; McAlaney, John
Although the suicidal and self-harming behaviour of individuals is often associated with similar behaviours in people they know, little is known about the impact of perceived social norms on those behaviours. In a range of other behavioural domains (e.g., alcohol consumption, smoking, eating behaviours) perceived social norms have been found to strongly predict individuals' engagement in those behaviours, although discrepancies often exist between perceived and reported norms. Interventions which align perceived norms more closely with reported norms have been effective in reducing damaging behaviours. The current study aimed to explore whether the Social Norms Approach is applicable to suicidal and self-harming behaviours in adolescents. Participants were 456 pupils from five Scottish high-schools (53% female, mean age = 14.98 years), who completed anonymous, cross-sectional surveys examining reported and perceived norms around suicidal and self-harming behaviour. Friedman's ANOVA with post-hoc Wilcoxen signed-ranks tests indicated that proximal groups were perceived as less likely to engage in or be permissive of suicidal and self-harming behaviours than participants' reported themselves, whilst distal groups tended towards being perceived as more likely to do so. Binary logistic regression analyses identified a number of perceived norms associated with reported norms, with close friends' norms positively associated with all outcome variables. The Social Norms Approach may be applicable to suicidal and self-harming behaviour, but associations between perceived and reported norms and predictors of reported norms differ to those found in other behavioural domains. Theoretical and practical implications of the findings are considered.
Quigley, Jody; Rasmussen, Susan; McAlaney, John
Although the suicidal and self-harming behaviour of individuals is often associated with similar behaviours in people they know, little is known about the impact of perceived social norms on those behaviours. In a range of other behavioural domains (e.g., alcohol consumption, smoking, eating behaviours) perceived social norms have been found to strongly predict individuals’ engagement in those behaviours, although discrepancies often exist between perceived and reported norms. Interventions which align perceived norms more closely with reported norms have been effective in reducing damaging behaviours. The current study aimed to explore whether the Social Norms Approach is applicable to suicidal and self-harming behaviours in adolescents. Participants were 456 pupils from five Scottish high-schools (53% female, mean age = 14.98 years), who completed anonymous, cross-sectional surveys examining reported and perceived norms around suicidal and self-harming behaviour. Friedman’s ANOVA with post-hoc Wilcoxen signed-ranks tests indicated that proximal groups were perceived as less likely to engage in or be permissive of suicidal and self-harming behaviours than participants’ reported themselves, whilst distal groups tended towards being perceived as more likely to do so. Binary logistic regression analyses identified a number of perceived norms associated with reported norms, with close friends’ norms positively associated with all outcome variables. The Social Norms Approach may be applicable to suicidal and self-harming behaviour, but associations between perceived and reported norms and predictors of reported norms differ to those found in other behavioural domains. Theoretical and practical implications of the findings are considered. PMID:28294999
Robinson, Susan N; Neyens, David M; Diller, Thomas
Most hospitals use occurrence reporting systems that facilitate identifying serious events that lead to root cause investigations. Thus, the events catalyze improvement efforts to mitigate patient harm. A serious limitation is that only a few of the occurrences are investigated. A challenge is leveraging the data to generate knowledge. The goal is to present a methodology to supplement these incident assessment efforts. The framework affords an enhanced understanding of patient safety through the use of control charts to monitor non-harm and harm incidents simultaneously. This approach can identify harm and non-harm reporting rates and also can facilitate monitoring occurrence trends. This method also can expedite identifying changes in workflow, processes, or safety culture. Although unable to identify root causes, this approach can identify changes in near real time. This approach also supports evaluating safety or policy interventions that may not be observable in annual safety climate surveys.
Introduction and Aims Increasing the frequency with which injecting drug users (IDUs) engage in self-initiated harm reduction strategies could improve their health, but few investigations have examined IDUs’ perceived barriers to engaging in these behaviors. Method We interviewed 90 IDUs recruited from needle exchanges to assess: a) perceived obstacles to their use of two specific harm reduction strategies (i.e., test shots and pre-injection skin cleaning) designed to reduce two unhealthy outcomes (i.e., overdose and bacterial infections, respectively) and b) their use of other risk-reduction practices. Results The most frequently cited barrier for both test shots and skin cleaning was being in a rush to inject one’s drugs. Other, less commonly cited barriers were strategy-specific (e.g., buying drugs from a known dealer as a reason not to do a test shot; not having access to cleaning supplies as a reason not to clean skin). Regarding other risk reduction practices, participants’ most frequently reported using new or clean injecting supplies and avoiding sharing needles and injecting supplies. Discussion and Conclusions Some, but not all, of the barriers generated by participants in our study were similar to those frequently reported in other investigations, perhaps due to differences in the type of sample recruited or in the harm reduction behaviors investigated. PMID:25419201
Lech, M M; Mngadi, T P
The Traditional Birth Attendants (TBAs) Survey in Swaziland was undertaken between March 27th 1996 and April 8th 1996. The objective of the survey was to generate reliable information regarding activities of TBAs in Swaziland. The survey was conducted in 25 Chiefdoms sampled out of a total of 206 Chiefdoms registered in Swaziland. The total number of sampled respondents in the 25 Chiefdoms was 721. From the survey, it is estimated that there were probably 3000 TBAs in the country, and in the majority of cases such TBAs would be a 51-year old woman who herself had delivered six children and had worked as a TBA for at least 10 years. Between 9,000 and 12,000 deliveries are estimated to take place out of health facilities. Of these many, nearly 43.5% are assisted by "TBAs"; 16.3% of woman interviewed deliver relative/family member and 15.1% are assisted by friends/neighbours, etc. Some of TBAs carry out procedures which are considered to be potentially harmful. Nearly 30% of TBAs have administered herbs; 45% attend to abnormal deliveries (breech and multiple pregnancies); 26.7% re-use their cord cutting tools and in the case of haemorrhage 23.4% do manual procedures within reproductive tract of delivering women.
Oldham, Michael J; DeSoi, Darren J; Rimmer, Lonnie T; Wagner, Karl A; Morton, Michael J
A total of 20 commercial cigarette and 16 commercial smokeless tobacco products were assayed for 96 compounds listed as harmful and potentially harmful constituents (HPHCs) by the US Food and Drug Administration. For each product, a single lot was used for all testing. Both International Organization for Standardization and Health Canada smoking regimens were used for cigarette testing. For those HPHCs detected, measured levels were consistent with levels reported in the literature, however substantial assay variability (measured as average relative standard deviation) was found for most results. Using an abbreviated list of HPHCs, statistically significant differences for most of these HPHCs occurred when results were obtained 4-6months apart (i.e., temporal variability). The assay variability and temporal variability demonstrate the need for standardized analytical methods with defined repeatability and reproducibility for each HPHC using certified reference standards. Temporal variability also means that simple conventional comparisons, such as two-sample t-tests, are inappropriate for comparing products tested at different points in time from the same laboratory or from different laboratories. Until capable laboratories use standardized assays with established repeatability, reproducibility, and certified reference standards, the resulting HPHC data will be unreliable for product comparisons or other decision making in regulatory science.
.Thus, California Department of Health Services prohibits promotion of snus and medicinal nicotine as a harm reduction strategy. However, the US Federal Family Smoking Prevention and Tobacco Control Act, signed by President Obama in 2009, places tobacco products under FDA jurisdiction: FDA must define criteria for lowering carcinogens and toxicants in tobacco products, making more available medicinal nicotine, evaluating PREPs, creating a federal Tobacco Control Agency.Which approaches is Italy going to follow?
Ames, Daniel L.; Fiske, Susan T.
Existing moral psychology research commonly explains certain phenomena in terms of a motivation to blame. However, this motivation is not measured directly, but rather is inferred from other measures, such as participants’ judgments of an agent’s blameworthiness. The present paper introduces new methods for assessing this theoretically important motivation, using tools drawn from animal-model research. We test these methods in the context of recent “harm-magnification” research, which shows that people often overestimate the damage caused by intentional (versus unintentional) harms. A preliminary experiment exemplifies this work and also rules out an alternative explanation for earlier harm-magnification results. Exp. 1 asks whether intended harm motivates blame or merely demonstrates the actor’s intrinsic blameworthiness. Consistent with a motivational interpretation, participants freely chose blaming, condemning, and punishing over other appealing tasks in an intentional-harm condition, compared with an unintentional-harm condition. Exp. 2 also measures motivation but with converging indicators of persistence (effort, rate, and duration) in blaming. In addition to their methodological contribution, these studies also illuminate people’s motivational responses to intentional harms. Perceived intent emerges as catalyzing a motivated social cognitive process related to social prediction and control. PMID:25733850
Ames, Daniel L; Fiske, Susan T
Existing moral psychology research commonly explains certain phenomena in terms of a motivation to blame. However, this motivation is not measured directly, but rather is inferred from other measures, such as participants' judgments of an agent's blameworthiness. The present paper introduces new methods for assessing this theoretically important motivation, using tools drawn from animal-model research. We test these methods in the context of recent "harm-magnification" research, which shows that people often overestimate the damage caused by intentional (versus unintentional) harms. A preliminary experiment exemplifies this work and also rules out an alternative explanation for earlier harm-magnification results. Exp. 1 asks whether intended harm motivates blame or merely demonstrates the actor's intrinsic blameworthiness. Consistent with a motivational interpretation, participants freely chose blaming, condemning, and punishing over other appealing tasks in an intentional-harm condition, compared with an unintentional-harm condition. Exp. 2 also measures motivation but with converging indicators of persistence (effort, rate, and duration) in blaming. In addition to their methodological contribution, these studies also illuminate people's motivational responses to intentional harms. Perceived intent emerges as catalyzing a motivated social cognitive process related to social prediction and control.
Sander, Gen; Scandurra, Alessio; Kamenska, Anhelita; MacNamara, Catherine; Kalpaki, Christina; Bessa, Cristina Fernandez; Laso, Gemma Nicolás; Parisi, Grazia; Varley, Lorraine; Wolny, Marcin; Moudatsou, Maria; Pontes, Nuno Henrique; Mannix-McNamara, Patricia; Libianchi, Sandro; Antypas, Tzanetos
While the last decade has seen a growth of support for harm reduction around the world, the availability and accessibility of quality harm reduction services in prison settings is uneven and continues to be inadequate compared to the progress achieved in the broader community. This article provides a brief overview of harm reduction in prisons in Catalonia (Spain), Greece, Ireland, Italy, Latvia, Poland, and Portugal. While each country provides a wide range of harm reduction services in the broader community, the majority fail to provide these same services or the same quality of these services, in prison settings, in clear violation of international human rights law and minimum standards on the treatment of prisoners. Where harm reduction services have been available and easily accessible in prison settings for some time, better health outcomes have been observed, including significantly reduced rates of HIV and HCV incidence. While the provision of harm reduction in each of these countries' prisons varies considerably, certain key themes and lessons can be distilled, including around features of an enabling environment for harm reduction, resource allocation, collection of disaggregated data, and accessibility of services.
Lee, Woo Kyeong
Recently, self-injury is drawing the attention of researchers and clinicians. The purpose of this study was to investigate the prevalence and psychological characteristics of adolescents who engage in self-harm and to examine the risk factors for engaging in this harmful behavior among Korean mid-adolescents. Participants were 784 adolescents aged 13-15 years. They completed self-report questionnaires that assessed (1) Non-Suicidal Self-Injury: the Self-Harm Questionnaire, Toronto Alexithymia Scale; (2) depression: Children's Depression Inventory; (3) adolescent-parent relationship: Parental Bonding Instrument; (4) peer attachment: Inventory of Parent and Peer Attachment; and (5) academic stress. Overall, 12.4% (n=97) of participants reported engaging in self-destructive behavior at least once in their lives. The primary reason for engaging in self-harm was to regulate negative emotions such as anger and sadness. As expected, the self-harm group showed statistically significant higher levels of academic stress, alexithymia, depression, and poor relationships with their parents and peers. Stepwise multiple regression analysis showed that alexithymia, depression, and peer relations were significant predictors of self-harming behavior. Given that the primary reason for engaging in self-harm is to cope with negative emotions, mental health professionals in school settings should regularly evaluate self-injurious behavior and provide prevention programs for adolescents at risk.
Orsi, Mylène M; Brochu, Serge
The prevalence rates of illicit drug consumption within the prison system are much higher than those in the Canadian population in general. Of the substances used in detention, those of most concern to prison and public health authorities are injection drugs, as the sharing of injection drug equipment may be responsible for the high prevalence of blood-borne diseases in prison facilities. Faced with this situation, the Correctional Service of Canada put in practice a number of harm reduction strategies targeting injection drug users, such as methadone maintenance programs and access to bleach. However, despite their use in the community, needle-exchange programs are not yet allowed in penitentiaries. This article analyzes the limits of harm reduction strategies approved by the prison authorities and discusses the sources of resistance that continue to impede the realization of a pilot project to assess the feasibility of needle-exchange programs in detention in Canada.
Harris, Jennifer L; Graff, Samantha K
The obesity epidemic cannot be reversed without substantial improvements in the food marketing environment that surrounds children. Food marketing targeted to children almost exclusively promotes calorie-dense, nutrient-poor foods and takes advantage of children's vulnerability to persuasive messages. Increasing scientific evidence reveals potentially profound effects of food marketing on children's lifelong eating behaviors and health. Much of this marketing occurs in nationwide media (eg, television, the Internet), but companies also directly target children in their own communities through the use of billboards and through local environments such as stores, restaurants, and schools. Given the harmful effect of this marketing environment on children's health and the industry's reluctance to make necessary changes to its food marketing practices, government at all levels has an obligation to act. This article focuses on policy options for municipalities that are seeking ways to limit harmful food marketing at the community level.
More than 1,000 licensed naturopathic physicians practice in the United States, and iridology is being described as "the most valuable diagnostic tool of the naturopath." Some therapists are using iridology as a basis for recommending dietary supplements and/or herbs. Several US iridologist organizations exist: the National Iridology Research Association is an iridologists' service organization, the International Association of Iridologists is the leading organization for European-style iridology and runs training programs (minimum of 72 hours in class), and the Bastyr Naturopathic College in Seattle, Wash, has an elective course on iridology (J. Colton, e-mail communication, December 2, 1998). In the United States, insurance programs do not normally cover iridology, but in some European countries, they do. In Germany, for instance, 80% of the Heilpraktiker (nonmedically qualified health practitioners) practice iridology. Ophthalmologists may therefore ask what is iridology and how valuable is it?
Background. A culture of stringent drug policy, one-size-fits-all treatment approaches, and drug-related stigma has clouded clinical HIV practice in the United States. The result is a series of missed opportunities in the HIV care environment. An approach which may address the broken relationship between patient and provider is harm reduction—which removes judgment and operates at the patient’s stage of readiness. Harm reduction is not a routine part of care; rather, it exists outside clinic walls, exacerbating the divide between compassionate, stigma-free services and the medical system. Methods. Qualitative, phenomenological, semi-structured, individual interviews with patients and providers were conducted in three publicly-funded clinics in Chicago, located in areas of high HIV prevalence and drug use and serving African-American patients (N = 38). A deductive thematic analysis guided the process, including: the creation of an index code list, transcription and verification of interviews, manual coding, notation of emerging themes and refinement of code definitions, two more rounds of coding within AtlasTi, calculation of Cohen’s Kappa for interrater reliability, queries of major codes and analysis of additional common themes. Results. Thematic analysis of findings indicated that the majority of patients felt receptive to harm reduction interventions (safer injection counseling, safer stimulant use counseling, overdose prevention information, supply provision) from their provider, and expressed anticipated gratitude for harm reduction information and/or supplies within the HIV care visit, although some were reluctant to talk openly about their drug use. Provider results were mixed, with more receptivity reported by advanced practice nurses, and more barriers cited by physicians. Notable barriers included: role-perceptions, limited time, inadequate training, and the patients themselves. Discussion. Patients are willing to receive harm reduction
Background. A culture of stringent drug policy, one-size-fits-all treatment approaches, and drug-related stigma has clouded clinical HIV practice in the United States. The result is a series of missed opportunities in the HIV care environment. An approach which may address the broken relationship between patient and provider is harm reduction-which removes judgment and operates at the patient's stage of readiness. Harm reduction is not a routine part of care; rather, it exists outside clinic walls, exacerbating the divide between compassionate, stigma-free services and the medical system. Methods. Qualitative, phenomenological, semi-structured, individual interviews with patients and providers were conducted in three publicly-funded clinics in Chicago, located in areas of high HIV prevalence and drug use and serving African-American patients (N = 38). A deductive thematic analysis guided the process, including: the creation of an index code list, transcription and verification of interviews, manual coding, notation of emerging themes and refinement of code definitions, two more rounds of coding within AtlasTi, calculation of Cohen's Kappa for interrater reliability, queries of major codes and analysis of additional common themes. Results. Thematic analysis of findings indicated that the majority of patients felt receptive to harm reduction interventions (safer injection counseling, safer stimulant use counseling, overdose prevention information, supply provision) from their provider, and expressed anticipated gratitude for harm reduction information and/or supplies within the HIV care visit, although some were reluctant to talk openly about their drug use. Provider results were mixed, with more receptivity reported by advanced practice nurses, and more barriers cited by physicians. Notable barriers included: role-perceptions, limited time, inadequate training, and the patients themselves. Discussion. Patients are willing to receive harm reduction interventions from
Moore, Michael; McKee, Martin; Daube, Mike
Some supporters of electronic cigarettes have argued that they should be considered a form of harm reduction, analogous to that which has been successful with narcotics. In this viewpoint, we contend that this argument is based on highly selective use of the evidence, coupled with a fundamental misunderstanding of a comprehensive harm minimisation strategy. This includes not only harm reduction but also reduction in demand and supply-two elements that are explicitly rejected by many advocates of electronic cigarettes. We contend that, in the absence of all three elements, there is a danger that electronic cigarettes will delay the achievement of a tobacco-free world.
Moore, Michael; McKee, Martin; Daube, Mike
Some supporters of electronic cigarettes have argued that they should be considered a form of harm reduction, analogous to that which has been successful with narcotics. In this viewpoint, we contend that this argument is based on highly selective use of the evidence, coupled with a fundamental misunderstanding of a comprehensive harm minimisation strategy. This includes not only harm reduction but also reduction in demand and supply-two elements that are explicitly rejected by many advocates of electronic cigarettes. We contend that, in the absence of all three elements, there is a danger that electronic cigarettes will delay the achievement of a tobacco-free world.
This article has implications for the ecological sustainability crisis now looming in China and what this portends for the practice of education. Chemical agriculture, although improving agricultural production, harms ecological systems in rural communities. The author presents research on a group of intellectuals and social activists in 1…
Objective To assess factors associated with drug-related harms related to policing among injection drug users (IDUs) in Tijuana, Mexico. Methods IDUs who were over 18 years old and had injected drugs within the last six months were recruited via respondent-driven sampling and underwent questionnaires and testing for HIV (human immunodeficiency virus), syphilis and TB (tuberculosis). Random effects logistic regression was used to simultaneously model factors associated with five drug-related harms related to policing practices in the prior six months (i.e., police led them to rush injections; affected where they bought drugs; affected locations where they used drugs; feared that police will interfere with their drug use; receptive syringe sharing). Results Of 727 IDUs, 85% were male; median age was 38 years. Within the last 6 months, 231 (32%) of IDUs reported that police had led them to rush injections, affected where they bought or used drugs or were very afraid police would interfere with their drug use, or shared syringes. Factors independently associated with drug-related harms related to policing within the last six months included: recent arrest, homelessness, higher frequencies of drug injection, use of methamphetamine, using the local needle exchange program and perceiving a decrease in the purity of at least one drug. Conclusions IDUs who experienced drug-related harms related to policing were those who were most affected by other micro and macro influences in the physical risk environment. Police education programs are needed to ensure that policing practices do not exacerbate risky behaviors or discourage protective behaviors such as needle exchange program use, which undermines the right to health for people who inject drugs. PMID:21477299
Sunstein, Cass R
In important cases, the Supreme Court has limited the scope of "substantive due process" by reference to tradition, but it has yet to explain why it has done so. Due process traditionalism might be defended in several distinctive ways. The most ambitious defense draws on a set of ideas associated with Edmund Burke and Friedrich Hayek, who suggested that traditions have special credentials by virtue of their acceptance by many minds. But this defense runs into three problems. Those who have participated in a tradition may not have accepted any relevant proposition; they might suffer from a systematic bias; and they might have joined a cascade. An alternative defense sees due process traditionalism as a second-best substitute for two preferable alternatives: a purely procedural approach to the Due Process Clause, and an approach that gives legislatures the benefit of every reasonable doubt. But it is not clear that in these domains, the first-best approaches are especially attractive; and even if they are, the second-best may be an unacceptably crude substitute. The most plausible defense of due process traditionalism operates on rule-consequentialist grounds, with the suggestion that even if traditions are not great, they are often good, and judges do best if they defer to traditions rather than attempting to specify the content of "liberty" on their own. But the rule-consequentialist defense depends on controversial and probably false assumptions about the likely goodness of traditions and the institutional incapacities of judges.
Procter, Nicholas G
This article describes the structure and function of emergency mental health nursing practice for self-harming refugees and asylum seekers on Temporary Protection Visas. Emergency nurses working in accident and emergency departments or as part of crisis intervention teams will see self-harming refugees and asylum seekers at the very point of their distress. This clinical paper is intended to support nurses in their practice should they encounter an adult asylum seeker needing emergency mental health care. Practical strategies are highlighted to help mental health nurses assess, care, and comfort refugees and asylum seekers in this predicament. Mental health nurses should, where possible, work closely with asylum seekers, their support workers, and accredited interpreters and translators to ensure the appropriate use of language when dealing with mental and emotional health issues without further isolating the asylum seeker from appropriate services. To help strengthen continuity and integration of mental health supports for refugees and asylum seekers, well-resourced care must be experienced as coherent and connected. A coherent, interdisciplinary and team-orientated approach will synthesize different viewpoints to shape clinical practice and create workable solutions in local situations.
This paper explores the way learning to cook remains important for the maintenance of "ethnic" food traditions and how sharing food knowledge plays a role in intercultural exchanges. Ethnographic data from an ongoing study in Melbourne is presented to highlight how, in everyday practices, both tradition and innovation are involved in…
... news/fullstory_164228.html 'Eraser Challenge' Latest Harmful Social Media Trend for Kids Burns, abrasions the result as ... March 22, 2017 (HealthDay News) -- It's spreading via social media: A "dare" where kids use erasers to rub ...
Harmful algal blooms (HABs) from algae, cyanobacteria and golden algae may occur naturally. However, human activities appear to be increasing the frequency of some HABs. HABs can have a variety of ecological, economic and human health impacts.
Tokars, Roger; Lekki, John
The Hyperspectral Imager mounted to an aircraft was used to develop a remote sensing capability to detect the pigment Phycocyanin, an indicator of Microcystis, in low concentration as an early indicator of harmful algal bloom prediction.
... SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.322 Harmful... Governmental Industrial Hygienists in “Threshold Limit Values for Substance in Workroom Air” (1972)....
... SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.322 Harmful... Governmental Industrial Hygienists in “Threshold Limit Values for Substance in Workroom Air” (1972)....
Marescotti, Diego; Gonzalez Suarez, Ignacio; Acali, Stefano; Johne, Stephanie; Laurent, Alexandra; Frentzel, Stefan; Hoeng, Julia; Peitsch, Manuel C.
Cigarette smoke (CS) is a major risk factor for cardiovascular and lung diseases. Because CS is a complex aerosol containing more than 7,000 chemicals1 it is challenging to assess the contributions of individual constituents to its overall toxicity. Toxicological profiles of individual constituents as well as mixtures can be however established in vitro, by applying high through-put screening tools, which enable the profiling of Harmful and Potentially Harmful Constituents (HPHCs) of tobacco smoke, as defined by the U.S. Food and Drug Administration (FDA).2 For an initial assessment, an impedance-based instrument was used for a real-time, label-free assessment of the compound's toxicity. The instrument readout relies on cell adhesion, viability and morphology that all together provide an overview of the cell status. A dimensionless parameter, named cell index, is used for quantification. A set of different staining protocols was developed for a fluorescence imaging-based investigation and a HCS platform was used to gain more in-depth information on the kind of cytotoxicity elicited by each HPHC. Of the 15 constituents tested, only five were selected for HCS-based analysis as they registered a computable LD50 (< 20 mM). These included 1-aminonaphtalene, Arsenic (V), Chromium (VI), Crotonaldehyde and Phenol. Based on their effect in the HCS, 1-aminonaphtalene and Phenol could be identified to induce mitochondrial dysfunction, and, together with Chromium (VI) as genotoxic based on the increased histone H2AX phosphorylation. Crotonaldehyde was identified as an oxidative stress inducer and Arsenic as a stress kinase pathway activator. This study demonstrates that a combination of impedance-based and HCS technologies provides a robust tool for in vitro assessment of CS constituents. PMID:27228213
Acts of deliberate self-harm (DSH) by adolescents are thought to be on the increase. Many of those who self-harm are of school age and it is to be expected that schools (and their teachers) will be aware of the problem and will respond appropriately as part of their pastoral-care provision. However, a recent survey of research in pastoral care and…
This paper addresses the likely impact on women of being denied emergency contraception (EC) by pharmacists who conscientiously refuse to provide it. A common view—defended by Elizabeth Fenton and Loren Lomasky, among others—is that these refusals inconvenience rather than harm women so long as the women can easily get EC somewhere else close by. I argue from a feminist perspective that the refusals harm women even when they can easily get EC somewhere else close by. PMID:20706565
Gammie, Charles, F.; McKinney, Jonathan C.; Tóth, Gábor
HARM uses a conservative, shock-capturing scheme for evolving the equations of general relativistic magnetohydrodynamics. The fluxes are calculated using the Harten, Lax, & van Leer scheme. A variant of constrained transport, proposed earlier by Tóth, is used to maintain a divergence-free magnetic field. Only the covariant form of the metric in a coordinate basis is required to specify the geometry. On smooth flows HARM converges at second order.
Khuat, Thu Hong; Nguyen, Van Anh Thi; Jardine, Melissa; Moore, Timothy; Bui, Thu Huong; Crofts, Nick
The findings of our research show that while police play multiple roles in the fight against drug-related crime, they often perceived their tasks - especially preventing and controlling drug use on the one hand, and supporting harm reduction on the other - as contradictory, and this creates tensions in their work and relations with their communities. Although they are leaders and implementers of harm reduction, not all police know about it, and some remain skeptical or perceive it as contradictory to their main task of fighting drugs. Methadone treatment is seen by some as in competition with their main task of coordinating conventional drug treatment in the rehabilitation center.The history of drug use and the evolution of discourses on drug use in Viet Nam have created these conflicting pressures on police, and thus created contradictory expectations and led to different views and attitudes of police regarding various harm reduction measures. This might aid understanding why, despite the comprehensive and progressive policies on HIV/AIDS and harm reduction in Viet Nam, it is not easy for police to actively and effectively support and be involved in harm reduction at the ground level.To promote the wider acceptance of harm reduction the concept of community safety must be expanded to include community health; harm reduction must be integrated into the "new society" movement; and laws and policies need further revision to reduce contradiction between current drug laws and HIV laws.Harm reduction guidelines for police and other actors need to be disseminated and supported, embodying better ways of working between sectors, and all sectors in the partnership require support for building capacity to contribute to the overall goal.
Bascombe, Ta Misha S; Scott, Kimberly N; Ballard, Denise; Smith, Samantha A; Thompson, Winifred; Berg, Carla J
Use prevalence of alternative tobacco products and marijuana has increased dramatically. Unfortunately, clinical guidelines have focused on traditional cigarettes with limited attention regarding these emerging public health issues. Thus, it is critical to understand how healthcare professionals view this issue and are responding to it. This qualitative study explored knowledge, beliefs and clinic-based practices regarding traditional and alternative tobacco products (cigar-like products, smokeless tobacco, hookah, e-cigarettes) and marijuana among rural and urban Georgia primary healthcare providers. The sample comprised 20 healthcare providers in primary care settings located in the Atlanta Metropolitan area and rural southern Georgia who participated in semi-structured interviews. Results indicated a lack of knowledge about these products, with some believing that some products were less harmful than traditional cigarettes or that they may be effective in promoting cessation or harm reduction. Few reported explicitly assessing use of these various products in clinic. In addition, healthcare providers reported a need for empirical evidence to inform their clinical practice. Healthcare providers must systematically assess use of the range of tobacco products and marijuana. Evidence-based recommendations or information sources are needed to inform clinical practice and help providers navigate conversations with patients using or inquiring about these products.
Bell, Brian G; Campbell, Stephen; Carson-Stevens, Andrew; Evans, Huw Prosser; Cooper, Alison; Sheehan, Christina; Rodgers, Sarah; Johnson, Christine; Edwards, Adrian; Armstrong, Sarah; Mehta, Rajnikant; Chuter, Antony; Donnelly, Ailsa; Ashcroft, Darren M; Lymn, Joanne; Smith, Pam; Sheikh, Aziz; Boyd, Matthew; Avery, Anthony J
Introduction Most patient safety research has focused on specialist-care settings where there is an appreciation of the frequency and causes of medical errors, and the resulting burden of adverse events. There have, however, been few large-scale robust studies that have investigated the extent and severity of avoidable harm in primary care. To address this, we will conduct a 12-month retrospective cross-sectional study involving case note review of primary care patients. Methods and analysis We will conduct electronic searches of general practice (GP) clinical computer systems to identify patients with avoidable significant harm. Up to 16 general practices from 3 areas of England (East Midlands, London and the North West) will be recruited based on practice size, to obtain a sample of around 100 000 patients. Our investigations will include an ‘enhanced sample’ of patients with the highest risk of avoidable significant harm. We will estimate the incidence of avoidable significant harm and express this as ‘per 100 000 patients per year’. Univariate and multivariate analysis will be conducted to identify the factors associated with avoidable significant harm. Ethics/Dissemination The decision regarding participation by general practices in the study is entirely voluntary; the consent to participate may be withdrawn at any time. We will not seek individual patient consent for the retrospective case note review, but if patients respond to publicity about the project and say they do not wish their records to be included, we will follow these instructions. We will produce a report for the Department of Health's Policy Research Programme and several high-quality peer-reviewed publications in scientific journals. The study has been granted a favourable opinion by the East Midlands Nottingham 2 Research Ethics Committee (reference 15/EM/0411) and Confidentiality Advisory Group approval for access to medical records without consent under section 251 of the NHS
Fluorescence in situ hybridisation (FISH) is a powerful molecular biological tool to detect and enumerate harmful microorganism in the marine environment. Different FISH methods are available, and especially in combination with automated counting techniques, the potential for a routine monitoring of harmful marine microalgae is attainable. Various oligonucleotide probes are developed for detecting harmful microalgae. However, FISH-based methods are not yet regularly included in monitoring programmes tracking the presence of harmful marine microalgae. A limitation factor of the FISH technique is the currently available number of suited fluorochromes attached to the FISH probes to detect various harmful species in one environmental sample at a time. However, coupled automated techniques, like flow cytometry or solid-phase cytometry, can facilitate the analysis of numerous field samples and help to overcome this drawback. A great benefit of FISH in contrast to other molecular biological detection methods for harmful marine microalgae is the direct visualisation of the hybridised target cells, which are not permitted in cell free formats, like DNA depending analysis methods. Therefore, an additional validation of the FISH-generated results is simultaneously given.
HIV epidemics in Asia have been initially driven through injecting drug use and the use of shared needles and syringes. Molecular epidemiological work has shown that where there is heroin trafficking and use, so too is there HIV. Given the often strict enforcement of national anti-narcotic laws, harm reduction responses to HIV infections driven by injecting drug use have been historically slow. As it became clear that preventing HIV meant embracing harm reduction, many countries in the region have adopted harm reduction as part of their national AIDS strategy and increasingly as part of their national drug strategy. Initial successes have proven that harm reduction, as it pertains to HIV among IDUs, can and does work in Asia. These initial successes have led to more comprehensive scale-up of other essential components of HIV prevention among IDUs, including increased availability of opiate substitution programs. Still, multiple challenges remain as overall coverage of services in the region remains poor. Changes in the availability and patterns of use of drugs, including the exponential increase in the use of amphetamine-type stimulants, is providing ongoing challenges to both the law enforcement and public health sectors. This paper reflects on the history of harm reduction in Asia and the shifting trends forcing policy makers to adapt and expand harm reduction strategies to include an ever widening approach to criminal justice, policing, public health, and human rights.
de Kleine, Rianne A; Hendriks, Lotte; Becker, Eni S; Broekman, Theo G; van Minnen, Agnes
Exposure therapy has proven efficacy in the treatment of posttraumatic stress disorder (PTSD). Emotional processing theory proposes that fear habituation is a central mechanism in symptom reduction, but the empirical evidence supporting this is mixed. Recently it has been proposed that violation of harm expectancies is a crucial mechanism of action in exposure therapy. But to date, changes in harm expectancies have not been examined during exposure therapy in PTSD. The goal of the current study was to examine harm expectancy violation as mechanism of change in exposure therapy for posttraumatic stress disorder (PTSD). Patients (N=50, 44 female) with a primary diagnosis of chronic PTSD received intensive exposure therapy. Harm expectancies, harm experiences and subjective units of distress (SUDs) were assessed at each imaginal exposure session, and PTSD symptoms were assessed pre- and posttreatment with the Clinician Administered PTSD Scale (CAPS). Results showed that harm expectancies were violated within and strongly declined in-between exposure therapy sessions. However, expectancy violation was not related to PTSD symptom change. Fear habituation measures were moderately related to PTSD symptom reductions. In line with theory, exposure therapy promotes expectancy violation in PTSD patients, but this is not related to exposure therapy outcome. More work is warranted to investigate mechanisms of change during exposure therapy in PTSD.
Farthing, Linda; Kohl, Benjamin
Harm reduction approaches to drug control have almost exclusively focussed on consumers in northern countries. This article supports recent analysis that indicates that such policies also hold relevance for producer countries by drawing on recent policy innovations in Bolivia. When Evo Morales, the president of the national coca grower confederation, was elected the country's first indigenous president in 2005, he promised to fundamentally change 25 years of the U.S.-funded "drug war" that had generated repeated human rights violations. The new policy, which implicitly incorporates harm reduction principles combined with respect for human rights, recognizes coca leaf's traditional use and cultural importance and relies on vigorous local organizations to implement a community-based programme called social control. Results to date indicate that Bolivia's social control experience has reduced violence in coca growing communities, ensured small farmers a subsistence income from coca and increased sovereignty, while making a modest contribution to containing expansion of coca cultivation. The programme has registered 50,000 farmers who are allowed to cultivate limited quantities of coca to supply traditional users and helped them gain secure title to their land. This registration is combined with satellite surveillance to guarantee that farmers do not exceed limits established by law. To date, the programme's reach is incomplete and coca is still diverted to the drug trade. Nonetheless, the approach may offer lessons for other drug producer countries, particularly where strong socio-political organizations are found in combination with closeknit communities holding shared cultural values.
While Native myths and legends were educational tools to transmit tribal beliefs and history, traditional American Indian poetry served a ritualistic function in everyday life. Few traditional Native songs, which all poems were, survive; only Mayan and Aztec poems were written, and most of these were burned by a Spanish bishop. In addition, many…
Enslin, Penny; Horsthemke, Kai
In recent years, the "Western tradition" has increasingly come under attack in anti-colonialist and postmodernist discourses. It is not difficult to sympathise with the concerns that underlie advocacy of historically marginalised traditions, and the West undoubtedly has a lot to answer for. Nonetheless, while arguing a qualified yes to…
Recognizing the importance of maintaining open communication with immediate and extended family members, this book provides a compilation of ideas for family traditions and customs that are grounded in compassion and human kindness. The traditions were gathered from families in the United States and Canada who responded to advertisements in…
Katter, Eldon, Ed.
"The articles in this issue were selected because, in one way or another, they all touched on the notion of tradition and innovation." Storytelling and tribal dances are examples of past, traditional methods of passing cultural knowledge from elders to youth. Contemporary youth have replaced tradtional rites of passage with their own…
The Ecological Stewardship Institute at Northern Kentucky University and the U.S. Environmental Protection Agency are collaborating to optimize a harmful algal bloom detection algorithm that estimates the presence and count of cyanobacteria in freshwater systems by image analysis...
Background Gaps exist in knowledge about the production and use of traditional alcohols, particularly in Asia. This study adds new information about the nature, production and sale of traditional distilled spirit alcohol in Vietnam. Method This was an ethnographic study of traditional distilled spirit alcohol production in rural areas of three provinces in Vietnam. Researchers interviewed more than 300 individuals and recorded responses to general open-ended questions about local alcohol production. Interviews were recorded, transcribed, and studied to discern what information about traditional alcohol was important to the speakers. Results Methods of production followed long-held traditions. Participants listed both personal and community benefits (economic, health, and social) from traditional alcohol making. Older people favoured traditional alcohol, while younger people favoured brand-name beer. Typically people consumed 2-4 drinks daily, mainly at meal times. People consumed more alcohol at special events and festivals. Distribution patterns ranged from low-risk distribution to family and neighbours to high-risk distribution by an agent who might combine alcohol from several producers, which increases the opportunity for dilution and adulteration. The most commonly listed health risks associated with locally-made alcohol were local air pollution and water pollution; participants also mentioned traffic crashes and bad public behaviour. Depending on the location, community leaders reported that production may be relatively stable or it may be declining. Conclusions Traditional alcohol manufacture, sale, and use in Vietnam is a long-standing practice and low- to moderate-risk to health. There do not appear to be instances of accidental or intentional contamination. Urbanization seems to be affecting the market share of traditional alcohol as urbanized youth turn to branded products, mainly beer, making traditional alcohol making and consumption an activity mainly
Courser, Matthew W.; Holder, Harold D.; Collins, David; Johnson, Knowlton; Ogilvie, Kristen A.
This paper reports results from a feasibility study of a community effort to reduce the availability of legal products that youth can use to get “high”. The study evaluated the potential of youth purchase attempts to detect actual changes in retail availability of harmful legal products. These results were triangulated with self-reports from retailers themselves about their own policies and practices. Before the intervention less than half of retailers reported using any of six possible strategies identified as ways to reduce youth access to harmful products and less than 7% of baseline youth attempts to purchase potentially harmful legal products were refused or questioned. After the low dosage intervention, retailers reported increased use of three strategies and a statistically significant increase in the percentage of purchase attempts that were either questioned or refused by retail clerks. These findings (1) demonstrate the potential feasibility of retailer focused environmental strategies and (2) support continued use of youth purchase attempts as a measure of actual retailer behavior. PMID:18660467
Hearne, Evelyn; Van Hout, Marie Claire
An array of dissociative novel psychoactive substances, including "methoxetamine," "3-MeO-PCP," and "methoxphenidine," have emerged as substitutes for the illicit substance "ketamine." A netographic research methodology aimed to describe online, dissociative novel psychoactive substance users' perceptions of risk, informed knowledge around use, and indigenous harm-reduction practices as advocated within online drug fora, so as to provide credible information which can be used to inform public online health education and drug prevention. Systematic Internet searches were performed using the terms "synthetic dissociative," "methoxetamine," "methoxphenidine," "diphenidine," "3-MeO-PCP," "4-MeO-PCP," "2-MDP," and "dissociative research chemical" in combination with "forum." Following screening of 3,476 forum threads with removal of duplicates and exclusion criteria, 90 user trip reports and 115 fora threads from seven drug fora websites were analyzed by conducting content analysis. Five themes emerged with 43 categories. The findings illustrated how forum activity within the cyber drug user community disseminated and exchanged "communal folk pharmacology" relating to the use of dissociative novel psychoactive substances. Further research and consistent monitoring of Internet drug fora are advised to explore variations in harm-reduction tactics throughout dissociative NPS populations, and to consider how existing harm-reduction initiatives are influencing these hard-to-reach groups.
Inglez-Dias, Aline; Ribeiro, José Mendes; Bastos, Francisco I; Page, Kimberly
Given the rapid spread of the HIV epidemic and the need to control its transmission among intravenous drug users (IDU), harm reduction strategies have been incorporated in many countries, including Brazil. Considering these aspects and taking into account the emergence of drugs as a core concern on the government's agenda, especially crack cocaine, this article presents some of the contributions acquired from observing and recording the practices of an American model of research and care for IDUs, namely the UFO (You Find Out) Study. Issues such as participants' access and adherence, financing difficulties, sustainability and outcome evaluation were considered. The study involved documental research, systematic observation and interviews with key informants. Some of the UFO features that could contribute to the formulation of harm reduction policies in Brazil are highlighted. The UFO appears to be a successful example of harm reduction initiatives that successfully contact and guarantee the commitment of that risk group, ensuring its access to health services and reducing risks associated with drug use.
Aloysius, N. R.; Martin, J.; Ludsin, S.; Stumpf, R. P.
Cyanobacteria blooms have become a major problem worldwide in aquatic ecosystems that receive excessive runoff of limiting nutrients from terrestrial drainage. Such blooms often are considered harmful because they degrade ecosystem services, threaten public health, and burden local economies. Owing to changing agricultural land-use practices, Lake Erie, the most biologically productive of the North American Great Lakes, has begun to undergo a re-eutrophication in which the frequency and extent of harmful algal blooms (HABs) has increased. Continued climate change has been hypothesized to magnify the HAB problem in Lake Erie in the absence of new agricultural management practices, although this hypothesis has yet to be formally tested empirically. Herein, we tested this hypothesis by predicting how the frequency and extent of potentially harmful cyanobacteria blooms will change in Lake Erie during the 21st century under the Intergovernmental Panel on Climate Change Fifth Assessment climate projections in the region. To do so, we used 80 ensembles of climate projections from 20 Global Climate Models (GCMs) and two greenhouse gas emission scenarios (moderate reduction, RCP4.5; business-as-usual, RCP8.5) to drive a spatiotemporally explicit watershed-hydrology model that was linked to several statistical predictive models of annual cyanobacteria blooms in Lake Erie. Owing to anticipated increases in precipitation during spring and warmer temperatures during summer, our ensemble of predictions revealed that, if current land-management practices continue, the frequency of severe HABs in Lake Erie will increase during the 21st century. These findings identify a real need to consider future climate projections when developing nutrient reduction strategies in the short term, with adaptation also needing to be encouraged under both greenhouse gas emissions scenarios in the absence of effective nutrient mitigation strategies.
Riggs, Anne E; Alibali, Martha W; Kalish, Charles W
A common practice in textbooks is to introduce concepts or strategies in association with specific people. This practice aligns with research suggesting that using "real-world" contexts in textbooks increases students' motivation and engagement. However, other research suggests this practice may interfere with transfer by distracting students or leading them to tie new knowledge too closely to the original learning context. The current study investigates the effects on learning and transfer of connecting mathematics strategies to specific people. A total of 180 college students were presented with an example of a problem-solving strategy that was either linked with a specific person (e.g., "Juan's strategy") or presented without a person. Students who saw the example without a person were more likely to correctly transfer the novel strategy to new problems than students who saw the example presented with a person. These findings are the first evidence that using people to present new strategies is harmful for learning and transfer.
Friedman, S R.; Southwell, M; Bueno, R; Paone, D; Byrne, J; Crofts, N
The harm reduction movement formed during a period in which social movements of the working class and the excluded were weak, neo-liberalism ideologically triumphant, and potential opposition movements were viewed as offering "tinkering" with the system rather than a total social alternative. This climate shaped and limited the perspectives, strategies, and tactics of harm reductionists almost everywhere. In many countries, this period was also marked by a "political economy of scapegoating" that often targeted drug users as the cause of social woes. This scapegoating took the form of "divide and rule" political initiatives by business and political leaderships to prevent social unrest in a long period of worldwide economic trends toward lowered profit rates and toward increasing income inequality. However, times have changed. Mass strikes and other labor struggles, opposition to the World Trade Organisation and other agencies of neo-liberalism, community-based protests against belt-tightening, and other forms of social unrest have been increasing in many countries. This opens up the possibility of new allies for the harm reduction movement, but also poses difficult problems for which we need to develop answers. On-the-ground experience in alliance formation needs to be combined with careful discussion of and research about what approaches work to convince other movements to work for and with harm reduction, and which approaches do not. Class differences within the harm reduction movement are likely to become more salient in terms of (a) creating internal tensions, (b) increasingly, opening up new ways in which working class harm reductionists can organize within their own communities and workplaces, and (c) producing different strategic orientations that will need to be discussed and debated. As a movement, we will need to find ways to accommodate and discuss differing perspectives, needs, and assessments of opportunities and threats without paralyzing harm
Samaras, T T; Storms, L H
Secular growth has been occurring in Europe for about 150 years. In the USA, since 1900, each new generation has increased by an average of 1in (2.54cm) in height and about 10lb (4.54kg) in weight. This trend has generally been viewed as favorable and tallness is admired, with the current ideal height for a man in the Western world being 6ft 2in (188cm). The Japanese have increased in height since the end of the Second World War by about 5in (12.7cm) in height and the Chinese have been growing at the rate of 2.54cm/decade since the 1950s. In spite of admiring greater height, a world population of increasing height and body-weight is a major threat to our environment, health and survival. Based on more than two decades of research, quantitative data are given for increased use of resources, and increased pollution, energy and fiscal costs resulting from a population of larger people. The laws of scaling are described to show why the impact of increasing stature has a non-linear impact on consumption, body-weight, strength, pollution and economic costs. Paleontological findings indicating that larger body size increases the risk of extinction are also discussed. Various studies indicate a loss of 0.47 year of longevity for each cm increment of height. Caloric restricted diets are also reviewed for their applicability to humans. Recommendations are made for dietary practices to moderate growth in our youth and to postpone development of chronic or degenerative diseases.
Discusses the traditional number systems and the origin of the number names used by several African peoples living south of the Sahara. Also included are limitations in African mathematical development, and possible topics for research. (RP)
Gastric cancer has remained a serious burden worldwide, particularly in East Asian countries. However, nationwide prevention and screening programs for gastric cancer have not yet been established in most countries except in South Korea and Japan. Although evidence regarding the effectiveness of endoscopic screening for gastric cancer has been increasingly accumulated, such evidence remains weak because it is based on results from studies other than randomized controlled trials. Specifically, evidence was mostly based on the results of cohort and case-control studies mainly conducted in South Korea and Japan. However, the consistent positive results from these studies suggest promising evidence of mortality reduction from gastric cancer by endoscopic screening. The major harms of endoscopic screening include infection, adverse effects, false-positive results, and overdiagnosis. Despite the possible harms of endoscopic screening, information regarding these harms remains insufficient. To provide appropriate cancer screening, a balance of benefits and harms should always be considered when cancer screening is introduced as a public policy. Quality assurance is very important for the implementation of cancer screening to provide high-quality and safe screening and minimize harms. Endoscopic screening for gastric cancer has shown promising results, and thus deserves further evaluation to reliably establish its effectiveness and optimal use. PMID:27605874
Bosque-Prous, Marina; Brugal, María Teresa
Harm reduction encompasses interventions, programmes and policies that seek to reduce the negative consequences of the consumption of both legal and illegal drugs on the individual and public health. Harm reduction looks to mitigate the harm suffered by drug users through drug use monitoring and prevention, and promotes initiatives that respect and protect the human rights of this population. The harm reduction policies that have proven effective and efficient are: opioid substitution maintenance therapy (methadone); needle and syringe exchange programmes; supervised drug consumption rooms; and overdose prevention through peer-based naloxone distribution. In order to be effective, these policies must have comprehensive coverage and be implemented in areas where the target population is prevalent. Resident-based opposition to the implementation of these policies is known as the NIMBY (Not In My Back Yard) phenomenon, which is characterised by being against the implementation of new measures in a particular place, but does not question their usefulness. Given that any NIMBY phenomenon is a complex social, cultural and political phenomenon, it is important to conduct a thorough analysis of the situation prior to implementing any of these measures. Harm reduction policies must be extended to other substances such as alcohol and tobacco, as well as to other conditions beyond infectious/contagious diseases and overdose.
Merkinaite, Simona; Grund, Jean Paul; Frimpong, Allen
Globally, young people under 25 accounted for an estimated 45% of all new HIV infections in 2007. Across the Eastern Europe and Central Asia region as many as 25% of injecting drug users (IDUs) are younger than 20. The Eurasian Harm Reduction assessment of young peoples' (under 25) drug use, risk behaviours and service availability and accessibility confirms, young people at risk of injecting, or those already experimenting with injecting drugs, find themselves isolated from health and prevention services, which increases the risks for health and social harms, while the approach towards young peoples' use rely heavily on law enforcement. Denying young drug users' access to life-saving drug treatment and other harm reduction services contributes to the risk environment surrounding their use and violates their right to health and well-being as identified in the Convention on the Rights of the Child. Governments, health care providers and harm reduction services should work together to create an environment in which young people can access needed services, including non-judgmental and low-threshold approaches offered by harm reduction programs.
Hall, Wayne D
This paper outlines the major policy challenges in reducing cannabis-related harm in Australia. The first is uncertainty about the health effects of cannabis, especially in young people. The second is uncertainty about the extent and severity of harms attributed to cannabis prohibition by its critics. The paper summarises and briefly states the extent of these putative harms to the degree that the data allow. The third challenge is a consequence of the first two, and the very different weightings that proponents of more liberal or restrictive policies give to harms arising from cannabis use and those arising from prohibition, namely, strong disagreements within the community about how we should respond to cannabis use by young people. In the face of such disagreement the formulation of cannabis policy necessitates a political compromise. The compromise that has emerged is a continued prohibition of cannabis production, sale and use, combined with either civil penalties for use in some states and reduced penalties or diversion in others. It concludes with suggestions about what needs to be learned about the health effects of cannabis use and the costs and benefits of cannabis prohibition if we are to develop policies that are more effective in reducing harms caused by cannabis use.
Homan, Kendra J; Sim, Leslie A; Fargo, Jamison D; Twohig, Michael P
Although borderline personality disorder (BPD) is frequently characterized by nonsuicidal self-injurious behavior (NSSI), suicide attempts (SA), suicidal ideation (SI), and/or suicide threats (ST), it is unclear whether these behaviors are precursors of BPD in adolescence. This study examined self-harm/suicide-related behaviors in the development of BPD from adolescence to adulthood in psychiatrically hospitalized adolescents. Participants were 116 adolescents consecutively admitted for a psychiatric hospitalization for self-harm/suicide-related behaviors. Adolescents completed self-report questionnaires assessing self-harm/suicide-related behaviors, maladaptive familial behavior, and peer victimization upon admission. Admission diagnoses and history of sexual/physical abuse were abstracted from medical/psychiatric records. Five years after index hospitalization, medical/psychiatric records were systematically reviewed and information on diagnoses was collected. Using multivariable logistic regression analyses, ST predicted BPD above and beyond NSSI, SA, and SI 5 years later (odds ratio = 1.31, 95% confidence interval [1.06, 1.62], p > .01). Traditional risk factors of BPD were not predictive of BPD at 5-year follow-up. Suicidal threats are an important risk factor in adolescents who engage in self-harm/suicide-related behaviors that may differentiate those adolescents who go on to develop BPD as adults. Implications for research and treatment are discussed. (PsycINFO Database Record
This article considers the impact of the global mental health discourse on India's traditional healing systems. Folk mental health traditions, based in religious lifeways and etiologies of supernatural affliction, are overwhelmingly sought by Indians in times of mental ill-health. This is despite the fact that the postcolonial Indian state has historically considered the popularity of these indigenous treatments regressive, and claimed Western psychiatry as the only mental health system befitting the country's aspirations as a modern nation-state. In the last decade however, as global mental health concerns for scaling up psychiatric interventions and instituting bioethical practices in mental health services begin to shape India's mental health policy formulations, the state's disapproving stance towards traditional healing has turned to vehement condemnation. In present-day India, traditional treatments are denounced for being antithetical to global mental health tenets and harmful for the population, while biomedical psychiatry is espoused as the only legitimate form of mental health care. Based on ethnographic research in the Hindu healing temple of Balaji, Rajasthan, and analysis of India's mental health policy environment, I demonstrate how the tenor of the global mental health agenda is negatively impacting the functioning of the country's traditional healing sites. I argue that crucial changes in the therapeutic culture of the Balaji temple, including the disappearance of a number of key healing rituals, are consequences of global mental health-inspired policy in India which is reducing the plural mental health landscape.
Martínez, Daniela V
This article is the product of the research work done on "Deliberate self-harm -DSH-: a constraint way to open to the world?" in which this Deliberate Self Harm was explored as from the phenomenological psychopathology and the suicidology theoretical approach, such research being done on the subjective and reflective narrations of people undergoing such problems, coming from different sources. Some discourse patterns are exposed that may be considered of great usefulness for the identification, the treatment -or postvention-, as well as for the prevention of the problem at issue. As an annex, a Survey of Self-harm is presented made for data collection and the planning of actions in communitarian interventions with adolescents form different places in Argentina, in conjunction with the Argentinean Professional Team of the Argentinean Association for Suicide Prevention.
Wang, Qihui; Xie, Lijun; Zhu, Bo; Zheng, Yao; Cao, Shihua
In this paper, a novel cataluminescence (CTL)-based sensor array consisting of nine types of catalytic materials is developed for the recognition of several harmful gases, namely carbon monoxide, acetone, chloroform and toluene. First, the experimental setup is constructed by using sensing nanomaterials, a heating plate, a pneumatic pump, a gas flow meter, a digital temperature device, a camera and a BPCL Ultra Weak Chemiluminescence Analyzer. Then, unique CTL patterns for the four types of harmful gas are obtained from the sensor array. The harmful gases are successful recognized by the PCA method. The optimal conditions are also investigated. Finally, experimental results show high sensitivity, long-term stability and good linearity of the sensor array, which combined with simplicity, make our system a promising application in this field. PMID:24113681
Hawk, Kathryn F; Vaca, Federico E; D'Onofrio, Gail
The opioid overdose epidemic is a major threat to the public's health, resulting in the development and implementation of a variety of strategies to reduce fatal overdose. Many strategies are focused on primary prevention and increased access to effective treatment, although the past decade has seen an exponential increase in harm reduction initiatives. To maximize identification of opportunities for intervention, initiatives focusing on prevention, access to effective treatment, and harm reduction are examined independently, although considerable overlap exists. Particular attention is given to harm reduction approaches, as increased public and political will have facilitated widespread implementation of several initiatives, including increased distribution of naloxone and policy changes designed to increase bystander assistance during a witnessed overdose.
Amir, Eitan; Bedard, Philippe L; Ocaña, Alberto; Seruga, Bostjan
Over the last few decades there has been an increase in the use of strategies to detect clinically occult breast cancer with the aim of achieving diagnosis at an earlier stage when prognosis may be improved. Such strategies include screening mammography in healthy women, diagnostic imaging and axillary staging in those diagnosed with breast cancer, and the use of follow-up imaging for the early detection of recurrent or metastatic disease. Some of these strategies are established, whereas for others there are inconsistent supportive data. Although the potential benefit of early detection of clinically occult breast cancer seems intuitive, use of such strategies can also be associated with harm. In this commentary, we provide an extended discussion on the potential benefits and harms of the routine and frequent use of screening interventions to detect clinically occult breast cancer and question whether we may be causing more harm than good.
Rosen, S; Collins, K J
This article comprises information on self-mutilation (and specifically on the Deliberate Self-harm Syndrome) which obtained from a study of mainly American and British literature. Included is data obtained from interviews conducted with a sample of South Africans suffering from the syndrome. Etiology was explained from both a psychological and biological perspective. The former highlighted deficiencies in coping and communication skills while the latter highlighted the compulsive and pain-killer role that endorphines play. From case studies and literature it was possible to clearly distinguish the Deliberate Self-harm Syndrome as a distinct disorder-a syndrome consisting of deliberate, repetitive and private acts of self-harm in the form of cutting, burning and banging oneself. This culminates in extreme tension release.
DiStefano, Anthony S
In this study, I used ethnographic methods to examine suicidality and nonsuicidal self-harm among gay, lesbian, bisexual, and transgender persons in Japan. Participants (N = 84) indicated that suicidality and self-harm are serious problems among sexual minorities and tend to be driven by (a) a homophobic/transphobic environment and the negative consequences of sexual minorities either disclosing their true selves or remaining hidden and silent within such an environment; (b) various antecedents to poor mental health; and (c) factors not directly related to being a sexual minority, particularly unemployment and debt in the context of a protracted national economic decline in Japan prior to the study period of 2003--2004. Participants also perceived a potentially higher risk for suicidality and self-harm among sexual minority adolescents and persons in their early 20s; those who work in the entertainment, bar, or sex industries; and survivors of violence perpetrated by intimate partners or family members.
Hawk, Kathryn F.; Vaca, Federico E.; D’Onofrio, Gail
The opioid overdose epidemic is a major threat to the public’s health, resulting in the development and implementation of a variety of strategies to reduce fatal overdose [1-3]. Many strategies are focused on primary prevention and increased access to effective treatment, although the past decade has seen an exponential increase in harm reduction initiatives. To maximize identification of opportunities for intervention, initiatives focusing on prevention, access to effective treatment, and harm reduction are examined independently, although considerable overlap exists. Particular attention is given to harm reduction approaches, as increased public and political will have facilitated widespread implementation of several initiatives, including increased distribution of naloxone and policy changes designed to increase bystander assistance during a witnessed overdose [4-7]. PMID:26339206
Walji, Muhammad; Sagaram, Smitha; Sagaram, Deepak; Meric-Bernstam, Funda; Johnson, Craig; Mirza, Nadeem Q
Background Many users search the Internet for answers to health questions. Complementary and alternative medicine (CAM) is a particularly common search topic. Because many CAM therapies do not require a clinician's prescription, false or misleading CAM information may be more dangerous than information about traditional therapies. Many quality criteria have been suggested to filter out potentially harmful online health information. However, assessing the accuracy of CAM information is uniquely challenging since CAM is generally not supported by conventional literature. Objective The purpose of this study is to determine whether domain-independent technical quality criteria can identify potentially harmful online CAM content. Methods We analyzed 150 Web sites retrieved from a search for the three most popular herbs: ginseng, ginkgo and St. John's wort and their purported uses on the ten most commonly used search engines. The presence of technical quality criteria as well as potentially harmful statements (commissions) and vital information that should have been mentioned (omissions) was recorded. Results Thirty-eight sites (25%) contained statements that could lead to direct physical harm if acted upon. One hundred forty five sites (97%) had omitted information. We found no relationship between technical quality criteria and potentially harmful information. Conclusions Current technical quality criteria do not identify potentially harmful CAM information online. Consumers should be warned to use other means of validation or to trust only known sites. Quality criteria that consider the uniqueness of CAM must be developed and validated. PMID:15249270
Wells, Mark L; Trainer, Vera L; Smayda, Theodore J; Karlson, Bengt S O; Trick, Charles G; Kudela, Raphael M; Ishikawa, Akira; Bernard, Stewart; Wulff, Angela; Anderson, Donald M; Cochlan, William P
Climate change pressures will influence marine planktonic systems globally, and it is conceivable that harmful algal blooms may increase in frequency and severity. These pressures will be manifest as alterations in temperature, stratification, light, ocean acidification, precipitation-induced nutrient inputs, and grazing, but absence of fundamental knowledge of the mechanisms driving harmful algal blooms frustrates most hope of forecasting their future prevalence. Summarized here is the consensus of a recent workshop held to address what currently is known and not known about the environmental conditions that favor initiation and maintenance of harmful algal blooms. There is expectation that harmful algal bloom (HAB) geographical domains should expand in some cases, as will seasonal windows of opportunity for harmful algal blooms at higher latitudes. Nonetheless there is only basic information to speculate upon which regions or habitats HAB species may be the most resilient or susceptible. Moreover, current research strategies are not well suited to inform these fundamental linkages. There is a critical absence of tenable hypotheses for how climate pressures mechanistically affect HAB species, and the lack of uniform experimental protocols limits the quantitative cross-investigation comparisons essential to advancement. A HAB "best practices" manual would help foster more uniform research strategies and protocols, and selection of a small target list of model HAB species or isolates for study would greatly promote the accumulation of knowledge. Despite the need to focus on keystone species, more studies need to address strain variability within species, their responses under multifactorial conditions, and the retrospective analyses of long-term plankton and cyst core data; research topics that are departures from the norm. Examples of some fundamental unknowns include how larger and more frequent extreme weather events may break down natural biogeographic barriers
Hu, Chuanmin; Muller-Karger, Frank E.
Workshop on Taxonomy of Harmful Algal Blooms; Veracruz, Mexico, 18-22 February 2008; A workshop on harmful algal bloom (HAB) taxonomy, sponsored by the U.S. Environmental Protection Agency (EPA) and the Department of Health of the state of Veracruz, Mexico, was held at the Aquarium of Veracruz and focused on standardizing methods to detect HABs that affect coastal waters in the Gulf of Mexico. This binational effort was established under the umbrella of the Gulf of Mexico Alliance (GOMA), initially formed in 2004 by the five U.S. Gulf states (Florida, Alabama, Mississippi, Louisiana, and Texas) with participation from U.S. federal agencies and other stakeholders.
Abbasi, Toni; Adornetto-Garcia, Debra; Johnston, Patricia A; Segovia, Julie H; Summers, Barbara
This quality improvement project evaluated the accuracy of harm scores entered into an event reporting system by inpatient nursing staff at a National Cancer Institute-designated comprehensive cancer center. Nurses scored 10 safety scenarios using 2 versions of the Agency for Healthcare Research and Quality scale to determine interrater reliability. Results indicated inconsistency in the way nurses scored the scenarios, suggesting that the event reporting system may not accurately portray the severity of harm in patient safety events. Nurse executives can use this information to guide the development and implementation of incident reporting systems.
Xu, Yan; Wang, Dong; Fan, Wen Lai; Mu, Xiao Qing; Chen, Jian
The earliest industrial biotechnology originated in ancient China and developed into a vibrant industry in traditional Chinese liquor, rice wine, soy sauce, and vinegar. It is now a significant component of the Chinese economy valued annually at about 150 billion RMB. Although the production methods had existed and remained basically unchanged for centuries, modern developments in biotechnology and related fields in the last decades have greatly impacted on these industries and led to numerous technological innovations. In this chapter, the main biochemical processes and related technological innovations in traditional Chinese biotechnology are illustrated with recent advances in functional microbiology, microbial ecology, solid-state fermentation, enzymology, chemistry of impact flavor compounds, and improvements made to relevant traditional industrial facilities. Recent biotechnological advances in making Chinese liquor, rice wine, soy sauce, and vinegar are reviewed.
Xu, Yan; Wang, Dong; Fan, Wen Lai; Mu, Xiao Qing; Chen, Jian
The earliest industrial biotechnology originated in ancient China and developed into a vibrant industry in traditional Chinese liquor, rice wine, soy sauce, and vinegar. It is now a significant component of the Chinese economy valued annually at about 150 billion RMB. Although the production methods had existed and remained basically unchanged for centuries, modern developments in biotechnology and related fields in the last decades have greatly impacted on these industries and led to numerous technological innovations. In this chapter, the main biochemical processes and related technological innovations in traditional Chinese biotechnology are illustrated with recent advances in functional microbiology, microbial ecology, solid-state fermentation, enzymology, chemistry of impact flavor compounds, and improvements made to relevant traditional industrial facilities. Recent biotechnological advances in making Chinese liquor, rice wine, soy sauce, and vinegar are reviewed.
This article complements the Rhinelander and Rubin article (this issue) and provides an account of US and USSR practice subsequent to the ABM Treaty. The Soviet subsequent practice from 1972 to date, like that of the US from 1972 until 1985, has fully supported the validity of the traditional interpretation, and explicitly rejected the reinterpretation, both before and after the reinterpretation was announced. The record is unambiguous. The Reagan administration's continued support of its radical reinterpretation of the ABM Treaty cannot be justified. In seeking to place the matter in perspective, one could do worse than apply the golden rule: what would the US have thought if after many years the USSR had suddenly, unilaterally, reinterpreted the ABM Treaty (or any other) to suit a policy purpose of its own, contrary to US policy and to the original clear understanding of both parties. What would the US have thought if the Soviets had then publicly acknowledged that they had done so without examining either their own ratification record of the record of the subsequent practice of the parties, without consulting any but one of their own negotiators, and before compiling much of their own relevant negotiating records.
This manual, primarily designed to help Peace Corps volunteers develop and strengthen their agricultural skills, deals with traditional field crops. The focus of the manual is on surveying and interpreting local agricultural environment and individual farm units, developing agricultural extension techniques and practices, and providing basic…
Muslim countries, previously considered protected from HIV/AIDS due to religious and cultural norms, are facing a rapidly rising threat. Despite the evidence of an advancing epidemic, the usual response from the policy makers in Muslim countries, for protection against HIV infection, is a major focus on propagating abstention from illicit drug and sexual practices. Sexuality, considered a private matter, is a taboo topic for discussion. Harm reduction, a pragmatic approach for HIV prevention, is underutilized. The social stigma attached to HIV/AIDS, that exists in all societies is much more pronounced in Muslim cultures. This stigma prevents those at risk from coming forward for appropriate counseling, testing, and treatment, as it involves disclosure of risky practices. The purpose of this paper is to define the extent of the HIV/AIDS problem in Muslim countries, outline the major challenges to HIV/AIDS prevention and treatment, and discuss the concept of harm reduction, with a cultural approach, as a strategy to prevent further spread of the disease. Recommendations include integrating HIV prevention and treatment strategies within existing social, cultural and religious frameworks, working with religious leaders as key collaborators, and provision of appropriate healthcare resources and infrastructure for successful HIV prevention and treatment programs in Muslim countries. PMID:16253145
Kozlowski, Lynn T
Some major national and international tobacco control organisations favour mandating a reduction in nicotine content of cigarettes to non-addictive levels as a tobacco control tool. Reducing nicotine content, it is argued, will make tobacco smoking less attractive. The 2009 U.S. Food and Drug Administration's regulation of cigarettes appears to have the power to reduce nicotine to non-addictive levels provided it is not taken to zero. A consideration of the U.S. context, however, raises doubts about (a) whether this will ever be practicable and (b), if practicable, how long it will take to implement. Current versions of the nicotine-reducing strategy propose the systematic, incentivised use of less harmful nicotine/tobacco products as elements of the mandatory cigarette nicotine-reduction strategy. Time will tell if and when mandatory nicotine reduction in tobacco cigarettes will occur and what impact it might have on smoking prevalence. The question posed here is "Why wait?" Resources used in implementing reduction in nicotine content have an opportunity cost. In the meantime, nicotine-maintaining harm reduction strategies can have nearer term effects on tobacco use as an individual and a public health issue.
Portman, Tarrell A. A.; Garrett, Michael T.
Indigenous healing practices among Native Americans have been documented in the United States since colonisation. Cultural encapsulation has deterred the acknowledgement of Native American medicinal practices as a precursor to folk medicine and many herbal remedies, which have greatly influenced modern medicine. Understanding Native American…
While some practicing physicians are bitter and resentful about the changes sweeping health care delivery and financing, others are learning to adapt, and finding new ways to lead. Surprisingly, in learning to retool what they do, physicians are discovering that many of the new roles and jobs now emerging are based on valued practices of the past.
Shepard, Benjamin C
considers models of harm reduction practice that emphasize health, pleasure and sustainability for practitioners.
considers models of harm reduction practice that emphasize health, pleasure and sustainability for practitioners. PMID:23548032
van den Berg, David P. G.; van der Vleugel, Berber M.; de Bont, Paul A.J.M.; Thijssen, Gwen; de Roos, Carlijn; de Kleine, Rianne; Kraan, Tamar; Ising, Helga; de Jongh, Ad; van Minnen, Agnes; van der Gaag, Mark
Background Despite robust empirical support for the efficacy of trauma-focused treatments, the dissemination proves difficult, especially in relation to patients with comorbid psychosis. Many therapists endorse negative beliefs about the credibility, burden, and harm of such treatment. Objective This feasibility study explores the impact of specialized training on therapists’ beliefs about trauma-focused treatment within a randomized controlled trial. Method Therapist-rated (n=16) credibility, expected burden, and harm expectancies of trauma-focused treatment were assessed at baseline, post-theoretical training, post-technical training, post-supervised practical training, and at 2-year follow-up. Credibility and burden beliefs of therapists concerning the treatment of every specific patient in the trial were also assessed. Results Over time, therapist-rated credibility of trauma-focused treatment showed a significant increase, whereas therapists’ expected burden and harm expectancies decreased significantly. In treating posttraumatic stress disorder (PTSD) in patients with psychotic disorders (n=79), pre-treatment symptom severity was not associated with therapist-rated credibility or expected burden of that specific treatment. Treatment outcome had no influence on patient-specific credibility or burden expectancies of therapists. Conclusions These findings support the notion that specialized training, including practical training with supervision, has long-term positive effects on therapists’ credibility, burden, and harm beliefs concerning trauma-focused treatment. Highlights of the article Specialized training improved therapists’ credibility, burden, and harm beliefs. Patients’ symptom severity and treatment outcome did not affect these beliefs. Replication of our findings in larger cohorts with a control group is warranted. PMID:27606710
Simm, Rebecca; Roen, Katrina; Daiches, Anna
There is evidence suggesting that self harm among young people is beginning earlier, in childhood and adolescent years. This paper reports on a qualitative study of primary school staff responses to self harm among children. Some studies with adolescents show self harm presents challenges to education professionals who may lack training or…
Chen, Bing-Chun; Zheng, Li-Li; Wang, Hai-Yan; Dong, Wei; Fu, Xian-Jun; Wang, Yu
Traditional mineral Chinese medicine is a characteristic part of Chinese medicine, in the development of traditional Chinese medicine has its unique role. With the development of science and technology and the increase of the medical level, traditional mineral medicine research is gradually thorough and wide-ranging. In recent years, traditional mineral Chinese medicine research mainly includes the physical properties of mineral medicine, structure, chemical composition, pharmacology and treatment mechanism research. The above several aspects of research in the mineral medicine has important practical and theoretical significance. The above several aspects of research status and the problems existing in the research were briefly summarized and reviewed in this paper, and its development were discussed, to provide reference for further studies in the future.
The provocative hypothesis that income inequality harms population health has sparked a large body of research, some of which has reported strong associations between income inequality and population health. Cross-national evidence is frequently cited in support of this important hypothesis, but the hypothesis remains controversial, and the…
Van Cleaf, David W.; Martin, Rita J.
Examines whether elementary school children relate to the "harmful hidden message" about nuclear war in Dr. Seuss's THE BUTTER BATTLE BOOK. After ascertaining the children's cognitive level, they participated in activities to find hidden meanings in stories, including Seuss's book. Students failed to identify the nuclear war message in…
Almond, Louise; Canter, David; Salfati, C. Gabrielle
This study investigates the variations in characteristics that exist among youths who sexually harm (YSH). Three conceptually distinct sets of background characteristics are hypothesized from the literature relating to whether the YSH was abused, delinquent or impaired. Forty-one characteristics were drawn from an extensive and detailed review of…
De Civita, Mirella
Much resilience research highlights protective factors that prevent risk. Here the author focuses on resilience as the ability to recover from psychological harm. The strength-based view sees resilience as a transformational experience. One applicant of this approach is the Phoenix Intervention Program for Children (PIPC) which combines concepts…
Mobley, Alan; Henry, Stuart; Plemmons, Dena
Improving the conditions under which incarcerated populations give "informed consent" is a desirable goal given prisoners' lack of autonomy; part of the Institutional Review Board's (IRB) procedures is the inclusion of representative voices from the prisoner population as a mechanism to reduce harms. The most recent review of the ethics of…
Gartner, Coral E
Legalization of cannabis is likely to lead to greater use. Balanced regulation of potentially less harmful modes of administration, such as vaporizers, is needed. Further research is warranted not only on the direct health effects of vaping cannabis, but also on its potential to decrease co-administration of tobacco with cannabis.
Meisel, Joshua S.
In this article I explore the ethical terrain of experiential learning activities drawing on my experiences leading college students on field trips into criminal justice settings. Though there are numerous educational benefits to adopting experiential learning activities, the rewards must be evaluated in light of the potential harms to nonstudent…
In tobacco control the focus has, for some time, been on abstinence from all types of tobacco use as the only solution to the problem of smoking, and harm reduction approaches are controversial. The most recent English tobacco strategy has incorporated harm reduction approaches in the form of new 'routes' to quitting smoking that encourage those who cannot quit to use safer sources of nicotine. This move away from a focus on abstinence can be seen as the result of gradual shifts over the past 50 years in the way that that the problem of smoking is understood and the solutions that are offered. These shifts have involved increasingly seeing tobacco use as a medical problem. This article uses conceptual tools from science and technology studies to examine developments over the last decade in England, primarily the increasing importance of harm reduction approaches. Drawing on 20 semi-structured qualitative interviews with key stakeholders and documentary analysis, I suggest that the shape harm reduction has taken in English tobacco control policy has been another shift towards the medicalisation of tobacco use, but that this process has occurred in ways that provide a contrast to commonly outlined 'drivers' of medicalisation.
Duncan, David F.; And Others
Harm reduction, a new model in the field of drug education, recognizes that people have always and always will use drugs. The new strategy attempts to minimize the potential hazards associated with drug use rather than the use itself. The rationale is presented as well as an example of needs assessment. (Author/JPS)
Lewis, Stephen P.; Santor, Darcy A.
Understanding the reasons for self-harm (SH) may be paramount for the identification and treatment of SH behavior. Presently, the psychometric properties for SH reason questionnaires are generally unknown or tested only in non-inpatient samples. Existing inpatient measures may have limited generalizability and do not examine SH apart from an…
Buccheri, Robin; Trygstad, Louise; Dowling, Glenna
The study objective was to evaluate changes in prevalence of command hallucinations to harm self or others, characteristics and intensity of auditory hallucinations, and levels of anxiety and depression after attendance at a 10-session course teaching behavioral strategies for managing persistent auditory hallucinations to adult outpatients with schizophrenia. Prevalence of command hallucinations to harm self or others was measured at baseline, end of course, and 1-year post-course. Pre-course scores on the Characteristics of Auditory Hallucinations Questionnaire, Unpleasant Voices Scale, tension-anxiety subscale of Profile of Mood States, and Beck Depression Inventory-II were compared with scores immediately post-course and 1 year later. The prevalence rate of command hallucinations to harm self of 44% at baseline decreased to 24% immediately after attending the 10-session course and remained at 24% 1-year post-course. The prevalence rate for command hallucinations to harm others of 21% at baseline decreased to 16% at end of course and 17% 1-year post-course. People who attended the course perceived it as helpful, and improvement was seen in all seven characteristics of auditory hallucinations, intensity of auditory hallucinations, and anxiety and depression immediately after the course and 1-year post-course.
Harmful and nuisance algal blooms have been increasing in size and extent since about 2000. In recent years, the release of the algal toxin microcystin has become a growing concern and has resulted in the inability to use water from Lake Erie as a drinking water source to the 400,000 residents of T...
Cluzel, Franck; Lopes, Rosa; Guévara, Francisco; Delport, Dominique
A participative pedagogical tool, simulation aids the transfer of competencies in relation to the complex situation of announcing health care-associated harm. The aim is to reinforce patient safety and to improve the quality of communication with patients and between health professionals.
Ainsworth, Frank; Hansen, Patricia
Every Australian citizen expects state and territory governments to protect children from child abuse and neglect. Protecting children from harm is seen as good. This however is not a simple matter. The ultimate act in protecting children is to remove them from parental care. This causes trauma for the child and pain and distress for parents no…
Rodrigues, António M M; Gardner, Andy
Social groups are often composed of individuals who differ in many respects. Theoretical studies on the evolution of helping and harming behaviors have largely focused upon genetic differences between individuals. However, nongenetic variation between group members is widespread in natural populations, and may mediate differences in individuals' social behavior. Here, we develop a framework to study how variation in individual quality mediates the evolution of unconditional and conditional social traits. We investigate the scope for the evolution of social traits that are conditional on the quality of the actor and/or recipients. We find that asymmetries in individual quality can lead to the evolution of plastic traits with different individuals expressing helping and harming traits within the same group. In this context, population viscosity can mediate the evolution of social traits, and local competition can promote both helping and harming behaviors. Furthermore, asymmetries in individual quality can lead to the evolution of competition-like traits between clonal individuals. Overall, we highlight the importance of asymmetries in individual quality, including differences in reproductive value and the ability to engage in successful social interactions, in mediating the evolution of helping and harming behaviors.
McGrath, Mary Jo
Every hour of every day, students experience bullying and harassment at school by their peers. The immediate and long-term impact on the victims' learning capabilities, emotional health, and self-esteem is staggering. " School Bullying: Tools for Avoiding Harm and Liability" tackles this critical problem with an easy-to-use framework that guides…