Public Attitudes towards Prevention of Obesity

PubMed Central

Sikorski, Claudia; Luppa, Melanie; Schomerus, Georg; Werner, Perla; König, Hans-Helmut; Riedel-Heller, Steffi G.

2012-01-01

Objective To investigate obesity prevention support in the German general public and to assess determinants of general prevention support as well as support of specific prevention measures. Methods This study was a cross-sectional analysis of a telephone based representative German study (3,003 subjects (52.8% women, mean age 51.9, s.d. = 18.0, range 18–97 years). Likert scale-based questions on general prevention support and support of specific measures were used. Furthermore willingness to take part in preventive programs and willingness to pay were assessed. Stigmatizing attitudes were assessed with the Fat Phobia Scale (FPS). Causation of obesity was differentiated in three dimensions (internal, e.g. lack of exercise; external, e.g. social surroundings; and genetic factors). Results Obesity prevention was perceived as possible (98.2%), however, almost exclusively lifestyle changes were named. Participants with higher stigmatizing attitudes were less likely to believe obesity prevention is possible. The majority of participants would take part in preventive programs (59.6%) and pay at least partially themselves (86.9%). Factor analysis revealed three dimensions of preventive measures: promoting healthy eating, restrictive and financial, governmental prevention efforts. In regard to these, promoting healthy eating was the most supported measure. Higher age, female gender and external causation were associated with higher support for all three dimensions of preventive measures. Only for governmental regulation, higher age was associated with lower support. Conclusion Obesity prevention support in Germany is high. Structural prevention efforts are supported by the majority of the general public in Germany. The vast majority proclaims willingness to pay themselves for programs of weight gain prevention. This could be an indication of higher perceived self-responsibility in the German system but also for risen “fear of fat” in the population due to media coverage. For Germany, the government and communities ought to be encouraged by these results to start the implementation of structural obesity prevention. PMID:22723996

13 CFR 102.33 - Security of systems of records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Security of systems of records....33 Security of systems of records. (a) Each Program/Support Office Head or designee shall establish administrative and physical controls to prevent unauthorized access to its systems of records, to prevent...

INTEGRATION OF POLLUTION PREVENTION TOOLS

EPA Science Inventory

A prototype computer-based decision support system was designed to provide small businesses with an integrated pollution prevention methodology. Preliminary research involved compilation of an inventory of existing pollution prevention tools (i.e., methodologies, software, etc.),...

Status of nosocomial tuberculosis transmission prevention in hospitals in Thailand.

PubMed

Unahalekhaka, Akeau; Lueang-a-papong, Suchada; Chitreecheur, Jittaporn

2014-03-01

A national survey was conducted during July to September 2009 to determine tuberculosis (TB) prevention activities, problems, and support needed of Thai hospitals. Ninety-seven percent of hospitals established TB isolation policy, 96.3% provided guidelines for caring of TB patients, 95% and 91.8% provided prevention of TB transmission and environmental management guideline, and 92.6% established screening system for TB in the outpatient department (OPD). A half of hospitals had problems with isolation rooms and difficulties in screening TB cases in the OPD. Support needed included consultation on structure and ventilation systems, personnel training, national TB prevention, and TB screening guideline. Strengthening TB prevention activities, providing expert consultation, and national guidelines may help hospitals improve their TB prevention activities. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

A Mobile Computerized Decision Support System to Prevent Hypoglycemia in Hospitalized Patients With Type 2 Diabetes Mellitus

PubMed Central

Spat, Stephan; Donsa, Klaus; Beck, Peter; Höll, Bernhard; Mader, Julia K.; Schaupp, Lukas; Augustin, Thomas; Chiarugi, Franco; Lichtenegger, Katharina M.; Plank, Johannes; Pieber, Thomas R.

2016-01-01

Background: Diabetes management requires complex and interdisciplinary cooperation of health care professionals (HCPs). To support this complex process, IT-support is recommended by clinical guidelines. The aim of this article is to report on results from a clinical feasibility study testing the prototype of a mobile, tablet-based client-server system for computerized decision and workflow support (GlucoTab®) and to discuss its impact on hypoglycemia prevention. Methods: The system was tested in a monocentric, open, noncontrolled intervention study in 30 patients with type 2 diabetes mellitus (T2DM). The system supports HCPs in performing a basal-bolus insulin therapy. Diabetes therapy, adverse events, software errors and user feedback were documented. Safety, efficacy and user acceptance of the system were investigated. Results: Only 1.3% of blood glucose (BG) measurements were <70 mg/dl and only 2.6% were >300 mg/dl. The availability of the system (97.3%) and the rate of treatment activities documented with the system (>93.5%) were high. Only few suggestions from the system were overruled by the users (>95.7% adherence). Evaluation of the 3 anonymous questionnaires showed that confidence in the system increased over time. The majority of users believed that treatment errors could be prevented by using this system. Conclusions: Data from our feasibility study show a significant reduction of hypoglycemia by implementing a computerized system for workflow and decision support for diabetes management, compared to a paper-based process. The system was well accepted by HCPs, which is shown in the user acceptance analysis and that users adhered to the insulin dose suggestions made by the system. PMID:27810995

The DELTA PREP Initiative: Accelerating Coalition Capacity for Intimate Partner Violence Prevention

PubMed Central

Zakocs, Ronda; Freire, Kimberley E.

2018-01-01

Background The DELTA PREP Project aimed to build the prevention capacity of 19 state domestic violence coalitions by offering eight supports designed to promote prevention integration over a 3-year period: modest grant awards, training events, technical assistance, action planning, coaching hubs, the Coalition Prevention Capacity Assessment, an online workstation, and the online documentation support system. Objectives Using quantitative and qualitative data, we sought to explain how coalitions integrated prevention within their structures and functions and document how DELTA PREP supports contributed to coalitions’ integration process. Results We found that coalitions followed a common pathway to integrate prevention. First, coalitions exhibited precursors of organizational readiness, especially having prevention champions. Second, coalitions engaged in five critical actions: engaging in dialogue, learning about prevention, forming teams, soliciting input from the coalition, and action planning. Last, by engaging in these critical actions, coalitions enhanced two key organizational readiness factors—developing a common understanding of prevention and an organizational commitment to prevention. We also found that DELTA PREP supports contributed to coalitions’ abilities to integrate prevention by supporting learning about prevention, fostering a prevention team, and engaging in action planning by leveraging existing opportunities. Two DELTA PREP supports—coaching hubs and the workstation—did not work as initially intended. From the DELTA PREP experience, we offer several lessons to consider when designing future prevention capacity-building initiatives. PMID:26245934

The diffusion of youth-led participatory research in urban schools: the role of the prevention support system in implementation and sustainability.

PubMed

Ozer, Emily J; Cantor, Jeremy P; Cruz, Gary W; Fox, Brian; Hubbard, Elizabeth; Moret, Lauren

2008-06-01

This article discusses the dissemination of a process of youth-led participatory research in urban secondary schools within the Interactive Systems Framework for Dissemination and Implementation (ISF) developed in collaboration with the CDC and its university partners (Wandersman et al. American Journal of Community Psychology, 41(3-4) 2008). The focus here is on the development of the Prevention Support System with respect to general and innovation-specific capacity building. The specific process under study involves youth-led needs assessment and research to inform the planning of prevention programs and policies to address students' health and developmental needs. The article first briefly describes the youth-led research process, its potential benefits, and a case example in two urban secondary schools. It then describes challenges and responses in providing support for the diffusion of this model in 6 secondary schools. The settings are urban public schools with a majority of students of color from diverse ethnic groups: Asian-American, Latino, and African-American. This project constitutes a collaborative partnership with a university school of public health and community-based organizations (CBOs) to build capacity for long-term, sustainable implementation of this innovative process within the local school system. The perspectives of the university-based researcher and the CBO partners on the development and effectiveness of the Prevention Support System are presented.

Strengthening Indian Country through Tribal Youth Programs

ERIC Educational Resources Information Center

Pearson, Sarah S.

2009-01-01

Grants awarded by the Office of Juvenile Justice and Delinquency Prevention (OJJDP) Tribal Youth Program (TYP) support and enhance tribal efforts to prevent and control delinquency and improve the juvenile justice system for American Indian/Alaska Native (AI/AN) youth ages 17 and under. TYPs operate in tribal communities, supporting tribal efforts…

Promising Directions in School-Based Systems Level Consultation: A Commentary on "Has Consultation Achieved Its Primary Prevention Potential?," an Article by Joseph E. Zins

ERIC Educational Resources Information Center

Hojnoski, Robin L.

2007-01-01

From his review of research on consultation, Zins (1995) concluded (a) that a paradigm shift to a more prevention-oriented approach was necessary; (b) that systems-level consultation held significant potential; and (c) that systems-level consultation had the most data to support its use in preventive efforts. This commentary reviews promising…

IMPROVEMENT SUPPORT RESEARCH OF LOCAL DISASTER PREVENTION POWER USING THE FIRE SPREADING SIMULATION SYSTEM IN CASE OF A BIG EARTHQUAKE

NASA Astrophysics Data System (ADS)

Futagami, Toru; Omoto, Shohei; Hamamoto, Kenichirou

This research describes the risk communication towards improvement in the local disaster prevention power for Gobusho town in Marugame city which is only a high density city area in Kagawa Pref. Specifically, the key persons and authors of the area report the practice research towards improvement in the local disaster prevention power by the PDCA cycle of the area, such as formation of local voluntary disaster management organizations and implementation of an emergency drill, applying the fire spreading simulation system in case of a big earthquake. The fire spreading simulation system in case of the big earthquake which authors are developing describes the role and subject which have been achieved to BCP of the local community as a support system.

[Information technology use in preventing infection].

PubMed

Ohmagari, Norio

2011-11-01

Infection prevention requires handling enormous amounts of medical information collection, analysis, and delivery--a cumbersome, inefficient process. Hospital information system (HIS) data not intended for preventing infection cannot be used directly for such prevention. The rapid introduction of information technology in infection prevention can potentially solve these problems. The IT-based infection prevention system (ITIPS) structure depends on the purpose specified, however, and using this information in hospitals requires that the detailed HIS structure be clarified, especially the connection between HIS and ITIPS. The future ITIPS role is envisioned in early infection detection and warning. This, in turn, requires that ITIPS field operational support systems for medical staff mature further.

Approach to Health Supporting System Using Traditional Chinese Medicine

NASA Astrophysics Data System (ADS)

Watsuji, Tadashi; Shinohara, Shoji; Arita, Seizaburo

The primary prevention of disease related to the lifestyle is an essential theme in medical research. Preventing before it arises is the important concept in traditional Chinese medicine (TCM). Since TCM, which emphasizes individual physical condition in medical treatment, has recently attracted considerable attention globally, objective diagnostic methods in TCM have been investigated in this work. Firstly, the fuzzy theory was applied to develop a tongue diagnosis supporting system based on the tongue diagnosis in TCM. Secondly, the usefulness of TCM health questionnaire was examined to identify individual physical condition. Our results suggest that the TCM health questionnaire is useful in the construction of a health supporting system based on TCM.

Association between organizational capacity and involvement in chronic disease prevention programming among Canadian public health organizations

PubMed Central

Hanusaik, Nancy; Sabiston, Catherine M.; Kishchuk, Natalie; Maximova, Katerina; O’Loughlin, Jennifer

2015-01-01

In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement in core chronic disease prevention practices) and (ii) examined differences in the nature of these relationships among organizations operating in more and less facilitating external environments. OC was conceptualized as skills and resources/supports for chronic disease prevention programming. Data were from a census of 210 Canadian public health organizations with mandates for chronic disease prevention. The hypothesized relationships were tested using structural equation modeling. Overall, the results supported the model. Organizational supports for evaluation accounted for 33% of the variance in skills. Skills and resources/supports were directly and strongly related to involvement. Organizations operating within facilitating external contexts for chronic disease prevention had more effective partnerships, more resources/supports, stronger skills and greater involvement in core chronic disease prevention practices. Results also suggested that organizations functioning in less facilitating environments may not benefit as expected from partnerships. Empirical testing of this conceptual model helps develop a better understanding of public health OC. PMID:25361958

Use of a computerized decision support system for primary and secondary prevention of work-related MSD disability.

PubMed

Womack, Sarah K; Armstrong, Thomas J

2005-09-01

The present study evaluates the effectiveness of a decision support system used to evaluate and control physical job stresses and prevent re-injury of workers who have experienced or are concerned about work-related musculoskeletal disorders. The software program is a database that stores detailed job information such as standardized work data, videos, and upper-extremity physical stress ratings for over 400 jobs in the plant. Additionally, the database users were able to record comments about the jobs and related control issues. The researchers investigated the utility and effectiveness of the software by analyzing its use over a 20-month period. Of the 197 comments entered by the users, 25% pertained to primary prevention, 75% pertained to secondary prevention, and 94 comments (47.7%) described ergonomic interventions. Use of the software tool improved primary and secondary prevention by improving the quality and efficiency of the ergonomic job analysis process.

Improving Childhood Obesity Treatment Using New Technologies: The ETIOBE System

PubMed Central

Baños, Rosa. M; Cebolla, Ausias; Botella, Cristina; García-Palacios, Azucena; Oliver, Elia; Zaragoza, Irene; Alcaniz, Mariano

2011-01-01

Childhood obesity is an increasing public health problem in western culture. Sedentary lifestyles and an “obesogenic environment” are the main influences on children leading to an increase in obesity. The objective of this paper is to describe an e-health platform for the treatment and prevention of childhood obesity called ETIOBE. This e-health platform is an e-therapy system for the treatment of obesity, aimed at improving treatment adherence and promoting the mechanisms of self-control in patients, to obtain weight loss maintenance and to prevent relapse by establishing healthy lifestyle habits. ETIOBE is composed of three different applications, the Clinician Support System (CSS), the Home Support System (HSS) and the Mobile Support System (MSS). The use of new Information and Communication (ICT) technologies can help clinicians to improve the effectiveness of weight loss treatments, especially in the case of children, and to achieve designated treatment goals. PMID:21559232

Development of a Systems Science Curriculum to Engage Rural African American Teens in Understanding and Addressing Childhood Obesity Prevention.

PubMed

Frerichs, Leah; Hassmiller Lich, Kristen; Young, Tiffany L; Dave, Gaurav; Stith, Doris; Corbie-Smith, Giselle

2018-06-01

Engaging youth from racial and ethnic minority communities as leaders for change is a potential strategy to mobilize support for addressing childhood obesity, but there are limited curricula designed to help youth understand the complex influences on obesity. Our aim was to develop and pilot test a systems science curriculum to elicit rural African American youth perspectives on childhood obesity and enhance their understanding of and support for obesity prevention solutions. The curriculum was designed so it could be integrated with existing positive youth development curricula that help youth advocate for and implement identified solutions. We conducted four workshop sessions with youth that engaged them in systems learning activities such as guided systems diagramming activities. The participants ( n = 21) completed validated surveys presession and postsession that assessed their causal attributions of obesity and support for obesity prevention policies. The youths' perception that environmental factors cause obesity increased ( p < .05), and perceptions that individual behavior and biology cause obesity did not change. Their support for policies that addressed food access and food pricing significantly increased ( p < .05). The youths' system diagrams elucidated links between multilevel factors such as personal attitudes, social influence, and the built environment, which provides important information for designing synergistic solutions. The changes we observed in youths' perceptions of obesity and support for policy changes have important implications for youths' interest and willingness to advocate for social and environmental changes in their community. The strategies have a promising role in supporting community mobilization to address childhood obesity.

The interactive systems framework applied to the strategic prevention framework: the Rhode Island experience.

PubMed

Florin, Paul; Friend, Karen B; Buka, Stephen; Egan, Crystelle; Barovier, Linda; Amodei, Brenda

2012-12-01

The Interactive Systems Framework for Dissemination and Implementation (ISF) was introduced as a heuristic systems level model to help bridge the gap between research and practice (Wandersman et al., in Am J Commun Psychol 41:171-181, 2008). This model describes three interacting systems with distinct functions that (1) distill knowledge to develop innovations; (2) provide supportive training and technical assistance for dissemination to; (3) a prevention delivery system responsible for implementation in the field. The Strategic Prevention Framework (SPF) is a major prevention innovation launched by the Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA). The SPF offers a structured, sequential, data-driven approach that explicitly targets environmental conditions in the community and aims for change in substance use and problems at the population level. This paper describes how the ISF was applied to the challenges of implementing the SPF in 14 Rhode Island communities, with a focus on the development of a new Training and Technical Assistance Resources Center to support SPF efforts. More specifically, we (1) describe each of the three ISF interacting systems as they evolved in Rhode Island; (2) articulate the lines of communication between the three systems; and (3) examine selected evaluation data to understand relationships between training and technical assistance and SPF implementation and outcomes.

Association between organizational capacity and involvement in chronic disease prevention programming among Canadian public health organizations.

PubMed

Hanusaik, Nancy; Sabiston, Catherine M; Kishchuk, Natalie; Maximova, Katerina; O'Loughlin, Jennifer

2015-04-01

In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement in core chronic disease prevention practices) and (ii) examined differences in the nature of these relationships among organizations operating in more and less facilitating external environments. OC was conceptualized as skills and resources/supports for chronic disease prevention programming. Data were from a census of 210 Canadian public health organizations with mandates for chronic disease prevention. The hypothesized relationships were tested using structural equation modeling. Overall, the results supported the model. Organizational supports for evaluation accounted for 33% of the variance in skills. Skills and resources/supports were directly and strongly related to involvement. Organizations operating within facilitating external contexts for chronic disease prevention had more effective partnerships, more resources/supports, stronger skills and greater involvement in core chronic disease prevention practices. Results also suggested that organizations functioning in less facilitating environments may not benefit as expected from partnerships. Empirical testing of this conceptual model helps develop a better understanding of public health OC. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

An integrated decision support system for diagnosing and managing patients with community-acquired pneumonia.

PubMed Central

Aronsky, D.; Haug, P. J.

1999-01-01

Decision support systems that integrate guidelines have become popular applications to reduce variation and deliver cost-effective care. However, adverse characteristics of decision support systems, such as additional and time-consuming data entry or manually identifying eligible patients, result in a "behavioral bottleneck" that prevents decision support systems to become part of the clinical routine. This paper describes the design and the implementation of an integrated decision support system that explores a novel approach for bypassing the behavioral bottleneck. The real-time decision support system does not require health care providers to enter additional data and consists of a diagnostic and a management component. Images Fig. 1 Fig. 2 Fig. 3 PMID:10566348

Using Systematic Screening Procedures to Identify Students Who Are Nonresponsive to Primary Prevention Efforts: Integrating Academic and Behavioral Measures

ERIC Educational Resources Information Center

Kalberg, Jemma Robertson; Lane, Kathleen Lynne; Menzies, Holly Mariah

2010-01-01

Many school systems are adopting three-tiered models of prevention (e.g., Response to Intervention and Positive Behavior Support) to support an increasingly diverse student population (Sugai, Horner, & Gresham, 2002). A central feature of these models is that data are monitored to determine responsiveness. We offer this paper as a guide for…

A knowledge engineering framework towards clinical support for adverse drug event prevention: the PSIP approach.

PubMed

Koutkias, Vassilis; Stalidis, George; Chouvarda, Ioanna; Lazou, Katerina; Kilintzis, Vassilis; Maglaveras, Nicos

2009-01-01

Adverse Drug Events (ADEs) are currently considered as a major public health issue, endangering patients' safety and causing significant healthcare costs. Several research efforts are currently concentrating on the reduction of preventable ADEs by employing Information Technology (IT) solutions, which aim to provide healthcare professionals and patients with relevant knowledge and decision support tools. In this context, we present a knowledge engineering approach towards the construction of a Knowledge-based System (KBS) regarded as the core part of a CDSS (Clinical Decision Support System) for ADE prevention, all developed in the context of the EU-funded research project PSIP (Patient Safety through Intelligent Procedures in Medication). In the current paper, we present the knowledge sources considered in PSIP and the implications they pose to knowledge engineering, the methodological approach followed, as well as the components defining the knowledge engineering framework based on relevant state-of-the-art technologies and representation formalisms.

The role of plant disease in the development of controlled ecological life support systems

NASA Technical Reports Server (NTRS)

Nelson, B.

1986-01-01

Plant diseases could be important factors affecting growth of higher plants in Closed Ecological Life Support Systems (CELSS). Disease control, therefore, will be needed to maintain healthy plants. The most important controls should be aimed at preventing the introduction, reproduction and spread of pathogens and preventing plant infection. An integrared ease control program will maximize that approach. In the design and operation of CELSS, plant disease should be considered an important aspect of plant growth. The effects of plant diseases are reviewed and several disease control measures are discussed.

Cultural beliefs and teenage pregnancy.

PubMed

Horn, B

1983-09-01

The influence of cultural variables on teenage pregnancy is not clearly understood. In-depth interviews with 20 Native American Indian, 17 black and 18 white teenage women indicated intercultural differences in beliefs about: (1) prevention of pregnancy, (2) significance of becoming a mother at an early age and (3) kinds of support systems available to them within their social network. The implications of these differences for nursing care include recognition and acceptance of intercultural differences and support of a decision-making model of pregnancy prevention for teenagers that incorporates diverse belief systems.

IEP (Individualized Educational Program) Co-operation between Optimal Support of Students with Special Needs

NASA Astrophysics Data System (ADS)

Ogoshi, Yasuhiro; Nakai, Akio; Ogoshi, Sakiko; Mitsuhashi, Yoshinori; Araki, Chikahiro

A key aspect of the optimal support of students with special needs is co-ordination and co-operation between school, home and specialized agencies. Communication between these entities is of prime importance and can be facilitated through the use of a support system implementing ICF guidelines as outlined. This communication system can be considered to be a preventative rather than allopathic support.

In Vivo Evaluation of Active and Passive Physiological Control Systems for Rotary Left and Right Ventricular Assist Devices.

PubMed

Gregory, Shaun D; Stevens, Michael C; Pauls, Jo P; Schummy, Emma; Diab, Sara; Thomson, Bruce; Anderson, Ben; Tansley, Geoff; Salamonsen, Robert; Fraser, John F; Timms, Daniel

2016-09-01

Preventing ventricular suction and venous congestion through balancing flow rates and circulatory volumes with dual rotary ventricular assist devices (VADs) configured for biventricular support is clinically challenging due to their low preload and high afterload sensitivities relative to the natural heart. This study presents the in vivo evaluation of several physiological control systems, which aim to prevent ventricular suction and venous congestion. The control systems included a sensor-based, master/slave (MS) controller that altered left and right VAD speed based on pressure and flow; a sensor-less compliant inflow cannula (IC), which altered inlet resistance and, therefore, pump flow based on preload; a sensor-less compliant outflow cannula (OC) on the right VAD, which altered outlet resistance and thus pump flow based on afterload; and a combined controller, which incorporated the MS controller, compliant IC, and compliant OC. Each control system was evaluated in vivo under step increases in systemic (SVR ∼1400-2400 dyne/s/cm(5) ) and pulmonary (PVR ∼200-1000 dyne/s/cm(5) ) vascular resistances in four sheep supported by dual rotary VADs in a biventricular assist configuration. Constant speed support was also evaluated for comparison and resulted in suction events during all resistance increases and pulmonary congestion during SVR increases. The MS controller reduced suction events and prevented congestion through an initial sharp reduction in pump flow followed by a gradual return to baseline (5.0 L/min). The compliant IC prevented suction events; however, reduced pump flows and pulmonary congestion were noted during the SVR increase. The compliant OC maintained pump flow close to baseline (5.0 L/min) and prevented suction and congestion during PVR increases. The combined controller responded similarly to the MS controller to prevent suction and congestion events in all cases while providing a backup system in the event of single controller failure. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Disparities in systems development for elder abuse prevention among municipalities in Japan: implications for strategies to help municipalities develop community systems.

PubMed

Nakanishi, Miharu; Nakashima, Taeko; Honda, Tatsuo

2010-07-01

In April 2006, a national elder abuse prevention and caregiver support law was enacted in Japan, where elder abuse prevention is carried out by municipalities, and caregiver support and intervention are provided by a public long-term care insurance program. The aims of this study were (1) to examine factors at baseline affecting disparities in the progress of systems development for elder abuse prevention among municipalities, and (2) to determine what kind of support municipalities request from prefectural or national governments to help municipalities develop systems for elder abuse prevention. Written questionnaires were administered to the most knowledgeable person in the department responsible for reporting elder abuse in each municipal government between December 2006 and October 2008. The final sample for analysis consisted of 489 (26.6% of 1840) municipalities that provided complete information. Municipalities that achieved a high level of implementation originally had a higher rate of reports of abuse per 1000 elderly persons and greater involvement by police and advocacy groups at baseline. Since cities were the largest type of municipality, they had the greatest number of activities as of 2 years after implementation of the law. The results highlight that the prefectural or national government should offer different types of support according to the kind of municipality: sharing and using experts in an extended association for municipalities with limited resources and smaller size (towns and villages) and aggregating information on difficult cases for larger municipalities (cities). Further research should investigate specific strategies that the prefectural or national government can implement to help promote systems development for municipalities with low rates of reported cases of elder abuse, such as training programs to ensure that all care providers can recognize the signs and symptoms of elder abuse. Copyright 2010 Elsevier Ltd. All rights reserved.

Improving the Weight of the Nation by engaging the medical setting in obesity prevention and control.

PubMed

Foltz, Jennifer L; Belay, Brook; Blackburn, George L

2013-01-01

This manuscript highlights examples of strategies that have made strides in improving the quality of health care environments, systems-level improvements to support self-management, and collaborations between primary care and public health to support effective approaches to prevent obesity among children and adults in the U.S. © 2013 American Society of Law, Medicine & Ethics, Inc.

Anti-Runaway Prevention System with Wireless Sensors for Intelligent Track Skates at Railway Stations.

PubMed

Jiang, Chaozhe; Xu, Yibo; Wen, Chao; Chen, Dilin

2017-12-19

Anti-runaway prevention of rolling stocks at a railway station is essential in railway safety management. The traditional track skates for anti-runaway prevention of rolling stocks have some disadvantages since they are operated and monitored completely manually. This paper describes an anti-runaway prevention system (ARPS) based on intelligent track skates equipped with sensors and real-time monitoring and management system. This system, which has been updated from the traditional track skates, comprises four parts: intelligent track skates, a signal reader, a database station, and a monitoring system. This system can monitor the real-time situation of track skates without changing their workflow for anti-runaway prevention, and thus realize the integration of anti-runaway prevention information management. This system was successfully tested and practiced at Sunjia station in Harbin Railway Bureau in 2014, and the results confirmed that the system showed 100% accuracy in reflecting the usage status of the track skates. The system could meet practical demands, as it is highly reliable and supports long-distance communication.

Anti-Runaway Prevention System with Wireless Sensors for Intelligent Track Skates at Railway Stations

PubMed Central

Jiang, Chaozhe; Xu, Yibo; Chen, Dilin

2017-01-01

Anti-runaway prevention of rolling stocks at a railway station is essential in railway safety management. The traditional track skates for anti-runaway prevention of rolling stocks have some disadvantages since they are operated and monitored completely manually. This paper describes an anti-runaway prevention system (ARPS) based on intelligent track skates equipped with sensors and real-time monitoring and management system. This system, which has been updated from the traditional track skates, comprises four parts: intelligent track skates, a signal reader, a database station, and a monitoring system. This system can monitor the real-time situation of track skates without changing their workflow for anti-runaway prevention, and thus realize the integration of anti-runaway prevention information management. This system was successfully tested and practiced at Sunjia station in Harbin Railway Bureau in 2014, and the results confirmed that the system showed 100% accuracy in reflecting the usage status of the track skates. The system could meet practical demands, as it is highly reliable and supports long-distance communication. PMID:29257108

Ebola in West Africa—CDC’s Role in Epidemic Detection, Control, and Prevention

PubMed Central

Damon, Inger K.

2015-01-01

Since Ebola virus disease was identified in West Africa on March 23, 2014, the Centers for Disease Control and Prevention (CDC) has undertaken the most intensive response in the agency’s history; >3,000 staff have been involved, including >1,200 deployed to West Africa for >50,000 person workdays. Efforts have included supporting incident management systems in affected countries; mobilizing partners; and strengthening laboratory, epidemiology, contact investigation, health care infection control, communication, and border screening in West Africa, Nigeria, Mali, Senegal, and the United States. All efforts were undertaken as part of national and global response activities with many partner organizations. CDC was able to support community, national, and international health and public health staff to prevent an even worse event. The Ebola virus disease epidemic highlights the need to strengthen national and international systems to detect, respond to, and prevent the spread of future health threats. PMID:26484940

Ebola in West Africa--CDC's Role in Epidemic Detection, Control, and Prevention.

PubMed

Frieden, Thomas R; Damon, Inger K

2015-11-01

Since Ebola virus disease was identified in West Africa on March 23, 2014, the Centers for Disease Control and Prevention (CDC) has undertaken the most intensive response in the agency's history; >3,000 staff have been involved, including >1,200 deployed to West Africa for >50,000 person workdays. Efforts have included supporting incident management systems in affected countries; mobilizing partners; and strengthening laboratory, epidemiology, contact investigation, health care infection control, communication, and border screening in West Africa, Nigeria, Mali, Senegal, and the United States. All efforts were undertaken as part of national and global response activities with many partner organizations. CDC was able to support community, national, and international health and public health staff to prevent an even worse event. The Ebola virus disease epidemic highlights the need to strengthen national and international systems to detect, respond to, and prevent the spread of future health threats.

Developing a Framework of System Change between Diametric and Concentric Spaces for Early School Leaving Prevention

ERIC Educational Resources Information Center

Downes, Paul

2016-01-01

A "spatial turn" is observed as taking place across a range of disciplines. This article discusses the relevance of this "spatial turn" to the issue of early school leaving prevention and engagement of marginalised students and their parents within the educational system and other support services. Building on…

The national response for preventing healthcare-associated infections: infrastructure development.

PubMed

Mendel, Peter; Siegel, Sari; Leuschner, Kristin J; Gall, Elizabeth M; Weinberg, Daniel A; Kahn, Katherine L

2014-02-01

In 2009, the US Department of Health and Human Services (HHS) launched the Action Plan to Prevent Healthcare-associated Infections (HAIs). The Action Plan adopted national targets for reduction of specific infections, making HHS accountable for change across the healthcare system over which federal agencies have limited control. This article examines the unique infrastructure developed through the Action Plan to support adoption of HAI prevention practices. Interviews of federal (n=32) and other stakeholders (n=38), reviews of agency documents and journal articles (n=260), and observations of interagency meetings (n=17) and multistakeholder conferences (n=17) over a 3-year evaluation period. We extract key progress and challenges in the development of national HAI prevention infrastructure--1 of the 4 system functions in our evaluation framework encompassing regulation, payment systems, safety culture, and dissemination and technical assistance. We then identify system properties--for example, coordination and alignment, accountability and incentives, etc.--that enabled or hindered progress within each key development. The Action Plan has developed a model of interagency coordination (including a dedicated "home" and culture of cooperation) at the federal level and infrastructure for stimulating change through the wider healthcare system (including transparency and financial incentives, support of state and regional HAI prevention capacity, changes in safety culture, and mechanisms for stakeholder engagement). Significant challenges to infrastructure development included many related to the same areas of progress. The Action Plan has built a foundation of infrastructure to expand prevention of HAIs and presents useful lessons for other large-scale improvement initiatives.

46 CFR 154.470 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Design, Construction and Equipment Support System § 154.470 General. (a) A cargo tank must have a support system that: (1) prevents movement of the cargo tank under the static and dynamic loads in § 154.406; and (2) allows the cargo tank to contract and expand from...

Prevention of Spacecraft Anomalies: The Role of Space Climate and Space Weather Models

NASA Technical Reports Server (NTRS)

Barth, Janet L.

2003-01-01

Space-based systems are developing into critical infrastructure to support the quality of life on Earth. Mission requirements along with rapidly evolving technologies have outpaced efforts to accommodate detrimental space environment impacts on systems. This chapter describes approaches to accommodate space climate and space weather impacts on systems and notes areas where gaps in model development limit our ability to prevent spacecraft anomalies.

Health care delivery system for long duration manned space operations

NASA Technical Reports Server (NTRS)

Logan, J. S.; Shulman, E. L.; Johnson, P. C.

1983-01-01

Specific requirements for medical support of a long-duration manned facility in a low earth orbit derive from inflight medical experience, projected medical scenarios, mission related spacecraft and environmental hazards, health maintenance, and preventive medicine. A sequential buildup of medical capabilities tailored to increasing mission complexity is proposed. The space station health maintenance facility must provide preventive, diagnostic, and therapeutic medical support as immediate rescue capability may not exist.

Advice for prevention from HIV-positive African-American women: 'My story is not just a story'.

PubMed

Robillard, Alyssa; Padi, Akhila; Lewis, Kaleea; Julious, Carmen; Troutman, Jamie

2017-05-01

Large disparities in HIV incidence, prevalence and mortality exist for African-American women, especially in the southern region of the USA. Based on the culture-centric health promotion model, HIV-positive African American women can use their stories to support primary prevention. The purpose of this study was to document advice from HIV-positive African-American women (n = 25) to young African-American women, as described in their own cultural narratives collected through qualitative interviews. Content analysis of women's advice identified five common themes revolving broadly around: (1) advice for prevention, (2) support systems for prevention, (3) education, (4) empowerment/self-care and (5) potential barriers to prevention. Advice reflected recommendations based on personal experience and highlighted social determinants linked to HIV, such as stigma, access to education and healthcare, social support, and gender and power dynamics. Women also offered advice for coping with an HIV-positive diagnosis. Communication with parents, family and friends regarding education and social support emerged as an important interpersonal factor for participants, as were interactions with sexual/romantic partners. Stigma, at the community level, was consistently discussed as a hindrance to prevention. Narratives of HIV-positive women as community health agents of change can enhance the effectiveness of HIV prevention interventions for young US African-American women.

Impact of vendor computerized physician order entry on patients with renal impairment in community hospitals.

PubMed

Leung, Alexander A; Schiff, Gordon; Keohane, Carol; Amato, Mary; Simon, Steven R; Cadet, Bismarck; Coffey, Michael; Kaufman, Nathan; Zimlichman, Eyal; Seger, Diane L; Yoon, Catherine; Bates, David W

2013-10-01

Adverse drug events (ADEs) are common among hospitalized patients with renal impairment. To determine whether computerized physician order entry (CPOE) systems with clinical decision support capabilities reduce the frequency of renally related ADEs in hospitals. Quasi-experimental study of 1590 adult patients with renal impairment who were admitted to 5 community hospitals in Massachusetts from January 2005 to September 2010, preimplementation and postimplementation of CPOE. Varying levels of clinical decision support, ranging from basic CPOE only (sites 4 and 5), rudimentary clinical decision support (sites 1 and 2), and advanced clinical decision support (site 3). Primary outcome was the rate of preventable ADEs from nephrotoxic and/or renally cleared medications. Similarly, secondary outcomes were the rates of overall ADEs and potential ADEs. There was a 45% decrease in the rate of preventable ADEs following implementation (8.0/100 vs 4.4/100 admissions; P < 0.01), and the impact was related to the level of decision support. Basic CPOE was not associated with any significant benefit (4.6/100 vs 4.3/100 admissions; P = 0.87). There was a nonsignificant decrease in preventable ADEs with rudimentary clinical decision support (9.1/100 vs 6.4/100 admissions; P = 0.22). However, substantial reduction was seen with advanced clinical decision support (12.4/100 vs 0/100 admissions; P = 0.01). Despite these benefits, a significant increase in potential ADEs was found for all systems (55.5/100 vs 136.8/100 admissions; P < 0.01). Vendor-developed CPOE with advanced clinical decision support can reduce the occurrence of preventable ADEs but may be associated with an increase in potential ADEs. © 2013 Society of Hospital Medicine.

The Obesity Prevention Initiative: A Statewide Effort to Improve Child Health in Wisconsin.

PubMed

Adams, Alexandra K; Christens, Brian; Meinen, Amy; Korth, Amy; Remington, Patrick L; Lindberg, Sara; Schoeller, Dale

2016-11-01

Obesity rates have increased dramatically, especially among children and disadvantaged populations. Obesity is a complex issue, creating a compelling need for prevention efforts in communities to move from single isolated programs to comprehensive multisystem interventions. To address these issues, we have established a childhood Obesity Prevention Initiative (Initiative) for Wisconsin. This Initiative seeks to test community change frameworks that can support multisystem interventions and provide data for local action as a means for influencing policies, systems, and environments that support individuals’ healthy eating and physical activity. The Initiative is comprised of three components: (1) infrastructure to support a statewide obesity prevention and health promotion network with state- and local-level public messaging and dissemination of evidence-based solutions (healthTIDE); (2) piloting a local, multisetting community-led intervention study in 2 Wisconsin counties; and (3) developing a geocoded statewide childhood obesity and fitness surveillance system. This Initiative is using a new model that involves both coalition action and community organizing to align resources to achieve health improvement at local and state levels. We expect that it will help lead to the implementation of cohesive and sustainable policy, system, and environment health promotion and obesity prevention strategies in communities statewide, and it has the potential to help Wisconsin become a national model for multisetting community interventions to address obesity. Addressing individual-level health through population-level changes ultimately will result in reductions in the prevalence of childhood obesity, current and future health care costs, and chronic disease mortality.

The Obesity Prevention Initiative: A Statewide Effort to Improve Child Health in Wisconsin.

PubMed

Adams, Alexandra K; Christens, Brian; Meinen, Amy; Korth, Amy; Remington, Patrick L; Lindberg, Sara; Schoeller, Dale

2016-11-01

Obesity rates have increased dramatically, especially among children and disadvantaged populations. Obesity is a complex issue, creating a compelling need for prevention efforts in communities to move from single isolated programs to comprehensive multisystem interventions. To address these issues, we have established a childhood Obesity Prevention Initiative (Initiative) for Wisconsin. This Initiative seeks to test community change frameworks that can support multisystem interventions and provide data for local action as a means for influencing policies, systems, and environments that support individuals' healthy eating and physical activity. The Initiative is comprised of three components: (1) infrastructure to support a statewide obesity prevention and health promotion network with state- and local-level public messaging and dissemination of evidence-based solutions (healthTIDE); (2) piloting a local, multisetting community-led intervention study in 2 Wisconsin counties; and (3) developing a geocoded statewide childhood obesity and fitness surveillance system. This Initiative is using a new model that involves both coalition action and community organizing to align resources to achieve health improvement at local and state levels. We expect that it will help lead to the implementation of cohesive and sustainable policy, system, and environment health promotion and obesity prevention strategies in communities statewide, and it has the potential to help Wisconsin become a national model for multisetting community interventions to address obesity. Addressing individual-level health through population-level changes ultimately will result in reductions in the prevalence of childhood obesity, current and future health care costs, and chronic disease mortality.

Data Mining for Web-Based Support Systems: A Case Study in e-Custom Systems

NASA Astrophysics Data System (ADS)

Razmerita, Liana; Kirchner, Kathrin

This chapter provides an example of a Web-based support system (WSS) used to streamline trade procedures, prevent potential security threats, and reduce tax-related fraud in cross-border trade. The architecture is based on a service-oriented architecture that includes smart seals and Web services. We discuss the implications and suggest further enhancements to demonstrate how such systems can move toward a Web-based decision support system with the support of data mining methods. We provide a concrete example of how data mining can help to analyze the vast amount of data collected while monitoring the container movements along its supply chain.

Risk Interfaces to Support Integrated Systems Analysis and Development

NASA Technical Reports Server (NTRS)

Mindock, Jennifer; Lumpkins, Sarah; Shelhamer, Mark; Anton, Wilma; Havenhill, Maria

2016-01-01

Objectives for systems analysis capability: Develop integrated understanding of how a complex human physiological-socio-technical mission system behaves in spaceflight. Why? Support development of integrated solutions that prevent unwanted outcomes (Implementable approaches to minimize mission resources(mass, power, crew time, etc.)); Support development of tools for autonomy (need for exploration) (Assess and maintain resilience -individuals, teams, integrated system). Output of this exercise: -Representation of interfaces based on Human System Risk Board (HSRB) Risk Summary information and simple status based on Human Research Roadmap; Consolidated HSRB information applied to support communication; Point-of-Departure for HRP Element planning; Ability to track and communicate status of collaborations. 4

Web-based expert system for foundry pollution prevention

NASA Astrophysics Data System (ADS)

Moynihan, Gary P.

2004-02-01

Pollution prevention is a complex task. Many small foundries lack the in-house expertise to perform these tasks. Expert systems are a type of computer information system that incorporates artificial intelligence. As noted in the literature, they provide a means of automating specialized expertise. This approach may be further leveraged by implementing the expert system on the internet (or world-wide web). This will allow distribution of the expertise to a variety of geographically-dispersed foundries. The purpose of this research is to develop a prototype web-based expert system to support pollution prevention for the foundry industry. The prototype system identifies potential emissions for a specified process, and also provides recommendations for the prevention of these contaminants. The system is viewed as an initial step toward assisting the foundry industry in better meeting government pollution regulations, as well as improving operating efficiencies within these companies.

A multi-faceted tailored strategy to implement an electronic clinical decision support system for pressure ulcer prevention in nursing homes: a two-armed randomized controlled trial.

PubMed

Beeckman, Dimitri; Clays, Els; Van Hecke, Ann; Vanderwee, Katrien; Schoonhoven, Lisette; Verhaeghe, Sofie

2013-04-01

Frail older people admitted to nursing homes are at risk of a range of adverse outcomes, including pressure ulcers. Clinical decision support systems are believed to have the potential to improve care and to change the behaviour of healthcare professionals. To determine whether a multi-faceted tailored strategy to implement an electronic clinical decision support system for pressure ulcer prevention improves adherence to recommendations for pressure ulcer prevention in nursing homes. Two-armed randomized controlled trial in a nursing home setting in Belgium. The trial consisted of a 16-week implementation intervention between February and June 2010, including one baseline, four intermediate, and one post-testing measurement. Primary outcome was the adherence to guideline-based care recommendations (in terms of allocating adequate pressure ulcer prevention in residents at risk). Secondary outcomes were the change in resident outcomes (pressure ulcer prevalence) and intermediate outcomes (knowledge and attitudes of healthcare professionals). Random sample of 11 wards (6 experimental; 5 control) in a convenience sample of 4 nursing homes in Belgium. In total, 464 nursing home residents and 118 healthcare professionals participated. The experimental arm was involved in a multi-faceted tailored implementation intervention of a clinical decision support system, including interactive education, reminders, monitoring, feedback and leadership. The control arm received a hard-copy of the pressure ulcer prevention protocol, supported by standardized 30 min group lecture. Patients in the intervention arm were significantly more likely to receive fully adequate pressure ulcer prevention when seated in a chair (F=16.4, P=0.003). No significant improvement was observed on pressure ulcer prevalence and knowledge of the professionals. While baseline attitude scores were comparable between both groups [exp. 74.3% vs. contr. 74.5% (P=0.92)], the mean score after the intervention was 83.5% in the experimental group vs. 72.1% in the control group (F=15.12, P<0.001). The intervention was only partially successful to improve the primary outcome. Attitudes improved significantly while the knowledge of the healthcare workers remained unsatisfactorily low. Further research should focus on the underlying reasons for these findings. Copyright © 2012 Elsevier Ltd. All rights reserved.

Parenting skills and family support programs for drug-abusing mothers.

PubMed

Kumpfer, Karol L; Fowler, Melissa A

2007-04-01

Children born to drug-using mothers can suffer from fetal alcohol or drug syndrome (FAS/FDS) or fetal alcohol or drug effect (FAE/FDE). Such children have a greater likelihood of developing acute or chronic physical, cognitive and behavioral problems. In-utero exposure to tobacco, alcohol or drugs impact on the developing fetus and, after birth, the family environment and family system exert effects on the infants and children of substance-abusing parents. Evidence-based prevention and maternal drug treatment programs focus on enhancing parental childcaring abilities, supporting parent-child attachment and encouraging family support systems to improve children's health and cognitive outcomes. FAS/FDS prevention programs, as well as selective and indicated prenatal and postnatal interventions, can improve the support given both to mother and to child, and evidence-based, in-home parenting and family-skills-training approaches are particularly useful.

An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy.

PubMed

Karwalajtys, Tina; Kaczorowski, Janusz

2010-01-01

Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.

Improving preventive health care in Aboriginal and Torres Strait Islander primary care settings.

PubMed

Bailie, Jodie; Matthews, Veronica; Laycock, Alison; Schultz, Rosalie; Burgess, Christopher P; Peiris, David; Larkins, Sarah; Bailie, Ross

2017-07-14

Like other colonised populations, Indigenous Australians experience poorer health outcomes than non-Indigenous Australians. Preventable chronic disease is the largest contributor to the health differential between Indigenous and non-Indigenous Australians, but recommended best-practice preventive care is not consistently provided to Indigenous Australians. Significant improvement in health care delivery could be achieved through identifying and minimising evidence-practice gaps. Our objective was to use clinical audit data to create a framework of the priority evidence-practice gaps, strategies to address them, and drivers to support these strategies in the delivery of recommended preventive care. De-identified preventive health clinical audit data from 137 primary health care (PHC) centres in five jurisdictions were analysed (n = 17,108 audited records of well adults with no documented major chronic disease; 367 system assessments; 2005-2014), together with stakeholder survey data relating to interpretation of these data, using a mixed-methods approach (n = 152 responses collated in 2015-16). Stakeholders surveyed included clinicians, managers, policy officers, continuous quality improvement (CQI) facilitators and academics. Priority evidence-practice gaps and associated barriers, enablers and strategies to address the gaps were identified and reported back through two-stages of consultation. Further analysis and interpretation of these data were used to develop a framework of strategies and drivers for health service improvement. Stakeholder identified priorities were: following-up abnormal test results; completing cardiovascular risk assessments; timely recording of results; recording enquiries about living conditions, family relationships and substance use; providing support for clients identified with emotional wellbeing risk; enhancing systems to enable team function and continuity of care. Drivers identified for improving care in these areas included: strong Indigenous participation in the PHC service; appropriate team structure and function to support preventive care; meaningful use of data to support quality of care and CQI; and corporate support functions and structures. The framework should be useful for guiding development and implementation of barrier-driven, tailored interventions for primary health care service delivery and policy contexts, and for guiding further research. While specific strategies to improve the quality of preventive care need to be tailored to local context, these findings reinforce the requirement for multi-level action across the system. The framework and findings may be useful for similar purposes in other parts of the world, with appropriate attention to context in different locations.

Prevention of and Early Intervention for Students with Emotional and Behavioral Disorders: Systems to Support Data-Based Decision Making

ERIC Educational Resources Information Center

Lewis, Timothy J.; Mitchell, Barbara S.

2012-01-01

Students with emotional and behavioral disorders are at great risk for long-term negative outcomes. Researchers and practitioners alike acknowledge the need for evidence-based, preventive, and early intervention strategies. Accordingly, in this chapter an expanded view of prevention is presented as a series of data driven decisions to guide…

Factors Influencing Implementation of a Physical Activity Intervention in Residential Children's Homes.

PubMed

Lau, Erica Y; Saunders, Ruth P; Pate, Russell R

2016-11-01

The Environmental Intervention in Children's Homes (ENRICH) study was the first published physical activity intervention undertaken in residential children's homes (RCHs). The study revealed differences in implementation across the homes, which may be a key factor that affects program effectiveness. The purpose of this study was to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation of the ENRICH intervention. This study analyzed the ENRICH process evaluation data collected from 24 RCHs. Bayesian Path analysis was used to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation. Level of implementation across RCHs was variable, ranging from 38 to 97 % (M = 68.3, SD = 14.45). Results revealed that organizational capacity and provider characteristics had significant direct associations with level of implementation. Neither direct nor indirect associations between quality of prevention support system and level of implementation reached statistical significance. Conducting formative assessments on organizational capacity and provider characteristics and incorporating such information in implementation planning may increase the likelihood of achieving higher levels of implementation in future studies.

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

PubMed Central

Harris, Sion K.; Aalsma, Matthew C.; Weitzman, Elissa R.; Garcia-Huidobro, Diego; Wong, Charlene; Hadland, Scott E.; Santelli, John; Park, M. Jane; Ozer, Elizabeth M.

2017-01-01

We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act’s provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. To optimize the clinical encounter, promising clinician-focused strategies to improve delivery of preventive services include screening and decision support tools, particularly when integrated into electronic medical record systems and supported by training and feedback. Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology—such as gaming platforms, mobile phone applications, and wearable devices—suggests opportunities to expand clinicians’ reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care. PMID:28011064

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

PubMed

Harris, Sion K; Aalsma, Matthew C; Weitzman, Elissa R; Garcia-Huidobro, Diego; Wong, Charlene; Hadland, Scott E; Santelli, John; Park, M Jane; Ozer, Elizabeth M

2017-03-01

We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act's provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. To optimize the clinical encounter, promising clinician-focused strategies to improve delivery of preventive services include screening and decision support tools, particularly when integrated into electronic medical record systems and supported by training and feedback. Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology-such as gaming platforms, mobile phone applications, and wearable devices-suggests opportunities to expand clinicians' reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Improving Performance on Preventive Health Quality Measures Using Clinical Decision Support to Capture Care Done Elsewhere and Patient Exceptions.

PubMed

Bowen, Michael E; Bhat, Deepa; Fish, Jason; Moran, Brett; Howell-Stampley, Temple; Kirk, Lynne; Persell, Stephen D; Halm, Ethan A

Preventive services required for performance measurement often are completed in outside health systems and not captured in electronic medical records (EMRs). A before-after study was conducted to examine the ability of clinical decision support (CDS) to improve performance on preventive quality measures, capture clinician-reported services completed elsewhere, and patient/medical exceptions and to describe their impact on quality measurement. CDS improved performance on colorectal cancer screening, osteoporosis screening, and pneumococcal vaccination measures ( P < .05) but not breast or cervical cancer screening. CDS captured clinician-reported services completed elsewhere (2% to 10%) and patient/medical exceptions (<3%). Compared to measures using only within-system data, including services completed elsewhere in the numerator improved performance: pneumococcal vaccine (73% vs 82%); breast (69% vs 75%), colorectal (58% vs 70%), and cervical cancer (53% vs 62%); and osteoporosis (72% vs 75%) screening ( P < .05). Visit-based CDS can capture clinician-reported preventive services, and accounting for services completed elsewhere improves performance on quality measures.

A Japanese model of disease management.

PubMed

Nakashima, Naoki; Kobayashi, Kunihisa; Inoguchi, Toyoshi; Nishida, Daisuke; Tanaka, Naomi; Nakazono, Hiromi; Hoshino, Akihiko; Soejima, Hidehisa; Takayanagi, Ryoichi; Nawata, Hajime

2007-01-01

We started a disease management model, Carna, that includes two programs: one for primary prevention of lifestyle diseases and one for secondary/tertiary prevention of diabetes mellitus. These programs support the family doctor system and education for participants to allow the concept of disease management to take root in Japan. We developed a critical pathway system that can optimize health care of individual participants by matching individual status. This is the core technology of the project. Under the primary prevention program, we can perform the health check-up/ instruction tasks in the 'Tokutei Kenshin', which will start for all Japanese citizens aged 40-74 years in April 2008. In the diabetic program, Carna matches doctors and new patients, prevents patient dropout, supports detection of early-stage complications by distributing questionnaires periodically, and facilitates medical specialists' cooperation with family doctors. Carna promotes periodic medical examinations and quickly provides the result of blood tests to patients. We are conducting a study to assess the medical outcomes and business model. The study will continue until the end of 2007.

Cardiac Cachexia: Perspectives for Prevention and Treatment.

PubMed

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

2017-01-01

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

Research on Modularized Design and Allocation of Infectious Disease Prevention and Control Equipment in China.

PubMed

Zhao, Xin; Wang, Yun-Dou; Zhang, Xiao-Feng; Gao, Shu-Tian; Guo, Li-Jun; Sun, Li-Na

2017-06-01

For the prevention and control of newly emergent or sudden infectious diseases, we built an on-site, modularized prevention and control system and tested the equipment by using the clustering analysis method. On the basis of this system, we propose a modular equipment allocation method and 4 applications of this method for different types of infectious disease prevention and control. This will help to improve the efficiency and productivity of anti-epidemic emergency forces and will provide strong technical support for implementing more universal and serialized equipment in China. (Disaster Med Public Health Preparedness. 2017;11:375-382).

DECISION-SUPPORT TOOLS FOR MANAGING WASTEWATER COLLECTION SYSTEMS

EPA Science Inventory

Wastewater collection systems are an extensive part of the nation's infrastructure. As these systems become older, more preventative maintenance and renewal are required. For municipalities to cost-effectively plan, organize, and implement this effort, they require improved inf...

Proposal of the School Children Support System Using ICF to Communicate with the Teachers, the Specialists and the Guardians, Requiring Special Support Education

NASA Astrophysics Data System (ADS)

Ogoshi, Yasuhiro; Nakai, Akio; Mitsuhashi, Yoshinori; Araki, Chikahiro

At the present, educational support is required to the school children who confronts problems on study, life style, mental and health. For the school children who hold these problems, inference and understanding of those around adults are mandatory, for that intimate cooperation between the school, home and specialized agencies should be important. With above reason, the school children support system using ICF to communicate the school, the specialist and the guardian is developed in this works. Realization of this system, immediate support to the school children and their guardians will be possible. It is also considered to be a preventive support instead of an allopathic support.

A Network Perspective on Dropout Prevention in Two Cities

ERIC Educational Resources Information Center

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

2015-01-01

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

BIM authoring for an image-based bridge maintenance system of existing cable-supported bridges

NASA Astrophysics Data System (ADS)

Dang, N. S.; Shim, C. S.

2018-04-01

Infrastructure nowadays is increasingly become the main backbone for the metropolitan development in general. Along with the rise of new facilities, the demand in term of maintenance for the existing bridges is indispensable. Recently, the terminology of “preventive maintenance” is not unfamiliar with the engineer, literally is the use of a bridge maintenance system (BMS) based on a BIM-oriented model. In this paper, the process of generating a BMS based on BIM model is introduced in detail. Data management for this BMS is separated into two modules: site inspection system and information management system. The noteworthy aspect of this model lays on the closed and automatic process of “capture image, generate the technical damage report, and upload/feedback to the BMS” in real-time. A pilot BMS system for a cable-supported bridge is presented which showed a good performance and potential to further development of preventive maintenance.

Cyrogenic Life Support Technology Development Project

NASA Technical Reports Server (NTRS)

Bush, David R.

2015-01-01

KSC has used cryogenic life support (liquid air based) technology successfully for many years to support spaceflight operations. This technology has many benefits unique to cryogenics when compared to traditional compressed gas systems: passive cooling, lighter, longer duration, and lower operating pressure. However, there are also several limiting factors that have prevented the technology from being commercialized. The National Institute of Occupational Safety and Health, Office of Mine Safety and Health Research (NIOSH-OMSHR) has partnered with NASA to develop a complete liquid air based life support solution for emergency mine escape and rescue. The project will develop and demonstrate various prototype devices and incorporate new technological innovations that have to date prevented commercialization.

The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology.

PubMed

Hansen, Dominique; Dendale, Paul; Coninx, Karin; Vanhees, Luc; Piepoli, Massimo F; Niebauer, Josef; Cornelissen, Veronique; Pedretti, Roberto; Geurts, Eva; Ruiz, Gustavo R; Corrà, Ugo; Schmid, Jean-Paul; Greco, Eugenio; Davos, Constantinos H; Edelmann, Frank; Abreu, Ana; Rauch, Bernhard; Ambrosetti, Marco; Braga, Simona S; Barna, Olga; Beckers, Paul; Bussotti, Maurizio; Fagard, Robert; Faggiano, Pompilio; Garcia-Porrero, Esteban; Kouidi, Evangelia; Lamotte, Michel; Neunhäuserer, Daniel; Reibis, Rona; Spruit, Martijn A; Stettler, Christoph; Takken, Tim; Tonoli, Cajsa; Vigorito, Carlo; Völler, Heinz; Doherty, Patrick

2017-07-01

Background Exercise rehabilitation is highly recommended by current guidelines on prevention of cardiovascular disease, but its implementation is still poor. Many clinicians experience difficulties in prescribing exercise in the presence of different concomitant cardiovascular diseases and risk factors within the same patient. It was aimed to develop a digital training and decision support system for exercise prescription in cardiovascular disease patients in clinical practice: the European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool. Methods EXPERT working group members were requested to define (a) diagnostic criteria for specific cardiovascular diseases, cardiovascular disease risk factors, and other chronic non-cardiovascular conditions, (b) primary goals of exercise intervention, (c) disease-specific prescription of exercise training (intensity, frequency, volume, type, session and programme duration), and (d) exercise training safety advices. The impact of exercise tolerance, common cardiovascular medications and adverse events during exercise testing were further taken into account for optimized exercise prescription. Results Exercise training recommendations and safety advices were formulated for 10 cardiovascular diseases, five cardiovascular disease risk factors (type 1 and 2 diabetes, obesity, hypertension, hypercholesterolaemia), and three common chronic non-cardiovascular conditions (lung and renal failure and sarcopaenia), but also accounted for baseline exercise tolerance, common cardiovascular medications and occurrence of adverse events during exercise testing. An algorithm, supported by an interactive tool, was constructed based on these data. This training and decision support system automatically provides an exercise prescription according to the variables provided. Conclusion This digital training and decision support system may contribute in overcoming barriers in exercise implementation in common cardiovascular diseases.

School-based systems change for obesity prevention in adolescents: outcomes of the Australian Capital Territory 'It's Your Move!'

PubMed

Malakellis, Mary; Hoare, Erin; Sanigorski, Andrew; Crooks, Nicholas; Allender, Steven; Nichols, Melanie; Swinburn, Boyd; Chikwendu, Cal; Kelly, Paul M; Petersen, Solveig; Millar, Lynne

2017-10-01

The Australian Capital Territory 'It's Your Move!' (ACT-IYM) was a three-year (2012-2014) systems intervention to prevent obesity among adolescents. The ACT-IYM project involved three intervention schools and three comparison schools and targeted secondary students aged 12-16 years. The intervention consisted of multiple initiatives at individual, community, and school policy level to support healthier nutrition and physical activity. Intervention school-specific objectives related to increasing active transport, increasing time spent physically active at school, and supporting mental wellbeing. Data were collected in 2012 and 2014 from 656 students. Anthropometric data were objectively measured and behavioural data self-reported. Proportions of overweight or obesity were similar over time within the intervention (24.5% baseline and 22.8% follow-up) and comparison groups (31.8% baseline and 30.6% follow-up). Within schools, two of three the intervention schools showed a significant decrease in the prevalence of overweight and obesity (p<0.05). There was some evidence of effectiveness of the systems approach to preventing obesity among adolescents. Implications for public health: The incorporation of systems thinking has been touted as the next stage in obesity prevention and public health more broadly. These findings demonstrate that the use of systems methods can be effective on a small scale. © 2017 The Authors.

75 FR 5084 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-01

... based on guidelines for the prevention of pediatric overweight and obesity and the management of chronic... minutes to complete. The Obesity Prevention and Clinical Decision Support System Usability and User Satisfaction Survey (obesity questionnaire) will be completed by 82 health care professionals across 2 sites...

Hispanic/Latino Natural Support Systems. CSAP Implementation Guide.

ERIC Educational Resources Information Center

Acosta, Annie; Hamel, Vicki

This guide is intended to share knowledge about the Hispanic/Latino community with Center for Substance Abuse Prevention (CSAP) grant recipients and to help them develop effective prevention services responsive to the communities they serve. The guide: (1) highlights specific characteristics of the Hispanic and Latino communities that affect…

Assessment of a head support system to prevent pediatric out-of-position: an observational study.

PubMed

Lopez-Valdes, Francisco J; Forman, Jason L; Ash, Joseph H; Kent, Richard; Alba, Juan J; Segui-Gomez, Maria

Head injuries are the most common severe injuries sustained by pediatric occupants in road traffic crashes. Preventing children from adopting positions that can result in an increased injury risk due to unfavorable interactions with the restraints is fundamental. The objective of this paper was to assess the effect of a head support system (SS) on the lateral position of the head, the vertical position of the sternum and the shoulder belt fit. Thirty pediatric rear-seat passengers were exposed to two 75-minute trials. Volunteers were restrained by a three-point belt and, if needed, used the appropriate child restraint system for their anthropometry (high-back booster, low-back booster, no booster). A case crossover study was designed in which the volunteers used the head support system (SS) during one of the trials, acting as their own controls (No SS) in the other. Compared to the control group, the head support reduced significantly the 90(th) percentile value of the absolute value of the relative lateral motion of the head, regardless of the restraint used. The system also reduced the maximum downward position of the sternal notch within the low-back booster group. As for the belt fit, the use of the head support improved significantly the position of the shoulder belt on the occupant in the low-back booster and in the no booster groups.

Assessment of a head support system to prevent pediatric out-of-position: an observational study

PubMed Central

Lopez-Valdes, Francisco J.; Forman, Jason L.; Ash, Joseph H.; Kent, Richard; Alba, Juan J.; Segui-Gomez, Maria

2013-01-01

Head injuries are the most common severe injuries sustained by pediatric occupants in road traffic crashes. Preventing children from adopting positions that can result in an increased injury risk due to unfavorable interactions with the restraints is fundamental. The objective of this paper was to assess the effect of a head support system (SS) on the lateral position of the head, the vertical position of the sternum and the shoulder belt fit. Thirty pediatric rear-seat passengers were exposed to two 75-minute trials. Volunteers were restrained by a three-point belt and, if needed, used the appropriate child restraint system for their anthropometry (high-back booster, low-back booster, no booster). A case crossover study was designed in which the volunteers used the head support system (SS) during one of the trials, acting as their own controls (No SS) in the other. Compared to the control group, the head support reduced significantly the 90th percentile value of the absolute value of the relative lateral motion of the head, regardless of the restraint used. The system also reduced the maximum downward position of the sternal notch within the low-back booster group. As for the belt fit, the use of the head support improved significantly the position of the shoulder belt on the occupant in the low-back booster and in the no booster groups. PMID:24406966

Development of Support Service for Prevention and Recovery from Dementia and Science of Lethe

NASA Astrophysics Data System (ADS)

Otake, Mihoko

This paper proposes multiscale service design method through the development of support service for prevention and recovery from dementia towards science of lethe. Proposed multiscale service model consists of tool, event, human, network, style and rule. Service elements at different scales are developed according to the model. Firstly, the author proposes and practices coimagination method as an ``event'', which is expected to prevent the progress of cognitive impairment. Coimagination support system was developed as a ``tool''. Experimental results suggest the effective activation of episodic memory, division of attention, and planning function of participants by the measurement of cognitive activities during the coimagination. Then, Fonobono Research Institute was established as a ''network'' for ``human'' who studies coimagination, which is a multisector research organization including elderly people living around Kashiwa city, companies including instrument and welfare companies, Kashiwa city and Chiba prefecture, researchers of the University of Tokyo. The institute proposes and realizes lifelong research as a novel life ``style'' for elderly people, and discusses life with two rounds as an innovative ``rule'' for social system of aged society.

Building an HIV continuum for inmates: New York State's criminal justice initiative.

PubMed

Klein, Susan J; O'Connell, Daniel A; Devore, Barbara S; Wright, Lester N; Birkhead, Guthrie S

2002-10-01

The benefits of public health, corrections, and community-based organization (CBO) collaboration to meet HIV prevention needs of inmates are recognized. Each year over 100,000 inmates, most of whom have a history that put them at HIV risk, pass through the New York State (NYS) prison system. The NYS Department of Health AIDS Institute, the NYS Department of Correctional Services, the NYS Division of Parole, and a statewide network of CBOs collaborate to meet HIV prevention and support services needs of inmates and parolees through a continuum of interventions and services. This article describes the evolution of the prevention, supportive services, and transitional planning continuum within the NYS prison system. It identifies other agencies involved, obstacles to service delivery, describes approaches to overcome them, discusses ways to meet capacity building and technical assistance needs of CBOs, identifies challenges remaining, and provides practical advice from actual experience in NYS.

Pharmacovigilance in resource-limited countries.

PubMed

Olsson, Sten; Pal, Shanthi N; Dodoo, Alex

2015-01-01

In the past 20 years, many low- and middle-income countries have created national pharmacovigilance (PV) systems and joined the WHO's global PV network. However, very few of them have fully functional systems. Scientific evidence on the local burden of medicine-related harm and their preventability is missing. Legislation and regulatory framework as well as financial support to build sustainable PV systems are needed. Public health programs need to integrate PV to monitor new vaccines and medicines introduced through these programs. Signal analysis should focus on high-burden preventable adverse drug problems. Increased involvement of healthcare professionals from public and private sectors, pharmaceutical companies, academic institutions and the public at large is necessary to assure a safe environment for drug therapy. WHO has a major role in supporting and coordinating these developments.

Organizational Strategies to Implement Hospital Pressure Ulcer Prevention Programs: Findings from a National Survey

PubMed Central

SOBAN, LYNN M.; KIM, LINDA; YUAN, ANITA H.; MILTNER, REBECCA S.

2017-01-01

Aim To describe the presence and operationalization of organizational strategies to support implementation of pressure ulcer prevention programs across acute care hospitals in a large, integrated healthcare system. Background Comprehensive pressure ulcer programs include nursing interventions such as use of a risk assessment tool and organizational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programs. Methods Data were collected by an email survey to all Chief Nursing Officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarize survey responses and evaluate relationships between some variables. Results Organizational strategies that support pressure ulcer prevention program implementation (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalized within individual hospitals. Conclusion Organizational strategies to support implementation of pressure ulcer preventive programs are often not optimally operationalized to achieve consistent, sustainable performance. Implications for Nursing Management The results of this study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. PMID:27487972

Nutritional approach to preeclampsia prevention.

PubMed

Achamrah, Najate; Ditisheim, Agnès

2018-05-01

Although not fully understood, the physiopathology of preeclampsia is thought to involve an abnormal placentation, diffuse endothelial cell dysfunction and increased systemic inflammation. As micronutrients play a key role in placental endothelial function, oxidative stress and expression of angiogenic factors, periconceptional micronutrient supplementation has been proposed to reduce the risk of preeclampsia. However, recent studies reported conflicting results. Calcium intake (>1 g/day) may reduce the risk of preeclampsia in women with low-calcium diet. Data from recently updated Cochrane reviews did not support routine supplementation of vitamins C, E or D for either the prevention or treatment of preeclampsia. Evidences are also poor to support zinc or folic acid supplementation for preeclampsia prevention. Dark chocolate, flavonoid-rich food, and long-chain polyunsaturated fatty acids might also be candidates for prevention of preeclampsia. Through antioxidant, anti-inflammatory or vasoactive proprieties, micronutrients are good candidates for preeclampsia prevention. Calcium supplementation is recommended to prevent preeclampsia in women with low-calcium intake. Despite positive clinical and in-vitro data, strong evidence to support periconceptional supplementation of other micronutrients for preeclampsia risk-reduction is still lacking. Further studies are also needed to evaluate the benefit of nutritional supplementation such as chocolate and long-chain polyunsaturated fatty acids.

Evaluation of a decision support system for pressure ulcer prevention and management: preliminary findings.

PubMed

Zielstorff, R D; Estey, G; Vickery, A; Hamilton, G; Fitzmaurice, J B; Barnett, G O

1997-01-01

A decision support system for prevention and management of pressure ulcers was developed based on AHCPR guidelines and other sources. The system was implemented for 21 weeks on a 20-bed clinical care unit. Fifteen nurses on that unit volunteered as subjects of the intervention to see whether use of the system would have a positive effect on their knowledge about pressure ulcers and on their decision-making skills related to this topic. A similar care unit was used as a control. In addition, the system was evaluated by experts for its instructional adequacy, and by end users for their satisfaction with the system. Preliminary results show no effect on knowledge about pressure ulcers and no effect on clinical decision making skills. The system was rated positively for instructional adequacy, and positively for user satisfaction. User interviews related to satisfaction supplemented the quantitative findings. A discussion of the issues of conducting experiments like this in today's clinical environment is included.

State Fall Prevention Coalitions as Systems Change Agents: An Emphasis on Policy.

PubMed

Schneider, Ellen C; Smith, Matthew Lee; Ory, Marcia G; Altpeter, Mary; Beattie, Bonita Lynn; Scheirer, Mary Ann; Shubert, Tiffany E

2016-03-01

Falls among older adults are an escalating public health issue, which requires a multidisciplinary and multilevel approach to affect systems change to effectively address this problem. The National Council on Aging established the Falls Free® Initiative, enfolding and facilitating statewide Fall Prevention Coalitions. Fall Free® activities included developing the State Policy Toolkit for Advancing Falls Prevention to promote sustainable change by supporting the dissemination and adoption of evidence-based strategies. To (1) determine if the policies being implemented were recommended and supported by the Toolkit, (2) identify the perceived barriers and facilitators to implementing policies, and (3) identify Coalitions' current and future fall prevention policy activities. A 63-item online survey was distributed to State Coalition Leads. Descriptive statistics (frequencies and counts) were used to describe Coalition characteristics and activities. Coalitions had several similarities, and varied greatly in their number of member organizations and members as well as meeting frequencies. Key activities included building partnerships, disseminating programs, and pursuing at least one of the eight National Council on Aging-recommended policy goals. The most commonly reported facilitator was active support from the Coalition Leads, whereas the lack of funding was the most cited barrier. This study serves as the first national census of empirical evidence regarding Falls Coalitions' composition, goals, and activities. Results indicate that Coalitions are actively pursuing evidence-based policies but could benefit from additional technical assistance and resources. Findings support the value of Toolkit recommendations by documenting what is feasible and being implemented. Knowledge about facilitators and barriers will inform future efforts to foster sustainable systems change in states with active Coalitions and encourage Coalitions in other states. © 2015 Society for Public Health Education.

The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs

PubMed Central

Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

2011-01-01

The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs. PMID:21816958

The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs.

PubMed

Kagan, Jonathan M; Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

2011-12-01

The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs.

The Influence of the Japanese Nationwide Cardiovascular Prevention System Health Guidance on Smoking Cessation Among Smokers: A Propensity Score Matching Analysis.

PubMed

Nakamura, Koshi; Watanabe, Makoto; Okuda, Nagako; Yoshita, Katsushi; Kabayama, Mai; Torii, Sayuki; Kuribayashi, Toru; Itai, Kazuyoshi; Kamide, Kei; Miura, Katsuyuki; Okayama, Akira

2018-04-01

We investigated whether 2 types of personalized health guidance (repeated and single counseling) in the Japanese nationwide cardiovascular prevention system promoted smoking cessation among smokers. The study included 47,745 Japanese smokers aged 40 to 74 years classified into 2 personalized health guidance schemes. After a 1-year follow-up, we compared the rates of smoking cessation between individuals who had received counseling ("supported") and those who had not received counseling ("unsupported"). Using propensity score matching analysis, we estimated the average treatment effect (ATE) of each approach on smoking cessation after balancing out the characteristics between the supported and unsupported groups. The propensity score regression model included age, medical insurance type, weight gain since the age of 20 years, exercise, eating habits, alcohol intake, quality of sleep, readiness to modify lifestyle, willingness to receive support, and body mass index. In the repeated counseling scheme, the age-adjusted rates of smoking cessation in the supported and unsupported groups were 8.8% and 6.3% for males, and 9.8% and 9.1% for females respectively. In the single counseling scheme, the corresponding rates were 8.4% and 7.3% for supported and unsupported males, and 11.0% and 11.7% for supported and unsupported females respectively. The ATE of repeated counseling was ＋2.64% (95% confidence interval: ＋1.51% to ＋3.77%) for males and ＋3.11% (－1.85% to ＋8.07%) for females. The ATE of single counseling was ＋0.61% (－1.17% to ＋2.38%) for males and －1.06% (－5.96% to ＋3.85%) for females. In the Japanese cardiovascular prevention system, repeated counseling may promote smoking cessation among male smokers.

A computer decision aid for medical prevention: a pilot qualitative study of the Personalized Estimate of Risks (EsPeR) system

PubMed Central

Colombet, Isabelle; Dart, Thierry; Leneveut, Laurence; Zunino, Sylvain; Ménard, Joël; Chatellier, Gilles

2003-01-01

Background Many preventable diseases such as ischemic heart diseases and breast cancer prevail at a large scale in the general population. Computerized decision support systems are one of the solutions for improving the quality of prevention strategies. Methods The system called EsPeR (Personalised Estimate of Risks) combines calculation of several risks with computerisation of guidelines (cardiovascular prevention, screening for breast cancer, colorectal cancer, uterine cervix cancer, and prostate cancer, diagnosis of depression and suicide risk). We present a qualitative evaluation of its ergonomics, as well as it's understanding and acceptance by a group of general practitioners. We organised four focus groups each including 6–11 general practitioners. Physicians worked on several structured clinical scenari os with the help of EsPeR, and three senior investigators leaded structured discussion sessions. Results The initial sessions identified several ergonomic flaws of the system that were easily corrected. Both clinical scenarios and discussion sessions identified several problems related to the insufficient comprehension (expression of risks, definition of familial history of disease), and difficulty for the physicians to accept some of the recommendations. Conclusion Educational, socio-professional and organisational components (i.e. time constraints for training and use of the EsPeR system during consultation) as well as acceptance of evidence-based decision-making should be taken into account before launching computerised decision support systems, or their application in randomised trials. PMID:14641924

Innovation in sexually transmitted disease and HIV prevention: internet and mobile phone delivery vehicles for global diffusion.

PubMed

Swendeman, Dallas; Rotheram-Borus, Mary Jane

2010-03-01

Efficacious behavioral interventions and practices have not been universally accepted, adopted, or diffused by policy makers, administrators, providers, advocates, or consumers. Biomedical innovations for sexually transmitted disease (STD) and HIV prevention have been embraced but their effectiveness is hindered by behavioral factors. Behavioral interventions are required to support providers and consumers for adoption and diffusion of biomedical innovations, protocol adherence, and sustained prevention for other STDs. Information and communication technology such as the Internet and mobile phones can deliver behavioral components for STD/HIV prevention and care to more people at less cost. Recent innovations in STD/HIV prevention with information and communication technology-mediated behavioral supports include STD/HIV testing and partner interventions, behavioral interventions, self-management, and provider care. Computer-based and Internet-based behavioral STD/HIV interventions have demonstrated efficacy comparable to face-to-face interventions. Mobile phone STD/HIV interventions using text-messaging are being broadly utilized but more work is needed to demonstrate efficacy. Electronic health records and care management systems can improve care, but interventions are needed to support adoption. Information and communication technology is rapidly diffusing globally. Over the next 5-10 years smart-phones will be broadly disseminated, connecting billions of people to the Internet and enabling lower cost, highly engaging, and ubiquitous STD/HIV prevention and treatment support interventions.

A Developmental Examination of School-Wide Positive Behavior Support in Elementary School: Behavior Patterns, School Climate, and Academic Achievement

ERIC Educational Resources Information Center

Betters-Bubon, Jennifer

2012-01-01

School-wide Positive Behavior Support (SWPBS) programs integrate research-based practice within a three-tier approach of prevention and intervention to impact change within school systems. Research suggests positive changes in student outcomes with the implementation of SWPBS. Supported by social-ecological and behavioral theory, this longitudinal…

14 CFR 29.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Fuel System Components § 29.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Fuel system lines and fittings. 29.993...

14 CFR 25.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Fuel System Components § 25.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Fuel system lines and fittings. 25.993...

14 CFR 29.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Fuel System Components § 29.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Fuel system lines and fittings. 29.993...

14 CFR 27.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Fuel System Components § 27.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Fuel system lines and fittings. 27.993...

14 CFR 25.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Fuel System Components § 25.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Fuel system lines and fittings. 25.993...

14 CFR 29.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Fuel System Components § 29.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fuel system lines and fittings. 29.993...

14 CFR 27.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Fuel System Components § 27.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Fuel system lines and fittings. 27.993...

14 CFR 27.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Fuel System Components § 27.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Fuel system lines and fittings. 27.993...

14 CFR 27.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Fuel System Components § 27.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fuel system lines and fittings. 27.993...

14 CFR 29.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Fuel System Components § 29.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Fuel system lines and fittings. 29.993...

14 CFR 25.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Fuel System Components § 25.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Fuel system lines and fittings. 25.993...

14 CFR 27.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Fuel System Components § 27.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Fuel system lines and fittings. 27.993...

14 CFR 29.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Fuel System Components § 29.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Fuel system lines and fittings. 29.993...

14 CFR 25.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Fuel System Components § 25.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fuel system lines and fittings. 25.993...

14 CFR 25.993 - Fuel system lines and fittings.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Fuel System Components § 25.993 Fuel system lines and fittings. (a) Each fuel line must be installed and supported to prevent excessive... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Fuel system lines and fittings. 25.993...

14 CFR 23.1123 - Exhaust system.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Exhaust system. 23.1123 Section 23.1123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... prevent failure due to expansion by operating temperatures. (b) Each exhaust system must be supported to...

14 CFR 23.1123 - Exhaust system.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Exhaust system. 23.1123 Section 23.1123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... prevent failure due to expansion by operating temperatures. (b) Each exhaust system must be supported to...

14 CFR 23.1123 - Exhaust system.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Exhaust system. 23.1123 Section 23.1123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... prevent failure due to expansion by operating temperatures. (b) Each exhaust system must be supported to...

14 CFR 23.1123 - Exhaust system.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Exhaust system. 23.1123 Section 23.1123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... prevent failure due to expansion by operating temperatures. (b) Each exhaust system must be supported to...

14 CFR 23.1123 - Exhaust system.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Exhaust system. 23.1123 Section 23.1123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... prevent failure due to expansion by operating temperatures. (b) Each exhaust system must be supported to...

DEVELOPMENT OF COMPUTER SUPPORTED INFORMATION SYSTEM SHELL FOR MEASURING POLLUTION PREVENTION PROGRESS

EPA Science Inventory

Basic elements and concepts of information systems are presented: definition of the term "information", main elements of data and database structure. The report also deals with the information system and its underlying theory and design. Examples of the application of formation ...

Cost analysis of an integrated vaccine-preventable disease surveillance system in Costa Rica.

PubMed

Toscano, C M; Vijayaraghavan, M; Salazar-Bolaños, H M; Bolaños-Acuña, H M; Ruiz-González, A I; Barrantes-Solis, T; Fernández-Vargas, I; Panero, M S; de Oliveira, L H; Hyde, T B

2013-07-02

Following World Health Organization recommendations set forth in the Global Framework for Immunization Monitoring and Surveillance, Costa Rica in 2009 became the first country to implement integrated vaccine-preventable disease (iVPD) surveillance, with support from the U.S. Centers for Disease Control and Prevention (CDC) and the Pan American Health Organization (PAHO). As surveillance for diseases prevented by new vaccines is integrated into existing surveillance systems, these systems could cost more than routine surveillance for VPDs targeted by the Expanded Program on Immunization. We estimate the costs associated with establishing and subsequently operating the iVPD surveillance system at a pilot site in Costa Rica. We retrospectively collected data on costs incurred by the institutions supporting iVPD surveillance during the preparatory (January 2007 through August 2009) and implementation (September 2009 through August 2010) phases of the iVPD surveillance project in Costa Rica. These data were used to estimate costs for personnel, meetings, infrastructure, office equipment and supplies, transportation, and laboratory facilities. Costs incurred by each of the collaborating institutions were also estimated. During the preparatory phase, the estimated total cost was 128,000 U.S. dollars (US$), including 64% for personnel costs. The preparatory phase was supported by CDC and PAHO. The estimated cost for 1 year of implementation was US$ 420,000, including 58% for personnel costs, 28% for laboratory costs, and 14% for meeting, infrastructure, office, and transportation costs combined. The national reference laboratory and the PAHO Costa Rica office incurred 64% of total costs, and other local institutions supporting iVPD surveillance incurred the remaining 36%. Countries planning to implement iVPD surveillance will require adequate investments in human resources, laboratories, data management, reporting, and investigation. Our findings will be valuable for decision makers and donors planning and implementing similar strategies in other countries. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cost analysis of an integrated vaccine-preventable disease surveillance system in Costa Rica✩

PubMed Central

Toscano, C.M.; Vijayaraghavan, M.; Salazar-Bolaños, H.M.; Bolaños-Acuña, H.M.; Ruiz-González, A.I.; Barrantes-Solis, T.; Fernández-Vargas, I.; Panero, M.S.; de Oliveira, L.H.; Hyde, T.B.

2015-01-01

Introduction Following World Health Organization recommendations set forth in the Global Framework for Immunization Monitoring and Surveillance, Costa Rica in 2009 became the first country to implement integrated vaccine-preventable disease (iVPD) surveillance, with support from the U.S. Centers for Disease Control and Prevention (CDC) and the Pan American Health Organization (PAHO). As surveillance for diseases prevented by new vaccines is integrated into existing surveillance systems, these systems could cost more than routine surveillance for VPDs targeted by the Expanded Program on Immunization. Objectives We estimate the costs associated with establishing and subsequently operating the iVPD surveillance system at a pilot site in Costa Rica. Methods We retrospectively collected data on costs incurred by the institutions supporting iVPD surveillance during the preparatory (January 2007 through August 2009) and implementation (September 2009 through August 2010) phases of the iVPD surveillance project in Costa Rica. These data were used to estimate costs for personnel, meetings, infrastructure, office equipment and supplies, transportation, and laboratory facilities. Costs incurred by each of the collaborating institutions were also estimated. Results During the preparatory phase, the estimated total cost was 128,000 U.S. dollars (US$), including 64% for personnel costs. The preparatory phase was supported by CDC and PAHO. The estimated cost for 1 year of implementation was US$ 420,000, including 58% for personnel costs, 28% for laboratory costs, and 14% for meeting, infrastructure, office, and transportation costs combined. The national reference laboratory and the PAHO Costa Rica office incurred 64% of total costs, and other local institutions supporting iVPD surveillance incurred the remaining 36%. Conclusions Countries planning to implement iVPD surveillance will require adequate investments in human resources, laboratories, data management, reporting, and investigation. Our findings will be valuable for decision makers and donors planning and implementing similar strategies in other countries. PMID:23777698

Water Recovery System Architecture and Operational Concepts to Accommodate Dormancy

NASA Technical Reports Server (NTRS)

Carter, Layne; Tabb, David; Anderson, Molly

2017-01-01

Future manned missions beyond low Earth orbit will include intermittent periods of extended dormancy. The mission requirement includes the capability for life support systems to support crew activity, followed by a dormant period of up to one year, and subsequently for the life support systems to come back online for additional crewed missions. NASA personnel are evaluating the architecture and operational concepts that will allow the Water Recovery System (WRS) to support such a mission. Dormancy could be a critical issue due to concerns with microbial growth or chemical degradation that might prevent water systems from operating properly when the crewed mission began. As such, it is critical that the water systems be designed to accommodate this dormant period. This paper identifies dormancy issues, concepts for updating the WRS architecture and operational concepts that will enable the WRS to support the dormancy requirement.

New approaches to hyperkalemia in patients with indications for renin angiotensin aldosterone inhibitors: Considerations for trial design and regulatory approval.

PubMed

Zannad, Faiez; Rossignol, Patrick; Stough, Wendy Gattis; Epstein, Murray; Alonso Garcia, Maria de Los Angeles; Bakris, George L; Butler, Javed; Kosiborod, Mikhail; Berman, Lance; Mebazaa, Alexandre; Rasmussen, Henrik S; Ruilope, Luis M; Stockbridge, Norman; Thompson, Aliza; Wittes, Janet; Pitt, Bertram

2016-08-01

Hyperkalemia is a common clinical problem, especially in patients with chronic kidney disease, diabetes mellitus, or heart failure. Treatment with renin angiotensin aldosterone system inhibitors exacerbates the risk of hyperkalemia in these patients. Concern about hyperkalemia can result in the failure to initiate, suboptimal dosing, or discontinuation of renin angiotensin aldosterone system inhibitor therapy in patients; effective treatments for hyperkalemia might mitigate such undertreatment. New treatments for hyperkalemia in development may offer better efficacy, tolerability and safety profiles than do existing approved treatments. These compounds might enable more eligible patients to receive renin angiotensin aldosterone system inhibitor therapy or to receive renin angiotensin aldosterone system inhibitors at target doses. The evidence needed to support a treatment claim (reduction in serum potassium) differs from that needed to support a prevention claim (preventing hyperkalemia to allow renin angiotensin aldosterone system inhibitor treatment). Thus, several issues related to clinical trial design and drug development need to be considered. This paper summarizes and expands upon a discussion at the Global Cardiovascular Clinical Trialists 2014 Forum and examines methodologic considerations for trials of new potassium binders for the prevention and management of hyperkalemia in patients with renin angiotensin aldosterone system inhibitor indications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Reducing risk with clinical decision support: a study of closed malpractice claims.

PubMed

Zuccotti, G; Maloney, F L; Feblowitz, J; Samal, L; Sato, L; Wright, A

2014-01-01

Identify clinical opportunities to intervene to prevent a malpractice event and determine the proportion of malpractice claims potentially preventable by clinical decision support (CDS). Cross-sectional review of closed malpractice claims over seven years from one malpractice insurance company and seven hospitals in the Boston area. For each event, clinical opportunities to intervene to avert the malpractice event and the presence or absence of CDS that might have a role in preventing the event, were assigned by a panel of expert raters. Compensation paid out to resolve a claim (indemnity), was associated with each CDS type. Of the 477 closed malpractice cases, 359 (75.3%) were categorized as substantiated and 195 (54%) had at least one opportunity to intervene. Common opportunities to intervene related to performance of procedure, diagnosis, and fall prevention. We identified at least one CDS type for 63% of substantiated claims. The 41 CDS types identified included clinically significant test result alerting, diagnostic decision support and electronic tracking of instruments. Cases with at least one associated intervention accounted for $40.3 million (58.9%) of indemnity. CDS systems and other forms of health information technology (HIT) are expected to improve quality of care, but their potential to mitigate risk had not previously been quantified. Our results suggest that, in addition to their known benefits for quality and safety, CDS systems within HIT have a potential role in decreasing malpractice payments. More than half of malpractice events and over $40 million of indemnity were potentially preventable with CDS.

AEGIS: a wildfire prevention and management information system

Treesearch

Kostas Kalabokidis; Alan Ager; Mark Finney; Nikos Athanasis; Palaiologos Palaiologou; Christos Vasilakos

2016-01-01

We describe a Web-GIS wildfire prevention and management platform (AEGIS) developed as an integrated and easy-to-use decision support tool to manage wildland fire hazards in Greece (http://aegis.aegean.gr). The AEGIS platform assists with early fire warning, fire planning, fire control and coordination of firefighting forces by providing online access to...

Automated Test Case Generator for Phishing Prevention Using Generative Grammars and Discriminative Methods

ERIC Educational Resources Information Center

Palka, Sean

2015-01-01

This research details a methodology designed for creating content in support of various phishing prevention tasks including live exercises and detection algorithm research. Our system uses probabilistic context-free grammars (PCFG) and variable interpolation as part of a multi-pass method to create diverse and consistent phishing email content on…

"Preventing the pain" when working with family and sexual violence in primary care.

PubMed

Coles, Jan; Dartnall, Elizabeth; Astbury, Jill

2013-01-01

Primary care professionals (PCPs) are increasingly being expected to identify and respond to family and sexual violence as the chronic nature and severity of the long-term health impacts are increasingly recognized. This discussion paper reports the authors' expert opinion from their experiences running international workshops to prevent trauma among those who work and research sexual violence. It describes the burnout and secondary traumatic stress literature which provides the evidence supporting their work. Implications for practicing basic training in response to trauma and ongoing education are a key area for responding to family violence and preventing professional stress. A professional culture that supports and values caring well for those who have experienced family violence as well as "caring for the carer" is needed. Working in teams and having more support systems in place are likely to protect PCPs from secondary traumatic stress and burnout. Undergraduate and postgraduate training of PCPs to develop trauma knowledge and the skills to ask about and respond to family violence safely are essential. In addition, the healthcare system, workplace, and the individual practitioner support structures need to be in place to enable PCPs to provide safe and effective long-term care and access to other appropriate services for those who have experienced family violence.

Error Generation in CATS-Based Agents

NASA Technical Reports Server (NTRS)

Callantine, Todd

2003-01-01

This research presents a methodology for generating errors from a model of nominally preferred correct operator activities, given a particular operational context, and maintaining an explicit link to the erroneous contextual information to support analyses. It uses the Crew Activity Tracking System (CATS) model as the basis for error generation. This report describes how the process works, and how it may be useful for supporting agent-based system safety analyses. The report presents results obtained by applying the error-generation process and discusses implementation issues. The research is supported by the System-Wide Accident Prevention Element of the NASA Aviation Safety Program.

Real-Time Surveillance in Emergencies Using the Early Warning Alert and Response Network.

PubMed

Cordes, Kristina M; Cookson, Susan T; Boyd, Andrew T; Hardy, Colleen; Malik, Mamunur Rahman; Mala, Peter; El Tahir, Khalid; Everard, Marthe; Jasiem, Mohamad; Husain, Farah

2017-11-01

Humanitarian emergencies often result in population displacement and increase the risk for transmission of communicable diseases. To address the increased risk for outbreaks during humanitarian emergencies, the World Health Organization developed the Early Warning Alert and Response Network (EWARN) for early detection of epidemic-prone diseases. The US Centers for Disease Control and Prevention has worked with the World Health Organization, ministries of health, and other partners to support EWARN through the implementation and evaluation of these systems and the development of standardized guidance. Although protocols have been developed for the implementation and evaluation of EWARN, a need persists for standardized training and additional guidance on supporting these systems remotely when access to affected areas is restricted. Continued collaboration between partners and the Centers for Disease Control and Prevention for surveillance during emergencies is necessary to strengthen capacity and support global health security.

Real-Time Surveillance in Emergencies Using the Early Warning Alert and Response Network

PubMed Central

Cordes, Kristina M.; Cookson, Susan T.; Boyd, Andrew T.; Hardy, Colleen; Malik, Mamunur Rahman; Mala, Peter; El Tahir, Khalid; Everard, Marthe; Jasiem, Mohamad

2017-01-01

Humanitarian emergencies often result in population displacement and increase the risk for transmission of communicable diseases. To address the increased risk for outbreaks during humanitarian emergencies, the World Health Organization developed the Early Warning Alert and Response Network (EWARN) for early detection of epidemic-prone diseases. The US Centers for Disease Control and Prevention has worked with the World Health Organization, ministries of health, and other partners to support EWARN through the implementation and evaluation of these systems and the development of standardized guidance. Although protocols have been developed for the implementation and evaluation of EWARN, a need persists for standardized training and additional guidance on supporting these systems remotely when access to affected areas is restricted. Continued collaboration between partners and the Centers for Disease Control and Prevention for surveillance during emergencies is necessary to strengthen capacity and support global health security. PMID:29155660

The Cancer Prevention and Control Research Network: An Interactive Systems Approach to Advancing Cancer Control Implementation Research and Practice

PubMed Central

Fernández, María E.; Melvin, Cathy L.; Leeman, Jennifer; Ribisl, Kurt M.; Allen, Jennifer D.; Kegler, Michelle C.; Bastani, Roshan; Ory, Marcia G.; Risendal, Betsy C.; Hannon, Peggy A.; Kreuter, Matthew W.; Hebert, James R.

2018-01-01

Background Although cancer research has advanced at a rapid pace, a gap remains between what is known about how to improve cancer prevention and control (CPC) and what is implemented as best practices within health care systems and communities. The Cancer Prevention and Control Research Network (CPCRN), with more than 10 years of dissemination and implementation research experience, aims to accelerate the uptake and use of evidence-based CPC interventions. Methods The collective work of the CPCRN has facilitated the analysis and categorization of research and implementation efforts according to the Interactive Systems Framework for Dissemination and Implementation (ISF), providing a useful heuristic for bridging the gap between prevention research and practice. The ISF authors have called for examples of its application as input to help refine the model. Results We provide examples of how the collaborative activities supported by the CPCRN, using community-engaged processes, accelerated the synthesis and translation of evidence, built both general and innovation-specific capacity, and worked with delivery systems to advance cancer control research and practice. Conclusions The work of the CPCRN has provided real-world examples of the application of the ISF and demonstrated that synthesizing and translating evidence can increase the potential that evidence-based CPC programs will be used and that capacity building for both the support system and the delivery system is crucial for the successful implementation and maintenance of evidence-based cancer control. Impact Adoption and implementation of CPC can be enhanced by better understanding ISF systems and intervening to improve them. PMID:25155759

Cardiovascular disease prevention and health promotion with the transcendental meditation program and Maharishi consciousness-based health care.

PubMed

Schneider, Robert H; Walton, Kenneth G; Salerno, John W; Nidich, Sanford I

2006-01-01

This article summarizes the background, rationale, and clinical research on a traditional system of natural health care that may be useful in the prevention of cardiovascular disease (CVD) and promotion of health. Results recently reported include reductions in blood pressure, psychosocial stress, surrogate markers for atherosclerotic CVD, and mortality. The randomized clinical trials conducted so far have involved applications to both primary and secondary prevention as well as to health promotion more generally. The results support the applicability of this approach for reducing ethnic health disparities associated with environmental and psychosocial stress. Proposed mechanisms for the effects of this traditional system include enhanced resistance to physiological and psychological stress and improvements in homeostatic and self-repair processes. This system may offer clinical and cost effectiveness advantages for health care, particularly in preventive cardiology.

A Quality System Database

NASA Technical Reports Server (NTRS)

Snell, William H.; Turner, Anne M.; Gifford, Luther; Stites, William

2010-01-01

A quality system database (QSD), and software to administer the database, were developed to support recording of administrative nonconformance activities that involve requirements for documentation of corrective and/or preventive actions, which can include ISO 9000 internal quality audits and customer complaints.

A Community-Based, Technology-Supported Health Service for Detecting and Preventing Frailty among Older Adults: A Participatory Design Development Process.

PubMed

van Velsen, Lex; Illario, Maddalena; Jansen-Kosterink, Stephanie; Crola, Catherine; Di Somma, Carolina; Colao, Annamaria; Vollenbroek-Hutten, Miriam

2015-01-01

Frailty is a multifaceted condition that affects many older adults and marks decline on areas such as cognition, physical condition, and nutritional status. Frail individuals are at increased risk for the development of disability, dementia, and falls. There are hardly any health services that enable the identification of prefrail individuals and that focus on prevention of further functional decline. In this paper, we discuss the development of a community-based, technology-supported health service for detecting prefrailty and preventing frailty and further functional decline via participatory design with a wide range of stakeholders. The result is an innovative service model in which an online platform supports the integration of traditional services with novel, Information Communication Technology supported tools. This service is capable of supporting the different phases of screening and offers training services, by also integrating them with community-based services. The service model can be used as a basis for developing similar services within a wide range of healthcare systems. We present the service model, the general functioning of the technology platform, and the different ways in which screening for and prevention of frailty has been localized. Finally, we reflect on the added value of participatory design for creating such health services.

Maximizing the Implementation Quality of Evidence-Based Preventive Interventions in Schools: A Conceptual Framework

PubMed Central

Domitrovich, Celene E.; Bradshaw, Catherine P.; Poduska, Jeanne M.; Hoagwood, Kimberly; Buckley, Jacquelyn A.; Olin, Serene; Romanelli, Lisa Hunter; Leaf, Philip J.; Greenberg, Mark T.; Ialongo, Nicholas S.

2011-01-01

Increased availability of research-supported, school-based prevention programs, coupled with the growing national policy emphasis on use of evidence-based practices, has contributed to a shift in research priorities from efficacy to implementation and dissemination. A critical issue in moving research to practice is ensuring high-quality implementation of both the intervention model and the support system for sustaining it. The paper describes a three-level framework for considering the implementation quality of school-based interventions. Future directions for research on implementation are discussed. PMID:27182282

Designing System Reforms: Using a Systems Approach to Translate Incident Analyses into Prevention Strategies.

PubMed

Goode, Natassia; Read, Gemma J M; van Mulken, Michelle R H; Clacy, Amanda; Salmon, Paul M

2016-01-01

Advocates of systems thinking approaches argue that accident prevention strategies should focus on reforming the system rather than on fixing the "broken components." However, little guidance exists on how organizations can translate incident data into prevention strategies that address the systemic causes of accidents. This article describes and evaluates a series of systems thinking prevention strategies that were designed in response to the analysis of multiple incidents. The study was undertaken in the led outdoor activity (LOA) sector in Australia, which delivers supervised or instructed outdoor activities such as canyoning, sea kayaking, rock climbing and camping. The design process involved workshops with practitioners, and focussed on incident data analyzed using Rasmussen's AcciMap technique. A series of reflection points based on the systemic causes of accidents was used to guide the design process, and the AcciMap technique was used to represent the prevention strategies and the relationships between them, leading to the creation of PreventiMaps. An evaluation of the PreventiMaps revealed that all of them incorporated the core principles of the systems thinking approach and many proposed prevention strategies for improving vertical integration across the LOA system. However, the majority failed to address the migration of work practices and the erosion of risk controls. Overall, the findings suggest that the design process was partially successful in helping practitioners to translate incident data into prevention strategies that addressed the systemic causes of accidents; refinement of the design process is required to focus practitioners more on designing monitoring and feedback mechanisms to support decisions at the higher levels of the system.

NASA Advanced Life Support Technology Testing and Development

NASA Technical Reports Server (NTRS)

Wheeler, Raymond M.

2012-01-01

Prior to 2010, NASA's advanced life support research and development was carried out primarily under the Exploration Life Support Project of NASA's Exploration Systems Mission Directorate. In 2011, the Exploration Life Support Project was merged with other projects covering Fire Prevention/Suppression, Radiation Protection, Advanced Environmental Monitoring and Control, and Thermal Control Systems. This consolidated project was called Life Support and Habitation Systems, which was managed under the Exploration Systems Mission Directorate. In 2012, NASA re-organized major directorates within the agency, which eliminated the Exploration Systems Mission Directorate and created the Office of the Chief Technologist (OCT). Life support research and development is currently conducted within the Office of the Chief Technologist, under the Next Generation Life Support Project, and within the Human Exploration Operation Missions Directorate under several Advanced Exploration System projects. These Advanced Exploration Systems projects include various themes of life support technology testing, including atmospheric management, water management, logistics and waste management, and habitation systems. Food crop testing is currently conducted as part of the Deep Space Habitation (DSH) project within the Advanced Exploration Systems Program. This testing is focused on growing salad crops that could supplement the crew's diet during near term missions.

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

PubMed

Moskowitz, J M

1989-01-01

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

Supporting Comprehensive, Integrated, Three-Tiered Models of Prevention in Schools: Administrators' Perspectives

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Carter, Erik W.; Jenkins, Abbie; Dwiggins, Lauren; Germer, Kathryn

2015-01-01

We report findings from a statewide survey of 365 site-level administrators developed to (a) learn about the extent to which schools across the state were implementing components of multi-tiered systems of support and (b) determine the areas in which these schools might need professional development or resources to support them. At least half of…

Systems approaches for chronic disease prevention: sound logic and empirical evidence, but is this view shared outside of academia?

PubMed

Wutzke, Sonia; Morrice, Emily; Benton, Murray; Wilson, Andrew

2016-07-15

There is a need and desire to improve chronic disease prevention efforts across Australia. Increasingly, scientists are urging the use of systems thinking and its methods to significantly shift the way we think about, and intervene in, chronic diseases. This research aimed to examine the convergence between the systems science literature and the views of those working in and advocating for prevention, in relation to the value of systems thinking and its methods for the prevention of chronic diseases. Individual and small-group semistructured interviews were undertaken with 29 individuals across Australia. The interviewees reflected a diverse cross-section of senior public health managers and program implementation staff from state and territory health departments, and senior thought leaders and public health advocates. Interviews were audio recorded and coded into key themes. Feedback from informants illustrated that, among those working in and advocating for prevention, there is a mix of support for systems thinking for chronic disease prevention, and some healthy scepticism. The lack of consistent confluence between those promoting the value of systems science, and those responsible for working in and advocating for prevention indicates a level of confusion about language and definitions. It also reflects a desire for published evidence about systems methods that have proven effectiveness. Systems thinking and its methods have a promising and important role to play in creating a robust, effective and sustainable strategy for prevention of chronic diseases throughout Australia. However, the method requires further development and refinement, and promotion of case studies of effectiveness. We also need to heed lessons learnt overseas.

Fall prevention intervention technologies: A conceptual framework and survey of the state of the art.

PubMed

Hamm, Julian; Money, Arthur G; Atwal, Anita; Paraskevopoulos, Ioannis

2016-02-01

In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

A state-wide partnership to promote safe and supportive schools: the PBIS Maryland Initiative.

PubMed

Bradshaw, Catherine P; Pas, Elise T; Bloom, Jerry; Barrett, Susan; Hershfeldt, Patricia; Alexander, Andrea; McKenna, Milton; Chafin, Ann E; Leaf, Philip J

2012-07-01

Schools continue to be an important context for preventive interventions targeting a range of behavioral and mental health problems. Yet competing demands on teachers and shifting priorities in response to federal legislation have posed some unique challenges to prevention researchers working in school settings. This paper summarizes an approach to prevention partnerships developed over a decade and centered on the three-tiered Positive Behavioral Interventions and Supports (PBIS) model. A state-wide initiative was formed and led through a partnership between the Maryland State Department of Education, Sheppard Pratt Health System, and Johns Hopkins University, which focused on implementing evidence-based practices and conducting prevention research in Maryland public schools. Drawing on a community-based participatory research framework for developing research partnerships, we highlight the importance of forming and sustaining authentic relationships to support school-based prevention research and implementation of evidence-based programs. We also discuss how these relationships have been used to disseminate PBIS and rigorously test its effectiveness. We describe some lessons learned from the partnership and identify potential areas for future research on the prevention partnership model. We conclude with a discussion of the implications for both researchers and community partners engaged in translational research in school settings.

Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey.

PubMed

Soban, Lynn M; Kim, Linda; Yuan, Anita H; Miltner, Rebecca S

2017-09-01

To describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system. Comprehensive pressure ulcer programmes include nursing interventions such as use of a risk assessment tool and organisational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programmes. Data were collected by an e-mail survey to all chief nursing officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarise survey responses and evaluate relationships between some variables. Organisational strategies that support implementation of a pressure ulcer prevention programme (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalised within individual hospitals. Organisational strategies to support implementation of pressure ulcer preventive programmes are often not optimally operationalised to achieve consistent, sustainable performance. The results of the present study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Association between Organizational Capacity and Involvement in Chronic Disease Prevention Programming among Canadian Public Health Organizations

ERIC Educational Resources Information Center

Hanusaik, Nancy; Sabiston, Catherine M.; Kishchuk, Natalie; Maximova, Katerina; O'Loughlin, Jennifer

2015-01-01

In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement…

Denmark's National Family Guidance Program: A Preventive Mental Health Program for Children and Families.

ERIC Educational Resources Information Center

Wagner, Marsden

This document describes Denmark's 10-year (1965-75) program of cost-effective provision of social services to crisis families with children under the Danish 1964 Child and Youth Welfare Act. The program, voluntary and open to all families, provided preventive psychosocial services for children based on a family support system. The background to…

Global tobacco prevention and control in relation to a cardiovascular health promotion and disease prevention framework: A narrative review.

PubMed

Carroll, Allison J; Labarthe, Darwin R; Huffman, Mark D; Hitsman, Brian

2016-12-01

The purpose of this review is to emphasize the role of tobacco prevention and control in cardiovascular health (CVH) promotion and cardiovascular disease (CVD) prevention, including the importance of these endpoints for measuring the full impact of tobacco-related policies, programs, and practices. In this review, we describe an overview of tobacco control interventions that have led to substantial declines in tobacco use and the relationship between these declines with CVH and CVD. We review interventions that have had success in high-income countries (HICs) as well as those that are gaining traction in low- and middle-income countries (LMICs). We emphasize the challenges to comprehensive tobacco prevention and control strategies faced by LMICs, and highlight the special role of cardiovascular health professionals in achieving CVH promotion and CVD prevention endpoints through tobacco control. Tobacco prevention and control strategies have a strong scientific basis, yet a distinct gap remains between this evidence and implementation of tobacco control policies, particularly in LMICs. Health professionals can contribute to tobacco control efforts, especially through patient-level clinical interventions, when supported by a health care system and government that recognize and support tobacco control as a critical strategy for CVH promotion and CVD prevention. Understanding, supporting, and applying current and evolving policies, programs, and practices in tobacco prevention and control is the province of all health professionals, especially those concerned with CVH promotion and CVD prevention. A new tobacco control roadmap from the World Heart Federation provides a strong impetus to the needed interdisciplinary collaboration. Copyright © 2016 Elsevier Inc. All rights reserved.

Global tobacco prevention and control in relation to a cardiovascular health promotion and disease prevention framework: A narrative review

PubMed Central

Carroll, Allison J.; Labarthe, Darwin R.; Huffman, Mark D.; Hitsman, Brian

2016-01-01

The purpose of this review is to emphasize the role of tobacco prevention and control in cardiovascular health (CVH) promotion and cardiovascular disease (CVD) prevention, including the importance of these endpoints for measuring the full impact of tobacco-related policies, programs, and practices. In this review, we describe an overview of tobacco control interventions that have led to substantial declines in tobacco use and the relationship between these declines with CVH and CVD. We review interventions that have had success in high-income countries (HICs) as well as those that are gaining traction in low- and middle-income countries (LMICs). We emphasize the challenges to comprehensive tobacco prevention and control strategies faced by LMICs, and highlight the special role of cardiovascular health professionals in achieving CVH promotion and CVD prevention endpoints through tobacco control. Tobacco prevention and control strategies have a strong scientific basis, yet a distinct gap remains between this evidence and implementation of tobacco control policies, particularly in LMICs. Health professionals can contribute to tobacco control efforts, especially through patient-level clinical interventions, when supported by a health care system and government that recognize and support tobacco control as a critical strategy for CVH promotion and CVD prevention. Understanding, supporting, and applying current and evolving policies, programs, and practices in tobacco prevention and control is the province of all health professionals, especially those concerned with CVH promotion and CVD prevention. A new tobacco control roadmap from the World Heart Federation provides a strong impetus to the needed interdisciplinary collaboration. PMID:27717667

Analysis of alternatives for using cable bolts as primary support at two low-seam coal mines

PubMed Central

Esterhuizen, Gabriel S.; Tulu, Ihsan B.

2016-01-01

Cable bolts are sometimes used in low-seam coal mines to provide support in difficult ground conditions. This paper describes cable bolting solutions at two low-seam coal mines in similar ground conditions. Both mines used support systems incorporating cable bolts as part of the primary support system. Two original cable bolt based support systems as well as two modified systems are evaluated to estimate their ability to prevent large roof falls. One of the support systems incorporated passive cable bolts, while the other used pre-tensioned cable bolts. The results and experience at the mines showed that the modified systems provided improved stability over the original support systems. The presence of the cable bolts is the most important contribution to stability against large roof falls, rather than the details of the support pattern. It was also found that a heavy steel channel can improve the safety of the system because of the ‘sling’ action it provides. Additionally, the analysis showed that fully-grouted rebar bolts load much earlier than the cable bolts, and pre-tensioning of the cable bolts can result in a more uniform distribution of loading in the roof. PMID:27722019

Assessing missed opportunities for the prevention of mother-to-child HIV transmission in an Eastern Cape local service area.

PubMed

Rispel, L C; Peltzer, K; Phaswana-Mafuya, N; Metcalf, C A; Treger, L

2009-03-01

Prevention of new HIV infections is a critical imperative for South Africa; the prevention of mother-to-child transmission (PMTCT) is one of the most efficacious HIV prevention interventions. Assessment of a PMTCT programme to determine missed opportunities. The Kouga local service area (LSA), bordering Nelson Mandela Bay Municipality (Port Elizabeth) in the Eastern Cape. An assessment was conducted in 2007 before implementing technical support for strengthening the PMTCT programme, including: interviews with 20 PMTCT managers, 4 maternity staff and 27 other health workers on service provision, management, infrastructure, human resources and the health information system; 296 antenatal clinic users on their service perceptions; 70 HIV-positive women on HIV knowledge, infant feeding, coping, support and service perceptions; 8 representatives from community organisations and 101 traditional health practitioners (THPs). Observations were conducted during site visits to health facilities, and the District Health Information System (DHIS) data were reviewed. Staff had high levels of awareness of HIV policies and most had received some relevant training. Nevirapine uptake varied by clinic, with an average of 56%. There were many missed opportunities for PMTCT, with 67% of pregnant women tested for HIV and only 43% of antenatal care attendees tested during a previous pregnancy. Only 6% of HIV-positive women reported support group participation. Reducing missed opportunities for PMTCT requires strengthening of the formal health sector, intersectoral liaison, and greater community support. Priority areas that require strengthening in the formal health sector include HIV counselling and testing; family planning and nutrition counselling; infant follow-up; human resources; and monitoring and evaluation.

The Use of Automated SNOMED CT Clinical Coding in Clinical Decision Support Systems for Preventive Care.

PubMed

Al-Hablani, Bader

2017-01-01

The objective of this study is to discuss and analyze the use of automated SNOMED CT clinical coding in clinical decision support systems (CDSSs) for preventive care. The central question that this study seeks to answer is whether the utilization of SNOMED CT in CDSSs can improve preventive care. PubMed, Google Scholar, and Cochrane Library were searched for articles published in English between 2001 and 2012 on SNOMED CT, CDSS, and preventive care. Outcome measures were the sensitivity or specificity of SNOMED CT coded data and the positive predictive value or negative predictive value of SNOMED CT coded data. Additionally, we documented the publication year, research question, study design, results, and conclusions of these studies. The reviewed studies suggested that SNOMED CT successfully represents clinical terms and negated clinical terms. The use of SNOMED CT in CDSS can be considered to provide an answer to the problem of medical errors as well as for preventive care in general. Enhancement of the modifiers and synonyms found in SNOMED CT will be necessary to improve the expected outcome of the integration of SNOMED CT with CDSS. Moreover, the application of the tree-augmented naïve (TAN) Bayesian network method can be considered the best technique to search SNOMED CT data and, consequently, to help improve preventive health services.

The Use of Automated SNOMED CT Clinical Coding in Clinical Decision Support Systems for Preventive Care

PubMed Central

Al-Hablani, Bader

2017-01-01

Objective The objective of this study is to discuss and analyze the use of automated SNOMED CT clinical coding in clinical decision support systems (CDSSs) for preventive care. The central question that this study seeks to answer is whether the utilization of SNOMED CT in CDSSs can improve preventive care. Method PubMed, Google Scholar, and Cochrane Library were searched for articles published in English between 2001 and 2012 on SNOMED CT, CDSS, and preventive care. Outcome Measures Outcome measures were the sensitivity or specificity of SNOMED CT coded data and the positive predictive value or negative predictive value of SNOMED CT coded data. Additionally, we documented the publication year, research question, study design, results, and conclusions of these studies. Results The reviewed studies suggested that SNOMED CT successfully represents clinical terms and negated clinical terms. Conclusion The use of SNOMED CT in CDSS can be considered to provide an answer to the problem of medical errors as well as for preventive care in general. Enhancement of the modifiers and synonyms found in SNOMED CT will be necessary to improve the expected outcome of the integration of SNOMED CT with CDSS. Moreover, the application of the tree-augmented naïve (TAN) Bayesian network method can be considered the best technique to search SNOMED CT data and, consequently, to help improve preventive health services. PMID:28566995

Lynx: Automatic Elderly Behavior Prediction in Home Telecare

PubMed Central

Lopez-Guede, Jose Manuel; Moreno-Fernandez-de-Leceta, Aitor; Martinez-Garcia, Alexeiw; Graña, Manuel

2015-01-01

This paper introduces Lynx, an intelligent system for personal safety at home environments, oriented to elderly people living independently, which encompasses a decision support machine for automatic home risk prevention, tested in real-life environments to respond to real time situations. The automatic system described in this paper prevents such risks by an advanced analytic methods supported by an expert knowledge system. It is minimally intrusive, using plug-and-play sensors and machine learning algorithms to learn the elder's daily activity taking into account even his health records. If the system detects that something unusual happens (in a wide sense) or if something is wrong relative to the user's health habits or medical recommendations, it sends at real-time alarm to the family, care center, or medical agents, without human intervention. The system feeds on information from sensors deployed in the home and knowledge of subject physical activities, which can be collected by mobile applications and enriched by personalized health information from clinical reports encoded in the system. The system usability and reliability have been tested in real-life conditions, with an accuracy larger than 81%. PMID:26783514

Lynx: Automatic Elderly Behavior Prediction in Home Telecare.

PubMed

Lopez-Guede, Jose Manuel; Moreno-Fernandez-de-Leceta, Aitor; Martinez-Garcia, Alexeiw; Graña, Manuel

2015-01-01

This paper introduces Lynx, an intelligent system for personal safety at home environments, oriented to elderly people living independently, which encompasses a decision support machine for automatic home risk prevention, tested in real-life environments to respond to real time situations. The automatic system described in this paper prevents such risks by an advanced analytic methods supported by an expert knowledge system. It is minimally intrusive, using plug-and-play sensors and machine learning algorithms to learn the elder's daily activity taking into account even his health records. If the system detects that something unusual happens (in a wide sense) or if something is wrong relative to the user's health habits or medical recommendations, it sends at real-time alarm to the family, care center, or medical agents, without human intervention. The system feeds on information from sensors deployed in the home and knowledge of subject physical activities, which can be collected by mobile applications and enriched by personalized health information from clinical reports encoded in the system. The system usability and reliability have been tested in real-life conditions, with an accuracy larger than 81%.

Water Recovery System Design to Accommodate Dormant Periods for Manned Missions

NASA Technical Reports Server (NTRS)

Tabb, David; Carter, Layne

2015-01-01

Future manned missions beyond lower Earth orbit may include intermittent periods of extended dormancy. Under the NASA Advanced Exploration System (AES) project, NASA personnel evaluated the viability of the ISS Water Recovery System (WRS) to support such a mission. The mission requirement includes the capability for life support systems to support crew activity, followed by a dormant period of up to one year, and subsequently for the life support systems to come back online for additional crewed missions. Dormancy could be a critical issue due to concerns with microbial growth or chemical degradation that might prevent water systems from operating properly when the crewed mission began. As such, it is critical that the water systems be designed to accommodate this dormant period. This paper details the results of this evaluation, which include identification of dormancy issues, results of testing performed to assess microbial stability of pretreated urine during dormancy periods, and concepts for updating to the WRS architecture and operational concepts that will enable the ISS WRS to support the dormancy requirement.

Contributing Factors to Driver's Over-trust in a Driving Support System for Workload Reduction

NASA Astrophysics Data System (ADS)

Itoh, Makoto

Avoiding over-trust in machines is a vital issue in order to establish intelligent driver support systems. It is necessary to distinguish systems for workload reduction from systems for accident prevention/mitigation. This study focuses on over-trust in an Adaptive Cruise Control (ACC) system as a typical driving support system for workload reduction. By conducting an experiment, we obtained a case in which a driver trusted the ACC system too much. Concretely speaking, the driver just watched the ACC system crashing into a stopped car even though the ACC system was designed to ignore such stopped cars. This paper investigates possible contributing factors to the driver' s over-trust in the ACC system. The results suggest that emerging trust in the dimension of performance may cause over-trust in the dimension of method or purpose.

Cardiovascular Disease Prevention and Health Promotion with the Transcendental Meditation Program and Maharishi Consciousness-Based Health Care

PubMed Central

Schneider, Robert H.; Walton, Kenneth G.; Salerno, John W.; Nidich, Sanford I.

2008-01-01

This article summarizes the background, rationale, and clinical research on a traditional system of natural health care that may be useful in the prevention of cardiovascular disease (CVD) and promotion of health. Results recently reported indude reductions in blood pressure, psychosocial stress, surrogate markers for atherosclerotic CVD, and mortality. The randomized clinical trials conducted so far have involved applications to both primary and secondary prevention as well as to health promotion more generally. The results support the applicability of this approach for reducing ethnic health disparities associated with environmental and psychosocial stress. Proposed mechanisms for the effects of this traditional system include enhanced resistance to physiological and psychological stress and improvements in homeostatic and self-repair processes. This system may offer clinical and cost effectiveness advantages for health care, particularly in preventive cardiology. PMID:16938913

Toward the Modularization of Decision Support Systems

NASA Astrophysics Data System (ADS)

Raskin, R. G.

2009-12-01

Decision support systems are typically developed entirely from scratch without the use of modular components. This “stovepiped” approach is inefficient and costly because it prevents a developer from leveraging the data, models, tools, and services of other developers. Even when a decision support component is made available, it is difficult to know what problem it solves, how it relates to other components, or even that the component exists, The Spatial Decision Support (SDS) Consortium was formed in 2008 to organize the body of knowledge in SDS within a common portal. The portal identifies the canonical steps in the decision process and enables decision support components to be registered, categorized, and searched. This presentation describes how a decision support system can be assembled from modular models, data, tools and services, based on the needs of the Earth science application.

Family members facilitating community re-integration and return to productivity following traumatic brain injury - motivations, roles and challenges.

PubMed

Gagnon, Alicia; Lin, Jenny; Stergiou-Kita, Mary

2016-01-01

This study explores the experiences of family members in supporting community re-integration and return to productive occupations of the traumatic brain injury (TBI) survivor in order to: (i) describe family members' supportive roles, (ii) determine challenges family members experience in supporting the TBI survivor; and (iii) identify supports that family members require to maintain and enhance their roles. This qualitative descriptive study involved 14 interviews with immediate family members of TBI survivors. Data was analyzed using thematic analysis. Family members expressed strong motivation and engaged in six key roles to support TBI survivors: researcher, case manager, advocate, coach, activities of daily living (ADL)/instrumental ADLs and emotional supporter. Personal and family stressors and challenges navigating the health care system were perceived as challenges in meeting demands of their supportive roles. Stigma also presented a barrier to successful community and vocational re-integration. Subsequently, family members desired more education related to the functional implications of TBI, to be connected to health care and community resources, and sought a greater family-centred care approach. Family members require on-going counseling and community supports to prevent burnout and allow for their continued engagement in their supportive roles. Further education on how to navigate the health care system, access community programs and rights to workplace accommodation is also warranted. Family members are strongly motivated to support survivors' return to productive occupation following a traumatic brain injury, but require counseling and community support to enable their on-going engagement and prevent burnout. Family members can be further empowered through the implementation of family-centred care. Family members requested further education on the long-term functional implications of TBI, how to navigate the health care system, how to access community programs and workers' rights to workplace accommodations.

Rheumatologist and Primary Care Management of Cardiovascular Disease Risk in Rheumatoid Arthritis: Patient and Provider Perspectives.

PubMed

Bartels, Christie M; Roberts, Tonya J; Hansen, Karen E; Jacobs, Elizabeth A; Gilmore, Andrea; Maxcy, Courtney; Bowers, Barbara J

2016-04-01

Despite increased cardiovascular disease (CVD) risk, rheumatoid arthritis (RA) patients often lack CVD preventive care. We examined CVD preventive care processes from RA patient and provider perspectives to develop a process map for identifying targets for future interventions to improve CVD preventive care. Thirty-one participants (15 patients, 7 rheumatologists, and 9 primary care physicians [PCPs]) participated in interviews that were coded using NVivo software and analyzed using grounded theory techniques. Patients and providers reported that receipt of preventive care depends upon identifying and acting on risk factors, although most noted that both processes rarely occurred. Engagement in these processes was influenced by various provider-, system-, visit-, and patient-related conditions, such as patient activation or patients' knowledge about their risk. While nearly half of patients and PCPs were unaware of RA-CVD risk, all rheumatologists were aware of risk. Rheumatologists reported not systematically identifying risk factors, or, if identified, they described communicating about CVD risk factors via clinic notes to PCPs instead of acting directly due to perceived role boundaries. PCPs suggested that scheduling PCP visits could improve CVD risk management, and all participants viewed comanagement positively. Findings from this study illustrate important gaps and opportunities to support identifying and acting on CVD risk factors in RA patients from the provider, system, visit, and patient levels. Future work should investigate professional role support through improved guidelines, patient activation, and system-based RA-CVD preventive care strategies. © 2016, American College of Rheumatology.

Preventing work-related stress among staff working in children's cancer Principal Treatment Centres in the UK: a brief survey of staff support systems and practices.

PubMed

Beresford, B; Gibson, F; Bayliss, J; Mukherjee, S

2018-03-01

Growing evidence of the association between health professionals' well-being and patient and organisational outcomes points to the need for effective staff support. This paper reports a brief survey of the UK's children's cancer Principal Treatment Centres (PTCs) regarding staff support systems and practices. A short on-line questionnaire, administered in 2012-2013, collected information about the availability of staff support interventions which seek to prevent work-related stress among different members of the multi-disciplinary team (MDT). It was completed by a member of staff with, where required, assistance from colleagues. All PTCs (n = 19) participated. Debriefs following a patient death was the most frequently reported staff support practice. Support groups were infrequently mentioned. There was wide variability between PTCs, and between professional groups, regarding the number and type of interventions available. Doctors appear to be least likely to have access to support. A few Centres routinely addressed work-related stress in wider staff management strategies. Two Centres had developed a bespoke intervention. Very few Centres were reported to actively raise awareness of support available from their hospital's Occupational Health department. A minority of PTCs had expert input regarding staff support from clinical psychology/liaison psychiatry. © 2016 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

Interprofessional Clinical Rounding: Effects on Processes and Outcomes of Care.

PubMed

Ashcraft, Susan; Bordelon, Curry; Fells, Sheila; George, Vera; Thombley, Karen; Shirey, Maria R

Communication breakdown is viewed as a significant contributor to preventable patient harm. Interprofessional rounding (IPR) is one method of communication supporting the evidenced-based care delivery. The purpose of this paper is to explore the benefits of IPR for patients, clinicians, and the healthcare system. Interprofessional rounding supports collaboration, discussion, and timely intervention to prevent miscommunication leading to adverse patient events. Adherence to evidence-based care suggests a positive impact on patient, process, and financial outcomes. Statistically significant IPR-related improvements are seen in reducing mortality, lengths of stay, medication errors, and hospitalization costs as well as improved staff and patient satisfaction. One IPR-related gap in the literature is integrative care delivery, a strategy that provides a unified plan to meet the complex needs of patients and produce optimal outcomes. Activation and standardization with active participation in IPR support a collaborative integration of care. Embracing IPR and advocating for collaboration across the care continuum is a crucial process in preventing adverse events. Integrated care delivery through IPR provides a unified plan to meet the complex needs of patients, prevent harm, and produce best possible outcomes.

Reducing Risk with Clinical Decision Support

PubMed Central

Maloney, F.L.; Feblowitz, J.; Samal, L.; Sato, L.; Wright, A.

2014-01-01

Summary Objective Identify clinical opportunities to intervene to prevent a malpractice event and determine the proportion of malpractice claims potentially preventable by clinical decision support (CDS). Materials and Methods Cross-sectional review of closed malpractice claims over seven years from one malpractice insurance company and seven hospitals in the Boston area. For each event, clinical opportunities to intervene to avert the malpractice event and the presence or absence of CDS that might have a role in preventing the event, were assigned by a panel of expert raters. Compensation paid out to resolve a claim (indemnity), was associated with each CDS type. Results Of the 477 closed malpractice cases, 359 (75.3%) were categorized as substantiated and 195 (54%) had at least one opportunity to intervene. Common opportunities to intervene related to performance of procedure, diagnosis, and fall prevention. We identified at least one CDS type for 63% of substantiated claims. The 41 CDS types identified included clinically significant test result alerting, diagnostic decision support and electronic tracking of instruments. Cases with at least one associated intervention accounted for $40.3 million (58.9%) of indemnity. Discussion CDS systems and other forms of health information technology (HIT) are expected to improve quality of care, but their potential to mitigate risk had not previously been quantified. Our results suggest that, in addition to their known benefits for quality and safety, CDS systems within HIT have a potential role in decreasing malpractice payments. Conclusion More than half of malpractice events and over $40 million of indemnity were potentially preventable with CDS. PMID:25298814

Structural factors in HIV prevention: concepts, examples, and implications for research.

PubMed

Sumartojo, E

2000-06-01

HIV-prevention behavior is affected by the environment as well as by characteristics of individuals at risk. HIV-related structural factors are defined as barriers to, or facilitators of, an individual's HIV prevention behaviors; they may relate to economic, social, policy, organizational or other aspects of the environment. A relatively small number of intervention studies demonstrates the potential of structural interventions to increase HIV prevention in the United States and internationally. The promise of structural interventions has also been shown in studies of interventions to prevent disease or promote public health in areas other than HIV. Frameworks help define and exemplify structural barriers and facilitators for HIV prevention. One framework developed at Centers for Disease Control and Prevention gives examples of structural facilitators in terms of the economic resources, policy supports, societal attitudes, and organizational structures and functions associated with governments, service organizations, businesses, workforce organizations, faith communities, justice systems, media organizations, educational systems, and healthcare systems. Frameworks should assist researchers and health officials to identify important areas for structural research and programming. A structural approach is timely and innovative. Despite limitations, including the challenge of a new perspective on prevention and the difficulty of evaluating their effects, researchers and public health officials are urged to pursue structural interventions to prevent HIV.

An Integrated Framework For The Prevention And Treatment Of Obesity And Its Related Chronic Diseases.

PubMed

Dietz, William H; Solomon, Loel S; Pronk, Nico; Ziegenhorn, Sarah K; Standish, Marion; Longjohn, Matt M; Fukuzawa, David D; Eneli, Ihuoma U; Loy, Lisel; Muth, Natalie D; Sanchez, Eduardo J; Bogard, Jenny; Bradley, Don W

2015-09-01

Improved patient experience, population health, and reduced cost of care for patients with obesity and other chronic diseases will not be achieved by clinical interventions alone. We offer here a new iteration of the Chronic Care Model that integrates clinical and community systems to address chronic diseases. Obesity contributes substantially to cardiovascular disease, type 2 diabetes mellitus, and cancer. Dietary and physical activity interventions will prevent, mitigate, and treat obesity and its related diseases. Challenges with the implementation of this model include provider training, the need to provide incentives for health systems to move beyond clinical care to link with community systems, and addressing the multiple elements necessary for integration within clinical care and with social systems. The Affordable Care Act, with its emphasis on prevention and new systems for care delivery, provides support for innovative strategies such as those proposed here. Project HOPE—The People-to-People Health Foundation, Inc.

Return on investment for vendor computerized physician order entry in four community hospitals: the importance of decision support.

PubMed

Zimlichman, Eyal; Keohane, Carol; Franz, Calvin; Everett, Wendy L; Seger, Diane L; Yoon, Catherine; Leung, Alexander A; Cadet, Bismarck; Coffey, Michael; Kaufman, Nathan E; Bates, David W

2013-07-01

In-hospital adverse events are a major cause of morbidity and mortality and represent a major cost burden to health care systems. A study was conducted to evaluate the return on investment (ROI) for the adoption of vendor-developed computerized physician oder entry (CPOE) systems in four community hospitals in Massachusetts. Of the four hospitals, two were under one management structure and implemented the same vendor-developed CPOE system (Hospital Group A), while the other two were under a second management structure and implemented another vendor-developed CPOE system (Hospital Group B). Cost savings were calculated on the basis of reduction in preventable adverse drug event (ADE) rates as measured previously. ROI, net cash flow, and the breakeven point during a 10-year cost-and-benefit model were calculated. At the time of the study, none of the participating hospitals had implemented more than a rudimentary decision support system together with CPOE. Implementation costs were lower for Hospital Group A than B ($7,130,894 total or $83/admission versus $19,293,379 total or $113/admission, respectively), as were preventable ADE-related avoided costs ($7,937,651 and $16,557,056, respectively). A cost-benefit analysis demonstrated that Hospital Group A had an ROI of 11.3%, breaking even on the investment eight years following implementation. Hospital Group B showed a negative return, with an ROI of -3.1%. Adoption of vendor CPOE systems in community hospitals was associated with a modest ROI at best when applying cost savings attributable to prevention of ADEs only. The modest financial returns can beattributed to the lack of clinical decision support tools.

Role of the Renin–Angiotensin System in the Pathogenesis of Intimal Hyperplasia: Therapeutic Potential for Prevention of Vein Graft Failure?

PubMed Central

Osgood, Michael J.; Harrison, David G.; Sexton, Kevin W.; Hocking, Kyle M.; Voskresensky, Igor V.; Komalavilas, Padmini; Cheung-Flynn, Joyce; Guzman, Raul J.; Brophy, Colleen M.

2014-01-01

The saphenous vein remains the most widely used conduit for peripheral and coronary revascularization despite a high rate of vein graft failure. The most common cause of vein graft failure is intimal hyperplasia. No agents have been proven to be successful for the prevention of intimal hyperplasia in human subjects. The rennin–angiotensin system is essential in the regulation of vascular tone and blood pressure in physiologic conditions. However, this system mediates cardiovascular remodeling in pathophysiologic states. Angiotensin II is becoming increasingly recognized as a potential mediator of intimal hyperplasia. Drugs modulating the renin–angiotensin system include angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. These drugs are powerful inhibitors of atherosclerosis and cardiovascular remodeling, and they are first-line agents for management of several medical conditions based on class I evidence that they delay progression of cardiovascular disease and improve survival. Several experimental models have demonstrated that these agents are capable of inhibiting intimal hyperplasia. However, there are no data supporting their role in prevention of intimal hyperplasia in patients with vein grafts. This review summarizes the physiology of the rennin–angiotensin system, the role of angiotensin II in the pathogenesis of cardiovascular remodeling, the medical indications for these agents, and the experimental data supporting an important role of the rennin–angiotensin system in the pathogenesis of intimal hyperplasia. PMID:22445245

Space Station Freedom ECLSS: A step toward autonomous regenerative life support systems

NASA Technical Reports Server (NTRS)

Dewberry, Brandon S.

1990-01-01

The Environmental Control and Life Support System (ECLSS) is a Freedom Station distributed system with inherent applicability to extensive automation primarily due to its comparatively long control system latencies. These allow longer contemplation times in which to form a more intelligent control strategy and to prevent and diagnose faults. The regenerative nature of the Space Station Freedom ECLSS will contribute closed loop complexities never before encountered in life support systems. A study to determine ECLSS automation approaches has been completed. The ECLSS baseline software and system processes could be augmented with more advanced fault management and regenerative control systems for a more autonomous evolutionary system, as well as serving as a firm foundation for future regenerative life support systems. Emerging advanced software technology and tools can be successfully applied to fault management, but a fully automated life support system will require research and development of regenerative control systems and models. The baseline Environmental Control and Life Support System utilizes ground tests in development of batch chemical and microbial control processes. Long duration regenerative life support systems will require more active chemical and microbial feedback control systems which, in turn, will require advancements in regenerative life support models and tools. These models can be verified using ground and on orbit life support test and operational data, and used in the engineering analysis of proposed intelligent instrumentation feedback and flexible process control technologies for future autonomous regenerative life support systems, including the evolutionary Space Station Freedom ECLSS.

Designing System Reforms: Using a Systems Approach to Translate Incident Analyses into Prevention Strategies

PubMed Central

Goode, Natassia; Read, Gemma J. M.; van Mulken, Michelle R. H.; Clacy, Amanda; Salmon, Paul M.

2016-01-01

Advocates of systems thinking approaches argue that accident prevention strategies should focus on reforming the system rather than on fixing the “broken components.” However, little guidance exists on how organizations can translate incident data into prevention strategies that address the systemic causes of accidents. This article describes and evaluates a series of systems thinking prevention strategies that were designed in response to the analysis of multiple incidents. The study was undertaken in the led outdoor activity (LOA) sector in Australia, which delivers supervised or instructed outdoor activities such as canyoning, sea kayaking, rock climbing and camping. The design process involved workshops with practitioners, and focussed on incident data analyzed using Rasmussen's AcciMap technique. A series of reflection points based on the systemic causes of accidents was used to guide the design process, and the AcciMap technique was used to represent the prevention strategies and the relationships between them, leading to the creation of PreventiMaps. An evaluation of the PreventiMaps revealed that all of them incorporated the core principles of the systems thinking approach and many proposed prevention strategies for improving vertical integration across the LOA system. However, the majority failed to address the migration of work practices and the erosion of risk controls. Overall, the findings suggest that the design process was partially successful in helping practitioners to translate incident data into prevention strategies that addressed the systemic causes of accidents; refinement of the design process is required to focus practitioners more on designing monitoring and feedback mechanisms to support decisions at the higher levels of the system. PMID:28066296

Spinal Stenosis

MedlinePlus

... neurosurgeons, who treat diseases of the nervous system. Orthopedic surgeons, who treat problems with the bones, joints, ... and Musculoskeletal and Skin Diseases is to support research into the causes, treatment, and prevention of arthritis ...

Persuasive user experiences of a health Behavior Change Support System: A 12-month study for prevention of metabolic syndrome.

PubMed

Karppinen, Pasi; Oinas-Kukkonen, Harri; Alahäivälä, Tuomas; Jokelainen, Terhi; Keränen, Anna-Maria; Salonurmi, Tuire; Savolainen, Markku

2016-12-01

Obesity has become a severe health problem in the world. Even a moderate 5% weight loss can significantly reduce the prevalence of metabolic syndrome, which can be vital for preventing comorbidities caused by the obesity. Health Behavior Change Support Systems (hBCSS) emphasize an autogenous approach, where an individual uses the system to influence one's own attitude or behavior to achieve his or her own goal. Regardless of promising results, such health interventions technology has often been considered merely as a tool for delivering content that has no effect or value of its own. More research on actual system features is required. The objective of this study is to describe how users perceive persuasive software features designed and implemented into a support system. The research medium in this study is a web-based information system designed as a lifestyle intervention for participants who are at risk of developing a metabolic syndrome or who are already suffering from it. The system was designed closely following the principles of the Persuasive Systems Design (PSD) model and the Behavior Change Support Systems (BCSS) framework. A total of 43 system users were interviewed for this study during and after a 52 week intervention period. In addition, the system's login data and subjects' Body Mass Index (BMI) measures were used to interpret the results. This study explains in detail how the users perceived using the system and its persuasive features. Self-monitoring, reminders, and tunneling were perceived as especially beneficial persuasive features. The need for social support appeared to grow along the duration of the intervention. Unobtrusiveness was found to be very important in all stages of the intervention rather than only at the beginning. Persuasive software features have power to affect individuals' health behaviors. Through their systematicity the PSD model and the BCSS framework provide effective support for the design and development of technological health interventions. Designers of such systems may choose, for instance, to implement more self-monitoring tools to help individuals to adjust their personal goals with the system's offerings better. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Implementing Schoolwide Positive Behavior Support in High School Settings: Analysis of Eight High Schools

ERIC Educational Resources Information Center

Flannery, K. Brigid; Frank, Jennifer L.; Kato, Mimi McGrath; Doren, Bonnie; Fenning, Pamela

2013-01-01

Schoolwide positive behavior support (SWPBS) is a systems-level intervention designed to prevent the occurrence of problem behavior and increase social competence. A growing body of research documents that SWPBS reduces problem behavior and improves academics (e.g., McIntosh, Chard, Boland, & Horner, 2006), yet documentation of the feasibility…

US Army Proposed Automatic Test Equipment Software Development and Support Facility.

DTIC Science & Technology

1982-10-29

programs would be prepared as weapon and prime system operating software. The ATE Software Development and Support Facility will help prevent the TPS...ONE AS A STANDARD **Partially being Developed (2) UNDER DEVELOP- by Navy CSS Prgram MENT (3) NEEDS TAILOR- (5) NEEDS ING FOR ARMY DEVELOPMENT A- 2

Going the Extra Mile: Supporting Distance Education at University of Alaska Fairbanks

ERIC Educational Resources Information Center

Hahn, Suzan; Lehman, Lisa; Dupras, Rheba

2007-01-01

The Elmer E. Rasmuson Library at the University of Alaska Fairbanks has a long history of supporting distance education through state-of-the-art, remote access services. Harsh climate conditions (heavy snowfall and icing, high winds, and extreme temperatures), rugged terrain, limited road and telephone systems, and permafrost that prevents the…

A Review Of Innovative International Financing Mechanisms To Address Noncommunicable Diseases.

PubMed

Meghani, Ankita; Basu, Sanjay

2015-09-01

Noncommunicable diseases have become prevalent in low- and middle-income countries. A key question that remains unresolved is how to support the development of systems to prevent and treat noncommunicable disease through international financing mechanisms. We conducted a review of articles and grey literature published from 2000 through 2014 on innovative financing models proposed or used for other disease control efforts. We found that the greatest available evidence supported pooled funding models, where funding from multiple groups is combined for a specific investment, with such models previously deployed in vaccine and infectious disease funding areas. Robust evidence also supported the viability of international transactions taxes or levies placed on specific transactions to fund investments in drug procurement and supply, and of the front-loading of development aid through bond sales, particularly to stabilize funding and subsidize drug procurement. Far less compelling evidence was available to support diaspora bonds or debt reduction programs as mechanisms to aid low- and middle-income countries' health systems in financing noncommunicable disease prevention and care services. Project HOPE—The People-to-People Health Foundation, Inc.

A Preliminary Investigation into the Added Value of Multiple Gates and Informants in Universal Screening for Behavioral and Emotional Risk

ERIC Educational Resources Information Center

Dowdy, Erin; Dever, Bridget V.; Raines, Tara C.; Moffa, Kathryn

2016-01-01

Mental health screening in schools is a progressive practice to identify students for prevention and intervention services. Multiple gating procedures, in which students are provided more intensive assessments following initial identification of risk, are aligned with prevention science and poised to enhance multi-tiered systems of support. Yet,…

40 CFR 51.361 - Motorist compliance enforcement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... database, generate computerized notices, and provide regular backup to said system while maintaining auxiliary storage devices to insure ongoing operation of the system and prevent data losses; (vi) Track each... mechanism shall be supported with detailed analyses. (3) The SIP shall include the legal authority to...

Development of mHealth system for supporting self-management and remote consultation of skincare.

PubMed

Parmanto, Bambang; Pramana, Gede; Yu, Daihua X; Fairman, Andrea D; Dicianno, Brad E

2015-12-30

Individuals with spina bifida (SB) are vulnerable to chronic skin complications such as wounds on the buttocks and lower extremities. Most of these complications can be prevented with adherence to self-care routines. We have developed a mobile health (mHealth) system for supporting self-care and management of skin problems called SkinCare as part of an mHealth suite called iMHere (interactive Mobile Health and Rehabilitation). The objective of this research is to develop an innovative mHealth system to support self-skincare tasks, skin condition monitoring, adherence to self-care regimens, skincare consultation, and secure two-way communications between patients and clinicians. In order to support self-skincare tasks, the SkinCare app requires three main functions: (1) self-care task schedule and reminders, (2) skin condition monitoring and communications that include imaging, information about the skin problem, and consultation with clinician, and (3) secure two-way messaging between the patient and clinician (wellness coordinator). The SkinCare system we have developed consists of the SkinCare app, a clinician portal, and a two-way communication protocol connecting the two. The SkinCare system is one component of a more comprehensive system to support a wellness program for individuals with SB. The SkinCare app has several features that include reminders to perform daily skin checks as well as the ability to report skin breakdown and injury, which uses a combination of skin images and descriptions. The SkinCare app provides reminders to visually inspect one's skin as a preventative measure, often termed a "skin check." The data is sent to the portal where clinicians can monitor patients' conditions. Using the two-way communication, clinicians can receive pictures of the skin conditions, track progress in healing over time, and provide instructions for how to best care for the wound. The system was capable of supporting self-care and adherence to regimen, monitoring adherence, and supporting clinician engagement with patients, as well as testing its feasibility in a long-term implementation. The study shows the feasibility of a long-term implementation of skincare mHealth systems to support self-care and two-way interactions between patients and clinicians.

PEPFAR support for the scaling up of collaborative TB/HIV activities.

PubMed

Howard, Andrea A; Gasana, Michel; Getahun, Haileyesus; Harries, Anthony; Lawn, Stephen D; Miller, Bess; Nelson, Lisa; Sitienei, Joseph; Coggin, William L

2012-08-15

The US President's Emergency Plan for AIDS Relief (PEPFAR) has supported a comprehensive package of care in which interventions to address HIV-related tuberculosis (TB) have received increased funding and support in recent years. PEPFAR's TB/HIV programming is based on the World Health Organization's 12-point policy for collaborative TB/HIV activities, which are integrated into PEPFAR annual guidance. PEPFAR implementing partners have provided crucial support to TB/HIV collaboration, and as a result, PEPFAR-supported countries in sub-Saharan Africa have made significant gains in HIV testing and counseling of TB patients and linkages to HIV care and treatment, intensified TB case finding, and TB infection control. PEPFAR's support of TB/HIV integration has also included significant investment in health systems, including improved laboratory services and educating and enlarging the workforce. The scale-up of antiretroviral therapy along with support of programs to increase HIV counseling and testing and improve linkage and retention in HIV care may have considerable impact on TB morbidity and mortality, if used synergistically with isoniazid preventive therapy, intensified case finding, and infection control. Issues to be addressed by future programming include accelerating implementation of isoniazid preventive therapy, increasing access and ensuring appropriate use of new TB diagnostics, supporting early initiation of antiretroviral therapy for HIV-infected TB patients, and strengthening systems to monitor and evaluate program implementation.

Runway Incursion Prevention System ADS-B and DGPS Data Link Analysis Dallas-Fort Worth International Airport

NASA Technical Reports Server (NTRS)

Timmerman, J.; Jones, Denise R. (Technical Monitor)

2001-01-01

A Runway Incursion Prevention System (RIPS) was tested at the Dallas - Ft. Worth International Airport in October 2000. The system integrated airborne and ground components to provide both pilots and controllers with enhanced situational awareness, supplemental guidance cues, a real-time display of traffic information, and warning of runway incursions in order to prevent runway incidents while also improving operational capability. Rockwell Collins provided and supported a prototype Automatic Dependent Surveillance - Broadcast (ADS-B) system using 1090 MHz and a prototype Differential GPS (DGPS) system onboard the NASA Boeing 757 research aircraft. This report describes the Rockwell Collins contributions to the RIPS flight test, summarizes the development process, and analyzes both ADS-B and DGPS data collected during the flight test. In addition, results are report on interoperability tests conducted between the NASA Advanced General Aviation Transport Experiments (AGATE) ADS-B flight test system and the NASA Boeing 757 ADS-B system.

Opportunities and Design Considerations for Peer Support in a Hospital Setting.

PubMed

Haldar, Shefali; Mishra, Sonali R; Khelifi, Maher; Pollack, Ari H; Pratt, Wanda

2017-05-01

Although research has demonstrated improved outcomes for outpatients who receive peer support-such as through online health communities, support groups, and mentoring systems-hospitalized patients have few mechanisms to receive such valuable support. To explore the opportunities for a hospital-based peer support system, we administered a survey to 146 pediatric patients and caregivers, and conducted semi-structured interviews with twelve patients and three caregivers in a children's hospital. Our analysis revealed that hospitalized individuals need peer support for five key purposes: (1) to ask about medical details-such as procedures, treatments, and medications; (2) to learn about healthcare providers; (3) to report and prevent medical errors; (4) to exchange emotional support; and (5) to manage their time in the hospital. In this paper, we examine these themes and describe potential barriers to using a hospital-based peer support system. We then discuss the unique opportunities and challenges that the hospital environment presents when designing for peer support in this setting.

Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA.

PubMed

Bauer, Ursula E; Briss, Peter A; Goodman, Richard A; Bowman, Barbara A

2014-07-05

With non-communicable conditions accounting for nearly two-thirds of deaths worldwide, the emergence of chronic diseases as the predominant challenge to global health is undisputed. In the USA, chronic diseases are the main causes of poor health, disability, and death, and account for most of health-care expenditures. The chronic disease burden in the USA largely results from a short list of risk factors--including tobacco use, poor diet and physical inactivity (both strongly associated with obesity), excessive alcohol consumption, uncontrolled high blood pressure, and hyperlipidaemia--that can be effectively addressed for individuals and populations. Increases in the burden of chronic diseases are attributable to incidence and prevalence of leading chronic conditions and risk factors (which occur individually and in combination), and population demographics, including ageing and health disparities. To effectively and equitably address the chronic disease burden, public health and health-care systems need to deploy integrated approaches that bundle strategies and interventions, address many risk factors and conditions simultaneously, create population-wide changes, help the population subgroups most affected, and rely on implementation by many sectors, including public-private partnerships and involvement from all stakeholders. To help to meet the chronic disease burden, the US Centers for Disease Control and Prevention (CDC) uses four cross-cutting strategies: (1) epidemiology and surveillance to monitor trends and inform programmes; (2) environmental approaches that promote health and support healthy behaviours; (3) health system interventions to improve the effective use of clinical and other preventive services; and (4) community resources linked to clinical services that sustain improved management of chronic conditions. Establishment of community conditions to support healthy behaviours and promote effective management of chronic conditions will deliver healthier students to schools, healthier workers to employers and businesses, and a healthier population to the health-care system. Collectively, these four strategies will prevent the occurrence of chronic diseases, foster early detection and slow disease progression in people with chronic conditions, reduce complications, support an improved quality of life, and reduce demand on the health-care system. Of crucial importance, with strengthened collaboration between the public health and health-care sectors, the health-care system better uses prevention and early detection services, and population health is improved and sustained by solidifying collaborations between communities and health-care providers. This collaborative approach will improve health equity by building communities that promote health rather than disease, have more accessible and direct care, and focus the health-care system on improving population health. Copyright © 2014 Elsevier Ltd. All rights reserved.

Carbon recycling in materially closed ecological life support systems

NASA Technical Reports Server (NTRS)

Obenhuber, D. C.; Folsome, C. E.

1988-01-01

Results of studies are presented of materially closed energetically open microbial ecosystems or 'closed ecosystems'. These are natural marine ecosystems that have been sealed in glass containers to prevent material exchange with the environment but allow energy to pass freely through them. They represent model life support systems for the future human habitation of space. The results are discussed analytically and indicate that these ecosystems, when subjected to a constant energy flux, seem to be reliable and self-sufficient systems for recycling of biologically produced carbon compounds.

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

PubMed

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

1997-12-01

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

The implementation of knowledge dissemination in the prevention of occupational skin diseases.

PubMed

Wilke, A; Bollmann, U; Cazzaniga, S; Hübner, A; John, S M; Karadzinska-Bislimovska, J; Mijakoski, D; Šimić, D; Simon, D; Sonsmann, F; Stoleski, S; Weinert, P; Wulfhorst, B

2018-03-01

Occupational skin diseases (OSD) have a high medical, social, economic and political impact. Knowledge dissemination from research activities to key stakeholders involved in health care is a prerequisite to make prevention effective. To study and prioritize different activity fields and stakeholders that are involved in the prevention of OSD, to reflect on their inter-relationships, to develop a strategic approach for knowledge dissemination and to develop a hands-on tool for OSD prevention projects METHODS: Seven different activity fields that are relevant in the prevention of OSD have been stepwise identified. This was followed by an impact analysis. Fifty-five international OSD experts rated the impact and the influence of the activity fields for the prevention of OSD with a standardized questionnaire. Activity fields identified to have a high impact in OSD prevention are the political system, mass media and industry. The political system has a strong but more indirect effect on the general population via the educational system, local public health services or the industry. The educational system, mass media, industry and local public health services have a strong direct impact on the OSD 'at risk' worker. Finally, a hands-on tool for future OSD prevention projects has been developed that addresses knowledge dissemination and different stakeholder needs. Systematic knowledge dissemination is important to make OSD prevention more effective and to close the gap between research and practice. This study provides guidance to identify stakeholders, strategies and dissemination channels for systematic knowledge dissemination which need to be adapted to country-specific structures, for example the social security system and healthcare systems. A key for successful knowledge dissemination is building linkages among different stakeholders, building strategic partnerships and gaining their support right from the inception phase of a project. © 2017 European Academy of Dermatology and Venereology.

Cancers by Body Location/System

Cancer.gov

A list of all cancers, organized by location and/or function in the body. Cancers on the list are linked to information about treatment, supportive care, screening, prevention, clinical trials, and other topics.

49 CFR 242.203 - Retaining information supporting determinations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... integrity of the electronic data storage system, including the prevention of unauthorized access to the program logic or individual records; (2) The program and data storage system must be protected by a... making the determinations. (b) A railroad shall retain the following information: (1) Relevant data from...

49 CFR 242.203 - Retaining information supporting determinations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... integrity of the electronic data storage system, including the prevention of unauthorized access to the program logic or individual records; (2) The program and data storage system must be protected by a... making the determinations. (b) A railroad shall retain the following information: (1) Relevant data from...

49 CFR 242.203 - Retaining information supporting determinations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... integrity of the electronic data storage system, including the prevention of unauthorized access to the program logic or individual records; (2) The program and data storage system must be protected by a... making the determinations. (b) A railroad shall retain the following information: (1) Relevant data from...

Lay Social Resources for Support of Adherence to Antiretroviral Prophylaxis for HIV Prevention Among Serodiscordant Couples in sub-Saharan Africa: A Qualitative Study.

PubMed

Ware, Norma C; Pisarski, Emily E; Haberer, Jessica E; Wyatt, Monique A; Tumwesigye, Elioda; Baeten, Jared M; Celum, Connie L; Bangsberg, David R

2015-05-01

Effectiveness of antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention will require high adherence. Using qualitative data, this paper identifies potential lay social resources for support of PrEP adherence by HIV serodiscordant couples in Uganda, laying the groundwork for incorporation of these resources into adherence support initiatives as part of implementation. The qualitative analysis characterizes support for PrEP adherence provided by HIV-infected spouses, children, extended family members, and the larger community. Results suggest social resources for support of PrEP adherence in Africa are plentiful outside formal health care settings and health systems and that couples will readily use them. The same shortage of health professionals that impeded scale-up of antiretroviral treatment for HIV/AIDS in Africa promises to challenge delivery of PrEP. Building on the treatment scale-up experience, implementers can address this challenge by examining the value of lay social resources for adherence support in developing strategies for delivery of PrEP.

Investing in HIV services while building Kenya's health system: PEPFAR's support to prevent mother-to-child HIV transmission.

PubMed

Dutta, Arin; Wallace, Nathan; Savosnick, Peter; Adungosi, John; Kioko, Urbanus Mutuku; Stewart, Scott; Hijazi, Mai; Gichanga, Bedan

2012-07-01

Trade-offs may exist between investments to promote health system strengthening, such as investments in facilities and training, and the rapid scale-up of HIV/AIDS services. We analyzed trends in expenditures to support the prevention of mother-to-child transmission of HIV in Kenya under the President's Emergency Plan for AIDS Relief (PEPFAR) from 2005 to 2010. We examined how expenditures changed over time, considering health system strengthening alongside direct treatment of patients. We focused on two organizations carrying out contracts under PEPFAR: the Elizabeth Glaser Pediatric AIDS Foundation and FHI360 (formerly Family Health International), a nonprofit health and development organization. We found that the average unit expenditure, or the spending on goods and services per mother living with HIV who was provided with antiretroviral drugs, declined by 52 percent, from $567 to $271, during this time period. The unit expenditure per mother-to-infant transmission averted declined by 66 percent, from $7,117 to $2,440. Meanwhile, the health system strengthening proportion of unit expenditure increased from 12 percent to 33 percent during the same time period. The analysis suggests that PEPFAR investments in prevention of mother-to-child transmission of HIV in Kenya became more efficient over time, and that there was no strong evidence of a trade-off between scaling up services and investing in health systems.

Forum: social network for the surveillance and prevention of workplace accidents.

PubMed

Vilela, R A G; Almeida, I M; Nunes da Silva, A; Gomes, M H P; Prado, H; Buoso, E; Dias, M D; Cavalcante, S; Lacorte, L E

2012-01-01

In 2008, academic researchers and public service officials created a university extension studies platform based on online and on-site meetings denominated "Work-Related Accidents Forum: Analysis, Prevention, and Other Relevant Aspects. Its aim was to help public agents and social partners to propagate a systemic approach that would be helpful in the surveillance and prevention of work-related accidents. This article describes and analyses such a platform. Online access is free and structured to: support dissemination of updated concepts; support on-site meetings and capacity to build educational activities; and keep a permanent space for debate among the registered participants. The desired result is the propagation of a social-technical-systemic view of work-related accidents that replaces the current traditional view that emphasizes human error and results in blaming the victims. The Forum uses an educational approach known as permanent health education, which is based on the experience and needs of workers and encourages debate among participants. The forum adopts a problematizing pedagogy that starts from the requirements and experiences of the social actors and stimulates support and discussions among them in line with an ongoing health educational approach. The current challenge is to turn the platform into a social networking website in order to broaden its links with society.

Alberta's systems approach to chronic disease management and prevention utilizing the expanded chronic care model.

PubMed

Delon, Sandra; Mackinnon, Blair

2009-01-01

Alberta's integrated approach to chronic disease management programming embraces client-centred care, supports self-management and facilitates care across the continuum. This paper presents strategies implemented through collaboration with primary care to improve care of individuals with chronic conditions, evaluation evidence supporting success and lessons learned from the Alberta perspective.

Computerized clinical decision support systems for primary preventive care: a decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes.

PubMed

Souza, Nathan M; Sebaldt, Rolf J; Mackay, Jean A; Prorok, Jeanette C; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

2011-08-03

Computerized clinical decision support systems (CCDSSs) are claimed to improve processes and outcomes of primary preventive care (PPC), but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs) assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63%) RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34%) trials assessed patient outcomes, and four (29%) reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15%) and two (5%) trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Evidence supports the effectiveness of CCDSSs for screening and treatment of dyslipidaemia in primary care with less consistent evidence for CCDSSs used in screening for cancer and mental health-related conditions, vaccinations, and other preventive care. CCDSS effects on patient outcomes, safety, costs of care, and provider satisfaction remain poorly supported.

Indicators of a balanced long-term service and support system: examining the impact on individuals aging with a lifelong disability.

PubMed

Ruiz, Sarah; Urdapilleta, Oswaldo; Clark-Shirley, Leanne J; Howard, Jennifer; Poey, Judith

2012-01-01

This article explores how rebalancing efforts can support the needs of individuals aging with a lifelong disability. The National Balancing Indicator project examined the overall long-term supports and services system (LTSS) progress in five indicators within the Sustainability, Coordination and Transparency, and Prevention principles toward a balanced LTSS system for those aging with a lifelong disability. In assessing state efforts to create a balanced participant-directed LTSS system with the National Balancing Indicators, the findings suggest states are better equipping the system to handle a burgeoning population of individuals aging with a lifelong disability, but more progress is still needed. Overall, states need to continue to create a seamless system that allows individuals with lifelong disabilities to transition smoothly through the life course.

DOD can save millions by using energy efficient centralized aircraft support systems

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

Not Available

1982-05-07

The ways the Department of Defense can save millions of dollars annually by using new energy efficient centralized aircraft support systems at certain Air Force and Navy bases are discussed. The Air Force and Navy have developed and installed several different systems and have realized some degree of success. However, each service has developed its systems independently. Consequently, there is no commonality between the services' systems which could permit economical procurements for standard servicewide systems. Standardization would also prevent duplication of design efforts by the services and minimize proliferation of aircraft support equipment. It also would allow the services tomore » further reduce costs by combining requirements to assure the most economical quantities for buying system components. GAO makes specific recommendations to the Secretaries of Defense and the Air Force to develop standard systems and to install them at all bases where feasible and practical.« less

Evidence-Based Early Reading Practices within a Response to Intervention System

ERIC Educational Resources Information Center

Bursuck, Bill; Blanks, Brooke

2010-01-01

Many students who experience reading failure are inappropriately placed in special education. A promising response to reducing reading failure and the overidentification of students for special education is Response to Intervention (RTI), a comprehensive early detection and prevention system that allows teachers to identify and support struggling…

Human rights-based approach to unintentional injury prevention.

PubMed

MacKay, J Morag; Ryan, Mark Andrew

2018-06-01

Unintentional injury remains an important global public health issue, and efforts to address it are often hampered by a lack of visibility, leadership, funding, infrastructure, capacity and evidence of effective solutions. The growing support for a socioecological model and a systems approach to prevention-along with the acknowledgement that injury prevention can be a byproduct of salutogenic design and activities-has increased opportunities to integrate unintentional injury prevention into other health promotion and disease prevention agendas. It has also helped to integrate it into the broader human development agenda through the Sustainable Development Goals. This growing support provides new opportunities to use a human rights-based approach to address the issue. The human rights-based approach is based on the idea that all members of society have social, economic and cultural rights and that governments are responsible and accountable for upholding those rights. It incorporates a systems approach, addresses inequity and places an emphasis on the most vulnerable corners of humanity. It also leverages legal statutes and provides organisations with the opportunity to build existing international goals and benchmarks into their monitoring efforts. This paper describes the approach and highlights how it can leverage attention and investment to address current challenges for unintentional injury. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Smart RTI: A Next-Generation Approach to Multilevel Prevention

PubMed Central

FUCHS, DOUGLAS; FUCHS, LYNN S.; COMPTON, DONALD L.

2012-01-01

During the past decade, responsiveness to intervention (RTI) has become popular among many practitioners as a means of transforming schooling into a multilevel prevention system. Popularity aside, its successful implementation requires ambitious intent, a comprehensive structure, and coordinated service delivery. An effective RTI also depends on building-based personnel with specialized expertise at all levels of the prevention system. Most agree on both its potential for strengthening schooling and its heavy demand on practitioners. In this article, we describe Smart RTI, which we define as making efficient use of school resources while maximizing students' opportunities for success. In light of findings from recent research, we discuss three important features of Smart RTI: (a) multistage screening to identify risk, (b) multistage assessment to determine appropriate levels of instruction, and (c) a role for special education that supports prevention. PMID:22736805

[The INSuLa Project: the survey of training needs in the SPSAL(Service for Prevention and Safety in the Work Environment)].

PubMed

Martini, Agnese; Iavicoli, Sergio; Bonafede, Michela; Corso, Luca; Iosuel, Michela; Isolani, Lucia; Di Leone, Giorgio; Di Marzio, Davide; Bertazzi, Pier Alberto

2014-01-01

According to Italian Legislative Decree 81/2008 and subsequent modifications the Regions and Autonomous Provinces have a innovative and complex role: 1) to regulate and coordinate the total prevention system and 2) to develop interventions/initiatives through regional/local occupational safety and health (OSH) department using not only inspections and controls but education, training and support. Recommendations also include consolidating the role of actors involved in preventing risks to occupational health throughout occupational safety and health education and training, keys for a successful process to improve prevention system. As result of changing world of work and OSH legislation the INSuLa project has creating a national survey involving of all Italian prevention system actors, in order to evaluate implementation and impact of the actual regulations. According to overall objective of the INSuLA project, for the first time in Italy, we studied about operators in regional/local OSH department. The purpose of this paper is to show and recognize the individual learning paths, the perception of adequacy education degree, the exploring criticalities andthe training needs.

Using Mobile & Personal Sensing Technologies to Support Health Behavior Change in Everyday Life: Lessons Learned

PubMed Central

Klasnja, Predrag; Consolvo, Sunny; McDonald, David W.; Landay, James A.; Pratt, Wanda

2009-01-01

Lifestyle modification is a key facet of the prevention and management of chronic diseases. Mobile devices that people already carry provide a promising platform for facilitating these lifestyle changes. This paper describes key lessons learned from the development and evaluation of two mobile systems for encouraging physical activity. We argue that by supporting persistent cognitive activation of health goals, encouraging an extensive range of relevant healthy behaviors, focusing on long-term patterns of activity, and facilitating social support as an optional but not primary motivator, systems can be developed that effectively motivate behavior change and provide support when and where people make decisions that affect their health. PMID:20351876

General characteristics of causes of urban flood damage and flood forecasting/warning system in Seoul, Korea Young-Il Moon1, 2, Jong-Suk Kim1, 2 1 Department of Civil Engineering, University of Seoul, Seoul 130-743, South Korea 2 Urban Flood Research Inst

NASA Astrophysics Data System (ADS)

Moon, Young-Il; Kim, Jong-Suk

2015-04-01

Due to rapid urbanization and climate change, the frequency of concentrated heavy rainfall has increased, causing urban floods that result in casualties and property damage. As a consequence of natural disasters that occur annually, the cost of damage in Korea is estimated to be over two billion US dollars per year. As interest in natural disasters increase, demands for a safe national territory and efficient emergency plans are on the rise. In addition to this, as a part of the measures to cope with the increase of inland flood damage, it is necessary to build a systematic city flood prevention system that uses technology to quantify flood risk as well as flood forecast based on both rivers and inland water bodies. Despite the investment and efforts to prevent landside flood damage, research and studies of landside-river combined hydro-system is at its initial stage in Korea. Therefore, the purpose of this research introduces the causes of flood damage in Seoul and shows a flood forecasting and warning system in urban streams of Seoul. This urban flood forecasting and warning system conducts prediction on flash rain or short-term rainfall by using radar and satellite information and performs prompt and accurate prediction on the inland flooded area and also supports synthetic decision-making for prevention through real-time monitoring. Although we cannot prevent damage from typhoons or localized heavy rain, we can minimize that damage with accurate and timely forecast and a prevention system. To this end, we developed a flood forecasting and warning system, so in case of an emergency there is enough time for evacuation and disaster control. Keywords: urban flooding, flood risk, inland-river system, Korea Acknowledgments This research was supported by a grant (13AWMP-B066744-01) from Advanced Water Management Research Program (AWMP) funded by Ministry of Land, Infrastructure and Transport of Korean government.

Design and Analysis of a Flexible, Reliable Deep Space Life Support System

NASA Technical Reports Server (NTRS)

Jones, Harry W.

2012-01-01

This report describes a flexible, reliable, deep space life support system design approach that uses either storage or recycling or both together. The design goal is to provide the needed life support performance with the required ultra reliability for the minimum Equivalent System Mass (ESM). Recycling life support systems used with multiple redundancy can have sufficient reliability for deep space missions but they usually do not save mass compared to mixed storage and recycling systems. The best deep space life support system design uses water recycling with sufficient water storage to prevent loss of crew if recycling fails. Since the amount of water needed for crew survival is a small part of the total water requirement, the required amount of stored water is significantly less than the total to be consumed. Water recycling with water, oxygen, and carbon dioxide removal material storage can achieve the high reliability of full storage systems with only half the mass of full storage and with less mass than the highly redundant recycling systems needed to achieve acceptable reliability. Improved recycling systems with lower mass and higher reliability could perform better than systems using storage.

Self-management support interventions that are clinically linked and technology enabled: can they successfully prevent and treat diabetes?

PubMed

Kaufman, Neal D; Woodley, Paula D Patnoe

2011-05-01

Patients with diabetes need a complex set of services and supports. The challenge of integrating these services into the diabetes regimen can be successfully overcome through self-management support interventions that are clinically linked and technology enabled: self-management support because patients need help mastering the knowledge, attitudes, skills, and behaviors so necessary for good outcomes; interventions because comprehensive theory-based, evidence-proven, long-term, longitudinal interventions work better than direct-to-consumer or nonplanned health promotion approaches; clinically linked because patients are more likely to adopt new behaviors when the approach is in the context of a trusted therapeutic relationship and within an effective medical care system; and technology enabled because capitalizing on the amazing power of information technology leads to the delivery of cost-effective, scalable, engaging solutions that prevent and manage diabetes. © 2011 Diabetes Technology Society.

Passive control of a biventricular assist device with compliant inflow cannulae.

PubMed

Gregory, Shaun David; Pearcy, Mark John; Timms, Daniel

2012-08-01

Rotary ventricular assist device (VAD) support of the cardiovascular system is susceptible to suction events due to the limited preload sensitivity of these devices. This may be of particular concern with rotary biventricular support (BiVAD) where the native, flow balancing Starling response is diminished in both ventricles. The reliability of sensor and sensorless-based control systems which aim to control VAD flow based on preload has limitations, and, thus, an alternative solution is desired. This study introduces a compliant inflow cannula (CIC) which could improve the preload sensitivity of a rotary VAD by passively altering VAD flow depending on preload. To evaluate the design, both the CIC and a standard rigid inflow cannula were inserted into a mock circulation loop to enable biventricular heart failure support using configurations of atrial and ventricular inflow, and arterial outflow cannulation. A range of left (LVAD) and right VAD (RVAD) rotational speeds were tested as well as step changes in systemic/pulmonary vascular resistance to alter relative preloads, with resulting flow rates recorded. Simulated suction events were observed, particularly at higher VAD speeds, during support with the rigid inflow cannula, while the CIC prevented suction events under all circumstances. The compliant section passively restricted its internal diameter as preload was reduced, which increased the VAD circuit resistance and thus reduced VAD flow. Therefore, a CIC could potentially be used as a passive control system to prevent suction events in rotary left, right, and biventricular support. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Should drivers be operating within an automation-free bandwidth? Evaluating haptic steering support systems with different levels of authority.

PubMed

Petermeijer, Sebastiaan M; Abbink, David A; de Winter, Joost C F

2015-02-01

The aim of this study was to compare continuous versus bandwidth haptic steering guidance in terms of lane-keeping behavior, aftereffects, and satisfaction. An important human factors question is whether operators should be supported continuously or only when tolerance limits are exceeded. We aimed to clarify this issue for haptic steering guidance by investigating costs and benefits of both approaches in a driving simulator. Thirty-two participants drove five trials, each with a different level of haptic support: no guidance (Manual); guidance outside a 0.5-m bandwidth (Band1); a hysteresis version of Band1, which guided back to the lane center once triggered (Band2); continuous guidance (Cont); and Cont with double feedback gain (ContS). Participants performed a reaction time task while driving. Toward the end of each trial, the guidance was unexpectedly disabled to investigate aftereffects. All four guidance systems prevented large lateral errors (>0.7 m). Cont and especially ContS yielded smaller lateral errors and higher time to line crossing than Manual, Band1, and Band2. Cont and ContS yielded short-lasting aftereffects, whereas Band1 and Band2 did not. Cont yielded higher self-reported satisfaction and faster reaction times than Band1. Continuous and bandwidth guidance both prevent large driver errors. Continuous guidance yields improved performance and satisfaction over bandwidth guidance at the cost of aftereffects and variability in driver torque (indicating human-automation conflicts). The presented results are useful for designers of haptic guidance systems and support critical thinking about the costs and benefits of automation support systems.

Conflict Prevention and Separation Assurance Method in the Small Aircraft Transportation System

NASA Technical Reports Server (NTRS)

Consiglio, Maria C.; Carreno, Victor A.; Williams, Daniel M.; Munoz, Cesar

2005-01-01

A multilayer approach to the prevention of conflicts due to the loss of aircraft-to-aircraft separation which relies on procedures and on-board automation was implemented as part of the SATS HVO Concept of Operations. The multilayer system gives pilots support and guidance during the execution of normal operations and advance warning for procedure deviations or off-nominal operations. This paper describes the major concept elements of this multilayer approach to separation assurance and conflict prevention and provides the rationale for its design. All the algorithms and functionality described in this paper have been implemented in an aircraft simulation in the NASA Langley Research Center s Air Traffic Operation Lab and on the NASA Cirrus SR22 research aircraft.

Survey of surveillance systems and select prevention activities for hepatitis B and C, European Union/European Economic Area, 2009.

PubMed

Duffell, E F; van de Laar, M J

2015-04-02

Hepatitis B and C viral infections are leading causes of hepatic cirrhosis and cancer. The incidence and prevalence of both hepatitis B and C varies across European countries. European wide surveillance data help to understand the dynamic epidemiology of hepatitis B and C, which is important for the implementation and effectiveness of prevention and control activities.Comparison of surveillance data between countries in Europe is hampered by the differences in national healthcare and reporting systems. This report presents the results of a survey in 2009 which was undertaken to collect baseline information on surveillance systems and core prevention programmes for hepatitis B and C in individual European Union/ European Economic Area countries. The results provide key information to aid the interpretation of surveillance data, and while indicating heterogeneity in national surveillance systems and programmes, they highlight the potential of these systems. This resource has supported the implementation of a standardised European enhanced surveillance programme.

Strategic Communication in the System for Health

DTIC Science & Technology

2013-03-01

have borne our share of real crises and even tragedies, every day our Soldiers and their families are protected from injuries , illnesses, and...combat wounds; receive state-of-the-art treatment when prevention fails; and are supported by extraordinarily talented people.”5 And yet, while LTG...design, it “Emulates, nests, and aligns with Army Strategic Planning Guidance (ASPG) Vision and Army Campaign Plan (ACP) end state: Prevent , Shape, Win

Analysis of System Training Impact for Major Defense Acquisition Programs

DTIC Science & Technology

2011-08-01

simulation fidelity but rather were due to poor training development planning, the absence of instructional support and training features on the simulation...reduce detectability of the soldier, prevent attack if detected, prevent damage if attacked, minimize medical injury if wounded or otherwise injured, and...instance, a National Guard tank battalion that stores and maintains its tanks at a central maintenance/training facility may find it more cost

Caries Risk Assessment for Determination of Focus and Intensity of Prevention in a Dental School Clinic.

ERIC Educational Resources Information Center

Dodds, Michael W. J.; Suddick, Richard P.

1995-01-01

A study at the University of Texas, San Antonio's dental school resulted in development of a system of caries risk assessment, applied to all undergraduate clinic patients. The rationale, structure, elements, and application of the system are outlined, and course content supporting the system is noted. Need for validation and other improvements is…

Covert Action: A Systems Approach

DTIC Science & Technology

2014-12-01

consider a covert action to support rebels within the Colombian province of Panama. The objective was relatively simple: support the creation of an...prevented Colombian reinforcements from either landing ashore or transiting from Colon to Panama City. The junta declared...154 He also exerted a significant level of control over the event by immediately deploying gunboats to the port which ensured that Colombian forces

Drinking on the dirt roads of America: NACCHO's Impaired Driving Prevention in Rural Communities demonstration site project.

PubMed

Cox, Erin; Fisher, Scott

2009-01-01

The National Association of County and City Health Officials (NACCHO) is the national organization representing local health departments. It supports efforts that protect and improve the health of all people and all communities by promoting national policy, developing resources and programs, seeking health equity, and supporting effective local public health practice and systems.

A Study of the Relationship between Quality of PBIS Implementation, School Context, and Academic and Behavioral Outcomes

ERIC Educational Resources Information Center

Mier, Matthew B.

2017-01-01

Positive Behavioral Interventions and Supports (PBIS) is a framework that has been employed in schools in order to promote not only improved behavioral outcomes but academic outcomes as well. PBIS has three core elements: use of a three-tiered prevention model, application of evidence-based practices, and creation of systems to support and sustain…

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

PubMed

Gibson, S Jo

2016-03-01

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

[What Surgeons Should Know about Risk Management].

PubMed

Strametz, R; Tannheimer, M; Rall, M

2017-02-01

Background: The fact that medical treatment is associated with errors has long been recognized. Based on the principle of "first do no harm", numerous efforts have since been made to prevent such errors or limit their impact. However, recent statistics show that these measures do not sufficiently prevent grave mistakes with serious consequences. Preventable mistakes such as wrong patient or wrong site surgery still frequently occur in error statistics. Methods: Based on insight from research on human error, in due consideration of recent legislative regulations in Germany, the authors give an overview of the clinical risk management tools needed to identify risks in surgery, analyse their causes, and determine adequate measures to manage those risks depending on their relevance. The use and limitations of critical incident reporting systems (CIRS), safety checklists and crisis resource management (CRM) are highlighted. Also the rationale for IT systems to support the risk management process is addressed. Results/Conclusion: No single tool of risk management can be effective as a standalone instrument, but unfolds its effect only when embedded in a superordinate risk management system, which integrates tailor-made elements to increase patient safety into the workflows of each organisation. Competence in choosing adequate tools, effective IT systems to support the risk management process as well as leadership and commitment to constructive handling of human error are crucial components to establish a safety culture in surgery. Georg Thieme Verlag KG Stuttgart · New York.

Autonomous medical care for exploration class space missions.

PubMed

Hamilton, Douglas; Smart, Kieran; Melton, Shannon; Polk, James D; Johnson-Throop, Kathy

2008-04-01

The US-based health care system of the International Space Station contains several subsystems, the Health Maintenance System, Environmental Health System and the Countermeasure System. These systems are designed to provide primary, secondary and tertiary medical prevention strategies. The medical system deployed in low Earth orbit for the International Space Station is designed to support a "stabilize and transport" concept of operations. In this paradigm, an ill or injured crewmember would be rapidly evacuated to a definitive medical care facility (DMCF) on Earth, rather than being treated for a protracted period on orbit. The medical requirements of the short (7 day) and long duration (up to 6 months) exploration class missions to the moon are similar to low Earth orbit class missions but also include an additional 4 to 5 days needed to transport an ill or injured crewmember to a DMCF on Earth. Mars exploration class missions are quite different in that they will significantly delay or prevent the return of an ill or injured crewmember to a DMCF. In addition the limited mass, power and volume afforded to medical care will prevent the mission designers from manifesting the entire capability of terrestrial care. National Aeronautics and Space Administration has identified five levels of care as part of its approach to medical support of future missions including the Constellation program. To implement an effective medical risk mitigation strategy for exploration class missions, modifications to the current suite of space medical systems may be needed, including new crew medical officer training methods, treatment guidelines, diagnostic and therapeutic resources, and improved medical informatics.

Cancer Ward Staff Group: An Intervention Designed to Prevent Disaster.

ERIC Educational Resources Information Center

Barber, William H.

1985-01-01

Describes a case study illustrating organizational and system contingencies for introducing and maintaining a support group for oncology nursing staff in a large general hospital culture. Criteria for long-run survivability of innovation in a work system are applied to a group structured like that described by Balint for training physicians in…

An Autonomic Framework for Integrating Security and Quality of Service Support in Databases

ERIC Educational Resources Information Center

Alomari, Firas

2013-01-01

The back-end databases of multi-tiered applications are a major data security concern for enterprises. The abundance of these systems and the emergence of new and different threats require multiple and overlapping security mechanisms. Therefore, providing multiple and diverse database intrusion detection and prevention systems (IDPS) is a critical…

Ecologically Oriented School-Based Mental Health Services: Implications for Service System Reform.

ERIC Educational Resources Information Center

Motes, Patricia Stone; Melton, Gary; Simmons, Wendy E. Waithe; Pumariega, Andres

1999-01-01

Describes an integrated school-based mental health services model established in pilot schools in under-served areas of South Carolina. States the approach bridges preventive efforts across settings, and links interventions with youths and their families to changes in environments and systems. Reports that findings are supportive of a broad…

Views of policymakers, healthcare workers and NGOs on HIV pre-exposure prophylaxis (PrEP): a multinational qualitative study

PubMed Central

Eisingerich, Andreas B; Gomez, Gabriela B; Gray, Emily; Dybul, Mark R; Piot, Peter

2012-01-01

Objectives To examine policymakers and providers' views on pre-exposure prophylaxis (PrEP) and their willingness to support its introduction, to inform policy and practice in this emerging field. Design Semistructured qualitative interview study. Setting Peru, Ukraine, India, Kenya, Uganda, Botswana and South Africa. Participants 35 policymakers, 35 healthcare workers and 21 non-governmental organisation representatives involved in HIV prevention. Results Six themes emerged from the data: (1) perceived HIV prevention landscape: prevention initiatives needed to be improved and expanded; (2) PrEP awareness: 50 of 91 participants had heard of PrEP; (3) benefits of PrEP: one component of the combination prevention arsenal that could help prioritise HIV prevention, empower key populations and result in economic gains; (4) challenges of PrEP: regimen complexity, cost and cost-effectiveness, risk compensation, efficacy and effectiveness, stigmatisation and criminalisation, information and training and healthcare system capacity; (5) programmatic considerations: user eligibility, communication strategy, cost, distribution, medication and HIV testing compliance and (6) early versus late implementation: participants were divided as to whether they would support an early introduction of PrEP in their country or would prefer to wait until it has been successfully implemented in other countries, with around half of those we spoke to supporting each option. Very few said they would not support PrEP at all. Conclusions Despite the multiple challenges identified, there was general willingness to support the introduction of PrEP. Yet, strengthening existing HIV prevention efforts was also deemed necessary. Our results suggest that an effective PrEP programme would be delivered in healthcare facilities and involve non-governmental organisations and the community and consider the needs of mobile populations. Comprehensive information packages and training for users and providers would be critical. The cost of PrEP would be affordable and possibly segmented. Extensive counselling and innovative monitoring measures ought to be considered. PMID:22761288

Developing a diabetes prevention education programme for community health-care workers in Thailand: formative findings.

PubMed

Sranacharoenpong, Kitti; Hanning, Rhona M

2011-10-01

The aim of this study was to investigate barriers to and supports for implementing a diabetes prevention education programme for community health-care workers (CHCWs) in Chiang Mai province, Thailand. The study also aimed to get preliminary input into the design of a tailored diabetes prevention education programme for CHCWs. Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. As access to diabetes prevention programme is limited in Thailand, especially in rural and semi-urban areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective, and sustainable. Health-care professionals (n = 12) selected from health centres within one district participated in in-depth interviews. In addition, screened people at risk for diabetes participated in interviews (n = 8) and focus groups (n = 4 groups, 23 participants). Coded transcripts from audio-taped interviews or focus groups were analysed by hand and using NVivo software. Concept mapping illustrated the findings. Health-care professionals identified potential barriers to programme success as a motivation for regular participation, and lack of health policy support for programme sustainability. Health-care professionals identified opportunities to integrate health promotion and disease prevention into CHCWs' duties. Health-care professionals recommended small-group workshops, hands-on learning activities, case studies, and video presentations that bring knowledge to practice within their cultural context. CHCWs should receive a credit for continuing study. People at risk for diabetes lacked knowledge of nutrition, diabetes risk factors, and resources to access health information. They desired two-way communication with CHCWs. Formative research supports the need for an effective, sustainable programme to support knowledge translation to CHCWs and at-risk populations in the communities they serve. Ultimately, this should support chronic disease prevention in Thailand.

[Psychological effects of road accidents: a challenge for public health].

PubMed

Waszkowska, Małgorzata; Merecz, Dorota

2006-01-01

The authors discuss psychological consequences of road accidents and the need for providing support for the victims and their families. The most common psychological effects include mental health problems, increased use of psychotropic drugs, and difficulty in performing occupational functions. Therefore, it is necessary to remodel the system of traffic safety and supplement it with a comprehensive system of support for both direct victims of accidents and their close relatives. To reach this goal, we need to develop optimal conditions for multidisciplinary research to investigate the effects of road accidents in Poland. This would make it possible to design effective psychological treatment and develop an institutional system for relevant support. However, some preventive measures can be taken right now, e.g., early intervention for severely injured victims during their hospital stay or providing support for non-injured victims and their families.

Tensions in perspectives on suicide prevention between men who have attempted suicide and their support networks: Secondary analysis of qualitative data.

PubMed

Fogarty, Andrea S; Spurrier, Michael; Player, Michael J; Wilhelm, Kay; Whittle, Erin L; Shand, Fiona; Christensen, Helen; Proudfoot, Judith

2018-02-01

Men generally have higher rates of suicide, despite fewer overt indicators of risk. Differences in presentation and response suggest a need to better understand why suicide prevention is less effective for men. To explore the views of at-risk men, friends and family about the tensions inherent in suicide prevention and to consider how prevention may be improved. Secondary analysis of qualitative interview and focus group data, using thematic analysis techniques, alongside bracketing, construction and contextualisation. A total of 35 men who had recently made a suicide attempt participated in interviews, and 47 family and friends of men who had made a suicide attempt took part in focus groups. Participants recounted their experiences with men's suicide attempts and associated interventions, and suggested ways in which suicide prevention may be improved. Five tensions in perspectives emerged between men and their support networks, which complicated effective management of suicide risk: (i) respecting privacy vs monitoring risk, (ii) differentiating normal vs risky behaviour changes, (iii) familiarity vs anonymity in personal information disclosure, (iv) maintaining autonomy vs imposing constraints to limit risk, and (v) perceived need for vs failures of external support services. Tension between the different perspectives increased systemic stress, compounding problems and risk, thereby decreasing the effectiveness of detection of and interventions for men at risk of suicide. Suggested solutions included improving risk communication, reducing reliance on single source supports and increasing intervention flexibility in response to individual needs. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Community-based parenting and family support interventions and the prevention of drug abuse.

PubMed

Sanders, M R

2000-01-01

This paper presents a model for the development of a comprehensive, multilevel, preventively-oriented parenting and family support strategy to reduce family risk factors associated with drug abuse in young people. If parenting interventions are to make a significant impact at a population level on the prevalence of dysfunctional parenting practices, there is a need for an ecological approach to parenting support. Such an approach needs to target a variety of social contexts that are in a position to provide parents with access to evidence-based parenting interventions. The Triple P-Positive Parenting Program is discussed as an example of such an approach to illustrate the distinguishing features of a population level strategy. The core constructs underpinning the Triple P system include the promotion of parental self-regulation (self-sufficiency, self-efficacy, self-management, personal agency, and problem solving), through making parenting programs of adequate intensity widely available in the community through flexible delivery modalities (individual, group, telephone assisted and self-directed). The system comprises a tiered continuum of increasingly intensive parenting interventions ranging from media interventions with wide reach, to intensive behavioural family interventions with narrow reach for high-risk families where parenting problems are complicated by other factors including marital conflict, parental mood disturbance, and lack of social support. The scientific basis of the system of intervention and possible directions for future research is discussed.

Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective

PubMed Central

2010-01-01

Background Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective. Discussion This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs. Summary Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children. PMID:20478054

Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective.

PubMed

Maclean, Lynne M; Clinton, Kathryn; Edwards, Nancy; Garrard, Michael; Ashley, Lisa; Hansen-Ketchum, Patti; Walsh, Audrey

2010-05-17

Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective. This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs. Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children.

Going tobacco-free on 24 New York City university campuses: A public health agency's partnership with a large urban public university system.

PubMed

Bresnahan, Marie P; Sacks, Rachel; Farley, Shannon M; Mandel-Ricci, Jenna; Patterson, Ty; Lamberson, Patti

2016-01-01

The New York City Department of Health and Mental Hygiene partnered with the nation's largest university system, the City University of New York (CUNY), to provide technical assistance and resources to support the development and implementation of a system-wide tobacco-free policy. This effort formed one component of Healthy CUNY-a larger initiative to support health promotion and disease prevention across the university system and resulted in the successful introduction of a system-wide tobacco-free policy on all CUNY campuses. Glassman et al (J Am Coll Health. 2011;59:764-768) published a blueprint for action related to tobacco policies that informed our work. This paper describes the policy development and implementation process and presents lessons learned from the perspective of the Health Department, as a practical case study to inform and support other health departments who may be supporting colleges and universities to become tobacco-free.

Perspectives on Providing And Receiving Preventive Health Care From Primary Care Providers and Their Patients With Mental Illnesses.

PubMed

Stumbo, Scott P; Yarborough, Bobbi Jo H; Yarborough, Micah T; Green, Carla A

2018-01-01

Individuals with mental illnesses have higher morbidity rates and reduced life expectancy compared to the general population. Understanding how patients and providers perceive the need for prevention, as well as the barriers and beliefs that may contribute to insufficient care, are important for improving service delivery tailored to this population. Cross-sectional; mixed methods. An integrated health system and a network of federally qualified health centers and safety net clinics. Interviews (n = 30) and surveys (n = 249) with primary care providers. Interviews (n = 158) and surveys (n = 160) with patients diagnosed with schizophrenia, bipolar, anxiety, or major depressive disorders. Semi-structured interviews and surveys. Thematic analysis for qualitative data; frequencies for quantitative data. More than half (n = 131, 53%) of clinicians believed patients with mental illnesses care less about preventive care than the general population, yet 88% (n = 139) of patients reported interest in improving health. Most providers (n = 216, 88%) lacked confidence that patients with mental illnesses would follow preventive recommendations; 82% (n = 129) of patients reported they would try to change lifestyles if their doctor recommended. Clinicians explained that their perception of patients' chaotic lives and lack of interest in preventive care contributed to their fatalistic attitudes on care delivery to this population. Clinicians and patients agreed on substantial need for additional support for behavior changes. Clinicians reported providing informational support by keeping messages simple; patients reported a desire for more detailed information on reasons to complete preventive care. Patients also detailed the need for assistive and tangible support to manage behavioral health changes. Our results suggest a few clinical changes could help patients complete preventive care recommendations and improve health behaviors: improving clinician-patient collaboration on realistic goal setting, increasing visit time or utilizing behavioral health consultants that bridge primary and specialty mental health care, and increasing educational and tangible patient support services.

Improving Obesity Prevention and Management in Primary Care in Canada.

PubMed

Campbell-Scherer, Denise; Sharma, Arya Mitra

2016-09-01

Obesity is a major risk factor for chronic diseases with significant morbidity, mortality and health care cost. There is concern due to the dramatic increase in overweight and obesity in Canada in the last 20 years. The causes of obesity are multifactorial, with underestimation by patients and healthcare providers of the long-term nature of the condition, and its complexity. Solutions related to prevention and management will require multifaceted strategies involving education, health policy, public health and health systems across the care continuum. We believe that to support such strategies we need to have a strong primary care workforce equipped with appropriate knowledge, skills and attitudes to support persons at risk for, or with, obesity. To achieve this end, significant skills building is required to improve primary care obesity prevention and management efforts. This review will first examine the current state, and then will outline how we can improve.

Combined Diet and Physical Activity Promotion Programs for Prevention of Diabetes: Community Preventive Services Task Force Recommendation Statement.

PubMed

Pronk, Nicolaas P; Remington, Patrick L

2015-09-15

Community Preventive Services Task Force recommendation on the use of combined diet and physical activity promotion programs to reduce progression to type 2 diabetes in persons at increased risk. The Task Force commissioned an evidence review that assessed the benefits and harms of programs to promote and support individual improvements in diet, exercise, and weight and supervised a review on the economic efficiency of these programs in clinical trial, primary care, and primary care-referable settings. Adolescents and adults at increased risk for progression to type 2 diabetes. The Task Force recommends the use of combined diet and physical activity promotion programs by health care systems, communities, and other implementers to provide counseling and support to clients identified as being at increased risk for type 2 diabetes. Economic evidence indicates that these programs are cost-effective.

Alcohol use by youth and adolescents: a pediatric concern.

PubMed

Kokotailo, Patricia K

2010-05-01

Alcohol use continues to be a major problem from preadolescence through young adulthood in the United States. Results of recent neuroscience research have substantiated the deleterious effects of alcohol on adolescent brain development and added even more evidence to support the call to prevent and reduce underaged drinking. Pediatricians should be knowledgeable about substance abuse to be able to recognize risk factors for alcohol and other substance abuse among youth, screen for use, provide appropriate brief interventions, and refer to treatment. The integration of alcohol use prevention programs in the community and our educational system from elementary school through college should be promoted by pediatricians and the health care community. Promotion of media responsibility to connect alcohol consumption with realistic consequences should be supported by pediatricians. Additional research into the prevention, screening and identification, brief intervention, and management and treatment of alcohol and other substance use by adolescents continues to be needed to improve evidence-based practices.

An Organizational Informatics Analysis of Colorectal, Breast, and Cervical Cancer Screening Clinical Decision Support and Information Systems within Community Health Centers

ERIC Educational Resources Information Center

Carney, Timothy Jay

2012-01-01

A study design has been developed that employs a dual modeling approach to identify factors associated with facility-level cancer screening improvement and how this is mediated by the use of clinical decision support. This dual modeling approach combines principles of (1) Health Informatics, (2) Cancer Prevention and Control, (3) Health Services…

Operational Overview for UAS Integration in the NAS Project Flight Test Series 3

NASA Technical Reports Server (NTRS)

Valkov, Steffi B.; Sternberg, Daniel; Marston, Michael

2018-01-01

The National Aeronautics and Space Administration Unmanned Aircraft Systems Integration in the National Airspace System Project has conducted a series of flight tests intended to support the reduction of barriers that prevent unmanned aircraft from flying without the required waivers from the Federal Aviation Administration. The 2015 Flight Test Series 3, supported two separate test configurations. The first configuration investigated the timing of Detect and Avoid alerting thresholds using a radar equipped unmanned vehicle and multiple live intruders flown at varying encounter geometries.

A Review of the Evidence Supporting the Vitamin D-Cancer Prevention Hypothesis in 2017.

PubMed

Grant, William B

2018-02-01

The vitamin D-cancer prevention hypothesis has been evaluated through several types of studies, including geographical ecological studies related to indices of solar ultraviolet-B (UVB) dose (the primary source of vitamin D for most people), observational studies related to UVB exposure or serum 25-hydroxyvitamin D [25(OH)D] concentrations, laboratory studies of mechanisms, and clinical trials. Each approach has strengths and limitations. Ecological studies indirectly measure vitamin D production and incorporate the assumption that vitamin D mediates the effect of UVB exposure. Findings from observational studies with long follow-up times are affected by changing 25(OH)D concentrations over time. Most clinical trials have been poorly designed and conducted, based largely on guidelines for pharmaceutical drugs rather than on nutrients. However, three clinical trials do support the hypothesis. In general, the totality of the evidence, as evaluated using Hill's criteria for causality in a biological system, supports the vitamin D-cancer prevention hypothesis. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Preventing Disruptive Behavior via Classroom Management: Validating the Color Wheel System in Kindergarten Classrooms.

PubMed

Watson, Tiffany L; Skinner, Christopher H; Skinner, Amy L; Cazzell, Samantha; Aspiranti, Kathleen B; Moore, Tara; Coleman, MariBeth

2016-07-01

Evidence suggests that installing a classroom management system known as the Color Wheel reduced inappropriate behaviors and increased on-task behavior in second- and fourth-grade classrooms; however, no systematic studies of the Color Wheel had been disseminated targeting pre-school or kindergarten participants. To enhance our understanding of the Color Wheel System (CWS) as a prevention system, a multiple-baseline design was used to evaluate the effects of the Color Wheel on inappropriate vocalizations (IVs) in three general education kindergarten classrooms. Partial-interval time-sampling was used to record classwide IVs, which were operationally defined as any comment or vocal noise that was not solicited by the teacher. Time series graphs and effect size calculations suggest that the CWS caused immediate, large, and sustained decreases in IVs across the three classrooms. Teacher acceptability and interview data also supported the CWS. Implications related to prevention are discussed and directions for future research are provided. © The Author(s) 2016.

[Design and implementation of Geographical Information System on prevention and control of cholera].

PubMed

Li, Xiu-jun; Fang, Li-qun; Wang, Duo-chun; Wang, Lu-xi; Li, Ya-pin; Li, Yan-li; Yang, Hong; Kan, Biao; Cao, Wu-chun

2012-04-01

To build the Geographical Information System (GIS) database for prevention and control of cholera programs as well as using management analysis and function demonstration to show the spatial attribute of cholera. Data from case reporting system regarding diarrhoea, vibrio cholerae, serotypes of vibrio cholerae at the surveillance spots and seafoods, as well as surveillance data on ambient environment and climate were collected. All the data were imported to system database to show the incidence of vibrio cholerae in different provinces, regions and counties to support the spatial analysis through the spatial analysis of GIS. The epidemic trends of cholera, seasonal characteristics of the cholera and the variation of the vibrio cholerae with times were better understood. Information on hotspots, regions and time of epidemics was collected, and helpful in providing risk prediction on the incidence of vibrio cholerae. The exploitation of the software can predict and simulate the spatio-temporal risks, so as to provide guidance for the prevention and control of the disease.

Comprehensive Anti-error Study on Power Grid Dispatching Based on Regional Regulation and Integration

NASA Astrophysics Data System (ADS)

Zhang, Yunju; Chen, Zhongyi; Guo, Ming; Lin, Shunsheng; Yan, Yinyang

2018-01-01

With the large capacity of the power system, the development trend of the large unit and the high voltage, the scheduling operation is becoming more frequent and complicated, and the probability of operation error increases. This paper aims at the problem of the lack of anti-error function, single scheduling function and low working efficiency for technical support system in regional regulation and integration, the integrated construction of the error prevention of the integrated architecture of the system of dispatching anti - error of dispatching anti - error of power network based on cloud computing has been proposed. Integrated system of error prevention of Energy Management System, EMS, and Operation Management System, OMS have been constructed either. The system architecture has good scalability and adaptability, which can improve the computational efficiency, reduce the cost of system operation and maintenance, enhance the ability of regional regulation and anti-error checking with broad development prospects.

Long-term conditions, self-management and systems of support: an exploration of health beliefs and practices within the Sikh community, Birmingham, UK.

PubMed

Sidhu, Manbinder S; Griffith, Laura; Jolly, Kate; Gill, Paramjit; Marshall, Tom; Gale, Nicola K

2016-10-01

The global prevalence of non-communicable diseases (NCDs), such as diabetes mellitus and coronary heart disease, continues to rise. Internationally, people of South Asian origin (i.e. by birth or heritage) are much more likely to develop and live with NCDs compared to the general population. The South Asian diaspora population is highly heterogeneous, varying by socioeconomic status, migration history, religion and ethnicity. This article reports the findings of a study to explore the types of support accessed by Punjabi Sikhs living in Birmingham and the Black Country, UK, who were living with NCDs. The study sought to develop a greater understanding of past experiences of accessing support and the importance of relationships in the mobilisation of resources for self-management. It was nested within a larger programme of research which explored attitudes to prevention of chronic diseases in local communities in the region. Seventeen Punjabi Sikh men and women were recruited through purposive sampling. Narrative interviews were conducted and analysed by the research team. Sociological theories on systems of support and social relations were consulted to inform the interpretation of data. The study findings suggest that participants interpreted chronic disease self-management in relation to four primary systems of support: health services for disease management; multiple sources of care, including traditional Indian medicines and the Internet, for symptom management; community groups for lifestyle management; and the family for emotional and physical care. Within these systems of support, participants identified barriers and facilitators to the maintenance of a healthy lifestyle. We focus on intra-group diversity; exploring the intersection of views and experiences by age, gender, generation and caste. The findings have implications for the design and delivery of primary care and community services which support the prevention and management of NCDs in an increasingly diverse population.

The roles of low literacy and social support in predicting the preventability of hospital admission.

PubMed

Arozullah, Ahsan M; Lee, Shoou-Yih D; Khan, Taha; Kurup, Sindhu; Ryan, Jeffrey; Bonner, Michael; Soltysik, Robert; Yarnold, Paul R

2006-02-01

Prior studies found higher hospitalization rates among patients with low literacy, but did not determine the preventability of these admissions or consider other determinants of hospitalization, such as social support. This study evaluated whether low literacy was a predictor for preventability of hospitalization when considered in the context of social support, sociodemographics, health status, and risk behaviors. A convenience sample of 400 patients, admitted to general medicine wards in a university-affiliated Veterans Affairs hospital between August 1, 2001 and April 1, 2003, completed a face-to-face interview to assess literacy, sociodemographics, social support, health status, and risk behaviors. Two Board-certified Internists independently assessed preventability of hospitalization and determined the primary preventable cause through blinded medical chart reviews. Neither low literacy ( or =12 people talked to weekly (P<.023). Among nonbinge drinkers with lower social support for medical care, larger social networks were predictive of preventability of hospitalization. Among nonbinge drinkers with higher support for medical care, lower outpatient utilization was predictive of the preventability of hospitalization. While low literacy was not predictive of admission preventability, the formal assessment of alcohol binge drinking, social support for medical care, social network size, and prior outpatient utilization may enhance our ability to predict the preventability of hospitalizations and develop targeted interventions.

Measuring agreement between decision support reminders: the cloud vs. the local expert.

PubMed

Dixon, Brian Edward; Simonaitis, Linas; Perkins, Susan M; Wright, Adam; Middleton, Blackford

2014-04-10

A cloud-based clinical decision support system (CDSS) was implemented to remotely provide evidence-based guideline reminders in support of preventative health. Following implementation, we measured the agreement between preventive care reminders generated by an existing, local CDSS and the new, cloud-based CDSS operating on the same patient visit data. Electronic health record data for the same set of patients seen in primary care were sent to both the cloud-based web service and local CDSS. The clinical reminders returned by both services were captured for analysis. Cohen's Kappa coefficient was calculated to compare the two sets of reminders. Kappa statistics were further adjusted for prevalence and bias due to the potential effects of bias in the CDS logic and prevalence in the relative small sample of patients. The cloud-based CDSS generated 965 clinical reminders for 405 patient visits over 3 months. The local CDSS returned 889 reminders for the same patient visit data. When adjusted for prevalence and bias, observed agreement varied by reminder from 0.33 (95% CI 0.24 - 0.42) to 0.99 (95% CI 0.97 - 1.00) and demonstrated almost perfect agreement for 7 of the 11 reminders. Preventive care reminders delivered by two disparate CDS systems show substantial agreement. Subtle differences in rule logic and terminology mapping appear to account for much of the discordance. Cloud-based CDSS therefore show promise, opening the door for future development and implementation in support of health care providers with limited resources for knowledge management of complex logic and rules.

Impact of Weight of the Nation Community Screenings on Obesity-Related Beliefs.

PubMed

Luecking, Courtney T; Noar, Seth M; Dooley, Rachel M; Gizlice, Ziya; Ammerman, Alice S

2017-03-01

HBO's Weight of the Nation was a collaborative effort among several national organizations to raise awareness about the complexity of the obesity epidemic and promote action through media and community forums. The primary aim of this study was to assess the short-term effects of Weight of the Nation community screenings on obesity-related beliefs, intentions, and policy support. Five Prevention Research Centers across the U.S. administered surveys at nine Weight of the Nation community screenings between September 2012 and May 2013. Adults aged ≥18 years who completed pre-post surveys were included. The survey assessed demographic information, perceptions of the documentary, efficacy to take action and influence policies that affect obesity, intentions to take actions to support a healthy weight, and positions on policy changes that impact food systems. Data were analyzed in 2015. A convenience sample of 442 individuals completed surveys. The sample was mostly health workers, female, college educated, aged 25-44 years, and racially and ethnically diverse. Significant increases (p<0.001) were observed for perceived self- and collective efficacy that individuals and communities can influence policies and environmental factors that affect obesity, intentions to take actions that contribute to a healthy weight, and support for policies that change the food system. A broad, nationwide effort, such as Weight of the Nation, that combines media with opportunities to bring community members together for discussion, may play a role in influencing beliefs, intentions, and policy support regarding obesity prevention. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Measuring agreement between decision support reminders: the cloud vs. the local expert

PubMed Central

2014-01-01

Background A cloud-based clinical decision support system (CDSS) was implemented to remotely provide evidence-based guideline reminders in support of preventative health. Following implementation, we measured the agreement between preventive care reminders generated by an existing, local CDSS and the new, cloud-based CDSS operating on the same patient visit data. Methods Electronic health record data for the same set of patients seen in primary care were sent to both the cloud-based web service and local CDSS. The clinical reminders returned by both services were captured for analysis. Cohen’s Kappa coefficient was calculated to compare the two sets of reminders. Kappa statistics were further adjusted for prevalence and bias due to the potential effects of bias in the CDS logic and prevalence in the relative small sample of patients. Results The cloud-based CDSS generated 965 clinical reminders for 405 patient visits over 3 months. The local CDSS returned 889 reminders for the same patient visit data. When adjusted for prevalence and bias, observed agreement varied by reminder from 0.33 (95% CI 0.24 – 0.42) to 0.99 (95% CI 0.97 – 1.00) and demonstrated almost perfect agreement for 7 of the 11 reminders. Conclusions Preventive care reminders delivered by two disparate CDS systems show substantial agreement. Subtle differences in rule logic and terminology mapping appear to account for much of the discordance. Cloud-based CDSS therefore show promise, opening the door for future development and implementation in support of health care providers with limited resources for knowledge management of complex logic and rules. PMID:24720863

Facilitators and barriers to effective scale-up of an evidence-based multilevel HIV prevention intervention.

PubMed

Kegeles, Susan M; Rebchook, Gregory; Tebbetts, Scott; Arnold, Emily

2015-04-17

Since the scale-up of HIV/AIDS prevention evidence-based interventions (EBIs) has not been simple, it is important to examine processes that occur in the translation of the EBIs into practice that affect successful implementation. The goal of this paper is to examine facilitators and barriers to effective implementation that arose among 72 community-based organizations as they moved into practice a multilevel HIV prevention intervention EBI, the Mpowerment Project, for young gay and bisexual men. CBOs that were implementing the Mpowerment Project participated in this study and were assessed at baseline, and 6-months, 1 year, and 2 years post-baseline. Semi-structured telephone interviews were conducted separately with individuals at each CBO. Study data came from 647 semi-structured interviews and extensive notes and commentaries from technical assistance providers. Framework Analysis guided the analytic process. Barriers and facilitators to implementation was the overarching thematic framework used across all the cases in our analysis. Thirteen themes emerged regarding factors that influence the successful implementation of the MP. These were organized into three overarching themes: HIV Prevention System Factors, Community Factors, and Intervention Factors. The entire HIV Prevention System, including coordinators, supervisors, executive directors, funders, and national HIV prevention policies, all influenced implementation success. Other Prevention System Factors that affected the effective translation of the EBI into practice include Knowledge About Intervention, Belief in the Efficacy of the Intervention, Desire to Change Existing Prevention Approach, Planning for Intervention Before Implementation, Accountability, Appropriateness of Individuals for Coordinator Positions, Evaluation of Intervention, and Organizational Stability. Community Factors included Geography and Sociopolitical Climate. Intervention Factors included Intervention Characteristics and Adaptation Issues. The entire ecological system in which an EBI occurs affects implementation. It is imperative to focus capacity-building efforts on getting individuals at different levels of the HIV Prevention System into alignment regarding understanding and believing in the program's goals and methods. For a Prevention Support System to be maximally useful, it must address facilitators or barriers to implementation, address the right people, and use modalities to convey information that are acceptable for users of the system.

Cost-effectiveness of an electronic medication ordering system (CPOE/CDSS) in hospitalized patients.

PubMed

Vermeulen, K M; van Doormaal, J E; Zaal, R J; Mol, P G M; Lenderink, A W; Haaijer-Ruskamp, F M; Kosterink, J G W; van den Bemt, P M L A

2014-08-01

Prescribing medication is an important aspect of almost all in-hospital treatment regimes. Besides their obviously beneficial effects, medicines can also cause adverse drug events (ADE), which increase morbidity, mortality and health care costs. Partially, these ADEs arise from medication errors, e.g. at the prescribing stage. ADEs caused by medication errors are preventable ADEs. Until now, medication ordering was primarily a paper-based process and consequently, it was error prone. Computerized Physician Order Entry, combined with basic Clinical Decision Support System (CPOE/CDSS) is considered to enhance patient safety. Limited information is available on the balance between the health gains and the costs that need to be invested in order to achieve these positive effects. Aim of this study was to study the balance between the effects and costs of CPOE/CDSS compared to the traditional paper-based medication ordering. The economic evaluation was performed alongside a clinical study (interrupted time series design) on the effectiveness of CPOE/CDSS, including a cost minimization and a cost-effectiveness analysis. Data collection took place between 2005 and 2008. Analyses were performed from a hospital perspective. The study was performed in a general teaching hospital and a University Medical Centre on general internal medicine, gastroenterology and geriatric wards. Computerized Physician Order Entry, combined with basic Clinical Decision Support System (CPOE/CDSS) was compared to a traditional paper based system. All costs of both medication ordering systems are based on resources used and time invested. Prices were expressed in Euros (price level 2009). Effectiveness outcomes were medication errors and preventable adverse drug events. During the paper-based prescribing period 592 patients were included, and during the CPOE/CDSS period 603. Total costs of the paper-based system and CPOE/CDSS amounted to €12.37 and €14.91 per patient/day respectively. The Incremental Cost-Effectiveness Ratio (ICER) for medication errors was 3.54 and for preventable adverse drug events 322.70, indicating the extra amount (€) that has to be invested in order to prevent one medication error or one pADE. CPOE with basic CDSS contributes to a decreased risk of preventable harm. Overall, the extra costs of CPOE/CDSS needed to prevent one ME or one pADE seem to be acceptable. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Social organization of self-management support of persons with diabetes: a health systems comparison.

PubMed

Schiøtz, Michaela; Frølich, Anne; Krasnik, Allan; Taylor, Warren; Hsu, John

2012-09-01

Identify important organizational elements for providing self-management support (SMS). Semi-structured qualitative interviews conducted in two healthcare systems. Kaiser Permanente Northern California and the Danish Health Care System. 36 managers and healthcare professionals in the two healthcare systems. Elements important to providing self-management support to persons with diabetes. Healthcare professionals' provision of SMS was influenced by healthcare system organization and their perceptions of SMS, the capability and responsibility of healthcare systems, and their roles in the healthcare organization. Enabling factors for providing SMS included: strong leadership; aligned incentives; use of an integrated health information technology (HIT) system; multidisciplinary healthcare provider teams; ongoing training for healthcare professionals; outreach; and quality goals. Barriers to providing SMS included lack of collaboration between providers and skeptical attitudes towards prevention and outreach. Implementation of SMS can be improved by an understanding of the elements that enhance its provision: (1) initiatives seeking to improve collaboration and integration between providers; (2) implementation of an integrated HIT system; and (3) ongoing training of healthcare professionals.

Peer Programs: An In-Depth Look at Peer Helping: Planning, Implementation, and Administration.

ERIC Educational Resources Information Center

Tindall, Judith A.

The goal of this book is to provide a program designed to teach peer helping professionals a method and rationale for training peer helpers. Peer helping programs are a major delivery system of affective education or deliberate psychological education. Peer helping programs can provide prevention, intervention, and support systems for people.…

Combustion and Reacting Systems for Exploration

NASA Technical Reports Server (NTRS)

Urban, David L.

2004-01-01

Contents include the foloving: 1. Spacecraft Fire Prevention, Detection, and Suppression. 2. Advanced Life Support. Air/water revitalization, waste management. 3. In Situ Resource Utilization (ISRU). Fuel/consumables from regolith/atmosphere. 4. Extra vehicular Activity. Air revitalization, power systems (MEMS scale combustors). 5. In-situ Fabrication and Repair.Of these we have the lead responsibility in Fire Safety.

Challenges and opportunities for preventing depression in the workplace: a review of the evidence supporting workplace factors and interventions.

PubMed

Couser, Gregory P

2008-04-01

To explore the literature regarding prevention of depression in the workplace. Literature review of what the author believes are seminal articles highlighting workplace factors and interventions in preventing depression in the workplace. Employees can help prevent depression by building protective factors such as better coping and stress management skills. Employees may be candidates for depression screening if they have certain risk factors such as performance concerns. Organizational interventions such as improving mental health literacy and focusing on work-life balance may help prevent depression in the workplace but deserve further study. A strategy to prevent depression in the workplace can include developing individual resilience, screening high-risk individuals and reducing that risk, improving organizational literacy, and integrating workplace and health care systems to allow access to proactive quality interventions.

[Medication error management climate and perception for system use according to construction of medication error prevention system].

PubMed

Kim, Myoung Soo

2012-08-01

The purpose of this cross-sectional study was to examine current status of IT-based medication error prevention system construction and the relationships among system construction, medication error management climate and perception for system use. The participants were 124 patient safety chief managers working for 124 hospitals with over 300 beds in Korea. The characteristics of the participants, construction status and perception of systems (electric pharmacopoeia, electric drug dosage calculation system, computer-based patient safety reporting and bar-code system) and medication error management climate were measured in this study. The data were collected between June and August 2011. Descriptive statistics, partial Pearson correlation and MANCOVA were used for data analysis. Electric pharmacopoeia were constructed in 67.7% of participating hospitals, computer-based patient safety reporting systems were constructed in 50.8%, electric drug dosage calculation systems were in use in 32.3%. Bar-code systems showed up the lowest construction rate at 16.1% of Korean hospitals. Higher rates of construction of IT-based medication error prevention systems resulted in greater safety and a more positive error management climate prevailed. The supportive strategies for improving perception for use of IT-based systems would add to system construction, and positive error management climate would be more easily promoted.

Using incident reports to inform the prevention of medication administration errors.

PubMed

Härkänen, Marja; Saano, Susanna; Vehviläinen-Julkunen, Katri

2017-11-01

To describe ways of preventing medication administration errors based on reporters' views expressed in medication administration incident reports. Medication administration errors are very common, and nurses play important roles in committing and in preventing such errors. Thus far, incident reporters' perceptions of how to prevent medication administration errors have rarely been analysed. This is a qualitative, descriptive study using an inductive content analysis of the incident reports related to medication administration errors (n = 1012). These free-text descriptions include reporters' views on preventing the reoccurrence of medication administration errors. The data were collected from two hospitals in Finland and pertain to incidents that were reported between 1 January 2013 and 31 December 2014. Reporters' views on preventing medication administration errors were divided into three main categories related to individuals (health professionals), teams and organisations. The following categories related to individuals in preventing medication administration errors were identified: (1) accuracy and preciseness; (2) verification; and (3) following the guidelines, responsibility and attitude towards work. The team categories were as follows: (1) distribution of work; (2) flow of information and cooperation; and (3) documenting and marking the drug information. The categories related to organisation were as follows: (1) work environment; (2) resources; (3) training; (4) guidelines; and (5) development of the work. Health professionals should administer medication with a high moral awareness and an attempt to concentrate on the task. Nonetheless, the system should support health professionals by providing a reasonable work environment and encouraging collaboration among the providers to facilitate the safe administration of medication. Although there are numerous approaches to supporting medication safety, approaches that support the ability of individual health professionals to manage daily medications should be prioritised. © 2017 John Wiley & Sons Ltd.

Integrated System for Monitoring and Prevention in Obstetrics-Gynaecology.

PubMed

Robu, Andreea; Gauca, Bianca; Crisan-Vida, Mihaela; Stoicu-Tivadar, Lăcrămioara

2016-01-01

A better monitoring of pregnant women, mainly during the third trimester of pregnancy and an easy communication between physician and patients are very important for the prevention and good health of baby and mother. The paper presents an integrated system as support for the Obstetrics - Gynaecology domain consisting in two modules: a mobile application, ObGynCare, dedicated to the pregnant women and a new component of the Obstetrics-Gynaecology Department Information System dedicated to the physicians for a better monitoring of the pregnant women. The mobile application informs the pregnant women about their status, permits them to introduce glycaemia and weight values and has as option pulse and blood pressure acquisition from a smart sensor and provides results in a graphic format. It also provides support for easy patient-doctor communication related to any health problems. ObGyn Care offers nutrition recommendations and gives the pregnant women the possibility to enter a social space of common interests using social networks (Facebook) to exchange useful and practical information. Data collected from patients and from sensor are stored on the cloud and the physician may access the information and analyse it. The extended module of the Obstetrics-Gynaecology Department Information System already developed supports the physicians to visualize weekly, monthly, or on a trimester, the patient data and to discuss with her through the chat module. The mobile application is in test by pregnant women and medical personnel.

Bonding after trauma: on the role of social support and the oxytocin system in traumatic stress

PubMed Central

Olff, Miranda

2012-01-01

This paper outlines the state of affairs in psychobiological research on psychotrauma and PTSD with a focus on the role of the oxytocin system in traumatic stress. With a high prevalence of trauma and PTSD in the Netherlands, new preventive and therapeutic interventions are needed. The focus is on the role of social support and bonding in coming to grips with psychological trauma, about the oxytocin system as a basis for reducing the stress response and creating a feeling of bonding, about binding words to painful emotions in psychotherapy, and about the bonds between researchers and clinicians. PMID:22893838

[The implementation of strategy of medicinal support in multi-type hospital].

PubMed

Ludupova, E Yu

2016-01-01

The article presents brief review of implementation of strategy of medicinal support of population of the Russian Federation and experience of application of at the level of regional hospital. The necessity and importance of implementation into practice of hospitals of methodology of pharmaco-economical management of medicinal care using modern technologies of XYZ-, ABC and VEN-analysis is demonstrated. The stages of development and implementation of process of medicinal support of multifield hospital applying principles of system of quality management (processing and systemic approaches, risk management) on the basis of standards ISO 9001 are described. The significance of monitoring of results ofprocess of medicinal support of the basis of implementation of priority target programs (prevention of venous thrombo-embolic complications, system od control of anti-bacterial therapy) are demonstrated in relation to multi-field hospital using technique of ATC/DDD-analysis for evaluating indices of effectiveness and efficiency.

Results of the Particulate Contamination Control Trade Study for Space Suit Life Support Development

NASA Technical Reports Server (NTRS)

Cognata, Thomas J.; Conger, Bruce; Paul, Heather L.

2009-01-01

As the United States plans to return astronauts to the moon and eventually to Mars, designing the most effective, efficient, and robust space suit life support system that will operate successfully in these dusty environments is vital. There is some knowledge of the contaminants and level of infiltration expected from the Lunar and Mars dust, however risk mitigation strategies and filtration designs to prevent contamination within the space suit life support system are still undefined. A trade study was initiated to identify and address these concerns, and to develop new requirements for the Constellation Space Suit Element (CSSE) Portable Life Support System (PLSS). This trade study investigates historical methods of particulate contamination control in space suits and vehicles, and evaluated the possibility of using commercial technologies for this application. In addition, the trade study examined potential filtration designs. This paper summarizes the results of this trade study.

The effects of situational obstacles and social support on suicide- prevention gatekeeper behaviors.

PubMed

Moore, J Taylor; Cigularov, Konstantin P; Chen, Peter Y; Martinez, Jeremy M; Hindman, Jarrod

2011-01-01

Although the effectiveness of suicide-prevention gatekeeper-training programs in improving knowledge, attitudes, and referral practices has been documented, their effects do not seem to be lasting. This study investigated situational obstacles at work that prevent suicide-prevention gatekeepers from engaging in suicide-prevention behavior and the role of social support in modifying the relationship between situational obstacles and suicide-prevention behaviors. 193 gatekeepers completed an online survey to rate the obstacles they had experienced at work since completing a gatekeeper-training program and the support received from coworkers, supervisors, and the organization. Participants also reported the frequency of suicide-prevention behaviors performed. The results indicated that both situational obstacles and social support predicted the number of suicide-prevention behaviors performed, as expected. There was also a trend that support from supervisors and the organization may alleviate the adverse effect of situational obstacles on suicide-prevention behavior. The cross-sectional nature of the study does not allow for directional, causal conclusions to be drawn. By understanding the roles of situational obstacles faced by trained gatekeepers at their work and the support they receive from supervisors and organizations, appropriate strategies can be identified and applied to facilitate gatekeeper performance.

Iterative user centered design for development of a patient-centered fall prevention toolkit.

PubMed

Katsulis, Zachary; Ergai, Awatef; Leung, Wai Yin; Schenkel, Laura; Rai, Amisha; Adelman, Jason; Benneyan, James; Bates, David W; Dykes, Patricia C

2016-09-01

Due to the large number of falls that occur in hospital settings, inpatient fall prevention is a topic of great interest to patients and health care providers. The use of electronic decision support that tailors fall prevention strategy to patient-specific risk factors, known as Fall T.I.P.S (Tailoring Interventions for Patient Safety), has proven to be an effective approach for decreasing hospital falls. A paper version of the Fall T.I.P.S toolkit was developed primarily for hospitals that do not have the resources to implement the electronic solution; however, more work is needed to optimize the effectiveness of the paper version of this tool. We examined the use of human factors techniques in the redesign of the existing paper fall prevention tool with the goal of increasing ease of use and decreasing inpatient falls. The inclusion of patients and clinical staff in the redesign of the existing tool was done to increase adoption of the tool and fall prevention best practices. The redesigned paper Fall T.I.P.S toolkit showcased a built in clinical decision support system and increased ease of use over the existing version. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using "get with the guidelines" to improve cardiovascular secondary prevention.

PubMed

LaBresh, Kenneth A; Gliklich, Richard; Liljestrand, James; Peto, Randolph; Ellrodt, A Gray

2003-10-01

"Get With The Guidelines (GWTG)" was developed and piloted by the American Heart Association (AHA), New England Affiliate; MassPRO, Inc.; and other organizations to reduce the gap in the application of secondary prevention guidelines in hospitalized cardiovascular disease patients. Collaborative learning programs and technology solutions were created for the project. The interactive Web-based patient management tool (PMT) was developed using quality measures derived from the AHA/American College of Cardiology secondary prevention guidelines. It provided data entry, embedded reminders and guideline summaries, and online reports of quality measure performance, including comparisons with the aggregate performance of all hospitals. Multidisciplinary teams from 24 hospitals participated in the 2000-2001 pilot. Four collaborative learning sessions and monthly conference calls supported team interaction. Best-practices sharing and the use of an Internet tool enabled hospitals to change systems and collect data on 1,738 patients. The GWTG program, a template of learning sessions with didactic presentations, best-practices sharing, and collaborative multidisciplinary team meetings supported by the Internet-based data collection and reporting system, can be extended to multiple regions without requiring additional development. Following the completion of the pilot, the AHA adopted GWTG as a national program.

Intraoperative Floppy Iris Syndrome: Pathophysiology, Prevention, and Treatment

PubMed Central

Flach, Allan J.

2009-01-01

Purpose: To extend upon previous reports, observations, and discussions of intraoperative floppy iris syndrome (IFIS) with the goal of providing new insight into the syndrome’s pathophysiology, prevention, and treatment. Methods: Following a review of IFIS and its relationship to autonomic pharmacology, evidence for anatomic changes following exposure of humans and other animals to autonomic drugs is described. The clinical implications for these findings are discussed as they relate to the treatment and prevention of this syndrome. Results: IFIS has been associated with the use of adrenergic antagonists even after they have been discontinued years prior to surgery. Some investigators believe that this persistence of IFIS reflects anatomic structural change. Evidence from laboratory experiments and human clinical studies using topically applied and systemic autonomic drugs supports the possibility of anatomic changes coexisting with IFIS observed during cataract surgery. Conclusions: IFIS is a relatively rare syndrome, often associated with the use of systemic α-blockers and conditions that influence dilator muscle tone. Laboratory and clinical evidence supports the possibility of anatomic changes following the use of autonomic drugs. The persistence of IFIS years after cessation of treatment with α-blockers suggests that the potential risks of discontinuing these drugs prior to cataract surgery outweigh potential benefits. PMID:20126500

Preventing Acute Kidney Injury: a qualitative study exploring 'sick day rules' implementation in primary care.

PubMed

Morris, Rebecca L; Ashcroft, Darren; Phipps, Denham; Bower, Peter; O'Donoghue, Donal; Roderick, Paul; Harding, Sarah; Lewington, Andrew; Blakeman, Thomas

2016-07-22

In response to growing demand for urgent care services there is a need to implement more effective strategies in primary care to support patients with complex care needs. Improving primary care management of kidney health through the implementation of 'sick day rules' (i.e. temporary cessation of medicines) to prevent Acute Kidney Injury (AKI) has the potential to address a major patient safety issue and reduce unplanned hospital admissions. The aim of this study is to examine processes that may enable or constrain the implementation of 'sick day rules' for AKI prevention into routine care delivery in primary care. Forty semi-structured interviews were conducted with patients with stage 3 chronic kidney disease and purposefully sampled, general practitioners, practice nurses and community pharmacists who either had, or had not, implemented a 'sick day rule'. Normalisation Process Theory was used as a framework for data collection and analysis. Participants tended to express initial enthusiasm for sick day rules to prevent AKI, which fitted with the delivery of comprehensive care. However, interest tended to diminish with consideration of factors influencing their implementation. These included engagement within and across services; consistency of clinical message; and resources available for implementation. Participants identified that supporting patients with multiple conditions, particularly with chronic heart failure, made tailoring initiatives complex. Implementation of AKI initiatives into routine practice requires appropriate resourcing as well as training support for both patients and clinicians tailored at a local level to support system redesign.

Measuring the effects of aborted takeoffs and landings on traffic flow at JFK

DOT National Transportation Integrated Search

2012-10-14

The FAA Office of Accident Investigation and Prevention (AVP) supports research, analysis and demonstration of quantitative air traffic analyses to estimate safety performance and benefits of the Next Generation Air Transportation System (NextGen). T...

Manned space programs accident/incident summaries (1963 - 1969)

NASA Technical Reports Server (NTRS)

1970-01-01

This summary is a compilation of 508 mishaps assembled from company and NASA records which cover several years of manned space flight activity. The purpose is to provide information to be applied towards accident prevention. The accident/incident summaries are categorized by the following ten systems: cryogenic; electrical; facility/GSE; fuel and propellant; life support; ordnance; pressure; propulsion; structural; and transport/handling. Each accident/incident summary has been summarized by description, cause and recommended preventive action.

Prevention and control of mental illnesses and mental health: National Action Plan for NCD Prevention, Control and Health Promotion in Pakistan.

PubMed

Nishtar, Sania; Minhas, Fareed A; Ahmed, Ashfaq; Badar, Asma; Mohamud, Khalif Bile

2004-12-01

As part of the National Action Plan for Non-communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD), mental illnesses have been grouped alongside non-communicable diseases (NCD) within a combined strategic framework in order to synchronize public health actions. The systematic approach for mental illnesses is centred on safeguarding the rights of the mentally ill, reducing stigma and discrimination, and de-institutionalisation and rehabilitation of the mentally ill in the community outlining roles of healthcare providers, the community, legislators and policy makers. The approach has implications for support functions in a number of areas including policy building, manpower and material development and research. Priority action areas for mental health as part of NAP-NCD include the integration of surveillance of mental illnesses in a comprehensive population-based NCD surveillance system; creating awareness about mental health as part of an integrated NCD behavioural change communication strategy; integration of mental health with primary healthcare; the development of sustainable public health infrastructure to support community mental health initiatives; building capacity of the health system in support of prevention and control activities; effective implementation of existing legislation and harmonizing working relationships with law enforcing agencies. NAP-NCD also stresses on the need to integrate mental health into health services as part of a sustainable and integrated medical education programme for all categories of healthcare providers and the availability of essential psychotropic drugs at all healthcare levels. It lays emphasis on protecting the interests of special groups such as prisoners, refugees and displaced persons, women, children and individuals with disabilities. Furthermore, it promotes need-based research for contemporary mental health issues.

About the Community Oncology and Prevention Trials Research Group | Division of Cancer Prevention

Cancer.gov

The Community Oncology and Prevention Trials Research Group supports clinical oncology trials in cancer prevention and control in community settings. The group also supports investigator-initiated research projects in supportive, palliative and end-of-life care, and coordinates clinical oncology research projects with other NCI programs to be done in the community setting. |

The PBS Triangle: Does It Fit as a Heuristic? A Reflection on the First International Conference on Positive Behavior Support

ERIC Educational Resources Information Center

Baker, Candace Kay

2005-01-01

In this article, the author explores the evolution of the use of the triangle as a communication tool for describing positive behavior support (PBS) systems. The conceptual framework for the triangle used for PBS is credited to Walker et al. In that seminal work, the a model of school-based prevention strategies for children displaying antisocial…

Policies and Procedures To Develop Effective School-Wide Discipline Practices at the Elementary School Level. CASE/CCBD Mini-Library Series on Safe, Drug-Free, and Effective Schools.

ERIC Educational Resources Information Center

Newcomer, Lori L.; Lewis, Timothy J.; Powers, Lisa J.

Elementary schools can play an important role in early identification of and intervention for children with problem behavior by creating the infrastructure to provide preventive, proactive supports for all students. This monograph provides an overview of key features of effective school-wide systems of positive behavior support (PBS) at the…

The Brief Classroom Interaction Observation-Revised: An Observation System to Inform and Increase Teacher Use of Universal Classroom Management Practices

ERIC Educational Resources Information Center

Reinke, Wendy M.; Stormont, Melissa; Herman, Keith C.; Wachsmuth, Sean; Newcomer, Lori

2015-01-01

Schools are increasingly using multi-tiered prevention models to address the academic and behavior needs of students. The foundation of these models is the implementation of universal, or Tier 1, practices designed to support the academic and behavioral needs of the vast majority of students. To support teachers in the use of effective Tier 1…

How the science of injury prevention contributes to advancing home fire safety in the USA: successes and opportunities.

PubMed

Gielen, Andrea C; Frattaroli, Shannon; Pollack, Keshia M; Peek-Asa, Corinne; Yang, Jingzhen G

2018-06-01

In the decades since the landmark report-America Burning-was published in 1973, the number of home fire deaths has shrunk from >5500 per year to 2650 in 2015. This paper: (1) describes how science and practice in injury prevention and fire and life safety contributed to successful interventions, and (2) identifies emerging strategies and future opportunities to prevent home fire-related deaths. The aims are addressed through the lens of population health research, with a focus on the work of selected Centers for Disease Control and Prevention-funded Injury Control Research Centers. Results are organised using the Haddon Matrix and an ecological model. We found evidence to support interventions that address all components of both the matrix and the model, including: reduced ignition propensity cigarettes, stop smoking campaigns, housing codes, residential sprinkler systems, smoke alarms, community risk reduction, school-based educational programmes, and fire and burn response systems. Future reductions are likely to come from enhancing residential sprinkler and smoke alarm technology, and increasing their utilisation; expanding the use of community risk reduction methods; and implementing new technological solutions. Despite the successes, substantial disparities in home fire death rates remain, reflecting underlying social determinants of health. Most of the evidence-supported interventions were focused on changing the policy and community environments to prevent home fires and reduce injury when a fire occurs. Future prevention efforts should give high priority to addressing the continued disparities in home fire deaths. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Addendum to "Population-Based Prevention of Child Maltreatment: The U.S. Triple P System Population Trial".

PubMed

Prinz, Ronald J; Sanders, Matthew R; Shapiro, Cheri J; Whitaker, Daniel J; Lutzker, John R

2016-04-01

A previous article published several years ago (Prinz et al. Prevention Science, 10, 1-12, 2009) described the main results of a place-randomized-design study focused on the prevention of child-maltreatment-related outcomes at a population level through the implementation of a multilevel system of parenting and family support (the Triple P-Positive Parenting Program). The current report, prepared at the encouragement of the journal, provides additional details about procedures, measures, and design-related decisions, presents an additional analysis of the main outcome variables, and poses questions about the study and its implications. We also offer guidance about how the field can move forward to build on this line of research. From the outset, the three designated primary child maltreatment outcomes were county-wide rates for substantiated child maltreatment cases, out-of-home placements, and hospital-treated child maltreatment injuries, derived from independent data sources available through administrative archival records. Baseline equivalence between the two intervention conditions was reaffirmed. The additional analysis, which made use of a 5-year baseline (replacing a 1-year baseline) and ANCOVA, yielded large effect sizes for all three outcomes that converged with those from the original analyses. Overall, the study underscored the potential for community-wide parenting and family support to produce population-level preventive impact on child maltreatment. Issues addressed included (1) the need for replication of population-oriented maltreatment prevention strategies like the one tested in this randomized experiment, (2) the need to demonstrate that a parenting-based population approach to maltreatment prevention can also impact children's adjustment apart from child abuse, and (3) the role of implementation science for achieving greater population reach and maintenance over time.

The State of Youth at Risk and the Juvenile Justice System: Prevention and Intervention. Hearing on Support for State Law Enforcement Efforts and for State Juvenile Justice Systems To Help Address the Wave of Violent Crimes among Youthful Offenders before the Subcommittee on Juvenile Justice of the Committee on the Judiciary, United States Senate, One Hundred Second Congress, Second Session (Atlanta, GA, October 21, 1992).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on the Judiciary.

This document presents witness testimonies and prepared statements from a Senate hearing held in Atlanta, Georgia to examine the problem of crime among youth and to discuss the reauthorization of the Juvenile Justice and Delinquency Prevention Act of 1974. In his opening statement, Senator Fowler notes that the reauthorization puts greater…

Nutrition and the science of disease prevention: a systems approach to support metabolic health

PubMed Central

Bennett, Brian J.; Hall, Kevin D.; Hu, Frank B.; McCartney, Anne L.; Roberto, Christina

2017-01-01

Progress in nutritional science, genetics, computer science, and behavioral economics can be leveraged to address the challenge of noncommunicable disease. This report highlights the connection between nutrition and the complex science of preventing disease and discusses the promotion of optimal metabolic health, building on input from several complementary disciplines. The discussion focuses on (1) the basic science of optimal metabolic health, including data from gene–diet interactions, microbiome, and epidemiological research in nutrition, with the goal of defining better targets and interventions, and (2) how nutrition, from pharma to lifestyle, can build on systems science to address complex issues. PMID:26415028

Design of a Digital-Based, Multicomponent Nutrition Guidance System for Prevention of Early Childhood Obesity

PubMed Central

Black, Maureen M.; Saavedra, Jose M.

2016-01-01

Interventions targeting parenting focused modifiable factors to prevent obesity and promote healthy growth in the first 1000 days of life are needed. Scale-up of interventions to global populations is necessary to reverse trends in weight status among infants and toddlers, and large scale dissemination will require understanding of effective strategies. Utilizing nutrition education theories, this paper describes the design of a digital-based nutrition guidance system targeted to first-time mothers to prevent obesity during the first two years. The multicomponent system consists of scientifically substantiated content, tools, and telephone-based professional support delivered in an anticipatory and sequential manner via the internet, email, and text messages, focusing on educational modules addressing the modifiable factors associated with childhood obesity. Digital delivery formats leverage consumer media trends and provide the opportunity for scale-up, unavailable to previous interventions reliant on resource heavy clinic and home-based counseling. Designed initially for use in the United States, this system's core features are applicable to all contexts and constitute an approach fostering healthy growth, not just obesity prevention. The multicomponent features, combined with a global concern for optimal growth and positive trends in mobile internet use, represent this system's future potential to affect change in nutrition practice in developing countries. PMID:27635257

Idaho National Laboratory Site Pollution Prevention Plan

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

E. D. Sellers

2007-03-01

It is the policy of the Department of Energy (DOE) that pollution prevention and sustainable environmental stewardship will be integrated into DOE operations as a good business practice to reduce environmental hazards, protect environmental resources, avoid pollution control costs, and improve operational efficiency and mission sustainability. In furtherance of this policy, DOE established five strategic, performance-based Pollution Prevention (P2) and Sustainable Environmental Stewardship goals and included them as an attachment to DOE O 450.1, Environmental Protection Program. These goals and accompanying strategies are to be implemented by DOE sites through the integration of Pollution Prevention into each site's Environmental Managementmore » System (EMS). This document presents a P2 and Sustainability Program and corresponding plan pursuant to DOE Order 450.1 and DOE O 435.1, Radioactive Waste Management. This plan is also required by the state of Idaho, pursuant to the Resource Conservation and Recovery Act (RCRA) partial permit. The objective of this document is to describe the Idaho National Laboratory (INL) Site P2 and Sustainability Program. The purpose of the program is to decrease the environmental footprint of the INL Site while providing enhanced support of its mission. The success of the program is dependent on financial and management support. The signatures on the previous page indicate INL, ICP, and AMWTP Contractor management support and dedication to the program. P2 requirements have been integrated into working procedures to ensure an effective EMS as part of an Integrated Safety Management System (ISMS). This plan focuses on programmatic functions which include environmentally preferable procurement, sustainable design, P2 and Sustainability awareness, waste generation and reduction, source reduction and recycling, energy management, and pollution prevention opportunity assessments. The INL Site P2 and Sustainability Program is administratively managed by the INL Site P2 Coordinator. Development and maintenance of this overall INL Site plan is ultimately the responsibility of DOE-ID. This plan is applicable to all INL Site contractors except those at the Naval Reactors Facility.« less

Best Practices for Pressure Ulcer Prevention in the Burn Center.

PubMed

Warner, Julia; Ann Raible, Mary; Hajduk, Gina; Collavo, Jacqueline

The State of Pennsylvania Hospital Engagement Network, in collaboration with a hospital system in Southwestern Pennsylvania, established a goal of reducing hospital-acquired pressure ulcers by 20%. A 6-month unfavorable trend of nurse-sensitive clinical indicators called for immediate process improvement. A retrospective chart review resulted in identification of predominant risk factors placing the burn patient at high risk for pressure ulcer formation. Implementations of pressure ulcer prevention measures were inconsistent. Nurses demonstrated varied levels of knowledge about products used for prevention. It became imperative to examine processes within the unit and provide nursing with education, access to skin care supplies, and advanced skin/wound care products for maintaining skin integrity. Creation of evidence-based guidelines was necessary to improve patient outcomes. A collaborative team approach influenced nursing and physician awareness of pressure ulcer risk. Evidence-based prevention guidelines were developed, and consistency in early intervention was achieved, supporting our culture of safety. A change in interprofessional collaborative practice and positive trend in pressure ulcer incidence data supports the success of our program.

Supportive short-term family therapy by nursing staff in the inpatient unit: preventing dependence and rehospitalization in the acutely ill and suicidal adolescent.

PubMed

Gokhshtein, Uri; Giner, Lucas; Mitrani, Marsel; Sharabi, Inbal; Gorlyn, Marianne; Sher, Leo; Goldberg, Pablo H; Misgav, Sagit; Carballo, Juan J; Bolovik, Luisa; Ben-Dor, David H

2005-01-01

Adolescents with acute mental illness or suicidal behavior are almost always hospitalized for safety and evaluation purposes. The tendency towards long-term or repeated hospitalizations has many adverse effects such as dependency on the mental health care system and increased chronicity of illness. The causes for these phenomena may be prevented in the early stages of hospitalization. We suggest a therapeutic model of supportive short-term family therapy. The family therapy component aims to enhance the quality of interaction and the level of support among family members. The therapy component dealing with the individual targets the patient's anxiety symptoms and coping strategies, and focuses on return to a healthy state. The child is encouraged to return home to a supportive family as soon as the treatment team feels this to be advisable. This paper discusses a case which highlights how a patient reacts in crisis, and ways in which a supportive environment can help bring about therapeutic success with reduced hospitalization.

mHealth: Using Mobile Technology to Support Healthcare

PubMed Central

Okuboyejo, Senanu; Eyesan, Omatseyin

2014-01-01

Adherence to long-term therapy in outpatient setting is required to reduce the prevalence of chronic diseases such as HIV/AIDS, Diabetes, Tuberculosis and Malaria. This paper presents a mobile technology-based medical alert system for outpatient adherence in Nigeria. The system makes use of the SMS and voice features of mobile phones. The system has the potential of improving adherence to medication in outpatient setting by reminding patients of dosing schedules and attendance to scheduled appointments through SMS and voice calls. It will also inform patients of benefits and risks associated with adherence. Interventions aimed at improving adherence would provide significant positive return on investment through primary prevention (of risk factors) and secondary prevention of adverse health outcomes. PMID:24678384

Protecting Data Privacy in Structured P2P Networks

NASA Astrophysics Data System (ADS)

Jawad, Mohamed; Serrano-Alvarado, Patricia; Valduriez, Patrick

P2P systems are increasingly used for efficient, scalable data sharing. Popular applications focus on massive file sharing. However, advanced applications such as online communities (e.g., medical or research communities) need to share private or sensitive data. Currently, in P2P systems, untrusted peers can easily violate data privacy by using data for malicious purposes (e.g., fraudulence, profiling). To prevent such behavior, the well accepted Hippocratic database principle states that data owners should specify the purpose for which their data will be collected. In this paper, we apply such principles as well as reputation techniques to support purpose and trust in structured P2P systems. Hippocratic databases enforce purpose-based privacy while reputation techniques guarantee trust. We propose a P2P data privacy model which combines the Hippocratic principles and the trust notions. We also present the algorithms of PriServ, a DHT-based P2P privacy service which supports this model and prevents data privacy violation. We show, in a performance evaluation, that PriServ introduces a small overhead.

Improving Patient Safety in Hospitals through Usage of Cloud Supported Video Surveillance.

PubMed

Dašić, Predrag; Dašić, Jovan; Crvenković, Bojan

2017-04-15

Patient safety in hospitals is of equal importance as providing treatments and urgent healthcare. With the development of Cloud technologies and Big Data analytics, it is possible to employ VSaaS technology virtually anywhere, for any given security purpose. For the listed benefits, in this paper, we give an overview of the existing cloud surveillance technologies which can be implemented for improving patient safety. Modern VSaaS systems provide higher elasticity and project scalability in dealing with real-time information processing. Modern surveillance technologies can prove to be an effective tool for prevention of patient falls, undesired movement and tempering with attached life supporting devices. Given a large number of patients who require constant supervision, a cloud-based monitoring system can dramatically reduce the occurring costs. It provides continuous real-time monitoring, increased overall security and safety, improved staff productivity, prevention of dishonest claims and long-term digital archiving. Patient safety is a growing issue which can be improved with the usage of high-end centralised surveillance systems allowing the staff to focus more on treating health issues rather that keeping a watchful eye on potential incidents.

The Views of the Public on Youth Offenders and the New Zealand Criminal Justice System.

PubMed

Barretto, Craig; Miers, Sarah; Lambie, Ian

2018-01-01

Public perceptions of crime and punishment have taken on increasing importance as countries grapple with how to address youth violence. The current study aimed to compare the views of those who have had personal experience of victimisation from youth offenders and those who have not, on what could be improved in managing youth offending in New Zealand. A qualitative methodology was used with data from open-ended survey responses from a nationally representative sample. Public sentiments favoured addressing systemic issues and providing rehabilitation as main emphases followed by more punitive measures, prevention, and restorative justice. Victims were over-represented on sentiments of prevention whereas non-victims were over-represented in support for more punitive measures and restorative justice. There was also considerable support for a multi-facetted approach that utilised a number of the approaches above, suggesting that the solution is as complex as the offender's circumstances. These findings are very much in line with the current goals of the youth justice system with its emphasis on diversion and rehabilitation.

[The economics of preventing psycho-social risks].

PubMed

Golzio, Luigi

2014-01-01

The aim of the essay is to show the SHIELD methodology for helping the firm management to improve the risks prevention policy. It has been tested in the field with positive results. SHIELD is a cost-benefit analysis application to compare prevention and non-prevention costs, which arise from non-market risks. In the economic perspective safety risks (which include psycho-social risks) are non-market ones as they cause injures to workers during the job. SHIELD (Social Health Indicators for Economic Labour Decisions), is the original method proposed by the author. It is a cost benefits analysis application, which compares safety prevention and non-prevention costs. The comparison allow stop management to evaluate the efficiency of the current safety prevention policy as it helps top management to answer to the policy question: how much to invest in prevention costs? The costs comparison is obtained through the reclassification of safety costs between prevention and non-prevention costs (which are composed by claim damages and penalty sanction costs). SHIELD has been tested empirically in four companies operating in the agribusiness sector during a research financed by the Assessorato all'Agricoltura and INAI Regionale of Emilia Romagna Region. Results are postive: it has been found that the increase of prevention costs causes the cut of non-prevention costs in all companies looked into, as assumed by the high reliability organization theory. SHIELD can be applied to all companies which must have an accounting system by law, no matter of the industry they act. Its application has limited costs as SHIELD doesn't need changes in the accounting system. Safety costs sustained by the company are simply reclassified in prevention and non-prevention costs. The comparison of these two costs categories has been appreciated by top management of companies investigated as a useful support to decide the risks prevention policy for the company. The SHIELD original feature compared with others cost benefit analysis application is to compute registered costs in the company accounting system.

Military Interoperable Digital Hospital Testbed (MIDHT)

DTIC Science & Technology

2013-01-01

users of the PACS system in terms of viewing images originating from Miners and Meyersdale are Emergency Medicine and Trauma physicians. This...conditions, over the counter/ herbal medications, physician list, and emergency contacts. Through secure messaging with their physician, patients...et al. (1999). Impact of a patient-centered, computer- based health information/support system. American Journal of Preventive Medicine , 16(1), 1- 9

Inventory Preparation Guide for Commercial or Industrial-Type Activities and Contract Support Services,

DTIC Science & Technology

1980-08-01

or injury ; includes primarily patients whose actual impairment is related to neuromusculoskeletal, pulmonary, and cardiovasular systems; includes the...disease or injury ; includes primarily patients whose actual impairment is related to neuromusculoskeletal, pulmonary, and cardiovascular systems...orthodontics, endo - dontics, oral hygiene, preventive dentistry, and radiodontics to eligible dental patients. (Formerly in code H113 - Dental Care.) N312

Evaluating School-Based Tobacco Control Programs and Policies: An Opportunity Gained and Many Opportunities Lost

ERIC Educational Resources Information Center

Leatherdale, Scott T.

2009-01-01

In the domain of school-based tobacco control, there is a large gap between the research being performed and the type of research needed to inform school-based prevention activities. The tobacco module of the school health action planning and evaluation system is a data collection and feedback system designed to support school-based tobacco…

Manufacturing Technology Support (MATES). Delivery Order 0002: Business Practices Assessment (BPA) Development

DTIC Science & Technology

2008-03-01

order fulfillment visibility, Kanban deployment, inventory count can be made visually, machines and tool labeling, costs, preventive maintenance...order fulfillment, computer scheduling versus Kanban , pull versus push systems, flow time efficiencies, back room costs of scheduling, MRP costs

A pilot study of distributed knowledge management and clinical decision support in the cloud.

PubMed

Dixon, Brian E; Simonaitis, Linas; Goldberg, Howard S; Paterno, Marilyn D; Schaeffer, Molly; Hongsermeier, Tonya; Wright, Adam; Middleton, Blackford

2013-09-01

Implement and perform pilot testing of web-based clinical decision support services using a novel framework for creating and managing clinical knowledge in a distributed fashion using the cloud. The pilot sought to (1) develop and test connectivity to an external clinical decision support (CDS) service, (2) assess the exchange of data to and knowledge from the external CDS service, and (3) capture lessons to guide expansion to more practice sites and users. The Clinical Decision Support Consortium created a repository of shared CDS knowledge for managing hypertension, diabetes, and coronary artery disease in a community cloud hosted by Partners HealthCare. A limited data set for primary care patients at a separate health system was securely transmitted to a CDS rules engine hosted in the cloud. Preventive care reminders triggered by the limited data set were returned for display to clinician end users for review and display. During a pilot study, we (1) monitored connectivity and system performance, (2) studied the exchange of data and decision support reminders between the two health systems, and (3) captured lessons. During the six month pilot study, there were 1339 patient encounters in which information was successfully exchanged. Preventive care reminders were displayed during 57% of patient visits, most often reminding physicians to monitor blood pressure for hypertensive patients (29%) and order eye exams for patients with diabetes (28%). Lessons learned were grouped into five themes: performance, governance, semantic interoperability, ongoing adjustments, and usability. Remote, asynchronous cloud-based decision support performed reasonably well, although issues concerning governance, semantic interoperability, and usability remain key challenges for successful adoption and use of cloud-based CDS that will require collaboration between biomedical informatics and computer science disciplines. Decision support in the cloud is feasible and may be a reasonable path toward achieving better support of clinical decision-making across the widest range of health care providers. Published by Elsevier B.V.

Prevention and control of hypertension: developing a global agenda.

PubMed

Campbell, Norm R C; Niebylski, Mark L

2014-07-01

This review demonstrates the need for enhancing strategic approaches to the prevention and control of hypertension, a global health issue. An epidemic of chronic noncommunicable diseases is threatening national healthcare systems' sustainability and the economy of many countries. Increased blood pressure is the leading risk for premature death and disability and accounts for approximately 10% of healthcare spending. Four of nine recent United Nations' targets for reducing chronic noncommunicable diseases relate directly or indirectly to hypertension. The expanded chronic care model provides a comprehensive framework for developing hypertension prevention and control strategies. The model addresses the roles of healthy public policy, healthy living environments, healthy communities, reorientation of health services delivery toward management of chronic illness, support for improving clinical decisions, enhanced skills of people to prevent and self-manage chronic disease, partnerships of stakeholders and information systems to track the impact of interventions and identify care 'gaps'. The authors advocate that hypertension organizations can lead aspects of hypertension strategy development and implementation. Prevention and control of hypertension requires a strategic approach that could have a central role for hypertension experts and the hypertension community.

Extended producer responsibility for consumer waste: the gap between economic theory and implementation.

PubMed

Dubois, Maarten

2012-09-01

Although economic theory supports the use of extended producer responsibility (EPR) to stimulate prevention and recycling of waste, EPR systems implemented in Europe are often criticized as a result of weak incentives for prevention and green product design. Using a stylized economic model, this article evaluates the efficiency of European EPR systems. The model reveals that the introduction of static collection targets creates a gap between theory and implementation. Static targets lead to inefficient market outcomes and weak incentives for prevention and green product design. The minimum collection targets should be complemented with a tax on producers for the non-collected waste fraction. Because such a tax internalizes the cost of waste disposal, more efficient price signals will lead to better incentives for waste management in a complex and dynamic market.

Developing and implementing an integrated delirium prevention system of care: a theory driven, participatory research study

PubMed Central

2013-01-01

Background Delirium is a common complication for older people in hospital. Evidence suggests that delirium incidence in hospital may be reduced by about a third through a multi-component intervention targeted at known modifiable risk factors. We describe the research design and conceptual framework underpinning it that informed the development of a novel delirium prevention system of care for acute hospital wards. Particular focus of the study was on developing an implementation process aimed at embedding practice change within routine care delivery. Methods We adopted a participatory action research approach involving staff, volunteers, and patient and carer representatives in three northern NHS Trusts in England. We employed Normalization Process Theory to explore knowledge and ward practices on delirium and delirium prevention. We established a Development Team in each Trust comprising senior and frontline staff from selected wards, and others with a potential role or interest in delirium prevention. Data collection included facilitated workshops, relevant documents/records, qualitative one-to-one interviews and focus groups with multiple stakeholders and observation of ward practices. We used grounded theory strategies in analysing and synthesising data. Results Awareness of delirium was variable among staff with no attention on delirium prevention at any level; delirium prevention was typically neither understood nor perceived as meaningful. The busy, chaotic and challenging ward life rhythm focused primarily on diagnostics, clinical observations and treatment. Ward practices pertinent to delirium prevention were undertaken inconsistently. Staff welcomed the possibility of volunteers being engaged in delirium prevention work, but existing systems for volunteer support were viewed as a barrier. Our evolving conception of an integrated model of delirium prevention presented major implementation challenges flowing from minimal understanding of delirium prevention and securing engagement of volunteers alongside practice change. The resulting Prevention of Delirium (POD) Programme combines a multi-component delirium prevention and implementation process, incorporating systems and mechanisms to introduce and embed delirium prevention into routine ward practices. Conclusions Although our substantive interest was in delirium prevention, the conceptual and methodological strategies pursued have implications for implementing and sustaining practice and service improvements more broadly. Study registration ISRCTN65924234 PMID:24004917

Developing and implementing an integrated delirium prevention system of care: a theory driven, participatory research study.

PubMed

Godfrey, Mary; Smith, Jane; Green, John; Cheater, Francine; Inouye, Sharon K; Young, John B

2013-09-03

Delirium is a common complication for older people in hospital. Evidence suggests that delirium incidence in hospital may be reduced by about a third through a multi-component intervention targeted at known modifiable risk factors. We describe the research design and conceptual framework underpinning it that informed the development of a novel delirium prevention system of care for acute hospital wards. Particular focus of the study was on developing an implementation process aimed at embedding practice change within routine care delivery. We adopted a participatory action research approach involving staff, volunteers, and patient and carer representatives in three northern NHS Trusts in England. We employed Normalization Process Theory to explore knowledge and ward practices on delirium and delirium prevention. We established a Development Team in each Trust comprising senior and frontline staff from selected wards, and others with a potential role or interest in delirium prevention. Data collection included facilitated workshops, relevant documents/records, qualitative one-to-one interviews and focus groups with multiple stakeholders and observation of ward practices. We used grounded theory strategies in analysing and synthesising data. Awareness of delirium was variable among staff with no attention on delirium prevention at any level; delirium prevention was typically neither understood nor perceived as meaningful. The busy, chaotic and challenging ward life rhythm focused primarily on diagnostics, clinical observations and treatment. Ward practices pertinent to delirium prevention were undertaken inconsistently. Staff welcomed the possibility of volunteers being engaged in delirium prevention work, but existing systems for volunteer support were viewed as a barrier. Our evolving conception of an integrated model of delirium prevention presented major implementation challenges flowing from minimal understanding of delirium prevention and securing engagement of volunteers alongside practice change. The resulting Prevention of Delirium (POD) Programme combines a multi-component delirium prevention and implementation process, incorporating systems and mechanisms to introduce and embed delirium prevention into routine ward practices. Although our substantive interest was in delirium prevention, the conceptual and methodological strategies pursued have implications for implementing and sustaining practice and service improvements more broadly. ISRCTN65924234.

Development of a decision support system for tsunami evacuation: application to the Jiyang District of Sanya city in China

NASA Astrophysics Data System (ADS)

Hou, Jingming; Yuan, Ye; Wang, Peitao; Ren, Zhiyuan; Li, Xiaojuan

2017-03-01

Major tsunami disasters often cause great damage in the first few hours following an earthquake. The possible severity of such events requires preparations to prevent tsunami disasters or mitigate them. This paper is an attempt to develop a decision support system for rapid tsunami evacuation for local decision makers. Based on the numerical results database of tsunami disasters, this system can quickly obtain the tsunami inundation and travel time. Because numerical models are calculated in advance, this system can reduce decision-making time. Population distribution, as a vulnerability factor, was analyzed to identify areas of high risk for tsunami disasters. Combined with spatial data, this system can comprehensively analyze the dynamic and static evacuation process and identify problems that negatively impact evacuation, thus supporting the decision-making for tsunami evacuation in high-risk areas. When an earthquake and tsunami occur, this system can rapidly obtain the tsunami inundation and travel time and provide information to assist with tsunami evacuation operations.

Tracking development assistance for HIV/AIDS: the international response to a global epidemic.

PubMed

Schneider, Matthew T; Birger, Maxwell; Haakenstad, Annie; Singh, Lavanya; Hamavid, Hannah; Chapin, Abigail; Murray, Christopher J L; Dieleman, Joseph L

2016-06-01

To better understand the global response to HIV/AIDS, this study tracked development assistance for HIV/AIDS at a granular, program level. We extracted data from the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report that captured development assistance for HIV/AIDS from 1990 to 2015 for all major bilateral and multilateral aid agencies. To build on these data, we extracted additional budget data, and disaggregated development assistance for HIV/AIDS into nine program areas, including prevention, treatment, and health system support. Since 2000, $109.8 billion of development assistance has been provided for HIV/AIDS. Between 2000 and 2010, development assistance for HIV/AIDS increased at an annualized rate of 22.8%. Since 2010, the annualized rate of growth has dropped to 1.3%. Had development assistance for HIV/AIDS continued to climb after 2010 as it had in the previous decade, $44.8 billion more in development assistance would have been available for HIV/AIDS. Since 1990, treatment and prevention were the most funded HIV/AIDS program areas receiving $24.6 billion and $22.7 billion, respectively. Since 2010, these two program areas and HIV/AIDS health system strengthening have continued to grow, marginally, with majority support from the US government and the Global Fund. An average of $252.9 of HIV/AIDS development assistance per HIV/AIDS prevalent case was disbursed between 2011 and 2013. The scale-up of development assistance for HIV/AIDS from 2000 to 2010 was unprecedented. During this period, international donors prioritized HIV/AIDS treatment, prevention, and health system support. Since 2010, funding for HIV/AIDS has plateaued.

The Seismic Alert System of Mexico (SASMEX): Performance and Evolution

NASA Astrophysics Data System (ADS)

Espinosa Aranda, J.

2013-05-01

Originally the Seismic Alert System of Mexico (SASMEX) was proposed to integrate the Seismic Alert System of Mexico City (SAS), operating since 1991, with the Seismic Alert System of Oaxaca City (SASO), in services since 2003. And today, after the intense big earthquake activity observed in our world during 2010 and 2011, local governments of Mexico City, Oaxaca Estate, and the Mexican Ministry of the Interior have been promoting the expansion of this technological EEW development. Until 2012 SASMEX better coverage includes 48 new field seismic sensors (FS) deployed over the seismic region of Jalisco, Colima, Michoacan and Puebla, with someone enhancements over Guerrero and Oaxaca, to reach 97 FS. During 2013, 35 new FS has been proposed to SASMEX enhancements covering the Chiapas and Veracruz seismic regions. The SASMEX, with the support of the Mexico Valley Broadcasters Association (ARVM) since 1993, automatically issue Public and Preventive earthquake early warning signals in the Cities of Mexico, Toluca, Acapulco, Chilpancingo, and Oaxaca. The seismic warning range in each case is seated in accordance with local Civil Protection Authorities: Public Alert, if they expect strong earthquake effects, and Preventive Alert one, the effect could be moderated. Now the SASMEX warning time opportunity could be different to the 60 sec. average typically generated when SAS warned earthquake effects coming from Guerrero to Mexico City valley. Mexican EEW issued today reach: 16 Public and 62 Preventive Alert in Mexico City; 25 Public and 19 Preventive Alerts in Oaxaca City; also 14 Public and 4 Preventive Alerts in Acapulco; 14 Public and 5 Preventive Alerts in Chilpancingo. The earthquakes events registered by SASMEX FS until now reach 3448. With the support of private and Federal telecommunications infrastructure like, TELMEX, Federal Electric Commission, and the Mexican Security Ministry, it was developed a redundant communication system with pads to link the different Cities, trough VHF and UHF radio signals, Fiber Optics, and Satellite technologies, to reach more reliability and availability SASMEX functions and services. To increase the seismic early warning efficiency the Mexico City Historical Center Authorities, promoted the installation of the NOAA VHF radio transmitters system to cover the Mexico City valley, operating with the Specific Area Message Encoding (SAME) called NWR-SAME, and with the Emergency Alert Systems (EAS) protocol of United States. As an enhancement of the NOAA receiver protocol, it was innovated to permit fast Public Alert issue, in no more than 2 sec. The new receiver applied in Mexico is called SARMEX™. Local and federal authorities acquired 90,000 SARMEX™ receivers to be distributed manly in public schools of Mexican cities covered by the SASMEX™ signals; the measure with the aim to promote better natural hazard prevention attitude in the Mexican young population segment.

Development of an electronic emergency department-based geo-information injury surveillance system in Hong Kong.

PubMed

Chow, C B; Leung, M; Lai, Adela; Chow, Y H; Chung, Joanne; Tong, K M; Lit, Albert

2012-06-01

To describe the experience in the development of an electronic emergency department (ED)-based injury surveillance (IS) system in Hong Kong using data-mining and geo-spatial information technology (IT) for a Safe Community setup. This paper described the phased development of an emergency department-based IS system based on World Health Organization (WHO) injury surveillance Guideline to support safety promotion and injury prevention in a Safe Community in Hong Kong starting 2002. The initial ED data-based only collected data on name, sex, age, address, eight general categories of injury types (traffic, domestic, common assault, indecent assault, batter, industrial, self-harm and sports) and disposal from ED. Phase 1--manual data collection on International Classification of External Causes of Injury pre-event data; Phase 2--manual form was converted to electronic format using web-based data mining technology with built in data quality monitoring mechanism; Phase 3--integration of injury surveillance-data with in-patient hospital information; and Phase 4--geo-spatial information and body mapping were introduced to geo-code exact place of injury in an electronic map and site of injury on body map. It was feasible to develop a geo-spatial IS system at busy ED to collect valuable information for safety promotion and injury prevention at Safe Community setting. The keys for successful development and implementation involves engagement of all stakeholders at design and implementation of the system with injury prevention as ultimate goal, detail workflow planning at front end, support from the management, building on exiting system and appropriate utilisation of modern technology. Copyright © 2011 Elsevier Ltd. All rights reserved.

Wayfinding the Live 5-2-1-0 Initiative-At the Intersection between Systems Thinking and Community-Based Childhood Obesity Prevention.

PubMed

Amed, Shazhan; Shea, Stephanie; Pinkney, Susan; Wharf Higgins, Joan; Naylor, Patti-Jean

2016-06-21

Childhood obesity is complex and requires a 'systems approach' that collectively engages across multiple community settings. Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has implemented Live 5-2-1-0-a multi-sector, multi-component childhood obesity prevention initiative informed by systems thinking and participatory research via an innovative knowledge translation (KT) model (RE-FRAME). This paper describes the protocol for implementing and evaluating RE-FRAME in two 'existing' (>2 years of implementation) and two 'new' Live 5-2-1-0 communities to understand how to facilitate and sustain systems/community-level change. In this mixed-methods study, RE-FRAME was implemented via online resources, webinars, a backbone organization (SCOPE) coordinating the initiative, and a linking system supporting KT. Qualitative and quantitative data were collected using surveys and stakeholder interviews, analyzed using thematic analysis and descriptive statistics, respectively. Existing communities described the consistency of Live 5-2-1-0 and extensive local partnerships/champions as catalysts for synergistic community-wide action; new communities felt that the simplicity of the message combined with the transfer of experiential learning would inform their own strategies and policies/programs to broadly disseminate Live 5-2-1-0. RE-FRAME effectively guided the refinement of the initiative and provided a framework upon which evaluation results described how to implement a community-based systems approach to childhood obesity prevention.

Delivering "Just-In-Time" Smoking Cessation Support Via Mobile Phones: Current Knowledge and Future Directions.

PubMed

Naughton, Felix

2016-05-28

Smoking lapses early on during a quit attempt are highly predictive of failing to quit. A large proportion of these lapses are driven by cravings brought about by situational and environmental cues. Use of cognitive-behavioral lapse prevention strategies to combat cue-induced cravings is associated with a reduced risk of lapse, but evidence is lacking in how these strategies can be effectively promoted. Unlike most traditional methods of delivering behavioral support, mobile phones can in principle deliver automated support, including lapse prevention strategy recommendations, Just-In-Time (JIT) for when a smoker is most vulnerable, and prevent early lapse. JIT support can be activated by smokers themselves (user-triggered), by prespecified rules (server-triggered) or through sensors that dynamically monitor a smoker's context and trigger support when a high risk environment is sensed (context-triggered), also known as a Just-In-Time Adaptive Intervention (JITAI). However, research suggests that user-triggered JIT cessation support is seldom used and existing server-triggered JIT support is likely to lack sufficient accuracy to effectively target high-risk situations in real time. Evaluations of mobile phone cessation interventions that include user and/or server-triggered JIT support have yet to adequately assess whether this improves management of high risk situations. While context-triggered systems have the greatest potential to deliver JIT support, there are, as yet, no impact evaluations of such systems. Although it may soon be feasible to learn about and monitor a smoker's context unobtrusively using their smartphone without burdensome data entry, there are several potential advantages to involving the smoker in data collection. This commentary describes the current knowledge on the potential for mobile phones to deliver automated support to help smokers manage or cope with high risk environments or situations for smoking, known as JIT support. The article categorizes JIT support into three main types: user-triggered, server-triggered, and context-triggered. For each type of JIT support, a description of the evidence and their potential to effectively target specific high risk environments or situations is described. The concept of unobtrusive sensing without user data entry to inform the delivery of JIT support is finally discussed in relation to potential advantages and disadvantages for behavior change. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Increased Adoption of Quality Improvement Interventions to Implement Evidence-Based Practices for Pressure Ulcer Prevention in U.S. Academic Medical Centers.

PubMed

Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Wald, Heidi L; Campbell, Jonathan D; Nair, Kavita V; Valuck, Robert J

2015-12-01

In 2008, the U.S. Centers for Medicare and Medicaid Services enacted a nonpayment policy for stage III and IV hospital-acquired pressure ulcers (HAPUs), which incentivized hospitals to improve prevention efforts. In response, hospitals looked for ways to support implementation of evidence-based practices for HAPU prevention, such as adoption of quality improvement (QI) interventions. The objective of this study was to quantify adoption patterns of QI interventions for supporting evidence-based practices for HAPU prevention. This study surveyed wound care specialists working at hospitals within the University HealthSystem Consortium. A questionnaire was used to retrospectively describe QI adoption patterns according to 25 HAPU-specific QI interventions into four domains: leadership, staff, information technology (IT), and performance and improvement. Respondents indicated QI interventions implemented between 2007 and 2012 to the nearest quarter and year. Descriptive statistics defined patterns of QI adoption. A t-test and statistical process control chart established statistically significant increase in adoption following nonpayment policy enactment in October 2008. Increase are described in terms of scope (number of QI domains employed) and scale (number of QI interventions within domains). Fifty-three of the 55 hospitals surveyed reported implementing QI interventions for HAPU prevention. Leadership interventions were most frequent, increasing in scope from 40% to 63% between 2008 and 2012; "annual programs to promote pressure ulcer prevention" showed the greatest increase in scale. Staff interventions increased in scope from 32% to 53%; "frequent consult driven huddles" showed the greatest increase in scale. IT interventions increased in scope from 31% to 55%. Performance and improvement interventions increased in scope from 18% to 40%, with "new skin care products . . ." increasing the most. Academic medical centers increased adoption of QI interventions following changes in nonpayment policy. These QI interventions supported adherence to implementation of pressure ulcer prevention protocols. Changes in payment policies for prevention are effective in QI efforts. © 2015 Sigma Theta Tau International.

Lessons from obesity prevention for the prevention of mental disorders: the primordial prevention approach.

PubMed

Hayward, Joshua; Jacka, Felice N; Waters, Elizabeth; Allender, Steven

2014-09-10

Emerging evidence supports a relationship between risk factors for obesity and the genesis of the common mental disorders, depression and anxiety. This suggests common mental disorders should be considered as a form of non-communicable disease, preventable through the modification of lifestyle behaviours, particularly diet and physical activity. Obesity prevention research since the 1970's represents a considerable body of knowledge regarding strategies to modify diet and physical activity and so there may be clear lessons from obesity prevention that apply to the prevention of mental disorders. For obesity, as for common mental disorders, adolescence represents a key period of vulnerability. In this paper we briefly discuss relationships between modifiable lifestyle risk factors and mental health, lifestyle risk factor interventions in obesity prevention research, the current state of mental health prevention, and the implications of current applications of systems thinking in obesity prevention research for lifestyle interventions. We propose a potential focus for future mental health promotion interventions and emphasise the importance of lessons available from other lifestyle modification intervention programmes.

A computerized clinical decision support system as a means of implementing depression guidelines.

PubMed

Trivedi, Madhukar H; Kern, Janet K; Grannemann, Bruce D; Altshuler, Kenneth Z; Sunderajan, Prabha

2004-08-01

The authors describe the history and current use of computerized systems for implementing treatment guidelines in general medicine as well as the development, testing, and early use of a computerized decision support system for depression treatment among "real-world" clinical settings in Texas. In 1999 health care experts from Europe and the United States met to confront the well-documented challenges of implementing treatment guidelines and to identify strategies for improvement. They suggested the integration of guidelines into computer systems that is incorporated into clinical workflow. Several studies have demonstrated improvements in physicians' adherence to guidelines when such guidelines are provided in a computerized format. Although computerized decision support systems are being used in many areas of medicine and have demonstrated improved patient outcomes, their use in psychiatric illness is limited. The authors designed and developed a computerized decision support system for the treatment of major depressive disorder by using evidence-based guidelines, transferring the knowledge gained from the Texas Medication Algorithm Project (TMAP). This computerized decision support system (CompTMAP) provides support in diagnosis, treatment, follow-up, and preventive care and can be incorporated into the clinical setting. CompTMAP has gone through extensive testing to ensure accuracy and reliability. Physician surveys have indicated a positive response to CompTMAP, although the sample was insufficient for statistical testing. CompTMAP is part of a new era of comprehensive computerized decision support systems that take advantage of advances in automation and provide more complete clinical support to physicians in clinical practice.

The design and implementation of urban earthquake disaster loss evaluation and emergency response decision support systems based on GIS

NASA Astrophysics Data System (ADS)

Yang, Kun; Xu, Quan-li; Peng, Shuang-yun; Cao, Yan-bo

2008-10-01

Based on the necessity analysis of GIS applications in earthquake disaster prevention, this paper has deeply discussed the spatial integration scheme of urban earthquake disaster loss evaluation models and visualization technologies by using the network development methods such as COM/DCOM, ActiveX and ASP, as well as the spatial database development methods such as OO4O and ArcSDE based on ArcGIS software packages. Meanwhile, according to Software Engineering principles, a solution of Urban Earthquake Emergency Response Decision Support Systems based on GIS technologies have also been proposed, which include the systems logical structures, the technical routes,the system realization methods and function structures etc. Finally, the testing systems user interfaces have also been offered in the paper.

40 CFR 51.166 - Prevention of significant deterioration of air quality.

Code of Federal Regulations, 2010 CFR

2010-07-01

... building supports and foundations, laying of underground pipework, and construction of permanent storage... source or modification through application of production processes or available methods, systems, and... application of measurement methodology to a particular emissions unit would make the imposition of an...

Factors Influencing Implementation of a Preschool-Based Physical Activity Intervention

ERIC Educational Resources Information Center

Lau, Erica Y.; Saunders, Ruth P.; Beets, Michael W.; Cai, Bo; Pate, Russell R.

2017-01-01

Examining factors that influence implementation of key program components that underlie an intervention's success provides important information to inform the development of effective dissemination strategies. We examined direct and indirect effects of preschool capacity, quality of prevention support system and teacher characteristics on…

Environmentally Friendly Corrosion Preventative Compounds for Ground Support Structures

NASA Technical Reports Server (NTRS)

Montgomery Eliza L.; Calle, Luz, Marina; Curran, Jerome P.; Kolody, Mark R.

2013-01-01

The need to use environmentally friendly technologies throughout future space-related launch programs prompted a study aimed at replacing current petroleum and solvent-based Corrosion Preventive Compounds (CPCs) with environmentally friendly alternatives. The work in this paper focused on the identification and evaluation of environmentally friendly CPCs for use in protecting flight hardware and ground support equipment from atmospheric corrosion. CPCs are used as temporary protective coatings and must survive in the aggressive coastal marine environment that exists throughout the Kennedy Space Center, Florida. The different protection behaviors of fifteen different oily film CPCs, both common petroleum-based and newer environmentally friendly types, were evaluated on various steel and aluminum substrates. CPC and substrate systems were subjected to atmospheric testing at the Kennedy Space Center's Beachside Atmospheric Corrosion Test Site, as well as cyclic accelerated corrosion testing. Each CPC also underwent physical characterization and launch-related compatibility testing. The results for the fifteen CPC systems are presented in this paper.

Environmentally friendly corrosion preventive compounds for ground support structures

NASA Astrophysics Data System (ADS)

Montgomery, Eliza; Curran, Jerome; Calle, Luz Marina; Kolody, Mark

The need to use environmentally friendly technologies throughout future space-related launch programs prompted a study aimed at replacing current petroleum and solvent-based corrosion preventive compounds (CPCs) with environmentally friendly alternatives. The work in this paper focused on the identification and evaluation of environmentally friendly CPCs for use in protecting flight hardware and ground support equipment from atmospheric corrosion. CPCs are used as temporary protective coatings and must survive in the aggressive coastal marine environment that exists throughout the Kennedy Space Center, Florida. The different protection behaviors of fifteen different oily film CPCs, both common petroleum-based and newer environmentally friendly types, were evaluated on various steel and aluminum substrates. CPC and substrate systems were subjected to atmospheric testing at the Kennedy Space Center's Beachside Atmospheric Corrosion Test Site, as well as cyclic accelerated corrosion testing. Each CPC also underwent physical characterization and launch-related compatibility testing. The results for the fifteen CPC systems are presented in this paper.

Activities of the Korean Institute of Tuberculosis

PubMed Central

Ryoo, Sungweon; Kim, Hee Jin

2014-01-01

The Korean National Tuberculosis Association (KNTA) set up the Korean Institute of Tuberculosis (KIT) in 1970 to foster research and technical activities pertaining to tuberculosis (TB). The KNTA/KIT had successfully conducted a countrywide TB prevalence survey from 1965 to 1995 at 5-year intervals. The survey results (decline in TB rates) established Korea as a country that had successfully implemented national control programs for TB. The KIT developed the Korea Tuberculosis Surveillance System and the Laboratory Management Information System, both of which were transferred to the Korea Centers for Disease Control and Prevention after its establishment. The KIT functions as a central and supranational reference TB laboratory for microbiological and epidemiological research and provides training and education for health-care workers and medical practitioners. Recently, the KIT has expanded its activities to countries such as Ethiopia, Laos, and Timor-Leste to support TB control and prevention. The KIT will continue to support research activities and provide technical assistance in diagnosing the infection until it is completely eliminated in Korea. PMID:25861580

A Fiber Bragg Grating-Based Monitoring System for Roof Safety Control in Underground Coal Mining

PubMed Central

Zhao, Yiming; Zhang, Nong; Si, Guangyao

2016-01-01

Monitoring of roof activity is a primary measure adopted in the prevention of roof collapse accidents and functions to optimize and support the design of roadways in underground coalmines. However, traditional monitoring measures, such as using mechanical extensometers or electronic gauges, either require arduous underground labor or cannot function properly in the harsh underground environment. Therefore, in this paper, in order to break through this technological barrier, a novel monitoring system for roof safety control in underground coal mining, using fiber Bragg grating (FBG) material as a perceived element and transmission medium, has been developed. Compared with traditional monitoring equipment, the developed, novel monitoring system has the advantages of providing accurate, reliable, and continuous online monitoring of roof activities in underground coal mining. This is expected to further enable the prevention of catastrophic roof collapse accidents. The system has been successfully implemented at a deep hazardous roadway in Zhuji Coal Mine, China. Monitoring results from the study site have demonstrated the advantages of FBG-based sensors over traditional monitoring approaches. The dynamic impacts of progressive face advance on roof displacement and stress have been accurately captured by the novel roadway roof activity and safety monitoring system, which provided essential references for roadway support and design of the mine. PMID:27775657

Embedded sensor systems for health - providing the tools in future healthcare.

PubMed

Lindén, Maria; Björkman, Mats

2014-01-01

Wearable, embedded sensor systems for health applications are foreseen to be enablers in the future healthcare. They will provide ubiquitous monitoring of multiple parameters without restricting the person to stay at home or in the hospital. By following trend changes in the health status, early deteriorations will be detected and treatment can start earlier. Also health prevention will be supported. Such future healthcare requires technology development, including miniaturized sensors, smart textiles and wireless communication. The tremendous amount of data generated by these systems calls for both signal processing and decision support to guarantee the quality of data and avoid overflow of information. Safe and secure communications have to protect the integrity of the persons monitored.

A decision-support tool to inform Australian strategies for preventing suicide and suicidal behaviour.

PubMed

Page, Andrew; Atkinson, Jo-An; Heffernan, Mark; McDonnell, Geoff; Hickie, Ian

2017-04-27

Dynamic simulation modelling is increasingly being recognised as a valuable decision-support tool to help guide investments and actions to address complex public health issues such as suicide. In particular, participatory system dynamics (SD) modelling provides a useful tool for asking high-level 'what if' questions, and testing the likely impacts of different combinations of policies and interventions at an aggregate level before they are implemented in the real world. We developed an SD model for suicide prevention in Australia, and investigated the hypothesised impacts over the next 10 years (2015-2025) of a combination of current intervention strategies proposed for population interventions in Australia: 1) general practitioner (GP) training, 2) coordinated aftercare in those who have attempted suicide, 3) school-based mental health literacy programs, 4) brief-contact interventions in hospital settings, and 5) psychosocial treatment approaches. Findings suggest that the largest reductions in suicide were associated with GP training (6%) and coordinated aftercare approaches (4%), with total reductions of 12% for all interventions combined. This paper highlights the value of dynamic modelling methods for managing complexity and uncertainty, and demonstrates their potential use as a decision-support tool for policy makers and program planners for community suicide prevention actions.

National infection prevention and control programmes: Endorsing quality of care.

PubMed

Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

2014-01-01

Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

Extending Cancer Prevention to Improve Fruit and Vegetable Consumption

PubMed Central

Freedman, Darcy A.; Peña-Purcell, Ninfa; Friedman, Daniela B.; Ory, Marcia; Flocke, Susan; Barni, Marie T.; Hébert, James R.

2014-01-01

Consuming a diet that is rich in fruits and vegetables is critical for preventing cancer and cancer-related disparities. Food systems approaches that increase spatial-temporal, economic, and social access to fruits and vegetables may ultimately result in improved consumption patterns among Americans. Engaging the triad of Cooperative Extension Services, public health systems, and community health centers may yield maximal public health benefits from food systems interventions. These entities have a mutual interest in promoting health equity and community and economic vitality that provides common ground to (a) implement solutions through the dissemination of evidence-based programs and (b) share resources to foster grassroots support for sustained change. Working together, these systems have an unprecedented opportunity to build on their common ground to implement, evaluate, and disseminate evidence-based food systems interventions in communities and with populations experiencing disparate risk for cancer and cancer-related diseases. PMID:24748060

The Global Emergency Observation and Warning System

NASA Technical Reports Server (NTRS)

Bukley, Angelia P.; Mulqueen, John A.

1994-01-01

Based on an extensive characterization of natural hazards, and an evaluation of their impacts on humanity, a set of functional technical requirements for a global warning and relief system was developed. Since no technological breakthroughs are required to implement a global system capable of performing the functions required to provide sufficient information for prevention, preparedness, warning, and relief from natural disaster effects, a system is proposed which would combine the elements of remote sensing, data processing, information distribution, and communications support on a global scale for disaster mitigation.

Monochloramine use for prevention of Legionella in hospital water systems.

PubMed

Kandiah, Sheetal; Yassin, Mohamed H; Stout, Janet

2013-06-01

Eradication of Legionella species from water distribution systems especially in hospital settings has proven to be challenging. Legionella species causes Legionnaire's disease that is a potentially fatal respiratory disease often acquired through the aerosolization of contaminated water. Monochloramine has been used successfully in the municipal water systems to eradicate Legionella and there is currently limited data to support its use in the hospital setting. This technology appears to be affordable, safe and effective at penetrating biofilm in water distribution systems.

Mathematical Modelling-Based Energy System Operation Strategy Considering Energy Storage Systems

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

Ryu, Jun-Hyung; Hodge, Bri-Mathias

2016-06-25

Renewable energy resources are widely recognized as an alternative to environmentally harmful fossil fuels. More renewable energy technologies will need to penetrate into fossil fuel dominated energy systems to mitigate the globally witnessed climate changes and environmental pollutions. It is necessary to prepare for the potential problems with increased proportions of renewable energy in the energy system, to prevent higher costs and decreased reliability. Motivated by this need, this paper addresses the operation of an energy system with an energy storage system in the context of developing a decision-supporting framework.

Elevated waterproof access floor system and method of making the same

NASA Technical Reports Server (NTRS)

Cohen, Marc M. (Inventor)

1987-01-01

An elevated waterproof access floor system having subfloor channels or compartments for power lines, gas lines or the like is adapted such that it can be opened and subsequently resealed without destroying the waterproofing and without destroying its aesthetic appearance. A multiplicity of tiles are supported on a support grid, and a flooring sheet is supported on the tiles. Attachment means are provided to prevent lateral but not vertical movement of the flooring sheet with respect to the tiles so that the flooring sheet can be lifted off the tiles, but when the flooring sheet is supported on the tiles, no lateral slipping will occur. The flooring sheet is made of a heat resealable material, so that it can be cut away in sections, and the tiles therebelow lifted off, to provide access to subfloor compartments.

Vaccine-preventable diseases: the role of the European Centre for Disease Prevention and Control.

PubMed

Kramarz, P; Lopalco, P L; Huitric, E; Pastore Celentano, L

2014-05-01

The role of the European Centre for Disease Prevention and Control (ECDC) is to strengthen the capacity of the European Union (EU) Member States to protect human health through the prevention and control of infectious diseases. The main objective of the programme on vaccine-preventable diseases and invasive bacterial infections (VPD) is to provide robust evidence and high-quality technical support to the EU Member States to help them in their efforts to prevent and control VPD. Since the establishment of ECDC, several existing VPD surveillance networks have been transferred to ECDC, namely EU-IBIS, DIPNET and EUVAC. In addition to surveillance of diseases, ECDC is collecting information and monitoring other parameters that are of crucial importance for a well-functioning immunization system, including vaccination coverage. The VPD programme also provides independent scientific opinions in the area of immunization and initiates and coordinates scientific studies in the area of vaccination to answer specific questions of public health importance, including risk perception and analysis of behaviour in different population groups. One of the overall ECDC priorities over recent years is the Centre's involvement in measles elimination. The 'Message' tool and the 'Measles Atlas' are examples of work aiming at supporting the efforts of Member States in the elimination phase. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Gis-Based Accessibility Analysis of Urban Emergency Shelters: the Case of Adana City

NASA Astrophysics Data System (ADS)

Unal, M.; Uslu, C.

2016-10-01

Accessibility analysis of urban emergency shelters can help support urban disaster prevention planning. Pre-disaster emergency evacuation zoning has become a significant topic on disaster prevention and mitigation research. In this study, we assessed the level of serviceability of urban emergency shelters within maximum capacity, usability, sufficiency and a certain walking time limit by employing spatial analysis techniques of GIS-Network Analyst. The methodology included the following aspects: the distribution analysis of emergency evacuation demands, the calculation of shelter space accessibility and the optimization of evacuation destinations. This methodology was applied to Adana, a city in Turkey, which is located within the Alpine-Himalayan orogenic system, the second major earthquake belt after the Pacific-Belt. It was found that the proposed methodology could be useful in aiding to understand the spatial distribution of urban emergency shelters more accurately and establish effective future urban disaster prevention planning. Additionally, this research provided a feasible way for supporting emergency management in terms of shelter construction, pre-disaster evacuation drills and rescue operations.

Development of a Systems Science Curriculum to Engage Rural African American Teens in Understanding and Addressing Childhood Obesity Prevention

ERIC Educational Resources Information Center

Frerichs, Leah; Lich, Kristen Hassmiller; Young, Tiffany L.; Dave, Gaurav; Stith, Doris; Corbie-Smith, Giselle

2018-01-01

Engaging youth from racial and ethnic minority communities as leaders for change is a potential strategy to mobilize support for addressing childhood obesity, but there are limited curricula designed to help youth understand the complex influences on obesity. Our aim was to develop and pilot test a systems science curriculum to elicit rural…

Guide for Oxygen Compatibility Assessments on Oxygen Components and Systems

NASA Technical Reports Server (NTRS)

Rosales, Keisa R.; Shoffstall, Michael S.; Stoltzfus, Joel M.

2007-01-01

Understanding and preventing fire hazards is necessary when designing, maintaining, and operating oxygen systems. Ignition risks can be minimized by controlling heat sources and using materials that will not ignite or will not support burning in the end-use environment. Because certain materials are more susceptible to ignition in oxygen-enriched environments, a compatibility assessment should be performed before the component is introduced into an oxygen system. This document provides an overview of oxygen fire hazards and procedures that are consistent with the latest versions of American Society for Testing and Materials (ASTM) Standards G63 (1999) and G94 (2005) to address fire hazards associated with oxygen systems. This document supersedes the previous edition, NASA Technical Memorandum 104823, Guide for Oxygen Hazards Analyses on Components and Systems (1996). The step-by-step oxygen compatibility assessment method described herein (see Section 4) enables oxygen-system designers, system engineers, and facility managers to determine areas of concern with respect to oxygen compatibility and, ultimately, prevent damage to a system or injury to personnel.

Platelet activation by extracellular matrix proteins in haemostasis and thrombosis.

PubMed

Watson, Steve P

2009-01-01

The prevention of excessive blood loss to avoid fatal haemorrhage is a pivotal process for all organisms possessing a circulatory system. Increased circulating blood volume and pressure, as required in larger animals, make this process all the more important and challenging. It is essential to have a powerful and rapid system to detect damage and generate an effective seal, and which is also exquisitely regulated to prevent unwanted, excessive or systemic activation so as to avoid blockage of vessels. Thus, a highly specialised and efficient haemostatic system has evolved that consists of cellular (platelets) and protein (coagulation factors) components. Importantly, this is able to support haemostasis in both the low shear environment of the venous system and the high shear environment of the arterial system. Endothelial cells, lining the entire circulation system, play a crucial role in the delicate balance between activation and inhibition of the haemostatic system. An intact and healthy endothelium supports blood flow by preventing attachment of cells and proteins which is required for initiation of coagulation and platelet activation. Endothelial cells produce and release the two powerful soluble inhibitors of platelet activation, nitric oxide and prostacyclin, and express high levels of CD39 which rapidly metabolises the major platelet feedback agonist, ADP. This antithrombotic environment however can rapidly change following activation or removal of endothelial cells through injury or rupture of atherosclerotic plaques. Loss of endothelial cells exposes the subendothelial extracellular matrix which creates strong signals for activation of the haemostatic system including powerful platelet adhesion and activation. Quantitative and qualitative changes in the composition of the subendothelial extracellular matrix influence these prothrombotic characteristics with life threatening thrombotic and bleeding complications, as illustrated by formation of atherosclerotic plaques or the disorder Ehler-Danlos syndrome, which is caused by a defect in collagen synthesis and is associated with fragile blood vessels. This review will focus on the role of the subendothelial matrix in haemostasis and thrombosis, highlighting its potential as a target for novel antithrombotics.

POOL WATER TREATMENT AND COOLING SYSTEM DESCRIPTION DOCUMENT

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

V. King

2000-06-19

The Pool Water Treatment and Cooling System is located in the Waste Handling Building (WHB), and is comprised of various process subsystems designed to support waste handling operations. This system maintains the pool water temperature within an acceptable range, maintains water quality standards that support remote underwater operations and prevent corrosion, detects leakage from the pool liner, provides the capability to remove debris from the pool, controls the pool water level, and helps limit radiological exposure to personnel. The pool structure and liner, pool lighting, and the fuel staging racks in the pool are not within the scope of themore » Pool Water Treatment and Cooling System. Pool water temperature control is accomplished by circulating the pool water through heat exchangers. Adequate circulation and mixing of the pool water is provided to prevent localized thermal hotspots in the pool. Treatment of the pool water is accomplished by a water treatment system that circulates the pool water through filters, and ion exchange units. These water treatment units remove radioactive and non-radioactive particulate and dissolved solids from the water, thereby providing the water clarity needed to conduct waste handling operations. The system also controls pool water chemistry to prevent advanced corrosion of the pool liner, pool components, and fuel assemblies. Removal of radioactivity from the pool water contributes to the project ALARA (as low as is reasonably achievable) goals. A leak detection system is provided to detect and alarm leaks through the pool liner. The pool level control system monitors the water level to ensure that the minimum water level required for adequate radiological shielding is maintained. Through interface with a demineralized water system, adequate makeup is provided to compensate for loss of water inventory through evaporation and waste handling operations. Interface with the Site Radiological Monitoring System provides continuous radiological monitoring of the pool water. The Pool Water Treatment and Cooling System interfaces with the Waste Handling Building System, Site-Generated Radiological Waste Handling System, Site Radiological Monitoring System, Waste Handling Building Electrical System, Site Water System, and the Monitored Geologic Repository Operations Monitoring and Control System.« less

Pressure ulcers: implementation of evidence-based nursing practice.

PubMed

Clarke, Heather F; Bradley, Chris; Whytock, Sandra; Handfield, Shannon; van der Wal, Rena; Gundry, Sharon

2005-03-01

A 2-year project was carried out to evaluate the use of multi-component, computer-assisted strategies for implementing clinical practice guidelines. This paper describes the implementation of the project and lessons learned. The evaluation and outcomes of implementing clinical practice guidelines to prevent and treat pressure ulcers will be reported in a separate paper. The prevalence and incidence rates of pressure ulcers, coupled with the cost of treatment, constitute a substantial burden for our health care system. It is estimated that treating a pressure ulcer can increase nursing time up to 50%, and that treatment costs per ulcer can range from US$10,000 to $86,000, with median costs of $27,000. Although evidence-based guidelines for prevention and optimum treatment of pressure ulcers have been developed, there is little empirical evidence about the effectiveness of implementation strategies. The study was conducted across the continuum of care (primary, secondary and tertiary) in a Canadian urban Health Region involving seven health care organizations (acute, home and extended care). Trained surveyors (Registered Nurses) determined the prevalence and incidence of pressure ulcers among patients in these organizations. The use of a computerized decision-support system assisted staff to select optimal, evidence-based care strategies, record information and analyse individual and aggregate data. Evaluation indicated an increase in knowledge relating to pressure ulcer prevention, treatment strategies, resources required, and the role of the interdisciplinary team. Lack of visible senior nurse leadership; time required to acquire computer skills and to implement new guidelines; and difficulties with the computer system were identified as barriers. There is a need for a comprehensive, supported and sustained approach to implementation of evidence-based practice for pressure ulcer prevention and treatment, greater understanding of organization-specific barriers, and mechanisms for addressing the barriers.

An update of a systematic review of controlled clinical trials on the primary prevention of back pain at the workplace.

PubMed

van Poppel, Mireille N M; Hooftman, Wendela E; Koes, Bart W

2004-08-01

To update the evidence on the effectiveness of lumbar supports, education and exercise in the primary prevention of low back pain at the workplace. A computerized search for controlled clinical trials published between 1997 and 2002 was conducted, and the methodological quality of the studies was assessed using a criteria list. The available evidence was graded with a rating system for the level of evidence. Effect sizes of individual studies were combined if the studies were sufficiently similar. Five new papers were identified for the update. These trials were added to the previously available trials (n = 11). The methodological quality of most studies was low. Since three of four RCTs on lumbar supports reported no effect, there is no evidence for the effectiveness of lumbar supports. No evidence for education could be found either, since all six RCTs showed negative results. The four RCTs on exercise consistently reported a positive effect, indicating limited evidence for the effectiveness of exercise. There is no evidence for the effectiveness of lumbar supports or education in the primary prevention of low back pain at the workplace. There is limited evidence for the efficacy of exercise, and the effect that can be obtained is moderate. There is still a need for methodologically sound studies and studies on the cost-effectiveness of exercise. Also the possible effect of lumbar supports in the treatment of back pain needs further investigation.

77 FR 27863 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... Therapy (CWT), HUD/VA Prevention pilot, and Supportive Services for Veterans and Families (SSVF). This... Veterans and their immediate family members, members of the armed services, current and former employees... Location Addiction Severity Index Veteran Affairs Medical Center, 7180 Highland Drive, Pittsburgh, PA 15206...

From innovation to implementation: the long and winding road.

PubMed

Galavotti, Christine; Kuhlmann, Anne K Sebert; Kraft, Joan Marie; Harford, Nicola; Petraglia, Joseph

2008-06-01

Building on theory and past research, in early 2000 scientists in the Division of Reproductive Health developed a prevention innovation for CDC's Global AIDS Program for use in countries severely affected by the HIV/AIDS epidemic. This innovative program model is called MARCH: Modeling and Reinforcement to Combat HIV/AIDS (Galavotti et al. Am J Public Health 91:1602-1607, 2001). MARCH promotes behavioral changes that reduce the risk of HIV infection and creates normative environments that sustain these changes through two key program components: entertainment-education using mass media, particularly long-running radio serial dramas, and reinforcement activities at the community level. Using the framework developed by Wandersman et al. (Am J Commun Psychol, 41(3-4), 2008), we describe the key elements of the MARCH prevention innovation and outline how we support its adaptation and implementation. We focus on the following questions: How do we get from an innovative model to effective program implementation in the field? How do we support implementation with fidelity when adaptation is required? And, once implemented, can we demonstrate fidelity of the adaptation to the original program model? Because our program model requires local adaptation for every instance of implementation, we suggest a potential enhancement to the Interactive Systems Framework-support for adaptation of the innovation-as part of the Prevention Support System. In this paper we describe how we supported adaptation of the radio serial drama component for unique contexts in several African countries. We focus attention on the tools and trainings we developed to build innovation specific capacity for implementation, including capacities for adaptation. We then present results of a qualitative analysis of scripts from the MARCH radio serial drama in Zimbabwe to assess the adapted program's fidelity to the original design of the innovation. Finally, we discuss lessons learned and explore implications for the field.

XVII International AIDS Conference: From Evidence to Action - Social, behavioural and economic science and policy and political science.

PubMed

Mykhalovskiy, Eric; Brown, Glen; Kort, Rodney

2009-10-06

AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for universal access to HIV prevention, treatment, care and support. Conference sessions and discussions reinforced the tangible negative effects of stigma on national legislation and policies. A strong theme throughout the conference was the need to replace prevention interventions that focus exclusively on individual behaviour change or biomedical prevention interventions with "combination prevention" approaches that address both individual and structural factors that increase vulnerability to HIV infection.Several high-level sessions addressed various aspects of the debate over "vertical" (disease-specific) versus "horizontal" (health systems) funding. The majority of evidence presented at the conference suggests that HIV investments strengthen health systems through the establishment of clinical and laboratory infrastructure, strengthened supply and procurement systems, improvements in health care worker training, and increased community engagement.Human rights were a focal point at the conference; several presentations emphasized the importance of securing human rights to achieve universal access goals, including workplace discrimination, travel restrictions, gender inequality, and the criminalization of homosexuality, drug use, sex work, and HIV transmission and/or exposure.

XVII International AIDS Conference: From Evidence to Action - Social, behavioural and economic science and policy and political science

PubMed Central

2009-01-01

AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for universal access to HIV prevention, treatment, care and support. Conference sessions and discussions reinforced the tangible negative effects of stigma on national legislation and policies. A strong theme throughout the conference was the need to replace prevention interventions that focus exclusively on individual behaviour change or biomedical prevention interventions with "combination prevention" approaches that address both individual and structural factors that increase vulnerability to HIV infection. Several high-level sessions addressed various aspects of the debate over "vertical" (disease-specific) versus "horizontal" (health systems) funding. The majority of evidence presented at the conference suggests that HIV investments strengthen health systems through the establishment of clinical and laboratory infrastructure, strengthened supply and procurement systems, improvements in health care worker training, and increased community engagement. Human rights were a focal point at the conference; several presentations emphasized the importance of securing human rights to achieve universal access goals, including workplace discrimination, travel restrictions, gender inequality, and the criminalization of homosexuality, drug use, sex work, and HIV transmission and/or exposure. PMID:19811671

Organizational determinants of evaluation practice in Australian prevention agencies.

PubMed

Schwarzman, J; Bauman, A; Gabbe, B; Rissel, C; Shilton, T; Smith, B J

2018-06-01

Program evaluation is essential to inform decision making, contribute to the evidence base for strategies, and facilitate learning in health promotion and disease prevention organizations. Theoretical frameworks of organizational learning, and studies of evaluation capacity building describe the organization as central to evaluation capacity. Australian prevention organizations recognize limitations to current evaluation effectiveness and are seeking guidance to build evaluation capacity. This qualitative study identifies organizational facilitators and barriers to evaluation practice, and explores their interactions in Australian prevention organizations. We conducted semi-structured interviews with 40 experienced practitioners from government and non-government organizations. Using thematic analysis, we identified seven key themes that influence evaluation practice: leadership, organizational culture, organizational systems and structures, partnerships, resources, workforce development and training and recruitment and skills mix. We found organizational determinants of evaluation to have multi-level interactions. Leadership and organizational culture influenced organizational systems, resource allocation and support of staff. Partnerships were important to overcome resource deficits, and systems were critical to embed evaluation within the organization. Organizational factors also influenced the opportunities for staff to develop skills and confidence. We argue that investment to improve these factors would allow organizations to address evaluation capacity at multiple levels, and ultimately facilitate effective evaluation practice.

Prevention in Poland: health care system reform.

PubMed Central

Sheahan, M D

1995-01-01

Despite the political and economic reforms that have swept Eastern Europe in the past 5 years, there has been little change in Poland's health care system. The Ministry of Health and Social Welfare has targeted preventive care as a priority, yet the enactment of legislation to meet this goal has been slow. The process of reform has been hindered by political stagnation, economic crisis, and a lack of delineation of responsibility for implementing the reforms. Despite the delays in reform, recent developments indicate that a realistic, sustainable restructuring of the health care system is possible, with a focus on preventive services. Recent proposals for change have centered on applying national goals to limited geographic areas, with both local and international support. Regional pilot projects to restructure health care delivery at a community level, local health education and disease prevention initiatives, and a national training program for primary care and family physicians and nurses are being planned. Through regionalization, an increase in responsibility for both the physician and the patient, and redefinition of primary health care and the role of family physicians, isolated local movements and pilot projects have shown promise in achieving these goals, even under the current budgetary constraints. PMID:7610217

Prevention in Poland: health care system reform.

PubMed

Sheahan, M D

1995-01-01

Despite the political and economic reforms that have swept Eastern Europe in the past 5 years, there has been little change in Poland's health care system. The Ministry of Health and Social Welfare has targeted preventive care as a priority, yet the enactment of legislation to meet this goal has been slow. The process of reform has been hindered by political stagnation, economic crisis, and a lack of delineation of responsibility for implementing the reforms. Despite the delays in reform, recent developments indicate that a realistic, sustainable restructuring of the health care system is possible, with a focus on preventive services. Recent proposals for change have centered on applying national goals to limited geographic areas, with both local and international support. Regional pilot projects to restructure health care delivery at a community level, local health education and disease prevention initiatives, and a national training program for primary care and family physicians and nurses are being planned. Through regionalization, an increase in responsibility for both the physician and the patient, and redefinition of primary health care and the role of family physicians, isolated local movements and pilot projects have shown promise in achieving these goals, even under the current budgetary constraints.

Effectiveness of electronic guideline-based implementation systems in ambulatory care settings - a systematic review

PubMed Central

2009-01-01

Background Electronic guideline-based decision support systems have been suggested to successfully deliver the knowledge embedded in clinical practice guidelines. A number of studies have already shown positive findings for decision support systems such as drug-dosing systems and computer-generated reminder systems for preventive care services. Methods A systematic literature search (1990 to December 2008) of the English literature indexed in the Medline database, Embase, the Cochrane Central Register of Controlled Trials, and CRD (DARE, HTA and NHS EED databases) was conducted to identify evaluation studies of electronic multi-step guideline implementation systems in ambulatory care settings. Important inclusion criterions were the multidimensionality of the guideline (the guideline needed to consist of several aspects or steps) and real-time interaction with the system during consultation. Clinical decision support systems such as one-time reminders for preventive care for which positive findings were shown in earlier reviews were excluded. Two comparisons were considered: electronic multidimensional guidelines versus usual care (comparison one) and electronic multidimensional guidelines versus other guideline implementation methods (comparison two). Results Twenty-seven publications were selected for analysis in this systematic review. Most designs were cluster randomized controlled trials investigating process outcomes more than patient outcomes. With success defined as at least 50% of the outcome variables being significant, none of the studies were successful in improving patient outcomes. Only seven of seventeen studies that investigated process outcomes showed improvements in process of care variables compared with the usual care group (comparison one). No incremental effect of the electronic implementation over the distribution of paper versions of the guideline was found, neither for the patient outcomes nor for the process outcomes (comparison two). Conclusions There is little evidence at the moment for the effectiveness of an increasingly used and commercialised instrument such as electronic multidimensional guidelines. After more than a decade of development of numerous electronic systems, research on the most effective implementation strategy for this kind of guideline-based decision support systems is still lacking. This conclusion implies a considerable risk towards inappropriate investments in ineffective implementation interventions and in suboptimal care. PMID:20042070

Operational support and service concepts for observatories

NASA Astrophysics Data System (ADS)

Emde, Peter; Chapus, Pierre

2014-08-01

The operational support and service for observatories aim at the provision, the preservation and the increase of the availability and performance of the entire structural, mechanical, drive and control systems of telescopes and the related infrastructure. The operational support and service levels range from the basic service with inspections, preventive maintenance, remote diagnostics and spare parts supply over the availability service with telephone hotline, online and on-site support, condition monitoring and spare parts logistics to the extended service with operations and site and facility management. For the level of improvements and lifecycle management support they consist of expert assessments and studies, refurbishments and upgrades including the related engineering and project management activities.

Cyanobacteria and Algae Blooms: Review of Health and Environmental Data from the Harmful Algal Bloom-Related Illness Surveillance System (HABISS) 2007–2011

PubMed Central

Backer, Lorraine C.; Manassaram-Baptiste, Deana; LePrell, Rebecca; Bolton, Birgit

2015-01-01

Algae and cyanobacteria are present in all aquatic environments. We do not have a good sense of the extent of human and animal exposures to cyanobacteria or their toxins, nor do we understand the public health impacts from acute exposures associated with recreational activities or chronic exposures associated with drinking water. We describe the Harmful Algal Bloom-related Illness Surveillance System (HABISS) and summarize the collected reports describing bloom events and associated adverse human and animal health events. For the period of 2007–2011, Departments of Health and/or Environment from 11 states funded by the National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention contributed reports for 4534 events. For 2007, states contributed 173 reports from historical data. The states participating in the HABISS program built response capacity through targeted public outreach and prevention activities, including supporting routine cyanobacteria monitoring for public recreation waters. During 2007–2010, states used monitoring data to support196 public health advisories or beach closures. The information recorded in HABISS and the application of these data to develop a wide range of public health prevention and response activities indicate that cyanobacteria and algae blooms are an environmental public health issue that needs continuing attention. PMID:25826054

Wilderness Medical Society practice guidelines for the prevention and treatment of lightning injuries: 2014 update.

PubMed

Davis, Chris; Engeln, Anna; Johnson, Eric L; McIntosh, Scott E; Zafren, Ken; Islas, Arthur A; McStay, Christopher; Smith, William R; Cushing, Tracy

2014-12-01

To provide guidance to clinicians about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the treatment and prevention of lightning injuries. These guidelines include a review of the epidemiology of lightning and recommendations for the prevention of lightning strikes, along with treatment recommendations organized by organ system. Recommendations are graded on the basis of the quality of supporting evidence according to criteria put forth by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for Prevention and Treatment of Lightning Injuries published in Wilderness & Environmental Medicine 2012;23(3):260-269. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

An Integrated Urban Flood Analysis System in South Korea

NASA Astrophysics Data System (ADS)

Moon, Young-Il; Kim, Min-Seok; Yoon, Tae-Hyung; Choi, Ji-Hyeok

2017-04-01

Due to climate change and the rapid growth of urbanization, the frequency of concentrated heavy rainfall has caused urban floods. As a result, we studied climate change in Korea and developed an integrated flood analysis system that systematized technology to quantify flood risk and flood forecasting in urban areas. This system supports synthetic decision-making through real-time monitoring and prediction on flash rain or short-term rainfall by using radar and satellite information. As part of the measures to deal with the increase of inland flood damage, we have found it necessary to build a systematic city flood prevention system that systematizes technology to quantify flood risk as well as flood forecast, taking into consideration both inland and river water. This combined inland-river flood analysis system conducts prediction on flash rain or short-term rainfall by using radar and satellite information and performs prompt and accurate prediction on the inland flooded area. In addition, flood forecasts should be accurate and immediate. Accurate flood forecasts signify that the prediction of the watch, warning time and water level is precise. Immediate flood forecasts represent the forecasts lead time which is the time needed to evacuate. Therefore, in this study, in order to apply rainfall-runoff method to medium and small urban stream for flood forecasts, short-term rainfall forecasting using radar is applied to improve immediacy. Finally, it supports synthetic decision-making for prevention of flood disaster through real-time monitoring. Keywords: Urban Flood, Integrated flood analysis system, Rainfall forecasting, Korea Acknowledgments This research was supported by a grant (16AWMP-B066744-04) from Advanced Water Management Research Program (AWMP) funded by Ministry of Land, Infrastructure and Transport of Korean government.

Designing Integrated Approaches to Support People with Multimorbidity: Key Messages from Systematic Reviews, Health System Leaders and Citizens.

PubMed

Wilson, Michael G; Lavis, John N; Gauvin, Francois-Pierre

2016-11-01

Living with multiple chronic conditions (multimorbidity) - and facing complex, uncoordinated and fragmented care - is part of the daily life of a growing number of Canadians. We undertook: a knowledge synthesis; a "gap analysis" of existing systematic reviews; an issue brief that synthesized the available evidence about the problem, three options for addressing it and implementation considerations; a stakeholder dialogue involving key health-system leaders; and a citizen panel. We identified several recommendations for actions that can be taken, including: developing evidence-based guidance that providers can use to help achieve goals set by patients; embracing approaches to supporting self-management; supporting greater communication and collaboration across healthcare providers as well as between healthcare providers and patients; and investing more efforts in health promotion and disease prevention. Our results point to the need for health system decision-makers to support bottom-up, person-centred approaches to developing models of care that are tailored for people with multimorbidity and support a research agenda to address the identified priorities. Copyright © 2016 Longwoods Publishing.

Probiotics for the prevention or treatment of allergic diseases.

PubMed

Prescott, Susan L; Björkstén, Bengt

2007-08-01

This review addresses the effects of probiotic bacteria on immune development and the role in the treatment and prevention of allergic disease. Although there is a sound theoretical basis for anticipating benefits, there are currently insufficient data to recommend probiotics as a part of standard therapy in any allergic conditions. Furthermore, although there have been several studies to show a benefit in prevention of atopic eczema, other studies have failed to support this. None of the studies has shown any clear preventive effect on sensitization, nor any allergic disease other than eczema. The term "probiotic" is often used loosely to include bacterial strains with little documented immunomodulatory capacity or controlled studies to support the claims. It is not known whether effects in experimental systems have any clinical relevance. Finally, very little is known about this large, complex internal ecosystem. Explanations for the varied results between studies include host factors (including genetic differences in microbial responses and allergic predisposition) and other environmental factors, such as general microbial burden, individual microbiota, diet (including consumption of prebiotic substances), and treatment with antibiotics. As more studies are completed, these factors are likely to make robust meta-analyses problematic to perform.

A Preventive Intervention Program for Urban African American Youth Attending an Alternative Education Program: Background, Implementation, and Feasibility.

PubMed

Carswell, Steven B; Hanlon, Thomas E; O'Grady, Kevin E; Watts, Amy M; Pothong, Pattarapan

2009-01-01

This paper presents background, implementation, and feasibility findings associated with planning and conducting an after-school intervention program in an alternative education setting designed to prevent the initiation and escalation of violence and substance abuse among urban African American youth at high risk for life-long problem behaviors. Evolving from earlier preventive interventions implemented in clinic and school settings, the program, entitled The Village Model of Care, consisted of structured group mentoring, parental support, and community outreach services administered to alternative education students and their primary caregiver(s) during the school year. Over a two-year intake period, 109 youth participated in the present process evaluation study. Findings from the study not only provided relevant demographic information on the characteristics of youth likely to be included in such programs but also indicated the importance of including the family in the rehabilitation effort and the need for school administrative system support for the underlying alternative education approach. The information presented in this report has a direct bearing on the planning of future prevention efforts conducted in similar settings that are aimed at reducing problem behaviors and promoting positive lifestyles among high-risk youth.

Geriatric dentistry and prevention: research and public policy.

PubMed

Gershen, J A

1991-12-01

Changing demographics, including the increase in life expectancy and the growing numbers of elderly, has focused attention on the need for dental research activities to be expanded for geriatric dentistry. The elderly are at greater risk for oral disease, since gains in longevity result in more medically compromising conditions or systemic disease with oral manifestations. Also, as edentulism decreases and as more teeth are retained by the elderly, the pattern of oral diseases and the treatment of dental conditions will be altered. Barriers to self-care and professional care must be removed, and prevention and early intervention strategies must be formulated to reduce the risk of oral disease. Risk factors for oral diseases in the elderly can be reduced by personal home-care regimens, professionally provided preventive, diagnostic, and therapeutic care, changes in high-risk behavior, and a supportive environment. Generating new information about the prevention of oral diseases and conditions that have an impact on the elderly requires a substantial research effort. A research agenda for the elderly should include: epidemiologic studies of relevant oral diseases and related risk factors; investigations of patient and provider attitudes and behavior related to oral health; studies of the relationship between general health and oral health; development and testing of preventive and treatment strategies for conditions such as xerostomia, root caries, secondary caries, and gingival recession; and studies for the evaluation of the impact of the aging population on the dental delivery system. Public policy options to support geriatric oral health care and research are limited by the Government's pre-occupation with cost containment and the lack of visibility for dental programs.(ABSTRACT TRUNCATED AT 250 WORDS)

Culture and context of HIV prevention in rural Zimbabwe: the influence of gender inequality.

PubMed

Duffy, Lynne

2005-01-01

After many years of HIV prevention in Zimbabwe, AIDS morbidity and mortality rates continue to rise. This study explores factors facilitating or hindering rural Ndau women's participation in HIV prevention that might influence health promotion programming. Ethnographic methods were used with a sample of 38 females and 10 males. Women's existence is revealed as difficult and oppressive. Their socialization to become workers and mothers occurs within a context of limited voice, subservience, violence, and economic powerlessness, all barriers to HIV prevention. Through analysis of sociocultural and economic factors, it is suggested that cultural beliefs and practices, along with national and international forces, support and sustain gender inequality. For a change in the AIDS crisis, prevention strategies need to be multifaceted, consider people's culture and context, and include gender analysis. It is imperative that nurses working with diverse populations be sensitive to culture while challenging unjust and oppressive systems.

Therapy of Chagas Disease: Implications for Levels of Prevention

PubMed Central

Sosa-Estani, Sergio; Colantonio, Lisandro; Segura, Elsa Leonor

2012-01-01

This paper reviews the evidence supporting the use of etiological treatment for Chagas disease that has changed the standard of care for patients with Trypanosoma cruzi infection in the last decades. Implications of this evidence on different levels of prevention as well as gaps in current knowledge are also discussed. In this regard, etiological treatment has shown to be beneficial as an intervention for secondary prevention to successfully cure the infection or to delay, reduce, or prevent the progression to disease, and as primary disease prevention by breaking the chain of transmission. Timely diagnosis during initial stages would allow for the prescription of appropriate therapies mainly in the primary health care system thus improving chances for a better quality of life. Based on current evidence, etiological treatment has to be considered as an essential public health strategy useful to reduce disease burden and to eliminate Chagas disease altogether. PMID:22523499

[Rituals of birth in Senegal].

PubMed

Ba, Idrissa; Diodo Ly, Oumou; Rizzi, Alice Titia; Sandri, Rosella; Thiam, Mamadou Habib

In a Senegalese society undergoing profound change, holding on to certain beliefs and social and cultural practices can sometimes prove difficult. Prevention and care systems must take into account social and cultural representations in order to support these families as best as possible. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Creating institutions of care: The case for democratic forest trusts

Treesearch

Gus diZerega

2007-01-01

Strong institutional and systemic barriers prevent traditional political and economic institutions from effectively managing national forests in the United States. Despite consistent support for ecological values by the public, Congress does not protect them, and existing political institutions are not designed to respond effectively to citizens with these concerns....

Core Competencies and the Prevention of Youth Violence

ERIC Educational Resources Information Center

Sullivan, Terri N.; Farrell, Albert D.; Bettencourt, Amie F.; Helms, Sarah W.

2008-01-01

We discuss how the five core competencies for healthy adjustment in adolescence (a positive sense of self, self-control, decision-making skills, a moral system of belief, and prosocial connectedness) are represented in theories of aggression and youth violence. We then discuss research supporting the relation between these core competencies and…

75 FR 57033 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

... promotion of improvements in clinical and health system practices, including the prevention of diseases and... database of evidence-based clinical practice guidelines meeting explicit criteria. The NGC also supports... evidence to make informed health care decisions. The NGC is a vehicle for such encouragement. The mission...

THE RISE OF THE NEGRO PROTEST.

ERIC Educational Resources Information Center

THOMPSON, DANIEL C.

SOCIAL CONTROLS SUPPORTING THE BIRACIAL SYSTEM IN THE UNITED STATES ARE PRIMARILY LEGAL AND ARE OFTEN IN CONFLICT WITH THE PREVAILING MORAL AND RELIGIOUS PRECEPTS. THE NEGRO PROTEST IS NOT ONLY AGAINST WIDESPREAD DEPRIVATIONS, BUT ALSO AGAINST RELATIVE DEPRIVATIONS OR BARRIERS DESIGNED TO PREVENT THEM FROM ENJOYING CERTAIN RIGHTS AND PRIVILEGES…

California Colleges and Universities Collaborate to Support Student Mental Health

ERIC Educational Resources Information Center

Woodbridge, Michelle W.; Goldweber, Asha; Yu, Jennifer; Golan, Shari; Stein, Bradley D.

2014-01-01

One key objective of California's Prevention and Early Intervention (PEI) Student Mental Health (SMH) initiative funded under Proposition 63 is to establish a formal process for ongoing collaboration between higher education systems and county mental health, as well as to increase collaboration among higher education campuses to improve student…

Do Maternal Caregiver Perceptions of Childhood Obesity Risk Factors and Obesity Complications Predict Support for Prevention Initiatives Among African Americans?

PubMed

Alexander, Dayna S; Alfonso, Moya L; Cao, Chunhua; Wright, Alesha R

2017-07-01

Objectives African American maternal caregiver support for prevention of childhood obesity may be a factor in implementing, monitoring, and sustaining children's positive health behaviors. However, little is known about how perceptions of childhood obesity risk factors and health complications influence caregivers' support of childhood obesity prevention strategies. The objective of this study was to determine if childhood obesity risk factors and health complications were associated with maternal caregivers' support for prevention initiatives. Methods A convenience sample of maternal caregivers (N = 129, ages 22-65 years) completed the childhood obesity perceptions (COP) survey. A linear regression was conducted to determine whether perceptions about childhood obesity risk factors and subsequent health complications influenced caregivers' support for prevention strategies. Results Caregivers' perceptions of childhood obesity risk factors were moderate (M = 3.4; SD = 0.64), as were their perceptions of obesity-related health complications (M = 3.3; SD = 0.75); however, they perceived a high level of support for prevention strategies (M = 4.2; SD = 0.74). In the regression model, only health complications were significantly associated with caregiver support (β = 0.348; p < 0.004). Conclusions Childhood obesity prevention efforts should emphasize health complications by providing education and strategies that promote self-efficacy and outcome expectations among maternal caregivers.

What evidence and support do state-level public health practitioners need to address obesity prevention.

PubMed

Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

2014-01-01

Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

Implementation of pre-exposure prophylaxis for human immunodeficiency virus infection: progress and emerging issues in research and policy.

PubMed

Cáceres, Carlos F; Borquez, Annick; Klausner, Jeffrey D; Baggaley, Rachel; Beyrer, Chris

2016-01-01

In this article, we present recent evidence from studies focused on the implementation, effectiveness and cost-effectiveness of pre-exposure prophylaxis (PrEP) for HIV infection; discuss PrEP scale-up to date, including the observed levels of access and policy development; and elaborate on key emerging policy and research issues to consider for further scale-up, with a special focus on lower-middle income countries. The 2015 WHO Early Release Guidelines for HIV Treatment and Prevention reflect both scientific evidence and new policy perspectives. Those guidelines present a timely challenge to health systems for the scaling up of not only treatment for every person living with HIV infection but also the offer of PrEP to those at substantial risk. Delivery and uptake of both universal antiretroviral therapy (ART) and PrEP will require nation-wide commitment and could reinvigorate health systems to develop more comprehensive "combination prevention" programmes and support wider testing linked to both treatments and other prevention options for populations at highest risk who are currently not accessing services. Various gaps in current health systems will need to be addressed to achieve strategic scale-up of PrEP, including developing prioritization strategies, strengthening drug regulations, determining cost and funding sources, training health providers, supporting user adherence and creating demand. The initial steps in the scale-up of PrEP globally suggest feasibility, acceptability and likely impact. However, to prevent setbacks in less well-resourced settings, countries will need to anticipate and address challenges such as operational and health systems barriers, drug cost and regulatory policies, health providers' openness to prescribing PrEP to populations at substantial risk, demand and legal and human rights issues. Emerging problems will require creative solutions and will continue to illustrate the complexity of PrEP implementation.

Community service provider perceptions of implementing older adult fall prevention in Ontario, Canada: a qualitative study.

PubMed

Dykeman, Catherine S; Markle-Reid, Maureen F; Boratto, Lorna J; Bowes, Chris; Gagné, Hélène; McGugan, Jennifer L; Orr-Shaw, Sarah

2018-02-01

Despite evidence for effective fall prevention interventions, measurable reductions in older adult (≥ 65 years) fall rates remain unrealized. This study aimed to describe the perceived barriers to and effective strategies for the implementation of evidence-based fall prevention practices within and across diverse community organizations. This study is unique in that it included community service providers who are not generally thought to provide fall prevention services to older adults, such as retail business, community support, volunteer services, community foundations, recreation centres, and various emergency services. Interviews and focus groups were conducted with a purposive sampling of providers (n = 84) in varied roles within diverse community-based organizations across disparate geographical settings. Community service providers experience significant multi-level barriers to fall prevention within and across organizations and settings. The overall challenge of serving dispersed populations in adverse environmental conditions was heightened in northern rural areas. Barriers across the system, within organizations and among providers themselves emerged along themes of Limited Coordination of Communication, Restrictive Organizational Mandates and Policies, Insufficient Resources, and Beliefs about Aging and Falls. Participants perceived that Educating Providers, Working Together, and Changing Policies and Legislation were strategies that have worked or would work well in implementing fall prevention. An unintentional observation was made that several participants in this extremely varied sample identified expanded roles in fall prevention for themselves during the interview process. Community service providers experience disabling contexts for implementing fall prevention on many levels: their specific geography, their service systems, their organizations and themselves. A systemic lack of fit between the older adult and fall prevention services limits access, making fall prevention inaccessible, unaccommodating, unavailable, unaffordable, and unacceptable. Educating Providers, Working Together, and Changing Policies and Legislation offers promise to create more enabling contexts for community stakeholders, including those who do not initially see their work as preventing falls.

Patient centered integrated clinical resource management.

PubMed

Hofdijk, Jacob

2011-01-01

The impact of funding systems on the IT systems of providers has been enormous and have prevented the implementation of designs to focused on the health issue of patients. The paradigm shift the Dutch Ministry of Health has taken in funding health care has a remarkable impact on the orientation of IT systems design. Since 2007 the next step is taken: the application of the funding concept on chronic diseases using clinical standards as the norm. The focus on prevention involves the patient as an active partner in the care plan. The impact of the new dimension in funding has initiated a process directed to the development of systems to support collaborative working and an active involvement of the patient and its informal carers. This national approach will be presented to assess its international potential, as all countries face the long term care crisis lacking resources to meet the health needs of the population.

Multifunctional Cooling Garment for Space Suit Environmental Control

NASA Technical Reports Server (NTRS)

Izenson, Michael; Chen, Weibo; Phillips, Scott; Chepko, Ariane; Bue, Grant; Ferl, Janet; Cencer, Daniel

2015-01-01

Future manned space exploration missions will require space suits with capabilities beyond the current state of the art. Portable Life Support Systems for these future space suits face daunting challenges, since they must maintain healthy and comfortable conditions inside the suit for long-duration missions while minimizing weight and water venting. We have demonstrated the feasibility of an innovative, multipurpose garment for thermal and humidity control inside a space suit pressure garment that is simple, rugged, compact, and lightweight. The garment is a based on a conventional liquid cooling and ventilation garment (LCVG) that has been modified to directly absorb latent heat as well as sensible heat. This hybrid garment will prevent buildup of condensation inside the pressure garment, prevent loss of water by absorption in regenerable CO2 removal beds, and conserve water through use of advanced lithium chloride absorber/radiator (LCAR) technology for nonventing heat rejection. We have shown the feasibility of this approach by sizing the critical components for the hybrid garment, developing fabrication methods, building and testing a proof-of-concept system, and demonstrating by test that its performance is suitable for use in space suit life support systems.

Multifunctional Cooling Garment for Space Suit Environmental Control

NASA Technical Reports Server (NTRS)

Izenson, Michael G.; Chen, Weibo; Phillips, Scott; Chepko, Ariane; Bue, Grant; Ferl, Janet

2014-01-01

Future manned space exploration missions will require space suits with capabilities beyond the current state of the art. Portable Life Support Systems for these future space suits face daunting challenges, since they must maintain healthy and comfortable conditions inside the suit for longduration missions while minimizing weight and water venting. We have demonstrated the feasibility of an innovative, multipurpose garment for thermal and humidity control inside a space suit pressure garment that is simple, rugged, compact, and lightweight. The garment is a based on a conventional liquid cooling and ventilation garment (LCVG) that has been modified to directly absorb latent heat as well as sensible heat. This hybrid garment will prevent buildup of condensation inside the pressure garment, prevent loss of water by absorption in regenerable CO2 removal beds, and conserve water through use of advanced lithium chloride absorber/radiator (LCAR) technology for nonventing heat rejection. We have shown the feasibility of this approach by sizing the critical components for the hybrid garment, developing fabrication methods, building and testing a proof-of-concept system, and demonstrating by test that its performance is suitable for use in space suit life support systems.

Improving Patient Safety in Hospitals through Usage of Cloud Supported Video Surveillance

PubMed Central

Dašić, Predrag; Dašić, Jovan; Crvenković, Bojan

2017-01-01

BACKGROUND: Patient safety in hospitals is of equal importance as providing treatments and urgent healthcare. With the development of Cloud technologies and Big Data analytics, it is possible to employ VSaaS technology virtually anywhere, for any given security purpose. AIM: For the listed benefits, in this paper, we give an overview of the existing cloud surveillance technologies which can be implemented for improving patient safety. MATERIAL AND METHODS: Modern VSaaS systems provide higher elasticity and project scalability in dealing with real-time information processing. Modern surveillance technologies can prove to be an effective tool for prevention of patient falls, undesired movement and tempering with attached life supporting devices. Given a large number of patients who require constant supervision, a cloud-based monitoring system can dramatically reduce the occurring costs. It provides continuous real-time monitoring, increased overall security and safety, improved staff productivity, prevention of dishonest claims and long-term digital archiving. CONCLUSION: Patient safety is a growing issue which can be improved with the usage of high-end centralised surveillance systems allowing the staff to focus more on treating health issues rather that keeping a watchful eye on potential incidents. PMID:28507610

Overcoming the organization-practice barrier in sports injury prevention: A nonhierarchical organizational model.

PubMed

Dahlström, Ö; Jacobsson, J; Timpka, T

2015-08-01

The organization of sports at the national level has seldom been included in scientific discussions of sports injury prevention. The aim of this study was to develop a model for organization of sports that supports prevention of overuse injuries. The quality function deployment technique was applied in seminars over a two-season period to develop a national organizational structure for athletics in Sweden that facilitates prevention of overuse injuries. Three central features of the resulting model for organization of sports at the national level are (a) diminishment of the organizational hierarchy: participatory safety policy design is introduced through annual meetings where actors from different sectors of the sporting community discuss training, injury prevention, and sports safety policy; (b) introduction of a safety surveillance system: a ubiquitous system for routine collection of injury and illness data; and (c) an open forum for discussion of safety issues: maintenance of a safety forum for participants from different sectors of the sport. A nonhierarchical model for organization of sports at the national level - facilitated by modern information technology - adapted for the prevention of overuse injuries has been developed. Further research is warranted to evaluate the new organizational model in prospective effectiveness studies. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Network Policy Languages: A Survey and a New Approach

DTIC Science & Technology

2000-08-01

go, throwing a community into economic chaos. These events could result from discontinued funding from Silicon Valley investors who became aware of...prevented. C. POLICY HIERARCHIES FOR DISTRIBUTED SYSTEMS MANAGEMENT In [23], Moffett and Sloman form a policy hierarchy is by refining general high...management behavior of a system, without coding the behavior into the manager agents. Lupu and Sloman focus on techniques and tool support for off-line

Advancing the application of systems thinking in health: why cure crowds out prevention.

PubMed

Bishai, David; Paina, Ligia; Li, Qingfeng; Peters, David H; Hyder, Adnan A

2014-06-16

This paper presents a system dynamics computer simulation model to illustrate unintended consequences of apparently rational allocations to curative and preventive services. A modeled population is subject to only two diseases. Disease A is a curable disease that can be shortened by curative care. Disease B is an instantly fatal but preventable disease. Curative care workers are financed by public spending and private fees to cure disease A. Non-personal, preventive services are delivered by public health workers supported solely by public spending to prevent disease B. Each type of worker tries to tilt the balance of government spending towards their interests. Their influence on the government is proportional to their accumulated revenue. The model demonstrates effects on lost disability-adjusted life years and costs over the course of several epidemics of each disease. Policy interventions are tested including: i) an outside donor rationally donates extra money to each type of disease precisely in proportion to the size of epidemics of each disease; ii) lobbying is eliminated; iii) fees for personal health services are eliminated; iv) the government continually rebalances the funding for prevention by ring-fencing it to protect it from lobbying.The model exhibits a "spend more get less" equilibrium in which higher revenue by the curative sector is used to influence government allocations away from prevention towards cure. Spending more on curing disease A leads paradoxically to a higher overall disease burden of unprevented cases of disease B. This paradoxical behavior of the model can be stopped by eliminating lobbying, eliminating fees for curative services, and ring-fencing public health funding. We have created an artificial system as a laboratory to gain insights about the trade-offs between curative and preventive health allocations, and the effect of indicative policy interventions. The underlying dynamics of this artificial system resemble features of modern health systems where a self-perpetuating industry has grown up around disease-specific curative programs like HIV/AIDS or malaria. The model shows how the growth of curative care services can crowd both fiscal and policy space for the practice of population level prevention work, requiring dramatic interventions to overcome these trends.

Foundational Tests of the Need-Support Model: A Framework for Bridging Regulatory Focus Theory and Self-Determination Theory.

PubMed

Vaughn, Leigh Ann

2017-03-01

This article introduces the need-support model, which proposes that regulatory focus can affect subjective support for the needs proposed by self-determination theory (autonomy, competence, and relatedness), and support of these needs can affect subjective labeling of experiences as promotion-focused and prevention-focused. Three studies tested these hypotheses ( N = 2,114). Study 1 found that people recall more need support in promotion-focused experiences than in prevention-focused experiences, and need support in their day yesterday (with no particular regulatory focus) fell in between. Study 2 found that experiences of higher need support were more likely to be labeled as promotion-focused rather than prevention-focused, and that each need accounted for distinct variance in the labeling of experiences. Study 3 varied regulatory focus within a performance task and found that participants in the promotion condition engaged in need-support inflation, whereas participants in the prevention condition engaged in need-support deflation. Directions for future research are discussed.

Healthcare-associated infections: challenges to public health in Brazil.

PubMed

Padoveze, Maria Clara; Fortaleza, Carlos Magno Castelo Branco

2014-12-01

This study presents a critical evaluation of the scientific literature related to this subject, aiming to assess the policies and administrative issues regarding the prevention and magnitude of healthcare-associated infections and discuss the challenges for their prevention in Brazil. The topics discussed included historical and administrative issues, challenges imposed by the characteristics of the healthcare system and the territorial dimension, laboratorial support limitations, costs, institutional culture, professional qualification, and patient engagement. It is urgent to hold a nationwide discussion among government representatives, institutions, and healthcare workers and users to overcome these challenges.

Integrated Care for Pediatric Substance Abuse.

PubMed

Barclay, Rebecca P; Hilt, Robert J

2016-10-01

Integrated care is a way to improve the prevention, identification, and treatment of mental health difficulties, including substance abuse, in pediatric care. The pediatrician's access, expertise in typical development, focus on prevention, and alignment with patients and families can allow successful screening, early intervention, and referral to treatment. Successful integrated substance abuse care for youth is challenged by current reimbursement systems, information exchange, and provider role adjustment issues, but these are being addressed as comfort with this care form and resources to support its development grow. Copyright © 2016 Elsevier Inc. All rights reserved.

Computer Program Development Specification for Ada Integrated Environment: KAPSE (Kernel Ada Programming Support Environment)/Database, Type B5, B5-AIE(1).KAPSE(1).

DTIC Science & Technology

1982-11-12

File 1/0 Prgram Invocation Other Access M and Control Services KAPSE/Host Interface most Operating System Peripherals/ 01 su ?eetworks 6282318-2 Figure 3...3.2.4.3.8.5 Transitory Windows The TRANSITORY flag is used to prevent permanent dependence on temporary windows created simply for focusing on a part of the...KAPSE/Tool interfaces in terms of these low-level host-independent interfaces. In addition, the KAPSE/Host interface packages prevent the application

Core competencies and the prevention of youth violence.

PubMed

Sullivan, Terri N; Farrell, Albert D; Bettencourt, Amie F; Helms, Sarah W

2008-01-01

We discuss how the five core competencies for healthy adjustment in adolescence (a positive sense of self, self-control, decision-making skills, a moral system of belief, and prosocial connectedness) are represented in theories of aggression and youth violence. We then discuss research supporting the relation between these core competencies and aggressive and violent behavior in childhood and adolescence. Finally, we address the degree to which these core competencies have been included and systematically evaluated within school-based prevention programs, and we end with suggestions for future directions. (c) Wiley Periodicals, Inc.

Dental rehabilitation using an implant-carrying plate system in a severely resorbed edentulous maxilla: a case report.

PubMed

Kurita, Hiroshi; Sakai, Hironori; Uehara, Shinobu; Kurashina, Kenji

2008-01-01

This clinical article describes a case of dental rehabilitation using an implant-carrying plate system (EPITEC) for a patient with severely resorbed edentulous maxilla and microstomia. In this case, the presence of microstomia prevented bone augmentation procedures through an intraoral approach. Treatment using 2 endosseous implants inserted in the canine regions and an implant-supported overdenture was planned. However, endosseous implants were not feasible on the right side because of insufficient available bone volume. An implant-carrying plate system was then utilized on the right side. Four months later, an implant-supported ball-attachment overdenture was fabricated. At the 2-year follow-up, the clinical course remained uneventful, and the patient remained satisfied with the treatment.

Implementing injury surveillance systems alongside injury prevention programs: evaluation of an online surveillance system in a community setting.

PubMed

Ekegren, Christina L; Donaldson, Alex; Gabbe, Belinda J; Finch, Caroline F

Previous research aimed at improving injury surveillance standards has focused mainly on issues of data quality rather than upon the implementation of surveillance systems. There are numerous settings where injury surveillance is not mandatory and having a better understanding of the barriers to conducting injury surveillance would lead to improved implementation strategies. One such setting is community sport, where a lack of available epidemiological data has impaired efforts to reduce injury. This study aimed to i) evaluate use of an injury surveillance system following delivery of an implementation strategy; and ii) investigate factors influencing the implementation of the system in community sports clubs. A total of 78 clubs were targeted for implementation of an online injury surveillance system (approximately 4000 athletes) in five community Australian football leagues concurrently enrolled in a pragmatic trial of an injury prevention program called FootyFirst. System implementation was evaluated quantitatively, using the RE-AIM framework, and qualitatively, via semi-structured interviews with targeted-users. Across the 78 clubs, there was 69% reach, 44% adoption, 23% implementation and 9% maintenance. Reach and adoption were highest in those leagues receiving concurrent support for the delivery of FootyFirst. Targeted-users identified several barriers and facilitators to implementation including personal (e.g. belief in the importance of injury surveillance), socio-contextual (e.g. understaffing and athlete underreporting) and systems factors (e.g. the time taken to upload injury data into the online system). The injury surveillance system was implemented and maintained by a small proportion of clubs. Outcomes were best in those leagues receiving concurrent support for the delivery of FootyFirst, suggesting that engagement with personnel at all levels can enhance uptake of surveillance systems. Interview findings suggest that increased uptake could also be achieved by educating club personnel on the importance of recording injuries, developing clearer injury surveillance guidelines, increasing club staffing and better remunerating those who conduct surveillance, as well as offering flexible surveillance systems in a range of accessible formats. By increasing the usage of surveillance systems, data will better represent the target population and increase our understanding of the injury problem, and how to prevent it, in specific settings.

Family first: Community-based supports for refugees.

PubMed

Pejic, Vanja; Hess, Robyn S; Miller, Gloria E; Wille, Alice

2016-01-01

This article presents a community-based approach that targets family interventions and services through a preventive, family systems ecological framework. A public health approach is used to emphasize the need for a tiered model of family support that builds on the strengths of refugee families while recognizing their specific needs and challenges. The rationale for a family systems ecological perspective is presented to highlight the critical features of effective family support programs for refugee families, followed by a discussion regarding the transitions and adaptation faced by refugee families when entering the United States. Finally, a public-health problem solving model is employed to promote a comprehensive vision for how more effective support can be developed to best serve the mental health needs of refugee families. An integrated case example highlighting the Somali Parent Program, a family-focused intervention, is also provided. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

[The health care system requires individuals to take more personal responsibility].

PubMed

Schaefer, Corinna; Weißbach, Lothar

2012-01-01

In the health care context, the phrase "personal responsibility" is frequently used as a euphemism for restricting publicly funded health care services. The concept of responsibility, however, primarily comprises the individual's own autonomous choices in consideration of their possible implications. In order to be able to act responsibly in respect to health care issues, the individual must rely on objective information about the possible consequences of his or her decision. The current profit-oriented competitive medical care environment prevents the distribution of objective information. A mutually supportive community benefits from its members acting responsibly, since citizens are capable of supporting themselves before they avail themselves of community support. This requires the State to respect the individual and his or her autonomous decision-making. If the community established rules as to what is considered a healthy lifestyle or even required people to adopt one, it would, to a large part, take away the citizens' autonomy and thus prevent them to assume responsibility. Copyright © 2012. Published by Elsevier GmbH.

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

PubMed Central

Bailey, Theodore C.; Sugarman, Jeremy

2014-01-01

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

Development of the Baylor-Nikkiso centrifugal pump with a purging system for circulatory support.

PubMed

Naito, K; Miyazoe, Y; Aizawa, T; Mizuguchi, K; Tasai, K; Ohara, Y; Orime, Y; Glueck, J; Takatani, S; Noon, G P

1993-07-01

The Baylor-Nikkiso centrifugal pump is a magnetically coupled system with a V-ring seal separating the pump and the actuator chamber. To prevent thrombus formation behind the impeller and to extend the life of the pump to 2 weeks of continuous operation, we incorporated a purging chamber behind the V-ring seal. An external pump connected to this purging chamber infused fluid at a constant rate to wash the shaft-seal area. To evaluate the effectiveness of the purging system, we have carried out biventricular bypass experiments using calves. The purging system was successful in reducing the level of thrombus formation after 2 weeks of operation. The results of these studies confirmed that the Baylor-Nikkiso centrifugal pump with this purging system is suitable for at least 2 weeks of continuous operation as a circulatory support system.

Healthy People 2020 Objectives for Violence Prevention and the Role of Nursing.

PubMed

Simon, Thomas R; Hurvitz, Kimberly

2014-01-31

Violence, including child maltreatment, youth violence, intimate partner violence, and sexual violence, is a significant public health problem in the United States. A public health approach can help providers understand the health burden from violence, evaluate evidence for prevention strategies, and learn where to turn for information about planning and implementing prevention strategies for this preventable problem. For the past three decades, the U.S. Department of Health and Human Services has published "Healthy People" objectives for the next decade. The Healthy People 2020 initiative includes 13 measurable objectives related to violence prevention, one of which was selected as a Healthy People 2020 Leading Health Indicator. Progress to achieve these objectives can save thousands of lives, reduce the suffering of victims and their families, and decrease financial cost to the law enforcement and healthcare systems. The role that nurses can and do play in violence prevention is critical and extends beyond just caring for victims to also include preventing violence before it happens. This article summarizes the violence prevention objectives in Healthy People 2020 and the resources for prevention available to support nurses and others as they move prevention efforts forward in communities to stop violence before it starts.

An Analysis of the Patient Appointing System of the 121st Combat Support Hospital to Determine an Optimal Appointing System

DTIC Science & Technology

2008-06-01

Their dedication and hard work for the students has ensured the success of myself and all other students who have had the privilege to earn their...Defense Inspector General, 2006). As the next generation medical and dental clinical information system, AHLTA will produce and maintain a life-long...of being focused only on a specific clinic or section. Cross training will also help to prevent burnout by providing staff with a change of pace. A

California's digital divide: clinical information systems for the haves and have-nots.

PubMed

Miller, Robert H; D'Amato, Katherine; Oliva, Nancy; West, Christopher E; Adelson, Joel W

2009-01-01

Strong barriers prevent the financing of clinical information systems (CIS) in health care delivery system organizations in market segments serving disadvantaged patients. These segments include community health centers, public hospitals, unaffiliated rural hospitals, and some Medicaid-oriented solo and small-group medical practices. Policy interventions such as loans, grants, pay-for-performance and other reimbursement changes, and support services assistance will help lower these barriers. Without intervention, progress will be slow and worsen health care disparities between the advantaged and disadvantaged populations.

Four-Fold Prevention: Strategies To Prevent Substance Abuse among Elementary School-Aged Children.

ERIC Educational Resources Information Center

Coker, J. Kelly

2001-01-01

Article describes a substance-abuse prevention program, Four-Fold Prevention, designed to specifically focus on four primary areas of social support-parents, schools, communities, and peers. This program enhances positive and supportive relationships among children and influencing adults and peers by opening the lines of communication about…

Medication-related clinical decision support in computerized provider order entry systems: a review.

PubMed

Kuperman, Gilad J; Bobb, Anne; Payne, Thomas H; Avery, Anthony J; Gandhi, Tejal K; Burns, Gerard; Classen, David C; Bates, David W

2007-01-01

While medications can improve patients' health, the process of prescribing them is complex and error prone, and medication errors cause many preventable injuries. Computer provider order entry (CPOE) with clinical decision support (CDS), can improve patient safety and lower medication-related costs. To realize the medication-related benefits of CDS within CPOE, one must overcome significant challenges. Healthcare organizations implementing CPOE must understand what classes of CDS their CPOE systems can support, assure that clinical knowledge underlying their CDS systems is reasonable, and appropriately represent electronic patient data. These issues often influence to what extent an institution will succeed with its CPOE implementation and achieve its desired goals. Medication-related decision support is probably best introduced into healthcare organizations in two stages, basic and advanced. Basic decision support includes drug-allergy checking, basic dosing guidance, formulary decision support, duplicate therapy checking, and drug-drug interaction checking. Advanced decision support includes dosing support for renal insufficiency and geriatric patients, guidance for medication-related laboratory testing, drug-pregnancy checking, and drug-disease contraindication checking. In this paper, the authors outline some of the challenges associated with both basic and advanced decision support and discuss how those challenges might be addressed. The authors conclude with summary recommendations for delivering effective medication-related clinical decision support addressed to healthcare organizations, application and knowledge base vendors, policy makers, and researchers.

Parents' perceptions of the role of schools in tobacco use prevention and cessation for youth.

PubMed

Wyman, Jodi; Price, James H; Jordan, Timothy R; Dake, Joseph A; Telljohann, Susan K

2006-06-01

The purpose of this study was to examine Ohio parents' perceptions of the role of schools in smoking prevention, cessation, and anti-tobacco policy for their children. A 46-item questionnaire was based on the CDC Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. Surveys (n = 800) were sent to a stratified random sample of parents of junior high and high school aged students and 57% responded. Parents were supportive of smoking prevention activities, but almost two-thirds believed their child's school should get parents' input. Furthermore, mothers/step-mothers were more likely than fathers/step-fathers to agree that the school had a role in smoking prevention activities. The majority of parents were also supportive of smoking cessation activities. However, only 8% of parent respondents supported schools providing nicotine gum or patches to students trying to quit smoking. Overall, the majority of parents were supportive of the seven recommendations developed by the CDC as guidelines for school health programs to prevent tobacco use and addiction. Schools have the opportunity to impact student smoking through prevention and cessation activities. Schools need to know that parents are supportive of these activities and want to be included in the process of implementing effective prevention or cessation programs.

Peer support of complex health behaviors in prevention and disease management with special reference to diabetes: systematic reviews.

PubMed

Fisher, Edwin B; Boothroyd, Renée I; Elstad, Emily A; Hays, Laura; Henes, Amy; Maslow, Gary R; Velicer, Clayton

2017-01-01

Examine Peer Support (PS) for complex, sustained health behaviors in prevention or disease management with emphasis on diabetes prevention and management. PS was defined as emotional, motivational and practical assistance provided by nonprofessionals for complex health behaviors. Initial review examined 65 studies drawn from 1442 abstracts identified through PubMed, published 1/1/2000-7/15/2011. From this search, 24 reviews were also identified. Extension of the search in diabetes identified 30 studies published 1/1/2000-12/31/2015. In initial review, 54 of all 65 studies (83.1%) reported significant impacts of PS, 40 (61.5%) reporting between-group differences and another 14 (21.5%) reporting significant within-group changes. Across 19 of 24 reviews providing quantifiable findings, a median of 64.5% of studies reviewed reported significant effects of PS. In extended review of diabetes, 26 of all 30 studies (86.7%) reported significant impacts of PS, 17 (56.7%) reporting between-group differences and another nine (30.0%) reporting significant within-group changes. Among 19 of these 30 reporting HbA1c data, average reduction was 0.76 points. Studies that did not find effects of PS included other sources of support, implementation or methodological problems, lack of acceptance of interventions, poor fit to recipient needs, and possible harm of unmoderated PS. Across diverse settings, including under-resourced countries and health care systems, PS is effective in improving complex health behaviors in disease prevention and management including in diabetes.

Pain management for children with cerebral palsy in school settings in two cultures: action and reaction approaches.

PubMed

Adolfsson, Margareta; Johnson, Ensa; Nilsson, Stefan

2017-05-18

Children with cerebral palsy (CP) face particular challenges, e.g. daily pain that threaten their participation in school activities. This study focuses on how teachers, personal assistants, and clinicians in two countries with different cultural prerequisites, Sweden and South Africa, manage the pain of children in school settings. Participants' statements collected in focus groups were analysed using a directed qualitative content analysis framed by a Frequency of attendance-Intensity of involvement model, which was modified into a Knowing-Doing model. Findings indicated that pain management focused more on children's attendance in the classroom than on their involvement, and a difference between countries in terms of action-versus-reaction approaches. Swedish participants reported action strategies to prevent pain whereas South African participants primarily discussed interventions when observing a child in pain. Differences might be due to school- and healthcare systems. To provide effective support when children with CP are in pain in school settings, an action-and-reaction approach would be optimal and the use of alternative and augmentative communication strategies would help to communicate children's pain. As prevention of pain is desired, structured surveillance and treatment programs are recommended along with trustful collaboration with parents and access to "hands-on" pain management when needed. Implications for rehabilitation • When providing support, hands-on interventions should be supplemented by structured preventive programs and routines for parent collaboration (action-and-reaction approach). • When regulating support, Sweden and South Africa can learn from each other; ○ In Sweden, the implementation of a prevention program has been successful. ○ In South Africa, the possibilities giving support directly when pain in children is observed have been beneficial.

Family Support in Prevention Programs for Children at Risk for Emotional/Behavioral Problems

PubMed Central

Olin, S. Serene; Kim, Annie; Hoagwood, Kimberly E.; Burns, Barbara J.

2014-01-01

We conducted a review of empirically based prevention programs to identify prevalence and types of family support services within these programs. A total of 238 articles published between 1990 and 2011 that included a family support component were identified; 37 met criteria for inclusion. Following the Institute of Medicine’s typology, prevention programs were categorized as universal, selective, or indicated; programs containing more than one prevention level were characterized as multilevel. Family support types included those led by a mental health professional, led by a peer, or team-led. Among the 37 prevention programs reviewed, 27% (n = 10) were universal, 41% (n = 15) were selective, 16% (n = 6) were indicated, and 16% (n = 6) were multi-level. The predominant model of family support was professionally led (95%, n = 35). Two (n = 5%) provided team-led services. None were purely peer-led. In terms of content of family support services, all (100%, n = 37) provided instruction/skill build. Information and education was provided by 70% (n = 26), followed by emotional support (n = 11, 30%) and instrumental or concrete assistance (n = 11, 30%). Only 14% (n = 5) provided assistance with advocacy. The distribution of models and content of services in prevention studies differ from family support within treatment studies. As family support is likely to be an enduring component of the child and family mental health service continuum, comparative effectiveness studies are needed to inform future development. PMID:22080305

Family support in prevention programs for children at risk for emotional/behavioral problems.

PubMed

Cavaleri, Mary A; Olin, S Serene; Kim, Annie; Hoagwood, Kimberly E; Burns, Barbara J

2011-12-01

We conducted a review of empirically based prevention programs to identify prevalence and types of family support services within these programs. A total of 238 articles published between 1990 and 2011 that included a family support component were identified; 37 met criteria for inclusion. Following the Institute of Medicine's typology, prevention programs were categorized as universal, selective, or indicated; programs containing more than one prevention level were characterized as multi-level. Family support types included those led by a mental health professional, led by a peer, or team-led. Among the 37 prevention programs reviewed, 27% (n=10) were universal, 41% (n=15) were selective, 16% (n=6) were indicated, and 16% (n=6) were multi-level. The predominant model of family support was professionally led (95%, n=35). Two (n=5%) provided team-led services. None were purely peer-led. In terms of content of family support services, all (100%, n=37) provided instruction/skill build. Information and education was provided by 70% (n=26), followed by emotional support (n=11, 30%) and instrumental or concrete assistance (n=11, 30%). Only 14% (n=5) provided assistance with advocacy. The distribution of models and content of services in prevention studies differ from family support within treatment studies. As family support is likely to be an enduring component of the child and family mental health service continuum, comparative effectiveness studies are needed to inform future development.

Evaluation of the Healthy Lifestyles Initiative for Improving Community Capacity for Childhood Obesity Prevention.

PubMed

Berman, Marcie; Bozsik, Frances; Shook, Robin P; Meissen-Sebelius, Emily; Markenson, Deborah; Summar, Shelly; DeWit, Emily; Carlson, Jordan A

2018-02-22

Policy, systems, and environmental approaches are recommended for preventing childhood obesity. The objective of our study was to evaluate the Healthy Lifestyles Initiative, which aimed to strengthen community capacity for policy, systems, and environmental approaches to healthy eating and active living among children and families. The Healthy Lifestyles Initiative was developed through a collaborative process and facilitated by community organizers at a local children's hospital. The initiative supported 218 partners from 170 community organizations through training, action planning, coalition support, one-on-one support, and the dissemination of materials and sharing of resources. Eighty initiative partners completed a brief online survey on implementation strategies engaged in, materials used, and policy, systems, and environmental activities implemented. In accordance with frameworks for implementation science, we assessed associations among the constructs by using linear regression to identify whether and which of the implementation strategies were associated with materials used and implementation of policy, systems, and environmental activities targeted by the initiative. Each implementation strategy was engaged in by 30% to 35% of the 80 survey respondents. The most frequently used materials were educational handouts (76.3%) and posters (66.3%). The most frequently implemented activities were developing or continuing partnerships (57.5%) and reviewing organizational wellness policies (46.3%). Completing an action plan and the number of implementation strategies engaged in were positively associated with implementation of targeted activities (action plan, effect size = 0.82; number of strategies, effect size = 0.51) and materials use (action plan, effect size = 0.59; number of strategies, effect size = 0.52). Materials use was positively associated with implementation of targeted activities (effect size = 0.35). Community-capacity-building efforts can be effective in supporting community organizations to engage in policy, systems, and environmental activities for healthy eating and active living. Multiple implementation strategies are likely needed, particularly strategies that involve a high level of engagement, such as training community organizations and working with them on structured action plans.

National Initiative to Prevent Suicide (NIPS): A New Proposal to Improve the Understanding and Prevention of Suicide.

PubMed

Preskorn, Sheldon H

2016-09-01

Suicide is a staggering, tragic, and growing cause of death in the United States. Despite a government-led 20-year effort, the suicide rate increased by 25% between 1999 and 2014. To prevent suicide, it is essential to understand the biological factors-genetic and epigenetic-and environmental factors that underlie it. To gain this increased understanding, the equivalent of the "War on Cancer" initiative is needed. The War on Cancer initiative, which began in the 1970s, has transformed the treatments and outcomes of cancer, and the same could occur with a similar initiative on suicide. This article proposes a National Initiative to Prevent Suicide (NIPS), with the first step being the establishment of a National Suicide Database (NSD). The NSD would be established by a government-private partnership much as was done by the National Cancer Institute in the War on Cancer. The NSD would be established under the auspices of the National Institute of Mental Health and the Centers for Disease Control and Prevention. Approximately $600 million are currently spent annually by taxpayers in the United States to support the medicolegal death investigation system, composed of 3137 county coroner or medical examiner offices across the country. In their investigation of deaths due to suicide, these offices collect extensive information, including biological samples, from the >40,000 deaths due to suicide that occur each year. The proposal presented in this column calls for this material to be stored in the NSD so that vetted government and public/private researchers can investigate the causes of suicide. This information will make possible the development of new methods, including laboratory evaluations, for assessing suicide risk as well as new treatments to prevent suicide. In support of this proposed new initiative, this article/proposal reviews the current medicolegal death investigation system and recent advances in our understanding of the biological basis of suicide. The time for action on this proposal is now.

Preventive intervention in diabetes: a new model for continuing medical education.

PubMed

Beaser, Richard S; Brown, Julie A

2013-04-01

Competence and skills in overcoming clinical inertia for diabetes treatment, and actually supporting and assisting the patient through adherence and compliance (as opposed to just reiterating what they "should" be doing and then assigning them the blame if they fail) is a key component to success in addressing diabetes, and to date it is a component that has received little formal attention. To improve and systematize diabetes care, it is critical to move beyond the "traditional" continuing medical education (CME) model of imparting knowledge as the entirety of the educational effort, and move toward a focus on Performance Improvement CME. This new approach does not just teach new information but also provides support for improvements where needed most within practice systems based on targeted data-based on self-assessments for the entire system of care. Joslin data conclude that this new approach will benefit support, clinical, and office teams as well as the specialist. In short, the Performance Improvement CME structure reflects the needed components of the successful practice today, particularly for chronic conditions such as diabetes, including the focus on interdisciplinary team care and on quality improvement, which is becoming more and more aligned with reimbursement schemes, public and private, in the U.S. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Effects of health and safety problem recognition on small business facility investment

PubMed Central

2013-01-01

Objectives This study involved a survey of the facility investment experiences, which was designed to recognize the importance of health and safety problems, and industrial accident prevention. Ultimately, we hope that small scale industries will create effective industrial accident prevention programs and facility investments. Methods An individual survey of businesses’ present physical conditions, recognition of the importance of the health and safety problems, and facility investment experiences for preventing industrial accidents was conducted. The survey involved 1,145 business operators or management workers in small business places with fewer than 50 workers in six industrial complexes. Results Regarding the importance of occupational health and safety problems (OHS), 54.1% said it was “very important”. Received technical and financial support, and industrial accidents that occurred during the past three years were recognized as highly important for OHS. In an investigation regarding facility investment experiences for industrial accident prevention, the largest factors were business size, greater numbers of industrial accidents, greater technical and financial support received, and greater recognition of the importance of the OHS. The related variables that decided facility investment for industry accident prevention in a logistic regression analysis were the experiences of business facilities where industrial accidents occurred during the past three years, received technical and financial support, and recognition of the OHS. Those considered very important were shown to be highly significant. Conclusions Recognition of health and safety issues was higher when small businesses had experienced industrial accidents or received financial support. The investment in industrial accidents was greater when health and safety issues were recognized as important. Therefore, the goal of small business health and safety projects is to prioritize health and safety issues in terms of business management and recognition of importance. Therefore, currently various support projects are being conducted. However, there are issues regarding the limitations of the target businesses and inadequacies in maintenance and follow-up. Overall, it is necessary to provide various incentives for onsite participation that can lead to increased recognition of health and safety issues and practical investments, while perfecting maintenance and follow up measures by thoroughly revising existing operating systems. PMID:24472180

Effects of health and safety problem recognition on small business facility investment.

PubMed

Park, Jisu; Jeong, Harin; Hong, Sujin; Park, Jong-Tae; Kim, Dae-Sung; Kim, Jongseo; Kim, Hae-Joon

2013-10-23

This study involved a survey of the facility investment experiences, which was designed to recognize the importance of health and safety problems, and industrial accident prevention. Ultimately, we hope that small scale industries will create effective industrial accident prevention programs and facility investments. An individual survey of businesses' present physical conditions, recognition of the importance of the health and safety problems, and facility investment experiences for preventing industrial accidents was conducted. The survey involved 1,145 business operators or management workers in small business places with fewer than 50 workers in six industrial complexes. Regarding the importance of occupational health and safety problems (OHS), 54.1% said it was "very important". Received technical and financial support, and industrial accidents that occurred during the past three years were recognized as highly important for OHS. In an investigation regarding facility investment experiences for industrial accident prevention, the largest factors were business size, greater numbers of industrial accidents, greater technical and financial support received, and greater recognition of the importance of the OHS. The related variables that decided facility investment for industry accident prevention in a logistic regression analysis were the experiences of business facilities where industrial accidents occurred during the past three years, received technical and financial support, and recognition of the OHS. Those considered very important were shown to be highly significant. Recognition of health and safety issues was higher when small businesses had experienced industrial accidents or received financial support. The investment in industrial accidents was greater when health and safety issues were recognized as important. Therefore, the goal of small business health and safety projects is to prioritize health and safety issues in terms of business management and recognition of importance. Therefore, currently various support projects are being conducted. However, there are issues regarding the limitations of the target businesses and inadequacies in maintenance and follow-up. Overall, it is necessary to provide various incentives for onsite participation that can lead to increased recognition of health and safety issues and practical investments, while perfecting maintenance and follow up measures by thoroughly revising existing operating systems.

Fifty communities putting prevention to work: accelerating chronic disease prevention through policy, systems and environmental change.

PubMed

Bunnell, Rebecca; O'Neil, Dara; Soler, Robin; Payne, Rebecca; Giles, Wayne H; Collins, Janet; Bauer, Ursula

2012-10-01

The burden of preventable chronic diseases is straining our nation's health and economy. Diseases caused by obesity and tobacco use account for the largest portions of this preventable burden. CDC funded 50 communities in 2010 to implement policy, systems, and environmental (PSE) interventions in a 2-year initiative. Funded communities developed PSE plans to reduce obesity, tobacco use, and second-hand smoke exposure for their combined 55 million residents. Community outcome objectives and milestones were categorized by PSE interventions as they related to media, access, promotion, pricing, and social support. Communities estimated population reach based on their jurisdiction's census data and target populations. The average proportion of each community's population that was reached was calculated for each intervention category. Outcome objectives that were achieved within 12 months of program initiation were identified from routine program records. The average proportion of a community's jurisdictional population reached by a specific intervention varied across interventions. Mean population reach for obesity-prevention interventions was estimated at 35%, with 14 (26%) interventions covering over 50% of the jurisdictional populations. For tobacco prevention, mean population reach was estimated at 67%, with 16 (84%) interventions covering more than 50% of the jurisdictional populations. Within 12 months, communities advanced over one-third of their obesity and tobacco-use prevention strategies. Tobacco interventions appeared to have higher potential population reach than obesity interventions within this initiative. Findings on the progress and potential reach of this major initiative may help inform future chronic disease prevention efforts.

Adapting an evidence based parenting program for child welfare involved teens and their caregivers

PubMed Central

Barkan, Susan E.; Salazar, Amy M.; Estep, Kara; Mattos, Leah M.; Eichenlaub, Caroline; Haggerty, Kevin P.

2015-01-01

The scarcity of caregivers and the unique vulnerability of teens involved with the child welfare system necessitate effective strategies for ensuring that caregivers are prepared and supported in the important role they play with children and youth within the child welfare system. They are in a position, through the establishment of a strong, positive, supportive connection with the youth, to potentially minimize the impacts of recent trauma and interrupt a negative trajectory by preventing the youth’s initiation of high-risk behavior. In this paper we describe the process used to systematically adapt Staying Connected with Your Teen™, an evidence-based, prevention-focused parenting program found in other studies to reduce the initiation of teens‘ risky behaviors, for use with foster teens and their relative or foster caregivers. This work has been guided by the ADAPT-ITT framework developed by Wingood and DiClemente (2008) for adapting evidence-based interventions. Qualitative work conducted in Phase 1 of this study identified the need for the development of a trusted connection between foster youth and their caregivers, as well as tools for helping them access community resources, social services, and educational supports. This paper describes the process used to develop new and adapted program activities in response to the needs identified in Phase 1. We conducted a theater test with dyads of foster youth and their caregivers to get feedback on the new activities. Findings from the theater test are provided and next steps in the research are discussed which include examining program usability, fidelity, feasibility, and testing this new prevention program that has been tailored for child welfare involved youth and their caregivers. This intervention program has the potential to fill an important gap in the availability of preventive programming for caregivers of teens in foster care. PMID:26052172

The role of grandparents in preventing aggressive and other externalizing behavior problems in children from rural, methamphetamine-involved families

PubMed Central

Sheridan, Kathryn; Haight, Wendy L.; Cleeland, Leah

2011-01-01

Preventive interventions are urgently needed for children from rural, methamphetamine-involved families, who are at risk for the development of aggressive and other externalizing behavioral problems. This mixed method study explored naturally occurring sources of protection and considers the implications for targeted interventions. Participants were 41 children aged six to 14 years from rural families involved with methamphetamine and the public child welfare system, their primary caregivers, and 19 parents recovering from methamphetamine addiction. When invited during semi-structured interviews to talk about their families, 48% of children spontaneously described socially and emotionally supportive relationships with healthy grandparents. Children’s reports of support from grandparents were associated with lower scores on CBCL Social Problems, [t(37)= 2.23, p<.05 ]; externalizing behaviors, [t(37)= 2.07, p<.05]; and aggressive behaviors, [t(37)= 2.75, p<.01]. When asked to talk about their families, 58% of parents spontaneously described the support their children received from grandparents, and 26% also described the support that they had received from their own grandparents. Children’s and parents’ descriptions of grandparent support suggest how grandparents may protect children from the development of aggressive and other externalizing behavior problems. First, grandparents may prevent obstacles to healthy development by providing their grandchildren with safe shelter and basic child care when parents are incapacitated from substance misuse. Second, they may promote their grandchildren’s positive social-emotional development through supportive relationships. Third, they may promote social competence through enjoyable leisure activities with healthy adults and non-delinquent peers. Understanding naturally occurring sources of protection for children can inform the development of interventions by identifying strengths on which to build, and suggesting culturally sensitive approaches when children are struggling. PMID:21804680

The Impact of Visual Aids and Enhanced Training on the Delivery of Positive Health, Dignity, and Prevention Messages to Adult Patients Living with HIV in Rural North Central Mozambique

PubMed Central

Audet, Carolyn M.; Gutin, Sarah A.; Blevins, Meridith; Chiau, Elvino; Alvim, Fernanda; Jose, Eurico; Vaz, Lara M. E.; Shepherd, Bryan E; Dawson Rose, Carol

2015-01-01

Introduction Positive health, dignity, and prevention (PHDP) interventions target people living with HIV and AIDS (PLHIV) to promote well-being and prevent onward transmission. Concern that increased life expectancy and improved well-being would lead to increased risky sexual behaviour and subsequent HIV transmission motivated researchers to test novel strategies to support treatment adherence, encourage safer sex, STI treatment and partner testing, prevention of mother to child transmission, and support uptake of family planning. Methods We assessed the number and type of PHDP messages delivered to PLHIV before and after the implementation of an educational intervention for health providers combined with the distribution of visual job aids and monthly technical assistance. Results From April 21, 2013 to March 20, 2014, we documented 54,731 clinical encounters at three rural health centres in Zambézia province, Mozambique from 9,248 unique patients. The percentage of patients who received all seven PHDP messages during their last three visits was 1.9% pre-intervention vs. 13.6% post- intervention (p=<0.001). Younger patients (25 years vs. 35) and those with a recent HIV diagnosis (two weeks vs. two years) had higher odds of receiving any PHDP message (Odds Ratio [OR]: 1.22 and 2.79, respectively). Patients >59 days late collecting medications were not more likely to receive adherence messages than adherent patients (p=0.17). Discussion Targeting HIV prevention efforts to PLHIV is an effective HIV prevention approach to eliminate HIV transmission. Despite intensive training and support, PHDP message delivery remained unacceptably low in rural Mozambique. Patients at high risk for treatment abandonment were not more likely to be counselled about adherence and support measures, something that needs to be addressed. Conclusions We need to develop novel strategies to motivate health care providers to deliver these messages more consistently to all patients and develop a system that assists counsellors and clinicians to quickly and effectively determine which messages should be delivered. PMID:26147115

The Genome-based Knowledge Management in Cycles model: a complex adaptive systems framework for implementation of genomic applications.

PubMed

Arar, Nedal; Knight, Sara J; Modell, Stephen M; Issa, Amalia M

2011-03-01

The main mission of the Genomic Applications in Practice and Prevention Network™ is to advance collaborative efforts involving partners from across the public health sector to realize the promise of genomics in healthcare and disease prevention. We introduce a new framework that supports the Genomic Applications in Practice and Prevention Network mission and leverages the characteristics of the complex adaptive systems approach. We call this framework the Genome-based Knowledge Management in Cycles model (G-KNOMIC). G-KNOMIC proposes that the collaborative work of multidisciplinary teams utilizing genome-based applications will enhance translating evidence-based genomic findings by creating ongoing knowledge management cycles. Each cycle consists of knowledge synthesis, knowledge evaluation, knowledge implementation and knowledge utilization. Our framework acknowledges that all the elements in the knowledge translation process are interconnected and continuously changing. It also recognizes the importance of feedback loops, and the ability of teams to self-organize within a dynamic system. We demonstrate how this framework can be used to improve the adoption of genomic technologies into practice using two case studies of genomic uptake.

Designing an Alternate Mission Operations Control Room

NASA Technical Reports Server (NTRS)

Montgomery, Patty; Reeves, A. Scott

2014-01-01

The Huntsville Operations Support Center (HOSC) is a multi-project facility that is responsible for 24x7 real-time International Space Station (ISS) payload operations management, integration, and control and has the capability to support small satellite projects and will provide real-time support for SLS launches. The HOSC is a service-oriented/ highly available operations center for ISS payloads-directly supporting science teams across the world responsible for the payloads. The HOSC is required to endure an annual 2-day power outage event for facility preventive maintenance and safety inspection of the core electro-mechanical systems. While complete system shut-downs are against the grain of a highly available sub-system, the entire facility must be powered down for a weekend for environmental and safety purposes. The consequence of this ground system outage is far reaching: any science performed on ISS during this outage weekend is lost. Engineering efforts were focused to maximize the ISS investment by engineering a suitable solution capable of continuing HOSC services while supporting safety requirements. The HOSC Power Outage Contingency (HPOC) System is a physically diversified compliment of systems capable of providing identified real-time services for the duration of a planned power outage condition from an alternate control room. HPOC was designed to maintain ISS payload operations for approximately three continuous days during planned HOSC power outages and support a local Payload Operations Team, International Partners, as well as remote users from the alternate control room located in another building.

Challenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya.

PubMed

Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M; Graham, Susan M; Price, Matt A; Sanders, Eduard J

2013-01-01

The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa.

Challenges in Providing Counselling to MSM in Highly Stigmatized Contexts: Results of a Qualitative Study from Kenya

PubMed Central

Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M.; Graham, Susan M.; Price, Matt A.; Sanders, Eduard J.

2013-01-01

The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa. PMID:23762241

Technology utilization to prevent medication errors.

PubMed

Forni, Allison; Chu, Hanh T; Fanikos, John

2010-01-01

Medication errors have been increasingly recognized as a major cause of iatrogenic illness and system-wide improvements have been the focus of prevention efforts. Critically ill patients are particularly vulnerable to injury resulting from medication errors because of the severity of illness, need for high risk medications with a narrow therapeutic index and frequent use of intravenous infusions. Health information technology has been identified as method to reduce medication errors as well as improve the efficiency and quality of care; however, few studies regarding the impact of health information technology have focused on patients in the intensive care unit. Computerized physician order entry and clinical decision support systems can play a crucial role in decreasing errors in the ordering stage of the medication use process through improving the completeness and legibility of orders, alerting physicians to medication allergies and drug interactions and providing a means for standardization of practice. Electronic surveillance, reminders and alerts identify patients susceptible to an adverse event, communicate critical changes in a patient's condition, and facilitate timely and appropriate treatment. Bar code technology, intravenous infusion safety systems, and electronic medication administration records can target prevention of errors in medication dispensing and administration where other technologies would not be able to intercept a preventable adverse event. Systems integration and compliance are vital components in the implementation of health information technology and achievement of a safe medication use process.

The national response for preventing healthcare-associated infections: system capacity and sustainability for improvement.

PubMed

Mendel, Peter; Weinberg, Daniel A; Gall, Elizabeth M; Leuschner, Kristin J; Kahn, Katherine L

2014-02-01

Strengthening capacity across the healthcare system for improvement is critical to ensuring that past efforts and investments establish a foundation for sustaining progress in patient safety. The objective of this analysis was to identify key system capacity issues for sustainability from evaluation of the Action Plan to prevent healthcare-associated infections, a major national initiative launched by the US Department of Health and Human Services in 2009. The analysis involves the review and synthesis of results across the components of a 3-year evaluation of the Action Plan, as described in the evaluation framework and detailed in separate analyses elsewhere in this special issue. Data collection methods included interviews with government and private stakeholders, document and literature reviews, and observations of meetings and conferences at multiple time points. Key developments in healthcare-associated infection prevention system capacity were extracted on the basis of "major activities" identified through multiple methods and organized into the level of progress based on perspectives of multiple stakeholders. Activities within each level were then examined and compared according to our evaluation's framework of 4 system functions and 5 system properties. Key system capacity and sustainability issues for the Action Plan to be addressed centered on coordination and alignment (among participating agencies, with other federal initiatives, and across levels of healthcare), infrastructure for data and accountability (including more efficient technologies and unintended consequences), cultural embedding of prevention practices, and uncertainty and variability in resources. Sustainability depends on improvements across system functions and properties and how they reinforce each other. Change is more robust if different system elements support and incentivize behavior in similar directions.

[Postoperative thromboembolic complications and preventive measures].

PubMed

Vegar-Brozović, Vesna; Prajdić-Predrijevac, D

2003-01-01

Modern surgical procedures become very extensive and aggressive in every surgical branch. Due to expressive development of anesthesia techniques with large monitoring systems support is provided to patients for broad spectrum of disorders. Therefore, we need to protect patients from imminent complications, as development of deep venous thrombosis and embolic pulmonary incidents. The main target in prophylaxis is to divide patients by risk and the type of surgical procedures during the time of "bed recovery". Today, current farmacological treatment is prone to control and prevent such events and to decrease mortality. Patients are divided in three groups: low risk (small operations with early mobilization); medium risk (surgery with risk in patients history); high risk (severe patients and long surgery, prolonged recovery). The best solutions in current medicine is to prevent most of complications, by administration of low molecular heparin (LMWH). Advantages of that treatment are: no need of intensive monitoring, long-time treatment, safe usage in "day case surgery" Beside LMWH, we still use heparin, although we tend to trial newer treatments and supports for prevention of complications. For special groups of patients recent trials examine heparinoid like drug-hyrudin, provided by chemical engeneering. That drug is metabolised in liver. Current therapy and prevention of DVT and pulmonary embolia is LMWH. It entered in every alghorythm of surgical and anaesthetic procedures and become CONDITIO SINE QUA NON.

A snapshot of the scope of obesity prevention practice in Australia

PubMed Central

Pettman, Tahna; Bolton, Kristy; Love, Penny; Waters, Elizabeth; Gill, Tim; Whelan, Jill; Boylan, Sinead; Armstrong, Rebecca; Coveney, John; Booth, Sue; Swinburn, Boyd; Allender, Steven

2016-01-01

Community-based initiatives (CBIs) that build capacity and promote healthy environments hold promise for preventing obesity and non-communicable disease, however their characteristics remain poorly understood and lessons are learned in isolation. This limits understanding of likely effectiveness of CBIs; the potential for actively supporting practice; and the translation of community-based knowledge into policy. Building on an initial survey (2010), an online survey was launched (2013) with the aim to describe the reach and characteristics of Australian CBIs and identify and evaluate elements known to contribute to best practice, effectiveness and sustainability. Responses from 104 CBIs were received in 2013. Geographic location generally reflected population density in Australia. Duration of CBIs was short-term (median 3 years; range 0.2–21.0 years), delivered mostly by health departments and local governments. Median annual funding had more than doubled since the 2010 survey, but average staffing had not increased. CBIs used at least two strategy types, with a preference for individual behaviour change strategies. Targeting children was less common (31%) compared with the 2010 survey (57%). Logic models and theory were used in planning, but there was low use of research evidence and existing prevention frameworks. Nearly, all CBIs had an evaluation component (12% of budget), but dissemination was limited. This survey provides information on the scope and varied quality of the current obesity prevention investment in Australia. To boost the quality and effectiveness of CBIs, further support systems may be required to ensure that organizations adopt upstream, evidence-informed approaches; and integrate CBIs into systems, policies and environments. PMID:25920399

HIV prevention in primary care: impact of a clinical intervention.

PubMed

Bluespruce, J; Dodge, W T; Grothaus, L; Wheeler, K; Rebolledo, V; Carey, J W; McAfee, T A; Thompson, R S

2001-05-01

Discomfort, lack of confidence in skills, and environmental constraints may cause primary care providers to miss opportunities to discuss human immunodeficiency virus (HIV) risk with patients. We used a systems approach to address both intrapersonal and environmental barriers to HIV risk assessment and prevention counseling in a managed care clinical setting. The design was one-group pretest/posttest. The study took place in two primary care clinics of a large Pacific Northwest managed care organization. Participants (n = 49) included physicians, physician assistants, nurse practitioners, registered nurses, and social workers. The intervention included training, clarification of provider/staff roles, assess to tools and materials, and reminders/reinforcers. Outcome measures were provider attitudes, beliefs, outcome expectations, knowledge, confidence in skills, and perceived supports and barriers, measured by written pretest/posttest surveys administered 12 months apart. Seven months after the most intensive part of the intervention, providers' attitudes and beliefs were more favorable to HIV risk assessment and prevention counseling. They were less likely to express frustration with high-risk patients (decrease from 100% to 79% agreement, p = 0.001) and more confident that their advice would be effective with gay men and single adult heterosexuals (p = 0.002 and 0.005, respectively). They reported more confidence in their training in sexual history taking (p = 0.0003) and their skills assessing readiness for change (p = 0.007), and more support in practice environments. This study demonstrated that it is possible to affect important personal and environmental factors that influence primary care providers' HIV prevention behavior using an interactive, real-world systems approach. Further research is needed on providers' impact on patient behavior.

A snapshot of the scope of obesity prevention practice in Australia.

PubMed

Pettman, Tahna; Bolton, Kristy; Love, Penny; Waters, Elizabeth; Gill, Tim; Whelan, Jill; Boylan, Sinead; Armstrong, Rebecca; Coveney, John; Booth, Sue; Swinburn, Boyd; Allender, Steven

2016-09-01

Community-based initiatives (CBIs) that build capacity and promote healthy environments hold promise for preventing obesity and non-communicable disease, however their characteristics remain poorly understood and lessons are learned in isolation. This limits understanding of likely effectiveness of CBIs; the potential for actively supporting practice; and the translation of community-based knowledge into policy. Building on an initial survey (2010), an online survey was launched (2013) with the aim to describe the reach and characteristics of Australian CBIs and identify and evaluate elements known to contribute to best practice, effectiveness and sustainability. Responses from 104 CBIs were received in 2013. Geographic location generally reflected population density in Australia. Duration of CBIs was short-term (median 3 years; range 0.2-21.0 years), delivered mostly by health departments and local governments. Median annual funding had more than doubled since the 2010 survey, but average staffing had not increased. CBIs used at least two strategy types, with a preference for individual behaviour change strategies. Targeting children was less common (31%) compared with the 2010 survey (57%). Logic models and theory were used in planning, but there was low use of research evidence and existing prevention frameworks. Nearly, all CBIs had an evaluation component (12% of budget), but dissemination was limited. This survey provides information on the scope and varied quality of the current obesity prevention investment in Australia. To boost the quality and effectiveness of CBIs, further support systems may be required to ensure that organizations adopt upstream, evidence-informed approaches; and integrate CBIs into systems, policies and environments. © The Author 2015. Published by Oxford University Press.

Cost and Economic Benefit of Clinical Decision Support Systems (CDSS) for Cardiovascular Disease Prevention: A Community Guide Systematic Review

PubMed Central

Jacob, Verughese; Thota, Anilkrishna B.; Chattopadhyay, Sajal K.; Njie, Gibril J.; Proia, Krista K.; Hopkins, David P.; Ross, Murray N.; Pronk, Nicolaas P.; Clymer, John M.

2017-01-01

Objective This review evaluates costs and benefits associated with acquiring, implementing, and operating clinical decision support systems (CDSS) to prevent cardiovascular disease (CVD). Materials and Methods Methods developed for The Community Guide were used to review CDSS literature covering the period from January 1976 to October 2015. Twenty-one studies were identified for inclusion. Results It was difficult to draw a meaningful estimate for the cost of acquiring and operating CDSS to prevent CVD from the available studies (n=12) due to considerable heterogeneity. Several studies (n=11) indicated healthcare costs were averted by using CDSS but many were partial assessments that did not consider all components of healthcare. Four cost-benefit studies reached conflicting conclusions about the net benefit of CDSS based on incomplete assessments of costs and benefits. Three cost-utility studies indicated inconsistent conclusions regarding cost-effectiveness based on a conservative $50,000 threshold. Discussion Intervention costs were not negligible but specific estimates were not derived because of the heterogeneity of implementation and reporting metrics. Expected economic benefits from averted healthcare cost could not be determined with confidence because many studies did not fully account for all components of healthcare. Conclusion We were unable to conclude whether CDSS for CVD prevention is either cost-beneficial or cost effective. Several evidence gaps are identified, most prominently the lack of information about major drivers of cost and benefit; the lack of standard metrics for the cost of CDSS; and not allowing for useful life of CDSS that generally extends beyond one accounting period. PMID:28049635

A Policy Change Strategy for Head Lice Management

ERIC Educational Resources Information Center

Andresen, Kathleen; McCarthy, Ann Marie

2009-01-01

The purpose of this project was to formulate an effective change strategy for head lice management in a group of five separate school districts within one county. Despite a desire to use evidence to support their practice, school nurses often encounter educational system barriers that prevent independent management of health conditions. The use of…

77 FR 72865 - Announcement of Requirements and Registration for “Mobilizing Data for Pressure Ulcer Prevention...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

...'s electronic documentation systems require nurses to enter oversimplified text narratives or check... the healthcare continuum while reducing health care costs. A mobile health app would support nurses... appropriate nursing knowledge, nurses achieve the ability to track changes in patient status and to exchange...

14 CFR 27.1017 - Oil lines and fittings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Oil lines and fittings. 27.1017 Section 27... AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Oil System § 27.1017 Oil lines and fittings. (a) Each oil line must be supported to prevent excessive vibration. (b) Each oil line connected to...

14 CFR 27.1017 - Oil lines and fittings.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Oil lines and fittings. 27.1017 Section 27... AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Oil System § 27.1017 Oil lines and fittings. (a) Each oil line must be supported to prevent excessive vibration. (b) Each oil line connected to...

Sexual Violence through a Social Justice Paradigm: Framing and Applications

ERIC Educational Resources Information Center

Hong, Luoluo; Marine, Susan B.

2018-01-01

In this chapter, we explore the factors that support the occurrence of sexual violence, including the role of interlocking systems of oppression. Traditional conceptions of "prevention" are deconstructed, a social justice paradigm for addressing sexual violence is advanced, and examples of how the paradigm can be applied to practice are…

Groundwater Protection through Prevention. A Curriculum for Agricultural Education in Secondary Schools.

ERIC Educational Resources Information Center

Iowa State Univ. of Science and Technology, Ames. Dept. of Agricultural Education.

Water is one of the natural resources vital to any agricultural system. This material was developed in support of the Iowa Agricultural Science, Technology and Marketing (ASTM) program, focusing on groundwater educational concepts related to the 1987 Iowa Groundwater Protection Act. This material was designed to assist teachers in providing…

Connecting Vulnerable Children and Families to Community-Based Programs Strengthens Parents' Perceptions of Protective Factors

ERIC Educational Resources Information Center

Hughes, Marcia; Joslyn, Allison; Wojton, Morella; O'Reilly, Mairead; Dworkin, Paul H.

2016-01-01

We employed principles from a nationally recognized prevention model on family support to investigate whether connecting vulnerable children to community-based programs and services through a statewide intervention system, the "Help Me Grow" program, strengthens parents' perceptions of protective factors. We used a parent survey modeled…

Internet and Cell Phone Based Smoking Cessation Programs among Adolescents

ERIC Educational Resources Information Center

Mehta, Purvi; Sharma, Manoj

2010-01-01

Smoking cessation among adolescents is a salient public health issue, as it can prevent the adoption of risky health behaviors and reduce negative impacts on health. Self-efficacy, household and social support systems, and perceived benefits are some important cessation determinants. With the popular use of the Internet and cell phone usage among…

Evaluation of a Knowledge Translation and Exchange Platform to Advance Non-Communicable Disease Prevention

ERIC Educational Resources Information Center

Pettman, Tahna Lee; Armstrong, Rebecca; Waters, Elizabeth; Allender, Steven; Love, Penelope; Gill, Tim; Coveney, John; Boylan, Sinead; Booth, Sue; Bolton, Kristy; Swinburn, Boyd

2016-01-01

Coordinated systems are required to ensure evidence-informed practice and evaluation of community-based interventions (CBIs). Knowledge translation and exchange (KTE) strategies show promise, but these require evaluation. This paper describes implementation and evaluation of COOPS, a national KTE platform to support best practice in obesity…

Black Suicide and Social Support Systems: An Overview and Some Implications for Mental Health Practitioners.

ERIC Educational Resources Information Center

Davis, Robert

1982-01-01

Examines suicide rates among Blacks and explores theories that attempt to explain this phenomenon. Suggests that increased incidence of suicide among young Blacks is due to decreased Black solidarity because of stresses from overt racism, and discusses intervention strategies for suicide prevention and therapy that emphasize strengthened social…

14 CFR 27.1017 - Oil lines and fittings.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Oil lines and fittings. 27.1017 Section 27... AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Oil System § 27.1017 Oil lines and fittings. (a) Each oil line must be supported to prevent excessive vibration. (b) Each oil line connected to...

14 CFR 27.1017 - Oil lines and fittings.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Oil lines and fittings. 27.1017 Section 27... AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Oil System § 27.1017 Oil lines and fittings. (a) Each oil line must be supported to prevent excessive vibration. (b) Each oil line connected to...

Understanding and Developing Interactive Voice Response Systems to Support Online Engagement of Older Adults

ERIC Educational Resources Information Center

Brewer, Robin Nicole

2017-01-01

Increasingly, people are engaging online and can participate in activities like searching for information, communicating with family and friends, and self-expression. However, some populations such as older adults, face barriers to online participation like device cost, access, and learnability, which prevent them from reaping the benefits of…

Mental "Space" Travel: Damage to Posterior Parietal Cortex Prevents Egocentric Navigation and Reexperiencing of Remote Spatial Memories

ERIC Educational Resources Information Center

Ciaramelli, Elisa; Rosenbaum, R. Shayna; Solcz, Stephanie; Levine, Brian; Moscovitch, Morris

2010-01-01

The ability to navigate in a familiar environment depends on both an intact mental representation of allocentric spatial information and the integrity of systems supporting complementary egocentric representations. Although the hippocampus has been implicated in learning new allocentric spatial information, converging evidence suggests that the…

Variation in Sharwil avocado maturity during the harvest season and resistance to fruit fly infestation.

USDA-ARS?s Scientific Manuscript database

Technical Abstract: Avocados cannot be exported from Hawaii without a quarantine treatment to prevent the spread of fruit flies. Research on the maturity and infestability of ‘Sharwil’ avocados was conducted to support development of a systems approach for quarantine security of exported fruit. Th...

Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study

PubMed Central

Whitford, David L; Hickey, Anne; Horgan, Frances; O'Sullivan, Bernadette; McGee, Hannah; O'Neill, Desmond

2009-01-01

Background Stroke is a major cause of mortality and morbidity with potential for improved care and prevention through general practice. A national survey was undertaken to determine current resources and needs for optimal stroke prevention and care. Methods Postal survey of random sample of general practitioners undertaken (N = 204; 46% response). Topics included practice organisation, primary prevention, acute management, secondary prevention, long-term care and rehabilitation. Results Service organisation for both primary and secondary prevention was poor. Home management of acute stroke patients was used at some stage by 50% of responders, accounting for 7.3% of all stroke patients. Being in a structured cardiovascular management scheme, a training practice, a larger practice, or a practice employing a practice nurse were associated with structures and processes likely to support stroke prevention and care. Conclusion General practices were not fulfilling their potential to provide stroke prevention and long-term management. Systems of structured stroke management in general practice are essential to comprehensive national programmes of stroke care. PMID:19402908

Catalytic wet-oxidation of human wastes produced in space: the effects of temperature elevation.

PubMed

Takeda, N; Takahashi, Y

1992-01-01

The filtrate of non-catalytical wet-oxidation sewage sludge was wet-oxidized again at 290 degrees C and 300 degrees C with a Ru-Rh catalyst. At each temperature, repeated batch tests were carried out. Both oxidation and denitrification efficiency of organic matter in the raw material were studied. In the 16 times batch tests at 300 degrees C, high and stable oxidation occurred. 98.0% of organic carbon in the raw material was oxidized and 98.3% of organic nitrogen was denitrified. At 290 degrees C, though high and stable denitrification occurred, oxidation did not occur highly and stably. A catalytic wet-oxidation system studied at 300 degrees C will be useful as a waste management system for a human life support system, where almost all food is resupplied from the earth. This system can prevent organic waste accumulation in the life support system.

21 CFR 880.5780 - Medical support stocking.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Devices § 880.5780 Medical support stocking. (a) Medical support stocking to prevent the pooling of blood in the legs—(1) Identification. A medical support stocking to prevent the pooling of blood in the legs is a device that is constructed of elastic material and designed to apply controlled pressure to...

21 CFR 880.5780 - Medical support stocking.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Devices § 880.5780 Medical support stocking. (a) Medical support stocking to prevent the pooling of blood in the legs—(1) Identification. A medical support stocking to prevent the pooling of blood in the legs is a device that is constructed of elastic material and designed to apply controlled pressure to...

21 CFR 880.5780 - Medical support stocking.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Devices § 880.5780 Medical support stocking. (a) Medical support stocking to prevent the pooling of blood in the legs—(1) Identification. A medical support stocking to prevent the pooling of blood in the legs is a device that is constructed of elastic material and designed to apply controlled pressure to...

21 CFR 880.5780 - Medical support stocking.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Devices § 880.5780 Medical support stocking. (a) Medical support stocking to prevent the pooling of blood in the legs—(1) Identification. A medical support stocking to prevent the pooling of blood in the legs is a device that is constructed of elastic material and designed to apply controlled pressure to...

21 CFR 880.5780 - Medical support stocking.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Devices § 880.5780 Medical support stocking. (a) Medical support stocking to prevent the pooling of blood in the legs—(1) Identification. A medical support stocking to prevent the pooling of blood in the legs is a device that is constructed of elastic material and designed to apply controlled pressure to...

Translating a Fall Prevention Intervention Into Practice: A Randomized Community Trial

PubMed Central

Peterson, Donna J.; Christiansen, Ann L.; Mahoney, Jane; Laud, Purushottam; Layde, Peter M.

2015-01-01

Objectives. We examined whether community translation of an effective evidence-based fall prevention program via standard monetary support can produce a community-wide reduction in fall injuries in older adults and evaluated whether an enhanced version with added technical support and capacity building amplified the fall reduction effect. Methods. We completed a randomized controlled community trial among adults aged 65 and older in (1) 10 control communities receiving no special resources or guidance on fall prevention, (2) 5 standard support communities receiving modest funding to implement Stepping On, and (3) 5 enhanced support communities receiving funding and technical support. The primary outcome was hospital inpatient and emergency department discharges for falls, examined with Poisson regression. Results. Compared with control communities, standard and enhanced support communities showed significantly higher community-wide reductions (9% and 8%, respectively) in fall injuries from baseline (2007–2008) to follow-up (2010–2011). No significant difference was found between enhanced and standard support communities. Conclusions. Population-based fall prevention interventions can be effective when implemented in community settings. More research is needed to identify the barriers and facilitators that influence the successful adoption and implementation of fall prevention interventions into broad community practice. PMID:25602891

Translating a Fall Prevention Intervention Into Practice: A Randomized Community Trial.

PubMed

Guse, Clare E; Peterson, Donna J; Christiansen, Ann L; Mahoney, Jane; Laud, Purushottam; Layde, Peter M

2015-07-01

We examined whether community translation of an effective evidence-based fall prevention program via standard monetary support can produce a community-wide reduction in fall injuries in older adults and evaluated whether an enhanced version with added technical support and capacity building amplified the fall reduction effect. We completed a randomized controlled community trial among adults aged 65 and older in (1) 10 control communities receiving no special resources or guidance on fall prevention, (2) 5 standard support communities receiving modest funding to implement Stepping On, and (3) 5 enhanced support communities receiving funding and technical support. The primary outcome was hospital inpatient and emergency department discharges for falls, examined with Poisson regression. Compared with control communities, standard and enhanced support communities showed significantly higher community-wide reductions (9% and 8%, respectively) in fall injuries from baseline (2007-2008) to follow-up (2010-2011). No significant difference was found between enhanced and standard support communities. Population-based fall prevention interventions can be effective when implemented in community settings. More research is needed to identify the barriers and facilitators that influence the successful adoption and implementation of fall prevention interventions into broad community practice.

Analysis of Aviation Safety Reporting System Incident Data Associated With the Technical Challenges of the Vehicle Systems Safety Technology Project

NASA Technical Reports Server (NTRS)

Withrow, Colleen A.; Reveley, Mary S.

2014-01-01

This analysis was conducted to support the Vehicle Systems Safety Technology (VSST) Project of the Aviation Safety Program (AVsP) milestone VSST4.2.1.01, "Identification of VSST-Related Trends." In particular, this is a review of incident data from the NASA Aviation Safety Reporting System (ASRS). The following three VSST-related technical challenges (TCs) were the focus of the incidents searched in the ASRS database: (1) Vechicle health assurance, (2) Effective crew-system interactions and decisions in all conditions; and (3) Aircraft loss of control prevention, mitigation, and recovery.

Preventing healthcare-associated infections through human factors engineering.

PubMed

Jacob, Jesse T; Herwaldt, Loreen A; Durso, Francis T

2018-05-24

Human factors engineering (HFE) approaches are increasingly being used in healthcare, but have been applied in relatively limited ways to infection prevention and control (IPC). Previous studies have focused on using selected HFE tools, but newer literature supports a system-based HFE approach to IPC. Cross-contamination and the existence of workarounds suggest that healthcare workers need better support to reduce and simplify steps in delivering care. Simplifying workflow can lead to better understanding of why a process fails and allow for improvements to reduce errors and increase efficiency. Hand hygiene can be improved using visual cues and nudges based on room layout. Using personal protective equipment appropriately appears simple, but exists in a complex interaction with workload, behavior, emotion, and environmental variables including product placement. HFE can help prevent the pathogen transmission through improving environmental cleaning and appropriate use of medical devices. Emerging evidence suggests that HFE can be applied in IPC to reduce healthcare-associated infections. HFE and IPC collaboration can help improve many of the basic best practices including use of hand hygiene and personal protective equipment by healthcare workers during patient care.

Insights in public health: Building support for an evidence-based teen pregnancy and sexually transmitted infection prevention program adapted for foster youth.

PubMed

Smith, Tamara; Clark, Judith F; Nigg, Claudio R

2015-01-01

Hawai'i Youth Services Network (HYSN) was founded in 1980 and is incorporated as a 501(c) (3) organization. HYSN plays a key role in the planning, creation, and funding of local youth services. One of HYSN's focuses is teen pregnancy and sexually transmitted infections (STI) prevention among foster youth. Foster youth are at a greater risk for teen pregnancy and STI due to a variety of complex factors including instability, trauma, and emancipation from the foster care system. This article highlights how HYSN is leveraging both federal and local funding, as well as other resources, in order to implement an evidence-based teen pregnancy and STI prevention program adapted for foster youth.

The Science of Cancer Prevention

Cancer.gov

The science of cancer prevention is described by Dr. Barnett S. Kramer, M.D., M.P.H., director of the Division of Cancer Prevention, National Cancer Institute (NCI). The Division of Cancer Prevention administers a broad spectrum of research that spans basic pre-clinical, laboratory research, supportive and palliative care research, early detection, and randomized controlled clinical trials. The Division also supports the Cancer Prevention Fellowship Program and is devoted to the balanced communication of scientific results.

Life concerns of elderly people living at home determined as by Community General Support Center staff: implications for organizing a more effective integrated community care system. The Kurihara Project.

PubMed

Takada, Junko; Meguro, Kenichi; Sato, Yuko; Chiba, Yumiko

2014-09-01

In Japan, the integrated community care system aims to enable people to continue to live in their homes. Based on the concept, one of the activities of a Community General Support Center (CGSC) is to provide preventive intervention based on a Community Support Program. Currently, a Basic Checklist (BC) is sent to elderly people to identify persons appropriate for a Secondary Prevention Program. To find people who had not responded to the BC, CGSC staff evaluated the files of 592 subjects who had participated in the Kurihara Project to identify activities they cannot do that they did in the past, decreased activity levels at home, loss of interaction with people other than their family, and the need for medical interventions. This information was classified, when applicable, into the following categories: (A) 'no life concerns'; (B) 'undecided'; and (C) 'life concerns'. The relationships between these classifications and clinical information, certified need for long-term care, and items on the BC were examined. The numbers of subjects in categories A, B, and C were 291, 42, and 186, respectively. Life concerns were related to scores on the Clinical Dementia Rating, global cognitive function, depressive state, and apathy. Most items on the BC were not associated with classification into category C, but ≥25% of the subjects had life concerns related to these items. Assessment of life concerns by the CGSC staff has clinical validity. The results suggest that there are people who do not respond to the checklist or apply for Long-Term Care Insurance, meaning that they 'hide' in the community, probably due to apathy or depressive state. To organize a more effective integrated community care system, the CGSC staff should focus mainly on preventive care. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Coordinated management of combined sewer overflows by means of environmental decision support systems.

PubMed

Murla, Damian; Gutierrez, Oriol; Martinez, Montse; Suñer, David; Malgrat, Pere; Poch, Manel

2016-04-15

During heavy rainfall, the capacity of sewer systems and wastewater treatment plants may be surcharged producing uncontrolled wastewater discharges and a depletion of the environmental quality. Therefore there is a need of advanced management tools to tackle with these complex problems. In this paper an environmental decision support system (EDSS), based on the integration of mathematical modeling and knowledge-based systems, has been developed for the coordinated management of urban wastewater systems (UWS) to control and minimize uncontrolled wastewater spills. Effectiveness of the EDSS has been tested in a specially designed virtual UWS, including two sewers systems, two WWTP and one river subjected to typical Mediterranean rain conditions. Results show that sewer systems, retention tanks and wastewater treatment plants improve their performance under wet weather conditions and that EDSS can be very effective tools to improve the management and prevent the system from possible uncontrolled wastewater discharges. Copyright © 2016 Elsevier B.V. All rights reserved.

Medication errors in anesthesia: unacceptable or unavoidable?

PubMed

Dhawan, Ira; Tewari, Anurag; Sehgal, Sankalp; Sinha, Ashish Chandra

Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be successful until a change in the existing protocols and system is incorporated. Often drug errors that occur cannot be reversed. The best way to 'treat' drug errors is to prevent them. Wrong medication (due to syringe swap), overdose (due to misunderstanding or preconception of the dose, pump misuse and dilution error), incorrect administration route, under dosing and omission are common causes of medication error that occur perioperatively. Drug omission and calculation mistakes occur commonly in ICU. Medication errors can occur perioperatively either during preparation, administration or record keeping. Numerous human and system errors can be blamed for occurrence of medication errors. The need of the hour is to stop the blame - game, accept mistakes and develop a safe and 'just' culture in order to prevent medication errors. The newly devised systems like VEINROM, a fluid delivery system is a novel approach in preventing drug errors due to most commonly used medications in anesthesia. Similar developments along with vigilant doctors, safe workplace culture and organizational support all together can help prevent these errors. Copyright © 2016. Published by Elsevier Editora Ltda.

Social Support Networks: An Underutilized Resource for the Prevention of HIV and other Sexually Transmitted Diseases among Hispanic/Latino Migrants and Immigrants.

PubMed

Painter, Thomas M

2018-01-01

Hispanic/Latino migrants and immigrants are vulnerable to infection by HIV and other sexually transmitted diseases (STDs). Participation in social support networks helps them cope with circumstances in the U.S. Studies of Hispanic/Latino migrants suggest that participation may also be protective against HIV/STD infection. However the studies do not satisfactorily explain how participation leads to protective actions, and recommend externally-induced interventions for HIV/STD prevention rather than incorporating the spontaneously occurring forms of social support they describe. Given the potential protective effects of support networks, a database search was conducted to ascertain the extent to which published HIV/STD prevention interventions for these populations incorporate their support networks. Very few interventions were identified and fewer still incorporate support networks. This commentary calls for research to understand more fully how support networks affect HIV/STD risks among Hispanic/Latino migrants and immigrants and identifies potential benefits of incorporating these networks in HIV/STD prevention for these vulnerable populations.

The environmental control and life support system advanced automation project. Phase 1: Application evaluation

NASA Technical Reports Server (NTRS)

Dewberry, Brandon S.

1990-01-01

The Environmental Control and Life Support System (ECLSS) is a Freedom Station distributed system with inherent applicability to advanced automation primarily due to the comparatively large reaction times of its subsystem processes. This allows longer contemplation times in which to form a more intelligent control strategy and to detect or prevent faults. The objective of the ECLSS Advanced Automation Project is to reduce the flight and ground manpower needed to support the initial and evolutionary ECLS system. The approach is to search out and make apparent those processes in the baseline system which are in need of more automatic control and fault detection strategies, to influence the ECLSS design by suggesting software hooks and hardware scars which will allow easy adaptation to advanced algorithms, and to develop complex software prototypes which fit into the ECLSS software architecture and will be shown in an ECLSS hardware testbed to increase the autonomy of the system. Covered here are the preliminary investigation and evaluation process, aimed at searching the ECLSS for candidate functions for automation and providing a software hooks and hardware scars analysis. This analysis shows changes needed in the baselined system for easy accommodation of knowledge-based or other complex implementations which, when integrated in flight or ground sustaining engineering architectures, will produce a more autonomous and fault tolerant Environmental Control and Life Support System.

[The organization of preventive examinations in the system of medical support of industrial enterprises].

PubMed

Zeliaieva, N V; Kamaiev, I A; Gurvich, N I

2017-01-01

The article presents the results of analysis of actual system of medical support of industrial enterprises and consumer estimate of accessibility o and quality of organization of medical examinations during dispensarization. The new form of complex medical examinations is proposed combining capacity of programs of examination of periodical medical check-ups of workers of enterprises and the first stage of dispensarization implemented on the basis of of integrated medical organization according to developed regulations. On the basis of increasing coverage of workers with measures of dispensarization the economic efficiency of complex medical examinations at the expense of decreasing of economic burden of chronic non-infectious diseases is substantiated.

LEVERAGING TECHNOLOGY TO ENHANCE ADDICTION TREATMENT AND RECOVERY

PubMed Central

Marsch, Lisa A.

2012-01-01

Technology such as the Internet and mobile phones offers considerable promise for affecting the assessment, prevention, and treatment of and recovery from substance use disorders. Technology may enable entirely new models of behavioral health care within and outside of formal systems of care. This article reviews the promise of technology-based therapeutic tools for affecting the quality and reach of addiction treatment and recovery support systems, as well as the empirical support to date for this approach. Potential models for implementing technology-based interventions targeting substance use disorders are described. Opportunities to optimize the effectiveness and impact of technology-based interventions targeting addiction and recovery, along with outstanding research needs, are discussed. PMID:22873192

Status of the Superconducting Insertion Device Control at TLS

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

Hu, K. H.; Wang, C. J.; Lee, Demi

2007-01-19

Superconducting insertion devices are installed at Taiwan Light Source to meet the rapidly growing demand of X-ray users. A control system supports the operation of all these superconducting insertion devices. Control system coordinates the operation of the main power supply and the trimming power supply to charge/discharge the magnet and provide essential interlock protection for the coils and vacuum ducts. Quench protection and various cryogenic interlocks are designed to prevent damage to the magnet. A friendly user interface supports routine operation. Various applications are also developed to aid the operation of these insertion devices. Design consideration and details of themore » implementation will be summarized in this report.« less

Bushing retention system for thermal medium cooling delivery tubes in a gas turbine rotor

DOEpatents

Mashey, Thomas Charles

2002-01-01

Bushings are provided in counterbores for wheels and spacers for supporting thermal medium cooling tubes extending axially adjacent the rim of the gas turbine rotor. The retention system includes a retaining ring disposed in a groove adjacent an end face of the bushing and which retaining ring projects radially inwardly to prevent axial movement of the bushing in one direction. The retention ring has a plurality of circumferentially spaced tabs along its inner diameter whereby the ring is supported by the lands of the tube maintaining its bushing retention function, notwithstanding operation in high centrifugal fields and rotation of the ring in the groove into other circular orientations.

Use of a coverlet system for the management of skin microclimate.

PubMed

Collier, Mark; Potts, Carol; Shaw, Elaine

2014-08-12

Pressure and shear are the two key extrinsic factors that cause pressure ulcer damage. However, if the resilience of the skin and soft tissue deteriorates, the individual's susceptibility to such pressure damage will increase. The risk is greater if the microclimate at the interface between the skin and the support surface is impaired. This will occur when the skin temperature is elevated and there is excess moisture on the skin surface. Microclimate management therefore plays an important role in pressure ulcer prevention. This article describes how use of a new coverlet system (Skin IQ Microclimate Manager, ArjoHuntleigh) can avoid the accumulation of heat and moisture at the patient/support-surface interface.

Leveraging technology to enhance addiction treatment and recovery.

PubMed

Marsch, Lisa A

2012-01-01

Technology such as the Internet and mobile phones offers considerable promise for affecting the assessment, prevention, and treatment of and recovery from substance use disorders. Technology may enable entirely new models of behavioral health care within and outside of formal systems of care. This article reviews the promise of technology-based therapeutic tools for affecting the quality and reach of addiction treatment and recovery support systems, as well as the empirical support to date for this approach. Potential models for implementing technology-based interventions targeting substance use disorders are described. Opportunities to optimize the effectiveness and impact of technology-based interventions targeting addiction and recovery, along with outstanding research needs, are discussed.

Research on Life Science and Life Support Engineering Problems of Manned Deep Space Exploration Mission

NASA Astrophysics Data System (ADS)

Qi, Bin; Guo, Linli; Zhang, Zhixian

2016-07-01

Space life science and life support engineering are prominent problems in manned deep space exploration mission. Some typical problems are discussed in this paper, including long-term life support problem, physiological effect and defense of varying extraterrestrial environment. The causes of these problems are developed for these problems. To solve these problems, research on space life science and space medical-engineering should be conducted. In the aspect of space life science, the study of space gravity biology should focus on character of physiological effect in long term zero gravity, co-regulation of physiological systems, impact on stem cells in space, etc. The study of space radiation biology should focus on target effect and non-target effect of radiation, carcinogenicity of radiation, spread of radiation damage in life system, etc. The study of basic biology of space life support system should focus on theoretical basis and simulating mode of constructing the life support system, filtration and combination of species, regulation and optimization method of life support system, etc. In the aspect of space medical-engineering, the study of bio-regenerative life support technology should focus on plants cultivation technology, animal-protein production technology, waste treatment technology, etc. The study of varying gravity defense technology should focus on biological and medical measures to defend varying gravity effect, generation and evaluation of artificial gravity, etc. The study of extraterrestrial environment defense technology should focus on risk evaluation of radiation, monitoring and defending of radiation, compound prevention and removal technology of dust, etc. At last, a case of manned lunar base is analyzed, in which the effective schemes of life support system, defense of varying gravity, defense of extraterrestrial environment are advanced respectively. The points in this paper can be used as references for intensive study on key technologies.

Initial Concept for Terminal Area Conflict Detection, Alerting, and Resolution Capability on or Near the Airport Surface

NASA Technical Reports Server (NTRS)

Green, David F.; Otero, Sharon D.; Barker, Glover D.; Jones, Denise R.

2009-01-01

The Next Generation Air Transportation System (NextGen) concept for 2025 envisions the movement of large numbers of people and goods in a safe, efficient, and reliable manner. The NextGen will remove many of the constraints in the current air transportation system, support a wider range of operations, and deliver an overall system capacity up to 3 times that of current operating levels. In order to achieve the NextGen vision, research is necessary in the areas of surface traffic optimization, maximum runway capacity, reduced runway occupancy time, simultaneous single runway operations, and terminal area conflict prevention, among others. The National Aeronautics and Space Administration (NASA) is conducting Collision Avoidance for Airport Traffic (CAAT) research to develop technologies, data, and guidelines to enable Conflict Detection and Resolution (CD&R) in the Airport Terminal Maneuvering Area (ATMA) under current and emerging NextGen operating concepts. In this report, an initial concept for an aircraft-based method for CD&R in the ATMA is presented. This method is based upon previous NASA work in CD&R for runway incursion prevention, the Runway Incursion Prevention System (RIPS). CAAT research is conducted jointly under NASA's Airspace Systems Program, Airportal Project and the Aviation Safety Program, Integrated Intelligent Flight Deck Project.

Storage resource manager

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

Perelmutov, T.; Bakken, J.; Petravick, D.

Storage Resource Managers (SRMs) are middleware components whose function is to provide dynamic space allocation and file management on shared storage components on the Grid[1,2]. SRMs support protocol negotiation and reliable replication mechanism. The SRM standard supports independent SRM implementations, allowing for a uniform access to heterogeneous storage elements. SRMs allow site-specific policies at each location. Resource Reservations made through SRMs have limited lifetimes and allow for automatic collection of unused resources thus preventing clogging of storage systems with ''orphan'' files. At Fermilab, data handling systems use the SRM management interface to the dCache Distributed Disk Cache [5,6] and themore » Enstore Tape Storage System [15] as key components to satisfy current and future user requests [4]. The SAM project offers the SRM interface for its internal caches as well.« less

MATES in Construction: Impact of a Multimodal, Community-Based Program for Suicide Prevention in the Construction Industry

PubMed Central

Gullestrup, Jorgen; Lequertier, Belinda; Martin, Graham

2011-01-01

A large-scale workplace-based suicide prevention and early intervention program was delivered to over 9,000 construction workers on building sites across Queensland. Intervention components included universal General Awareness Training (GAT; general mental health with a focus on suicide prevention); gatekeeper training provided to construction worker volunteer ‘Connectors’; Suicide First Aid (ASIST) training offered to key workers; outreach support provided by trained and supervised MIC staff; state-wide suicide prevention hotline; case management service; and postvention support provided in the event of a suicide. Findings from over 7,000 workers (April 2008 to November 2010) are reported, indicating strong construction industry support, with 67% building sites and employers approached agreeing to participate in MIC. GAT participants demonstrated significantly increased suicide prevention awareness compared with a comparison group. Connector training participants rated MIC as helpful and effective, felt prepared to intervene with a suicidal person, and knew where to seek help for a suicidal individual following the training. Workers engaged positively with the after-hours crisis support phone line and case management. MIC provided postvention support to 10 non-MIC sites and sites engaged with MIC, but not yet MIC-compliant. Current findings support the potential effectiveness and social validity of MIC for preventing suicide in construction workers. PMID:22163201

The Relationship between Neighborhood Characteristics and Effective Parenting Behaviors: The Role of Social Support.

PubMed

Byrnes, Hilary F; Miller, Brenda A

2012-12-01

Neighborhood characteristics have been linked to healthy behavior, including effective parenting behaviors. This may be partially explained through the neighborhood's relation to parents' access to social support from friends and family. The current study examined associations of neighborhood characteristics with parenting behaviors indirectly through social support. The sample included 614 mothers of 11-12 year old youths enrolled in a health care system in the San Francisco area. Structural equations modeling shows that neighborhood perceptions were related to parenting behaviors, indirectly through social support, while archival census neighborhood indicators were unrelated to social support and parenting. Perceived neighborhood social cohesion and control were related to greater social support, which was related to more effective parenting style, parent-child communication, and monitoring. Perceived neighborhood disorganization was unrelated to social support. Prevention strategies should focus on helping parents build a social support network that can act as a resource in times of need.

How change management can prevent the failure of information systems implementation among Malaysian government hospitals?

NASA Astrophysics Data System (ADS)

ChePa, Noraziah; Jasin, Noorhayati Md; Bakar, Nur Azzah Abu

2017-10-01

Fail to prevent or control challenges of Information System (IS) implementation have led to the failure of its implementation. Successful implementation of IS has been a challenging task to any organization including government hospitals. Government has invested a big amount of money on information system (IS) projects to improve service delivery in healthcare. However, several of them failed to be implemented successfully due to several factors. This article proposes a prevention model which incorporated Change Management (CM) concepts to avoid the failure of IS implementation, hence ensuring the success of it. Challenges of IS implementation in government hospitals have been discovered. Extensive literature review and deep interview approaches were employed to discover these challenges. A prevention model has been designed to cater the challenges. The model caters three main phases of implementation; pre-implementation, during implementation, and post-implementation by adopting CM practices of Lewin's, Kotter's and Prosci's CM model. Six elements of CM comprising thirteen sub-elements adopted from the three CM models have been used to handle CFFs of Human and Support issues; guiding team, resistance avoidance, IS adoption, enforcement, monitoring, and IS sustainability. Successful practice of the proposed mapping is expected to prevent CFFs to occur, hence ensuring a successful implementation of IS in the hospitals. The proposed model has been presented and successfully evaluated by the domain experts from the selected hospitals. The proposed model is believed to be beneficial for top management, IT practitioners and medical practitioners in preventing IS implementation failure among government hospitals towards ensuring the success implementation.

Prevention in Mental Health: Organizational and Ideological Perspectives.

ERIC Educational Resources Information Center

Walsh, Joseph A.

1982-01-01

Studied 33 community mental health centers to determine what types of organizational variables and ideological factors might affect whether a community health center conducted prevention programs. Results indicated organizational support and ideological support of mental health professionals were critical variables for prevention programs.…

Towards automated traceability maintenance

PubMed Central

Mäder, Patrick; Gotel, Orlena

2012-01-01

Traceability relations support stakeholders in understanding the dependencies between artifacts created during the development of a software system and thus enable many development-related tasks. To ensure that the anticipated benefits of these tasks can be realized, it is necessary to have an up-to-date set of traceability relations between the established artifacts. This goal requires the creation of traceability relations during the initial development process. Furthermore, the goal also requires the maintenance of traceability relations over time as the software system evolves in order to prevent their decay. In this paper, an approach is discussed that supports the (semi-) automated update of traceability relations between requirements, analysis and design models of software systems expressed in the UML. This is made possible by analyzing change events that have been captured while working within a third-party UML modeling tool. Within the captured flow of events, development activities comprised of several events are recognized. These are matched with predefined rules that direct the update of impacted traceability relations. The overall approach is supported by a prototype tool and empirical results on the effectiveness of tool-supported traceability maintenance are provided. PMID:23471308

Using old technology to implement modern computer-aided decision support for primary diabetes care.

PubMed Central

Hunt, D. L.; Haynes, R. B.; Morgan, D.

2001-01-01

BACKGROUND: Implementation rates of interventions known to be beneficial for people with diabetes mellitus are often suboptimal. Computer-aided decision support systems (CDSSs) can improve these rates. The complexity of establishing a fully integrated electronic medical record that provides decision support, however, often prevents their use. OBJECTIVE: To develop a CDSS for diabetes care that can be easily introduced into primary care settings and diabetes clinics. THE SYSTEM: The CDSS uses fax-machine-based optical character recognition software for acquiring patient information. Simple, 1-page paper forms, completed by patients or health practitioners, are faxed to a central location. The information is interpreted and recorded in a database. This initiates a routine that matches the information against a knowledge base so that patient-specific recommendations can be generated. These are formatted and faxed back within 4-5 minutes. IMPLEMENTATION: The system is being introduced into 2 diabetes clinics. We are collecting information on frequency of use of the system, as well as satisfaction with the information provided. CONCLUSION: Computer-aided decision support can be provided in any setting with a fax machine, without the need for integrated electronic medical records or computerized data-collection devices. PMID:11825194

Using old technology to implement modern computer-aided decision support for primary diabetes care.

PubMed

Hunt, D L; Haynes, R B; Morgan, D

2001-01-01

Implementation rates of interventions known to be beneficial for people with diabetes mellitus are often suboptimal. Computer-aided decision support systems (CDSSs) can improve these rates. The complexity of establishing a fully integrated electronic medical record that provides decision support, however, often prevents their use. To develop a CDSS for diabetes care that can be easily introduced into primary care settings and diabetes clinics. THE SYSTEM: The CDSS uses fax-machine-based optical character recognition software for acquiring patient information. Simple, 1-page paper forms, completed by patients or health practitioners, are faxed to a central location. The information is interpreted and recorded in a database. This initiates a routine that matches the information against a knowledge base so that patient-specific recommendations can be generated. These are formatted and faxed back within 4-5 minutes. The system is being introduced into 2 diabetes clinics. We are collecting information on frequency of use of the system, as well as satisfaction with the information provided. Computer-aided decision support can be provided in any setting with a fax machine, without the need for integrated electronic medical records or computerized data-collection devices.

Listening to paediatric primary care nurses: a qualitative study of the potential for interprofessional oral health practice in six federally qualified health centres in Massachusetts and Maryland

PubMed Central

Bernstein, Judith; Gebel, Christina; Vargas, Clemencia; Geltman, Paul; Walter, Ashley; Garcia, Raul; Tinanoff, Norman

2017-01-01

Objectives To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers. Sample Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format. Design Grounded theory research. Topics included feasibility of integration, perceived barriers and strategies for incorporating oral health into paediatric primary care. Measurements Qualitative data were coded and analysed using NVivo 10 to generate themes iteratively. Results Nurses in diverse roles recognised the importance of oral health prevention but were unaware of professional guidelines for incorporating oral health into paediatric encounters. They valued collaborative care, specifically internal communication, joint initiatives and training and partnering with dental schools or community dental practices. Barriers to IPC included inadequate training, few opportunities for cross-communication and absence of charting templates in electronic health records. Conclusions NMs, NPs and paediatric nursing staff all value IPC to improve patients' oral health, yet are constrained by lack of oral health training and supportive charting and referral systems. With supports, they are willing to take on responsibility for introducing oral health preventive measures into the well-child visit, but will require IPC approaches to training and systems changes. IPC teams in the health centre setting can work together, if policy and administrative supports are in place, to provide oral health assessments, education, fluoride varnish application and dental referrals, decrease the prevalence of early childhood caries and increase access to a dental home for low-income children. PMID:28360245

The Immunomodulation and Anti-Inflammatory Effects of Garlic Organosulfur Compounds in Cancer Chemoprevention

PubMed Central

Schäfer, Georgia; Kaschula, Catherine H.

2014-01-01

Garlic (Allium sativum) has been used for centuries as a prophylactic and therapeutic medicinal agent. Importantly, garlic has been suggested to have both cancer-preventive potential as well as significant enhancing effects on the immune system. While these observations are supported experimentally both in vitro and in vivo, the impact of garlic in assisting the immune system in the prevention of cancer still lacks experimental confirmation. Studies addressing the immunomodulatory effects of garlic reveal conflicting data as to pro- or anti-inflammatory responses depending on the particular experimental set-ups and the garlic preparation used (i.e. garlic extract versus chemically pure garlic compounds). Here we provide an overview of the chemistry of the major garlic organosulfur compounds, summarize the current understanding and propose a link between the immunomodulating activity of garlic and the prevention of cancer. We hypothesize that garlic rather elicits anti-inflammatory and anti-oxidative responses that aid in priming the organism towards eradication of an emerging tumor. PMID:24237225

It's Complicated: Negotiating Between Traditional Research and Community-Based Participatory Research in a Translational Study.

PubMed

Hopkins, Allison L; Moore-Monroy, Martha; Wilkinson-Lee, Ada M; Nuño, Velia Leybas; Armenta, Alexandra; Lopez, Elvia; Vanzzini, Susan; Garcia, Francisco A

2016-01-01

The Interactive Systems Framework (ISF), a guide for translational research, encourages the balancing of traditional research and community-based participatory research (CBPR) approaches. This paper focuses on the challenges, solutions, and lessons learned in applying the ISF to our translational research project. A community-campus partnership translated evidence-based screening guidelines on sexually transmitted infections (STIs) and depression into culturally relevant educational materials. Community health workers (CHWs) disseminated the information through a cross-over design to Hispanic women in Pima County, Arizona. Challenges, solutions, and lessons learned were identified throughout this process. We identified challenges in the areas of research design, and in the ISF systems of prevention synthesis and translation, prevention support, and prevention delivery. We successfully negotiate solutions between the scientific and local community that resulted in acceptable compromises for both groups. The model presented by the ISF is difficult to achieve, but we offer concrete solutions to community members and scientists to move toward that ideal.

Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

PubMed Central

Schwalm, Jon-David; McKee, Martin; Huffman, Mark D.; Yusuf, Salim

2016-01-01

Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality. PMID:26903017

Organizational capacity for chronic disease prevention: a survey of Canadian public health organizations.

PubMed

Hanusaik, Nancy; O'Loughlin, Jennifer L; Kishchuk, Natalie; Paradis, Gilles; Cameron, Roy

2010-04-01

There are no national data on levels of organizational capacity within the Canadian public health system to reduce the burden of chronic disease. Cross-sectional data were collected in a national survey (October 2004 to April 2005) of all 216 national, provincial and regional-level organizations engaged in chronic disease prevention through primary prevention or healthy lifestyle promotion. Levels of organizational capacity (defined as skills and resources to implement chronic disease prevention programmes), potential determinants of organizational capacity and involvement in chronic disease prevention programming were compared in western, central and eastern Canada and across three types of organizations (formal public health organizations, non-governmental organizations and grouped organizations). Forty percent of organizations were located in Central Canada. Approximately 50% were formal public health organizations. Levels of skill and involvement were highest for activities that addressed tobacco control and healthy eating; lowest for stress management, social determinants of health and programme evaluation. The few notable differences in skill levels by provincial grouping favoured Central Canada. Resource adequacy was rated low across the country; but was lowest in eastern Canada and among formal public health organizations. Determinants of organizational capacity (organizational supports and partnerships) were highest in central Canada and among grouped organizations. These data provide an evidence base to identify strengths and gaps in organizational capacity and involvement in chronic disease prevention programming in the organizations that comprise the Canadian public health system.

Approaches to the Implementation of Environment Pollution Prevention Technologies at Military Bases (Approches de l’application des techniques de prevention de la pollution sur les bases militaires)

DTIC Science & Technology

2000-04-01

The objective is to support the development and effective use of national defence research and technology and to meet the military needs of the...on materials and energy through developing an effective management system. There are many definitions to describe environmental auditing. I would...anthropogenic increase of CH4 (e.g., from rice fields). Therefore the net effect of aircraft is a negative RF due to the CH4 changes: -0.014 Wm" 2 in 1992

Healthcare-associated infections: challenges to public health in Brazil

PubMed Central

Padoveze, Maria Clara; Fortaleza, Carlos Magno Castelo Branco

2014-01-01

This study presents a critical evaluation of the scientific literature related to this subject, aiming to assess the policies and administrative issues regarding the prevention and magnitude of healthcare-associated infections and discuss the challenges for their prevention in Brazil. The topics discussed included historical and administrative issues, challenges imposed by the characteristics of the healthcare system and the territorial dimension, laboratorial support limitations, costs, institutional culture, professional qualification, and patient engagement. It is urgent to hold a nationwide discussion among government representatives, institutions, and healthcare workers and users to overcome these challenges. PMID:26039403

The influence of social support relationships on mammography screening in African-American women.

PubMed

Fowler, Barbara Ann

2007-07-01

Evidence indicates that mammography screenings have increased in African-American women who are 50 years of age or older; however, they continue to experience later-stage discovery and poorer survival rates from breast cancer compared to White women. Although research has consistently found that social support relationships affects mammography screening in African-American women, little is known about the preventive health behaviors of individuals in these relationships that may be associated with mammography screening. This study examined that association and found that social support relationships, defined as blood-relatives and extended kinship networks, stressed personal responsibility and accountability for preventive health; therefore, supporting mammography screening. Of perhaps the greatest importance, the relationships emphasized positive strengths of African-American culture and invoked the necessity to confront prior negative experiences in health-care systems. These relationships also negated the fears or fatalistic beliefs about breast cancer that had been perpetuated by myths through informal communication and "deliberate silence" from significant others who had previously discouraged or de-emphasized the importance of mammography screening. Further research is needed to determine if the emphasis on cultural heritage was the only motivator that encouraged personal responsibility for mammography screening.

Importance of Public-Private Partnerships: Strengthening Laboratory Medicine Systems and Clinical Practice in Africa

PubMed Central

Shrivastava, Ritu; Gadde, Renuka; Nkengasong, John N.

2016-01-01

After the launch of the US President's Emergency Plan for AIDS Relief in 2003, it became evident that inadequate laboratory systems and services would severely limit the scale-up of human immunodeficiency virus infection prevention, care, and treatment programs. Thus, the Office of the US Global AIDS Coordinator, Centers for Disease Control and Prevention, and Becton, Dickinson and Company developed a public-private partnership (PPP). Between October 2007 and July 2012, the PPP combined the competencies of the public and private sectors to boost sustainable laboratory systems and develop workforce skills in 4 African countries. Key accomplishments of the initiative include measurable and scalable outcomes to strengthen national capacities to build technical skills, develop sample referral networks, map disease prevalence, support evidence-based health programming, and drive continuous quality improvement in laboratories. This report details lessons learned from our experience and a series of recommendations on how to achieve successful PPPs. PMID:27025696

Transition of occupational health issues associated with stabilization and decommissioning of the nuclear reactors in the Fukushima Daiichi Nuclear Power Plant through 2013.

PubMed

Mori, Koji; Tateishi, Seiichiro; Kubo, Tatsuhiko; Okazaki, Ryuji; Suzuki, Katsunori; Kobayashi, Yuichi; Hiraoka, Koh; Hayashi, Takeshi; Takeda, Masaru; Kiyomoto, Yoshifumi; Kawashita, Futoshi; Yoshikawa, Toru; Sakai, Kazuhiro

2014-11-01

To clarify the occupational health (OH) issues that arose, what actions were taken, and the OH performances during the disaster involving the Fukushima Daiichi Nuclear Power Plant and thus improve the OH management system with respect to long-term decommissioning work and preparation for future disasters. We used information in advisory reports to the Tokyo Electric Power Company by an OH expert group, observation through support activities, and data officially released by the Tokyo Electric Power Company. Occupational health issues transitioned as work progressed and seasons changed. They were categorized into OH management system establishment, radiation exposure control, heat illness prevention, infectious disease prevention and control, and fitness for workers' duties. Occupational health management systems involving OH experts should be implemented to manage multiple health risks with several conflicts and trade-offs after a disaster.

Introducing vouchers for malaria prevention in Ghana and Tanzania: context and adoption of innovation in health systems.

PubMed

de Savigny, Don; Webster, Jayne; Agyepong, Irene Akua; Mwita, Alex; Bart-Plange, Constance; Baffoe-Wilmot, Aba; Koenker, Hannah; Kramer, Karen; Brown, Nick; Lengeler, Christian

2012-10-01

There are striking similarities in health system and other contexts between Tanzania and Ghana that are relevant to the scaling up of continuous delivery of insecticide treated nets (ITNs) for malaria prevention. However, specific contextual factors of relevance to ITN delivery have led implementation down very different pathways in the two countries. Both countries have made major efforts and investments to address this intervention through integrating consumer discount vouchers into the health system. Discount vouchers require arrangements among the public, private and non-governmental sectors and constitute a complex intervention in both health systems and business systems. In Tanzania, vouchers have moved beyond the planning agenda, had policies and programmes formulated, been sustained in implementation at national scale for many years and have become as of 2012 the main and only publicly supported continuous delivery system for ITNs. In Ghana national-scale implementation of vouchers never progressed beyond consideration on the agenda and piloting towards formulation of policy; and the approach was replaced by mass distribution campaigns with less dependency on or integration with the health system. By 2011, Ghana entered a phase with no publicly supported continuous delivery system for ITNs. To understand the different outcomes, we compared the voucher programme timelines, phases, processes and contexts in both countries in reference to the main health system building blocks (governance, human resources, financing, informatics, technologies and service delivery). Contextual factors which provided an enabling environment for the voucher scheme in Tanzania did not do so in Ghana. The voucher scheme was never seen as an appropriate national strategy, other delivery systems were not complementary and the private sector was under-developed. The extensive time devoted to engagement and consensus building among all stakeholders in Tanzania was an important and clearly enabling difference, as was public sector support of the private sector. This contributed to the alignment of partner action behind a single co-ordinated strategy at service delivery level which in turn gave confidence to the business sector and avoided the 'interference' of competing delivery systems that occurred in Ghana. Principles of systems thinking for intervention design correctly emphasize the importance of enabling contexts and stakeholder management.

Study of Wearable Knee Assistive Instruments for Walk Rehabilitation

NASA Astrophysics Data System (ADS)

Zhu, Yong; Nakamura, Masahiro; Ito, Noritaka; Fujimoto, Hiroshi; Horikuchi, Kenichi; Wakabayashi, Shojiro; Takahashi, Rei; Terada, Hidetsugu; Haro, Hirotaka

A wearable Knee Assistive Instrument for the walk rehabilitation was newly developed. Especially, this system aimed at supporting the rehabilitation for the post-TKA (Total Knee Arthroplasty) which is a popular surgery for aging people. This system consisted of an assisting mechanism for the knee joint, a hip joint support system and a foot pressure sensor system. The driving system of this robot consisted of a CPU board which generated the walking pattern, a Li-ion battery, DC motors with motor drivers, contact sensors to detect the state of foot and potentiometers to detect the hip joint angle. The control method was proposed to reproduce complex motion of knee joint as much as possible, and to increase hip or knee flexion angle. Especially, this method used the timing that heel left from the floor. This method included that the lower limb was raised to prevent a subject's fall. Also, the prototype of knee assisting system was tested. It was confirmed that the assisting system is useful.

Integrated tracking of components by engineering and logistics utilizing logistics asset tracking system

NASA Technical Reports Server (NTRS)

Renfroe, Michael B.; Mcdonald, Edward J.; Bradshaw, Kimberly

1988-01-01

The Logistics Asset Tracking System (LATS) devised by NASA contains data on Space Shuttle LRUs that are daily updated to reflect such LRU status changes as repair due to failure or modification due to changing engineering requirements. The implementation of LATS has substantially increased personnel responsiveness, preventing costly delays in Space Shuttle processing and obviating hardware cannibalization. An evaluation is presented of LATS achievements in the direction of an integrated logistical support posture.

The medical care system of Hungary.

PubMed

Raffel, N K; Raffel, M W

1988-01-01

Medical care in Hungary has made significant progress since World War II in spite of other social priorities which have limited financial support of the health system. A shortage of hard currency in a high technological era is now having a particularly severe adverse impact on further development. Decentralized administration and local finance have, however, provided some room for progress. Preventive efforts are hampered by a deeply entrenched life style which is not conducive to improving the population's health status.

Special Inspector General for Iraq Reconstruction. Quarterly Report and Semiannual Report to the United States Congress

DTIC Science & Technology

2008-01-30

Energy Fusion Cell, and allocations include $110 million for oil pipeline exclusion zones—which aim to prevent illegal tapping and sabotage of...sectors in Iraq. This quarter SIGIR highlights two of these programs: the electronic funds transfer ( EFT ) system and U.S. advisory support provided to...the Iraq Stock Exchange. eleCTroniC funds Transfer SIGIR noted last quarter that Iraq finally acti- vated an electronic funds transfer ( EFT ) system

Special Inspector General for Iraq Reconstruction: Quarterly Report and Semiannual Report to the United States Congress

DTIC Science & Technology

2008-01-30

Cell, and allocations include $110 million for oil pipeline exclusion zones—which aim to prevent illegal tapping and sabotage of pipelines—$51...This quarter SIGIR highlights two of these programs: the electronic funds transfer ( EFT ) system and U.S. advisory support provided to the Iraq Stock...Exchange. eleCTroniC funds Transfer SIGIR noted last quarter that Iraq finally acti- vated an electronic funds transfer ( EFT ) system. The United

An Action Research Project to Determine the Utility of Bully Prevention in Positive Behavior Support for Elementary School Bullying Prevention

ERIC Educational Resources Information Center

Goodman-Scott, Emily; Doyle, Beth; Brott, Pamelia

2014-01-01

A trio of researchers presents a case study from a practical, participatory action research project to demonstrate how one school district implemented a school-wide bullying prevention initiative for all elementary schools based on Bully Prevention in Positive Behavior Support (BP-PBS). The purpose of this manuscript is to discuss the process of…

The Effects of Drug-Prevention Messages on the Accessibility of Identity-Related Constructs

PubMed Central

COMELLO, MARIA LEONORA G.; SLATER, MICHAEL D.

2011-01-01

Recent theoretical work has posited that the self-system guides behavior via currently activated self-concepts. We adopt this framework to the study of drug-prevention messages by examining the extent to which messages can alter the accessibility of views of self and of drugs that would support non-use. Participants were exposed to one of three print-ad conditions: autonomy-themed prevention messages (treatment), health-information themed prevention messages (comparison), and informational consumer ads (control). Outcomes were reaction times to make dichotomous judgments. Relative to comparison and control ads, treatment ads were more successful at activating a self-view as a nonuser, a view that marijuana use is inconsistent with autonomy, and unwillingness to use marijuana. Post-hoc analysis revealed that the effect of ad condition on unwillingness was partially mediated by the accessibility of self-view as a nonuser. PMID:21271426

Impact Challenges in Community Science-with-Practice: Lessons from PROSPER on Transformative Practitioner-Scientist Partnerships and Prevention Infrastructure Development

PubMed Central

Greenberg, Mark

2011-01-01

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships—networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy. PMID:21222151

Impact challenges in community science-with-practice: lessons from PROSPER on transformative practitioner-scientist partnerships and prevention infrastructure development.

PubMed

Spoth, Richard; Greenberg, Mark

2011-09-01

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships-networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy.

Conduct of Occupational Health During Major Disasters: A Comparison of Literature on Occupational Health Issues in the World Trade Center Terrorist Attack and the Fukushima Nuclear Power Plant Accident.

PubMed

Toyoda, Hiroyuki; Mori, Koji

2017-01-01

Workers who respond to large-scale disasters can be exposed to health hazards that do not exist in routine work. It is assumed that learning from past cases is effective for preparing for and responding to such problems, but published information is still insufficient. Accordingly, we conducted a literature review about the health issues and occupational health activities at the World Trade Center (WTC) terrorist attack and at the Fukushima Nuclear Power Plant accident to investigate how occupational health activities during disasters should be conducted. Seven studies about the WTC attack were extracted and categorized into the following topics: "in relation to emergency systems including occupational health management"; "in relation to improvement and prevention of health effects and occupational hygiene"; and "in relation to care systems aimed at mitigating health effects." Studies about the Fukushima Nuclear Power Plant accident have been used in a previous review. We conclude that, to prevent health effects in workers who respond to large-scale disasters, it is necessary to incorporate occupational health regulations into the national response plan, and to develop practical support functions that enable support to continue for an extended period, training systems for workers with opportunities to report accidents, and care systems to mitigate the health effects.

The process of developing and implementing a telephone-based peer support program for postpartum depression: evidence from two randomized controlled trials

PubMed Central

2014-01-01

Background A randomized controlled trial evaluated the effect of telephone-based peer support on preventing postpartum depression (PPD) among high-risk mothers. The results indicated that support provided by peer volunteers may be an effective preventative strategy. The purpose of this paper is to outline the process of developing, implementing, maintaining, and evaluating the peer support program that we used in this PPD prevention trial. Methods The peer support program had been used successfully in a pilot trial and a previous breastfeeding peer support trial. Based on our experience and lessons learned, we developed a 4-phase, 12-step approach so that the peer support model could be copied and used by different health providers in various settings. We will use the PPD prevention trial to demonstrate the suggested steps. Results The trial aim to prevent the onset of PPD was established. Peer volunteers who previously experienced and recovered from self-reported PPD were recruited and attended a four-hour training session. Volunteers were screened and those identified as appropriate to provide support to postpartum mothers were selected. Women who scored more than 9 on the Edinburgh Postnatal Depression Scale within the first two weeks after childbirth were recruited to participate in the trial and proactive, individualized, telephone-based peer support (mother-to-mother) was provided to those randomized to the intervention group. Peer volunteers maintained the intervention, supported other volunteers, and evaluated the telephone-based support program. Possible negative effects of the intervention were assessed. An in-depth assessment of maternal perspectives of the program at 12 weeks postpartum was performed. Conclusions The 4-phase, 12-step approach delineated in this paper provides clear and concise guidelines for health professionals to follow in creating and implementing community-based, peer-support interventions with the potential to prevent PPD. Trial registration Current Controlled Trials ISRCTN68337727. PMID:24742217

How home HIV testing and counselling with follow-up support achieves high testing coverage and linkage to treatment and prevention: a qualitative analysis from Uganda.

PubMed

Ware, Norma C; Wyatt, Monique A; Asiimwe, Stephen; Turyamureeba, Bosco; Tumwesigye, Elioda; van Rooyen, Heidi; Barnabas, Ruanne V; Celum, Connie L

2016-01-01

The successes of HIV treatment scale-up and the availability of new prevention tools have raised hopes that the epidemic can finally be controlled and ended. Reduction in HIV incidence and control of the epidemic requires high testing rates at population levels, followed by linkage to treatment or prevention. As effective linkage strategies are identified, it becomes important to understand how these strategies work. We use qualitative data from The Linkages Study, a recent community intervention trial of community-based testing with linkage interventions in sub-Saharan Africa, to show how lay counsellor home HIV testing and counselling (home HTC) with follow-up support leads to linkage to clinic-based HIV treatment and medical male circumcision services. We conducted 99 semi-structured individual interviews with study participants and three focus groups with 16 lay counsellors in Kabwohe, Sheema District, Uganda. The participant sample included both HIV+ men and women (N=47) and HIV-uncircumcised men (N=52). Interview and focus group audio-recordings were translated and transcribed. Each transcript was summarized. The summaries were analyzed inductively to identify emergent themes. Thematic concepts were grouped to develop general constructs and framing propositional statements. Trial participants expressed interest in linking to clinic-based services at testing, but faced obstacles that eroded their initial enthusiasm. Follow-up support by lay counsellors intervened to restore interest and inspire action. Together, home HTC and follow-up support improved morale, created a desire to reciprocate, and provided reassurance that services were trustworthy. In different ways, these functions built links to the health service system. They worked to strengthen individuals' general sense of capability, while making the idea of accessing services more manageable and familiar, thus reducing linkage barriers. Home HTC with follow-up support leads to linkage by building "social bridges," interpersonal connections established and developed through repeated face-to-face contact between counsellors and prospective users of HIV treatment and male circumcision services. Social bridges link communities to the service system, inspiring individuals to overcome obstacles and access care.

A cloud medication safety support system using QR code and Web services for elderly outpatients.

PubMed

Tseng, Ming-Hseng; Wu, Hui-Ching

2014-01-01

Drug is an important part of disease treatment, but medication errors happen frequently and have significant clinical and financial consequences. The prevalence of prescription medication use among the ambulatory adult population increases with advancing age. Because of the global aging society, outpatients need to improve medication safety more than inpatients. The elderly with multiple chronic conditions face the complex task of medication management. To reduce the medication errors for the elder outpatients with chronic diseases, a cloud medication safety supporting system is designed, demonstrated and evaluated. The proposed system is composed of a three-tier architecture: the front-end tier, the mobile tier and the cloud tier. The mobile tier will host the personalized medication safety supporting application on Android platforms that provides some primary functions including reminders for medication, assistance with pill-dispensing, recording of medications, position of medications and notices of forgotten medications for elderly outpatients. Finally, the hybrid technology acceptance model is employed to understand the intention and satisfaction level of the potential users to use this mobile medication safety support application system. The result of the system acceptance testing indicates that this developed system, implementing patient-centered services, is highly accepted by the elderly. This proposed M-health system could assist elderly outpatients' homecare in preventing medication errors and improving their medication safety.

Child maltreatment in DSM-5 and ICD-11.

PubMed

Slep, Amy M Smith; Heyman, Richard E; Foran, Heather M

2015-03-01

Child maltreatment is widespread and has a tremendous impact on child victims and their families. Over the past decade, definitions of child maltreatment have been developed that are operationalized, face valid, and can be reliably applied in clinical settings. These definitions have informed the revised Diagnostic and Statistical Manual (American Psychiatric Association, 2013) and are being considered for the International Classification of Disease-11 (World Health Organization). Now that these definitions are available in major diagnostic systems, primary healthcare providers and clinicians who see children and families are poised to help screen for, identify, prevent, and treat child maltreatment. This article reviews the definitions of maltreatment in these diagnostic systems, along with assessment and screening tools, and empirically supported prevention and intervention approaches. © 2015 Family Process Institute.

VineSens: An Eco-Smart Decision-Support Viticulture System

PubMed Central

Pérez-Expósito, Josman P.; Fernández-Caramés, Tiago M.; Fraga-Lamas, Paula; Castedo, Luis

2017-01-01

This article presents VineSens, a hardware and software platform for supporting the decision-making of the vine grower. VineSens is based on a wireless sensor network system composed by autonomous and self-powered nodes that are deployed throughout a vineyard. Such nodes include sensors that allow us to obtain detailed knowledge on different viticulture processes. Thanks to the use of epidemiological models, VineSens is able to propose a custom control plan to prevent diseases like one of the most feared by vine growers: downy mildew. VineSens generates alerts that warn farmers about the measures that have to be taken and stores the historical weather data collected from different spots of the vineyard. Such data can then be accessed through a user-friendly web-based interface that can be accessed through the Internet by using desktop or mobile devices. VineSens was deployed at the beginning in 2016 in a vineyard in the Ribeira Sacra area (Galicia, Spain) and, since then, its hardware and software have been tested to prevent the development of downy mildew, showing during its first season that the system can led to substantial savings, to decrease the amount of phytosanitary products applied, and, as a consequence, to obtain a more ecologically sustainable and healthy wine. PMID:28245619

VineSens: An Eco-Smart Decision-Support Viticulture System.

PubMed

Pérez-Expósito, Josman P; Fernández-Caramés, Tiago M; Fraga-Lamas, Paula; Castedo, Luis

2017-02-25

This article presents VineSens, a hardware and software platform for supporting the decision-making of the vine grower. VineSens is based on a wireless sensor network system composed by autonomous and self-powered nodes that are deployed throughout a vineyard. Such nodes include sensors that allow us to obtain detailed knowledge on different viticulture processes. Thanks to the use of epidemiological models, VineSens is able to propose a custom control plan to prevent diseases like one of the most feared by vine growers: downy mildew. VineSens generates alerts that warn farmers about the measures that have to be taken and stores the historical weather data collected from different spots of the vineyard. Such data can then be accessed through a user-friendly web-based interface that can be accessed through the Internet by using desktop or mobile devices. VineSens was deployed at the beginning in 2016 in a vineyard in the Ribeira Sacra area (Galicia, Spain) and, since then, its hardware and software have been tested to prevent the development of downy mildew, showing during its first season that the system can led to substantial savings, to decrease the amount of phytosanitary products applied, and, as a consequence, to obtain a more ecologically sustainable and healthy wine.

Innovation in Data-Driven Decision Making within SWPBIS Systems: Welcome to the Gallery Walk

ERIC Educational Resources Information Center

Kennedy, Michael J.; Mimmack, Jody; Flannery, K. Brigid

2012-01-01

Schools implementing school-wide positive behavioral interventions and supports (SWPBIS) at the high school level face the same challenges as elementary and middle schools, but also encounter an additional set of barriers all their own. To name but a few, these barriers include the need to focus on dropout prevention, postsecondary outcomes,…

Initial Development of the Teen Screen for Dating Violence: Exploratory Factor Analysis, Rasch Model, and Psychometric Data

ERIC Educational Resources Information Center

Emelianchik-Key, Kelly; Hays, Danica G.; Hill, Tara

2018-01-01

The Teen Screen for Dating Violence (TSDV) is an assessment that examines adolescent dating violence perpetration and victimization, perception and exposure to violence, and support systems. Through assessment, adolescents who are at high risk could be identified for prevention and early intervention. This article presents the development,…

77 FR 19069 - Airworthiness Directives; Goodrich Evacuation Systems Approved Under Technical Standard Order...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... seal and allowed the pressure in certain slides/ rafts to fall below the minimum raft mode pressure for the unit. We are issuing this AD to prevent loss of pressure in the escape slides/rafts after an emergency evacuation, which could result in inadequate buoyancy to support the raft's passenger capacity...

From Special Tasks to Extensive Roles: The Changing Face of Special Needs Teachers in Finnish Vocational Further Education

ERIC Educational Resources Information Center

Pirttimaa, Raija; Hirvonen, Maija

2016-01-01

Following the development of inclusive education in vocational education and training (VET), the discussion about the prevention of marginalisation and dropouts has increased. At the same time, the formal education system has strengthened the position of support services, such as special educational needs (SEN) teachers, social workers and…

Evaluation of the Effect of Decision Support on the Efficiency of Primary Care Providers in the Outpatient Practice

PubMed Central

Hankey, Ronald A.; Decker, Lindsay K.; Cha, Stephen S.; Greenes, Robert A.; Liu, Hongfang; Chaudhry, Rajeev

2015-01-01

Background: Clinical decision support (CDS) for primary care has been shown to improve delivery of preventive services. However, there is little evidence for efficiency of physicians due to CDS assistance. In this article, we report a pilot study for measuring the impact of CDS on the time spent by physicians for deciding on preventive services and chronic disease management. Methods: We randomly selected 30 patients from a primary care practice, and assigned them to 10 physicians. The physicians were requested to perform chart review to decide on preventive services and chronic disease management for the assigned patients. The patients assignment was done in a randomized crossover design, such that each patient received 2 sets of recommendations—one from a physician with CDS assistance and the other from a different physician without CDS assistance. We compared the physician recommendations made using CDS assistance, with the recommendations made without CDS assistance. Results: The physicians required an average of 1 minute 44 seconds, when they were they had access to the decision support system and 5 minutes when they were unassisted. Hence the CDS assistance resulted in an estimated saving of 3 minutes 16 seconds (65%) of the physicians’ time, which was statistically significant (P < .0001). There was no statistically significant difference in the number of recommendations. Conclusion: Our findings suggest that CDS assistance significantly reduced the time spent by physicians for deciding on preventive services and chronic disease management. The result needs to be confirmed by performing similar studies at other institutions. PMID:25155103

Oil-Free Shaft Support System Rotordynamics: Past, Present, and Future Challenges and Opportunities

NASA Technical Reports Server (NTRS)

DellaCorte, Christopher

2011-01-01

Recent breakthroughs in Oil-Free technologies have enabled new high-speed rotor systems and turbomachinery. Such technologies can include compliant-surface gas bearings, magnetic bearings, and advanced solid lubricants and tribo-materials. This presentation briefly reviews critical technology developments and the current state-of-the-art, emerging Oil-Free rotor systems and discusses obstacles preventing more widespread use. Key examples of "best practices" for deploying Oil-Free technologies will be presented and remaining major technical questions surrounding Oil-Free technologies will be brought forward.

Construction of In-house Databases in a Corporation

NASA Astrophysics Data System (ADS)

Fujii, Yohzo

The author outlines the inhouse technical information system, OSTI of Osaka Research Institute, Sumitomo Chemical company as an example of inhouse database construction and use at a chemical industry. This system is to compile database for technical information generated inside the Laboratory and to provide online searching as well as title lists of the latest data output from it aiming at effective use of information among the departments, prevention from overlapped research thema, and support of research activities. The system outline, characteristics, materials to be covered, input items and search examples are described.

Generic Health Management: A System Engineering Process Handbook Overview and Process

NASA Technical Reports Server (NTRS)

Wilson, Moses Lee; Spruill, Jim; Hong, Yin Paw

1995-01-01

Health Management, a System Engineering Process, is one of those processes-techniques-and-technologies used to define, design, analyze, build, verify, and operate a system from the viewpoint of preventing, or minimizing, the effects of failure or degradation. It supports all ground and flight elements during manufacturing, refurbishment, integration, and operation through combined use of hardware, software, and personnel. This document will integrate Health Management Processes (six phases) into five phases in such a manner that it is never a stand alone task/effort which separately defines independent work functions.

Olfactory learning prevents MK-801-induced psychosis-like behaviour in an animal model of schizophrenia.

PubMed

Naimark, Ari; Barkai, Edi; Michael, Matar A; Kozlovsky, Nitzan; Kaplan, Zeev; Cohen, Hagit

2008-01-01

There is mounting evidence to support the concept that education is associated with the formation of a functional reserve in the brain, a process that appears to provide some protection against certain aspects of severe central nervous system disorders. The goal of this study was to examine whether learning prevents psychosis-like behaviour in an animal model of schizophrenia. A series of behavioural tasks were used to assess olfactory learning-induced protection against the effects of NMDA channel blocker, MK801. This blocker caused sensory-motor disturbances, spatial learning acquisition deficit, and swimming strategy alterations in pseudo-trained and naive rats, but had a considerably lesser effect on trained rats. In sharp contrast, olfactory learning provided no protection against d-amphetamine application. Our data support the notion that learning-induced protection against schizophrenic behaviour is maintained by non-NMDA-mediated enhanced activation of local connections in the relevant cortical networks.

Research Networks Map | Division of Cancer Prevention

Cancer.gov

The Division of Cancer Prevention supports major scientific collaborations and research networks at more than 100 sites across the United States. Seven Major Programs' sites are shown on this map. | The Division of Cancer Prevention supports major scientific collaborations and research networks at more than 100 sites across the United States.

Australian community pharmacists' awareness and practice in supporting secondary prevention of cardiovascular disease.

PubMed

Puspitasari, Hanni Prihhastuti; Aslani, Parisa; Krass, Ines

2013-12-01

Pharmacists are well placed to identify, prevent and resolve medicine related problems as well as monitor the effectiveness of treatments in cardiovascular disease (CVD). Pharmacists' interventions in CVD secondary prevention have been shown to improve outcomes for clients with established CVD. To explore the scope of pharmacists' activities in supporting CVD secondary prevention. Community pharmacies in New South Wales, Australia. Twenty-one in-depth, semi-structured interviews with a range of community pharmacists were conducted. All interviews were audio-recorded and transcribed ad verbatim. Data were analyzed using a 'grounded-theory' approach by applying methods of constant comparison. Community pharmacists' awareness and current practice in supporting secondary prevention of CVD. Four key themes identified included 'awareness', 'patient counselling', 'patient monitoring', and 'perceptions of the role of pharmacists in CVD secondary prevention'. The pharmacists demonstrated a moderate understanding of CVD secondary prevention. There was considerable variability in the scope of practice among the participants, ranging from counselling only about medicines to providing continuity of care. A minority of pharmacists who had negative beliefs about their roles in CVD secondary prevention offered limited support to their clients. The majority of pharmacists, however, believed that they have an important role to play in supporting clients with established CVD. Community pharmacists in Australia make a contribution to the care of clients with established CVD despite the gap in their knowledge and understanding of CVD secondary prevention. The scope of practice in CVD secondary prevention ranged from only counselling about medicines to offering continuity of care. The extent of pharmacists' involvement in offering disease management appears to be influenced by their beliefs regarding what is required within their scope of practice.

Advancing the application of systems thinking in health: why cure crowds out prevention

PubMed Central

2014-01-01

Introduction This paper presents a system dynamics computer simulation model to illustrate unintended consequences of apparently rational allocations to curative and preventive services. Methods A modeled population is subject to only two diseases. Disease A is a curable disease that can be shortened by curative care. Disease B is an instantly fatal but preventable disease. Curative care workers are financed by public spending and private fees to cure disease A. Non-personal, preventive services are delivered by public health workers supported solely by public spending to prevent disease B. Each type of worker tries to tilt the balance of government spending towards their interests. Their influence on the government is proportional to their accumulated revenue. Results The model demonstrates effects on lost disability-adjusted life years and costs over the course of several epidemics of each disease. Policy interventions are tested including: i) an outside donor rationally donates extra money to each type of disease precisely in proportion to the size of epidemics of each disease; ii) lobbying is eliminated; iii) fees for personal health services are eliminated; iv) the government continually rebalances the funding for prevention by ring-fencing it to protect it from lobbying. The model exhibits a “spend more get less” equilibrium in which higher revenue by the curative sector is used to influence government allocations away from prevention towards cure. Spending more on curing disease A leads paradoxically to a higher overall disease burden of unprevented cases of disease B. This paradoxical behavior of the model can be stopped by eliminating lobbying, eliminating fees for curative services, and ring-fencing public health funding. Conclusions We have created an artificial system as a laboratory to gain insights about the trade-offs between curative and preventive health allocations, and the effect of indicative policy interventions. The underlying dynamics of this artificial system resemble features of modern health systems where a self-perpetuating industry has grown up around disease-specific curative programs like HIV/AIDS or malaria. The model shows how the growth of curative care services can crowd both fiscal and policy space for the practice of population level prevention work, requiring dramatic interventions to overcome these trends. PMID:24935344

CIDA funds AIDS counselling and care centre in Zambia.

PubMed

Meehan, S T

1993-12-01

In its fight against the spread of AIDS, which is inextricably linked to the issues of international development, the Canadian International Development Agency (CIDA) has focused support on strengthening existing health care systems, helping vulnerable groups gain control over their lives and health, promoting AIDS prevention measures, and building links to other related health services. Funding includes 1) a grant to Hope House in Zambia (counseling and support for persons with AIDS); 2) a contribution to the Canadian Public Health Association's $11 million Southern Africa AIDS Training Programme (helps regional organizations working in AIDS prevention and support through education, training, hospital outreach, peer education for vulnerable groups, assistance to women's shelters, and networking); 3) support for Laval University's Laval Centre for International Cooperation in Health and Development (runs a $22 million program in French-speaking West Africa that operates in over 10 countries and focuses on epidemiological surveillance, information, education, and communication, control of sexually transmitted diseases [STDs], and management of national AIDS programs); 4) support for the University of Manitoba's $3 million program with the University of Nairobi to slow the spread of HIV (strengthens local health care capabilities for STD/HIV diagnosis, treatment, and counseling, with special emphasis on training and education); 5) support in the past for a study of proposed AIDS legislation and its potential impact on the human rights of PLWHIV/AIDS in Thailand; 6) a contribution to help equip the office of the National Movement for Street Children, Rio de Janeiro (focuses on preventing the spread of AIDS among child prostitutes); and 7) long-term financial support to the Interagency Coalition on AIDS and Development, a coalition of Canadian development nongovernmental organizations responding to AIDS in developing countries. An address to obtain a pamphlet giving more information on Canada's contributions to the worldwide fight against AIDS is given.

NASA Human Research Program Behavioral Health and Performance Element (BHP)

NASA Technical Reports Server (NTRS)

Whitmire, Sandra; Faulk, Jeremy; Leveton, Lauren

2010-01-01

The goal of NASA BHP is to identify, characterize, and prevent or reduce behavioral health and performance risks associated with space travel, exploration, and return to terrestrial life. The NASA Behavioral Health and Performance Operations Group (BHP Ops) supports astronauts and their families before, during, and after a long-duration mission (LDM) on the ISS. BHP Ops provides ISS crews with services such as preflight training (e.g., psychological factors of LDM, psychological support, cross-cultural); preflight, in-flight, and postflight support services, including counseling for astronauts and their families; and psychological support such as regular care packages and a voice-over IP phone system between crew members and their families to facilitate real-time one-on-one communication.

''Towards a High-Performance and Robust Implementation of MPI-IO on Top of GPFS''

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

Prost, J.P.; Tremann, R.; Blackwore, R.

2000-01-11

MPI-IO/GPFS is a prototype implementation of the I/O chapter of the Message Passing Interface (MPI) 2 standard. It uses the IBM General Parallel File System (GPFS), with prototyped extensions, as the underlying file system. this paper describes the features of this prototype which support its high performance and robustness. The use of hints at the file system level and at the MPI-IO level allows tailoring the use of the file system to the application needs. Error handling in collective operations provides robust error reporting and deadlock prevention in case of returning errors.

Avulsed Nasoenteric Bridle System Magnet as an Intranasal Foreign Body.

PubMed

Puricelli, Michael D; Newberry, Christopher Ian; Gov-Ari, Eliav

2016-02-01

Nasoenteric tubes provide short-term nutrition support to patients unable to take an adequate oral diet. Bridling systems may be used to secure tubes to guard against displacement. We present the first case of an avulsed magnet from a bridling system to raise awareness of this potential complication. The primary methods of securing a nasogastric tube are reviewed, and comparative assessment of the 3 main systems is presented. Diagnosis and management of nasal foreign bodies relevant to this case are reviewed and prevention/safety considerations discussed. © 2015 American Society for Parenteral and Enteral Nutrition.

Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention.

PubMed

Markkanen, Pia; Galligan, Catherine; Laramie, Angela; Fisher, June; Sama, Susan; Quinn, Margaret

2015-04-11

Home healthcare is one of the fastest growing sectors in the United States. Percutaneous injuries from sharp medical devices (sharps) are a source of bloodborne pathogen infections among home healthcare workers and community members. Sharps use and disposal practices in the home are highly variable and there is no comprehensive analysis of the system of sharps procurement, use and disposal in home healthcare. This gap is a barrier to effective public health interventions. The objectives of this study were to i) identify the full range of pathways by which sharps enter and exit the home, stakeholders involved, and barriers for using sharps with injury prevention features; and ii) assess the leverage points for preventive interventions. This study employed qualitative research methods to develop two systems maps of the use of sharps and prevention of sharps injuries in home healthcare. Twenty-six in-depth interview sessions were conducted including home healthcare agency clinicians, public health practitioners, sharps device manufacturers, injury prevention advocates, pharmacists and others. Interview transcripts were audio-recorded and analyzed thematically using NVIVO qualitative research analysis software. Analysis of supporting archival material also was conducted. All findings guided development of the two maps. Sharps enter the home via multiple complex pathways involving home healthcare providers and home users. The providers reported using sharps with injury prevention features. However, home users' sharps seldom had injury prevention features and sharps were commonly re-used for convenience and cost-savings. Improperly discarded sharps present hazards to caregivers, waste handlers, and community members. The most effective intervention potential exists at the beginning of the sharps systems maps where interventions can eliminate or minimize sharps injuries, in particular with needleless treatment methods and sharps with injury prevention features. Manufacturers and insurance providers can improve safety with more affordable and accessible sharps with injury prevention features for home users. Sharps disposal campaigns, free-of-charge disposal containers, and convenient disposal options remain essential. Sharps injuries are preventable through public health actions that promote needleless treatment methods, sharps with injury prevention features, and safe disposal practices. Communication about hazards regarding sharps is needed for all home healthcare stakeholders.

Microtubule-Targeting Agents Enter the Central Nervous System (CNS): Double-edged Swords for Treating CNS Injury and Disease.

PubMed

Hur, Eun-Mi; Lee, Byoung Dae

2014-12-01

Microtubules have been among the most successful targets in anticancer therapy and a large number of microtubule-targeting agents (MTAs) are in various stages of clinical development for the treatment of several malignancies. Given that injury and diseases in the central nervous system (CNS) are accompanied by acute or chronic disruption of the structural integrity of neurons and that microtubules provide structural support for the nervous system at cellular and intracellular levels, microtubules are emerging as potential therapeutic targets for treating CNS disorders. It has been postulated that exogenous application of MTAs might prevent the breakdown or degradation of microtubules after injury or during neurodegeneration, which will thereby aid in preserving the structural integrity and function of the nervous system. Here we review recent evidence that supports this notion and also discuss potential risks of targeting microtubules as a therapy for treating nerve injury and neurodegenerative diseases.

Design of a Multi-mode Flight Deck Decision Support System for Airborne Conflict Management

NASA Technical Reports Server (NTRS)

Barhydt, Richard; Krishnamurthy, Karthik

2004-01-01

NASA Langley has developed a multi-mode decision support system for pilots operating in a Distributed Air-Ground Traffic Management (DAG-TM) environment. An Autonomous Operations Planner (AOP) assists pilots in performing separation assurance functions, including conflict detection, prevention, and resolution. Ongoing AOP design has been based on a comprehensive human factors analysis and evaluation results from previous human-in-the-loop experiments with airline pilot test subjects. AOP considers complex flight mode interactions and provides flight guidance to pilots consistent with the current aircraft control state. Pilots communicate goals to AOP by setting system preferences and actively probing potential trajectories for conflicts. To minimize training requirements and improve operational use, AOP design leverages existing alerting philosophies, displays, and crew interfaces common on commercial aircraft. Future work will consider trajectory prediction uncertainties, integration with the TCAS collision avoidance system, and will incorporate enhancements based on an upcoming air-ground coordination experiment.

The Reduction of Bullying in an Elementary Program: An Action Research Study

ERIC Educational Resources Information Center

Brock, Jacqueline M.

2013-01-01

Bully Prevention in Positive Behavior Support (BP-PBS) is a prevention-oriented program created to support students with strategies to combat bullying. BP-PBS supports the idea that all students should have access to positive behavior support to minimize problem behavior at school (Horner, 2011). The goal of this study was to investigate the…

Preventive home visits to older people in Denmark--why, how, by whom, and when?

PubMed

Vass, M; Avlund, K; Hendriksen, C; Philipson, L; Riis, P

2007-08-01

In Denmark, political decisions improved the implementation of 'preventative thinking' into every-day clinical work. The potential benefits of preventive efforts have been supported by legislative and administrative incentives, and an ongoing effort to remain focused on the benefits of these initiatives towards older people is politically formulated and underlined as part of the new structured municipality reform. Evidence of beneficial effects of health promotion and prevention of disease in old age is well documented. In-home visits with individualised assessments make it possible to reach older persons not normally seen in the health care system. In-home assessment is not just a health check, but also an opportunity to meet individual needs that may be of importance for older people to stay independent. Preventive home visits may be part of an overall culture and strategy to avoid or prevent functional decline. There is an urgent need of an interdisciplinary teamwork and management for such programmes, incorporating flexible cooperation between the primary and secondary health care sector. The value and importance of geriatric and gerontological education is evidence based.

[What do psychiatrists know about the children of their patients?].

PubMed

Franz, Michael; Kettemann, Beate; Jäger, Karin; Hanewald, Bernd; Gallhofer, Bernd

2012-07-01

Psychiatry could be a good starting point for preventive work for children of mentally ill parents by detecting children who are potentially at risk and connecting affected families with preventive services. However, it is unclear how much attention clinical psychiatrists pay for children of their patients. Therefore, this study examines the knowledge of german psychiatrists about the children of their patients and their attitude towards the youth welfare and prevention system. Seven psychiatric hospitals of one federal state in Germany participated in a questionnaire survey. The majority of the psychiatrists know whether their patients have children or not, but they can not answer differentiate questions of the children's life circumstances or name preventive programs for children and their families. Furthermore, psychiatrists potentially could forestall preventive programs because of a lack of knowledge about the youth welfare. Psychiatrists need more information about the children of their patients and about the general possibilities of prevention as well as more knowledge of supportive offers of the youth welfare. © Georg Thieme Verlag KG Stuttgart · New York.

[Consensus document and recommendations for the prevention of cardiovascular disease in Italy - 2018].

PubMed

Volpe, Massimo; Tocci, Giuliano; Accettura, Domenico; Battistoni, Allegra; Bellone, Simonetta; Bellotti, Paolo; Bertolotti, Marco; Borghi, Claudio; Casasco, Maurizio; Consoli, Agostino; Coppini, Raffaele; Corsini, Alberto; Costanzo, Gianfranco; Desideri, Giovambattista; Ferri, Claudio; Galanti, Giorgio; Giada, Franco; Icardi, Giancarlo; Lombardi, Niccolò; Modena, Maria Grazia; Modesti, Pietro Amedeo; Monti, Giorgio; Mugelli, Alessandro; Orsi, Andrea; Parati, Gianfranco; Pedretti, Roberto F.E.; Perseghin, Gianluca; Pirro, Matteo; Ricotti, Roberta; Rizzoni, Damiano; Rotella, Carlo; Rubattu, Speranza; Salvetti, Guido; Sarto, Patrizio; Tassinari, Federico; Trimarco, Bruno; de Kreutzenberg, Saula Vigili; Volpe, Roberto

2018-02-01

Cardiovascular prevention represents a cornerstone of modern strategies to reduce the burden of cardiovascular disease. It is of key importance to prevent cardiovascular diseases and associated events, not only to reduce morbidity and mortality, but also to increase the years of wellness in the aging population and to make the growing socio-economic burden imposed by cardiovascular events more sustainable.The current approach to prevention is based on an integrated use of effective lifestyle measures and, whenever appropriate, of antihypertensive and antidiabetic drugs, lipid-lowering agents and antiplatelet drugs.Given that population characteristics, in terms of ethnicity, demography and lifestyle habits, and healthcare system organizations differ among countries, international guidelines are not always applicable to specific countries and, often, are difficult to translate into daily clinical practice.In order to afford the specific features of Italy, 10 Scientific Societies and Research Institutions, mostly involved in preventive strategies, contributed to the present Italian consensus document, which includes brief, practical recommendations to support the preventive actions within the physician community and the general practice setting.

Prevention of hospital-acquired pneumonia: European perspective.

PubMed

Bonten, Marc J M

2003-12-01

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

Evaluating Behavioral Health Surveillance Systems.

PubMed

Azofeifa, Alejandro; Stroup, Donna F; Lyerla, Rob; Largo, Thomas; Gabella, Barbara A; Smith, C Kay; Truman, Benedict I; Brewer, Robert D; Brener, Nancy D

2018-05-10

In 2015, more than 27 million people in the United States reported that they currently used illicit drugs or misused prescription drugs, and more than 66 million reported binge drinking during the previous month. Data from public health surveillance systems on drug and alcohol abuse are crucial for developing and evaluating interventions to prevent and control such behavior. However, public health surveillance for behavioral health in the United States has been hindered by organizational issues and other factors. For example, existing guidelines for surveillance evaluation do not distinguish between data systems that characterize behavioral health problems and those that assess other public health problems (eg, infectious diseases). To address this gap in behavioral health surveillance, we present a revised framework for evaluating behavioral health surveillance systems. This system framework builds on published frameworks and incorporates additional attributes (informatics capabilities and population coverage) that we deemed necessary for evaluating behavioral health-related surveillance. This revised surveillance evaluation framework can support ongoing improvements to behavioral health surveillance systems and ensure their continued usefulness for detecting, preventing, and managing behavioral health problems.

Evaluating Behavioral Health Surveillance Systems

PubMed Central

Azofeifa, Alejandro; Lyerla, Rob; Largo, Thomas; Gabella, Barbara A.; Smith, C. Kay; Truman, Benedict I.; Brewer, Robert D.; Brener, Nancy D.

2018-01-01

In 2015, more than 27 million people in the United States reported that they currently used illicit drugs or misused prescription drugs, and more than 66 million reported binge drinking during the previous month. Data from public health surveillance systems on drug and alcohol abuse are crucial for developing and evaluating interventions to prevent and control such behavior. However, public health surveillance for behavioral health in the United States has been hindered by organizational issues and other factors. For example, existing guidelines for surveillance evaluation do not distinguish between data systems that characterize behavioral health problems and those that assess other public health problems (eg, infectious diseases). To address this gap in behavioral health surveillance, we present a revised framework for evaluating behavioral health surveillance systems. This system framework builds on published frameworks and incorporates additional attributes (informatics capabilities and population coverage) that we deemed necessary for evaluating behavioral health–related surveillance. This revised surveillance evaluation framework can support ongoing improvements to behavioral health surveillance systems and ensure their continued usefulness for detecting, preventing, and managing behavioral health problems. PMID:29752804

Holistic System of Care: a ten-year perspective.

PubMed

Nebelkopf, Ethan; Wright, Serena

2011-01-01

The Holistic System of Care for Native Americans in an Urban Environment is a community-focused intervention that provides behavioral health care, promotes health, and prevents disease. This approach is based on a community strategic planning process that honored Native American culture and relationships. Substance abuse, mental illness, homelessness, poverty, crime, physical illness, and violence are symptoms of historical trauma, family dysfunction, and spiritual imbalance. The holistic model links treatment, prevention, and recovery. The link between prevention and treatment is early intervention. Peer support is the link between treatment and recovery. Recovering individuals serve as role models linking recovery to prevention. Culture and spirituality build a strong and resilient foundation for recovery. This article documents the effectiveness of the holistic model over a ten-year period that it has been implemented at the Family & Child Guidance Clinic of the Native American Health Center in the San Francisco Bay Area. The holistic model has produced statistically significant reductions in substance abuse among adult Native American women, men, reentry, and homeless populations; reductions in substance abuse among Native American adolescents; reductions in HIV/AIDS high-risk behavior among Native American men, women, and adolescents; and decreases in acting out behavior among Native American severely emotionally disturbed children.