The National Cross-Site Evaluation of High-Risk Youth Programs. Preventing Substance Abuse: Major Findings from the National Cross-Site Evaluation of High-Risk Youth Programs. Monograph Series.

ERIC Educational Resources Information Center

Springer, J. Fred; Sambrano, Soledad; Sale, Elizabeth; Kasim, Rafa; Herman, Jack

This multiple-site study assessed 48 prevention programs for high-risk youth funded by the Center for Substance Abuse Prevention, identifying program characteristics associated with strong substance abuse prevention outcomes. Data analysis indicated that substance abuse programs reduced rates of substance use, and the positive effects of program…

Participation in Older Adult Physical Activity Programs and Risk for Falls Requiring Medical Care, Washington State, 2005-2011.

PubMed

Greenwood-Hickman, Mikael Anne; Rosenberg, Dori E; Phelan, Elizabeth A; Fitzpatrick, Annette L

2015-06-11

Physical activity is known to prevent falls; however, use of widely available exercise programs for older adults, including EnhanceFitness and Silver Sneakers, has not been examined in relation to effects on falls among program participants. We aimed to determine whether participation in EnhanceFitness or Silver Sneakers is associated with a reduced risk of falls resulting in medical care. A retrospective cohort study examined a demographically representative sample from a Washington State integrated health system. Health plan members aged 65 or older, including 2,095 EnhanceFitness users, 13,576 Silver Sneakers users, and 55,127 nonusers from 2005 through 2011, were classified as consistent users (used a program ≥2 times in all years they were enrolled in the health plan during the study period); intermittent users (used a program ≥2 times in 1 or more years enrolled but not all years), or nonusers of EnhanceFitness or Silver Sneakers. The main outcome was measured as time-to-first-fall requiring inpatient or out-of-hospital medical treatment based on the International Classification of Diseases, 9th Revision, Clinical Modification, Sixth Edition and E-codes. In fully adjusted Cox proportional hazards models, consistent (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.63-0.88) and intermittent (HR, 0.87; 95% CI, 0.8-0.94) EnhanceFitness participation were both associated with a reduced risk of falls resulting in medical care. Intermittent Silver Sneakers participation showed a reduced risk (HR, 0.93; 95% CI, 0.90-0.97). Participation in widely available community-based exercise programs geared toward older adults (but not specific to fall prevention) reduced the risk of medical falls. Structured programs that include balance and strength exercise, as EnhanceFitness does, may be effective in reducing fall risk.

Evaluation of a Digital Behavioral Counseling Program for Reducing Risk Factors for Chronic Disease in a Workforce.

PubMed

Wilson, Mark G; Castro Sweet, Cynthia M; Edge, Michael D; Madero, Erica N; McGuire, Megan; Pilsmaker, Megan; Carpenter, Dan; Kirschner, Scott

2017-08-01

To evaluate a digitally delivered, intensive behavioral counseling program for a workforce at risk for obesity-related chronic disease. Employees were offered a digital health program modeled after the diabetes prevention program (DPP). Annual workforce health assessments were used to examine changes in chronic disease risk factors between participants (n = 634) relative to a matched comparison group (n = 1268). Overall, employees were gaining an average of 3.5 pounds annually before program inception. Program engagement was positive; 83% completed the majority of the curriculum and 31% lost at least 5% of their starting weight. Compared with non-participating peers, participants demonstrated reduced weight, improved fasting blood glucose, and improved nutritional intake after a year. The digital health program was effective for engaging employees in health behavior change. Digital options facilitate widespread implementation.

Conditional Economic Incentives for Reducing HIV Risk Behaviors: Integration of Psychology and Behavioral Economics

PubMed Central

Operario, Don; Kuo, Caroline C.; Sosa-Rubí, Sandra G.; Gálarraga, Omar

2014-01-01

Objective This paper reviews psychology and behavioral economic approaches to HIV prevention, and examines the integration and application of these approaches in conditional economic incentive (CEI) programs for reducing HIV risk behavior. Methods We discuss the history of HIV prevention approaches, highlighting the important insights and limitations of psychological theories. We provide an overview of the theoretical tenets of behavioral economics that are relevant to HIV prevention, and utilize CEIs as an illustrative example of how traditional psychological theories end behavioral economics can be combined into new approaches for HIV prevention. Results Behavioral economic interventions can complement psychological frameworks for reducing HIV risk by introducing unique theoretical understandings about the conditions under which risky decisions are amenable to intervention. Findings from illustrative CEI programs show mixed but generally promising effects of economic interventions on HIV and STI prevalence, HIV testing, HIV medication adherence, and drug use. Conclusion CEI programs can complement psychological interventions for HIV prevention and behavioral risk reduction. To maximize program effectiveness, CEI programs must be designed according to contextual and population-specific factors that may determine intervention applicability and success. PMID:24001243

MULTI-MEDIA MICROBIOLOGICAL RISK ASSESSMENT METHODOLOGY FOR MUNICIPAL WASTEWATER SLUDGES

EPA Science Inventory

In order to reduce the risk of municipal sludge to acceptable levels, the U.S. EPA has undertaken a regulatory program based on risk assessment and risk management. The key to such a program is the development of a methodology which allows the regulatory agency to quantify the re...

Screening and treatment of asymptomatic bacteriuria in pregnancy prevent pyelonephritis.

PubMed

Gratacós, E; Torres, P J; Vila, J; Alonso, P L; Cararach, V

1994-06-01

Although asymptomatic bacteriuria during pregnancy is associated with an increased risk of developing pyelonephritis, the effectiveness of screening programs to reduce this risk is controversial. A sharp reduction in the annual incidence of pyelonephritis (1.8% to 0.6%, P < .001) occurred after the introduction of a program to screen and treat asymptomatic bacteriuria among pregnant women followed at a large teaching hospital. The data provide retrospective and prospective evidence that screening and treatment programs for asymptomatic bacteriuria during pregnancy reduce the risk of pyelonephritis in a population with a moderate to high prevalence of bacteriuria.

Shuttle Risk Progression: Use of the Shuttle Probabilistic Risk Assessment (PRA) to Show Reliability Growth

NASA Technical Reports Server (NTRS)

Hamlin, Teri L.

2011-01-01

It is important to the Space Shuttle Program (SSP), as well as future manned spaceflight programs, to understand the early mission risk and progression of risk as the program gains insights into the integrated vehicle through flight. The risk progression is important to the SSP as part of the documentation of lessons learned. The risk progression is important to future programs to understand reliability growth and the first flight risk. This analysis uses the knowledge gained from 30 years of operational flights and the current Shuttle PRA to calculate the risk of Loss of Crew and Vehicle (LOCV) at significant milestones beginning with the first flight. Key flights were evaluated based upon historical events and significant re-designs. The results indicated that the Shuttle risk tends to follow a step function as opposed to following a traditional reliability growth pattern where risk exponentially improves with each flight. In addition, it shows that risk can increase due to trading safety margin for increased performance or due to external events. Due to the risk drivers not being addressed, the risk did not improve appreciably during the first 25 flights. It was only after significant events occurred such as Challenger and Columbia, where the risk drivers were apparent, that risk was significantly improved. In addition, this paper will show that the SSP has reduced the risk of LOCV by almost an order of magnitude. It is easy to look back afte r 30 years and point to risks that are now obvious, however; the key is to use this knowledge to benefit other programs which are in their infancy stages. One lesson learned from the SSP is understanding risk drivers are essential in order to considerably reduce risk. This will enable the new program to focus time and resources on identifying and reducing the significant risks. A comprehensive PRA, similar to that of the Shuttle PRA, is an effective tool quantifying risk drivers if support from all of the stakeholders is given.

HIV Prevention for Adults With Criminal Justice Involvement: A Systematic Review of HIV Risk-Reduction Interventions in Incarceration and Community Settings

PubMed Central

Dumont, Dora; Operario, Don

2014-01-01

We summarized and appraised evidence regarding HIV prevention interventions for adults with criminal justice involvement. We included randomized and quasi-randomized controlled trials that evaluated an HIV prevention intervention, enrolled participants with histories of criminal justice involvement, and reported biological or behavioral outcomes. We used Cochrane methods to screen 32 271 citations from 16 databases and gray literature. We included 37 trials enrolling n = 12 629 participants. Interventions were 27 psychosocial, 7 opioid substitution therapy, and 3 HIV-testing programs. Eleven programs significantly reduced sexual risk taking, 4 reduced injection drug risks, and 4 increased testing. Numerous interventions may reduce HIV-related risks among adults with criminal justice involvement. Future research should consider process evaluations, programs involving partners or families, and interventions integrating biomedical, psychosocial, and structural approaches. PMID:25211725

Evaluation of a Digital Behavioral Counseling Program for Reducing Risk Factors for Chronic Disease in a Workforce

PubMed Central

Wilson, Mark G.; Castro Sweet, Cynthia M.; Edge, Michael D.; Madero, Erica N.; McGuire, Megan; Pilsmaker, Megan; Carpenter, Dan; Kirschner, Scott

2017-01-01

Objective: To evaluate a digitally delivered, intensive behavioral counseling program for a workforce at risk for obesity-related chronic disease. Methods: Employees were offered a digital health program modeled after the diabetes prevention program (DPP). Annual workforce health assessments were used to examine changes in chronic disease risk factors between participants (n = 634) relative to a matched comparison group (n = 1268). Results: Overall, employees were gaining an average of 3.5 pounds annually before program inception. Program engagement was positive; 83% completed the majority of the curriculum and 31% lost at least 5% of their starting weight. Compared with non-participating peers, participants demonstrated reduced weight, improved fasting blood glucose, and improved nutritional intake after a year. Conclusions: The digital health program was effective for engaging employees in health behavior change. Digital options facilitate widespread implementation. PMID:28650899

A comparative review of the isotretinoin pregnancy risk management programs across four continents.

PubMed

Kovitwanichkanont, Tom; Driscoll, Tim

2018-03-06

Isotretinoin has revolutionized the treatment of severe acne vulgaris, a condition which if left untreated may result in significant socio-psychological implications for those affected. Timely access to isotretinoin therapy is important to avoid the risks of potential physical and emotional scarring. However, due to its high risks of teratogenicity, isotretinoin must be used with care in females of childbearing potential. Since isotretinoin's introduction, numerous risk management programs have been implemented across the world in an attempt to prevent isotretinoin use in pregnancy. This paper aims to provide an evidence-based review of the risk management programs for isotretinoin in Australia, Europe, Singapore, New Zealand, and the United States of America. The effectiveness of these programs and the factors leading to isotretinoin exposure in pregnancy are critically analyzed in an effort to inform the future direction with respect to designing the ideal regulatory program. Stringent risk management programs, such as the iPLEDGE in the US and Pregnancy Prevention Program (PPP) in Europe, may not be effective in reducing the risks of fetal exposure to isotretinoin when used alone. There is evidence that such strenuous regulation results in increased fear of teratogenic risks but does not translate into a reduced rate of pregnancies exposed to isotretinoin. A successful program must prioritize education about effective contraception, while minimizing any extraneous requirements, to ensure that women are not inadvertently undertreated for acne. © 2018 The International Society of Dermatology.

Conditional economic incentives for reducing HIV risk behaviors: integration of psychology and behavioral economics.

PubMed

Operario, Don; Kuo, Caroline; Sosa-Rubí, Sandra G; Gálarraga, Omar

2013-09-01

This article reviews psychology and behavioral economic approaches to HIV prevention, and examines the integration and application of these approaches in conditional economic incentive (CEI) programs for reducing HIV risk behavior. We discuss the history of HIV prevention approaches, highlighting the important insights and limitations of psychological theories. We provide an overview of the theoretical tenets of behavioral economics that are relevant to HIV prevention, and utilize CEIs as an illustrative example of how traditional psychological theories and behavioral economics can be combined into new approaches for HIV prevention. Behavioral economic interventions can complement psychological frameworks for reducing HIV risk by introducing unique theoretical understandings about the conditions under which risky decisions are amenable to intervention. Findings from illustrative CEI programs show mixed but generally promising effects of economic interventions on HIV and sexually transmitted infection (STI) prevalence, HIV testing, HIV medication adherence, and drug use. CEI programs can complement psychological interventions for HIV prevention and behavioral risk reduction. To maximize program effectiveness, CEI programs must be designed according to contextual and population-specific factors that may determine intervention applicability and success. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Managing risk with chance-constrained programming

Treesearch

Michael Bevers; Brian Kent

2007-01-01

Reducing catastrophic fire risk is an important objective of many fuel treatment programs (Kent et al. 2003; Machlis et al. 2002; USDA/USDI 2001a). In practice, risk reductions can be accomplished by lowering the probability of a given loss to forest fires, the amount of probable loss, or both. Forest fire risk objectives are seldom quantified, however, making it...

Does Targeting Higher Health Risk Employees or Increasing Intervention Intensity Yield Savings in a Workplace Wellness Program?

PubMed

Kapinos, Kandice A; Caloyeras, John P; Liu, Hangsheng; Mattke, Soeren

2015-12-01

This article aims to test whether a workplace wellness program reduces health care cost for higher risk employees or employees with greater participation. The program effect on costs was estimated using a generalized linear model with a log-link function using a difference-in-difference framework with a propensity score matched sample of employees using claims and program data from a large US firm from 2003 to 2011. The program targeting higher risk employees did not yield cost savings. Employees participating in five or more sessions aimed at encouraging more healthful living had about $20 lower per member per month costs relative to matched comparisons (P = 0.002). Our results add to the growing evidence base that workplace wellness programs aimed at primary prevention do not reduce health care cost, with the exception of those employees who choose to participate more actively.

Special Diabetes Program for Indians: Retention in Cardiovascular Risk Reduction

ERIC Educational Resources Information Center

Manson, Spero M.; Jiang, Luohua; Zhang, Lijing; Beals, Janette; Acton, Kelly J.; Roubideaux, Yvette

2011-01-01

Purpose: This study examined the associations between participant and site characteristics and retention in a multisite cardiovascular disease risk reduction project. Design and Methods: Data were derived from the Special Diabetes Program for Indians Healthy Heart Demonstration Project, an intervention to reduce cardiovascular risk among American…

Evaluating an In-School Drug Prevention Program for At-Risk Youth.

ERIC Educational Resources Information Center

DeWit, David J.; Steep, Barbara; Silverman, Gloria; Stevens-Lavigne, Andrea; Ellis, Kathy; Smythe, Cindy; Rye, Barbara J.; Braun, Kathy; Wood, Eileen

2000-01-01

A drug prevention program involving 167 at-risk students in grades 8-10 at 9 Ontario schools resulted in reduced use of and less supportive attitudes toward alcohol, cannabis, tobacco, and tranquilizers. Program success is attributed to high attendance and retention, community health professionals' participation, comprehensive approach, strong…

A theory-based newsletter nutrition education program reduces nutritional risk and improves dietary intake for congregate meal participants.

PubMed

Francis, Sarah L; MacNab, Lindsay; Shelley, Mack

2014-01-01

At-risk older adults need community-based nutrition programs that improve nutritional status and practices. This 6-month study assessed the impact of the traditional Chef Charles (CC) program (Control) compared to a theory-based CC program (Treatment) on nutritional risk (NR), dietary intakes, self-efficacy (SE), food security (FS), and program satisfaction for congregate meal participants. Participants were mostly educated, single, "food secure" White females. NR change for the treatment group was significantly higher (P = 0.042) than the control group. No differences were noted for SE or FS change and program satisfaction between groups. The overall distribution classification levels of FS changed significantly (P < .001) from pre to post. Over half (n = 46, 76.7%) reported making dietary changes and the majority (n = 52, 86.7%) rated CC as good to excellent. Results suggest the theory-based CC program (treatment) is more effective in reducing NR and dietary practices than the traditional CC program (control).

Communicating Risk to Program Managers

NASA Technical Reports Server (NTRS)

Shivers, C. Herbert

2005-01-01

Program Managers (PM) can protect program resources and improve chances of success by anticipating, understanding and managing risks. Understanding the range of potential risks helps one to avoid or manage the risks. A PM must choose which risks to accept to reduce fire fighting, must meet the expectations of stakeholders consistently, and avoid falling into costly "black holes" that may open. A good risk management process provides the PM more confidence to seize opportunities save money, meet schedule, even improve relationships with people important to the program. Evidence of managing risk and sound internal controls can mean better support from superiors for the program by building a trust and reputation from being on top of issues. Risk managers have an obligation to provide the PM with the best information possible to allow the benefits to be realized (Small Business Consortium, 2004). The Institute for Chartered Accountants in England and Wales sees very important benefits for companies in providing better information about what they do to assess and manage key business risks. Such information will: a) provide practical forward-looking information; b) reduce the cost of capital; c) encourage better risk management; and d) improve accountability for stewardship, investor protection and the usefulness of financial reporting. We are particularly convinced that enhanced risk reporting will help listed companies obtain capital at the lowest possible cost (The Institute of Chartered Accountants in England &Wales, June 2002). Risk managers can take a significant role in quantifying the success of their department and communicating those figures to executive (program) management levels while pushing for a broader risk management role. Overall, risk managers must show that risk management work matters in the most crucial place-the bottom line- as they prove risk management can be a profit center (Sullivan, 2004).

Applying the Social Ecological Model and Theory of Self-Efficacy in the Worksite Heart Health Improvement Project-PLUS.

PubMed

Doran, Kelly; Resnick, Barbara; Kim, Natalie; Lynn, Donna; McCormick, Tyrell

2017-02-01

Long-term care (LTC) employees are at high risk for cardiovascular disease. Despite the documented benefits of worksite health promotion (WHP) programs for employees and employers and the potential benefits to residents in LTC facilities, LTC employees are rarely offered WHP programs. The purpose of the intervention described in this article is to reduce cardiovascular disease risk factors among LTC workers using a physical activity, nutrition, and stress management WHP implemented during paid work time with 98 LTC staff members. This article describes a 9-month physical activity, nutrition, and stress management WHP intervention delivered during paid work time to reduce the cardiovascular disease risk of employees working in LTC. The intervention is rooted in the social ecological model and social cognitive theory. The intervention is based on formative research and evidence-based practice recommendations and is specifically designed to reduce barriers to intervention participation (e.g., inconsistent break times and unpredictable resident care needs) and enhance motivators to program participation (e.g., enhanced social support). The intervention is ongoing, but measures are described. As more employers offer WHP programs, it is important that programs are tailored to meet specific employee groups and work environments. This article operationalizes a WHP research protocol with LTC employees that can be applied to reduce cardiovascular disease risk in LTC employees or similar employee groups in similar work environments.

A gloomy picture: a meta-analysis of randomized controlled trials reveals disappointing effectiveness of programs aiming at preventing child maltreatment.

PubMed

Euser, Saskia; Alink, Lenneke Ra; Stoltenborgh, Marije; Bakermans-Kranenburg, Marian J; van IJzendoorn, Marinus H

2015-10-18

Consistent findings about the effectiveness of parent programs to prevent or reduce child maltreatment are lacking. In the present meta-analysis we synthesized findings from 27 independent samples from randomized controlled trials (RCTs) on the effectiveness of 20 different intervention programs aimed at (i) preventing the occurrence of child maltreatment in the general population or with at-risk but non-maltreating families, or (ii) reducing the incidence of child maltreatment in maltreating families. A significant combined effect on maltreatment (d = 0.13; N = 4883) disappeared after the trim-and-fill approach that takes into account publication bias against smaller studies without significant outcomes. However, moderator analyses showed that larger effect sizes were found for more recent studies, studies with smaller samples, programs that provide parent training instead of only support, programs that target maltreating instead of at-risk families, and programs with a moderate length (6-12 months) or a moderate number of sessions (16-30). More RCTs are needed to further unravel which factors are associated with program effectiveness. Because currently existing programs appeared to only reduce and not prevent child maltreatment, efforts in the field of preventive intervention should also focus on the development and testing of preventive programs for families at risk for child maltreatment.

Invest in People with a Staff Wellness Program.

ERIC Educational Resources Information Center

Bell, Spicer

1986-01-01

Adopting a wellness program for school personnel can reduce health insurance costs, workman's compensation insurance costs, absenteeism, and staff turnover while improving productivity and morale. Wellness programs focus on improving health and reducing the risk and impact of disease rather than on curing illnesses already contracted. Successful…

Reducing HIV Risk among Transgender Women in Thailand: A Quasi-Experimental Evaluation of the Sisters Program

PubMed Central

Pawa, Duangta; Firestone, Rebecca; Ratchasi, Sindh; Dowling, Olivia; Jittakoat, Yaowalak; Duke, Alex; Mundy, Gary

2013-01-01

Transgender women are particularly at risk of HIV infection, but little evidence exists on effective HIV prevention strategies with this population. We evaluated whether Sisters, a peer-led program for transgender women, could reduce HIV risks in Pattaya, Thailand. The study used time-location sampling to recruit 308 transgender women in Pattaya into a behavioral survey in 2011. Coarsened exact matching was used to create statistically equivalent groups of program participants and non-participants, based on factors influencing likelihood of program participation. Using multivariable logistic regression, we estimated effects of any program participation and participation by delivery channel on: condom use at last sex; consistent condom and condom/water-based lubricant use in the past 3 months with commercial, casual, and regular partners; and receipt of HIV testing in the past 6 months. Program coverage reached 75% of the population. In a matched sub-sample (n = 238), participation in outreach was associated with consistent condom/water-based lubricant use with commercial partners (AOR 3.22, 95% CI 1.64–6.31). Attendance at the Sisters drop-in center was associated with receiving an HIV test (AOR 2.58, 95% CI 1.47–4.52). Dedicated transgender-friendly programs are effective at reducing HIV risks and require expansion to better serve this key population and improve HIV prevention strategies. PMID:24204750

Benefits of a hospital-based peer intervention program for violently injured youth.

PubMed

Shibru, Daniel; Zahnd, Elaine; Becker, Marla; Bekaert, Nic; Calhoun, Deane; Victorino, Gregory P

2007-11-01

Exposure to violence predisposes youths to future violent behavior. Breaking the cycle of violence in inner cities is the primary objective of hospital-based violence intervention and prevention programs. An evaluation was undertaken to determine if a hospital-based, peer intervention program, "Caught in the Crossfire," reduces the risk of criminal justice involvement, decreases hospitalizations from traumatic reinjury, diminishes death from intentional violent trauma, and is cost effective. We designed a retrospective cohort study conducted between January 1998 and June 2003 at a university-based urban trauma center. The duration of followup was 18 months. Patients were 12 to 20 years of age and were hospitalized for intentional violent trauma. The "enrolled" group had a minimum of five interactions with an intervention specialist. The control group was selected from the hospital database by matching age, gender, race or ethnicity, type of injury, and year of admission. All patients came from socioeconomically disadvantaged areas. The total sample size was 154 patients. Participation in the hospital-based peer intervention program lowered the risk of criminal justice involvement (relative risk=0.67; 95% CI, 0.45, 0.99; p=0.04). There was no effect on risks of reinjury and death. Subsequent violent criminal behavior was reduced by 7% (p=0.15). Logistic regression analysis showed age had a confounding effect on the association between program participation and criminal justice involvement (relative risk=0.71; p=0.043). When compared with juvenile detention center costs, the total cost reduction derived from the intervention program annually was $750,000 to $1.5 million. This hospital-based peer intervention program reduces the risk of criminal justice system involvement, is more effective with younger patients, and is cost effective. Any effect on reinjury and death will require a larger sample size and longer followup.

An Evidence-Based Assessment of Faith-Based Programs: Do Faith-Based Programs "Work" to Reduce Recidivism?

ERIC Educational Resources Information Center

Dodson, Kimberly D.; Cabage, Leann N.; Klenowski, Paul M.

2011-01-01

Faith-based organizations administer many of the prison-based programs aimed at reducing recidivism. Many of these organizations also manage treatment programs for substance abusers, at-risk juveniles, and ex-offenders. Much of the research on religiosity and delinquency indicates that the two are inversely related. Therefore, it seems plausible…

An after-school dance and lifestyle education program reduces risk factors for heart disease and diabetes in elementary school children

PubMed Central

Hogg, Jeannette; Diaz, Alejandro; Cid, Margareth Del; Mueller, Charles; Lipman, Elizabeth Grace; Cheruvu, Sunita; Chiu, Ya-lin; Vogiatzi, Maria; Nimkarn, Saroj

2013-01-01

Background Forty-three percent of New York City's (NYC) school-age children are overweight or obese, placing them at risk for heart disease and type 2 diabetes mellitus (T2DM). Objective The objective of this study was to determine if an intensive after-school dance and lifestyle education program would reduce risk factors for heart disease, T2DM, and improve lifestyle choices. Subjects Subject include 64 fourth- and fifth-grade students at an elementary school in NYC. Methods Students received freestyle dance and lifestyle classes for 16 weeks and were evaluated for changes in body composition, endurance, biochemical measurements, and lifestyle choices. Results Significant improvements in BMI percentiles were found among children in the overweight and obese categories as well as in endurance and biochemical measurements that reflect heart disease and diabetes risk. Improvement was also reported in lifestyle choices. Conclusion An intensive after-school dance and lifestyle education program can reduce risk factors for heart disease and T2DM and improve lifestyle choices among elementary school children. PMID:22876547

Computer Security: Improvements Needed to Reduce Risk to Critical Federal Operations and Assets

DTIC Science & Technology

2001-11-09

COMPUTER SECURITY Improvements Needed to Reduce Risk to Critical Federal Operations and Assets Statement of Robert F. Dacey Director, Information...Improvements Needed to Reduce Risk to Critical Federal Operations and Assets Contract Number Grant Number Program Element Number Author(s...The benefits have been enormous. Vast amounts of information are now literally at our fingertips, facilitating research on virtually every topic

Reducing Substance Abuse Risk Factors among Children through a Teacher as Facilitator Program.

ERIC Educational Resources Information Center

McLaughlin, Robert J.; And Others

1993-01-01

Teachers as Facilitators (TAF) program used teachers as leaders of small groups that promoted social, emotional, and academic development of children at high risk for substance abuse. Found that school personnel were capable of accurately identifying and referring students; TAF program was effective in improving students' perceived academic…

An Effectiveness Trial of a Dissonance-Based Eating Disorder Prevention Program for High-Risk Adolescent Girls

ERIC Educational Resources Information Center

Stice, Eric; Rohde, Paul; Gau, Jeff; Shaw, Heather

2009-01-01

Efficacy trials indicate that an eating disorder prevention program involving dissonance-inducing activities that decrease thin-ideal internalization reduces risk for current and future eating pathology, yet it is unclear whether this program produces effects under real-world conditions. The present effectiveness trial tested whether this program…

The EPA's Human Exposure Research Program for Assessing Cumulative Risk in Communities

EPA Science Inventory

Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available...

Organizational Policies and Programs to Reduce Job Stress and Risk of Workplace Violence Among K-12 Education Staff.

PubMed

Landsbergis, Paul; Zoeckler, Jeanette; Kashem, Zerin; Rivera, Bianca; Alexander, Darryl; Bahruth, Amy

2018-02-01

We examine strategies, programs, and policies that educators have developed to reduce work stressors and thus health risks. First, we review twenty-seven empirical studies and review papers on organizational programs and policies in K-12 education published from 1990 to 2015 and find some evidence that mentoring, induction, and Peer Assistance and Review programs can increase support, skill development, decision-making authority, and perhaps job security, for teachers-and thus have the potential to reduce job stressors. Second, we describe efforts to reduce workplace violence in Oregon, especially in special education, including legislation, collective bargaining, research, and public awareness. We conclude that to reduce workplace violence, adequate resources are needed for staffing, training, equipment, injury/assault reporting, and investigation. Third, we discuss collective bargaining initiatives that led to mentoring and Peer Assistance and Review and state legislation on prevention of bullying and harassment of school staff. Finally, we present a research agenda on these issues.

Influences on Adaptive Planning to Reduce Flood Risks among Parishes in South Louisiana.

PubMed

Paille, Mary; Reams, Margaret; Argote, Jennifer; Lam, Nina S-N; Kirby, Ryan

2016-02-01

Residents of south Louisiana face a range of increasing, climate-related flood exposure risks that could be reduced through local floodplain management and hazard mitigation planning. A major incentive for community planning to reduce exposure to flood risks is offered by the Community Rating System (CRS) of the National Flood Insurance Program (NFIP). The NFIP encourages local collective action by offering reduced flood insurance premiums for individual policy holders of communities where suggested risk-reducing measures have been implemented. This preliminary analysis examines the extent to which parishes (counties) in southern Louisiana have implemented the suggested policy actions and identifies key factors that account for variation in the implementation of the measures. More measures implemented results in higher CRS scores. Potential influences on scores include socioeconomic attributes of residents, government capacity, average elevation and past flood events. The results of multiple regression analysis indicate that higher CRS scores are associated most closely with higher median housing values. Furthermore, higher scores are found in parishes with more local municipalities that participate in the CRS program. The number of floods in the last five years and the revenue base of the parish does not appear to influence CRS scores. The results shed light on the conditions under which local adaptive planning to mitigate increasing flood risks is more likely to be implemented and offer insights for program administrators, researchers and community stakeholders.

Influences on Adaptive Planning to Reduce Flood Risks among Parishes in South Louisiana

PubMed Central

Paille, Mary; Reams, Margaret; Argote, Jennifer; Lam, Nina S.-N.; Kirby, Ryan

2016-01-01

Residents of south Louisiana face a range of increasing, climate-related flood exposure risks that could be reduced through local floodplain management and hazard mitigation planning. A major incentive for community planning to reduce exposure to flood risks is offered by the Community Rating System (CRS) of the National Flood Insurance Program (NFIP). The NFIP encourages local collective action by offering reduced flood insurance premiums for individual policy holders of communities where suggested risk-reducing measures have been implemented. This preliminary analysis examines the extent to which parishes (counties) in southern Louisiana have implemented the suggested policy actions and identifies key factors that account for variation in the implementation of the measures. More measures implemented results in higher CRS scores. Potential influences on scores include socioeconomic attributes of residents, government capacity, average elevation and past flood events. The results of multiple regression analysis indicate that higher CRS scores are associated most closely with higher median housing values. Furthermore, higher scores are found in parishes with more local municipalities that participate in the CRS program. The number of floods in the last five years and the revenue base of the parish does not appear to influence CRS scores. The results shed light on the conditions under which local adaptive planning to mitigate increasing flood risks is more likely to be implemented and offer insights for program administrators, researchers and community stakeholders. PMID:27330828

Evaluation of a Voluntary Worksite Weight Loss Program on Metabolic Syndrome.

PubMed

Earnest, Conrad P; Church, Timothy S

2015-11-01

Health care costs increase with the presence of metabolic syndrome and present a significant burden to companies throughout the world. Identifying effective behavioral programs within the workplace can reduce health care costs. We examined the effect of a voluntary worksite program on weight loss and metabolic syndrome. Participants (N = 3880, from 93 companies) volunteered within their workplaces to participate in a 10-week weight loss program (Naturally Slim) focused on self-monitoring, eating behaviors, understanding hunger signals, reducing refined carbohydrate and sugar intake, and increasing protein intake to 25%-30%. Primary outcomes included weight loss and metabolic syndrome prevalence. Secondary analyses examined the individual components of metabolic syndrome and a categorical analysis within each World Health Organization body mass index category. Overall, women and men lost 9.4 (-4.8%) and 13.2 pounds (-5.8%), respectively. Each metabolic risk factor for both genders had a significant improvement but men exhibited the largest relative improvement for each risk factor. At baseline, 43% of women and 52% of men presented with metabolic syndrome, which was reduced to 30% in women and 26% in men (P < 0.001 for each) at the conclusion of the program. Secondary analysis demonstrated that individuals with greater baseline levels of metabolic dysfunction had larger metabolic improvements, similar benefits to risk factors across baseline body mass index categories, and the greater the weight loss, the greater the metabolic benefit. Our results demonstrate that a worksite program targeting core behavioral skills associated with weight loss is an effective strategy to reduce weight and improve the components of metabolic syndrome amongst at-risk employees.

RISK D/C

NASA Technical Reports Server (NTRS)

Dias, W. C.

1994-01-01

RISK D/C is a prototype program which attempts to do program risk modeling for the Space Exploration Initiative (SEI) architectures proposed in the Synthesis Group Report. Risk assessment is made with respect to risk events, their probabilities, and the severities of potential results. The program allows risk mitigation strategies to be proposed for an exploration program architecture and to be ranked with respect to their effectiveness. RISK D/C allows for the fact that risk assessment in early planning phases is subjective. Although specific to the SEI in its present form, RISK D/C can be used as a framework for developing a risk assessment program for other specific uses. RISK D/C is organized into files, or stacks, of information, including the architecture, the hazard, and the risk event stacks. Although predefined, all stacks can be upgraded by a user. The architecture stack contains information concerning the general program alternatives, which are subsequently broken down into waypoints, missions, and mission phases. The hazard stack includes any background condition which could result in a risk event. A risk event is anything unfavorable that could happen during the course of a specific point within an architecture, and the risk event stack provides the probabilities, consequences, severities, and any mitigation strategies which could be used to reduce the risk of the event, and how much the risk is reduced. RISK D/C was developed for Macintosh series computers. It requires HyperCard 2.0 or later, as well as 2Mb of RAM and System 6.0.8 or later. A Macintosh II series computer is recommended due to speed concerns. The standard distribution medium for this package is one 3.5 inch 800K Macintosh format diskette. RISK D/C was developed in 1991 and is a copyrighted work with all copyright vested in NASA. Macintosh and HyperCard are trademarks of Apple Computer, Inc.

Estimating the return-on-investment from changes in employee health risks on the Dow Chemical Company's health care costs.

PubMed

Goetzel, Ron Z; Ozminkowski, Ronald J; Baase, Catherine M; Billotti, Gary M

2005-08-01

We sought to estimate the impact of corporate health-management and risk-reduction programs for The Dow Chemical Company by using a prospective return-on-investment (ROI) model. The risk and expenditure estimates were derived from multiple regression analyses showing relationships between worker demographics, health risks, and medical expenditures. A "break-even" scenario would require Dow to reduce each of 10 population health risks by 0.17% points per year over the course of 10 years. More successful efforts at reducing health risks in the population would produce a more significant ROI for the company. Findings from this study were incorporated into other components of a business case for health and productivity management, and these supported continued investments in health improvement programs designed to achieve risk reduction and cost savings.

Utilization of 3-month yoga program for adults at high risk for type 2 diabetes: a pilot study.

PubMed

Yang, Kyeongra; Bernardo, Lisa M; Sereika, Susan M; Conroy, Molly B; Balk, Judy; Burke, Lora E

2011-01-01

Various modes of physical activity, combined with dieting, have been widely recommended to prevent or delay type 2 diabetes. Among these, yoga holds promise for reducing risk factors for type 2 diabetes by promoting weight loss, improving glucose levels and reducing blood pressure and lipid levels. This pilot study aimed to assess the feasibility of implementing a 12-week yoga program among adults at high risk for type 2 diabetes. Twenty-three adults (19 Whites and 4 non-Whites) were randomly assigned to the yoga intervention group or the educational group. The yoga group participated in a 3-month yoga intervention with sessions twice per week and the educational group received general health educational materials every 2 weeks. All participants completed questionnaires and had blood tests at baseline and at the end of 3 months. Effect sizes were reported to summarize the efficacy of the intervention. All participants assigned to the yoga intervention completed the yoga program without complication and expressed high satisfaction with the program (99.2%). Their yoga session attendance ranged from 58.3 to 100%. Compared with the education group, the yoga group experienced improvements in weight, blood pressure, insulin, triglycerides and exercise self-efficacy indicated by small to large effect sizes. This preliminary study indicates that a yoga program would be a possible risk reduction option for adults at high risk for type 2 diabetes. In addition, yoga holds promise as an approach to reducing cardiometabolic risk factors and increasing exercise self-efficacy for this group.

Mediation of a Preventive Intervention’s Six-Year Effects on Health Risk Behaviors

PubMed Central

Soper, Ana C.; Wolchik, Sharlene A.; Tein, Jenn-Yun; Sandler, Irwin N.

2010-01-01

Using data from a 6-year longitudinal follow-up sample of 240 youth who participated in a randomized experimental trial of a preventive intervention for divorced families with children ages 9 -12, the current study tested mechanisms by which the intervention reduced substance use and risky sexual behavior in mid to late adolescence (15–19 years old). Mechanisms tested included parental monitoring, adaptive coping, and negative errors. Parental monitoring at 6-year follow-up mediated program effects to reduce alcohol and marijuana use, polydrug use, and other drug use for those with high pre-test risk for maladjustment. In the condition that included a program for mothers only, increases in youth adaptive coping at 6-year follow-up mediated program effects on risky sexual behavior for those with high pre-test risk for maladjustment. Contrary to expectation, program participation increased negative errors and decreased adaptive coping among low risk youth in some of the analyses. Ways in which this study furthers our understanding of pathways through which evidence-based preventive interventions affect health risk behaviors are discussed. PMID:20565156

Long-term effects of a parenting preventive intervention on young adults' painful feelings about divorce.

PubMed

Christopher, Caroline; Wolchik, Sharlene; Tein, Jenn-Yun; Carr, Colleen; Mahrer, Nicole E; Sandler, Irwin

2017-10-01

This study examined whether the New Beginnings Program (NBP), a parenting preventive intervention for divorced mothers that was designed to reduce children's postdivorce mental health problems, reduced painful feelings about divorce in young adults whose families had participated 15 years earlier. This study also explored whether NBP participation reduced the relations between young adults' painful feelings about divorce and their concurrent internalizing, externalizing, and substance use problems. Participants (M = 25.6 years; 50% female; 88% Caucasian) were from 240 families that had been recruited into a randomized experimental trial (NBP vs. literature control). Data from the pretest and 15-year follow-up were used. NBP participants reported less feelings of seeing life through a filter of divorce (e.g., thinking about how the divorce causes continued struggles for them) than those in the control condition. Program effects on maternal blame and acceptance of the divorce were moderated by pretest risk, a composite of divorce-related stressors and externalizing problems. NBP participants with elevated risk at program entry had lower levels of maternal blame. Program participation was associated with higher acceptance for those with elevated risk at program entry but lower acceptance for those with low risk at program entry. Program participation decreased the relations between maternal blame, acceptance of the divorce and filter of divorce and some, but not all, of the adjustment outcomes. These findings suggest that programs designed to help families after divorce have benefits in terms of long-term feelings about parental divorce as well as their relations with adjustment problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Impact of Apollo-Era Microbiology on Human Space Flight

NASA Technical Reports Server (NTRS)

Elliott, T. F; Castro, V. A.; Bruce, R. J.; Pierson, D. L.

2014-01-01

The microbiota of crewmembers and the spacecraft environment contributes significant risk to crew health during space flight missions. NASA reduces microbial risk with various mitigation methods that originated during the Apollo Program and continued to evolve through subsequent programs: Skylab, Shuttle, and International Space Station (ISS). A quarantine of the crew and lunar surface samples, within the Lunar Receiving Laboratory following return from the Moon, was used to prevent contamination with unknown extraterrestrial organisms. The quarantine durations for the crew and lunar samples were 21 days and 50 days, respectively. A series of infections among Apollo crewmembers resulted in a quarantine before launch to limit exposure to infectious organisms. This Health Stabilization Program isolated the crew for 21 days before flight and was effective in reducing crew illness. After the program developed water recovery hardware for Apollo spacecraft, the 1967 National Academy of Science Space Science Board recommended the monitoring of potable water. NASA implemented acceptability limits of 10 colony forming units (CFU) per mL and the absence of viable E. coli, anaerobes, yeasts, and molds in three separate 150 mL aliquots. Microbiological investigations of the crew and spacecraft environment were conducted during the Apollo program, including the Apollo-Soyuz Test Project and Skylab. Subsequent space programs implemented microbial screening of the crew for pathogens and acceptability limits on spacecraft surfaces and air. Microbiology risk mitigation methods have evolved since the Apollo program. NASA cancelled the quarantine of the crew after return from the lunar surface, reduced the duration of the Health Stabilization Program; and implemented acceptability limits for spacecraft surfaces and air. While microbial risks were not a main focus of the early Mercury and Gemini programs, the extended duration of Apollo flights resulted in the increased scrutiny of impact of the space flight environment on crew health. The lessons learned during that era of space flight continue to impact microbiology risk mitigation in space programs today.

Firefighter health and fitness assessment: a call to action.

PubMed

Storer, Thomas W; Dolezal, Brett A; Abrazado, Marlon L; Smith, Denise L; Batalin, Maxim A; Tseng, Chi-Hong; Cooper, Christopher B

2014-03-01

Sudden cardiac deaths experienced by firefighters in the line of duty account for the largest proportion of deaths annually. Several fire service standards for fitness and wellness have been recommended but currently only 30% of U.S. fire departments are implementing programs for this purpose. The Department of Homeland Security Science and Technology Directorate has initiated the Physiological Health Assessment System for Emergency Responders (PHASER) program aiming to reduce these line-of-duty deaths through an integration of medical science and sensor technologies. Confirming previous reports, PHASER comprehensive risk assessment has identified lack of physical fitness with propensity for overexertion as a major modifiable risk factor. We sought to determine if current levels of fitness and cardiovascular disease (CVD) risk factors in a contemporary cohort of firefighters were better than those reported over the past 30 years. Fifty-one firefighters from a Southern California department were characterized for physical fitness and CVD risk factors using standard measures. Overall, physical fitness and risk factors were not different from previous reports of firefighter fitness and most subjects did not achieve recommended fitness standards. Considering the lack of widespread implementation of wellness/fitness programs in the U.S. fire service together with our findings that low physical fitness and the presence of CVD risk factors persist, we issue a call to action among health and fitness professionals to assist the fire service in implementing programs for firefighters that improve fitness and reduce CVD risk factors. Fitness professionals should be empowered to work with fire departments lending their expertise to guide programs that achieve these objectives, which may then lead to reduced incidence of sudden cardiac death or stroke.

Reducing the Risk of Tick-Borne Diseases through Smart, Safe and Sustainable Pest Control

EPA Pesticide Factsheets

Each year PestWise programs form new partnerships to address ongoing and emerging issues. Reducing the risk from ticks and tick-borne disease is an issue of importance and EPA is contributing to a larger federal effort.

Reconnecting with Nature: Educational Self-Esteem Sensory Activities for Reducing Drug Use and Irresponsible Relationships in Students at Risk.

ERIC Educational Resources Information Center

Davies, Kurtland; Cohen, Michael J.

A model of an integrated ecologically-based counseling and recovery program is explored as a means of incorporating educational and psychological nature-connecting methods and materials with traditional recovery activities for people at risk and as a preventative. The first part of the program introduces high-risk high school students, most of…

Addressing excess risk of overdose among recently incarcerated people in the USA: harm reduction interventions in correctional settings.

PubMed

Brinkley-Rubinstein, Lauren; Cloud, David H; Davis, Chelsea; Zaller, Nickolas; Delany-Brumsey, Ayesha; Pope, Leah; Martino, Sarah; Bouvier, Benjamin; Rich, Josiah

2017-03-13

Purpose The purpose of this paper is to discuss overdose among those with criminal justice experience and recommend harm reduction strategies to lessen overdose risk among this vulnerable population. Design/methodology/approach Strategies are needed to reduce overdose deaths among those with recent incarceration. Jails and prisons are at the epicenter of the opioid epidemic but are a largely untapped setting for implementing overdose education, risk assessment, medication assisted treatment, and naloxone distribution programs. Federal, state, and local plans commonly lack corrections as an ingredient in combating overdose. Harm reduction strategies are vital for reducing the risk of overdose in the post-release community. Findings Therefore, the authors recommend that the following be implemented in correctional settings: expansion of overdose education and naloxone programs; establishment of comprehensive medication assisted treatment programs as standard of care; development of corrections-specific overdose risk assessment tools; and increased collaboration between corrections entities and community-based organizations. Originality/value In this policy brief the authors provide recommendations for implementing harm reduction approaches in criminal justice settings. Adoption of these strategies could reduce the number of overdoses among those with recent criminal justice involvement.

Cardiovascular Risk Reduction in Children.

ERIC Educational Resources Information Center

Murray, David M.; And Others

1987-01-01

The paper presents a community model for reducing the risk of coronary heart disease in children and youth. The model addresses the individual, the family, social groups, and the larger social and physical environments. Exemplary programs are described and recommendations are made for additional research and program development. (Author/DB)

Income diversification and risk for fishermen.

PubMed

Kasperski, Stephen; Holland, Daniel S

2013-02-05

Catches and prices from many fisheries exhibit high interannual variability, leading to variability in the income derived by fishery participants. The economic risk posed by this may be mitigated in some cases if individuals participate in several different fisheries, particularly if revenues from those fisheries are uncorrelated or vary asynchronously. We construct indices of gross income diversification from fisheries at the level of individual vessels and find that the income of the current fleet of vessels on the US West Coast and in Alaska is less diverse than at any point in the past 30 y. We also find a dome-shaped relationship between the variability of individuals' income and income diversification, which implies that a small amount of diversification does not reduce income risk but that higher levels of diversification can substantially reduce the variability of income from fishing. Moving from a single fishery strategy to a 50-25-25 split in revenues reduces the expected coefficient of variation of gross revenues between 24% and 65% for the vessels included in this study. The increasing access restrictions in many marine fisheries through license reductions and moratoriums have the potential to limit fishermen's ability to diversify their income risk across multiple fisheries. Catch share programs often result in consolidation initially and may reduce diversification. However, catch share programs also make it feasible for fishermen to build a portfolio of harvest privileges and potentially reduce their income risk. Therefore, catch share programs create both threats and opportunities for fishermen wishing to maintain diversified fishing strategies.

Income diversification and risk for fishermen

PubMed Central

Kasperski, Stephen; Holland, Daniel S.

2013-01-01

Catches and prices from many fisheries exhibit high interannual variability, leading to variability in the income derived by fishery participants. The economic risk posed by this may be mitigated in some cases if individuals participate in several different fisheries, particularly if revenues from those fisheries are uncorrelated or vary asynchronously. We construct indices of gross income diversification from fisheries at the level of individual vessels and find that the income of the current fleet of vessels on the US West Coast and in Alaska is less diverse than at any point in the past 30 y. We also find a dome-shaped relationship between the variability of individuals' income and income diversification, which implies that a small amount of diversification does not reduce income risk but that higher levels of diversification can substantially reduce the variability of income from fishing. Moving from a single fishery strategy to a 50-25-25 split in revenues reduces the expected coefficient of variation of gross revenues between 24% and 65% for the vessels included in this study. The increasing access restrictions in many marine fisheries through license reductions and moratoriums have the potential to limit fishermen's ability to diversify their income risk across multiple fisheries. Catch share programs often result in consolidation initially and may reduce diversification. However, catch share programs also make it feasible for fishermen to build a portfolio of harvest privileges and potentially reduce their income risk. Therefore, catch share programs create both threats and opportunities for fishermen wishing to maintain diversified fishing strategies. PMID:23341621

Project ARM: alcohol risk management to prevent sales to underage and intoxicated patrons.

PubMed

Toomey, T L; Wagenaar, A C; Gehan, J P; Kilian, G; Murray, D M; Perry, C L

2001-04-01

Clear policies and expectations are key to increasing responsible service of alcohol in licensed establishments. Few training programs focus exclusively on owners and managers of alcohol establishments to reduce the risk of alcohol service. Project ARM: Alcohol Risk Management is a one-on-one consultation program for owners and managers. Participants received information on risk level, policies to prevent illegal sales, legal issues, and staff communication. This nonrandomized demonstration project was implemented in five diverse bars. Two waves of underage and pseudo-intoxicated purchase attempts were conducted pre- and postintervention in the five intervention bars and nine matched control bars. Underage sales decreased by 11.5%, and sales to pseudo-intoxicated buyers decreased by 46%. Results were in the hypothesized direction but not statistically significant. A one-on-one, outlet-specific training program for owners and managers is a promising way to reduce illegal alcohol sales, particularly to obviously intoxicated individuals.

School-Located Influenza Vaccination Reduces Community Risk for Influenza and Influenza-Like Illness Emergency Care Visits

PubMed Central

Tran, Cuc H.; Sugimoto, Jonathan D.; Pulliam, Juliet R. C.; Ryan, Kathleen A.; Myers, Paul D.; Castleman, Joan B.; Doty, Randell; Johnson, Jackie; Stringfellow, Jim; Kovacevich, Nadia; Brew, Joe; Cheung, Lai Ling; Caron, Brad; Lipori, Gloria; Harle, Christopher A.; Alexander, Charles; Yang, Yang; Longini, Ira M.; Halloran, M. Elizabeth; Morris, J. Glenn; Small, Parker A.

2014-01-01

Background School-located influenza vaccination (SLIV) programs can substantially enhance the sub-optimal coverage achieved under existing delivery strategies. Randomized SLIV trials have shown these programs reduce laboratory-confirmed influenza among both vaccinated and unvaccinated children. This work explores the effectiveness of a SLIV program in reducing the community risk of influenza and influenza-like illness (ILI) associated emergency care visits. Methods For the 2011/12 and 2012/13 influenza seasons, we estimated age-group specific attack rates (AR) for ILI from routine surveillance and census data. Age-group specific SLIV program effectiveness was estimated as one minus the AR ratio for Alachua County versus two comparison regions: the 12 county region surrounding Alachua County, and all non-Alachua counties in Florida. Results Vaccination of ∼50% of 5–17 year-olds in Alachua reduced their risk of ILI-associated visits, compared to the rest of Florida, by 79% (95% confidence interval: 70, 85) in 2011/12 and 71% (63, 77) in 2012/13. The greatest indirect effectiveness was observed among 0–4 year-olds, reducing AR by 89% (84, 93) in 2011/12 and 84% (79, 88) in 2012/13. Among all non-school age residents, the estimated indirect effectiveness was 60% (54, 65) and 36% (31, 41) for 2011/12 and 2012/13. The overall effectiveness among all age-groups was 65% (61, 70) and 46% (42, 50) for 2011/12 and 2012/13. Conclusion Wider implementation of SLIV programs can significantly reduce the influenza-associated public health burden in communities. PMID:25489850

School-located influenza vaccination reduces community risk for influenza and influenza-like illness emergency care visits.

PubMed

Tran, Cuc H; Sugimoto, Jonathan D; Pulliam, Juliet R C; Ryan, Kathleen A; Myers, Paul D; Castleman, Joan B; Doty, Randell; Johnson, Jackie; Stringfellow, Jim; Kovacevich, Nadia; Brew, Joe; Cheung, Lai Ling; Caron, Brad; Lipori, Gloria; Harle, Christopher A; Alexander, Charles; Yang, Yang; Longini, Ira M; Halloran, M Elizabeth; Morris, J Glenn; Small, Parker A

2014-01-01

School-located influenza vaccination (SLIV) programs can substantially enhance the sub-optimal coverage achieved under existing delivery strategies. Randomized SLIV trials have shown these programs reduce laboratory-confirmed influenza among both vaccinated and unvaccinated children. This work explores the effectiveness of a SLIV program in reducing the community risk of influenza and influenza-like illness (ILI) associated emergency care visits. For the 2011/12 and 2012/13 influenza seasons, we estimated age-group specific attack rates (AR) for ILI from routine surveillance and census data. Age-group specific SLIV program effectiveness was estimated as one minus the AR ratio for Alachua County versus two comparison regions: the 12 county region surrounding Alachua County, and all non-Alachua counties in Florida. Vaccination of ∼50% of 5-17 year-olds in Alachua reduced their risk of ILI-associated visits, compared to the rest of Florida, by 79% (95% confidence interval: 70, 85) in 2011/12 and 71% (63, 77) in 2012/13. The greatest indirect effectiveness was observed among 0-4 year-olds, reducing AR by 89% (84, 93) in 2011/12 and 84% (79, 88) in 2012/13. Among all non-school age residents, the estimated indirect effectiveness was 60% (54, 65) and 36% (31, 41) for 2011/12 and 2012/13. The overall effectiveness among all age-groups was 65% (61, 70) and 46% (42, 50) for 2011/12 and 2012/13. Wider implementation of SLIV programs can significantly reduce the influenza-associated public health burden in communities.

Workplace Interventions to Reduce Obesity and Cardiometabolic Risk

PubMed Central

Thorndike, Anne N.

2012-01-01

The worksite is ideal for implementing interventions to reduce obesity and cardiometabolic risk factors. Although worksite health promotion is not new, employer-sponsored wellness programs have become more widespread due to the rising prevalence and high cost of obesity. Over the past two decades, employers and researchers focused efforts on individual-based programs to change employees’ nutrition and exercise behaviors, but more recently, the worksite environment has been targeted. Overall, there is good evidence that individual-based worksite programs can produce modest weight loss, but the evidence for effects on other risk factors and on long-term health outcomes and costs is inconsistent. There is less evidence for the benefit of environmental-based interventions, and more data will be needed to establish conclusions about the benefits of these types of interventions. A major challenge for employers and researchers in the future will be to find the balance between effectiveness and economic viability of worksite wellness programs. PMID:22708000

Workplace Interventions to Reduce Obesity and Cardiometabolic Risk.

PubMed

Thorndike, Anne N

2011-02-01

The worksite is ideal for implementing interventions to reduce obesity and cardiometabolic risk factors. Although worksite health promotion is not new, employer-sponsored wellness programs have become more widespread due to the rising prevalence and high cost of obesity. Over the past two decades, employers and researchers focused efforts on individual-based programs to change employees' nutrition and exercise behaviors, but more recently, the worksite environment has been targeted. Overall, there is good evidence that individual-based worksite programs can produce modest weight loss, but the evidence for effects on other risk factors and on long-term health outcomes and costs is inconsistent. There is less evidence for the benefit of environmental-based interventions, and more data will be needed to establish conclusions about the benefits of these types of interventions. A major challenge for employers and researchers in the future will be to find the balance between effectiveness and economic viability of worksite wellness programs.

Impact of family planning programs in reducing high-risk births due to younger and older maternal age, short birth intervals, and high parity.

PubMed

Brown, Win; Ahmed, Saifuddin; Roche, Neil; Sonneveldt, Emily; Darmstadt, Gary L

2015-08-01

Several studies show that maternal and neonatal/infant mortality risks increase with younger and older maternal age (<18 and >34 years), high parity (birth order >3), and short birth intervals (<24 months). Family planning programs are widely viewed as having contributed to substantial maternal and neonatal mortality decline through contraceptive use--both by reducing unwanted births and by reducing the burden of these high-risk births. However, beyond averting births, the empirical evidence for the role of family planning in reducing high-risk births at population level is limited. We examined data from 205 Demographic and Health Surveys (DHS), conducted between 1985 and 2013, to describe the trends in high-risk births and their association with the pace of progress in modern contraceptive prevalence rate (yearly increase in rate of MCPR) in 57 developing countries. Using Blinder-Oaxaca decomposition technique, we then examine the contributions of family planning program, economic development (GDP per capita), and educational improvement (secondary school completion rate) on the progress of MCPR in order to link the net contribution of family planning program to the reduction of high-risk births mediated through contraceptive use. Countries that had the fastest progress in improving MCPR experienced the greatest declines in high-risk births due to short birth intervals (<24 months), high parity births (birth order >3), and older maternal age (>35 years). Births among younger women <18 years, however, did not decline significantly during this period. The decomposition analysis suggests that 63% of the increase in MCPR was due to family planning program efforts, 21% due to economic development, and 17% due to social advancement through women's education. Improvement in MCPR, predominately due to family planning programs, is a major driver of the decline in the burden of high-risk births due to high parity, shorter birth intervals, and older maternal age in developing countries. The lack of progress in the decline of births in younger women <18 years of age underscores the need for more attention to ensure that quality contraceptive methods are available to adolescent women in order to delay first births. This study substantiates the significance of family planning programming as a major health intervention for preventing high-risk births and associated maternal and child mortality, but it highlights the need for concerted efforts to strengthen service provision for adolescents. Copyright © 2015 Elsevier Inc. All rights reserved.

Healthy Communities Grant Program | Urban Environmental ...

EPA Pesticide Factsheets

2018-03-06

The Healthy Communities Grant Program is EPA New England's main competitive grant program to work directly with communities to reduce environmental risks to protect and improve human health and the quality of life.

Impact of the CHOICES Intervention in Preventing Alcohol-Exposed Pregnancies in American Indian Women.

PubMed

Hanson, Jessica D; Nelson, Morgan E; Jensen, Jamie L; Willman, Amy; Jacobs-Knight, Jacque; Ingersoll, Karen

2017-04-01

Fetal alcohol spectrum disorders (FASD) comprise a continuum of lifelong outcomes in those born prenatally exposed to alcohol. Although studies have shown no differences in rates by race, FASD is of particular concern for American Indian communities. One tribally run prevention program is the Oglala Sioux Tribe (OST) CHOICES Program, which is modeled after the evidence-based CHOICES program that was focused on preconceptional prevention of alcohol-exposed pregnancy (AEP) by reducing risky drinking in women at risk for pregnancy and/or preventing unintended pregnancy. The OST CHOICES Program was made culturally appropriate for American Indian women and implemented with 3 communities, 2 on the reservation and 1 off. Data on drinking, sexual activity, and contraception use were collected at baseline and 3 and 6 months postintervention. Data were analyzed using descriptive statistics, 1-way analysis of variance, and a random intercept generalized estimating equation model. A total of 193 nonpregnant American Indian women enrolled in the OST CHOICES Program, and all were at risk for AEP because of binge drinking and being at risk for an unintended pregnancy. Fifty-one percent of participants completed both 3- and 6-month follow-ups. Models showed a significant decrease in AEP risk from baseline at both 3- and 6-month follow-ups, indicating the significant impact of the OST CHOICES intervention. Women in the OST CHOICES Program were more likely to reduce their risk for AEP by utilizing contraception, rather than decreasing binge drinking. Even with minor changes to make the CHOICES intervention culturally and linguistically appropriate and the potential threats to program validity those changes entail, we found a significant impact in reducing AEP risk. This highlights the capacity for the CHOICES intervention to be implemented in a wide variety of settings and populations. Copyright © 2017 by the Research Society on Alcoholism.

Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study.

PubMed

Kutyifa, Valentina; Daubert, James P; Schuger, Claudio; Goldenberg, Ilan; Klein, Helmut; Aktas, Mehmet K; McNitt, Scott; Stockburger, Martin; Merkely, Bela; Zareba, Wojciech; Moss, Arthur J

2016-01-01

The Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate therapy (MADIT-RIT) trial showed a significant reduction in inappropriate implantable cardioverter defibrillator (ICD) therapy in patients programmed to high-rate cut-off (Arm B) or delayed ventricular tachycardia therapy (Arm C), compared with conventional programming (Arm A). There is limited data on the effect of cardiac resynchronization therapy with a cardioverter defibrillator (CRT-D) on the effect of ICD programming. We aimed to elucidate the effect of CRT-D on ICD programming to reduce inappropriate ICD therapy in patients implanted with CRT-D or an ICD, enrolled in MADIT-RIT. The primary end point of this study was the first inappropriate ICD therapy. Secondary end points were inappropriate anti-tachycardia pacing and inappropriate ICD shock. The study enrolled 742 (49%) patients with an ICD and 757 (51%) patients with a CRT-D. Patients implanted with a CRT-D had 62% lower risk of inappropriate ICD therapy than those with an ICD only (hazard ratio [HR] =0.38, 95% confidence interval: 0.25-0.57; P<0.001). High-rate cut-off or delayed ventricular tachycardia therapy programming significantly reduced the risk of inappropriate ICD therapy compared with conventional ICD programming in ICD (HR=0.14 [B versus A]; HR=0.21 [C versus A]) and CRT-D patients (HR=0.15 [B versus A]; HR=0.23 [C versus A]; P<0.001 for all). There was a significant reduction in inappropriate anti-tachycardia pacings in both group and a significant reduction in inappropriate ICD shock in CRT-D patients. Patients implanted with a CRT-D have lower risk of inappropriate ICD therapy than those with an ICD. Innovative ICD programming significantly reduces the risk of inappropriate ICD therapy in both ICD and CRT-D patients. http://clinicaltrials.gov; Unique identifier: NCT00947310. © 2016 American Heart Association, Inc.

Preventing falls in assisted living: Results of a quality improvement pilot study.

PubMed

Zimmerman, Sheryl; Greene, Angela; Sloane, Philip D; Mitchell, Madeline; Giuliani, Carol; Nyrop, Kirsten; Walsh, Edith

Residents of assisted living (AL) communities are at high risk for falls, which result in negative outcomes and high health care costs. Adapting effective falls prevention programs for AL quality improvement (QI) has the potential to reduce falls, improve resident quality of life, and reduce costs. This project tested the feasibility and outcomes of an evidence-based multi-component QI program, the Assisted Living Falls Prevention and Monitoring Program (AL-FPMP). Resident posture and gait improved, likely due to exercise and/or physical therapy. Effective falls prevention QI programs can be implemented in AL, and are advised to (1) establish and maintain a falls team to create a culture focused on the reduction of falls risk; (2) teach staff to assess residents using the Morse Falls Scale to increase their awareness of residents' falls risk and improvement; and (3) modify existing exercise programs to address balance and lower body strength. Copyright © 2016 Elsevier Inc. All rights reserved.

Minimizing Accidents and Risks in High Adventure Outdoor Pursuits.

ERIC Educational Resources Information Center

Meier, Joel

The fundamental dilemma in adventure programming is eliminating unreasonable risks to participants without also reducing levels of excitement, challenge, and stress. Most accidents are caused by a combination of unsafe conditions, unsafe acts, and error judgments. The best and only way to minimize critical human error in adventure programs is…

75 FR 20556 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

..., electronic, mechanical, or other technological collection techniques or other forms of information technology... destructive forces. To reduce risks to life and property from earthquakes, Congress enacted the Earthquake... requirements; (2) improve the effectiveness of all RUS programs; and (3) reduce the risk to life and property...

The Glass Is Half Full: Evidence for Efficacy of Alcohol-Wise at One University But Not the Other

PubMed Central

CROOM, KATHERINE; STAIANO-COICO, LISA; LESSER, MARTIN L.; LEWIS, DEBORAH K.; REYNA, VALERIE F.; MARCHELL, TIMOTHY C.; FRANK, JEREMY; IVES, STEPHANIE

2017-01-01

This research extends the growing literature about online alcohol prevention programs for first-year college students. Two independent randomized control studies, conducted at separate universities, evaluated the short-term effectiveness of Alcohol-Wise, an online alcohol prevention program not previously studied. It was hypothesized the prevention program would increase alcohol knowledge and reduce alcohol consumption, including high-risk alcohol-related behaviors, among first-year college students. At both universities, the intervention significantly increased alcohol-related knowledge. At one university, the prevention program also significantly reduced alcohol consumption and high-risk drinking behaviors, such as playing drinking games, heavy drinking, and extreme ritualistic alcohol consumption. Implications for the use of online alcohol prevention programs and student affairs are discussed. PMID:25909233

Shark Spotters: Successfully reducing spatial overlap between white sharks (Carcharodon carcharias) and recreational water users in False Bay, South Africa

PubMed Central

Kock, Alison; Waries, Sarah; O’Riain, M. Justin

2017-01-01

White sharks (Carcharodon carcharias) are apex predators that play an important role in the structure and stability of marine ecosystems. Despite their ecological importance and protected status, white sharks are still subject to lethal control to reduce the risk of shark bites for recreational water users. The Shark Spotters program, pioneered in Cape Town, South Africa, provides a non-lethal alternative for reducing the risk of human-shark conflict. In this study we assessed the efficacy of the Shark Spotters program in reducing overlap between water users and white sharks at two popular beaches in False Bay, South Africa. We investigated seasonal and diel patterns in water use and shark presence at each beach, and thereafter quantified the impact of different shark warnings from shark spotters on water user abundance. We also assessed the impact of a fatal shark incident on patterns of water use. Our results revealed striking diel and seasonal overlap between white sharks and water users at both beaches. Despite this, there was a low rate of shark-human incidents (0.5/annum) which we attribute partly to the success of the Shark Spotters program. Shark spotters use visual (coloured flags) and auditory (siren) cues to inform water users of risk associated with white shark presence in the surf zone. Our results showed that the highest risk category (denoted by a white flag and accompanying siren) caused a significant reduction in water user abundance; however the secondary risk category (denoted by a red flag with no siren) had no significant effect on water users. A fatal shark incident was shown to negatively impact the number of water users present for at least three months following the incident. Our results indicate that the Shark Spotters program effectively reduces spatial overlap between white sharks and water users when the risk of conflict is highest. PMID:28945806

Shark Spotters: Successfully reducing spatial overlap between white sharks (Carcharodon carcharias) and recreational water users in False Bay, South Africa.

PubMed

Engelbrecht, Tamlyn; Kock, Alison; Waries, Sarah; O'Riain, M Justin

2017-01-01

White sharks (Carcharodon carcharias) are apex predators that play an important role in the structure and stability of marine ecosystems. Despite their ecological importance and protected status, white sharks are still subject to lethal control to reduce the risk of shark bites for recreational water users. The Shark Spotters program, pioneered in Cape Town, South Africa, provides a non-lethal alternative for reducing the risk of human-shark conflict. In this study we assessed the efficacy of the Shark Spotters program in reducing overlap between water users and white sharks at two popular beaches in False Bay, South Africa. We investigated seasonal and diel patterns in water use and shark presence at each beach, and thereafter quantified the impact of different shark warnings from shark spotters on water user abundance. We also assessed the impact of a fatal shark incident on patterns of water use. Our results revealed striking diel and seasonal overlap between white sharks and water users at both beaches. Despite this, there was a low rate of shark-human incidents (0.5/annum) which we attribute partly to the success of the Shark Spotters program. Shark spotters use visual (coloured flags) and auditory (siren) cues to inform water users of risk associated with white shark presence in the surf zone. Our results showed that the highest risk category (denoted by a white flag and accompanying siren) caused a significant reduction in water user abundance; however the secondary risk category (denoted by a red flag with no siren) had no significant effect on water users. A fatal shark incident was shown to negatively impact the number of water users present for at least three months following the incident. Our results indicate that the Shark Spotters program effectively reduces spatial overlap between white sharks and water users when the risk of conflict is highest.

Changing the Context Is Important and Necessary, but Not Sufficient, for Reducing Adolescent Risky Sexual Behavior: A Reply to Steinberg (2015).

PubMed

Bryan, Angela D; Gillman, Arielle S; Hansen, Natasha S

2016-07-01

Starting school later, keeping adolescents busy with structured programming, and making free condoms available, as Steinberg (2015) suggests, are important and necessary steps, but they are simply not sufficient if the goal is reducing sexually transmitted infections and unplanned pregnancy. We agree that the current state of affairs, which in many schools involves sexuality education using programs that are not empirically supported, is unacceptable. However, abandoning sexuality education entirely would leave adolescents ill equipped to protect themselves. Despite the fact that current intervention technology is neither perfect nor optimally effective, there are empirically supported, school-based sexual risk reduction interventions that teach these skills and are readily available. In addition, even though we agree that structured afternoon programs for school-aged adolescents would reduce the opportunity for sexual risk behavior during the school years, such programs would not address the demographic reality of sexual risk that continues for adolescents and emerging adults far past the end of traditional secondary education. We believe Steinberg's suggestions are an excellent start and ought to be implemented. But complementary to this approach should be the use of existing empirically supported sexual risk reduction interventions and research into the development of even more effective interventions. © The Author(s) 2016.

Motivation for Treatment Among Women Offenders in Prison-Based Treatment and Longitudinal Outcomes Among Those Who Participate in Community Aftercare

PubMed Central

Grella, Christine E.; Rodriguez, Luz

2011-01-01

Participation in aftercare may reduce risk of recidivism among women offenders with substance use problems following their release to the community. This study examines motivation to participate in aftercare among women offenders and whether their participation in both in-custody and aftercare treatment reduces their risk of recidivism. Surveys were conducted with women (N = 1,158) in prison-based substance abuse treatment programs. Return-to-prison was examined among participants in community-based aftercare (N = 1,182) over 12 months following treatment discharge. Higher treatment motivation was associated with child welfare involvement, prior treatment, and use of “harder” drugs; ethnic minority women had lower treatment motivation compared with White women. Participants who completed the aftercare program, or who had longer treatment duration, and those who had participated in an in-prison program prior to parole had reduced risk of recidivism. Study findings suggest the value of community aftercare for women offenders, particularly when combined with prior in-prison treatment. PMID:22185040

Does an on-road motorcycle coaching program reduce crashes in novice riders? A randomised control trial.

PubMed

Ivers, Rebecca Q; Sakashita, Chika; Senserrick, Teresa; Elkington, Jane; Lo, Serigne; Boufous, Soufiane; de Rome, Liz

2016-01-01

Motorcycle riding is increasing globally and confers a high risk of crash-related injury and death. There is community demand for investment in rider training programs but no high-quality evidence about its effectiveness in preventing crashes. This randomised trial of an on-road rider coaching program aimed to determine its effectiveness in reducing crashes in novice motorcycle riders. Between May 2010 and October 2012, 2399 newly-licensed provisional riders were recruited in Victoria, Australia and completed a telephone interview before randomisation to intervention or control groups. Riders in the intervention group were offered an on-road motorcycle rider coaching program which involved pre-program activities, 4h riding and facilitated discussion in small groups with a riding coach. Outcome measures were collected for all participants via telephone interviews at 3 and 12 months after program delivery (or equivalent for controls), and via linkage to police-recorded crash and offence data. The primary outcome was a composite measure of police-recorded and self-reported crashes; secondary outcomes included traffic offences, near crashes, riding exposure, and riding behaviours and motivations. Follow-up was 89% at 3 months and 88% at 12 months; 60% of the intervention group completed the program. Intention-to-treat analyses conducted in 2014 indicated no effect on crash risk at 3 months (adjusted OR 0.90, 95% CI: 0.65-1.27) or 12 months (adjusted OR 1.00, 95% CI: 0.78-1.29). Riders in the intervention group reported increased riding exposure, speeding behaviours and rider confidence. There was no evidence that this on-road motorcycle rider coaching program reduced the risk of crash, and we found an increase in crash-related risk factors. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

A systematic review of effective interventions for reducing multiple health risk behaviors in adolescence.

PubMed

Hale, Daniel R; Fitzgerald-Yau, Natasha; Viner, Russell Mark

2014-05-01

We systematically searched 9 biomedical and social science databases (1980-2012) for primary and secondary interventions that prevented or reduced 2 or more adolescent health risk behaviors (tobacco use, alcohol use, illicit drug use, risky sexual behavior, aggressive acts). We identified 44 randomized controlled trials of universal or selective interventions and were effective for multiple health risk behaviors. Most were school based, conducted in the United States, and effective for multiple forms of substance use. Effects were small, in line with findings for other universal prevention programs. In some studies, effects for more than 1 health risk behavior only emerged at long-term follow-up. Integrated prevention programs are feasible and effective and may be more efficient than discrete prevention strategies.

78 FR 37199 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... those who are to respond, including through the use of appropriate automated, electronic, mechanical, or..., strike with great destructive forces. To reduce risks to life and property from earthquakes, Congress... programs; and (3) reduce the risk to life and property through the use of approved building codes aimed at...

7 CFR 226.10 - Program payment procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... or reduced-price meals or are title XX beneficiaries. However, children who only receive at-risk afterschool snacks and/or at-risk afterschool meals must not be considered in determining this eligibility... less) that documents that at least 25 percent are eligible for free or reduced-price meals or are title...

Implementing reduced-risk integrated pest management in fresh-market cabbage: improved net returns via scouting and timing of effective control.

PubMed

Burkness, Eric C; Hutchison, W D

2008-04-01

During 1998-2001, field studies were done to assess the efficacy of an integrated pest management (IPM) program using an action threshold and "reduced-risk" insecticides. The IPM program was compared with a conventional grower-based program. Program performance was evaluated based on management of Trichoplusia ni (Hiibner), Pieris (=Artogeia) rapae (L.), and Plutella xylostella (L.), as well as the economic impact of each program on net returns. The action threshold used in the IPM program consisted of 10% plants infested with T. ni larvae, based on previous small-plot experiment station trials. In all years of the study, the IPM program resulted in significantly lower percentages of plants infested than the conventional program or untreated check. The mean reduction in insecticide applications for the IPM program compared with the conventional program was 23.5%, whereas, on average, the costs of the IPM program were 46.0% higher than the conventional program. Pest reduction in the IPM program resulted in an average of 10.5% higher marketable yields than the conventional program. Percentages of marketable heads in the IPM program ranged from 82 to 99% and from 63 to 96% in the conventional program. Mean net returns for the IPM program exceeded the conventional program by $984.20/ha. These results indicated that the IPM program reduced insecticide use overall, even though costs of the IPM program, with either spinosad or indoxacarb, were sometimes higher. Overall, net returns of the IPM program were higher due to active pest scouting, improved application timing, and increases in marketable yield. Given the potential decrease in insecticide applications and increases in net profit resulting from this IPM program, additional analyses should be conducted to quantify the economic risk, or consistency of the results, to fully evaluate the benefits of the IPM program compared with a conventional program.

Factors Influencing Running-Related Musculoskeletal Injury Risk Among U.S. Military Recruits.

PubMed

Molloy, Joseph M

2016-06-01

Running-related musculoskeletal injuries among U.S. military recruits negatively impact military readiness. Low aerobic fitness, prior injury, and weekly running distance are known risk factors. Physical fitness screening and remedial physical training (or discharging the most poorly fit recruits) before entry-level military training have tended to reduce injury rates while decreasing attrition, training, and medical costs. Incorporating anaerobic running sessions into training programs can offset decreased weekly running distance and decrease injury risk. Varying lower extremity loading patterns, stride length or cadence manipulation, and hip stability/strengthening programming may further decrease injury risk. No footstrike pattern is ideal for all runners; transitioning to forefoot striking may reduce risk for hip, knee, or tibial injuries, but increase risk for calf, Achilles, foot or ankle injuries. Minimal evidence associates running surfaces with injury risk. Footwear interventions should focus on proper fit and comfort; the evidence does not support running shoe prescription per foot type to reduce injury risk among recruits. Primary injury mitigation efforts should focus on physical fitness screening, remedial physical training (or discharge for unfit recruits), and continued inclusion of anaerobic running sessions to offset decreased weekly running distance. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Reducing the Risk of Cardiovascular Diseases in Non-selected Outpatients With Schizophrenia: A 30-Month Program Conducted in a Real-life Setting.

PubMed

Hjorth, Peter; Juel, Anette; Hansen, Mette Vinther; Madsen, Nikolaj Juul; Viuff, Anne Grethe; Munk-Jørgensen, Povl

2017-12-01

The most common cause of premature death in people with schizophrenia is cardiovascular disease, partially explained by an unhealthy lifestyle, smoking, poor diet and sedentary behavior. We aimed to reduce cardiovascular risk factors. Naturalistic follow-up study with 54 long-term-treated non-selected outpatients with schizophrenia. The 30-month program consisted of individual guidance, group sessions and normal treatment and care offered in our clinic. On average, the participating women reduced their waist circumference by 11.4cm (P=0.037), whereas the participating men increased their waist circumference by 3.3cm (P=0.590). Patients' consumption of fast food was reduced from 1.2 to 0.8 times/week (P=0.016), just as their consumption of soft drinks was reduced from 0.7 to 0.1l/day (P=0.006). Their consumption of coffee increased from 1.6 to 2.5 cups/day (P=0.086). The time women spent on light physical activity increased from 134 to 469min/week (P=0.055). The number of daily cigarettes smoked was reduced by 25.7% for all smokers. Our program showed that it is possible for women but not for men to reduce their risk factors for developing cardiovascular disease. The program is manageable in most outpatient clinics and can be performed by nursing staff interested in physical health with support from and in cooperation with medical doctors, psychiatrist and leaders/managers. Copyright © 2017 Elsevier Inc. All rights reserved.

Impact of programming strategies aimed at reducing nonessential implantable cardioverter defibrillator therapies on mortality: a systematic review and meta-analysis.

PubMed

Tan, Vern Hsen; Wilton, Stephen B; Kuriachan, Vikas; Sumner, Glen L; Exner, Derek V

2014-02-01

Patients who receive implantable cardioverter defibrillator therapies are at higher risk of death versus those who do not. Programmed settings to reduce nonessential implantable cardioverter defibrillator therapies (therapy reduction programming) have been developed but may have adverse effects. This systematic review and meta-analysis assessed the relationship between therapy reduction programming with the risks of death from any cause, implantable cardioverter defibrillator shocks, and syncope. MEDLINE, EMBASE, and clinicaltrials.gov databases were searched to identify relevant studies. Those that followed patients for ≥6 months and reported mortality were included. Six met the inclusion criteria; 4 randomized (Comparison of Empiric to Physician-Tailored Programming of ICDs [EMPIRIC], Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy [MADIT-RIT], Avoid Delivering Therapies for Non-sustained Arrhythmias in ICD Patients III [ADVANCE III], and Programming Implantable Cardioverter-Defibrillators in Patients with Primary Prevention Indication to Prolong Time to First Shock [PROVIDE]) and 2 prospective studies (Role of Long Detection Window Programming in Patients With Left Ventricular Dysfunction, Non-ischemic Etiology in Primary Prevention Treated with a Biventricular ICD [RELEVANT] and Primary Prevention Parameters Evaluation [PREPARE]). These 6 studies included 7687 (3598 conventional and 4089 therapy reduction programming) patients. Most (77%) participants were men, had a history of ischemic heart disease (56%), and were prescribed β-blockers (84%). Therapy reduction programming was associated with a 30% relative reduction in mortality (95% confidence interval, 16%-41%; P<0.001). No significant heterogeneity among studies was observed (P=0.6). A similar 26% reduction in mortality was observed when only the 4 randomized trials were included (95% confidence interval, 11%-40%; P=0.002). These results were not significantly altered after adjustment for baseline characteristics. No significant difference in the risk of syncope was observed with conventional versus therapy reduction programming (P=0.5). Therapy reduction programming results in a large, significant, and consistent reduction in mortality, with no apparent increase in the risk of syncope.

Health promotion and disease prevention: a look at demand management programs.

PubMed

Fronstin, P

1996-09-01

This Issue Brief describes employers' efforts to contain health expenditures through demand management programs. These programs are designed to reduce utilization by focusing on disease prevention and health promotion. Demand management includes work site health promotion, wellness programs, and access management. Work site health promotion is a comprehensive approach to improving health and includes awareness, health education, behavioral change, and organizational health initiatives. Wellness programs usually include stress management, smoking cessation, weight management, back care, health screenings, nutrition education, work place safety, prenatal and well baby care, CPR and first aid classes, and employee assistance programs (EAPs). These programs are often viewed positively by workers and can have long-term benefits for employers above and beyond health care cost containment. Demand management can benefit employers by increasing productivity, employee retention, and employee morale and by reducing turnover, absenteeism, future medical claims, and ultimately expenditures on health care. Even though a growing number of employers are offering wellness programs, only 37 percent of full-time workers employed in medium and large private establishments were eligible for wellness programs by 1993. However, a recent survey found that 88 percent of major employers have introduced some form of health promotion, disease prevention, or early intervention initiative to encourage healthy lifestyles among their salaried employees. Distinctions must be drawn between short- and long-term strategies. Demand management can be thought of as a short-term strategy when the focus of the program is on creating more appropriate and efficient health care utilization. Disease prevention is characterized by longer-term health improvement objectives. Whether the purpose is to reduce utilization in the short term or in the long term, the ultimate goal remains the same: to reduce health care expenditures while improving overall health. This goal can be achieved through the use of health risk appraisals, organizational health risk appraisals, high risk programs, awareness programs, medical call centers, return to work programs, EAPs, and smoking cessation programs. Studies of a health program's cost effectiveness must disentangle the effects of many competing factors on cost effectiveness. For example, a health risk appraisal program may identify health problems of which the patient and the health care provider were unaware, resulting in the treatment of these health problems. At the same time, the employer may have switched from a nonmanaged pharmaceutical program to a managed program with incentives for participants to utilize generic and/or mail order drugs. As a result, when evaluating a health promotion program, the long-run impact on the program's cost effectiveness is most important.

Cardiovascular Risk Factors and Behavioral Contracting in Exercise Programs.

ERIC Educational Resources Information Center

Neale, Anne Victoria; And Others

The use of behavioral contracting in exercise programs has been shown to be effective in increasing the frequency of exercise activity and in reducing dropout rates. A study was undertaken to examine the impact of three cardiovascular risk factors (poor physical fitness, obesity, and smoking) on both client willingness to sign a behavioral…

After-School Programs: Keeping Children Safe and Smart.

ERIC Educational Resources Information Center

Chung, An-Me

This guide provides information on the benefits of afterschool programs and the qualities of good after school programs. Afterschool programs reduce the risk of juvenile delinquency, substance use, and violent crime victimization. Children involved in quality programs decrease their chances of dropping out, earn higher grades, and develop better…

Using the Design for Demise Philosophy to Reduce Casualty Risk Due to Reentering Spacecraft

NASA Technical Reports Server (NTRS)

Kelley, R. L.

2012-01-01

Recently the reentry of a number of vehicles has garnered public attention due to their risk of human casualty due to fragments surviving reentry. In order to minimize this risk for their vehicles, a number of NASA programs have actively sought to minimize the number of components likely to survive reentry at the end of their spacecraft's life in order to meet and/or exceed NASA safety standards for controlled and uncontrolled reentering vehicles. This philosophy, referred to as "Design for Demise" or D4D, has steadily been adopted, to at least some degree, by numerous programs. The result is that many programs are requesting evaluations of components at the early stages of vehicle design, as they strive to find ways to reduce the number surviving components while ensuring that the components meet the performance requirements of their mission. This paper will discuss some of the methods that have been employed to ensure that the consequences of the vehicle s end-of-life are considered at the beginning of the design process. In addition this paper will discuss the technical challenges overcome, as well as some of the more creative solutions which have been utilized to reduce casualty risk.

Estimating risk reduction required to break even in a health promotion program.

PubMed

Ozminkowski, Ronald J; Goetzel, Ron Z; Santoro, Jan; Saenz, Betty-Jo; Eley, Christine; Gorsky, Bob

2004-01-01

To illustrate a formula to estimate the amount of risk reduction required to break even on a corporate health promotion program. A case study design was implemented. Base year (2001) health risk and medical expenditure data from the company, along with published information on the relationships between employee demographics, health risks, and medical expenditures, were used to forecast demographics, risks, and expenditures for 2002 through 2011 and estimate the required amount of risk reduction. Motorola. 52,124 domestic employees. Demographics included age, gender, race, and job type. Health risks for 2001 were measured via health risk appraisal. Risks were noted as either high or low and related to exercise/eating habits, body weight, blood pressure, blood sugar levels, cholesterol levels, depression, stress, smoking/drinking habits, and seat belt use. Medical claims for 2001 were used to calculate medical expenditures per employee. Assuming a dollar 282 per employee program cost, Motorola employees would need to reduce their lifestyle-related health risks by 1.08% to 1.42% per year to break even on health promotion programming, depending upon the discount rate. Higher or lower program investments would change the risk reduction percentages. Employers can use information from published studies, along with their own data, to estimate the amount of risk reduction required to break even on their health promotion programs.

Targeted population health management can help a hospital grow market share.

PubMed

Olson, Gary; Talbert, Pearson

2012-06-01

In 2005, St. Luke's Hospital in Chesterfield, Mo., launched the "Passport to Wellness" program to help employers reduce preventable illnesses by providing access to screenings, health education, health coaching, disease management, and healthy lifestyle programs. The program was designed to influence consumer choice of hospitals and physicians and influence health insurance purchasing decisions. St. Luke's program also met goals created by local businesses, including identifying health risks of each employer's workforce and reducing health-related costs.

Gender and racial/ethnic disparities in the impact of HIV prevention programming in substance abuse treatment.

PubMed

Cao, Dingcai; Marsh, Jeanne C; Shin, Hee-Choon

2008-01-01

The objective of the study was to evaluate the capacity of HIV prevention programs offered in substance abuse treatment to reduce HIV-related risk behavior for women and men and for Black, Latino, and White groups. Prospective data was collected at intake, discharage, and 12 months post-treatment from 1992 to 1997 for the National Treatment Improvement Evaluation Study with a sample consisting of 3,142 clients from 59 service delivery units: 972 females, 1,870 males, 1,812 Blacks, 486 Latinos, and 844 Whites. Study findings show that receipt of HIV prevention programming as part of substance abuse treatment services resulted in reductions in HIV-related risk behavior for the sample overall and for women as well as men. However, although Blacks received more prevention services than Latinos and Whites, the significant positive effect of HIV services on reduced HIVrisk behavior held only for Whites. Racial/ethnic disparities exist in the capacity for HIV prevention programming offered as part of substance abuse treatment to reduce HIV-risk behavior. The findings highlight the need for the development of culturally competent service delivery strategies to enhance the impact of these services for all groups.

Cost shared wildfire risk mitigation in Log Hill Mesa, Colorado: Survey evidence on participation and willingness to pay

Treesearch

James R. Meldrum; Patricia A. Champ; Travis Warziniack; Hannah Brenkert-Smith; Christopher M. Barth; Lilia C. Falk

2014-01-01

Wildland-urban interface (WUI) homeowners who do not mitigate the wildfire risk on their properties impose a negative externality on society. To reduce the social costs of wildfire and incentivise homeowners to take action, cost sharing programs seek to reduce the barriers that impede wildfire risk mitigation. Using survey data from a WUI community in western Colorado...

A Systematic Review of Effective Interventions for Reducing Multiple Health Risk Behaviors in Adolescence

PubMed Central

Fitzgerald-Yau, Natasha; Viner, Russell Mark

2014-01-01

We systematically searched 9 biomedical and social science databases (1980–2012) for primary and secondary interventions that prevented or reduced 2 or more adolescent health risk behaviors (tobacco use, alcohol use, illicit drug use, risky sexual behavior, aggressive acts). We identified 44 randomized controlled trials of universal or selective interventions and were effective for multiple health risk behaviors. Most were school based, conducted in the United States, and effective for multiple forms of substance use. Effects were small, in line with findings for other universal prevention programs. In some studies, effects for more than 1 health risk behavior only emerged at long-term follow-up. Integrated prevention programs are feasible and effective and may be more efficient than discrete prevention strategies. PMID:24625172

How Can Men Reduce the Risk of Getting a Sexually Transmitted Disease (STD)?

MedlinePlus

... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

Fit 5 Kids TV reduction program for Latino preschoolers: A cluster randomized controlled trial

USDA-ARS?s Scientific Manuscript database

Reducing Latino preschoolers' TV viewing is needed to reduce their risk of obesity and other chronic diseases. This study's objective was to evaluate the Fit 5 Kids (F5K) TV reduction program's impact on Latino preschooler's TV viewing. The study design was a cluster randomized controlled trial (RCT...

The use of third-party review to reduce health and environmental hazards from surfactants and cleaning products in the janitorial industry.

PubMed

Okumura, Kazuhiro

2009-05-01

The demand for environmentally preferable products is increasing in the area of Institutional and Industrial (I&I) cleaners. The GreenBlue Institute (GreenBlue) and U.S. Environmental Protection Agency's (U.S. EPA's) Design for Environment (DfE) launched two programs to review surfactant ingredients and final cleaning products, with the National Sanitation Foundation (NSF) conducting third-party reviews. The Local Hazardous Waste Management Program (LHWMP) in King County, Washington, has a strategic goal to reduce the risk of exposure of hazardous chemicals to vulnerable populations such as janitorial workers. This report summarizes the NSF partnership with GreenBlue, CleanGredients, and U.S. EPA's DfE to perform third-party reviews of cleaning product ingredients and its relevance to LHWMP's interest in reducing risks to workers in the janitorial industry. Due to information barriers, workers in the janitorial industry are at risk daily to these hazardous chemicals. The surfactant and formulator review program will make positive contributions towards the reduction of toxic chemical exposure to the employees of the janitorial industry. With proper communication and an increased use of less toxic cleaners, exposures to vulnerable populations can be reduced.

Creative Financing.

ERIC Educational Resources Information Center

Esteves, Richard M.

1984-01-01

This article analyzes cooperative programs that reduce the risks of financing energy conservation equipment. Savings guarantees, cash flow leasing, shared savings, and cooperative savings programs are described and sources of further information noted. (MJL)

Influence of environmental factors on college alcohol drinking patterns.

PubMed

Bani, Ridouan; Hameed, Rasheed; Szymanowski, Steve; Greenwood, Priscilla; Kribs-Zaleta, Christopher M; Mubayi, Anuj

2013-01-01

Alcohol abuse is a major problem, especially among students on and around college campuses. We use the mathematical framework of [16] and study the role of environmental factors on the long term dynamics of an alcohol drinking population. Sensitivity and uncertainty analyses are carried out on the relevant functions (for example, on the drinking reproduction number and the extinction time of moderate and heavy drinking because of interventions) to understand the impact of environmental interventions on the distributions of drinkers. The reproduction number helps determine whether or not the high-risk alcohol drinking behavior will spread and become persistent in the population, whereas extinction time of high-risk drinking measures the effectiveness of control programs. We found that the reproduction number is most sensitive to social interactions, while the time to extinction of high-risk drinkers is significantly sensitive to the intervention programs that reduce initiation, and the college drop-out rate. The results also suggest that in a population, higher rates of intervention programs in low-risk environments (more than intervention rates in high-risk environments) are needed to reduce heavy drinking in the population.

Reflections on Being a Department of the Army Systems Coordinator (DASC)

DTIC Science & Technology

1977-11-01

essential to successful development. Extensive reductions will adversely affect essential tasks, thereby i.ncreasing the program risk and making the program...necessary staffing and to make adjo~tmetits for problems ariiit$g at the ASARC prlimillary review. Lessa thaf 20 day, inicreajes risk if incoplete ASARC...he risks losing control of the orogram, and being reduced to a reaction officer rather than a DASC. In addition to understanding the overall

Preventing Adolescent Social Anxiety and Depression and Reducing Peer Victimization: Intervention Development and Open Trial

ERIC Educational Resources Information Center

La Greca, Annette M.; Ehrenreich-May, Jill; Mufson, Laura; Chan, Sherilynn

2016-01-01

Background: Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the…

Green Construction and Energy Training Program for At-Risk Individuals: A Case Study

ERIC Educational Resources Information Center

del Puerto, Carla Lopez; Crowson, Adrienne

2013-01-01

Training individuals who are at risk of unemployment/underemployment to increase their employability is a mission of many nonprofit agencies. These training programs, often supported by government funding, attempt to reduce these individuals' reliance on government assistance. The purpose of this study is to obtain hard data and an in-depth…

Computeen: A Randomized Trial of a Preventive Computer and Psychosocial Skills Curriculum for At-Risk Adolescents

ERIC Educational Resources Information Center

Lang, Jason M.; Waterman, Jill; Baker, Bruce L.

2009-01-01

Computeen, a preventive technology and psychosocial skills development program for at-risk adolescents, was designed to improve computer skills, self-esteem, and school attitudes, and reduce behavior problems, by combining elements of community-based and empirically supported prevention programs. Fifty-five mostly Latino adolescents from 12 to 16…

The design of a purpose-built exergame for fall prediction and prevention for older people.

PubMed

Marston, Hannah R; Woodbury, Ashley; Gschwind, Yves J; Kroll, Michael; Fink, Denis; Eichberg, Sabine; Kreiner, Karl; Ejupi, Andreas; Annegarn, Janneke; de Rosario, Helios; Wienholtz, Arno; Wieching, Rainer; Delbaere, Kim

2015-01-01

Falls in older people represent a major age-related health challenge facing our society. Novel methods for delivery of falls prevention programs are required to increase effectiveness and adherence to these programs while containing costs. The primary aim of the Information and Communications Technology-based System to Predict and Prevent Falls (iStoppFalls) project was to develop innovative home-based technologies for continuous monitoring and exercise-based prevention of falls in community-dwelling older people. The aim of this paper is to describe the components of the iStoppFalls system. The system comprised of 1) a TV, 2) a PC, 3) the Microsoft Kinect, 4) a wearable sensor and 5) an assessment and training software as the main components. The iStoppFalls system implements existing technologies to deliver a tailored home-based exercise and education program aimed at reducing fall risk in older people. A risk assessment tool was designed to identify fall risk factors. The content and progression rules of the iStoppFalls exergames were developed from evidence-based fall prevention interventions targeting muscle strength and balance in older people. The iStoppFalls fall prevention program, used in conjunction with the multifactorial fall risk assessment tool, aims to provide a comprehensive and individualised, yet novel fall risk assessment and prevention program that is feasible for widespread use to prevent falls and fall-related injuries. This work provides a new approach to engage older people in home-based exercise programs to complement or provide a potentially motivational alternative to traditional exercise to reduce the risk of falling.

The NASA Space Radiation Research Program

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.

2006-01-01

We present a comprehensive overview of the NASA Space Radiation Research Program. This program combines basic research on the mechanisms of radiobiological action relevant for improving knowledge of the risks of cancer, central nervous system and other possible degenerative tissue effects, and acute radiation syndromes from space radiation. The keystones of the NASA Program are five NASA Specialized Center's of Research (NSCOR) investigating space radiation risks. Other research is carried out through peer-reviewed individual investigations and in collaboration with the US Department of Energies Low-Dose Research Program. The Space Radiation Research Program has established the Risk Assessment Project to integrate data from the NSCOR s and other peer-reviewed research into quantitative projection models with the goals of steering research into data and scientific breakthroughs that will reduce the uncertainties in current risk projections and developing the scientific knowledge needed for future individual risk assessment approaches and biological countermeasure assessments or design. The NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory was created by the Program to simulate space radiation on the ground in support of the above research programs. New results from NSRL will be described.

What Works to Reduce Victimization? Synthesizing What We Know and Where to Go From Here.

PubMed

Fox, Kathleen A; Shjarback, John A

2016-01-01

While some attention has been paid to "what works" to reduce crime, little is known about the effectiveness of programs designed to reduce victimization. This study systematically reviews 83 program evaluations to identify what works to (a) reduce victimization, (b) enhance beliefs/attitudes about victims, and (c) improve knowledge/awareness of victimization issues. Evidence-based findings are organized around 4 major forms of victimization, including bullying, intimate partner violence, sexual abuse, and other general forms of victimization. Determining whether certain types of programs can reduce the risk of victimization has important implications for improving people's quality of life. Based on our findings, we offer several promising directions for the next generation of research on evaluating victimization programs. The goal of this study is to improve the strength of future program evaluations, replications, and other systematic reviews as researchers and practitioners continue to learn what works to reduce victimization.

Four Weeks of Nordic Hamstring Exercise Reduce Muscle Injury Risk Factors in Young Adults.

PubMed

Ribeiro-Alvares, João Breno; Marques, Vanessa B; Vaz, Marco A; Baroni, Bruno M

2018-05-01

Ribeiro-Alvares, JB, Marques, VB, Vaz, MA, and Baroni, BM. Four weeks of Nordic hamstring exercise reduce muscle injury risk factors in young adults. J Strength Cond Res 32(5): 1254-1262, 2018-The Nordic hamstring exercise (NHE) is a field-based exercise designed for knee-flexor eccentric strengthening, aimed at prevention of muscle strains. However, possible effects of NHE programs on other hamstring injury risk factors remain unclear. The purpose of this study was to investigate the effects of a NHE training program on multiple hamstring injury risk factors. Twenty physically active young adults were allocated into 2 equal-sized groups: control group (CG) and training group (TG). The TG was engaged in a 4-week NHE program, twice a week, 3 sets of 6-10 repetitions; while CG received no exercise intervention. The knee flexor and extensor strength were assessed through isokinetic dynamometry, the biceps femoris long head muscle architecture through ultrasound images, and the hamstring flexibility through sit-and-reach test. The results showed that CG subjects had no significant change in any outcome. TG presented higher percent changes than CG for hamstring isometric peak torque (9%; effect size [ES] = 0.27), eccentric peak torque (13%; ES = 0.60), eccentric work (18%; ES = 0.86), and functional hamstring-to-quadriceps torque ratio (13%; ES = 0.80). The NHE program led also to increased fascicle length (22%; ES = 2.77) and reduced pennation angle (-17%; ES = 1.27) in biceps femoris long head of the TG, without significant changes on muscle thickness. In conclusion, a short-term NHE training program (4 weeks; 8 training sessions) counteracts multiple hamstring injury risk factors in physically active young adults.

Exercise--A Preventive Prescription.

ERIC Educational Resources Information Center

Pollock, Michael L.

1979-01-01

School health and physical education programs are encouraged to increase scheduled time and incorporate regular endurance and physical fitness activities into other programs to reduce the risk factors of coronary heart disease. (JMF)

Effect of a Dissonance-Based Prevention Program on Risk for Eating Disorder Onset in the Context of Eating Disorder Risk Factors

PubMed Central

Rohde, Paul; Gau, Jeff; Shaw, Heather

2013-01-01

Test (a) whether a dissonance-based eating disorder prevention program that reduces thin-ideal internalization mitigates the effects of risk factors for eating disorder onset and (b) whether the risk factors moderate the effects of this intervention on risk for eating disorder onset, to place the effects of this intervention within the context of established risk factors. Female adolescents (N=481) with body image concerns were randomized to the dissonance-based program, healthy weight control program, expressive writing control condition, or assessment-only control condition. Denial of costs of pursuing the thin-ideal was the most potent risk factor for eating disorder onset during the 3-year follow-up (OR=5.0). The dissonance program mitigated the effect of this risk factor. For participants who did not deny costs of pursuing the thin-ideal, emotional eating and externalizing symptoms increased risk for eating disorder onset. Negative affect attenuated the effects of each of the active interventions in this trial. Results imply that this brief prevention program offsets the risk conveyed by the most potent risk factor for eating disorder onset in this sample, implicate three vulnerability pathways to eating pathology involving thin-ideal pursuit, emotional eating, and externalizing symptoms, and suggest that negative affect mitigates the effects of eating disorder prevention programs. PMID:21975593

Mindfulness programming for parents and teachers of children with ADHD.

PubMed

Miller, Carlin J; Brooker, Brianne

2017-08-01

Parents and teachers of children with attention-deficit/hyperactivity disorder (ADHD) are at-risk for a range of suboptimal psychosocial outcomes, including mental health difficulties and heightened stress, problems perhaps ameliorated through mindfulness-based programming. To show pilot data from an investigation of the outcomes of a purpose-built mindfulness training for parents and teachers of children with ADHD (N = 26). The program represents a purpose-driven modification of the Mindfulness-Based Stress Reduction (MBSR) curriculum. Namely, we reduced participant time commitment and added psychoeducation about ADHD with brief parent training. The measurement protocol included measures of stress, anxiety, depression, and mindfulness. Following the 8-week program, parents and teachers reported reduced perceived stress, reduced self-reported anxiety, and improvements in some facets of mindfulness. The work highlights the promise of specialized mindfulness-based interventions in promoting positive psychosocial outcomes in specific at-risk groups, such as the carers of children with ADHD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Successful heel pressure ulcer prevention program in a long-term care setting.

PubMed

Lyman, Vicky

2009-01-01

Heel pressure ulcers (PUs) are common in long-term healthcare settings. Early identification of risk and the use of preventive measures are central to reducing the morbidity, mortality, and high medical costs associated with heel PUs. A Quality Improvement Process was initated based on a tailored protocol, in-service education program, and a heel protective device was approved by the US Food and Drug Administration. The Braden Scale was used to evaluate PU risk in 550 patients in a long-term healthcare facility. Patients with a Braden Scale score of 18 or less and with 1 of 7 high-risk comorbidities were considered at high risk for PUs, and this prompted a more aggressive prevention program that included a protocol for reducing the risk of heel ulceration. The number of hospital-acquired heel PUs during the 6-month preintervention period was 39. Following the intervention, there were 2 occurrences, representing a 95% reduction in heel ulcers between the 2 periods. After the cost of 2 heel protectors for 550 at-risk patients was subtracted from the estimated cost of treating the 37 heel ulcers prevented, the estimated cost savings was calculated to be between $12,400 and $1,048,400.

Reducing Pesticide Drift

EPA Pesticide Factsheets

Provides information about pesticide spray drift, including problems associated with drift, managing risks from drift and the voluntary Drift Reduction Technology program that seeks to reduce spray drift through improved spray equipment design.

Risk Prediction Score for HIV Infection: Development and Internal Validation with Cross-Sectional Data from Men Who Have Sex with Men in China.

PubMed

Yin, Lu; Zhao, Yuejuan; Peratikos, Meridith Blevins; Song, Liang; Zhang, Xiangjun; Xin, Ruolei; Sun, Zheya; Xu, Yunan; Zhang, Li; Hu, Yifei; Hao, Chun; Ruan, Yuhua; Shao, Yiming; Vermund, Sten H; Qian, Han-Zhu

2018-05-21

Receptive anal intercourse, multiple partners, condomless sex, sexually transmitted infections (STIs), and drug/alcohol addiction are familiar factors that correlate with increased human immunodeficiency virus (HIV) risk among men who have sex with men (MSM). To improve estimation to HIV acquisition, we created a composite score using questions from routine survey of 3588 MSM in Beijing, China. The HIV prevalence was 13.4%. A risk scoring tool using penalized maximum likelihood multivariable logistic regression modeling was developed, deploying backward step-down variable selection to obtain a reduced-form model. The full penalized model included 19 sexual predictors, while the reduced-form model had 12 predictors. Both models calibrated well; bootstrap-corrected c-indices were 0.70 (full model) and 0.71 (reduced-form model). Non-Beijing residence, short-term living in Beijing, illegal drug use, multiple male sexual partners, receptive anal sex, inconsistent condom use, alcohol consumption before sex, and syphilis infection were the strongest predictors of HIV infection. Discriminating higher-risk MSM for targeted HIV prevention programming using a validated risk score could improve the efficiency of resource deployment for educational and risk reduction programs. A valid risk score can also identify higher risk persons into prevention and vaccine clinical trials, which would improve trial cost-efficiency.

Active fans and grizzly bears: Reducing risks for wilderness campers

NASA Astrophysics Data System (ADS)

Sakals, M. E.; Wilford, D. J.; Wellwood, D. W.; MacDougall, S. A.

2010-03-01

Active geomorphic fans experience debris flows, debris floods and/or floods (hydrogeomorphic processes) that can be hazards to humans. Grizzly bears ( Ursus arctos) can also be a hazard to humans. This paper presents the results of a cross-disciplinary study that analyzed both hydrogeomorphic and grizzly bear hazards to wilderness campers on geomorphic fans along a popular hiking trail in Kluane National Park and Reserve in southwestern Yukon Territory, Canada. Based on the results, a method is proposed to reduce the risks to campers associated with camping on fans. The method includes both landscape and site scales and is based on easily understood and readily available information regarding weather, vegetation, stream bank conditions, and bear ecology and behaviour. Educating wilderness campers and providing a method of decision-making to reduce risk supports Parks Canada's public safety program; a program based on the principle of user self-sufficiency. Reducing grizzly bear-human conflicts complements the efforts of Parks Canada to ensure a healthy grizzly bear population.

Internet based HIV prevention research targeting rural MSM: feasibility, acceptability, and preliminary efficacy

PubMed Central

Williams, M. L.; Daniel, C. M.; Clayton, S.

2008-01-01

Internet delivered primary prevention interventions for HIV risk reduction present significant challenges. Changing lifestyle behaviors, such as beginning to use condoms, is difficult and men seeking dates on line may want to avoid thinking about HIV risk which may lead to low initiation and high dropout rates. Many Internet delivered HIV risk reduction programs have mimicked face-to-face outreach programs, failing to take advantage of the Internet’s capabilities or did not conduct evaluation. This study focuses on examining the feasibility, acceptability, and efficacy of an Internet delivered HIV risk reduction program for rural men who have sex with men (MSM). The program included online recruiting, three intervention modules, each with two sessions, online questionnaires. The intervention was developed based on iterative research and the Information-Motivation-Behavioral skills model. Participants (N = 475) were randomly assigned to one of six module orders and data were collected automatically at pre-test and after each module. Data supports the feasibility and acceptability of the program as demonstrated by good retention and rapid program completion. Knowledge, self-efficacy, outcome expectancies and motivation increase in a dose response fashion. Post-intervention behavior changes included reduced anal sex and significant increases in condom use. Limitations include a short follow-up period, a predominantly young white rural sample, and the lack of an attention control. Overall the results of the study provide support for the efficacy of Internet-based interventions to reduce risk of HIV infection. Results also support traditional research methods to evaluate HIV prevention programs delivered exclusively through the Internet. PMID:18770021

Population-based screening program for reducing oral cancer mortality in 2,334,299 Taiwanese cigarette smokers and/or betel quid chewers.

PubMed

Chuang, Shu-Lin; Su, William Wang-Yu; Chen, Sam Li-Sheng; Yen, Amy Ming-Fang; Wang, Cheng-Ping; Fann, Jean Ching-Yuan; Chiu, Sherry Yueh-Hsia; Lee, Yi-Chia; Chiu, Han-Mo; Chang, Dun-Cheng; Jou, Yann-Yuh; Wu, Chien-Yuan; Chen, Hsiu-Hsi; Chen, Mu-Kuan; Chiou, Shu-Ti

2017-05-01

To reduce oral cancer mortality, an organized, population-based screening program for the early detection of oral premalignancy and oral cancer was designed for high-risk individuals with habits of betel quid chewing, cigarette smoking, or both. The objective of this report was to evaluate the long-term effectiveness of this program in reducing the incidence of advanced disease and deaths from oral cancer. A nationwide, population-based screening program for oral cancer has been conducted in Taiwan since 2004. Residents aged ≥ 18 years with oral habits of cigarette smoking and/or betel quid chewing were invited. The standardized mortality ratio method was used to compare the observed numbers of advanced oral cancers and deaths from oral cancer among screening attendees with the expected numbers derived from mortality among nonattendees. An intention-to-treat analysis of the relative rate of reductions in advanced-stage oral cancers and oral cancer mortality also was conducted. The overall screening rate was 55.1%. The relative risk of death from oral cancer was 0.53 (95% confidence interval [CI], 0.51-0.56) as a result of screening compared with the expected risk of oral cancer deaths in the absence of screening. The corresponding relative risk was 0.74 (95% CI, 0.72-0.77) after adjusting for self-selection bias. The relative risk of advanced oral cancer for the screened group versus the nonscreened group was 0.62 (95% CI, 0.59-0.64), which increased to 0.79 (95% CI, 0.76-0.82) after adjustment for self-selection bias. An organized, population-based oral cancer screening program targeting more than 2 million Taiwanese cigarette smokers and/or betel quid chewers demonstrated the effectiveness of reducing stage III or IV oral cancers and oral cancer mortality. These evidence-based findings corroborate and support the screening strategy of oral visual inspection for the prevention of oral cancer among high-risk individuals in areas with a high incidence of oral cancer. Cancer 2017;123:1597-1609. © 2017 American Cancer Society. © 2017 American Cancer Society.

Why Market the Music Program?

ERIC Educational Resources Information Center

Thoms, Paul E.

1992-01-01

Discusses the need to promote school music programs. Includes a checklist for testing a music program's promotional effectiveness. Suggests using public relations (PR) to reduce the risk of music program cuts before they occur. Recommends setting and determining the means of achieving PR goals. Identifies the benefits of effective PR. (SG)

Preventing Depression among Adolescent Girls: Pathways toward Effective and Sustainable Programs

ERIC Educational Resources Information Center

Wolfe, Vicky Veitch; Dozois, David J. A.; Fisman, Sandra; DePace, JoAnne

2008-01-01

Up to 25% of adolescent girls experience an episode of major depression, at least twice the rate found with adolescent boys. In addition to reducing the suffering associated with depression, prevention efforts with this high-risk population have the potential to avert short- and long-term functional impairment, reduce the risk of associated mental…

Patient and practitioner perspectives on reducing sedentary behavior at an exercise-based cardiac rehabilitation program.

PubMed

Biswas, Aviroop; Faulkner, Guy E; Oh, Paul I; Alter, David A

2017-06-06

To understand the awareness of sedentary behavior, as well as the perceived facilitators and barriers to reducing sedentary behaviors from the perspectives of patients undertaking an exercise-based cardiac rehabilitation program, and from staff involved in supporting patient self-management. A qualitative study was conducted at a large cardiac rehabilitation program in a metropolitan city in Canada. Guided by an ecological framework, semi-structured interviews were conducted individually with 15 patients, and in two focus groups with six staff. Transcribed interviews were analyzed by thematic analysis. Patients placed little importance on reducing sedentary behavior as they were unconvinced of the health benefits, did not perceive themselves to be sedentary, or associated such behaviors with enjoyment and relaxation. While staff were aware of the risks, they saw them as less critical than other health behaviors. Intrapersonal factors (physical and psychosocial health) and environment factors (the information environment, socio-cultural factors) within leisure time, the home, and work, influenced sedentary behavior. While these findings require further testing, future interventions may be effective if aimed at increasing awareness of the health benefits of reducing sedentary behavior, utilizing existing behavior change strategies, and using a participatory approach to tailor strategies to patients. Implications for rehabilitation Cardiac rehabilitation programs effectively use exercise promotion to improve the health of people with established cardiovascular disease. As sedentary lifestyles become more prevalent, recommendations to reduce the health risks of prolonged sedentary behavior that are specific to the characteristics and prognostic profiles of cardiac rehabilitation patients are needed. Cardiac rehabilitation programs must consider extending existing behavior change strategies utilized for exercise promotion towards addressing sedentary behaviors in order to be effective at reducing the sedentary time of patients. A participatory approach involving both patients and health professionals can support patients in reducing their sedentary behavior by providing a supportive environment for behavior change, increasing awareness and understanding of risks, discussing the feasibility of potential strategies, and setting achievable and actionable goals.

Effects of Parenting Programs on Child Maltreatment Prevention: A Meta-Analysis.

PubMed

Chen, Mengtong; Chan, Ko Ling

2016-01-01

The objective of this study is to evaluate the effectiveness of parenting programs in reducing child maltreatment and modifying associated factors as well as to examine the moderator variables that are linked to program effects. For this meta-analysis, we searched nine electronic databases to identify randomized controlled trials published before September 2013. The effect sizes of various outcomes at different time points were computed. From the 3,578 studies identified, we selected 37 studies for further analysis. The total random effect size was 0.296. Our results showed that parenting programs successfully reduced substantiated and self-reported child maltreatment reports and reduced the potential for child maltreatment. The programs also reduced risk factors and enhanced protective factors associated with child maltreatment. However, the effects of the parenting programs on reducing parental depression and stress were limited. Parenting programs produced positive effects in low-, middle-, and high-income countries and were effective in reducing child maltreatment when applied as primary, secondary, or tertiary child maltreatment intervention. In conclusion, parenting programs are effective public health approaches to reduce child maltreatment. The evidence-based service of parenting programs could be widely adopted in future practice. © The Author(s) 2015.

Emerging Answers: Research Findings on Programs To Reduce Teen Pregnancy.

ERIC Educational Resources Information Center

Kirby, Douglas

This report summarizes three bodies of research on teenage pregnancy and programs to reduce the risk of teenage pregnancy. Studies included in this report were completed in 1980 or later, conducted in the United States or Canada, targeted adolescents, employed an experimental or quasi-experimental design, had a sample size of at least 100 in the…

Patient Protection and Affordable Care Act; standards related to reinsurance, risk corridors, and risk adjustment. Final rule.

PubMed

2012-03-23

This final rule implements standards for States related to reinsurance and risk adjustment, and for health insurance issuers related to reinsurance, risk corridors, and risk adjustment consistent with title I of the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. These programs will mitigate the impact of potential adverse selection and stabilize premiums in the individual and small group markets as insurance reforms and the Affordable Insurance Exchanges ("Exchanges") are implemented, starting in 2014. The transitional State-based reinsurance program serves to reduce uncertainty by sharing risk in the individual market through making payments for high claims costs for enrollees. The temporary Federally administered risk corridors program serves to protect against uncertainty in rate setting by qualified health plans sharing risk in losses and gains with the Federal government. The permanent State-based risk adjustment program provides payments to health insurance issuers that disproportionately attract high-risk populations (such as individuals with chronic conditions).

Preschool-Based Programs for Externalizing Problems

ERIC Educational Resources Information Center

Arnold, David H.; Brown, Sharice A.; Meagher, Susan; Baker, Courtney N.; Dobbs, Jennifer; Doctoroff, Greta L.

2006-01-01

Few mental health initiatives for young children have used classroom programs. Preschool-based efforts targeting externalizing behavior could help prevent conduct disorders. Additional benefits may include improved academic achievement and reduced risk for other mental health difficulties. Pro-grams that target multiple developmental domains are…

Goddard Technology Efforts to Improve Space Borne Laser Reliability

NASA Technical Reports Server (NTRS)

Heaps, William S.

2006-01-01

In an effort to reduce the risk, perceived and actual, of employing instruments containing space borne lasers NASA initiated the Laser Risk Reduction Program (LRRP) in 2001. This program managed jointly by NASA Langley and NASA Goddard and employing lasers researchers from government, university and industrial labs is nearing the conclusion of its planned 5 year duration. This paper will describe some of the efforts and results obtained by the Goddard half of the program.

Secondary and 2-Year Outcomes of a Sexual Assault Resistance Program for University Women

PubMed Central

Eliasziw, Misha; Hobden, Karen L.; Newby-Clark, Ian R.; Barata, Paula C.; Radtke, H. Lorraine; Thurston, Wilfreda E.

2017-01-01

We report the secondary outcomes and longevity of efficacy from a randomized controlled trial that evaluated a novel sexual assault resistance program designed for first-year women university students. Participants (N = 893) were randomly assigned to receive the Enhanced Assess, Acknowledge, Act (EAAA) program or a selection of brochures (control). Perception of personal risk, self-defense self-efficacy, and rape myth acceptance was assessed at baseline; 1-week postintervention; and 6-, 12-, 18-, and 24-month postrandomization. Risk detection was assessed at 1 week, 6 months, and 12 months. Sexual assault experience and knowledge of effective resistance strategies were assessed at all follow-ups. The EAAA program produced significant increases in women’s perception of personal risk, self-defense self-efficacy, and knowledge of effective (forceful verbal and physical) resistance strategies; the program also produced decreases in general rape myth acceptance and woman blaming over the entire 24-month follow-up period. Risk detection was significantly improved for the intervention group at post-test. The program significantly reduced the risk of completed and attempted rape, attempted coercion, and nonconsensual sexual contact over the entire follow-up period, yielding reductions between 30% and 64% at 2 years. The EAAA program produces long-lasting changes in secondary outcomes and in the incidence of sexual assault experienced by women students. Universities can reduce the harm and the negative health consequences that young women experience as a result of campus sexual assault by implementing this program. Online slides for instructors who want to use this article for teaching are available on PWQ’s website at http://journals.sagepub.com/page/pwq/suppl/index. PMID:29503496

Secondary and 2-Year Outcomes of a Sexual Assault Resistance Program for University Women.

PubMed

Senn, Charlene Y; Eliasziw, Misha; Hobden, Karen L; Newby-Clark, Ian R; Barata, Paula C; Radtke, H Lorraine; Thurston, Wilfreda E

2017-06-01

We report the secondary outcomes and longevity of efficacy from a randomized controlled trial that evaluated a novel sexual assault resistance program designed for first-year women university students. Participants ( N = 893) were randomly assigned to receive the Enhanced Assess, Acknowledge, Act (EAAA) program or a selection of brochures (control). Perception of personal risk, self-defense self-efficacy, and rape myth acceptance was assessed at baseline; 1-week postintervention; and 6-, 12-, 18-, and 24-month postrandomization. Risk detection was assessed at 1 week, 6 months, and 12 months. Sexual assault experience and knowledge of effective resistance strategies were assessed at all follow-ups. The EAAA program produced significant increases in women's perception of personal risk, self-defense self-efficacy, and knowledge of effective (forceful verbal and physical) resistance strategies; the program also produced decreases in general rape myth acceptance and woman blaming over the entire 24-month follow-up period. Risk detection was significantly improved for the intervention group at post-test. The program significantly reduced the risk of completed and attempted rape, attempted coercion, and nonconsensual sexual contact over the entire follow-up period, yielding reductions between 30% and 64% at 2 years. The EAAA program produces long-lasting changes in secondary outcomes and in the incidence of sexual assault experienced by women students. Universities can reduce the harm and the negative health consequences that young women experience as a result of campus sexual assault by implementing this program. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index .

Evaluation of an Alcohol Risk Reduction Program (PRIME for Life) in Young Swedish Military Conscripts

ERIC Educational Resources Information Center

Hallgren, Mats A.; Kallmen, Hakan; Leifman, Hakan; Sjolund, Torbjorn; Andreasson, Sven

2009-01-01

Purpose: The purpose of this paper is to evaluate the effectiveness of the PRIME for Life risk reduction program in reducing alcohol consumption and improving knowledge and attitudes towards alcohol use in male Swedish military conscripts, aged 18 to 22 years. Design/methodology/approach: A quasi-experimental design was used in which 1,371…

Effectiveness of an Attachment-Focused Manualized Intervention for Parents of Teens at Risk for Aggressive Behaviour: The Connect Program

ERIC Educational Resources Information Center

Moretti, Marlene M.; Obsuth, Ingrid

2009-01-01

Aggressive, violent and antisocial behaviour in children and adolescents is a growing concern across the globe. Targeting parent-teen relationships is critical in reducing problem behaviour. "Connect" is a manualized ten-week program for parents or alternative caregivers of at-risk teens that focuses on the building blocks of secure attachment:…

Why Parents Matter!: The Conceptual Basis for a Community-Based HIV Prevention Program for the Parents of African American Youth

ERIC Educational Resources Information Center

Dittus, Patricia; Miller, Kim S.; Kotchick, Beth A.; Forehand, Rex

2004-01-01

The Parents Matter! Program (PMP) is a community-based family intervention designed to promote positive parenting and effective parent-child communication about sexuality and sexual risk reduction. Its ultimate goal is to reduce sexual risk behavior among adolescents. PMP offers parents instruction and guidance in general parenting skills related…

Public finance of rotavirus vaccination in India and Ethiopia: an extended cost-effectiveness analysis.

PubMed

Verguet, Stéphane; Murphy, Shane; Anderson, Benjamin; Johansson, Kjell Arne; Glass, Roger; Rheingans, Richard

2013-10-01

An estimated 4% of global child deaths (approximately 300,000 deaths) were attributed to rotavirus in 2010. About a third of these deaths occurred in India and Ethiopia. Public finance of rotavirus vaccination in these two countries could substantially decrease child mortality and also reduce rotavirus-related hospitalizations, prevent health-related impoverishment and bring significant cost savings to households. We use a methodology of 'extended cost-effectiveness analysis' (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. We measure program impact along four dimensions: 1) rotavirus deaths averted; 2) household expenditures averted; 3) financial risk protection afforded; 4) distributional consequences across the wealth strata of the country populations. In India and Ethiopia, the program would lead to a substantial decrease in rotavirus deaths, mainly among the poorer; it would reduce household expenditures across all income groups and it would effectively provide financial risk protection, mostly concentrated among the poorest. Potential indirect benefits of vaccination (herd immunity) would increase program benefits among all income groups, whereas potentially decreased vaccine efficacy among poorer households would reduce the equity benefits of the program. Our approach incorporates financial risk protection and distributional consequences into the systematic economic evaluation of vaccine policy, illustrated here with the case study of public finance for rotavirus vaccination. This enables selection of vaccine packages based on the quantitative inclusion of information on equity and on how much financial risk protection is being bought per dollar expenditure on vaccine policy, in addition to how much health is being bought. Copyright © 2013 Elsevier Ltd. All rights reserved.

SGLT2 inhibitors with cardiovascular benefits: Transforming clinical care in Type 2 diabetes mellitus.

PubMed

d'Emden, Michael; Amerena, John; Deed, Gary; Pollock, Carol; Cooper, Mark E

2018-02-01

Cardiovascular risk reduction in individuals with Type 2 diabetes mellitus (T2DM) is a key part of clinical management. Sodium-glucose co-transporter (SGLT2) inhibitors improve glycaemic control, reduce body weight and decrease blood pressure. In addition, the SGLT2 inhibitors empagliflozin and canagliflozin reduced the risk of composite cardiovascular events in high-risk individuals with T2DM in the EMPA-REG OUTCOME trial and the CANVAS Program, respectively. Empagliflozin also reduced cardiovascular deaths and improved renal outcomes. This class of agents should be considered in people with established cardiovascular disease, usually in combination with other glucose lowering medications, when satisfactory glycaemic control has not been achieved. The dose of insulin or sulfonylureas may need to be lowered when used with SGLT2 inhibitors, to reduce the risk of hypoglycaemia. Genitourinary infections can occur with SGLT2 inhibitors in a small proportion of people. In people with osteoporosis or prior amputation, it may be prudent to use empagliflozin rather than canagliflozin, based on the increased risk for bone fractures and amputations observed with canagliflozin in the CANVAS Program. SGLT2 inhibitors have the potential to transform the clinical care of persons with T2DM by not only improving glycaemic control but also reducing blood pressure, body weight and diabetes-related end-organ complications. Copyright © 2017 Elsevier B.V. All rights reserved.

Behavioral Health and Performance Element: Tools and Technologies

NASA Technical Reports Server (NTRS)

Leveton, Lauren B.

2009-01-01

This slide presentation reviews the research into the Behavioral Health and Performance (BHP) of the Human Research Program. The program element goal is to identify, characterize and prevent or reduce behavioral health and performance risks associated with space travel, exploration, and return to terrestrial life. To accomplish this goal the program focuses on applied research that is designed to yield deliverables that reduce risk. There are several different elements that are of particular interest: Behavioral Medicine, Sleep, and team composition, and team work. In order to assure success for NASA missions the Human Research Program develops and validate the standards for each of the areas of interest. There is discussion of the impact on BHP while astronauts are on Long Duration Missions. The effort in this research is to create tools to meet the BHP concerns, these prospective tools are reviewed.

A job safety program for construction workers designed to reduce the potential for occupational injury using tool box training sessions and computer-assisted biofeedback stress management techniques.

PubMed

Johnson, Kenneth A; Ruppe, Joan

2002-01-01

This project was conducted with a multicultural construction company in Hawaii, USA. The job duties performed included drywall and carpentry work. The following objectives were selected for this project: (a) fire prevention training and inspection of first aid equipment; (b) blood-borne pathogen training and risk evaluation; (c) ergonomic and risk evaluation intervention program; (d) electrical safety training and inspection program; (e) slips, trips, and falls safety training; (f) stress assessment and Personal Profile System; (g) safety and health program survey; (h) improving employee relations and morale by emphasizing spirituality; and (i) computer-assisted biofeedback stress management training. Results of the project indicated that observed safety hazards, reported injuries, and levels of perceived stress. were reduced for the majority of the population.

25 CFR 103.2 - Who does the Program help?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Who does the Program help? 103.2 Section 103.2 Indians... INTEREST SUBSIDY General Provisions § 103.2 Who does the Program help? The purpose of the Program is to... direct function of the Program is to help lenders reduce excessive risks on loans they make. That...

25 CFR 103.2 - Who does the Program help?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Who does the Program help? 103.2 Section 103.2 Indians... INTEREST SUBSIDY General Provisions § 103.2 Who does the Program help? The purpose of the Program is to... direct function of the Program is to help lenders reduce excessive risks on loans they make. That...

Developing a Gap Taxonomy to Address Crew Health Risks in NASA's Human Research Program

NASA Technical Reports Server (NTRS)

Kundrot, Craig E.; Edwards, J. Michelle

2009-01-01

The mission of NASA's Human Research Program (HRP) is to understand and reduce the risk to crew health and performance in exploration missions. The HRP addresses 27 specific risks by identifying and then filling gaps in understanding the risks and in the ability to disposition the risks. The primary bases for identifying gaps have been past experience and requirements definition. This approach has been very effective in identifying some important, relevant gaps, but may be inadequate for identifying gaps outside the past experience base. We are exploring the use of a gap taxonomy as a comprehensive, underlying conceptual framework that allows a more systematic identification of gaps. The taxonomy is based on these stages in medical care: prediction, prevention, detection/diagnosis, treatment, monitoring, rehabilitation, and lifetime surveillance. This gap taxonomy approach identifies new gaps in HRP health risks. Many of the new gaps suggest risk reduction approaches that are more cost effective than present approaches. A major benefit of the gap taxonomy approach is to identify new, economical approaches that reduce the likelihood and/or consequence of a risk.

[Impact of interventions in the pressure ulcer rate].

PubMed

Araya Farías, I; Febré, N

To evaluate the impact of a risk management program for prevention of pressure ulcers (PUs) in an adult Intensive Care Unit (ICU). A quantitative, prospective study performed with a «before and after» evaluation, and designed in three stages: 1) PU incidence study; 2) Intervention by implementing a risk management program, and 3) Assessment of the impact. Adherence to the preventive measures showed a significant increase (11.7%) between the first month of the program and the final month (58.5%) of the assessment. Initial PU rate was 20.9, with a decrease in the rate to 14.0 per 1000 bed occupancy days (P<.05) after the risk management program. The data show that the risk management program, using prevention measures, was effective in reducing the rate of PU in the period under study by more than 33%. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Overcoming the Challenges in Implementing Type 2 Diabetes Mellitus Prevention Programs Can Decrease the Burden on Healthcare Costs in the United States.

PubMed

Subramanian, Kritika; Midha, Inuka; Chellapilla, Vijaya

2017-01-01

Theoretically, identifying prediabetics would reduce the diabetic burden on the American healthcare system. As we expect the prevalence rate of prediabetes to continue increasing, we wonder if there is a better way of managing prediabetics and reducing the economic cost on the healthcare system. To do so, understanding the demographics and behavioral factors of known prediabetics was important. For this purpose, responses of prediabetic/borderline diabetes patients from the most recent publicly available 2015 Behavioral Risk Factor Surveillance System (BRFSS) survey were analyzed. The findings showed that there was a correlation between household income, geographic residence in the US, and risk for developing diabetes mellitus type 2, aside from the accepted risk factors such as high BMI. In conclusion, implementation of the National Diabetes Prevention Program is a rational way of reducing the burden of DM on the healthcare system both economically and by prevalence. However, difficulties arise in ensuring patient compliance to the program and providing access to all regions and communities of the United States. Technology incorporation in the NDPP program would maintain a low-cost implementation by the healthcare system, be affordable and accessible for all participants, and decrease economic burden attributed to diabetes mellitus.

Exploring the potential of a conditional cash transfer intervention to reduce HIV risk among young women in Iringa, Tanzania.

PubMed

Kennedy, Caitlin E; Brahmbhatt, Heena; Likindikoki, Samuel; Beckham, Sarah W; Mbwambo, Jessie K; Kerrigan, Deanna

2014-01-01

Cash transfer programs seek to alter structural determinants of HIV risk such as poverty and gender inequality. We sought to explore the feasibility and potential effectiveness of a cash transfer intervention for young women as part of combination HIV prevention in Iringa, Tanzania. Qualitative, in-depth interviews were conducted with 116 stakeholders and residents from the region, including key informants, service delivery users, and members of key populations. Most respondents felt a cash transfer program would assist young women in Iringa to have more control over sexual decision-making and reduce poverty-driven transactional sex. Respondents were divided on who should receive funds: young women themselves, their parents/guardians, or community leaders. Cash amounts and suggested target groups varied, and several respondents suggested providing microcredit or small business capital instead of cash. Potential concerns included jealousy, dependency, and corruption. However, most respondents felt that some intervention was needed to address underlying poverty driving some sexual risk behavior. A cash transfer program could fill this role, ultimately reducing HIV, sexually transmitted infections, and unintended pregnancies. As increased attention is given to economic and structural interventions for HIV prevention, local input and knowledge should be considered in a program design.

Perceived benefits and challenges of coordinated approaches to chronic disease prevention in state health departments.

PubMed

Allen, Peg; Sequeira, Sonia; Best, Leslie; Jones, Ellen; Baker, Elizabeth A; Brownson, Ross C

2014-05-08

Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding. A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ(2) tests, and analysis of variance were conducted. The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges "lack of communication across programs" (P = .02) and "funding might be reduced" differed by program area (P < .001). Findings can be used by funding agencies and state health departments for planning, training, and technical assistance. The information on perceived challenges demonstrates the need to improve communication across programs, enhance organizational support for coordinated approaches, and create benefits for organizational partners.

Evaluation of certification in the Milk and Dairy Beef Quality Assurance Program and associated factors on the risk of having violative antibiotic residues in milk from dairy farms in Michigan.

PubMed

Gibbons-Burgener, S N; Kaneene, J B; Lloyd, J W; Erskine, R J

1999-10-01

To determine whether certification in a Milk and Dairy Beef Quality Assurance Program (MDBQAP) was associated with a reduced risk of having antibiotic residues in milk and to define specific management factors that may have predisposed dairy farms to having violative antibiotic residues in milk. 124 dairy farms in Michigan that had > 1 violative residue in milk during 1993 and 248 randomly selected control farms in Michigan that did not have violative residues in milk during 1993. A pretested structured questionnaire was mailed to case and control farms. A conditional multivariate logistic regression model was developed to determine risk factors associated with having a violative antibiotic residue in milk. Certification in the MDBQAP did not significantly reduce the risk of having a violative antibiotic residue. Annual treatment of > 10% of a herd for metritis was associated with a reduced risk of having a violative residue. Evidence suggested that a routine request for a milk processor to perform residue testing was associated with a decreased risk of having had a violative antibiotic residue, but routine on-farm residue testing was associated with an increased risk of having had a residue. MDBQAP certification was associated, although not significantly, with a reduced risk of having violative antibiotic residues in milk. Risk factors significantly associated with violative antibiotic residues are addressed by various critical control points in the MDBQAP and may be indicators for strengths and weaknesses of MDBQAP.

Very high rate programming in primary prevention patients with reduced ejection fraction implanted with a defibrillator: Results from a large multicenter controlled study.

PubMed

Clementy, Nicolas; Challal, Farid; Marijon, Eloi; Boveda, Serge; Defaye, Pascal; Leclercq, Christophe; Deharo, Jean-Claude; Sadoul, Nicolas; Klug, Didier; Piot, Olivier; Gras, Daniel; Bordachar, Pierre; Algalarrondo, Vincent; Fauchier, Laurent; Babuty, Dominique

2017-02-01

Programming implantable cardioverter-defibrillators (ICDs) with a high-rate therapy strategy has proven to be effective in reducing shocks and is associated with a reduced mortality. We sought to determine the impact of a very high rate cutoff programming strategy on outcomes in patients with a primary indication for an ICD due to reduced left ventricular ejection fraction. Using data from the multicenter French DAI-PP registry, this cohort-controlled study compared outcomes in 500 patients programmed with a very high rate cutoff (VH-RATE group: monitor zone 170-219 beats/min; ventricular fibrillation zone ≥220 beats/min with 13 ± 4 detection intervals) with 1500 matched control patients programmed with 1 or 2 therapy zone. All ICDs were implanted for primary prevention in patients with systolic dysfunction. Risks of events were compared after propensity score matching of sex, age, ejection fraction, New York Heart Association class, cardiomyopathy, atrial fibrillation, and type of device. After a mean follow-up of 3.6 ± 2.3 years, VH-RATE programming was associated with a reduction of appropriate therapy risk (hazard ratio [HR] 0.40; 95% confidence interval [CI] 0.31-0.51; P < .0001) and inappropriate shock (HR 0.42; 95% CI 0.27-0.63; P < .0001). It was also associated with a decreased risk of sudden cardiac death (HR 0.43; 95% CI 0.17-0.99; P = .04) as compared with patients programmed with 2 therapy zones. There was no significant difference in overall survival between the groups. In patients implanted with an ICD in primary prevention with left ventricular dysfunction, very high rate cutoff programming (single therapy zone ≥220 beats/min) was associated with a 60% reduction of appropriate therapies as well as inappropriate shocks, without affecting mortality. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Risk-reducing surgery on the uterine adnexa: timing and type of surgical treatment, and pathology report.

PubMed

Signorelli, Mauro; Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Chiappa, Valentina; Lopez, Carlos; Scaffa, Cono; Lorusso, Domenica; Raspagliesi, Francesco

2016-10-01

Inherited mutations in BRCA1 and BRCA2 increase significantly the risk of developing breast and ovarian cancers, and they have been associated with increased risks of developing other types of cancer. Although screening programs have been implemented in order to detect cancers at the early stage, they resulted ineffective. To date, risk-reducing bilateral salpingo-oophorectomy represents the only procedure allowing reducing the incidence of ovarian cancer and increasing survival among BRCA1 and -2 mutation carriers. In the present review we will discuss the advantages and disadvantages related to the execution of prophylactic surgery, thus underlying possible beneficial and detrimental effects of this kind of surgery in premenopausal women. Additionally, we will investigate further therapeutic strategies aimed to reduce the risk of developing ovarian cancer, without affected patients' hormonal status.

Better Building Blocks

Treesearch

Cheryl R. Renner; Terry K. Haines; Margaret A. Reams

2010-01-01

As researchers for the National Database of State and Local Wildfire Mitigation Programs, we began cataloging programs to reduce wildfire risk on private land in 2001. Over the years, more than 250 programs in 35 states were described at www.wildfireprograms.usda.gov, and we wondered about their relative success. Was there one type of program that wildfire managers...

The Integration and Test Program of the James Webb Space Telescope

NASA Technical Reports Server (NTRS)

Kimble, Randy

2012-01-01

The James Webb Space Telescope (JWST) project has entered into a comprehensive integration and test (I&T) program that over the coming years will assemble the various elements of the observatory (the Optical Telescope Element [OTE], the Integrated Science Instrument Module [ISIM], and the Spacecraft) and verify the readiness of the integrated system for launch. The I&T program as replanned for a 2018 launch readiness date has a number of interesting features. These include a streamlined ISIM cryo-vacuum test program at Goddard Space Flight Center, a streamlined OTIS (OTE + ISIM) test program at Johnson Space Center (JSC), the addition of a second Core cryo-vacuum thermal test, the enhancement of the Pathfinder program at JSC, and enhancement of the subsystem-level testing program for the MIRI cryo-cooler. These latter activities all serve to reduce the risk heading into the end-to-end optical and thermal testing of the telescope at JSC, leading to reduced cost and schedule risk for that critical activity. We report here on the overall I&T program for JWST and on the status of the hardware and plans that support it.

The Effect of a Coronary Artery Risk Evaluation Program on the Serum Lipid Values of a Selected Military Population

DTIC Science & Technology

1991-05-01

interventions reduced low density lipoproteins and serum cholesterol levels. The goals of risk factor reduction are disease prevention , delay of disease... preventing CAD (Lipid Research Clinics Program, 1984). A 1% reduction in cholesterol was associated with a 2 % reduction in risk (NIH, 1984). This includes...heart attack before age 65? Yes No 2 . Do you have Diabetes Mellitus ? Yes No 3. Do you have uncontrolled hypertension? (Blood Pressure consistently

Pesticide Environmental Stewardship Program (PESP)

EPA Pesticide Factsheets

PESP is an EPA partnership program that works with the nation's pesticide-user community to promote IPM practices. Pesticide users can reduce the risks from pests and pesticides. Members include organizations and companies in the pesticide-user community.

Reducing Alcohol Use in First-Year University Students: Evaluation of a Web-Based Personalized Feedback Program

ERIC Educational Resources Information Center

Doumas, Diana M.; Andersen, Lorna L.

2009-01-01

The efficacy of a Web-based personalized feedback program--electronic CHECKUP TO GO (e-CHUG), aimed at reducing heavy drinking in 1st-year university students--is evaluated. Results indicated that high-risk students in the e-CHUG group reported significantly greater reductions in weekly drinking quantity, frequency of drinking to intoxication, and…

Managing manifest diseases, but not health risks, saved PepsiCo money over seven years.

PubMed

Caloyeras, John P; Liu, Hangsheng; Exum, Ellen; Broderick, Megan; Mattke, Soeren

2014-01-01

Workplace wellness programs are increasingly popular. Employers expect them to improve employee health and well-being, lower medical costs, increase productivity, and reduce absenteeism. To test whether such expectations are warranted, we evaluated the cost impact of the lifestyle and disease management components of PepsiCo's wellness program, Healthy Living. We found that seven years of continuous participation in one or both components was associated with an average reduction of $30 in health care cost per member per month. When we looked at each component individually, we found that the disease management component was associated with lower costs and that the lifestyle management component was not. We estimate disease management to reduce health care costs by $136 per member per month, driven by a 29 percent reduction in hospital admissions. Workplace wellness programs may reduce health risks, delay or avoid the onset of chronic diseases, and lower health care costs for employees with manifest chronic disease. But employers and policy makers should not take for granted that the lifestyle management component of such programs can reduce health care costs or even lead to net savings.

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Corporate and program objectives focus on desired performance and results. ?Management decisions that affect how to meet these objectives now involve a complex mix of: technology, safety issues, operations, process considerations, employee considerations, regulatory requirements, financial concerns and legal issues. ?Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures. Using a risk assessment methodology is only a starting point. ?A risk assessment program provides management with important input in the decision making process. ?A pro-active organization looks to the future to avoid problems, a reactive organization can be blindsided by risks that could have been avoided. ?You get out what you put in, how useful your program is will be up to the individual organization.

Implementing Filters to Identify and Prioritize Industrial Base Risk: Rules of Thumb to Reduce Cognitive Overload

DTIC Science & Technology

2015-04-30

Thumb to Reduce Cognitive Overload Sally Sleeper, ODASD[M&IBP] John F. Starns, Northrop Grumman Published April 30, 2015 Disclaimer: The views...Prioritize Industrial Base Risk: Rules of Thumb to Reduce Cognitive Overload 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6... Cognitive Overload Sally Sleeper—joined the Office of the Deputy Assistant Secretary of Defense for Manufacturing and Industrial Base Policy as Senior

Enhancing Supportive-Educative Nursing Systems to Reduce Risk of Post-Breast Cancer Lymphedema.

PubMed

Armer, Jane M; Shook, Robin P; Schneider, Melanie K; Brooks, Constance W; Peterson, Julie; Stewart, Bob R

2009-10-01

This study describes the use of data regarding self-care agency to enhance a supportive-educative nursing system for breast cancer survivors to reduce the risk of developing lymphedema post surgery. Impetus for this study came from the analysis of participant feedback from a parent study (Lance Armstrong Foundation pilot study) that sought to plan an educational program for nurses that will improve their supportive-educative nursing system when working with breast cancer survivors. The goal is to enable these women to reduce the risk of lymphedema post surgery. The parent study examined a bundled behavioral-educative intervention, which included standard lymphedema education coupled with Modified Manual Lymph Drainage (MMLD) to reduce the risk of developing lymphedema in newly-diagnosed breast cancer survivors. Based upon the feedback received from the parent study, the research team recognized that many of the participants were not fully following the recommendations of the intervention protocol. In order for nurses to help patients develop self-care agency (SCA) (Orem, 2001) to engage in actions that addressed the self-care requisites associated with post-breast cancer surgery, these nurses needed to refine their intervention skills. Prior to the development of a program for the nurses, the research team conducted a study to explore the state of power related to SCA of the study participants. The information obtained from this was then used in the development of an educational program for bundled intervention. Both motivational interviewing (Miller & Rollnick, 2002) and solution-focused therapy (Berg & DeJong, 1996) were incorporated into the educational program for the research nurse team to strengthen and improve supportive-educative nursing systems. Supportive-educative systems of care that integrate self-care deficit nursing theory, motivational interviewing, and solution-focused therapy can assist patients to develop and sustain self-care agency.

Butterfly Girls; promoting healthy diet and physical activity to young African American girls online: rationale and design.

PubMed

Thompson, Debbe; Mahabir, Rory; Bhatt, Riddhi; Boutte, Cynthia; Cantu, Dora; Vazquez, Isabel; Callender, Chishinga; Cullen, Karen; Baranowski, Tom; Liu, Yan; Walker, Celeste; Buday, Richard

2013-08-02

Young African American girls have a high risk of obesity. Online behavior change programs promoting healthy diet and physical activity are convenient and may be effective for reducing disparities related to obesity. This report presents the protocol guiding the design and evaluation of a culturally and developmental appropriate online obesity prevention program for young African American girls. The Butterfly Girls and the Quest for Founder's Rock is an 8-episode online program delivered as an animated, interactive comic. The program promotes healthy diet and physical activity and is specifically designed for 8-10 year old African American girls. Girls, parents, and community representatives provided formative feedback on cultural relevance and developmental appropriateness. A three-group (treatment, comparison, wait-list control) randomized design (n=390 parent/child dyads) is employed, with child as the unit of assignment. Change in body mass index is the primary outcome; change in fruit and vegetable consumption, water, and physical activity are secondary outcomes. Data collection occurs at baseline, approximately 3 months after baseline (i.e., completion of the online program), and approximately three months later (i.e., maintenance assessment). Two dietary recalls are collected at each data collection period by trained interviewers using the Nutrient Data System for Research (NDSR 2012) system. Physical activity is objectively measured by seven days of accelerometry. Psychosocial and process data are also collected. Girls in the treatment and comparison groups will be interviewed at post 1 to obtain information on personal reactions to the program. This research will develop and evaluate the efficacy of an online program for reducing obesity risk among girls at risk of obesity and related diseases. Online programs offer the potential for wide dissemination, thus reducing disparities related to obesity. NCT01481948.

Development and Implementation of an AIDS Prevention Program for African-American Women at a Child Care Center.

ERIC Educational Resources Information Center

Moten-Tolson, Paula

This program was designed to provide Acquired Immune Deficiency Syndrome (AIDS) prevention education for African-American women of child bearing age at a child care center which serves low income high risk families. The primary goal was to reduce the risk of African-American women at the child care center for contracting the Human Immunodeficiency…

Apollo experience report: Safety activities

NASA Technical Reports Server (NTRS)

Rice, C. N.

1975-01-01

A description is given of the flight safety experiences gained during the Apollo Program and safety, from the viewpoint of program management, engineering, mission planning, and ground test operations was discussed. Emphasis is placed on the methods used to identify the risks involved in flight and in certain ground test operations. In addition, there are discussions on the management and engineering activities used to eliminate or reduce these risks.

Outdoor Wilderness Program: A Campus Makes a Commitment to the Individual.

ERIC Educational Resources Information Center

Grimm, Gary; Neal, Larry

1980-01-01

A resource room containing information about outdoor programs generates individual and cooperative learning activities and outdoor experiences. Although adventure participants are responsible for decisions and risks undertaken, the program should attempt to enhance experiences by reducing difficulties brought on by outsiders, institutions, and red…

Evaluation Project of a Postvention Program.

ERIC Educational Resources Information Center

Simon, Robert; And Others

A student suicide or parasuicide increases the risk that potentially suicidal teenagers see suicide as an enviable option. The "copycat effect" can be reduced by a postvention program. This proposed evaluative research project will provide an implementation and impact evaluation of a school's postvention program following a suicide or…

Behavioral and psychosocial effects of two middle school sexual health education programs at tenth-grade follow-up.

PubMed

Markham, Christine M; Peskin, Melissa F; Shegog, Ross; Baumler, Elizabeth R; Addy, Robert C; Thiel, Melanie; Escobar-Chaves, Soledad Liliana; Robin, Leah; Tortolero, Susan R

2014-02-01

An earlier randomized controlled trial found that two middle school sexual education programs-a risk avoidance (RA) program and a risk reduction (RR) program-delayed initiation of sexual intercourse (oral, vaginal, or anal sex) and reduced other sexual risk behaviors in ninth grade. We examined whether these effects extended into 10th grade. Fifteen middle schools were randomly assigned to RA, RR, or control conditions. Follow-up surveys were conducted with participating students in 10th grade (n = 1,187; 29.2% attrition). Participants were 60% female, 50% Hispanic, and 39% black; seventh grade mean age was 12.6 years. In 10th grade, compared with the control condition, both programs significantly delayed anal sex initiation in the total sample (RA: adjusted odds ratio [AOR], .64, 95% confidence interval [CI], .42-.99; RR: AOR, .65, 95% CI, .50-.84) and among Hispanics (RA: AOR, .53, 95% CI, .31-.91; RR: AOR, .82, 95% CI, .74-.93). Risk avoidance students were less likely to report unprotected vaginal sex, either by using a condom or by abstaining from sex (AOR: .61, 95% CI, .45-.85); RR students were less likely to report recent unprotected anal sex (AOR: .34, 95% CI, .20-.56). Both programs sustained positive impact on some psychosocial outcomes. Although both programs delayed anal sex initiation into 10th grade, effects on the delayed initiation of oral and vaginal sex were not sustained. Additional high school sexual education may help to further delay sexual initiation and reduce other sexual risk behaviors in later high school years. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Diet-induced changes in maternal gut microbiota and metabolomic profiles influence programming of offspring obesity risk in rats.

PubMed

Paul, Heather A; Bomhof, Marc R; Vogel, Hans J; Reimer, Raylene A

2016-02-12

Maternal obesity and overnutrition during pregnancy and lactation can program an increased risk of obesity in offspring. In this context, improving maternal metabolism may help reduce the intergenerational transmission of obesity. Here we show that, in Sprague-Dawley rats, selectively altering obese maternal gut microbial composition with prebiotic treatment reduces maternal energy intake, decreases gestational weight gain, and prevents increased adiposity in dams and their offspring. Maternal serum metabolomics analysis, along with satiety hormone and gut microbiota analysis, identified maternal metabolic signatures that could be implicated in programming offspring obesity risk and highlighted the potential influence of maternal gut microbiota on maternal and offspring metabolism. In particular, the metabolomic signature of insulin resistance in obese rats normalized when dams consumed the prebiotic. In summary, prebiotic intake during pregnancy and lactation improves maternal metabolism in diet-induced obese rats in a manner that attenuates the detrimental nutritional programming of offspring associated with maternal obesity. Overall, these findings contribute to our understanding of the maternal mechanisms influencing the developmental programming of offspring obesity and provide compelling pre-clinical evidence for a potential strategy to improve maternal and offspring metabolic outcomes in human pregnancy.

Diet-induced changes in maternal gut microbiota and metabolomic profiles influence programming of offspring obesity risk in rats

PubMed Central

Paul, Heather A.; Bomhof, Marc R.; Vogel, Hans J.; Reimer, Raylene A.

2016-01-01

Maternal obesity and overnutrition during pregnancy and lactation can program an increased risk of obesity in offspring. In this context, improving maternal metabolism may help reduce the intergenerational transmission of obesity. Here we show that, in Sprague-Dawley rats, selectively altering obese maternal gut microbial composition with prebiotic treatment reduces maternal energy intake, decreases gestational weight gain, and prevents increased adiposity in dams and their offspring. Maternal serum metabolomics analysis, along with satiety hormone and gut microbiota analysis, identified maternal metabolic signatures that could be implicated in programming offspring obesity risk and highlighted the potential influence of maternal gut microbiota on maternal and offspring metabolism. In particular, the metabolomic signature of insulin resistance in obese rats normalized when dams consumed the prebiotic. In summary, prebiotic intake during pregnancy and lactation improves maternal metabolism in diet-induced obese rats in a manner that attenuates the detrimental nutritional programming of offspring associated with maternal obesity. Overall, these findings contribute to our understanding of the maternal mechanisms influencing the developmental programming of offspring obesity and provide compelling pre-clinical evidence for a potential strategy to improve maternal and offspring metabolic outcomes in human pregnancy. PMID:26868870

Surveillance Recommendations in Reducing Risk of and Optimally Managing Breast Cancer-Related Lymphedema

PubMed Central

Ostby, Pamela L.; Armer, Jane M.; Dale, Paul S.; Van Loo, Margaret J.; Wilbanks, Cassie L.; Stewart, Bob R.

2014-01-01

Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE). A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance. PMID:25563360

Functional Fitness Training: Is it Right for You?

MedlinePlus

... risk of injury and improve your quality of life. Functional exercise training may be especially beneficial as part of a comprehensive program for older adults to improve balance, agility and muscle strength, and reduce the risk ...

PACE and the Medicare+Choice risk-adjusted payment model.

PubMed

Temkin-Greener, H; Meiners, M R; Gruenberg, L

2001-01-01

This paper investigates the impact of the Medicare principal inpatient diagnostic cost group (PIP-DCG) payment model on the Program of All-Inclusive Care for the Elderly (PACE). Currently, more than 6,000 Medicare beneficiaries who are nursing home certifiable receive care from PACE, a program poised for expansion under the Balanced Budget Act of 1997. Overall, our analysis suggests that the application of the PIP-DCG model to the PACE program would reduce Medicare payments to PACE, on average, by 38%. The PIP-DCG payment model bases its risk adjustment on inpatient diagnoses and does not capture adequately the risk of caring for a population with functional impairments.

The Early Impact Program: An Early Intervention and Prevention Program for Children and Families At-Risk of Conduct Problems

ERIC Educational Resources Information Center

Larmar, Stephen; Gatfield, Terry

2007-01-01

The Early Impact (EI) program is an early intervention and prevention program for reducing the incidence of conduct problems in pre-school aged children. The EI intervention framework is ecological in design and includes universal and indicated components. This paper delineates key principles and associated strategies that underpin the EI program.…

Assessment of risks for high-speed rail grade crossings on the Empire Corridor : next generation high-speed rail program

DOT National Transportation Integrated Search

2000-08-01

The report describes a risk-based approach for assessing the implications of higher train speeds on highway-railroad grade crossing safety, and allocating limited resources to best reduce this risk. To predict accident frequency, an existing DOT mode...

major_program | Division of Cancer Prevention

Cancer.gov

The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

77 FR 76044 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

... delivery of services for women who have limited access to health care and elevated risk factors for cardiovascular disease (CVD). The program focuses on reducing CVD risk factors and provides screening services for select risk factors such as elevated blood cholesterol, hypertension and abnormal blood glucose...

Achieving a high seat belt use rate : a guide for selective traffic enforcement programs

DOT National Transportation Integrated Search

2001-04-01

When used properly, lap/shoulder belts reduce the risk of fatal injury to front-seat passenger car occupants by 45% and the risk of moderate-to-critical injury by 50%. Even greater risk reduction results when seat belts are used properly in light tru...

Behavioral Health and Performance (BHP) Work-Rest Cycles

NASA Technical Reports Server (NTRS)

Leveton, Lauren B.; Whitmire, Alexandra

2011-01-01

BHP Program Element Goal: Identify, characterize, and prevent or reduce behavioral health and performance risks associated with space travel, exploration and return to terrestrial life. BHP Requirements: a) Characterize and assess risks (e.g., likelihood and consequences). b) Develop tools and technologies to prevent, monitor, and treat adverse outcomes. c) Inform standards. d) Develop technologies to: 1) reduce risks and human systems resource requirements (e.g., crew time, mass, volume, power) and 2) ensure effective human-system integration across exploration mission.

Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part I—Efficacy

PubMed Central

Rothstein, Mark A.; Harrell, Heather L.

2011-01-01

Objective We sought to determine whether workplace health risk reduction programs (HRRPs) using health risk assessments (HRAs), individually focused risk reduction, and financial incentives succeeded in improving employee health and reducing employer health benefit costs. Methods We reviewed the proprietary HRA available to us and conducted a literature review to determine the efficacy of HRRPs using HRAs, individualized employee interventions, and financial incentives for employee participation. Results There is some evidence that HRRPs in employer-sponsored programs improve measures of employee health, but the results of these studies are somewhat equivocal. Conclusion Employer-sponsored HRRPs may have some benefits, but problems in plan design and in the studies assessing their efficacy complicate drawing conclusions. PMID:19625972

Driving habits and risk exposure in older drivers: lessons learned from the implementation of a self-regulation curriculum.

PubMed

Jones, Vanya C; Cho, Juhee; Abendschoen-Milani, Jackie; Gielen, Andrea

2011-10-01

This article describes the development and pilot testing of Seniors on the MOVE (Mature Operators Vehicular Education), a safe driving education program for older adults. The study aims are to describe driving experiences and habits of a community sample of older drivers and to determine whether the program reduces their driving risk exposures. A 2-group randomized design was used. Fifty-eight participants with an average age of 70 were randomly assigned to the MOVE program or a no treatment control group. MOVE is a 4-session program designed to help older drivers better understand and utilize self-regulation skills for safer driving. Baseline and 4-week follow-up questionnaires were completed by both groups, after which the control group received the MOVE program. In the total sample, 14 percent reported having ever been in a traffic crash where someone was injured, and 10 percent reported having received a traffic citation in the past 6 months. Almost one half of the sample (47%) reported thinking about reducing the amount of driving done at night. Nearly one third were thinking about reducing the amount of driving done in unfamiliar places (32%) and the number of miles driven each week (30%). Participants reported most frequently driving between 2 to 10 miles from home, on local roadways, and between 9:00 am and 4:00 pm. Based on responses to items that measured such driving habits, a risk exposure score was created by combining driving exposure variables. Participants were categorized into lower and higher driving risk exposure groups at baseline and follow-up. There were no statistical differences in changes in higher or lower risk driving exposure variables when comparing the 2 groups. Although the impact of this program on reported driving behaviors yielded null results, descriptions of older drivers' habits and plans are informative. Because many participants were thinking about making changes to their driving habits, and many already had, the need for more effective self-regulation driving safety programs to help with this process is clear.

Adolescent Perpetrator Treatment Programs: Program Models.

ERIC Educational Resources Information Center

Abbey, Joan M.

It has become increasingly evident that juveniles are the perpetrators of a substantial nunber of sexual assaults. Programs designed to treat these adolescent perpetrators usually have similar goals. They attempt to reduce the youth's risk of recidivism by helping him to recognize his problem, take responsibility for his actions, learn how to…

Required Academic Proficiency (RAP) Program: Final Report.

ERIC Educational Resources Information Center

Ronacher, Karl; And Others

The Required Academic Proficiency (RAP) program was established by the Houston (Texas) Independent School District to reduce and remediate the academic failure of students. The purpose of the RAP program was twofold: (1) to provide supplemental instruction to students identified as being at risk of failing academic subjects; and (2) to provide…

Dissonance-based eating disorder program reduces cardiac risk: A preliminary trial.

PubMed

Green, Melinda A; Willis, Mary; Fernandez-Kong, Kristen; Reyes, Shuhan; Linkhart, Ruby; Johnson, Molly; Thorne, Tyler; Kroska, Emily; Woodward, Halley; Lindberg, Jessica

2017-04-01

We conducted a randomized, controlled preliminary trial to examine the effect of a dissonance-based eating disorder program on eating disorder symptoms and cardiac risk indices in a community sample of women with subclinical and clinical symptoms (N = 47), examining the efficacy of the program in both the indicated prevention and treatment realms. Eating disorder symptoms, body mass index, and biomarkers of cardiac risk were examined in dissonance and assessment-only control conditions at baseline, postintervention, and 2-month follow-up. Specifically, we assessed mean R wave amplitude, QT interval length, vagal tone (high frequency spectral power of heart rate variability), and sympathetic tone (low/high frequency spectral power ratio) via electocardiography (ECG) at each assessment period. We predicted a statistically significant 2 (condition: control, dissonance) × 3 (time: baseline, postintervention, 2-month follow-up) interaction in the mixed factorial MANOVA results. Results confirmed this hypothesis. Eating disorder symptoms and cardiac risk indices decreased significantly among participants in the dissonance condition at postintervention and 2-month follow-up compared with baseline. Results provide support for the efficacy of a dissonance-based program in the reduction of eating disorder symptoms and cardiac risk indices among women with subclinical and clinical eating disorder symptoms. Findings establish the efficaciousness of this dissonance-based approach in the indicated prevention and treatment realms and establish its efficacy in reducing cardiac risk indicators. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Paternal programming in sticklebacks

PubMed Central

Stein, Laura R.; Bell, Alison M.

2015-01-01

In a wide range of organisms, including humans, mothers can influence offspring via the care they provide. Comparatively little is known about the effects of fathering on offspring. Here, we test the hypothesis that fathers are capable of programming their offspring for the type of environment they are likely to encounter. Male threespine sticklebacks, Gasterosteus aculeatus, were either exposed to predation risk while fathering or not. Fathers altered their paternal behaviour when exposed to predation risk, and consequently produced adult offspring with phenotypes associated with strong predation pressure (smaller size, reduced body condition, reduced behavioural activity). Moreover, more attentive fathers produced offspring that showed stronger antipredator responses. These results are consistent with behaviourally mediated paternal programming: fathers can alter offspring phenotypes to match their future environment and influence offspring traits well into adulthood. PMID:27011391

Pre- and posttest evaluation of a breast cancer risk assessment program for nurse practitioners.

PubMed

Edwards, Quannetta T; Seibert, Diane

2010-07-01

Numerous studies have shown that healthcare providers, including nurse practitioners (NPs) fail to provide breast cancer risk assessment (BrCRA) in primary care settings. A potential barrier to the use of BrCRA is insufficient knowledge or training of risk assessment. The purpose of this study was to analyze the outcome of a BrCRA program developed to enhance NPs' knowledge of risk assessment and use of empiric risk assessment models. Thirty-five NPs participated in a before-after (pretest-posttest design) study evaluating the effectiveness of a BrCRA education program conducted at a national NP conference. Demographics, pre/post knowledge, and course satisfaction measures were all examined as a part of this pilot study. Continuing education through the implementation of a BrCRA program significantly increased NPs knowledge in assessing breast cancer risk and the use of empiric risk assessment models. Many healthcare providers, including NPs, are inadequately prepared to assess a woman's risk for breast cancer. Understanding breast cancer risk assessment is essential if NPs are to provide appropriate counseling, management, and referral strategies needed to reduce a woman's risk for developing the disease. Continuing education provides one means to enhance NP's knowledge of BrCRA.

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs

PubMed Central

Thomas, Melanie; Delgadillo-Duenas, Adriana T.; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A.

2016-01-01

Background. Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods. STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18–39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results. Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion. The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420. PMID:27830157

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs.

PubMed

Athavale, Priyanka; Thomas, Melanie; Delgadillo-Duenas, Adriana T; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A

2016-01-01

Background . Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods . STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18-39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results . Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion . The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420.

States Create Low-Cost Loan Programs to Help Middle Class Pay for College.

ERIC Educational Resources Information Center

Blumenstyk, Goldie

1990-01-01

State low-interest college loans programs for middle-class families have emerged in response to restrictions on federally subsidized Stafford Loans. The key difference between federal and state programs is that most state programs require student borrowers and cosigners to prove good credit risks, reducing loan default and making the programs…

Fall Prevention for Older Adults Receiving Home Healthcare.

PubMed

Bamgbade, Sarah; Dearmon, Valorie

2016-02-01

Falls pose a significant risk for community-dwelling older adults. Fall-related injuries increase healthcare costs related to hospitalization, diagnostic procedures, and/or surgeries. This article describes a quality improvement project to reduce falls in older adults receiving home healthcare services. The fall prevention program incorporated best practices for fall reduction, including fall risk assessment, medication review/management, home hazard and safety assessment, staff and patient fall prevention education, and an individualized home-based exercise program. The program was implemented and evaluated during a 6-month time frame. Fewer falls occurred post implementation of the falls prevention program with no major injuries.

Implementation of an ergonomics program for the welding department inside a car assembly company.

PubMed

Francisco, Caceres; Edwin, Troya

2012-01-01

The premise for this project is to implement an ergonomics program for the welding department of a car assembly company, considering that this area represents the highest occupational risk in relation to musculoskeletal injuries. The project also allows the demonstration of the different implementation processes of an ergonomics program; it also permits the determination of individual risks faced by workers of the welding department, and finally gives a chance of improving common injuries using the sentinel system. The main challenge is to reduce musculoskeletal injuries and absenteeism among welders through actions implemented by the ergonomics program.

Lipid-lowering therapy in older persons

PubMed Central

2015-01-01

Numerous randomized, double-blind, placebo-controlled studies and observational studies have shown that statins reduce mortality and major cardiovascular events in older high-risk persons with hypercholesterolemia. The Heart Protection Study showed that statins reduced mortality and major cardiovascular events in high-risk persons regardless of the initial level of serum lipids, age, or gender. The updated National Cholesterol Education Program III guidelines state that in very high-risk persons, a serum low-density lipoprotein (LDL) cholesterol level of < 70 mg/dl (1.8 mmol/l) is a reasonable clinical strategy for moderately high-risk persons (2 or more risk factors and a 10-year risk for coronary artery disease of 10% to 20%), and the serum LDL cholesterol should be reduced to < 100 mg/dl (2.6 mmol/l). When LDL cholesterol-lowering drug therapy is used to treat high-risk persons or moderately high-risk persons, the serum LDL cholesterol should be reduced by at least 30% to 40%. The serum LDL cholesterol should be decreased to less than 160 mg/dl in persons at low risk for cardiovascular disease. Addition of other lipid-lowering drugs to statin therapy has not been demonstrated to further reduce cardiovascular events and mortality. PMID:25861289

New strategy toward dioxin risk reduction for local residents surrounding severe dioxin hotspots in Vietnam

PubMed Central

Thi Tran, Tuyet-Hanh; Nguyen, Ngoc-Bich; Le, Vu-Anh

2013-01-01

Background A public health intervention program with active involvement of local related stakeholders was piloted in the Bien Hoa dioxin hotspot (2007–2009), and then expanded to the Da Nang dioxin hotspot in Vietnam (2009–2011). It aimed to reduce the risk of dioxin exposure of local residents through foods. This article presents the results of the intervention in Da Nang. Methodology To assess the results of this intervention program, pre- and post-intervention knowledge, attitude, and practice (KAP) surveys were implemented in 400 households, randomly selected from four wards surrounding the Da Nang Airbase in 2009 and 2011, respectively. Results After the intervention, the knowledge on the existence of dioxin in food, dioxin exposure pathways, potential high-risk foods, and preventive measures significantly increased (P<0.05). Ninety-eight percent were willing to follow advice on preventing dioxin exposure. Practices to reduce the risk of dioxin exposure also significantly improved (P<0.05). After intervention, 60.4% of households undertook exposure preventive measures, significantly higher than that of the pre-intervention survey (39.6%; χ2=40.15, P<0.001). High-risk foods had quite low rates of daily consumption (from 0 to 2.5%) and were significantly reduced (P<0.05). Conclusions This is seen as an effective intervention strategy toward reducing the risk of human exposure to dioxin at dioxin hotspots. While greater efforts are needed for remediating dioxin-polluted areas inside airbases, there is also evidence to suggest that, during the past four decades, pollution has expanded to the surrounding areas. For this reason, this model should be quickly expanded to the remaining dioxin hotspots in Vietnam to further reduce the exposure risks in other areas. PMID:23791241

Effect of an injury awareness education program on risk-taking behaviors and injuries in juvenile justice offenders: a retrospective cohort study.

PubMed

Ho, Kwok M; Litton, Edward; Geelhoed, Elizabeth; Gope, Monica; Burrell, Maxine; Coribel, Jacqueline; McDowall, Angela; Rao, Sudhakar

2012-01-01

Risk-taking behavior is a leading cause of injury and death amongst young people. This was a retrospective cohort study on the effectiveness of a 1-day youth injury awareness education program (Prevent Alcohol and Risk-related Trauma in Youth, P.A.R.T.Y.) program in reducing risk taking behaviors and injuries of juvenille justice offenders in Western Australia. Of the 3659 juvenile justice offenders convicted by the court magistrates between 2006 and 2010, 225 were referred to the P.A.R.T.Y. education program. In a before and after survey of these 225 participants, a significant proportion of them stated that they were more receptive to modifying their risk-taking behavior (21% before vs. 57% after). Using data from the Western Australia Police and Department of Health, the incidence of subsequent offences and injuries of all juvenile justice offenders was assessed. The incidence of subsequent traffic or violence-related offences was significantly lower for those who had attended the program compared to those who did not (3.6% vs. 26.8%; absolute risk reduction [ARR] = 23.2%, 95% confidence interval [CI] 19.9%-25.8%; number needed to benefit = 4.3, 95%CI 3.9-5.1; p = 0.001), as were injuries leading to hospitalization (0% vs. 1.6% including 0.2% fatality; ARR = 1.6%, 95%CI 1.2%-2.1%) and alcohol or drug-related offences (0% vs. 2.4%; ARR 2.4%, 95%CI 1.9%-2.9%). In the multivariate analysis, only P.A.R.T.Y. education program attendance (odds ratio [OR] 0.10, 95%CI 0.05-0.21) and a higher socioeconomic background (OR 0.97 per decile increment in Index of Relative Socioeconomic Advantage and Disadvantage, 95%CI 0.93-0.99) were associated with a lower risk of subsequent traffic or violence-related offences. Participation in an injury education program involving real-life trauma scenarios was associated with a reduced subsequent risk of committing violence- or traffic-related offences, injuries, and death for juvenille justice offenders.

Creating REAL MEN: description of an intervention to reduce drug use, HIV risk, and rearrest among young men returning to urban communities from jail.

PubMed

Daniels, Jessie; Crum, Martha; Ramaswamy, Megha; Freudenberg, Nicholas

2011-01-01

This article describes the life circumstances and risk behaviors of 552 adolescent males returning home from jail. Most young men reported several sources of support in their lives and many had more tolerant views toward women and intimate relationships than portrayed in mainstream media. They also reported high levels of marijuana and alcohol use, risky sexual behavior, and prior arrests. Investigators designed the Returning Educated African American and Latino Men to Enriched Neighborhoods (REAL MEN) program, a jail and community program to reduce drug use, HIV risk, and rearrest. By helping participants examine alternative paths to manhood and consider racial/ethnic pride as a source of strength, REAL MEN addressed the assets of these young men as well as their challenges. Our findings suggest that interventions that emphasize the assets of these young men may be better able to engage them than programs that seek to impose adult values.

Heat injury prevention practices in high school football.

PubMed

Luke, Anthony C; Bergeron, Michael F; Roberts, William O

2007-11-01

To survey high school American football programs regarding current prevention measures for reducing heat injuries during the football season. Web-based survey of 27 questions based on consensus statement guidelines by the American College of Sports Medicine on reducing heat injury risk in youth football. National (United States) and community-based. High school programs receiving survey distribution from their state athletic association and the National Federation of State High School Associations. Responses (percentage and incidence) to questions on preseason acclimatization procedures, practice modification protocols, preparticipation risk factors, hydration management strategies, rest period strategies, heat injury education and policies, and preparation for heat-related emergency care. A total of 540 high school football programs from 26 states completed the survey. The reported number of preseason heat injuries per program (1.38+/-2.08) was greater (P<0.001) compared to during the regular season (0.98+/-1.84). Programs modified equipment configurations during preseason (no helmets or pads, 31.3%; just helmets, 57.0%; helmets and shoulder pads only, 33.5%) or altered the practice schedule when there was excessive heat. Hydration management, education, and preparation for dealing with an acute heat injury varied among programs. Greater implementation of effective prevention measures to reduce the incidence of heat-related injury and death in high school American football is needed. Strategies should focus on modifying practices appropriately on a day-to-day basis to minimize heat strain and optimize hydration, identifying and educating at-risk individuals during the preparticipation period, and developing an emergency action plan for effectively managing heat injuries.

Speed enforcement program guidelines

DOT National Transportation Integrated Search

2008-03-01

It is well-established that speeding represents a risk to public safety. Excessive speed increases the likelihood of crashing and the risk of severe injury in a crash. In 2005, more than 13,000 lives were lost in speeding-related crashes. Reducing sp...

Organizing Asian Pacific Islanders in an urban community to reduce HIV risk: a case study.

PubMed

Loue, S; Lloyd, L S; Phoombour, E

1996-10-01

We present a case study of community organization efforts within the Asian Pacific Islander communities of San Diego County to reduce the risk of HIV transmission. We utilized a five-phase process to implement the strategies of locality development, social planning, and social action: community analysis, program design and initiation, program implementation, program maintenance and consolidation, and program reassessment. An evaluation of the process indicates that there were increases over time in the project's activities as well as in the levels of interagency connectedness. This is one of the few reported efforts to organize Asian Pacific Islander groups to address HIV transmission. Key elements that led to the successful organization of the original project into a tax-exempt nonprofit entity (the Asian Pacific Islander Community AIDS Project) were emphasis on community ownership, reliance on group consensus, use of "gatekeepers" to access communities, simultaneous multilevel programming, and service to the community as a "coordinating" entity.

Belief In Numbers: When and why women disbelieve tailored breast cancer risk statistics

PubMed Central

Scherer, Laura D.; Ubel, Peter A.; McClure, Jennifer; Green, Sarah M.; Alford, Sharon Hensley; Holtzman, Lisa; Exe, Nicole; Fagerlin, Angela

2013-01-01

Objective To examine when and why women disbelieve tailored information about their risk of developing breast cancer. Methods 690 women participated in an online program to learn about medications that can reduce the risk of breast cancer. The program presented tailored information about each woman’s personal breast cancer risk. Half of women were told how their risk numbers were calculated, whereas the rest were not. Later, they were asked whether they believed that the program was personalized, and whether they believed their risk numbers. If a woman did not believe her risk numbers, she was asked to explain why. Results Beliefs that the program was personalized were enhanced by explaining the risk calculation methods in more detail. Nonetheless, nearly 20% of women did not believe their personalized risk numbers. The most common reason for rejecting the risk estimate was a belief that it did not fully account for personal and family history. Conclusions The benefits of tailored risk statistics may be attenuated by a tendency for people to be skeptical that these risk estimates apply to them personally. Practice Implications Decision aids may provide risk information that is not accepted by patients, but addressing the patients’ personal circumstances may lead to greater acceptance. PMID:23623330

The Distinct Role of Comparative Risk Perceptions in a Breast Cancer Prevention Program

PubMed Central

Dillard, Amanda J.; Ubel, Peter A.; Smith, Dylan M.; Zikmund-Fisher, Brian J.; Nair, Vijay; Derry, Holly A.; Zhang, Aijun; Pitsch, Rosemarie K.; Alford, Sharon Hensley; McClure, Jennifer B.; Fagerlin, Angela

2013-01-01

Background Comparative risk perceptions may rival other types of information in terms of effects on health behavior decisions. Purpose We examined associations between comparative risk perceptions, affect, and behavior while controlling for absolute risk perceptions and actual risk. Methods Women at an increased risk of breast cancer participated in a program to learn about tamoxifen which can reduce the risk of breast cancer. Women reported comparative risk perceptions of breast cancer and completed measures of anxiety, knowledge, and tamoxifen-related behavior intentions. Three months later, women reported their behavior. Results Comparative risk perceptions were positively correlated with anxiety, knowledge, intentions, and behavior three months later. After controlling for participants’ actual risk of breast cancer and absolute risk perceptions, comparative risk perceptions predicted anxiety and knowledge, but not intentions or behavior. Conclusions Comparative risk perceptions can affect patient outcomes like anxiety and knowledge independently of absolute risk perceptions and actual risk information. PMID:21698518

An integrated simulation and optimization approach for managing human health risks of atmospheric pollutants by coal-fired power plants.

PubMed

Dai, C; Cai, X H; Cai, Y P; Guo, H C; Sun, W; Tan, Q; Huang, G H

2014-06-01

This research developed a simulation-aided nonlinear programming model (SNPM). This model incorporated the consideration of pollutant dispersion modeling, and the management of coal blending and the related human health risks within a general modeling framework In SNPM, the simulation effort (i.e., California puff [CALPUFF]) was used to forecast the fate of air pollutants for quantifying the health risk under various conditions, while the optimization studies were to identify the optimal coal blending strategies from a number of alternatives. To solve the model, a surrogate-based indirect search approach was proposed, where the support vector regression (SVR) was used to create a set of easy-to-use and rapid-response surrogates for identifying the function relationships between coal-blending operating conditions and health risks. Through replacing the CALPUFF and the corresponding hazard quotient equation with the surrogates, the computation efficiency could be improved. The developed SNPM was applied to minimize the human health risk associated with air pollutants discharged from Gaojing and Shijingshan power plants in the west of Beijing. Solution results indicated that it could be used for reducing the health risk of the public in the vicinity of the two power plants, identifying desired coal blending strategies for decision makers, and considering a proper balance between coal purchase cost and human health risk. A simulation-aided nonlinear programming model (SNPM) is developed. It integrates the advantages of CALPUFF and nonlinear programming model. To solve the model, a surrogate-based indirect search approach based on the combination of support vector regression and genetic algorithm is proposed. SNPM is applied to reduce the health risk caused by air pollutants discharged from Gaojing and Shijingshan power plants in the west of Beijing. Solution results indicate that it is useful for generating coal blending schemes, reducing the health risk of the public, reflecting the trade-offbetween coal purchase cost and health risk.

Results of a Pilot Study to Investigate Community College Student Perceptions of the Value of an Online Health-Risk Reduction Program

ERIC Educational Resources Information Center

Donovan, Elizabeth; Hernandez, Jack; Chiauzzi, Emil; DasMahapatra, Pronabesh; Achilles, Tyler; Hemm, Amanda

2012-01-01

Health is associated with academic success. Universal, web-based interventions to reduce risks associated with alcohol and other drug use have been found to be effective at changing four-year college students' health behaviors. An online health program may also be well-suited to a community college population, as it can reach students off campus…

Legionella (Legionnaires' Disease and Pontiac Fever): Prevention

MedlinePlus

... on Facebook Tweet Share Compartir Español: Prevención Water Management Programs There are no vaccines that can prevent ... owners and managers develop and implement a water management program to reduce their building’s risk for growing ...

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.

A preliminary study of the population-adjusted effectiveness of substance abuse prevention programming: towards making IOM program types comparable.

PubMed

Shamblen, Stephen R; Derzon, James H

2009-03-01

The Institute of Medicine distinguishes between programs based on who is targeted: the entire population (universal), those at risk (selective), or persons exhibiting the early stages of use or related problem behavior (indicated). Evaluations suggest that although universal programs can be effective in reducing and preventing substance use, selective and indicated programs are both more effective and have greater cost-benefit ratios. This paper tests these assumptions by comparing the impact of these program types in reducing and preventing substance use at the individual level (i.e., those exposed to intervention services) and in the population (i.e., those exposed and not exposed to intervention services). A meta-analysis was performed on 43 studies of 25 programs to examine program comparability across IOM categories. When examining unadjusted effect sizes at the individual level, universal programs were modestly more successful in reducing tobacco use, but selective and indicated programs were modestly more successful in reducing alcohol and marijuana use. When adjusted to the population level, the average effect sizes for selective and indicated programs were reduced by approximately half. At the population level, universal programs were more successful in reducing tobacco and marijuana use and selective and indicated programs were more successful in reducing alcohol use. Editors' Strategic Implications: the authors' focus on the public health value of a prevention strategy is compelling and provides a model for analyses of other strategies and content areas.

Reduction of the incidence of pressure sores by an education program on nursing care.

PubMed

Srisupan, Vijitr; Senaratana, Wilawan; Picheansatian, Wilawan; Chittreecheur, Jittaporn; Watanakool, Malinee; Chaisri, Pratin; Singhakumfu, Laddawan; Tribuddharat, Chanwit; Danchaivijitr, Somwang

2005-12-01

To determine whether an education and campaign program would reduce the incidence of pressure sores. The study was performed in a 1,400-bed teaching hospital in Thailand with a total number of 697patients from 47 wards for a point prevalence study; 1,201 and 1,268 patients from 12 wards to determine whether reduction of pressure sore occurrence would be obtained by an education program. The point prevalence of pressure sores was 10.8%. The significant risk factors were age older than 60 years, fecal incontinence, and history of diarrhea. The occurrence of pressure sores was significantly reduced after the educational program from 9.91% to 5. 76%. The education on patient care aiming at reduction of the occurrence of pressure sores could be adopted nation-wide in order to reduce the morbidity, mortality and expenses. The education program was effective in reducing the incidence of pressure sores.

The EPA's human exposure research program for assessing cumulative risk in communities.

PubMed

Zartarian, Valerie G; Schultz, Bradley D

2010-06-01

Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available and most relevant, and understanding how to use those tools; given these barriers, community groups tend to rely more on risk perception than science. The U.S. Environmental Protection Agency's Office of Research and Development, National Exposure Research Laboratory (NERL) and collaborators are developing and applying tools (models, data, methods) for enhancing cumulative risk assessments. The NERL's "Cumulative Communities Research Program" focuses on key science questions: (1) How to systematically identify and prioritize key chemical stressors within a given community?; (2) How to develop estimates of exposure to multiple stressors for individuals in epidemiologic studies?; and (3) What tools can be used to assess community-level distributions of exposures for the development and evaluation of the effectiveness of risk reduction strategies? This paper provides community partners and scientific researchers with an understanding of the NERL research program and other efforts to address cumulative community risks; and key research needs and opportunities. Some initial findings include the following: (1) Many useful tools exist for components of risk assessment, but need to be developed collaboratively with end users and made more comprehensive and user-friendly for practical application; (2) Tools for quantifying cumulative risks and impact of community risk reduction activities are also needed; (3) More data are needed to assess community- and individual-level exposures, and to link exposure-related information with health effects; and (4) Additional research is needed to incorporate risk-modifying factors ("non-chemical stressors") into cumulative risk assessments. The products of this research program will advance the science for cumulative risk assessments and empower communities with information so that they can make informed, cost-effective decisions to improve public health.

Steering Clear of Driving After Drinking: a Tailored e-Health Intervention for Reducing Repeat Offending and Modifying Alcohol Use in a High-Risk Cohort.

PubMed

Wilson, Hollie Jai; Palk, Gavan; Sheehan, Mary Christina; Wishart, Darren; Watson, Barry

2017-10-01

Digital interventions to reduce risk behaviours are emerging as effective public health measures; however, few have been applied to drink driving and associated alcohol use based on a harm reduction perspective. This paper reports on the design, development, and pilot of a novel intervention which aims to reduce repeat offending by first-time convicted drink driving offenders. It explores whether an online program is acceptable and user friendly and contains useful and relevant content, with a sample of first-time drink driving offenders recruited at the time of conviction. Building upon existing research into interventions to reduce drink driving recidivism and problem alcohol use, a tailored program was designed to provide content specifically concerned with drink driving and with an additional component related to alcohol use. Following stakeholder and internal review, the 'Steering Clear First Offender Drink Driving Program' was subsequently piloted with 15 first-time drink driving offenders. Evaluative data was analysed both quantitatively and qualitatively. The pilot results indicate that the participants found the program to be user friendly, as demonstrated by high scores in relation to navigation, online delivery, engagement, avatar usage and straightforwardness. They reported that they found the content to be useful and relevant and that the key learning area was in relation to the consequences of drink driving. Online interventions for reducing risky behaviour such as drink driving may be useful and cost effective from a public health perspective. Potentially, they can directly address risky behaviours associated with alcohol use in high-risk cohorts that may not ordinarily receive intervention.

The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the Diabetes Prevention Program outcomes study 10-year follow-up.

PubMed

Aroda, V R; Christophi, C A; Edelstein, S L; Zhang, P; Herman, W H; Barrett-Connor, E; Delahanty, L M; Montez, M G; Ackermann, R T; Zhuo, X; Knowler, W C; Ratner, R E

2015-04-01

Gestational diabetes (GDM) confers a high risk of type 2 diabetes. In the Diabetes Prevention Program (DPP), intensive lifestyle (ILS) and metformin prevented or delayed diabetes in women with a history of GDM. The objective of the study was to evaluate the impact of ILS and metformin intervention over 10 years in women with and without a history of GDM in the DPP/Diabetes Prevention Program Outcomes Study. This was a randomized controlled clinical trial with an observational follow-up. The study was conducted at 27 clinical centers. Three hundred fifty women with a history of GDM and 1416 women with previous live births but no history of GDM participated in the study. The participants had an elevated body mass index and fasting glucose and impaired glucose tolerance at study entry. Interventions included placebo, ILS, or metformin. Outcomes measure was diabetes mellitus. Over 10 years, women with a history of GDM assigned to placebo had a 48% higher risk of developing diabetes compared with women without a history of GDM. In women with a history of GDM, ILS and metformin reduced progression to diabetes compared with placebo by 35% and 40%, respectively. Among women without a history of GDM, ILS reduced the progression to diabetes by 30%, and metformin did not reduce the progression to diabetes. Women with a history of GDM are at an increased risk of developing diabetes. In women with a history of GDM in the DPP/Diabetes Prevention Program Outcomes Study, both lifestyle and metformin were highly effective in reducing progression to diabetes during a 10-year follow-up period. Among women without a history of GDM, lifestyle but not metformin reduced progression to diabetes.

Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial.

PubMed

Trombetti, Andrea; Hars, Mélany; Herrmann, François R; Kressig, Reto W; Ferrari, Serge; Rizzoli, René

2011-03-28

Falls occur mainly while walking or performing concurrent tasks. We determined whether a music-based multitask exercise program improves gait and balance and reduces fall risk in elderly individuals. We conducted a 12-month randomized controlled trial involving 134 community-dwelling individuals older than 65 years, who are at increased risk of falling. They were randomly assigned to an intervention group (n = 66) or a delayed intervention control group scheduled to start the program 6 months later (n = 68). The intervention was a 6-month multitask exercise program performed to the rhythm of piano music. Change in gait variability under dual-task condition from baseline to 6 months was the primary end point. Secondary outcomes included changes in balance, functional performances, and fall risk. At 6 months, there was a reduction in stride length variability (adjusted mean difference, -1.4%; P < .002) under dual-task condition in the intervention group, compared with the delayed intervention control group. Balance and functional tests improved compared with the control group. There were fewer falls in the intervention group (incidence rate ratio, 0.46; 95% confidence interval, 0.27-0.79) and a lower risk of falling (relative risk, 0.61; 95% confidence interval, 0.39-0.96). Similar changes occurred in the delayed intervention control group during the second 6-month period with intervention. The benefit of the intervention on gait variability persisted 6 months later. In community-dwelling older people at increased risk of falling, a 6-month music-based multitask exercise program improved gait under dual-task condition, improved balance, and reduced both the rate of falls and the risk of falling. Trial Registration clinicaltrials.gov Identifier: NCT01107288.

Alcohol Consumption and Women's Vulnerability to Sexual Victimization: Can Reducing Women's Drinking Prevent Rape?

PubMed Central

Testa, Maria; Livingston, Jennifer A.

2009-01-01

Before effective prevention interventions can be developed, it is necessary to identify the mechanisms that contribute to the targeted negative outcomes. A review of the literature on women's substance use and sexual victimization points to women's heavy episodic drinking as a proximal risk factor, particularly among college samples. At least half of sexual victimization incidents involve alcohol use and the majority of rapes of college women occur when the victim is too intoxicated to resist (“incapacitated rape”). Despite the importance of women's heavy episodic drinking as being a risk factor, existing rape prevention programs have rarely addressed women's alcohol use and have shown little success in reducing rates of sexual victimization. We argue that given the strength of the association between heavy episodic drinking and sexual victimization among young women, prevention programs targeting drinking may prove more efficacious than programs targeting sexual vulnerability. Applications of existing drinking prevention strategies to reducing women's sexual victimization are discussed. PMID:19938922

Implications of Our Developing Understanding of Risk and Protective Factors in the Treatment of Adult Male Sexual Offenders

ERIC Educational Resources Information Center

Thornton, David

2013-01-01

This paper summarizes our developing knowledge of factors that contribute added risk of sexual recidivism (risk factors) and factors that are associated with a reduced risk of sexual recidivism (protective factors). Specific implications for the design of future treatment programs are drawn. This information is contrasted with the common foci of…

Effects of a multifactorial falls prevention program for people with stroke returning home after rehabilitation: a randomized controlled trial.

PubMed

Batchelor, Frances A; Hill, Keith D; Mackintosh, Shylie F; Said, Catherine M; Whitehead, Craig H

2012-09-01

To determine whether a multifactorial falls prevention program reduces falls in people with stroke at risk of recurrent falls and whether this program leads to improvements in gait, balance, strength, and fall-related efficacy. A single blind, multicenter, randomized controlled trial with 12-month follow-up. Participants were recruited after discharge from rehabilitation and followed up in the community. Participants (N=156) were people with stroke at risk of recurrent falls being discharged home from rehabilitation. Tailored multifactorial falls prevention program and usual care (n=71) or control (usual care, n=85). Primary outcomes were rate of falls and proportion of fallers. Secondary outcomes included injurious falls, falls risk, participation, activity, leg strength, gait speed, balance, and falls efficacy. There was no significant difference in fall rate (intervention: 1.89 falls/person-year, control: 1.76 falls/person-year, incidence rate ratio=1.10, P=.74) or the proportion of fallers between the groups (risk ratio=.83, 95% confidence interval=.60-1.14). There was no significant difference in injurious fall rate (intervention: .74 injurious falls/person-year, control: .49 injurious falls/person-year, incidence rate ratio=1.57, P=.25), and there were no significant differences between groups on any other secondary outcome. This multifactorial falls prevention program was not effective in reducing falls in people with stroke who are at risk of falls nor was it more effective than usual care in improving gait, balance, and strength in people with stroke. Further research is required to identify effective interventions for this high-risk group. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Cancer Prevention Fellowship Program | Division of Cancer Prevention

Cancer.gov

The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

NCI Community Oncology Research Program Clinical Trials | Division of Cancer Prevention

Cancer.gov

The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

Active NCI Community Oncology Research Program Grants | Division of Cancer Prevention

Cancer.gov

The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

College students' perceived risk of sexual victimization and the role of optimistic bias.

PubMed

Saling Untied, Amy; Dulaney, Cynthia L

2015-05-01

Many college women believe that their chances of experiencing a sexual assault are less than their peers. This phenomenon, called optimistic bias, has been hypothesized to be one important element to address in sexual assault risk reduction and awareness programs aimed at reducing women's chances of experiencing a sexual assault. The present study examined the role that participants' (N = 89) perceived similarity to a narrator (portraying a sexual assault survivor) describing an assault plays in reducing this bias. The age of the narrator was manipulated (similar or dissimilar to age of participants) with the aim of assessing whether the program could produce reductions in optimistic bias for those participants who watched a video of someone similar to them in age. A significant interaction between pre- and post-program and age similarity indicated a significant decrease in optimistic bias from pre- to posttest for the similar group. Furthermore, an exploratory analysis indicated optimistic bias for White participants decreased from pre- to posttest, whereas optimistic bias for the Black participants increased. These results suggest that some factors such as age similarity may reduce optimistic bias in sexual assault risk reduction and awareness programs. However, a race dissimilarity may increase optimistic bias. Thus, more research is needed to understand the factors that affect optimistic bias with regard to sexual assault awareness. © The Author(s) 2014.

The Brazilian Cardioprotective Nutritional Program to reduce events and risk factors in secondary prevention for cardiovascular disease: study protocol (The BALANCE Program Trial).

PubMed

Weber, Bernardete; Bersch-Ferreira, Ângela Cristine; Torreglosa, Camila Ragne; Ross-Fernandes, Maria Beatriz; da Silva, Jacqueline Tereza; Galante, Andrea Polo; Lara, Enilda de Sousa; Costa, Rosana Perim; Soares, Rafael Marques; Cavalcanti, Alexandre Biasi; Moriguchi, Emilio H; Bruscato, Neide M; Kesties; Vivian, Lilian; Schumacher, Marina; de Carli, Waldemar; Backes, Luciano M; Reolão, Bruna R; Rodrigues, Milena P; Baldissera, Dúnnia M B; Tres, Glaucia S; Lisbôa, Hugo R K; Bem, João B J; Reolão, Jose B C; Deucher, Keyla L A L; Cantarelli, Maiara; Lucion, Aline; Rampazzo, Daniela; Bertoni, Vanessa; Torres, Rosileide S; Verríssimo, Adriana O L; Guterres, Aldair S; Cardos, Andrea F R; Coutinho, Dalva B S; Negrão, Mayara G; Alencar, Mônica F A; Pinho, Priscila M; Barbosa, Socorro N A A; Carvalho, Ana P P F; Taboada, Maria I S; Pereira, Sheila A; Heyde, Raul V; Nagano, Francisca E Z; Baumgartner, Rebecca; Resende, Fernanda P; Tabalipa, Ranata; Zanini, Ana C; Machado, Michael J R; Araujo, Hevila; Teixeira, Maria L V; Souza, Gabriela C; Zuchinali, Priccila; Fracasso, Bianca M; Ulliam, Karen; Schumacher, Marina; Pierotto, Moara; Hilário, Thamires; Carlos, Daniele M O; Cordeiro, Cintia G N C; Carvalho, Daniele A; Gonçalves, Marília S; Vasconcelos, Valdiana B; Bosquetti, Rosa; Pagano, Raira; Romano, Marcelo L P; Jardim, César A; de Abreu, Bernardo N A; Marcadenti, Aline; Schmitt, Alessandra R; Tavares, Angela M V; Faria, Christiane C; Silva, Flávia M; Fink, Jaqueline S; El Kik, Raquel M; Prates, Clarice F; Vieira, Cristiane S; Adorne, Elaine F; Magedanz, Ellen H; Chieza, Fernanda L; Silva, Ingrid S; Teixeira, Joise M; Trescastro, Eduardo P; Pellegrini, Lívia A; Pinto, Jéssika C; Telles, Cristina T; Sousa, Antonio C S; Almeida, Andreza S; Costa, Ariane A; Carmo, José A C; Silva, Juliana T; Alves, Luciana V S; Sales, Saulo O C; Ramos, Maria E M; Lucas, Marilia C S; Damiani, Monica; Cardoso, Patricia C; Ramos, Salvador S; Dantas, Clenise F; Lopes, Amanda G; Cabral, Ana M P; Lucena, Ana C A; Medeiros, Auriene L; Terceiro, Bernardino B; Leda, Neuma M F S; Baía, Sandra R D; Pinheiro, Josilene M F; Cassiano, Alexandra N; Melo, Andressa N L; Cavalcanti, Anny K O; Souza, Camila V S; Queiroz, Dayanna J M; Farias, Hercilla N C F; Souza, Larissa C F; Santos, Letícia S; Lima, Luana R M; Hoffmann, Meg S; Ribeiro, Átala S Silva; Vasconcelos, Daniel F; Dutra, Eliane S; Ito, Marina K; Neto, José A F; Santos, Alexsandro F; Sousa, Rosângela M L; Dias, Luciana Pereira P; Lima, Maria T M A; Modanesi, Victor G; Teixeira, Adriana F; Estrada, Luciana C N C D; Modanesi, Paulo V G; Gomes, Adriana B L; Rocha, Bárbara R S; Teti, Cristina; David, Marta M; Palácio, Bruna M; Junior, Délcio G S; Faria, Érica H S; Oliveira, Michelle C F; Uehara, Rose M; Sasso, Sandramara; Moreira, Annie S B; Cadinha, Ana C A H; Pinto, Carla W M; Castilhos, Mariana P; Costa, Mariana; Kovacs, Cristiane; Magnoni, Daniel; Silva, Quênia; Germini, Michele F C A; da Silva, Renata A; Monteiro, Aline S; dos Santos, Karina G; Moreira, Priscila; Amparo, Fernanda C; Paiva, Catharina C J; Poloni, Soraia; Russo, Diana S; Silveira, Izabele V; Moraes, Maria A; Boklis, Mirena; Cardoso, Quinto I; Moreira, Annie S B; Damaceno, Aline M S; Santos, Elisa M; Dias, Glauber M; Pinho, Cláudia P S; Cavalcanti, Adrilene C; Bezerra, Amanda S; Queiroga, Andrey V; Rodrigues, Isa G; Leal, Tallita V; Sahade, Viviane; Amaral, Daniele A; Souza, Diana S; Araújo, Givaldo A; Curvello, Karine; Heine, Manuella; Barretto, Marília M S; Reis, Nailson A; Vasconcelos, Sandra M L; Vieira, Danielly C; Costa, Francisco A; Fontes, Jessica M S; Neto, Juvenal G C; Navarro, Laís N P; Ferreira, Raphaela C; Marinho, Patrícia M; Abib, Renata Torres; Longo, Aline; Bertoldi, Eduardo G; Ferreira, Lauren S; Borges, Lúcia R; Azevedo, Norlai A; Martins, Celma M; Kato, Juliana T; Izar, Maria C O; Asoo, Marina T; de Capitani, Mariana D; Machado, Valéria A; Fonzar, Waléria T; Pinto, Sônia L; Silva, Kellen C; Gratão, Lúcia H A; Machado, Sheila D; de Oliveira, Susane R U; Bressan, Josefina; Caldas, Ana P S; Lima, Hatanne C F M; Hermsdorff, Helen H M; Saldanha, Tânia M; Priore, Sílvia E; Feres, Naoel H; Neves, Adila de Queiroz; Cheim, Loanda M G; Silva, Nilma F; Reis, Silvia R L; Penafort, Andreza M; de Queirós, Ana Paula O; Farias, Geysa M N; de los Santos, Mônica L P; Ambrozio, Cíntia L; Camejo, Cirília N; dos Santos, Cristiano P; Schirmann, Gabriela S; Boemo, Jorge L; Oliveira, Rosane E C; Lima, Súsi M B; Bortolini, Vera M S; Matos, Cristina H; Barretta, Claiza; Specht, Clarice M; de Souza, Simone R; Arruda, Cristina S; Rodrigues, Priscila A; Berwanger, Otávio

2016-01-01

This article reports the rationale for the Brazilian Cardioprotective Nutritional Program (BALANCE Program) Trial. This pragmatic, multicenter, nationwide, randomized, concealed, controlled trial was designed to investigate the effects of the BALANCE Program in reducing cardiovascular events. The BALANCE Program consists of a prescribed diet guided by nutritional content recommendations from Brazilian national guidelines using a unique nutritional education strategy, which includes suggestions of affordable foods. In addition, the Program focuses on intensive follow-up through one-on-one visits, group sessions, and phone calls. In this trial, participants 45 years or older with any evidence of established cardiovascular disease will be randomized to the BALANCE or control groups. Those in the BALANCE group will receive the afore mentioned program interventions, while controls will be given generic advice on how to follow a low-fat, low-energy, low-sodium, and low-cholesterol diet, with a view to achieving Brazilian nutritional guideline recommendations. The primary outcome is a composite of death (any cause), cardiac arrest, acute myocardial infarction, stroke, myocardial revascularization, amputation for peripheral arterial disease, or hospitalization for unstable angina. A total of 2468 patients will be enrolled in 34 sites and followed up for up to 48 months. If the BALANCE Program is found to decrease cardiovascular events and reduce risk factors, this may represent an advance in the care of patients with cardiovascular disease. Copyright © 2015 Elsevier Inc. All rights reserved.

Medicare Part D and Portfolio Choice.

PubMed

Ayyagari, Padmaja; He, Daifeng

2016-05-01

This study evaluates the impact of medical expenditure risk on portfolio choice among the elderly. The risk of large medical expenditures can be substantial for elderly individuals and is only partially mitigated by access to health insurance. The presence of deductibles, copayments, and other cost-sharing mechanisms implies that medical spending risk can be viewed as an undiversifiable background risk. Economic theory suggests that increases in background risk reduce the optimal financial risk that an individual or household is willing to bear (Pratt and Zeckhauser 1987; Elmendorf and Kimball 2000). In this study, we evaluate this hypothesis by estimating the impact of the introduction of the Medicare Part D program, which significantly reduced prescription drug spending risk for seniors, on portfolio choice.

The Building Assets-Reducing Risks Program: Replication and Expansion of an Effective Strategy to Turn Around Low-Achieving Schools. i3 Development Grant. Final Report

ERIC Educational Resources Information Center

Corsello, Maryann; Sharma, Anu

2015-01-01

The Building Assets Reducing Risks (BARR) Model BARR is a comprehensive model that addresses the challenges that are part of the 9th grade transition year. BARR employs eight different school-wide and individual strategies that are built on positive relationships and ongoing monitoring of student data. In 2010, BARR received an Investing in…

Graduated Driver Licensing in the United States: Evaluation Results from the Early Programs.

ERIC Educational Resources Information Center

Shope, Jean T.; Molnar, Lisa J.

2003-01-01

Review of graduated driver-licensing (GDL) programs in six states. Concludes that GDL programs are effective in reducing the crash risk of teenage drivers and that the impact of these studies and others to come will guide future research, practice, and policy. (Contains 2 tables and 19 references.) (AUTHOR/WFA)

The High Costs and Doubtful Efficacy of Extended Teacher-Preparation Programs: An Invitation to More Basic Reforms.

ERIC Educational Resources Information Center

Hawley, Willis D.

1987-01-01

Extended programs are likely to reduce the quality and quantity of teachers and probably will not improve teacher performance. Because the risks of extended programs are great and the benefits uncertain, other strategies for improving teacher education should be explored more aggressively. (Author/LHW)

The Langley Fitness Center

NASA Technical Reports Server (NTRS)

1993-01-01

NASA Langley recognizes the importance of healthy employees by committing itself to offering a complete fitness program. The scope of the program focuses on promoting overall health and wellness in an effort to reduce the risks of illness and disease and to increase productivity. This is accomplished through a comprehensive Health and Fitness Program offered to all NASA employees. Various aspects of the program are discussed.

WASTE REDUCTION OF TECHNOLOGY EVALUATIONS OF THE U.S. EPA WRITE PROGRAM

EPA Science Inventory

The Waste Reduction Innovative Technology Evaluation (WRITE)Program was established in 1989 to provide objective, accurate performance and cost data about waste reducing technologies for a variety of industrial and commercial application. EPA's Risk Reduction Engineering Laborato...

Randomized clinical trial to change parental practices for drug use in a telehealth prevention program: a pilot study.

PubMed

Valente, Juliana Y; Moreira, Tais Campos; Ferigolo, Maristela; Barros, Helena M T

2018-03-21

Programs for parents have been found to have a direct positive impact on reducing the consumption of psychoactive substances by adolescents, as well as having an indirect impact on reducing risk factors and increasing protective factors. The present study aimed to verify if a telehealth prevention program based on a brief motivational intervention helps to reduce parental risk practices and increase parental protective practices for drug use in comparison with psychoeducation. A pilot randomized controlled trial was performed at the National Service of Guidance and Information on Drug Use (Ligue 132), from September 2014 to December 2015, with the parents of adolescents (n=26). The outcome measures were parental style, risk, and protective parental practices. The brief motivational intervention was found to be more effective than psychoeducation in reducing the negligent behavior of parents. Furthermore, when comparing pre- and post-intervention data, the brief motivational intervention helped to change parental style and the large majority of parental practices: increasing positive monitoring, as well as decreasing physical abuse, relaxed discipline, inconsistent punishment, and negative monitoring. These results demonstrate that the telehealth intervention is effective in modifying the parental practices known to help in preventing drug use. Studies with more number of subjects are required so that the results can be substantiated and generalized. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

The Healthy Teen Girls project: comparison of health education and STD risk reduction intervention for incarcerated adolescent females.

PubMed

Robertson, Angela A; Robertson, Angela R; St Lawrence, Janet; Morse, David T; Baird-Thomas, Connie; Liew, Hui; Gresham, Kathleen

2011-06-01

Adolescent girls incarcerated in a state reformatory (N = 246) were recruited and assigned to an 18-session health education program or a time-equivalent HIV prevention program. Cohorts were assigned to conditions using a randomized block design separated by a washout period to reduce contamination. Post intervention, girls in the HIV risk reduction program demonstrated the acquisition of risk-reduction behavioral skills and improved condom application skill. At a follow-up assessment approximately 9 months after release from the correctional facility, girls in both conditions reported fewer unprotected sexual intercourse occasions and less sex while under the influence of alcohol or other drugs.

A computerized dynamic posturography (CDP) program to reduce fall risk in a community dwelling older adult with chronic stroke: a case report.

PubMed

Hakim, Renée M; Davies, Lauren; Jaworski, Kate; Tufano, Nina; Unterstein, Allison

2012-04-01

A systematic review by Barclay-Goddard et al (2004) reported that force platform feedback improved stance symmetry but not sway, clinical balance outcomes, or measures of independence in adults with stroke. However, the role of computerized dynamic posturography (CDP) systems was not explored. The purpose of this case report was to describe a CDP training program to improve balance and reduce fall risk in a patient with a diagnosis of chronic stroke. A 61-year-old patient 8 years poststroke participated in 1 hour of CDP training, three times a week over a period of 6 weeks. Examination was conducted before and after intervention using the Sensory Organization Test (SOT), Limits of Stability (LOS) test, and Weight Bearing/Squat Symmetry test on a CDP system, and clinical testing with the Berg Balance Scale (BBS), Timed Up and Go (TUG), Activities-specific Balance Confidence (ABC) scale, 30-second Chair Stand (CS), and range of motion of the ankle joints. The patient improved in sensory integration abilities on the SOT for conditions 4, 5, and 6, and maximum excursion abilities improved by a range of 23-103% on the LOS test. Scores on the BBS increased from 37/56 to 47/56, which indicated reduced fall risk and her ABC score improved from 50% to 70%. Ankle ROM improved bilaterally by 6 to 8 degrees. This CDP training program showed promise as a systematic, objective method to reduce fall risk with improved overground performance of balance tasks in an individual with chronic stroke.

Soccer-Specific Warm-Up and Lower Extremity Injury Rates in Collegiate Male Soccer Players

PubMed Central

Grooms, Dustin R.; Palmer, Thomas; Onate, James A.; Myer, Gregory D.; Grindstaff, Terry

2013-01-01

Context: A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effects but have had limited adoption across athletic settings. This may be due to program noncompliance, minimal exercise supervision, lack of exercise progression, and sport specificity. A soccer-specific program described as the F-MARC 11+ was developed by an expert group in association with the Federation Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC) to require minimal equipment and implementation as part of regular soccer training. The F-MARC 11+ has been shown to reduce injury risk in youth female soccer players but has not been evaluated in an American male collegiate population. Objective: To investigate the effects of a soccer-specific warm-up program (F-MARC 11+) on lower extremity injury incidence in male collegiate soccer players. Design: Cohort study. Setting: One American collegiate soccer team followed for 2 seasons. Patients or Other Participants: Forty-one male collegiate athletes aged 18–25 years. Intervention(s): The F-MARC 11+ program is a comprehensive warm-up program targeting muscular strength, body kinesthetic awareness, and neuromuscular control during static and dynamic movements. Training sessions and program progression were monitored by a certified athletic trainer. Main Outcome Measure(s): Lower extremity injury risk and time lost to lower extremity injury. Results: The injury rate in the referent season was 8.1 injuries per 1000 exposures with 291 days lost and 2.2 injuries per 1000 exposures and 52 days lost in the intervention season. The intervention season had reductions in the relative risk (RR) of lower extremity injury of 72% (RR = 0.28, 95% confidence interval = 0.09, 0.85) and time lost to lower extremity injury (P < .01). Conclusions: This F-MARC 11+ program reduced overall risk and severity of lower extremity injury compared with controls in collegiate-aged male soccer athletes. PMID:23848519

The Upside of Helicopter Parenting: Engaging Parents to Reduce First-Year Student Drinking

PubMed Central

Earle, Andrew M.; LaBrie, Joseph W.

2016-01-01

University personnel tend to view “helicopter” parents as problematic. This paper presents an alternative view in which these highly engaged parents can instead be utilized productively. We describe and assess the fidelity of a novel program in which involved parents were effectively leveraged to mitigate student alcohol-related risk. The feasibility of utilizing similar programs at other schools is discussed as are implications for alcohol risk prevention. PMID:27818727

The Upside of Helicopter Parenting: Engaging Parents to Reduce First-Year Student Drinking.

PubMed

Earle, Andrew M; LaBrie, Joseph W

2016-01-01

University personnel tend to view "helicopter" parents as problematic. This paper presents an alternative view in which these highly engaged parents can instead be utilized productively. We describe and assess the fidelity of a novel program in which involved parents were effectively leveraged to mitigate student alcohol-related risk. The feasibility of utilizing similar programs at other schools is discussed as are implications for alcohol risk prevention.

Environmental Assessment for Management of South End of Runway Wetlands, Moody AFB, Georgia

DTIC Science & Technology

2010-11-01

implement a management program for the wetlands at the south end of runway (EOR) at Moody AFB to reduce the bird/wildlife aircraft strike hazard (BASH) risk...because birds and other wildlife pose an increased bird/wildlife aircraft strike hazard (BASH) risk to aircraft utilizing the Moody AFB airfield. ln...support ofthe military mission, Moody AFB has implemented a BASH management program designed to minimize aircraft exposure to potentially hazardous

Reducing the risk of falls through proprioceptive dynamic posture training in osteoporotic women with kyphotic posturing: a randomized pilot study.

PubMed

Sinaki, Mehrsheed; Lynn, Susan G

2002-04-01

To assess the effect of a proprioceptive dynamic posture training program on balance in osteoporotic women with kyphotic posture. Subjects were randomly assigned to either a proprioceptive dynamic posture training program or exercise only group. Anthropometric measurements, muscle strength, level of physical activity, computerized dynamic posturography, and spine radiography were performed at baseline and 1 mo. At the 1-mo follow-up, three groups were formed on the basis of the baseline computerized dynamic posturography results. In general, groups 1 and 2 had no significant change at 1 mo, whereas group 3 improved balance significantly at 1 mo. The subjects who had abnormal balance and used the proprioceptive dynamic posture training program had the most significant improvement in balance. Improved balance could reduce the risk of falls.

Design for Minimum Risk

NASA Technical Reports Server (NTRS)

Wetherholt, Jon; Heimann, Timothy J.

2010-01-01

Design for Minimum Risk (DFMR) is a term used by NASA programs as an expansion of the general hazard reduction process where if an identified hazard cannot be eliminated, the design is modified to reduce the associated mishap risk to an acceptable level. DFMR is a set of specific requirements to minimize risk. DFMR is not well understood and there are many misconceptions concerning the meaning and use. This paper will provide insight into the use of DFMR for space applications; it s comparison to other hazard mitigation strategies and examples of how the approach has been used in the past. It will also highlight documents used by NASA on various programs to determine DFMR.

Financing commercial RLVs: Considering government incentives

NASA Astrophysics Data System (ADS)

Greenberg, Joel S.

1997-01-01

There appears to be a national goal to achieve a commercial space transportation industry that provides launch services utilizing a fleet of reusable launch vehicles (RLVs). Because of the combination of large required investment, inadequate rate of return, and perceived high risk, industry has indicated that this goal may not be achievable without government support. What form of government support will likely be necessary? Government programs and policies can effect private sector investment decisions by reducing risk perceptions, reducing capital requirements, and increasing expected rates of return. Different programs and policies will have different impacts. For example, tax policies will affect expected return on investment but are likely to have little or no effect on risk perceptions and magnitude of required investment, whereas anchor tenancy is likely to alter risk perceptions and may increase expected rates of return. This paper is concerned with the development of an approach that may be used to identify packages of government incentives that may be required to influence private sector investment decisions so as to achieve the desired goal of a commercial space transportation industry that provides launch services utilizing a fleet of RLVs. The paper discusses the relationship of government incentive programs and policies to the RLV investment decision.

NASA Collaborative Approach Mitigates Environmentally-Driven Obsolescence

NASA Technical Reports Server (NTRS)

Greene, Brian; Leeney, Bob; Richards, Joni

2016-01-01

National Aeronautics and Space Administration (NASA) missions, like Department of Defense (DoD) organizations, require the rigorous testing and qualification of critical materials. Obsolescence supply risks created by environmental requirements can affect the cost, schedule and performance of NASA missions and the resilience of critical infrastructure. The NASA Technology Evaluation for Environmental Risk Mitigation (TEERM) Principal Center helps to identify obsolescence supply risks driven by environmental requirements and works proactively with NASA Centers and Programs, the DoD, the European Space Agency (ESA) and other agencies and partners to identify and evaluate environmentally friendly alternatives. TEERM tracks environmental regulations, identifies the potential loss of material availability and works with NASA programs and Centers to evaluate potential impacts through a risk assessment approach. TEERM collaborative projects identify, demonstrate and evaluate commercially viable alternative technologies and materials. A major focus during the Space Shuttle Program was the need to replace ozone depleting substances that were used in spray foam and cleaning applications. The potential obsolescence of coatings containing hexavalent chromium and the risks associated with lead free solder were also of concern for the Space Shuttle and present ongoing risks to new programs such as the Space Launch System. One current project teams NASA and ESA in the evaluation and testing of individual coatings and coating systems as replacements for hexavalent chromium coatings in aerospace applications. The proactive, collaborative approach used by TEERM helps reduce the cost burden on any one team partner, reduces duplication of effort, and enhances the technical quality and overall applicability of the testing and analysis.

Reducing software security risk through an integrated approach research initiative model based verification of the Secure Socket Layer (SSL) Protocol

NASA Technical Reports Server (NTRS)

Powell, John D.

2003-01-01

This document discusses the verification of the Secure Socket Layer (SSL) communication protocol as a demonstration of the Model Based Verification (MBV) portion of the verification instrument set being developed under the Reducing Software Security Risk (RSSR) Trough an Integrated Approach research initiative. Code Q of the National Aeronautics and Space Administration (NASA) funds this project. The NASA Goddard Independent Verification and Validation (IV&V) facility manages this research program at the NASA agency level and the Assurance Technology Program Office (ATPO) manages the research locally at the Jet Propulsion Laboratory (California institute of Technology) where the research is being carried out.

Childhood obesity prevention in rural settings: background, rationale, and study design of '4-Health,' a parent-only intervention.

PubMed

Lynch, Wesley C; Martz, Jill; Eldridge, Galen; Bailey, Sandra J; Benke, Carrie; Paul, Lynn

2012-04-02

Childhood obesity in rural communities is a serious but understudied problem. The current experiment aims to assess a wide range of obesity risk factors among rural youth and to offer an 8-month intervention program for parents to reduce obesity risk in their preteen child. A two-group, repeated measures design is used to assess the effectiveness of the 4-Health intervention program. Assessments include anthropometric measures, child self-evaluations, parent self-evaluations, and parent evaluations of child. County Extension agents from 21 rural Montana counties recruit approximately 150 parent-child dyads and counties are semi-randomly assigned to the active intervention group (4-Health Educational Program) or a "best-practices" (Healthy Living Information) control group. This study will shed light on the effectiveness of this parent-only intervention strategy in reducing obesity risk factors among rural preteens. The 4-Health program is designed to provide information and skills development for busy rural parents that will increase healthy lifestyles of their preteen children and improve the parents' ability to intervene effectively in the lives of their families during this critical developmental period. ClinicalTrials.gov ID: NCT01510587.

Of Malthus and Methuselah: does longevity treatment aggravate global catastrophic risks?

NASA Astrophysics Data System (ADS)

Jebari, Karim

2014-12-01

Global catastrophic risk is a term that refers to the risk of the occurrence of an event that kills at least millions of people across several continents. While it has been argued by a number of scholars that one major potential risk comes from technology, the obscure nature of future technologies makes it difficult to utilize traditional probabilistic risk for the meaningful study of these risks. This article describes an alternative approach and applies it to a research program that has attracted a considerable amount of resources recently: namely longevity research. The aim of this research is to delay or reverse the ageing process. This article argues that this research program is much more risky or less beneficial than its proponents argue. In particular, they tend to underestimate the concerns associated with the potentially drastic population growth that longevity treatment could cause. The ethical benefit often ascribed to longevity treatment is that such treatment would add more subjective life-years that are worth living. However, in light of contemporary environmental problems, such an increase of the human population might be reckless. Drastically reducing fertility to reduce risks associated with environmental stress would make the benefits of such technology much less compelling.

Reducing drinking water supply chemical contamination: risks from underground storage tanks.

PubMed

Enander, Richard T; Hanumara, R Choudary; Kobayashi, Hisanori; Gagnon, Ronald N; Park, Eugene; Vallot, Christopher; Genovesi, Richard

2012-12-01

Drinking water supplies are at risk of contamination from a variety of physical, chemical, and biological sources. Ranked among these threats are hazardous material releases from leaking or improperly managed underground storage tanks located at municipal, commercial, and industrial facilities. To reduce human health and environmental risks associated with the subsurface storage of hazardous materials, government agencies have taken a variety of legislative and regulatory actions--which date back more than 25 years and include the establishment of rigorous equipment/technology/operational requirements and facility-by-facility inspection and enforcement programs. Given a history of more than 470,000 underground storage tank releases nationwide, the U.S. Environmental Protection Agency continues to report that 7,300 new leaks were found in federal fiscal year 2008, while nearly 103,000 old leaks remain to be cleaned up. In this article, we report on an alternate evidence-based intervention approach for reducing potential releases from the storage of petroleum products (gasoline, diesel, kerosene, heating/fuel oil, and waste oil) in underground tanks at commercial facilities located in Rhode Island. The objective of this study was to evaluate whether a new regulatory model can be used as a cost-effective alternative to traditional facility-by-facility inspection and enforcement programs for underground storage tanks. We conclude that the alternative model, using an emphasis on technical assistance tools, can produce measurable improvements in compliance performance, is a cost-effective adjunct to traditional facility-by-facility inspection and enforcement programs, and has the potential to allow regulatory agencies to decrease their frequency of inspections among low risk facilities without sacrificing compliance performance or increasing public health risks. © 2012 Society for Risk Analysis.

Violence exposure and health related risk among African American adolescent female detainees: A strategy for reducing recidivism

PubMed Central

Woodson, Kamilah M.; Hives, Courtney; Sanders-Phillips, Kathy

2010-01-01

Juvenile crime and violent victimization continue to be significant social problems (Fitzpatrick, Piko, Wright, & LaGory, 2005); in that, adolescents, females in particular, are likely to participate in health related risk behaviors as result of having been victimized or exposed to a violent environment. Specifically, abuse, neglect, sexual molestation, poverty, and witnessing violence are well known risk factors for the development of trauma-related psychopathology and poor outcomes relative to delinquency, drug and alcohol abuse, and HIV risk behaviors (Steiner, Garcia, & Matthews, 1997). HIV infection is a common public health concern disproportionally affecting adolescent African American female detainees. This unique population has a serious history of violence exposure, which subsequently tends to lead to engaging in risky sexual behaviors, mental health problems, and abusing substances. Also, as a result of little to no intervention, this population is recidivating at an alarming rate, a problem that may further exacerbate the expression of health-related risk behaviors among African American adolescent female detainees. The authors briefly describe a pilot program to be implemented in the juvenile justice system that is based on the Model of Accumulated Risk (Garbarino, 1996), Bronfenbrenner’s Ecological Model (1994), and the Positive Youth Justice Model (Butts, Bazemore, & Meroe, 2009). The program proposes to reduce risky sexual behaviors, teach alternatives to abusing substances, treat mental health concerns, and reduce the rate of recidivism through “positive youth development”, PYD (Butts, Bazemore, & Meroe, 2009). Tying elements of wraparound services and reeducation together, this program addresses salient concerns that may have an impact on an adolescent detainees’ success following their release from prison in a holistic manner. PMID:21373205

Implementation of a patient safety program at a tertiary health system: A longitudinal analysis of interventions and serious safety events.

PubMed

Cropper, Douglas P; Harb, Nidal H; Said, Patricia A; Lemke, Jon H; Shammas, Nicolas W

2018-04-01

We hypothesize that implementation of a safety program based on high reliability organization principles will reduce serious safety events (SSE). The safety program focused on 7 essential elements: (a) safety rounding, (b) safety oversight teams, (c) safety huddles, (d) safety coaches, (e) good catches/safety heroes, (f) safety education, and (g) red rule. An educational curriculum was implemented focusing on changing high-risk behaviors and implementing critical safety policies. All unusual occurrences were captured in the Midas system and investigated by risk specialists, the safety officer, and the chief medical officer. A multidepartmental committee evaluated these events, and a root cause analysis (RCA) was performed. Events were tabulated and serious safety event (SSE) recorded and plotted over time. Safety success stories (SSSs) were also evaluated over time. A steady drop in SSEs was seen over 9 years. Also a rise in SSSs was evident, reflecting on staff engagement in the program. The parallel change in SSEs, SSSs, and the implementation of various safety interventions highly suggest that the program was successful in achieving its goals. A safety program based on high-reliability organization principles and made a core value of the institution can have a significant positive impact on reducing SSEs. © 2018 American Society for Healthcare Risk Management of the American Hospital Association.

Natural hazards research and response; international decade for reducing loss from natural disasters

USGS Publications Warehouse

Hays, W.W.

1992-01-01

IDNDR offers an unprecedented opportunity to apply new knowledge and technology to minimize losses in regions at high risks. The program is very challenging because full implementation requires a multidisciplinary effort on a global scale, an undertaking never before attempted. In concert with the other signatory nations, the Untied States is carrying out a balanced and comprehensive program of research and applications as a contribution to the IDNDR. The U.S program is designed to reduce both loss of life and property damage from natural disasters.  

A Cardiovascular Risk Reduction Program for American Indians with Metabolic Syndrome: The Balance Study

ERIC Educational Resources Information Center

Lee, Elisa T.; Jobe, Jared B.; Yeh, Jeunliang; Ali, Tauqeer; Rhoades, Everett R.; Knehans, Allen W.; Willis, Diane J.; Johnson, Melanie R.; Zhang, Ying; Poolaw, Bryce; Rogers, Billy

2012-01-01

The Balance Study is a randomized controlled trial designed to reduce cardiovascular disease (CVD) risk in 200 American Indian (AI) participants with metabolic syndrome who reside in southwestern Oklahoma. Major risk factors targeted include weight, diet, and physical activity. Participants are assigned randomly to one of two groups, a guided or a…

The Influence of Homebuyer Education on Default and Foreclosure Risk: A Natural Experiment

ERIC Educational Resources Information Center

Brown, Scott R.

2016-01-01

The recent housing crisis has generated debate over the benefits and risks of policies and programs promoting homeownership for low and moderate income households. One important facet of this conversation is whether prepurchase homebuyer education (HBE) is effective in reducing default or foreclosure risk. Studies to date have primarily focused on…

Phase 0/I/II Cancer Prevention Clinical Trials Program Clinical Trials | Division of Cancer Prevention

Cancer.gov

The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

Risk Management for Human Support Technology Development

NASA Technical Reports Server (NTRS)

jones, Harry

2005-01-01

NASA requires continuous risk management for all programs and projects. The risk management process identifies risks, analyzes their impact, prioritizes them, develops and carries out plans to mitigate or accept them, tracks risks and mitigation plans, and communicates and documents risk information. Project risk management is driven by the project goal and is performed by the entire team. Risk management begins early in the formulation phase with initial risk identification and development of a risk management plan and continues throughout the project life cycle. This paper describes the risk management approach that is suggested for use in NASA's Human Support Technology Development. The first step in risk management is to identify the detailed technical and programmatic risks specific to a project. Each individual risk should be described in detail. The identified risks are summarized in a complete risk list. Risk analysis provides estimates of the likelihood and the qualitative impact of a risk. The likelihood and impact of the risk are used to define its priority location in the risk matrix. The approaches for responding to risk are either to mitigate it by eliminating or reducing the effect or likelihood of a risk, to accept it with a documented rationale and contingency plan, or to research or monitor the risk, The Human Support Technology Development program includes many projects with independently achievable goals. Each project must do independent risk management, considering all its risks together and trading them against performance, budget, and schedule. Since the program can succeed even if some projects fail, the program risk has a complex dependence on the individual project risks.

A Community Health Advisor Program to reduce cardiovascular risk among rural African-American women

PubMed Central

Cornell, C. E.; Littleton, M. A.; Greene, P. G.; Pulley, L.; Brownstein, J. N.; Sanderson, B. K.; Stalker, V. G.; Matson-Koffman, D.; Struempler, B.; Raczynski, J. M.

2009-01-01

The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and training, community intervention and maintenance. Formative data collected to develop the training, intervention and evaluation methods and materials indicated the need for programs to increase knowledge, skills and resources for changing behaviors that increase the risk of CVD. CHAs worked in partnership with staff to develop, implement, evaluate and maintain strategies to reduce risk for CVD in women and to influence city officials, business owners and community coalitions to facilitate project activities. Process data documented sustained increases in social capital and community capacity to address health-related issues, as well as improvements in the community’s physical infrastructure. This project is unique in that it documents that a comprehensive CHA-based intervention for CVD can facilitate wide-reaching changes in capacity to address health issues in a rural community that include improvements in community infrastructure and are sustained beyond the scope of the originally funded intervention. PMID:19047648

DARPA Workshop on Geothermal Energy for Military Operations

DTIC Science & Technology

2010-05-01

is administered by its Geothermal Program Office (GPO) at the Navy Air Weapons Station, China Lake, CA. GPO manages the Coso Geo- thermal Field at...advanced geothermal technologies might reduce the risk and cost to the point where the U.S. military would be able to take advantage. Supplying geothermal...was con- vened to explore whether investment in advanced geothermal technologies might reduce the risk and cost to the point where the U.S. military

HIV Risk Reduction Among Young Adult Chronic Psychiatric Patients

DTIC Science & Technology

1990-08-28

was noted in a cohort of gay men in California. The human immunodeficiency virus (HIV) was discovered as the cause of AIDS and the HI V antibody...sexual practices among homosexual and bisexual men provide a framework for the development of any prevention program designed to reduce the risk of HIV...and the Multicenter Aids Cohort Study and note that many gay men have significantly reduced the frequency of unprotected anal Intercourse. Winkelstein

Can a school-wide bullying prevention program improve the plight of victims? Evidence for risk × intervention effects.

PubMed

Juvonen, Jaana; Schacter, Hannah L; Sainio, Miia; Salmivalli, Christina

2016-04-01

This study was designed to examine whether a school-wide antibullying program, effective in reducing incidents of bullying, can also reduce the harm associated with victimization. Specifically, we test whether baseline victimization moderates the KiVa program intervention effects on school perceptions, depression, and self-esteem. Relying on a randomized control sample consisting of 7,010 fourth to sixth grade Finnish elementary school students, self-report data were examined using multilevel modeling across 39 intervention and 38 control schools over a 12-month period. The KiVa program was particularly effective in facilitating perceptions of a caring school climate among students who were most victimized before the intervention, while program benefits on attitudes toward school did not vary by level of victimization. The intervention effects on depression and self-esteem were strongest only among the most victimized sixth graders. The results suggest that antibullying programs designed to improve the school ecology can alleviate the plight of the victimized and underscore that harm reduction should be assessed by testing risk × intervention effects when evaluating effectiveness of such programs. (c) 2016 APA, all rights reserved).

Translation of an Evidence-Based Tailored Childhood Injury Prevention Program

PubMed Central

Weaver, Nancy L.; Williams, Janice; Jacobsen, Heather A.; Botello-Harbaum, Maria; Glasheen, Cristie; Noelcke, Elizabeth; Nansel, Tonja R.

2008-01-01

This article describes the process of translating Safe n’ Sound, a computer-based program for parents of young children, for a general clinic environment. Safe n’ Sound is designed to reduce the risk of unintentional childhood injuries, the leading cause of death among children older than 1 year in the United States. The evidence-based program produces tailored information for parents and their healthcare provider about burns, falls, poisoning, drowning, suffocations, choking prevention, and car safety. To offer Safe n’ Sound to a broader audience, we translated the program from the form used for efficacy testing to a stand-alone application. Notable steps in this translation included (1) conducting an organizational assessment to determine the needs of the clinic staff and feasibility of implementation, (2) modifying the program to reduce length, prioritize risk areas, and update content, (3) repackaging the program to minimize cost and space requirements, and (4) developing promotional and instructional materials. Factors contributing to the success of this effort include strong collaborative partnerships, the relative advantage of Safe n’ Sound over traditional materials, the modifiable design of the program, and the support of the clinic staff and providers. Challenges and areas for future work are discussed. PMID:18287925

Ground support system methodology and architecture

NASA Technical Reports Server (NTRS)

Schoen, P. D.

1991-01-01

A synergistic approach to systems test and support is explored. A building block architecture provides transportability of data, procedures, and knowledge. The synergistic approach also lowers cost and risk for life cycle of a program. The determination of design errors at the earliest phase reduces cost of vehicle ownership. Distributed scaleable architecture is based on industry standards maximizing transparency and maintainability. Autonomous control structure provides for distributed and segmented systems. Control of interfaces maximizes compatibility and reuse, reducing long term program cost. Intelligent data management architecture also reduces analysis time and cost (automation).

78 FR 31554 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... Brief Description Cardiovascular disease (CVD), which includes heart disease, myocardial infarction, and... assess the effectiveness of the WISEWOMAN program in reducing the burden of cardiovascular disease risk... incidence, cardiovascular disease risk-factors, health promotion, to improve the availability of screening...

Resource List--Using Evidence-Based Programs as the Foundation of Comprehensive Sex Education

ERIC Educational Resources Information Center

Advocates for Youth, 2015

2015-01-01

Decades of research have identified dozens of programs that are effective in helping young people reduce their risk for pregnancy, HIV, and STDs. These evidence-based programs utilize strategies that include the provision of accurate, honest information about abstinence as well as contraception and can serve as the foundation for comprehensive sex…

Improved Physical Fitness among Older Female Participants in a Nationally Disseminated, Community-Based Exercise Program

ERIC Educational Resources Information Center

Seguin, Rebecca A.; Heidkamp-Young, Eleanor; Kuder, Julia; Nelson, Miriam E.

2012-01-01

Background: Strength training (ST) is an important health behavior for aging women; it helps maintain strength and function and reduces risk for chronic diseases. This study assessed change in physical fitness following participation in a ST program implemented and evaluated by community leaders. Method: The StrongWomen Program is a nationally…

A School-Based Dental Program Evaluation: Comparison to the Massachusetts Statewide Survey

ERIC Educational Resources Information Center

Culler, Corinna S.; Kotelchuck, Milton; Declercq, Eugene; Kuhlthau, Karen; Jones, Kari; Yoder, Karen M.

2017-01-01

Background: School-based dental programs target high-risk communities and reduce barriers to obtaining dental services by delivering care to students in their schools. We describe the evaluation of a school-based dental program operating in Chelsea, a city north of Boston, with a low-income and largely minority population, by comparing…

A Primary Prevention Program to Reduce Bulimia and Anorexia Nervosa.

ERIC Educational Resources Information Center

Cullari, Salvatore; Redmon, William K.

This paper presents a theoretical model for a primary prevention program for bulimia and anorexia nervosa to be used with adolescents and young women considered most at risk of developing these eating disorders. Characteristics of potential anorexics and bulimics are identified to aid in the selection of target groups for the program. It is…

Evaluating Knowledge, Attitudinal, and Behavioral Change Effects from a Multinational HIV/AIDS Education Program for Youth

ERIC Educational Resources Information Center

Hardre, Patricia L.; Garcia, Fe; Apamo, Peter; Mutheu, Lucy; Ndege, Monica; Bois, Iderle

2010-01-01

This project tracked the mid-term evaluation processes, practices, and products of a multinational program to reduce at-risk behaviors for HIV/AIDS among children in Kenya, Tanzania, and Haiti. It focused on participant and community perceptions; program effectiveness in promoting abstinence and monogamy decisions; and factors supporting ongoing…

Bioastronautics Roadmap: A Risk Reduction Strategy for Human Space Exploration

NASA Technical Reports Server (NTRS)

2005-01-01

The Bioastronautics Critical Path Roadmap is the framework used to identify and assess the risks to crews exposed to the hazardous environments of space. It guides the implementation of research strategies to prevent or reduce those risks. Although the BCPR identifies steps that must be taken to reduce the risks to health and performance that are associated with human space flight, the BCPR is not a "critical path" analysis in the strict engineering sense. The BCPR will evolve to accommodate new information and technology development and will enable NASA to conduct a formal critical path analysis in the future. As a management tool, the BCPR provides information for making informed decisions about research priorities and resource allocation. The outcome-driven nature of the BCPR makes it amenable for assessing the focus, progress and success of the Bioastronautics research and technology program. The BCPR is also a tool for communicating program priorities and progress to the research community and NASA management.

Legal and ethical implications of health care provider insurance risk assumption.

PubMed

Cox, Thomas

2010-01-01

From bedside to boardroom, nurses deal with the consequences of health care provider insurance risk assumption. Professional caregiver insurance risk refers to insurance risks assumed through contracts with third parties, federal and state Medicare and Medicaid program mandates, and the diagnosis-related groups and Prospective Payment Systems. This article analyzes the financial, legal, and ethical implications of provider insurance risk assumption by focusing on the degree to which patient benefits are reduced.

Long-Term International Space Station (ISS) Risk Reduction Activities

NASA Astrophysics Data System (ADS)

Fodroci, M. P.; Gafka, G. K.; Lutomski, M. G.; Maher, J. S.

2012-01-01

As the assembly of the ISS nears completion, it is worthwhile to step back and review some of the actions pursued by the Program in recent years to reduce risk and enhance the safety and health of ISS crewmembers, visitors, and space flight participants. While the initial ISS requirements and design were intended to provide the best practicable levels of safety, it is always possible to further reduce risk - given the determination, commitment, and resources to do so. The following is a summary of some of the steps taken by the ISS Program Manager, by our International Partners, by hardware and software designers, by operational specialists, and by safety personnel to continuously enhance the safety of the ISS, and to reduce risk to all crewmembers. While years of work went into the development of ISS requirements, there are many things associated with risk reduction in a Program like the ISS that can only be learned through actual operational experience. These risk reduction activities can be divided into roughly three categories: Areas that were initially noncompliant which have subsequently been brought into compliance or near compliance (i.e., Micrometeoroid and Orbital Debris [MMOD] protection, acoustics) Areas where initial design requirements were eventually considered inadequate and were subsequently augmented (i.e., Toxicity Hazard Level- 4 [THL] materials, emergency procedures, emergency equipment, control of drag-throughs) Areas where risks were initially underestimated, and have subsequently been addressed through additional mitigation (i.e., Extravehicular Activity [EVA] sharp edges, plasma shock hazards) Due to the hard work and cooperation of many parties working together across the span of more than a decade, the ISS is now a safer and healthier environment for our crew, in many cases exceeding the risk reduction targets inherent in the intent of the original design. It will provide a safe and stable platform for utilization and discovery for years to come.

Long-Term International Space Station (ISS) Risk Reduction Activities

NASA Technical Reports Server (NTRS)

Forroci, Michael P.; Gafka, George K.; Lutomski, Michael G.; Maher, Jacilyn S.

2011-01-01

As the assembly of the ISS nears completion, it is worthwhile to step back and review some of the actions pursued by the Program in recent years to reduce risk and enhance the safety and health of ISS crewmembers, visitors, and space flight participants. While the initial ISS requirements and design were intended to provide the best practicable levels of safety, it is always possible to further reduce risk given the determination, commitment, and resources to do so. The following is a summary of some of the steps taken by the ISS Program Manager, by our International Partners, by hardware and software designers, by operational specialists, and by safety personnel to continuously enhance the safety of the ISS, and to reduce risk to all crewmembers. While years of work went into the development of ISS requirements, there are many things associated with risk reduction in a Program like the ISS that can only be learned through actual operational experience. These risk reduction activities can be divided into roughly three categories: Areas that were initially noncompliant which have subsequently been brought into compliance or near compliance (i.e., Micrometeoroid and Orbital Debris [MMOD] protection, acoustics) Areas where initial design requirements were eventually considered inadequate and were subsequently augmented (i.e., Toxicity hazard level-4 materials, emergency procedures, emergency equipment, control of drag-throughs) Areas where risks were initially underestimated, and have subsequently been addressed through additional mitigation (i.e., Extravehicular Activity [EVA] sharp edges, plasma shock hazards). Due to the hard work and cooperation of many parties working together across the span of more than a decade, the ISS is now a safer and healthier environment for our crew, in many cases exceeding the risk reduction targets inherent in the intent of the original design. It will provide a safe and stable platform for utilization and discovery for years to come.

40 CFR 35.700 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants for Tribes Indoor Radon Grants (section 306) § 35.700 Purpose. (a... programs that assess and mitigate radon and that aim at reducing radon health risks. Indoor Radon Grant...

7 CFR 1437.1 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Provisions § 1437.1 Applicability. (a) The Noninsured Crop Disaster Assistance Program (NAP) is intended to... of crop insurance. NAP is designed to help reduce production risks faced by producers of commercial crops or other agricultural commodities. NAP will reduce financial losses that occur when natural...

Transfer of financial risk and alternative financing solutions.

PubMed

Levitt, Jeffrey C

2004-01-01

The high cost of health care in the United States has created a number of alarming economic and social problems. It has contributed to a greater number of underinsured and uninsured individuals living in the United States, and forced people to either ration or not purchase the care they need. Accumulated medical debt is grossly disproportionate to the US median AGI, and accounted for at least 25 percent of all personal bankruptcies. For patients, a guaranteed loan program specifically for medical procedures and treatments with below market interest rates would help alleviate bankruptcies related to medical debt by lowering payments and extending the loan maturities. A guaranteed loan program would also improve the debt charge-off rate for medical providers that carry patient receivables and reduce the risk of their balance sheets. This might hold or reduce the rate at which health care inflation grows. The health care loan program could model the current student loan programs and produce significant economic and societal benefits.

Human Research Program: 2012 Fiscal Year Annual Report

NASA Technical Reports Server (NTRS)

Effenhauser, Laura

2012-01-01

Crew health and performance are critical to successful human exploration beyond low Earth orbit. Risks to health and performance include physiologic effects from radiation, hypogravity, and planetary environments, as well as unique challenges in medical treatment, human factors, and support of behavioral health. The scientists and engineers of the Human Research Program (HRP) investigate and reduce the greatest risks to human health and performance, and provide essential countermeasures and technologies for human space exploration. In its seventh year of operation, the HRP continued to refine its management architecture of evidence, risks, gaps, tasks, and deliverables. Experiments continued on the International Space Station (ISS), on the ground in analog environments that have features similar to those of spaceflight, and in laboratory environments. Data from these experiments furthered the understanding of how the space environment affects the human system. These research results contributed to scientific knowledge and technology developments that address the human health and performance risks. As shown in this report, HRP has made significant progress toward developing medical care and countermeasure systems for space exploration missions which will ultimately reduce risks to crew health and performance.

Enhancing Supportive-Educative Nursing Systems to Reduce Risk of Post-Breast Cancer Lymphedema

PubMed Central

Armer, Jane M.; Shook, Robin P.; Schneider, Melanie K; Brooks, Constance W.; Peterson, Julie; Stewart, Bob R

2010-01-01

This study describes the use of data regarding self-care agency to enhance a supportive-educative nursing system for breast cancer survivors to reduce the risk of developing lymphedema post surgery. Impetus for this study came from the analysis of participant feedback from a parent study (Lance Armstrong Foundation pilot study) that sought to plan an educational program for nurses that will improve their supportive-educative nursing system when working with breast cancer survivors. The goal is to enable these women to reduce the risk of lymphedema post surgery. The parent study examined a bundled behavioral-educative intervention, which included standard lymphedema education coupled with Modified Manual Lymph Drainage (MMLD) to reduce the risk of developing lymphedema in newly-diagnosed breast cancer survivors. Based upon the feedback received from the parent study, the research team recognized that many of the participants were not fully following the recommendations of the intervention protocol. In order for nurses to help patients develop self-care agency (SCA) (Orem, 2001) to engage in actions that addressed the self-care requisites associated with post-breast cancer surgery, these nurses needed to refine their intervention skills. Prior to the development of a program for the nurses, the research team conducted a study to explore the state of power related to SCA of the study participants. The information obtained from this was then used in the development of an educational program for bundled intervention. Both motivational interviewing (Miller & Rollnick, 2002) and solution-focused therapy (Berg & DeJong, 1996) were incorporated into the educational program for the research nurse team to strengthen and improve supportive-educative nursing systems. Supportive-educative systems of care that integrate self-care deficit nursing theory, motivational interviewing, and solution-focused therapy can assist patients to develop and sustain self-care agency. PMID:22872189

Safer choices: reducing teen pregnancy, HIV, and STDs.

PubMed Central

Coyle, K.; Basen-Engquist, K.; Kirby, D.; Parcel, G.; Banspach, S.; Collins, J.; Baumler, E.; Carvajal, S.; Harrist, R.

2001-01-01

OBJECTIVES: This study evaluated the long-term effectiveness of Safer Choices, a theory-based, multi-component educational program designed to reduce sexual risk behaviors and increase protective behaviors in preventing HIV, other STDs, and pregnancy among high school students. METHODS: The study used a randomized controlled trial involving 20 high schools in California and Texas. A cohort of 3869 ninth-grade students was tracked for 31 months from fall semester 1993 (baseline) to spring semester 1996 (31-month follow-up). Data were collected using self-report surveys administered by trained data collectors. Response rate at 31-month follow-up was 79%. RESULTS: Safer Choices had its greatest effect on measures involving condom use. The program reduced the frequency of intercourse without a condom during the three months prior to the survey, reduced the number of sexual partners with whom students had intercourse without a condom, and increased use of condoms and other protection against pregnancy at last intercourse. Safer Choices also improved 7 of 13 psychosocial variables, many related to condom use, but did not have a significant effect upon rates of sexual initiation. CONCLUSIONS: The Safer Choices program was effective in reducing important risk behaviors for HIV, other STDs, and pregnancy and in enhancing most psychosocial determinants of such behavior. PMID:11889277

Public Risk Assessment Program

NASA Technical Reports Server (NTRS)

Mendeck, Gavin

2010-01-01

The Public Entry Risk Assessment (PERA) program addresses risk to the public from shuttle or other spacecraft re-entry trajectories. Managing public risk to acceptable levels is a major component of safe spacecraft operation. PERA is given scenario inputs of vehicle trajectory, probability of failure along that trajectory, the resulting debris characteristics, and field size and distribution, and returns risk metrics that quantify the individual and collective risk posed by that scenario. Due to the large volume of data required to perform such a risk analysis, PERA was designed to streamline the analysis process by using innovative mathematical analysis of the risk assessment equations. Real-time analysis in the event of a shuttle contingency operation, such as damage to the Orbiter, is possible because PERA allows for a change to the probability of failure models, therefore providing a much quicker estimation of public risk. PERA also provides the ability to generate movie files showing how the entry risk changes as the entry develops. PERA was designed to streamline the computation of the enormous amounts of data needed for this type of risk assessment by using an average distribution of debris on the ground, rather than pinpointing the impact point of every piece of debris. This has reduced the amount of computational time significantly without reducing the accuracy of the results. PERA was written in MATLAB; a compiled version can run from a DOS or UNIX prompt.

Folic Acid Food Fortification—Its History, Effect, Concerns, and Future Directions

PubMed Central

Crider, Krista S.; Bailey, Lynn B.; Berry, Robert J.

2011-01-01

Periconceptional intake of folic acid is known to reduce a woman’s risk of having an infant affected by a neural tube birth defect (NTD). National programs to mandate fortification of food with folic acid have reduced the prevalence of NTDs worldwide. Uncertainty surrounding possible unintended consequences has led to concerns about higher folic acid intake and food fortification programs. This uncertainty emphasizes the need to continually monitor fortification programs for accurate measures of their effect and the ability to address concerns as they arise. This review highlights the history, effect, concerns, and future directions of folic acid food fortification programs. PMID:22254102

Research on Captive Broodstock Programs for Pacific Salmon, 2001-2002 Annual Report.

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

Berejikian, Barry A.; Tezak, E.P.; Endicott, Rick

In the 2000 Federal Columbia River Power System (FCRPS) Biological Opinion, NMFS identified six populations of steelhead and several salmon populations that had dropped to critically low levels and continue to decline. Following thorough risk-benefit analyses, captive propagation programs for some or all of the steelhead (Oncorhynchus mykiss) populations may be required to reduce the risk of extinction, and more programs may be required in the future. Thus, captive propagation programs designed to maintain or rebuild steelhead populations require intensive and rigorous scientific evaluation, much like the other objectives of BPA Project 1993-056-00 currently underway for chinook (O. tshawytscha) andmore » sockeye salmon (O. nerka). Pacific salmon reared to the adult stage in captivity exhibit poor reproductive performance when released to spawn naturally. Poor fin quality and swimming performance, incomplete development of secondary sex characteristics, changes in maturation timing, and other factors may contribute to reduced spawning success. Improving natural reproductive performance is critical for the success of captive broodstock programs in which adult-release is a primary reintroduction strategy for maintaining ESA-listed populations.« less

Header: Do adult DTC programs prevent child maltreatment? Parental criminal justice involvement and children’s involvement with child protective services: Do adult drug treatment courts prevent child maltreatment?

PubMed Central

Eldred, Lindsey M.; Sloan, Frank A.; Evans, Kelly E.

2016-01-01

Background In light of evidence showing reduced criminal recidivism and cost savings, adult drug treatment courts have grown in popularity. However, the potential spillover benefits to family members are understudied. Objectives To examine: 1) the overlap between parents who were convicted of a substance-related offense and their children’s involvement with child protective services (CPS); and 2) whether parental participation in an adult drug treatment court program reduces children’s risk for CPS involvement. Methods Administrative data from North Carolina courts, birth records, and social services were linked at the child level. First, children of parents convicted of a substance-related offense were matched to (a) children of parents convicted of a non-substance-related offense and (b) those not convicted of any offense. Second, we compared children of parents who completed a DTC program with children of parents who were referred but did not enroll, who enrolled for <90 days but did not complete, and who enrolled for 90+ days but did not complete. Multivariate logistic regression was used to model group differences in the odds of being reported to CPS in the one to three years following parental criminal conviction or, alternatively, being referred to a DTC program. Results Children of parents convicted of a substance-related offense were at greater risk of CPS involvement than children whose parents were not convicted of any charge, but DTC participation did not mitigate this risk. Conclusion/Importance The role of specialty courts as a strategy for reducing children’s risk of maltreatment should be further explored. PMID:26789656

Emotional Intelligence: An Untapped Resource for Alcohol and Other Drug Related Prevention among Adolescents and Adults

PubMed Central

Coelho, Ken Russell

2012-01-01

Alcohol and Other Drug abuse in adolescents and adults continues to be a major public health problem in the United States. Care in intervention programs aimed at high risk populations identified occurs after the maladaptive behavioral delinquency has occurred, and only then is an individual afforded the opportunity to join an intervention program. The focus of this paper is to illustrate and highlight the value of prevention programs which emphasize altering maladaptive behavior before the behavior becomes problematic. Emotional Intelligence is not only an indicator of alcohol and other drug abuse, but is linked to emotional competence, social and emotional learning, the development of healthy and life promoting behavior, and has been proven to reduce some of the risk factors associated with alcohol and other drug abuse in adolescents and adults. This paper seeks to recognize the significance of Emotional Intelligence as a desirable health promoting attribute and to establish the importance of its conceptual use in a prevention based model for reducing associated high risk behaviors. PMID:22570777

Steps to reduce favorable risk selection in medicare advantage largely succeeded, boding well for health insurance exchanges

PubMed Central

Newhouse, Joseph P.; Price, Mary; Huang, Jie; McWilliams, J. Michael; Hsu, John

2012-01-01

Managing competition among health plans that attract different risks has been a challenging policy problem. Within Medicare, the Medicare Advantage (MA) program historically attracted better risks than did Traditional Medicare (TM). This favorable selection resulted in Medicare’s paying more for persons enrolled in MA than if they had been enrolled in TM. We studied whether policies Medicare implemented in the past decade to reduce favorable selection in the MA program succeeded, in particular improved matching of reimbursement with a beneficiary’s expected cost and restricting when beneficiaries could switch from MA to TM. We found they did. Differences in predicted spending between those switching from TM to MA relative to those who remained in TM markedly narrowed, as did adjusted mortality rates. Because insurance exchanges will employ similar policies to combat selection, our results give reason for optimism about managing competition among health plans. PMID:23213145

Psychosocial Stress and Cardiovascular Disease Part 2: Effectiveness of the Transcendental Meditation Program in Treatment and Prevention

PubMed Central

Walton, Kenneth G.; Schneider, Robert H.; Nidich, Sanford I.; Salerno, John W.; Nordstrom, Cheryl K.; Merz, C. Noel Bairey

2009-01-01

Psychosocial stress is a nontraditional risk factor for cardiovascular morbidity and mortality that may respond to behavioral or psychosocial interventions. To date, studies applying such interventions have reported a wide range of success rates in treatment or prevention of cardiovascular disease (CVD). The authors focus on a natural medicine approach that research indicates reduces both psychosocial and traditional risk factors for cardiovascular disease—the Transcendental Meditation (TM) program. Randomized controlled trials, meta-analyses, and other controlled studies indicate this meditation technique reduces risk factors and can slow or reverse the progression of pathophysiological changes underlying cardiovascular disease. Studies with this technique have revealed reductions in blood pressure, carotid artery intima-media thickness, myocardial ischemia, left ventricular hypertrophy, mortality, and other relevant outcomes. The magnitudes of these effects compare favorably with those of conventional interventions for secondary prevention. PMID:16463759

Case histories in pharmaceutical risk management.

PubMed

McCormick, Cynthia G; Henningfield, Jack E; Haddox, J David; Varughese, Sajan; Lindholm, Anders; Rosen, Susan; Wissel, Janne; Waxman, Deborah; Carter, Lawrence P; Seeger, Vickie; Johnson, Rolley E

2009-12-01

The development and implementation of programs in the U.S. to minimize risks and assess unintended consequences of new medications has been increasingly required by the Food and Drug Administration (FDA) since the mid 1990s. This paper provides four case histories of risk management and post-marketing surveillance programs utilized recently to address problems associated with possible abuse, dependence and diversion. The pharmaceutical sponsors of each of these drugs were invited to present their programs and followed a similar template for their summaries that are included in this article. The drugs and presenting companies were OxyContin, an analgesic marketed by Purdue Pharma L.P., Daytrana and Vyvanse, ADHD medications marketed by Shire Pharmaceuticals, Xyrem for narcolepsy marketed by Jazz Pharmaceuticals, and Subutex and Suboxone for opioid dependence marketed by Reckitt Benckiser Pharmaceuticals Inc. These case histories and subsequent discussions provide invaluable real-world examples and illustrate both the promise of risk management programs in providing a path to market and/or for keeping on the market drugs with serious potential risks. They also illustrate the limitations of such programs in actually controlling unintended consequences, as well as the challenge of finding the right balance of reducing risks without posing undue barriers to patient access. These experiences are highly relevant as the FDA increasingly requires pharmaceutical sponsors to develop and implement the more formalized and enforceable versions of the risk management term Risk Evaluation and Mitigation Strategies (REMS).

Exercise programs may be effective in preventing a new episode of neck pain: a systematic review and meta-analysis.

PubMed

de Campos, Tarcisio F; Maher, Chris G; Steffens, Daniel; Fuller, Joel T; Hancock, Mark J

2018-06-13

What is the effectiveness of interventions that aim to prevent a new episode of neck pain? Systematic review and meta-analysis of randomised, controlled trials. People without neck pain at study entry. Any intervention aiming to prevent a future episode of neck pain. New episode of neck pain. Five trials including a total of 3852 individuals met the inclusion criteria. The pooled results from two randomised, controlled trials (500 participants) found moderate-quality evidence that exercise reduces the risk of a new episode of neck pain (OR 0.32, 95% CI 0.12 to 0.86). One of the meta-analysed trials included some co-interventions with the exercise. There was low-quality evidence from three randomised, controlled trials (3352 participants) that ergonomic programs do not reduce the risk of a new neck pain episode (OR 1.00, 95% CI 0.74 to 1.35). This review found moderate-quality evidence supporting the effectiveness of an exercise program for reducing the risk of a new episode of neck pain. There is a need for high-quality randomised, controlled trials evaluating interventions to prevent new episodes of neck pain. PROSPERO CRD42017055174. [de Campos TF, Maher CG, Steffens D, Fuller JT, Hancock MJ (2018) Exercise programs may be effective in preventing a new episode of neck pain: a systematic review. Journal of Physiotherapy XX: XX-XX]. Copyright © 2018 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Practical Implementation of Failure Mode and Effects Analysis for Safety and Efficiency in Stereotactic Radiosurgery

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

Younge, Kelly Cooper, E-mail: kyounge@med.umich.edu; Wang, Yizhen; Thompson, John

2015-04-01

Purpose: To improve the safety and efficiency of a new stereotactic radiosurgery program with the application of failure mode and effects analysis (FMEA) performed by a multidisciplinary team of health care professionals. Methods and Materials: Representatives included physicists, therapists, dosimetrists, oncologists, and administrators. A detailed process tree was created from an initial high-level process tree to facilitate the identification of possible failure modes. Group members were asked to determine failure modes that they considered to be the highest risk before scoring failure modes. Risk priority numbers (RPNs) were determined by each group member individually and then averaged. Results: A totalmore » of 99 failure modes were identified. The 5 failure modes with an RPN above 150 were further analyzed to attempt to reduce these RPNs. Only 1 of the initial items that the group presumed to be high-risk (magnetic resonance imaging laterality reversed) was ranked in these top 5 items. New process controls were put in place to reduce the severity, occurrence, and detectability scores for all of the top 5 failure modes. Conclusions: FMEA is a valuable team activity that can assist in the creation or restructuring of a quality assurance program with the aim of improved safety, quality, and efficiency. Performing the FMEA helped group members to see how they fit into the bigger picture of the program, and it served to reduce biases and preconceived notions about which elements of the program were the riskiest.« less

Mortality reduction in relation to implantable cardioverter defibrillator programming in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT).

PubMed

Ruwald, Anne-Christine; Schuger, Claudio; Moss, Arthur J; Kutyifa, Valentina; Olshansky, Brian; Greenberg, Henry; Cannom, David S; Estes, N A Mark; Ruwald, Martin H; Huang, David T; Klein, Helmut; McNitt, Scott; Beck, Christopher A; Goldstein, Robert; Brown, Mary W; Kautzner, Josef; Shoda, Morio; Wilber, David; Zareba, Wojciech; Daubert, James P

2014-10-01

The benefit of novel implantable cardioverter defibrillator (ICD) programming in reducing inappropriate ICD therapy and mortality was demonstrated in Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT). However, the cause of mortality reduction remains incompletely evaluated. We aimed to identify factors associated with mortality, with focus on ICD therapy and programming in the MADIT-RIT population. In MADIT-RIT, 1500 patients with a primary prophylactic indication for ICD or cardiac resynchronization therapy with defibrillator were randomized to 1 of 3 different ICD programming arms: conventional programming (ventricular tachycardia zone ≥170 beats per minute), high-rate programming (ventricular tachycardia zone ≥200 beats per minute), and delayed programming (60-second delay before therapy ≥170 beats per minute). Multivariate Cox models were used to assess the influence of time-dependent appropriate and inappropriate ICD therapy (shock and antitachycardia pacing) and randomized programming arm on all-cause mortality. During an average follow-up of 1.4±0.6 years, 71 of 1500 (5%) patients died: cardiac in 40 patients (56.3%), noncardiac in 23 patients (32.4%), and unknown in 8 patients (11.3%). Appropriate shocks (hazard ratio, 6.32; 95% confidence interval, 3.13-12.75; P<0.001) and inappropriate therapy (hazard ratio, 2.61; 95% confidence interval, 1.28-5.31; P=0.01) were significantly associated with an increased mortality risk. There was no evidence of increased mortality risk in patients who experienced appropriate antitachycardia pacing only (hazard ratio, 1.02; 95% confidence interval, 0.36-2.88; P=0.98). Randomization to conventional programming was identified as an independent predictor of death when compared with patients randomized to high-rate programming (hazard ratio, 2.0; 95% confidence interval, 1.06-3.71; P=0.03). In MADIT-RIT, appropriate shocks, inappropriate ICD therapy, and randomization to conventional ICD programming were independently associated with an increased mortality risk. Appropriate antitachycardia pacing was not related to an adverse outcome. clinicaltrials.gov Unique identifier: NCT00947310. © 2014 American Heart Association, Inc.

Advanced Turbine Systems annual program review

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

Koop, W.E.

1995-10-01

Integrated High Performance Turbine Engine Technology (IHPTET) is a joint Air Force, Navy, Army, NASA, ARPA, and industry program focused on developing turbine engine technologies, with the goal of doubling propulsion capability by around the turn-of-the-century, and thus providing smaller, lighter, more durable, more affordable turbine engines in the future. IHPTET`s technology development plan for increasing propulsion capability with respect to time is divided into three phases. This phased approach reduces the technological risk of taking one giant leap, and also reduces the {open_quotes}political{close_quotes} risk of not delivering a product for an extended period of time, in that the phasingmore » allows continuous transfer of IHPTET technologies to our warfighters and continuous transfer to the commercial sector (dual-use). The IHPTET program addresses the three major classes of engines: turbofan/turbojet, turboshaft/turboprop, and expendables.« less

Change IS Possible: Reducing High-Risk Drinking Using a Collaborative Improvement Model.

PubMed

Lanter, Patricia L; Wolff, Kristina B; Johnson, Lisa C; Ercolano, Ellyn M; Kilmer, Jason R; Provost, Lloyd

2015-01-01

To describe the adoption of public health and improvement methodologies to address college students' high-risk drinking behaviors and to aid in prevention efforts. Members of 32 colleges and universities, content experts, and staff members of the National College Health Improvement Program (NCHIP). A 2-year learning collaborative developed by NCHIP trained individuals from 32 different college and universities in using the Plan-Do-Study-Act cycle as a method to create and implement initiatives aimed at reducing students' high-risk drinking behaviors and related harms. Participants experienced success ranging from noteworthy increases in type and amount of interventions directed at reducing high-risk drinking, to creating collaboratives across campus, the local community, and stakeholders. Challenges related to data collection and creating lasting cultural change remain. The use of quality improvement methodologies and creation of a national collaborative successfully effected meaningful change in high-risk drinking behaviors on college campuses.

75 FR 76345 - Risk Reduction Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... Management Plan Each RRPP must include a Fatigue Management Plan (FMP) that will be designed to reduce the... organizations to develop voluntary proactive safety programs designed to improve railroad safety and build... contractors. A railroad's RRPP may be required to specify how the railroad will periodically review the design...

Managing 'tail liability'.

PubMed

Frese, Richard C; Weber, Ryan J

2013-11-01

To reduce and control their level of tail liability, hospitals should: Utilize a self-insurance vehicle; Consider combined limits between the hospital and physicians; Communicate any program changes to the actuary, underwriter, and auditor; Continue risk management and safety practices; Ensure credit is given to the organization's own medical malpractice program.

PRA (Probabilistic Risk Assessments) Participation versus Validation

NASA Technical Reports Server (NTRS)

DeMott, Diana; Banke, Richard

2013-01-01

Probabilistic Risk Assessments (PRAs) are performed for projects or programs where the consequences of failure are highly undesirable. PRAs primarily address the level of risk those projects or programs posed during operations. PRAs are often developed after the design has been completed. Design and operational details used to develop models include approved and accepted design information regarding equipment, components, systems and failure data. This methodology basically validates the risk parameters of the project or system design. For high risk or high dollar projects, using PRA methodologies during the design process provides new opportunities to influence the design early in the project life cycle to identify, eliminate or mitigate potential risks. Identifying risk drivers before the design has been set allows the design engineers to understand the inherent risk of their current design and consider potential risk mitigation changes. This can become an iterative process where the PRA model can be used to determine if the mitigation technique is effective in reducing risk. This can result in more efficient and cost effective design changes. PRA methodology can be used to assess the risk of design alternatives and can demonstrate how major design changes or program modifications impact the overall program or project risk. PRA has been used for the last two decades to validate risk predictions and acceptability. Providing risk information which can positively influence final system and equipment design the PRA tool can also participate in design development, providing a safe and cost effective product.

A Low-Cost Method for Multiple Disease Prediction.

PubMed

Bayati, Mohsen; Bhaskar, Sonia; Montanari, Andrea

Recently, in response to the rising costs of healthcare services, employers that are financially responsible for the healthcare costs of their workforce have been investing in health improvement programs for their employees. A main objective of these so called "wellness programs" is to reduce the incidence of chronic illnesses such as cardiovascular disease, cancer, diabetes, and obesity, with the goal of reducing future medical costs. The majority of these wellness programs include an annual screening to detect individuals with the highest risk of developing chronic disease. Once these individuals are identified, the company can invest in interventions to reduce the risk of those individuals. However, capturing many biomarkers per employee creates a costly screening procedure. We propose a statistical data-driven method to address this challenge by minimizing the number of biomarkers in the screening procedure while maximizing the predictive power over a broad spectrum of diseases. Our solution uses multi-task learning and group dimensionality reduction from machine learning and statistics. We provide empirical validation of the proposed solution using data from two different electronic medical records systems, with comparisons to a statistical benchmark.

Peri-operative physiotherapy.

PubMed

Makhabah, Dewi Nurul; Martino, Federica; Ambrosino, Nicolino

2013-01-23

Postoperative pulmonary complications (PPC) are a major cause of morbidity, mortality, prolonged hospital stay, and increased cost of care. Physiotherapy (PT) programs in post-surgical and critical area patients are aimed to reduce the risks of PPC due to long-term bed-rest, to improve the patient's quality of life and residual function, and to avoid new hospitalizations. At this purpose, PT programs apply advanced cost-effective therapeutic modalities to decrease complications and patient's ventilator-dependency. Strategies to reduce PPC include monitoring and reduction of risk factors, improving preoperative status, patient education, smoking cessation, intra-operative and postoperative pulmonary care. Different PT techniques, as a part of the comprehensive management of patients undergoing cardiac, upper abdominal, and thoracic surgery, may prevent and treat PPC such as secretion retention, atelectasis, and pneumonia.

What's Working (and What's Not). A Summary of Research on the Economic Impacts of Employment and Training Programs.

ERIC Educational Resources Information Center

Department of Labor, Washington, DC.

The effectiveness of employment and training (E&T) programs in improving labor market outcomes can be assessed by measuring the impact on the future success of participants. The program with the greatest success in reducing dropout rates among at-risk youth is the Quantum Opportunities Project. Comprehensive Employment and Training Act (CETA)…

Self-Reported Changes in Food Safety Behaviors among Foodservice Employees: Impact of a Retail Food Safety Education Program

ERIC Educational Resources Information Center

Anding, Jenna D.; Boleman, Chris; Thompson, Britta

2007-01-01

A food safety education program developed for retail food establishments was evaluated to assess the extent to which participants were practicing selected behaviors linked to reducing the risk of foodborne disease both before and after the program. Scores from the state health department's Certified Food Manager (CFM) exam also were examined.…

Student Loan Programs. As Federal Costs of Loan Consolidation Rise, Other Options Should be Examined. Report to Congressional Requesters.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

In this report GAO recommends that the Secretary of Education assess the advantages of consolidation loans for borrowers and the government in light of program costs and identify options for reducing federal costs. Options could include targeting the program to borrowers at risk of default and extending existing consolidation alternatives to more…

Indoor Air Quality Tools for Schools Program: Benefits of Improving Air Quality in the School Environment.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC. Office of Radiation and Indoor Air.

The U.S. Environmental Protection Agency (EPA) developed the Indoor Air Quality Tools for Schools (IAQ TfS) Program to help schools prevent, identify, and resolve their IAQ problems. This publication describes the program and its advantages, explaining that through simple, low-cost measures, schools can: reduce IAQ-related health risks and…

Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease.

PubMed

Chen, Fang; Su, Wenqing; Becker, Shawn H; Payne, Mike; Castro Sweet, Cynthia M; Peters, Anne L; Dall, Timothy M

2016-01-01

Type 2 diabetes and cardiovascular disease impose substantial clinical and economic burdens for seniors (age 65 and above) and the Medicare program. Intensive Behavioral Counseling (IBC) interventions like the National Diabetes Prevention Program (NDPP), have demonstrated effectiveness in reducing excess body weight and lowering or delaying morbidity onset. This paper estimated the potential health implications and medical savings of a digital version of IBC modeled after the NDPP. Participants in this digital IBC intervention, the Omada program, include 1,121 overweight or obese seniors with additional risk factors for diabetes or heart disease. Weight changes were objectively measured via participant use of a networked weight scale. Participants averaged 6.8% reduction in body weight within 26 weeks, and 89% of participants completed 9 or more of the 16 core phase lessons. We used a Markov-based microsimulation model to simulate the impact of weight loss on future health states and medical expenditures over 10 years. Cumulative per capita medical expenditure savings over 3, 5 and 10 years ranged from $1,720 to 1,770 (3 years), $3,840 to $4,240 (5 years) and $11,550 to $14,200 (10 years). The range reflects assumptions of weight re-gain similar to that seen in the DPP clinical trial (lower bound) or minimal weight re-gain aligned with age-adjusted national averages (upper bound). The estimated net economic benefit after IBC costs is $10,250 to $12,840 cumulative over 10 years. Simulation outcomes suggest reduced incidence of diabetes by 27-41% for participants with prediabetes, and stroke by approximately 15% over 5 years. A digital, remotely-delivered IBC program can help seniors at risk for diabetes and cardiovascular disease achieve significant weight loss, reduces risk for diabetes and cardiovascular disease, and achieve meaningful medical cost savings. These findings affirm recommendations for IBC coverage by the U.S. Preventive Services Task Force.

Effectiveness of a peer-delivered dissonance-based program in reducing eating disorder risk factors in high school girls.

PubMed

Ciao, Anna C; Latner, Janet D; Brown, Krista E; Ebneter, Daria S; Becker, Carolyn B

2015-09-01

This pilot study investigated the feasibility, acceptability, and effectiveness of a peer-led dissonance-based eating disorders (ED) prevention/risk factor reduction program with high school girls. Ninth grade girls (n = 50) received the peer-led program within the school curriculum. A quasi-experimental design was used to assess changes in ED risk factors preintervention and postintervention compared with waitlist control. Participants were followed through 3-month follow-up. Peer-leader adherence to an intervention manual tailored for this age group was high. The intervention was rated as highly acceptable, with a large proportion of participants reporting that they enjoyed the program and learned and applied new information. Intervention participants exhibited significantly greater pre-post reductions in a majority of risk-factor outcomes compared to waitlist controls. When groups were combined to assess program effects over time there were significant pre-post reductions in a majority of outcomes that were sustained through 3-month follow-up. This pilot study provides tentative support for the effectiveness of using peer leaders to implement an empirically supported ED risk factor reduction program in a high school setting. Additional research is needed to replicate results in larger, better-controlled trials with longer follow-up. © 2015 Wiley Periodicals, Inc.

Long term effects of community-based STI screening and mass media HIV prevention messages on sexual risk behaviors of African American adolescents.

PubMed

Sznitman, Sharon; Stanton, Bonita F; Vanable, Peter A; Carey, Michael P; Valois, Robert F; Brown, Larry K; DiClemente, Ralph; Hennessy, Michael; Salazar, Laura F; Romer, Daniel

2011-11-01

We examined the long-term effects of two interventions designed to reduce sexual risk behavior among African American adolescents. African American adolescents (N = 1383, ages 14-17) were recruited from community-based organizations over a period of 16 months in two northeastern and two southeastern mid-sized U.S. cities with high rates of sexually transmitted infection (STI). Participants were screened for three STIs (gonorrhea, chlamydia, and trichomoniasis) and completed an audio computer-assisted attitude, intention, and behavior self-interview. Youth who tested positive for an STI (8.3%) received treatment and risk reduction counseling. In addition, television and radio HIV-prevention messages were delivered during the recruitment period and 18 months of follow-up in one randomly selected city in each region. Analyses determined effects of the media program for those receiving a positive versus negative STI test result on number of sexual partners and occurrence of unprotected sex. Adolescents who tested STI-positive reduced their number of vaginal sex partners and the probability of unprotected sex over the first 6 months. However, in the absence of the mass media program, adolescents returned to their previously high levels of sexual risk behavior after 6 months. Adolescents who tested STI-positive and received the mass media program showed more stable reductions in unprotected sex. Community-based STI treatment and counseling can achieve significant, but short-lived reductions in sexual risk behavior among STI-positive youth. A culturally sensitive mass media program has the potential to achieve more stable reductions in sexual risk behavior and can help to optimize the effects of community-based STI screening.

Reputationally Strong HIV Prevention Programs: Lessons from the Front Line

ERIC Educational Resources Information Center

Eke, Agatha N.; Mezoff, Jane S.; Duncan, Ted; Sogolow, Ellen D.

2006-01-01

Although HIV prevention researchers have conducted numerous controlled outcome studies to evaluate the effectiveness of theory-based interventions aimed at reducing HIV risk behaviors, many HIV risk reduction interventions are conducted not by researchers but by staff in local health departments or community-based organizations (CBOs). Despite…

Dcx Re-expression Reduces Subcortical Band Heterotopia and Seizure Threshold in an Animal Model of Neuronal Migration Disorder

PubMed Central

Manent, Jean-Bernard; Wang, Yu; Chang, YoonJeung; Paramasivam, Murugan; LoTurco, Joseph J

2009-01-01

Disorders of neuronal migration can lead to malformations of the cerebral neocortex that greatly increase the risk of seizures. It remains untested whether malformations caused by disorders in neuronal migration can be reduced by reactivating cellular migration, and whether such repair can decrease seizure risk. Here we show, in a rat model of subcortical band heterotopia (SBH) generated by in utero RNAi of Dcx, that aberrantly positioned neurons can be stimulated to migrate by re-expressing Dcx after birth. Re-starting migration in this way both reduces neocortical malformations and restores neuronal patterning. We find further that the capacity to reduce SBH has a critical period in early postnatal development. Moreover, intervention after birth reduces convulsant-induced seizure threshold to levels similar to that of malformation-free controls. These results suggest that disorders of neuronal migration may be eventually treatable by re-engaging developmental programs both to reduce the size of cortical malformations and to reduce seizure risk. PMID:19098909

Cost effectiveness analysis of a smoke alarm giveaway program in Oklahoma City, Oklahoma.

PubMed

Haddix, A C; Mallonee, S; Waxweiler, R; Douglas, M R

2001-12-01

To estimate the cost effectiveness of the Lifesavers Residential Fire and Injury Prevention Program (LRFIPP), a smoke alarm giveaway program. In 1990, the LRFIPP distributed over 10,000 smoke alarms in an area of Oklahoma City at high risk for residential fire injuries. The program also included fire prevention education and battery replacement components. A cost effectiveness analysis was conducted from the societal and health care systems perspectives. The study compared program costs with the total costs of medical treatment and productivity losses averted over a five year period. Fatal and non-fatal residential fire related injuries prevented were estimated from surveillance data. Medical costs were obtained from chart reviews of patients with fire related injuries that occurred during the pre-intervention period. During the five years post-intervention, it is estimated that the LRFIPP prevented 20 fatal and 24 non-fatal injuries. From the societal perspective, the total discounted cost of the program was $531,000. Total discounted net savings exceeded $15 million. From the health care system perspective, the total discounted net savings were almost $1 million and would have a net saving even if program effectiveness was reduced by 64%. The program was effective in reducing fatal and non-fatal residential fire related injuries and was cost saving. Similar programs in other high risk areas would be good investments even if program effectiveness was lower than that achieved by the LRFIPP.

The School Breakfast Program strengthens household food security among low-income households with elementary school children.

PubMed

Bartfeld, Judith S; Ahn, Hong-Min

2011-03-01

The School Breakfast Program is an important component of the nutritional safety net and has been linked to positive changes in meal patterns and nutritional outcomes. By offering a breakfast, which for low-income children is available either at no cost or reduced price, the program also has the potential to increase household food security. This study examined the relationship between availability of the School Breakfast Program and household food security among low-income third-grade students by using data from the Early Childhood Longitudinal Survey-Kindergarten Cohort. The primary sample included 3010 students. Availability of school breakfast was assessed by surveys of school administrators. Food security was assessed by parents' reports by using the standard 18-item food security scale and considering 2 different food security thresholds. A probit model was estimated to measure the relationship between school breakfast availability and household food security while controlling for a range of other characteristics. Access to school breakfast reduced the risk of marginal food insecurity but not the risk of food insecurity at the standard threshold. That is, the program appeared beneficial in offsetting food-related concerns among at-risk families, although not necessarily in alleviating food insecurity once hardships had crossed the food insecurity threshold. Increasing the availability of school breakfast may be an effective strategy to maintain food security among low-income households with elementary school children.

A Risk Assessment Model for Reduced Aircraft Separation: A Quantitative Method to Evaluate the Safety of Free Flight

NASA Technical Reports Server (NTRS)

Cassell, Rick; Smith, Alex; Connors, Mary; Wojciech, Jack; Rosekind, Mark R. (Technical Monitor)

1996-01-01

As new technologies and procedures are introduced into the National Airspace System, whether they are intended to improve efficiency, capacity, or safety level, the quantification of potential changes in safety levels is of vital concern. Applications of technology can improve safety levels and allow the reduction of separation standards. An excellent example is the Precision Runway Monitor (PRM). By taking advantage of the surveillance and display advances of PRM, airports can run instrument parallel approaches to runways separated by 3400 feet with the same level of safety as parallel approaches to runways separated by 4300 feet using the standard technology. Despite a wealth of information from flight operations and testing programs, there is no readily quantifiable relationship between numerical safety levels and the separation standards that apply to aircraft on final approach. This paper presents a modeling approach to quantify the risk associated with reducing separation on final approach. Reducing aircraft separation, both laterally and longitudinally, has been the goal of several aviation R&D programs over the past several years. Many of these programs have focused on technological solutions to improve navigation accuracy, surveillance accuracy, aircraft situational awareness, controller situational awareness, and other technical and operational factors that are vital to maintaining flight safety. The risk assessment model relates different types of potential aircraft accidents and incidents and their contribution to overall accident risk. The framework links accident risks to a hierarchy of failsafe mechanisms characterized by procedures and interventions. The model will be used to assess the overall level of safety associated with reducing separation standards and the introduction of new technology and procedures, as envisaged under the Free Flight concept. The model framework can be applied to various aircraft scenarios, including parallel and in-trail approaches. This research was performed under contract to NASA and in cooperation with the FAA's Safety Division (ASY).

Trends in cardiovascular diseases in Bosnia and Herzegovina and perspectives with heartscore programme.

PubMed

Masic, Izet; Dilic, Mirza; Raljevic, Enver; Vulic, Dusko; Mott, Dario

2010-01-01

Cardiovascular diseases are still the major cause of death, morbidity, mortality and loss of quality of life in European countries and worldwide. In Bosnia and Herzegovina we have burden of cardiovascular diseases with higher rate of morbidity and mortality than in the countries of EU zone or broader Europe. The cause of mortality is in close relation to multiple risk factors but also with specific conditions in our country; post war situation, transition and overall economic position. The main mission of European Society of Cardiology is to improve quality of life in the European population by reducing the impact of cardiovascular diseases. HeartScore web based program and PS Standalone program are introduce to assesses the overall risk of cardiovascular death for a period of 10 years, based on variables such as age, sex, smoking, systolic blood pressure and cholesterol levels in the blood, or total cholesterol/HDL ratio. Standalone PS HeartScore is practical to use, requires no permanent internet connection, the system offers its own database for each patient and the print version of the guidelines to reduce risk factors, based on evidence based medicine Program is tailored to patients, the system provides a graphical representation of the absolute risk of CVD, a version for our country is developed on the principle of high-risk populations and is available in the languages of the peoples of Bosnia and Herzegovina. Program is available for all types of medical practice which is equipped with computers, the laptop, and suitable for community nursing service as well.

77 FR 62515 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

... Disease Control and Prevention (CDC). Background and Brief Description Cardiovascular disease (CVD), which... program is at reducing the burden of cardiovascular disease risk factors among women who utilize program... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [60Day-13-0612...

78 FR 8153 - National Institutes of Health

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-05

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Human Research Program Opportunities

NASA Technical Reports Server (NTRS)

Kundrot, Craig E.

2014-01-01

The goal of HRP is to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. The Human Research Program was designed to meet the needs of human space exploration, and understand and reduce the risk to crew health and performance in exploration missions.

Reduction of Shape and Weight Concern in Young Adolescents: A 30-Month Controlled Evaluation of a Media Literacy Program

ERIC Educational Resources Information Center

Wilksch, Simon M.; Wade, Tracey D.

2009-01-01

The effectiveness of a media literacy program in preventing eating disorders among adolescents is studied. Media literacy can be effective in helping reduce shape and weight concern and other eating disorder risk factors in adolescents over the long term.

Designing the Healthy Bodies, Healthy Souls Church-Based Diabetes Prevention Program through a Participatory Process

ERIC Educational Resources Information Center

Summers, Amber; Confair, Amy R.; Flamm, Laura; Goheer, Attia; Graham, Karlene; Muindi, Mwende; Gittelsohn, Joel

2013-01-01

Background: The Healthy Bodies, Healthy Souls (HBHS) program aims to reduce diabetes risk among urban African Americans by creating healthy food and physical activity environments within churches. Participant engagement supports the development of applicable intervention strategies by identifying priority concerns, resources, and opportunities.…

Responsible Hospitality. Prevention Updates

ERIC Educational Resources Information Center

Colthurst, Tom

2004-01-01

Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…

SmartWay

EPA Pesticide Factsheets

SmartWay is an EPA program that helps the freight transportation sector improve supply chain efficiency. SmartWay reduces transportation-related emissions, environmental risks for companies and increases global energy security.

Effectiveness of individualized fall prevention program in geriatric rehabilitation hospital setting: a cluster randomized trial.

PubMed

Aizen, Efraim; Lutsyk, Galina; Wainer, Lea; Carmeli, Sarit

2015-10-01

There is no conclusive evidence that hospital fall prevention programs can reduce the number of falls. We aimed to investigate the effect of a targeted individualized falls prevention program in a geriatric rehabilitation hospital. This was a two-stage cluster-controlled trial carried out in five geriatric rehabilitation wards. Participants were 752 patients with mean age 83.2 years. The intervention was a two-phase targeted intervention falls prevention program. The intervention included an assessment of patient's risk by a risk assessment tool and an individual management that includes medical, behavioral, cognitive and environmental modifications. Patients with moderate risk received additionally orientation guidance, and mobility restriction. Patients determined as high risk were additionally placed under permanent personal supervision. Outcome measures were falls during hospital stay. In both stages of the trial, intervention and control wards were almost similar at baseline for individual patient characteristics. Overall, 37 falls occurred during the study. No significant difference was found in fall rates during follow-up between intervention and control wards: 1.306 falls per 1000 bed days in the intervention groups and 1.763-1.826 falls per 1000 bed days in the control groups. The adjusted hazard ratio for falls in the intervention groups was 1.36 (95 % confidence interval 0.89-1.77) (P = 0.08) in the first stage and 1.27 (95 % confidence interval 0.92-1.67) (P = 0.12) in the second stage. These results suggest that in a geriatric rehabilitation hospital a targeted individualized intervention falls prevention program is not effective in reducing falls.

The role of physicians in a community-wide program for prevention of cardiovascular disease: the Minnesota Heart Health Program.

PubMed Central

Mittelmark, M B; Leupker, R V; Grimm, R; Kottke, T E; Blackburn, H

1988-01-01

The Minnesota Heart Health Program (MHHP) aims to reduce cardiovascular disease (CVD) morbidity and mortality by reducing risk factors among the mass of residents in three midwestern communities. A major aspect of the program is the involvement of community physicians because they have high credibility as citizen leaders, especially on health issues. In the MHHP, physicians contributed in a number of ways. The initial contacts with physicians resulted in their providing support and introductions to other community leaders, whose active support was also gained. Physicians sit as members of the central Community Advisory Borads of MHHP and serve on the executive committees of these boards. All MHHP issues related to medical practice are brought before Physicians' Advisory Groups in each community for resolution. Primary care physicians attend MHHP continuing education programs. In a survey of 109 physicians in one of the MHHP communities, 95 percent of respondents believed cigarette smoking to be an important risk factor for CVD, but only 15 percent judged themselves to be effective in dealing with patients who smoked. Forty-one percent of respondents said that elevated blood cholesterol is an important risk factor, but only 20 percent felt effective in treating the condition. Only 18 percent of the physicians in the sample believed that a poor eating pattern plays a substantial role in CVD, and 9 percent felt effective in counseling patients about eating habits. This pattern of results indicates the need not only for continuing education about risk factors for CVD, but also for training to improve patient counseling skills. PMID:3136495

Critical control points for avian influenza A H5N1 in live bird markets in low resource settings.

PubMed

Samaan, Gina; Gultom, Anita; Indriani, Risa; Lokuge, Kamalini; Kelly, Paul M

2011-06-01

Live bird markets can become contaminated with and become a source of transmission for avian influenza viruses including the highly pathogenic H5N1 strain. Many countries affected by the H5N1-virus have limited resources for programs in environmental health, sanitation and disease control in live bird markets. This study proposes five critical control points (CCPs) to reduce the risk of H5N1-virus contamination in markets in low resource settings. The CCPs were developed based on three surveys conducted in Indonesia: a cross-sectional survey in 119 markets, a knowledge, attitudes and practice survey in 3 markets and a microbiological survey in 83 markets. These surveys assessed poultry workflow, market infrastructure, hygiene and regulatory practices and microbiological contamination with the H5N1-virus. The five CCPs identified were (1) reducing risk of receiving infected birds into the market, (2) reducing the risk of virus spread between different bird flocks in holding cages, (3) reducing surface contamination by isolating slaughter processes from other poultry-related processes, (4) minimizing the potential for contamination during evisceration of carcasses and (5) reducing the risk of surface contamination in the sale zone of the market. To be relevant for low resource settings, the CCPs do not necessitate large infrastructure changes. The CCPs are suited for markets that slaughter poultry and have capacity for daily disposal and removal of solid waste from the market. However, it is envisaged that the CCPs can be adapted for the development of risk-based programs in various settings. Copyright © 2011 Elsevier B.V. All rights reserved.

Informal assistance to urban families and the risk of household food insecurity.

PubMed

King, Christian

2017-09-01

Food insecurity is a persistent social problem affecting one out of eight households in the United States. While evidence shows that public assistance programs (formal assistance) are effective in reducing food insecurity, there is more limited evidence documenting how informal support, through social capital, affects food insecurity. To examine the role of informal support (through instrumental social support, social cohesion, social control, and social participation) on food insecurity transitions using longitudinal data of a sample of disadvantaged urban mothers from the Fragile Families and Child Wellbeing Study. In addition, the study examines whether these associations vary by participation in the Supplemental Nutrition Assistance Program (SNAP) using interaction terms. The sample includes 2481 mothers of children between ages three and five. The analysis uses unadjusted and adjusted logistic regressions. Interaction terms are included to examine formal and informal support. In addition, the analysis uses structural equation modeling to examine direct and indirect associations of the informal support variables on food insecurity. Social support and social cohesion reduce the risk of food insecurity, reduce the risk of remaining food insecure, and reduce the risk of becoming food insecure. Social control has an indirect effect on food insecurity, which is mainly through social cohesion. Social participation also has an indirect effect through social support and social cohesion. SNAP participation for mothers with little to no informal support did not reduce the risk of food insecurity. Instead of focusing on improving the food access of households, interventions should be expanded to the neighborhood level. Building social capital for low-income residents would increase the cohesiveness of their neighborhoods and their access to social support, which would increase the availability of resources to prevent or overcome food insecurity and other hardships. Copyright © 2017 Elsevier Ltd. All rights reserved.

Premarital screening for hemoglobinopathies: experience of a single center in Kurdistan, Iraq.

PubMed

Al-Allawi, Nasir A S; Al-Doski, Adnan A S; Markous, Raji S D; Mohamad Amin, Khyria A K; Eissa, Adil A Z; Badi, Ameer I A; Asmaro, Rafal R H; Hamamy, Hanan

2015-01-01

A program for the prevention of major hemoglobinopathies was initiated in 2008 in the Kurdistan region of Iraq. This study reports on the achievements and challenges of the program. A total of 102,554 individuals (51,277 couples) visiting a premarital center between 2008 and 2012 were screened for carrier status of hemoglobinopathies, and at-risk couples were counseled. A total of 223 (4.3/1,000) couples were identified and counseled as high-risk couples. Available data on 198 high-risk couples indicated that 90.4% proceeded with their marriage plans, and 15% of these married couples decided to have prenatal diagnosis (PND) in subsequent pregnancies with the identification of 8 affected fetuses; all were terminated as chosen by the parents. Thirty affected births were recorded among the high-risk couples. The premarital program managed to reduce the affected birth rate of major hemoglobinopathies by 21.1%. Of the 136 affected babies born during the study period, 77.9% were born to couples married prior to the start of the program, while 22.1% were born to couples identified as having a high risk. The main reason for not taking the option of PND was unaffordable costs. Financial support would have increased opting for PND by high-risk couples. Further reduction in affected birth rates could be achieved by including parallel antenatal screening programs to cover those married before the initiation of the premarital program and improving the public health education and counseling programs. © 2015 S. Karger AG, Basel.

Biomechanical Effects of an Injury Prevention Program in Preadolescent Female Soccer Athletes

PubMed Central

Thompson, Julie A.; Tran, Andrew A.; Gatewood, Corey T.; Shultz, Rebecca; Silder, Amy; Delp, Scott L.; Dragoo, Jason L.

2017-01-01

Background Anterior cruciate ligament (ACL) injuries are common, and children as young as 10 years of age exhibit movement patterns associated with an ACL injury risk. Prevention programs have been shown to reduce injury rates, but the mechanisms behind these programs are largely unknown. Few studies have investigated biomechanical changes after injury prevention programs in children. Purpose/Hypothesis To investigate the effects of the F-MARC 11+ injury prevention warm-up program on changes to biomechanical risk factors for an ACL injury in preadolescent female soccer players. We hypothesized that the primary ACL injury risk factor of peak knee valgus moment would improve after training. In addition, we explored other kinematic and kinetic variables associated with ACL injuries. Study Design Controlled laboratory study. Methods A total of 51 female athletes aged 10 to 12 years were recruited from soccer clubs and were placed into an intervention group (n = 28; mean [±SD] age, 11.8 ± 0.8 years) and a control group (n = 23; mean age, 11.2 ± 0.6 years). The intervention group participated in 15 in-season sessions of the F-MARC 11+ program (2 times/wk). Pre- and postseason motion capture data were collected during preplanned cutting, unanticipated cutting, double-leg jump, and single-leg jump tasks. Lower extremity joint angles and moments were estimated using OpenSim, a biomechanical modeling system. Results Athletes in the intervention group reduced their peak knee valgus moment compared with the control group during the double-leg jump (mean [±standard error of the mean] pre- to posttest change, −0.57 ± 0.27 %BW×HT vs 0.25 ± 0.25 %BW×HT, respectively; P = .034). No significant differences in the change in peak knee valgus moment were found between the groups for any other activity; however, the intervention group displayed a significant pre- to posttest increase in peak knee valgus moment during unanticipated cutting (P = .044). Additional analyses revealed an improvement in peak ankle eversion moment after training during preplanned cutting (P = .015), unanticipated cutting (P = .004), and the double-leg jump (P = .016) compared with the control group. Other secondary risk factors did not significantly improve after training, although the peak knee valgus angle improved in the control group compared with the intervention group during unanticipated cutting (P = .018). Conclusion The F-MARC 11+ program may be effective in improving some risk factors for an ACL injury during a double-leg jump in preadolescent athletes, most notably by reducing peak knee valgus moment. Clinical Relevance This study provides motivation for enhancing injury prevention programs to produce improvement in other ACL risk factors, particularly during cutting and single-leg tasks. PMID:27793803

Biomechanical Effects of an Injury Prevention Program in Preadolescent Female Soccer Athletes.

PubMed

Thompson, Julie A; Tran, Andrew A; Gatewood, Corey T; Shultz, Rebecca; Silder, Amy; Delp, Scott L; Dragoo, Jason L

2017-02-01

Anterior cruciate ligament (ACL) injuries are common, and children as young as 10 years of age exhibit movement patterns associated with an ACL injury risk. Prevention programs have been shown to reduce injury rates, but the mechanisms behind these programs are largely unknown. Few studies have investigated biomechanical changes after injury prevention programs in children. Purpose/Hypothesis: To investigate the effects of the F-MARC 11+ injury prevention warm-up program on changes to biomechanical risk factors for an ACL injury in preadolescent female soccer players. We hypothesized that the primary ACL injury risk factor of peak knee valgus moment would improve after training. In addition, we explored other kinematic and kinetic variables associated with ACL injuries. Controlled laboratory study. A total of 51 female athletes aged 10 to 12 years were recruited from soccer clubs and were placed into an intervention group (n = 28; mean [±SD] age, 11.8 ± 0.8 years) and a control group (n = 23; mean age, 11.2 ± 0.6 years). The intervention group participated in 15 in-season sessions of the F-MARC 11+ program (2 times/wk). Pre- and postseason motion capture data were collected during preplanned cutting, unanticipated cutting, double-leg jump, and single-leg jump tasks. Lower extremity joint angles and moments were estimated using OpenSim, a biomechanical modeling system. Athletes in the intervention group reduced their peak knee valgus moment compared with the control group during the double-leg jump (mean [±standard error of the mean] pre- to posttest change, -0.57 ± 0.27 %BW×HT vs 0.25 ± 0.25 %BW×HT, respectively; P = .034). No significant differences in the change in peak knee valgus moment were found between the groups for any other activity; however, the intervention group displayed a significant pre- to posttest increase in peak knee valgus moment during unanticipated cutting ( P = .044). Additional analyses revealed an improvement in peak ankle eversion moment after training during preplanned cutting ( P = .015), unanticipated cutting ( P = .004), and the double-leg jump ( P = .016) compared with the control group. Other secondary risk factors did not significantly improve after training, although the peak knee valgus angle improved in the control group compared with the intervention group during unanticipated cutting ( P = .018). The F-MARC 11+ program may be effective in improving some risk factors for an ACL injury during a double-leg jump in preadolescent athletes, most notably by reducing peak knee valgus moment. This study provides motivation for enhancing injury prevention programs to produce improvement in other ACL risk factors, particularly during cutting and single-leg tasks.

Childhood obesity prevention in rural settings: background, rationale, and study design of ‘4-Health,’ a parent-only intervention

PubMed Central

2012-01-01

Background Childhood obesity in rural communities is a serious but understudied problem. The current experiment aims to assess a wide range of obesity risk factors among rural youth and to offer an 8-month intervention program for parents to reduce obesity risk in their preteen child. Methods/Design A two-group, repeated measures design is used to assess the effectiveness of the 4-Health intervention program. Assessments include anthropometric measures, child self-evaluations, parent self-evaluations, and parent evaluations of child. County Extension agents from 21 rural Montana counties recruit approximately 150 parent–child dyads and counties are semi-randomly assigned to the active intervention group (4-Health Educational Program) or a “best-practices” (Healthy Living Information) control group. Discussion This study will shed light on the effectiveness of this parent-only intervention strategy in reducing obesity risk factors among rural preteens. The 4-Health program is designed to provide information and skills development for busy rural parents that will increase healthy lifestyles of their preteen children and improve the parents’ ability to intervene effectively in the lives of their families during this critical developmental period. Trial registration ClinicalTrials.gov ID: NCT01510587 PMID:22471650

Effectiveness of a Reduced-Risk Insecticide Based Bed Bug Management Program in Low-Income Housing.

PubMed

Singh, Narinderpal; Wang, Changlu; Cooper, Richard

2013-11-28

Bed bug (Cimex lectularius L.) infestations are becoming increasingly common in low-income communities. Once they are introduced, elimination is very difficult. As part of the efforts to develop effective and safe bed bug management programs, we conducted a laboratory study evaluating the efficacy of a reduced-risk insecticide-Alpine aerosol (0.5% dinotefuran). We then conducted a field evaluation of a reduced-risk insecticide based integrated pest management (IPM) program in low-income family apartments with young children. In laboratory evaluations, direct spray and 5 min exposure to dry Alpine aerosol residue caused 100.0 ± 0.0 and 91.7 ± 8.3% mortality to bed bug nymphs, respectively. Direct Alpine aerosol spray killed 91.3 ± 4.3% of the eggs. The IPM program included education, steam, bagging infested linens, placing intercepting devices under furniture legs and corners of rooms, applying Alpine aerosol and Alpine dust (0.25% dinotefuran, 95% diatomaceous earth dust), and regularly scheduled monitoring and re-treatment. Nine apartments ranging from 1-1,428 (median: 29) bed bugs based on visual inspection and Climbup interceptor counts were included. Over a 6-month period, an average 172 g insecticide (Alpine aerosol + Alpine dust) was used in each apartment, a 96% reduction in pesticide usage compared to chemical only treatment reported in a similar environment. The IPM program resulted in an average of 96.8 ± 2.2% reduction in the number of bed bugs. However, elimination of bed bugs was only achieved in three lightly infested apartments (<30 bed bugs at the beginning). Elimination success was closely correlated with the level of bed bug populations.

Effectiveness of a Reduced-Risk Insecticide Based Bed Bug Management Program in Low-Income Housing

PubMed Central

Singh, Narinderpal; Wang, Changlu; Cooper, Richard

2013-01-01

Bed bug (Cimex lectularius L.) infestations are becoming increasingly common in low-income communities. Once they are introduced, elimination is very difficult. As part of the efforts to develop effective and safe bed bug management programs, we conducted a laboratory study evaluating the efficacy of a reduced-risk insecticide—Alpine aerosol (0.5% dinotefuran). We then conducted a field evaluation of a reduced-risk insecticide based integrated pest management (IPM) program in low-income family apartments with young children. In laboratory evaluations, direct spray and 5 min exposure to dry Alpine aerosol residue caused 100.0 ± 0.0 and 91.7 ± 8.3% mortality to bed bug nymphs, respectively. Direct Alpine aerosol spray killed 91.3 ± 4.3% of the eggs. The IPM program included education, steam, bagging infested linens, placing intercepting devices under furniture legs and corners of rooms, applying Alpine aerosol and Alpine dust (0.25% dinotefuran, 95% diatomaceous earth dust), and regularly scheduled monitoring and re-treatment. Nine apartments ranging from 1–1,428 (median: 29) bed bugs based on visual inspection and Climbup interceptor counts were included. Over a 6-month period, an average 172 g insecticide (Alpine aerosol + Alpine dust) was used in each apartment, a 96% reduction in pesticide usage compared to chemical only treatment reported in a similar environment. The IPM program resulted in an average of 96.8 ± 2.2% reduction in the number of bed bugs. However, elimination of bed bugs was only achieved in three lightly infested apartments (<30 bed bugs at the beginning). Elimination success was closely correlated with the level of bed bug populations. PMID:26462533

Translating evidence based violence and drug use prevention to obesity prevention: development and construction of the pathways program.

PubMed

Sakuma, Kari-Lyn K; Riggs, Nathaniel R; Pentz, Mary Ann

2012-04-01

Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health, a school-based obesity prevention program that was developed by translating from evidence-based violence and drug use prevention programs, Promoting Alternative THinking Strategies and the Midwestern Prevention Project STAR (STAR). We illustrate how a hypothesized underlying behavior change mechanism in two domains of risk behavior, violence and substance use, can be applied to obesity prevention. A 4-step translational process is provided and may be relevant for use in developing other curricula to address multiple health risk behaviors. Practical application and decision points are also provided.

Translating evidence based violence and drug use prevention to obesity prevention: development and construction of the Pathways program

PubMed Central

Sakuma, Kari-Lyn K.; Riggs, Nathaniel R.; Pentz, Mary Ann

2012-01-01

Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health, a school-based obesity prevention program that was developed by translating from evidence-based violence and drug use prevention programs, Promoting Alternative THinking Strategies and the Midwestern Prevention Project STAR (STAR). We illustrate how a hypothesized underlying behavior change mechanism in two domains of risk behavior, violence and substance use, can be applied to obesity prevention. A 4-step translational process is provided and may be relevant for use in developing other curricula to address multiple health risk behaviors. Practical application and decision points are also provided. PMID:21987475

A 12-week multidomain intervention versus active control to reduce risk of Alzheimer’s disease: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Disappointing results from clinical trials of disease-modifying interventions for Alzheimer’s dementia (AD), along with reliable identification of modifiable risk factors in mid life from epidemiological studies, have contributed to calls to invest in risk-reduction interventions. It is also well known that AD-related pathological processes begin more than a decade before the development of clinical signs. These observations suggest that lifestyle interventions might be most effective when targeting non-symptomatic adults at risk of AD. To date, however, the few dementia risk-reduction programs available have targeted individual risk factors and/or were restricted to clinical settings. The current study describes the development of an evidence-based, theoretically-driven multidomain intervention to reduce AD risk in adults at risk. Method The design of Body Brain Life (BBL) is a randomized controlled trial (RCT) to evaluate a 12-week online AD risk-reduction intervention. Eligible participants with several modifiable risk factors on the Australian National University (ANU) AD Risk Index (ANU-ADRI) are randomly allocated to an online only group, an online and face-to-face group, or an active control group. We aim to recruit 180 participants, to undergo a comprehensive cognitive and physical assessment at baseline, post-intervention, and 6-month follow-up assessment. The intervention comprises seven online modules (dementia literacy, risk factor education, engagement in physical, social, and cognitive lifestyles, nutrition, and health monitoring) designed using contemporary models of health behavior change. Discussion The BBL program is a novel online intervention to reduce the risk of AD in middle-aged adults at risk. The trial is currently under way. It is hypothesized that participants in the intervention arms will make lifestyle changes in several domains, and that this will lead to a reduction in their AD risk profile. We also expect to show that health behavior change is underpinned by changes in psychological determinants of behavior. If successful, the findings will contribute to the development of further dementia risk reduction interventions, and thus contribute to the urgent need to lower dementia risk factors in the population to alter future projections of disease prevalence. Longer follow-up of BBL participants and replications using large samples are required to examine whether reduction in AD risk factors will be associated with reduced prevalence. Trial registration Reg. no. ACTRN12612000147886 PMID:23442574

Investing: reducing risks to enhance returns.

PubMed

West, J; Glickman, S; Seidner, A G

1996-09-01

The financial assets of a healthcare organization can present many opportunities for investment. In order to develop a profitable investment program that avoids risky speculation, however, healthcare financial managers must fully understand the nature and risks of their organizations' investments. They must define and monitor their investment objectives, limitations, levels of acceptable risk and policies and conditions through a statement of investment policy and comprehensive investment guidelines.

Preventive Care in Appalachia: Use of the Theory of Planned Behavior to Identify Barriers to Participation in Cholesterol Screenings among West Virginians

ERIC Educational Resources Information Center

Deskins, Shelli; Harris, Carole V.; Bradlyn, Andrew S.; Cottrell, Lesley; Coffman, Jessica W.; Olexa, Julie; Neal, William

2006-01-01

Context: West Virginians are at increased risk for heart disease. Given that the process of atherosclerosis begins in childhood, the Coronary Artery Risk Detection in Appalachian Communities Project was developed to reduce this risk by implementing a cholesterol screening program in the schools. However, participation rates have been less than…

Factors Associated With Participation in a University Worksite Wellness Program.

PubMed

Beck, Angela J; Hirth, Richard A; Jenkins, Kristi Rahrig; Sleeman, Kathryn K; Zhang, Wei

2016-07-01

Healthcare reform legislation encourages employers to implement worksite wellness activities as a way to reduce rising employer healthcare costs. Strategies for increasing program participation is of interest to employers, though few studies characterizing participation exist in the literature. The University of Michigan conducted a 5-year evaluation of its worksite wellness program, MHealthy, in 2014. MHealthy elements include Health Risk Assessment, biometric screening, a physical activity tracking program (ActiveU), wellness activities, and participation incentives. Individual-level data were obtained for a cohort of 20,237 employees who were continuously employed by the university all 5 years. Multivariate logistic regression was used to assess the independent predictive power of characteristics associated with participation in the Health Risk Assessment, ActiveU, and incentive receipt, including employee and job characteristics, as well as baseline (2008) healthcare spending and health diagnoses obtained from claims data. Data were collected from 2008 to 2013; analyses were conducted in 2014. Approximately half of eligible employees were MHealthy participants. A consistent profile emerged for Health Risk Assessment and ActiveU participation and incentive receipt with female, white, non-union staff and employees who seek preventive care among the most likely to participate in MHealthy. This study helps characterize employees who choose to engage in worksite wellness programs. Such information could be used to better target outreach and program content and reduce structural barriers to participation. Future studies could consider additional job characteristics, such as job type and employee attitudinal variables regarding health status and wellness program effectiveness. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The effectiveness of risk management program on pediatric nurses' medication error.

PubMed

Dehghan-Nayeri, Nahid; Bayat, Fariba; Salehi, Tahmineh; Faghihzadeh, Soghrat

2013-09-01

Medication therapy is one of the most complex and high-risk clinical processes that nurses deal with. Medication error is the most common type of error that brings about damage and death to patients, especially pediatric ones. However, these errors are preventable. Identifying and preventing undesirable events leading to medication errors are the main risk management activities. The aim of this study was to investigate the effectiveness of a risk management program on the pediatric nurses' medication error rate. This study is a quasi-experimental one with a comparison group. In this study, 200 nurses were recruited from two main pediatric hospitals in Tehran. In the experimental hospital, we applied the risk management program for a period of 6 months. Nurses of the control hospital did the hospital routine schedule. A pre- and post-test was performed to measure the frequency of the medication error events. SPSS software, t-test, and regression analysis were used for data analysis. After the intervention, the medication error rate of nurses at the experimental hospital was significantly lower (P < 0.001) and the error-reporting rate was higher (P < 0.007) compared to before the intervention and also in comparison to the nurses of the control hospital. Based on the results of this study and taking into account the high-risk nature of the medical environment, applying the quality-control programs such as risk management can effectively prevent the occurrence of the hospital undesirable events. Nursing mangers can reduce the medication error rate by applying risk management programs. However, this program cannot succeed without nurses' cooperation.

Reducing sexual victimization among adolescent girls: a randomized controlled pilot trial of my voice, my choice.

PubMed

Rowe, Lorelei Simpson; Jouriles, Ernest N; McDonald, Renee

2015-05-01

Despite extensive efforts to develop and implement programs to prevent sexual violence, few programs have empirically-demonstrated efficacy. The primary exceptions are programs that emphasize risk-reduction skills; yet even these programs are not consistently effective. This study seeks to add to the literature by evaluating the effects of My Voice, My Choice (MVMC), a 90-minute assertive resistance training program that emphasizes skill practice in an immersive virtual environment (IVE). We hypothesized that MVMC would reduce male-to-female sexual victimization among adolescent girls over a 3-month follow-up period. We also examined whether these results would generalize to other forms of male-to-female relationship violence and to girls' psychological distress. Eighty-three female students from an urban public high school were randomized to MVMC (n=47) or to a wait-list control condition (n=36); 78 provided data over the 3-month follow-up period. Participants assigned to MVMC were less likely than control participants to report sexual victimization during the follow-up period. Our results also suggest that MVMC reduced risk for psychological victimization and for psychological distress among participants with greater prior victimization at baseline. The promising results of this pilot trial suggest that MVMC may help girls evade male-to-female relationship violence. Copyright © 2014. Published by Elsevier Ltd.

The Beneficial Effects of Group-Based Exercises on Fall Risk Profile and Physical Activity Persist One-Year Post-Intervention in Older Women with Low Bone Mass: Follow-up After Withdrawal of Exercise

PubMed Central

Liu-Ambrose, Teresa YL; Khan, Karim M; Eng, Janice J; Gillies, Graham L; Lord, Stephen R; McKay, Heather A

2012-01-01

OBJECTIVE To determine whether exercise-induced reductions in fall risk are maintained in older women one year following the cessation of three types of interventions – resistance training, agility training, and general stretching. DESIGN One-year observational study. PARTICIPANTS 98 women aged 75–85 years with low bone mass. MEASUREMENTS Primary outcome measure was fall risk as measured by the Physiological Profile Assessment tool. Secondary outcome measures were current physical activity level as assessed by the Physical Activity Scale for the Elderly and formal exercise participation as assessed by interview. RESULTS At the end of the follow-up, the fall risk among former participants of all three exercise programs was maintained (i.e., still reduced) from trial completion. Mean fall risk value at the end of follow-up was 43.3% reduced compared with the mean baseline value among former participants of the Resistance Training group, 40.1% reduced in the Agility Training group, and 37.4% reduced in the general Stretching group. Physical activity levels were also maintained from trial completion. Specifically, there was a 3.8% increase in physical activity from baseline for the Resistance Training group, a 29.2% increase for the Agility Training group, and 37.7% increase for the general Stretching group. CONCLUSION After three types of group-based exercise programs, benefits are sustained for at least 12 months without further formal exercise intervention. Thus, these six-month exercise interventions appeared to act as a catalyst for increasing physical activity with resultant reductions in fall risk profile that were maintained for at least 18 months among older women with low bone mass. PMID:16181178

ICT-based system to predict and prevent falls (iStoppFalls): results from an international multicenter randomized controlled trial.

PubMed

Gschwind, Yves J; Eichberg, Sabine; Ejupi, Andreas; de Rosario, Helios; Kroll, Michael; Marston, Hannah R; Drobics, Mario; Annegarn, Janneke; Wieching, Rainer; Lord, Stephen R; Aal, Konstantin; Vaziri, Daryoush; Woodbury, Ashley; Fink, Dennis; Delbaere, Kim

2015-01-01

Falls and fall-related injuries are a serious public health issue. Exercise programs can effectively reduce fall risk in older people. The iStoppFalls project developed an Information and Communication Technology-based system to deliver an unsupervised exercise program in older people's homes. The primary aims of the iStoppFalls randomized controlled trial were to assess the feasibility (exercise adherence, acceptability and safety) of the intervention program and its effectiveness on common fall risk factors. A total of 153 community-dwelling people aged 65+ years took part in this international, multicentre, randomized controlled trial. Intervention group participants conducted the exercise program for 16 weeks, with a recommended duration of 120 min/week for balance exergames and 60 min/week for strength exercises. All intervention and control participants received educational material including advice on a healthy lifestyle and fall prevention. Assessments included physical and cognitive tests, and questionnaires for health, fear of falling, number of falls, quality of life and psychosocial outcomes. The median total exercise duration was 11.7 h (IQR = 22.0) over the 16-week intervention period. There were no adverse events. Physiological fall risk (Physiological Profile Assessment, PPA) reduced significantly more in the intervention group compared to the control group (F1,127 = 4.54, p = 0.035). There was a significant three-way interaction for fall risk assessed by the PPA between the high-adherence (>90 min/week; n = 18, 25.4 %), low-adherence (<90 min/week; n = 53, 74.6 %) and control group (F2,125 = 3.12, n = 75, p = 0.044). Post hoc analysis revealed a significantly larger effect in favour of the high-adherence group compared to the control group for fall risk (p = 0.031), postural sway (p = 0.046), stepping reaction time (p = 0.041), executive functioning (p = 0.044), and quality of life (p for trend = 0.052). The iStoppFalls exercise program reduced physiological fall risk in the study sample. Additional subgroup analyses revealed that intervention participants with better adherence also improved in postural sway, stepping reaction, and executive function. Australian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096651 International Standard Randomised Controlled Trial Number: ISRCTN15932647.

External benefits of biomass-e in Spain: an economic valuation.

PubMed

Soliño, Mario

2010-03-01

This article analyses the willingness to pay for a program that promotes the production of electricity from forest biomass, instead of that based on fossil fuels. The program decreases greenhouse gas emissions, reduces the pressure on non-renewable resources, lowers the risk of summer forest fires, creates employment in rural areas. Results from a choice experiment show that consumers are willing to pay a higher price for electricity in order to obtain the external benefits of the substitution. Respondents attach a higher value to programs that decrease the pressure of non-renewable resources and the risk of forest fires. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Hardware test program for evaluation of baseline range/range rate sensor concept

NASA Technical Reports Server (NTRS)

1985-01-01

The Hardware Test Program for evaluation of the baseline range/range rate sensor concept was initiated 11 September 1984. This ninth report covers the period 12 May through 11 June 1885. A contract amendment adding a second phase has extended the Hardware Test Program through 10 December 1985. The objective of the added program phase is to establish range and range measurement accuracy and radar signature characteristics for a typical spacecraft target. Phase I of the Hardware Test Program was designed to reduce the risks associated with the Range/Range Rate (R/R) Sensor baseline design approach. These risks are associated with achieving the sensor performance required for the two modes of operation, the Interrupted CW (ICW) mode for initial acquisition and tracking to close-in ranges, and the CW mode, providing coverage during the final docking maneuver. The risks associated with these modes of operation have to do with the realization of adequate sensitivity to operate to their individual maximum ranges.

Community responses to violence.

PubMed

Elliott, B A

1993-06-01

Community level efforts are effective in the reduction of violence. Community-level interventions have three goals: to prevent the escalation of risk for violence among the families in the community, to assist families at risk of or using violence, and to protect victims of abuse. To prevent violence or reduce its prevalence, community groups need to collaborate to reduce the community-level risk factors. Assisting families and protecting victims of violence requires coordination of community services, including law enforcement, schools, therapists, courts, child care, and social services. All of these goals can best be achieved through the efforts of a community level, multidisciplinary council or board that directs the programs. A community process to establish an integrated program involves several steps. The leaders that are identified need to represent all the disciplines and the entire geographic area involved in the project. Once the leaders start meeting, the baseline information and plan can be developed. Then the project itself can be undertaken, with the support of the media and other appropriate organizations. Several examples of effective projects document this process and its success; the best efforts involve coalitions of private and governmental agencies working together. Physicians are integral to this process. The practice of medicine provides opportunities every day to prevent and intervene in potential cases of abuse and violence. Also, by participating actively in the community, physicians can be effective leaders to change attitudes and behaviors and institute programs toward reducing violence.

A Preliminary Trial of a Prototype Internet Dissonance-Based Eating Disorder Prevention Program for Young Women with Body Image Concerns

ERIC Educational Resources Information Center

Stice, Eric; Rohde, Paul; Durant, Shelley; Shaw, Heather

2012-01-01

Objective: A group dissonance-based eating disorder prevention program, in which young women critique the thin ideal, reduces eating disorder risk factors and symptoms, but it can be difficult to identify school clinicians with the time and expertise to deliver the intervention. Thus, we developed a prototype Internet version of this program and…

[New guidelines in regard to cervical cancer screening].

PubMed

Vargas-Hernández, Víctor Manuel; Acosta-Altamirano, Gustavo; Moreno-Eutimio, Mario Adán; Vargas-Aguilar, Víctor Manuel

2014-01-01

Cancer screening programs have been successful in reducing the incidence and mortality due to cervical cancer. For more than a decade, the human papillomavirus test has been recommended as part of these programs, however, Pap tests is not currently recommended for women 65 years of age who participated adequately in screening programs, continuing with these screening programs is not needed. Screening programs will be different in special populations at greatest risk where tests are frequently needed or use of alternative methods.

Moderating factors in the path from physical abuse to attempted suicide in adolescents: application of the interpersonal-psychological theory of suicide.

PubMed

Cero, Ian; Sifers, Sarah

2013-06-01

Childhood physical abuse is a major risk factor for suicide attempt, but factors that moderate this risk remain largely unexamined. Moderated mediation analysis was used with 186 adolescents who responded to the Profiles of Student Life: Attitudes and Behavior survey. Physical abuse increased risk directly and indirectly through reduced self-esteem. Involvement in youth programs moderated the direct effect. Community service moderated the indirect effect. Results indicate 2 hours per week of involvement in youth programs and 2 hours per week of community service mitigated suicide attempt risk associated with abuse. Providing avenues for youth experiencing abuse to increase their community service and involvement is recommended. © 2013 The American Association of Suicidology.

EPA Recognized for Research on Reducing Risks to Drinking ...

EPA Pesticide Factsheets

Technical Brief Threat Ensemble Vulnerability Assessment (TEVA) among finalists for Edelman Award On February 7, 2008, the Institute for Operations Research and the Management Sciences (INFORMS ® of Hanover, MD) announced that a TEVA Research project is one of six finalists vying for this year’s prestigious Franz Edelman Award. The project is called “Reducing Security Risks in American Drinking Water Systems.” Edelman Award Information This is the thirty-seventh year of the Edelman competition. Every year, the competition recognizes outstanding operations research-based projects that transform companies, entire industries, and people’s lives. Operations research uses advanced analytical methods to make optimal decisions in order to solve complex problems. The winner of the award will be announced in mid-April 2008. Past Edelman Award finalists include Travelocity; IBM; Merrill Lynch; the Memorial Sloan-Kettering Cancer Center; and Georgia Tech. The winning team for 2007 reduced both patient suffering and health care costs from the treatment of prostate and breast cancer. The Edelman competition attests to the contributions of operations research in the profit and nonprofit sectors. It is estimated that the cumulative dollar benefits from Edelman finalist projects between 1984 and 2006 reached the $100 billion mark. TEVA Research Program The TEVA research program has focused on reducing the security risks to drinking water systems. Ad

Identifying postpartum intervention approaches to reduce cardiometabolic risk among American Indian women with prior gestational diabetes, Oklahoma, 2012-2013.

PubMed

Jones, Emily J; Peercy, Michael; Woods, J Cedric; Parker, Stephany P; Jackson, Teresa; Mata, Sara A; McCage, Shondra; Levkoff, Sue E; Nicklas, Jacinda M; Seely, Ellen W

2015-04-02

Innovative approaches are needed to reduce cardiometabolic risk among American Indian women with a history of gestational diabetes. We assessed beliefs of Oklahoma American Indian women about preventing type 2 diabetes and cardiovascular disease after having gestational diabetes. We also assessed barriers and facilitators to healthy lifestyle changes postpartum and intervention approaches that facilitate participation in a postpartum lifestyle program. In partnership with a tribal health system, we conducted a mixed-method study with American Indian women aged 19 to 45 years who had prior gestational diabetes, using questionnaires, focus groups, and individual interviews. Questionnaires were used to identify women's cardiometabolic risk perceptions and feasibility and acceptability of Internet or mobile phone technology for delivery of a postpartum lifestyle modification program. Focus groups and individual interviews were conducted to identify key perspectives and preferences related to a potential program. Participants were 26 women, all of whom completed surveys; 11 women participated in focus group sessions, and 15 participated in individual interviews. Most women believed they would inevitably develop diabetes, cardiovascular disease, or both; however, they were optimistic that they could delay onset with lifestyle change. Most women expressed enthusiasm for a family focused, technology-based intervention that emphasizes the importance of delaying disease onset, provides motivation, and promotes accountability while accommodating women's competing priorities. Our findings suggest that an intervention that uses the Internet, text messaging, or both and that emphasizes the benefits of delaying disease onset should be tested as a novel, culturally relevant approach to reducing rates of diabetes and cardiovascular disease in this high-risk population.

Good choices, great future: an applied theatre prevention program to reduce alcohol-related risky behaviours during Schoolies.

PubMed

Quek, Lake-Hui; White, Angela; Low, Christine; Brown, Judith; Dalton, Nigel; Dow, Debbie; Connor, Jason P

2012-11-01

The contextual and temporal factors of post-school celebratory events ('Schoolies') place young people at elevated risk of excessive drinking compared with other social occasions. This study investigates the impact of an applied theatre prevention program 'Choices' in reducing the risk of drinking and other risk behaviours during Schoolies celebrations. Choices was delivered in the last term of Year 12 across 28 North Queensland schools. A total of 352 school leavers (43.1% male, mean age = 17.14 years) completed a questionnaire at Whitsunday Schoolies, Queensland, Australia on 23-24 November 2010. Nearly 49% of respondents had attended Choices. The survey included measures of alcohol use, illicit drug use and associated problems during Schoolies and a month prior to Schoolies. After controlling for gender and pre-Schoolies drinking, school leavers who attended Choices were significantly less likely to report illicit drug use (OR = 0.51, P < 0.05) and problem behaviours (OR = 0.40, P < 0.01) than those who did not attend Choices. There was, however, no intervention effect in risky drinking (i.e. drank on 5 or more days, typical amount five or more standard drink and binge drank on 3 or more days) at Schoolies (OR = 0.92, P = 0.80). Delivery of a youth-specific applied theatre prevention program employing a harm minimisation framework may be effective in reducing high-risk behaviours associated with alcohol consumption at celebratory events, even if young people expect to engage in excessive alcohol consumption. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Risk and Hazard Management in High Adventure Outdoor Pursuits.

ERIC Educational Resources Information Center

Meier, Joel

The dilemma in adventure education is to eliminate unreasonable risks to participants without reducing the levels of excitement, challenge, and stress that are inherent in adventure programming. Most accidents in outdoor pursuits are caused by a combination of unsafe conditions; unsafe acts (usually on the part of the student); and error judgments…

A Systematic Review of Suicide Prevention Programs for Military or Veterans

ERIC Educational Resources Information Center

Bagley, Steven C.; Munjas, Brett; Shekelle, Paul

2010-01-01

Military personnel and veterans have important suicide risk factors. After a systematic review of the literature on suicide prevention, seven (five in the U.S.) studies of military personnel were identified containing interventions that may reduce the risk of suicide. The effectiveness of the individual components was not assessed, and problems in…

Is There Evidence To Show That Fetal Alcohol Syndrome Can Be Prevented?

ERIC Educational Resources Information Center

Murphy-Brennan, Majella G.; Oei, Tian P. S.

1999-01-01

Reviews the effectiveness of prevention programs in reducing Fetal Alcohol Syndrome (FAS). Results reveal that prevention programs, to date, have been successful in raising awareness of FAS; however this awareness has not been translated into behavioral changes in high-risk drinkers as consumption levels in this group have increased. (Author/MKA)

National dissemination of StrongWomen – Healthy Hearts: A community-based program to reduce risk of cardiovascular disease among midlife and older women

USDA-ARS?s Scientific Manuscript database

Objective: We describe the national dissemination of an evidence-based community cardiovascular disease prevention program for midlife and older women using the RE-AIM (reach effectiveness adoption implementation maintenance) framework and share key lessons learned during translation. Methods: In a ...

Preventing Child Abuse: A Meta-Analysis of Parent Training Programs

ERIC Educational Resources Information Center

Lundahl, Brad W.; Nimer, Janelle; Parsons, Bruce

2006-01-01

Objective: A meta-analysis was conducted to evaluate the ability of parent training programs to reduce parents' risk of abusing a child. Method: A total of 23 studies were submitted to a meta-analysis. Outcomes of interest included parents' attitudes toward abuse, emotional adjustment, child-rearing skills, and actual abuse. Conclusions:…

Fuels Management-How to Measure Success: Conference Proceedings

Treesearch

Patricia L. Andrews; Bret W. Butler

2006-01-01

Fuels management programs are designed to reduce risks to communities and to improve and maintain ecosystem health. The International Association of Wildland Fire initiated the 1st Fire Behavior and Fuels Conference to address development, implementation, and evaluation of these programs. The focus was on how to measure success. Over 500 participants from several...

77 FR 62518 - Proposed Collection; Comment Request: Recipient Epidemiology and Donor Evaluation Study-III (REDS...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

..., translational, and clinical research to improve the benefits of transfusion while reducing its risks. The... Institute (NHLBI) REDS programs have proven to be the premier research programs in blood collection and... successes that this research network has realized over the years while being responsive to changing research...

Effect of structured physical activity on prevention of serious fall injuries in adults aged 70-89: randomized clinical trial (LIFE Study)

USDA-ARS?s Scientific Manuscript database

OBJECTIVE: To test whether a long term, structured physical activity program compared with a health education program reduces the risk of serious fall injuries among sedentary older people with functional limitations. DESIGN: Multicenter, single blinded randomized trial (Lifestyle Interventions and ...

Firewise forever? Voluntary community participation and retention in Firewise programs

Treesearch

Michele Steinberg

2011-01-01

Firewise Communities/USA® is a national program designed to encourage residents of wildfire-prone areas to take action to reduce wildfire risks to their homes and neighborhoods. Residents of homeowner associations and small communities who are interested in improving their wildfire safety work with state forestry and fire professionals and follow a simple,...

Process Evaluation of a Parenting Program for Low-Income Families in South Africa

ERIC Educational Resources Information Center

Lachman, Jamie M.; Kelly, Jane; Cluver, Lucie; Ward, Catherine L.; Hutchings, Judy; Gardner, Frances

2018-01-01

Objective: This mixed-methods process evaluation examined the feasibility of a parenting program delivered by community facilitators to reduce the risk of child maltreatment in low-income families with children aged 3-8 years in Cape Town, South Africa (N = 68). Method: Quantitative measures included attendance registers, fidelity checklists,…

77 FR 18809 - Notice of Tentative Approval and Opportunity for Public Comment and Public Hearing for Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... Public Comment and Public Hearing for Public Water System Supervision Program Revision for Virginia... revising its approved Public Water System Supervision Program. The Commonwealth has adopted the drinking... by reducing public water system consumers' risk of microbial illness from drinking water. EPA has...

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

Laughlin, Gary L.

The International, Homeland, and Nuclear Security (IHNS) Program Management Unit (PMU) oversees a broad portfolio of Sandia’s programs in areas ranging from global nuclear security to critical asset protection. We use science and technology, innovative research, and global engagement to counter threats, reduce dangers, and respond to disasters. The PMU draws on the skills of scientists and engineers from across Sandia. Our programs focus on protecting US government installations, safeguarding nuclear weapons and materials, facilitating nonproliferation activities, securing infrastructures, countering chemical and biological dangers, and reducing the risk of terrorist threats. We conduct research in risk and threat analysis, monitoringmore » and detection, decontamination and recovery, and situational awareness. We develop technologies for verifying arms control agreements, neutralizing dangerous materials, detecting intruders, and strengthening resiliency. Our programs use Sandia’s High-Performance Computing resources for predictive modeling and simulation of interdependent systems, for modeling dynamic threats and forecasting adaptive behavior, and for enabling decision support and processing large cyber data streams. In this report, we highlight four advanced computation projects that illustrate the breadth of the IHNS mission space.« less

Reduced 10-year risk of coronary heart disease in patients who participated in a community-based diabetes prevention program: the DEPLOY pilot study.

PubMed

Lipscomb, Elaine R; Finch, Emily A; Brizendine, Edward; Saha, Chandan K; Hays, Laura M; Ackermann, Ronald T

2009-03-01

We evaluated whether participation in a community-based group diabetes prevention program might lead to relative changes in composite 10-year coronary heart disease (CHD) risk for overweight adults with abnormal glucose metabolism. We used the UK Prospective Diabetes Study engine to estimate CHD risk for group-lifestyle and brief counseling (control) groups. Between-group risk changes after 4 and 12 months were compared using ANCOVA. Baseline 10-year risk was similar between treatment groups (P = 0.667). At 4 and 12 months, the intervention group experienced significant decreases in 10-year risk from baseline (-3.28%, P < 0.001; and -2.23%, P = 0.037) compared with control subjects (-0.78%, P = 0.339; and +1.88%, P = 0.073). Between-group differences were statistically significant and increased from the 4- to 12-month visits. Community-based delivery of the Diabetes Prevention Program lifestyle intervention could be a promising strategy to prevent both CHD and type 2 diabetes in adults with pre-diabetes.

Can an Integrated Approach Reduce Child Vulnerability to Anaemia? Evidence from Three African Countries

PubMed Central

Siekmans, Kendra; Receveur, Olivier; Haddad, Slim

2014-01-01

Addressing the complex, multi-factorial causes of childhood anaemia is best done through integrated packages of interventions. We hypothesized that due to reduced child vulnerability, a “buffering” of risk associated with known causes of anaemia would be observed among children living in areas benefiting from a community-based health and nutrition program intervention. Cross-sectional data on the nutrition and health status of children 24–59 mo (N = 2405) were obtained in 2000 and 2004 from program evaluation surveys in Ghana, Malawi and Tanzania. Linear regression models estimated the association between haemoglobin and immediate, underlying and basic causes of child anaemia and variation in this association between years. Lower haemoglobin levels were observed in children assessed in 2000 compared to 2004 (difference -3.30 g/L), children from Tanzania (-9.15 g/L) and Malawi (-2.96 g/L) compared to Ghana, and the youngest (24–35 mo) compared to oldest age group (48–59 mo; -5.43 g/L). Children who were stunted, malaria positive and recently ill also had lower haemoglobin, independent of age, sex and other underlying and basic causes of anaemia. Despite ongoing morbidity, risk of lower haemoglobin decreased for children with malaria and recent illness, suggesting decreased vulnerability to their anaemia-producing effects. Stunting remained an independent and unbuffered risk factor. Reducing chronic undernutrition is required in order to further reduce child vulnerability and ensure maximum impact of anaemia control programs. Buffering the impact of child morbidity on haemoglobin levels, including malaria, may be achieved in certain settings. PMID:24598692

Can an integrated approach reduce child vulnerability to anaemia? Evidence from three African countries.

PubMed

Siekmans, Kendra; Receveur, Olivier; Haddad, Slim

2014-01-01

Addressing the complex, multi-factorial causes of childhood anaemia is best done through integrated packages of interventions. We hypothesized that due to reduced child vulnerability, a "buffering" of risk associated with known causes of anaemia would be observed among children living in areas benefiting from a community-based health and nutrition program intervention. Cross-sectional data on the nutrition and health status of children 24-59 mo (N=2405) were obtained in 2000 and 2004 from program evaluation surveys in Ghana, Malawi and Tanzania. Linear regression models estimated the association between haemoglobin and immediate, underlying and basic causes of child anaemia and variation in this association between years. Lower haemoglobin levels were observed in children assessed in 2000 compared to 2004 (difference -3.30 g/L), children from Tanzania (-9.15 g/L) and Malawi (-2.96 g/L) compared to Ghana, and the youngest (24-35 mo) compared to oldest age group (48-59 mo; -5.43 g/L). Children who were stunted, malaria positive and recently ill also had lower haemoglobin, independent of age, sex and other underlying and basic causes of anaemia. Despite ongoing morbidity, risk of lower haemoglobin decreased for children with malaria and recent illness, suggesting decreased vulnerability to their anaemia-producing effects. Stunting remained an independent and unbuffered risk factor. Reducing chronic undernutrition is required in order to further reduce child vulnerability and ensure maximum impact of anaemia control programs. Buffering the impact of child morbidity on haemoglobin levels, including malaria, may be achieved in certain settings.

Prevention and Control Program for Cardiovascular Diseases in Turkish Population: PRE-CONTROL Study Group.

PubMed

Kozan, Ömer; Zoghi, Mehdi; Ergene, Oktay; Arıcı, Mustafa; Derici, Ülver; Bakaç, Göksel; Güllü, Sevim; Sain Güven, Gülay

2013-06-01

Cardiovascular disease (CVD) is the leading cause of death throughout the world. Despite its high prevalence, the atherosclerotic process can be slowed and its consequences markedly reduced by preventive measures. The lack of risk factor awareness is a major barrier. We aimed to assess total CV risk, determine the knowledge and awareness regarding CVD, and evaluate the effectiveness of education program in urban population of Turkey. A 24-item questionnaire was used to detect CV risk factors and the awareness of participants about CVD. The feedback data for the education program were collected by either questionnaires or individual interviews with participants. For comparison of total CVD risk in men and women in different age groups, a sample t test was used. The level of statistical significance was set at p < 0.05. The prevalence of hyperlipidemia was established to be 41.3%. Nearly one-quarter of the women and one-third of the men were smokers (p < 0.001). One-quarter of the responders had a history of hypertension (men: 21.5%, women: 18.6%), and one-tenth were diabetic. The high CV risk rate was more pronounced among men (p < 0.01) and those with low socioeconomic level (p < 0.01). Awareness regarding CV risk factors following the educational program increased from 6.6% to 12.7% for high blood pressure, from 3.9% to 9.2% for diabetes mellitus, and from 10.2% to 15.1% for elevated cholesterol levels. All the increases were statistically significant. The educational program significantly increased the awareness of CVD and risk factors. The prevalence of CV risk factors was higher in low socioeconomic level groups. The knowledge and awareness of the risk factors for CVD before the education program was very low in our study group. The awareness of CVD and risk factors significantly increased following our education programs. Copyright © 2013 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

Go Grrrls: A Randomized Controlled Trial of a Gender-Specific Intervention to Reduce Sexual Risk Factors in Middle School Females.

PubMed

LeCroy, Craig Winston; McCullough Cosgrove, Jenny; Cotter, Katie; Fordney, Marie

2018-04-01

Adolescent females continue to face health consequences associated with risky sexual behaviors such as unintended pregnancies and sexually transmitted diseases. The purpose of this study was to investigate the efficacy of a gender-specific intervention targeted to early adolescent females. This study used an intent to treat randomized clinical trial comparing a broad-based female empowerment curriculum with a dose-matched science and technology female leadership curriculum. The sample ( N = 801) was recruited from schools and was implemented in community-based settings mostly in an after school context. Assessments were conducted at baseline, postintervention, 6-, and 18-month follow-up time periods. Both groups in the study obtained good implementation and engagement. The average attendance rate was 81% of program sessions. There were significant differences between the two groups favoring the intervention group on measures of sexually transmitted disease knowledge and condom technical skills. On a measure of condom self-efficacy, there was a significant trend. At the postassessment, there was a significant difference on the intentions to reduce sexual risk behaviors. Both the intervention and control groups made gains on the self-assertive behavior scale. Gender-specific programs for early adolescent females can help reduce indicators that are related to sexual risk reduction. More long-term follow-up is needed to assess impact on sexual behaviors. Efforts directed at a younger population of females should continue to be researched for potential in reducing sexual risks.

Minimizing Injuries and Enhancing Performance in Golf Through Training Programs

PubMed Central

Meira, Erik P.; Brumitt, Jason

2010-01-01

Context: Golf is a popular sport, particularly in older populations. Regardless of age and skill level, golfers risk injury to the back, shoulder, wrist and hand, elbow, and knee. Because of the unique compressive, shear, rotational, and lateral bending forces created in the lumbar region during the golf swing, the primary sport-related malady experienced by amateurs and professionals is low back pain. Extrinsic and intrinsic injury risk factors have been reported in the literature. A growing body of evidence supports the prescription of strength training routines to enhance performance and reduce the risk of injury. Evidence Acquisition: Relevant studies were reviewed on golf injuries, swing mechanics, training routines, and general training program design. The following electronic databases were used to identify research relevant to this report: MEDLINE (from 1950–November 2009), CINAHL (1982–November 2009), and SPORTDiscus (1830–November 2009). Results: Injuries may be associated with lack of warm-up, poor trunk flexibility and strength, faulty swing technique, and overuse. Conclusions: Implementing a training program that includes flexibility, strength, and power training with correction of faulty swing mechanics will help the golfer reduce the likelihood of injury and improve overall performance. PMID:23015957

Cost and accuracy of advanced breeding trial designs in apple

PubMed Central

Harshman, Julia M; Evans, Kate M; Hardner, Craig M

2016-01-01

Trialing advanced candidates in tree fruit crops is expensive due to the long-term nature of the planting and labor-intensive evaluations required to make selection decisions. How closely the trait evaluations approximate the true trait value needs balancing with the cost of the program. Designs of field trials of advanced apple candidates in which reduced number of locations, the number of years and the number of harvests per year were modeled to investigate the effect on the cost and accuracy in an operational breeding program. The aim was to find designs that would allow evaluation of the most additional candidates while sacrificing the least accuracy. Critical percentage difference, response to selection, and correlated response were used to examine changes in accuracy of trait evaluations. For the quality traits evaluated, accuracy and response to selection were not substantially reduced for most trial designs. Risk management influences the decision to change trial design, and some designs had greater risk associated with them. Balancing cost and accuracy with risk yields valuable insight into advanced breeding trial design. The methods outlined in this analysis would be well suited to other horticultural crop breeding programs. PMID:27019717

Review of 5 years of a combined dietary and physical fitness intervention for control of serum cholesterol

NASA Technical Reports Server (NTRS)

Angotti, C. M.; Levine, M. S.

1994-01-01

A chart review covering the first 5 years of clinical experience with a combined dietary and exercise intervention program for the reduction of hypercholesterolemia at the National Aeronautics and Space Administration headquarters demonstrated the program's success in maintaining high-density lipoprotein cholesterol (HDL-C) levels while significantly lowering total serum cholesterol levels. This combined program also resulted in improved ratios of total serum cholesterol to HDL-C and lowered levels of low-density lipoprotein cholesterol, thus further reducing the risk for cardiovascular disease. The National Aeronautics and Space Administration Cardiovascular Risk Reduction Program was developed after it was determined that although dietary intervention alone improved total cholesterol levels, it often resulted in a more than proportionate decrease in HDL-C and a worsening of the ratio of cholesterol to HDL-C. An approach was needed that would positively affect all factors of the lipid profile. The findings from the program indicate that reduction of cardiovascular risk can be accomplished easily and effectively at the worksite through dietary intervention, personal monitoring, and a reasonable exercise program.

Economic assessment of home-based COPD management programs.

PubMed

Liu, Sheena Xin; Lee, Michael C; Atakhorrami, Maryam; Tatousek, Jan; McCormack, Meredith; Yung, Rex; Hart, Nicholas; White, David P

2013-12-01

Home-based exacerbation management programs have been proposed as an approach to reducing the clinical and financial burden of COPD. We demonstrate a framework to evaluate such programs in order to guide program design and performance decisions towards optimizing cost and clinical outcomes. This study models the impact of hypothetical exacerbation management programs through probabilistic Markov simulations. Patients were stratified by risk using exacerbation rates from the ECLIPSE study and expert opinion. Three scenarios were modeled, using base, worst and best case parameters to suggest potential telehealth program performance. In these scenarios, acute exacerbations could be detected early, with sensitivity and specificity ranging from 60-90%. Detected acute exacerbations could be diverted to either a sub-acute pathway (12.5-50% probability), thus entirely avoiding hospitalization, or a lower cost pathway through length-of-stay reduction (14-28% reduction). For a cohort of patients without prior hospitalization, the base case telehealth scenario results in a cumulative per-patient lifetime savings of $2.9 K over ≈ 12 years. For a higher risk cohort of patients with a prior admission and 1 to 2 acute exacerbations per year, a cumulative $16K per patient was saved during the remaining ≈ 3 life-years. Acceptable prices for home-based exacerbation detection testing were highly dependent on patient risk and scenario, but ranged from $290-$1263 per month for the highest risk groups. These results suggest the economic viability of exacerbation management programs and highlight the importance of risk stratification in such programs. The presented model can further be adapted to model specific programs as trial data becomes available.

Improving access and equity in reducing cardiovascular risk: the Queensland Health model.

PubMed

Ski, Chantal F; Vale, Margarite J; Bennett, Gary R; Chalmers, Victoria L; McFarlane, Kim; Jelinek, V Michael; Scott, Ian A; Thompson, David R

2015-02-16

To measure changes in cardiovascular risk factors among patients with coronary heart disease (CHD) and/or type 2 diabetes enrolled in a centralised statewide coaching program delivered by telephone and mail-out in the public health sector in Queensland. A population-based audit of cardiovascular risk factor data collected prospectively as part of The COACH (Coaching Patients On Achieving Cardiovascular Health) Program (TCP) delivered through Queensland Health's Health Contact Centre. 1962 patients with CHD and 707 patients with type 2 diabetes who completed TCP from 20 February 2009 to 20 June 2013, of whom 145 were Indigenous Australians. Changes in fasting lipids, fasting glucose, glycosylated haemoglobin levels, blood pressure, body weight, body mass index, smoking, alcohol consumption and physical activity, as measured at entry to and completion of the program. Statistically significant improvements in cardiovascular risk factor status, from entry to completion of the program, were found across all biomedical and lifestyle factors in patients with CHD and/or type 2 diabetes. For both diseases, improvements in serum lipids, blood glucose, smoking habit and alcohol consumption combined with increases in physical activity were the most notable findings. Similar differences were found in mean change scores in cardiovascular risk factors between Indigenous and non-Indigenous Queenslanders. A centralised statewide coaching program delivered by telephone and mail-out overcomes obstacles of distance and limited access to health services and facilitates a guideline-concordant decrease in cardiovascular risk.

Risk Factors for Substance Misuse and Adolescents’ Symptoms of Depression

PubMed Central

Siennick, Sonja E.; Widdowson, Alex O.; Woessner, Mathew K.; Feinberg, Mark E.; Spoth, Richard L.

2016-01-01

Purpose Depressive symptoms during adolescence are positively associated with peer-related beliefs, perceptions, and experiences that are known risk factors for substance misuse. These same risk factors are targeted by many universal substance misuse prevention programs. This study examined whether a multicomponent universal substance misuse intervention for middle schoolers reduced the associations between depressive symptoms, these risk factors, and substance misuse. Methods The study used data from a place-randomized trial of the PROSPER (PROmoting School-Community-University Partnerships to Enhance Resilience) model for delivery of evidence-based substance misuse programs for middle schoolers. Three-level within-person regression models were applied to four waves of survey and social network data from 636 adolescents followed from 6th through 9th grades. Results When adolescents in control school districts had more symptoms of depression, they believed more strongly that substance use had social benefits, perceived higher levels of substance misuse among their peers and friends, and had more friends who misused substances, although they were not more likely to use substances themselves. Many of the positive associations of depressive symptoms with peer-related risk factors were significantly weaker or not present among adolescents in intervention school districts. Conclusions The PROSPER interventions reduced the positive associations of adolescent symptoms of depression with peer-related risk factors for substance misuse. PMID:27751712

Alzheimer disease is substantially preventable in the United States -- review of risk factors, therapy, and the prospects for an expert software system.

PubMed

Jansson, Erik T

2005-01-01

Epidemiology studies, including both regional incidence and the analysis of specific risk factors for Alzheimer's disease indicate that substantial prevention of the disease, in the 50-70 percent range, is a practical possibility for the United States. Epidemiology has identified a rich diversity of specific prevention strategies relating to nutrition, dietary supplements, lifestyle, food and environmental toxins, and in some cases medication, many of which have a capacity to reduce Alzheimer's risk by 50 percent or more. The interaction of these risk factors with brain biology is increasingly understood. In contrast, therapeutic strategies for un-prevented Alzheimer's generally prove incapable of delaying disease progression by more than 3-11 months, because extensive brain cell death occurs even in preclinical or mild cases. A public health program aimed at prevention can be fashioned with expert software packages, based on already identified risk factors. Such statistical analysis should allow the prediction of individual and group Alzheimer's risks of sufficient power to instruct the formulation of lifestyle, nutritional and environmental programs to substantially reduce disease incidence. A less satisfactory but complementary alternative is very early disease detection with therapeutic strategies focused on retardation of brain cell death, so that the person dies of another cause before the disease is clinically manifested.

Are falls prevention programs effective at reducing the risk factors for falls in people with type-2 diabetes mellitus and peripheral neuropathy: A systematic review with narrative synthesis.

PubMed

Gu, Yu; Dennis, Sarah M

2017-02-01

Diabetic peripheral neuropathy (DPN) is a common complication of type-2 diabetes mellitus (T2DM) that predisposes the elderly to a higher falls risk. Falls prevention programs with a component of weight-bearing exercises are effective in decreasing future falls in the elderly. However, weight-bearing exercise was only recently recommended in guidelines for exercise for people with T2DM and DPN. Since then, there have been an increasing number of studies to evaluate the effectiveness of falls prevention programs on this targeted population. A systematic literature review was undertaken to determine the effectiveness of falls prevention programs for people with T2DM and DPN. Nine published studies that investigated the effect of exercise training on falls risk among people with T2DM and DPN were included in the review. Interventions included lower limb strengthening, balance practice, aerobic exercise, walking programs, and Tai Chi. The preliminary evidence presented in this review suggests that people with T2DM and DPN can improve their balance and walking after a targeted multicomponent program without risk of serious adverse events. There is insufficient long-term follow-up data to determine whether the improvements in balance or strength resulted in a decrease falls risk in the community setting. Copyright © 2016 Elsevier Inc. All rights reserved.

Osteo-cise: Strong Bones for Life: Protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures

PubMed Central

2012-01-01

Background Osteoporosis affects over 220 million people worldwide, and currently there is no ‘cure’ for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition. Methods/design The Osteo-cise: Strong Bones for Life study will investigate the effectiveness and feasibility of a multi-component targeted exercise, osteoporosis education/awareness and behavioural change program for improving bone health and muscle function and reducing falls risk in community-dwelling older adults at an increased risk of fracture. Men and women aged ≥60 years will participate in an 18-month randomised controlled trial comprising a 12-month structured and supervised community-based program and a 6-month ‘research to practise’ translational phase. Participants will be randomly assigned to either the Osteo-cise intervention or a self-management control group. The intervention will comprise a multi-modal exercise program incorporating high velocity progressive resistance training, moderate impact weight-bearing exercise and high challenging balance exercises performed three times weekly at local community-based fitness centres. A behavioural change program will be used to enhance exercise adoption and adherence to the program. Community-based osteoporosis education seminars will be conducted to improve participant knowledge and understanding of the risk factors and preventative measures for osteoporosis, falls and fractures. The primary outcomes measures, to be collected at baseline, 6, 12, and 18 months, will include DXA-derived hip and spine bone mineral density measurements and functional muscle power (timed stair-climb test). Secondary outcomes measures include: MRI-assessed distal femur and proximal tibia trabecular bone micro-architecture, lower limb and back maximal muscle strength, balance and function (four square step test, functional reach test, timed up-and-go test and 30-second sit-to-stand), falls incidence and health-related quality of life. Cost-effectiveness will also be assessed. Discussion The findings from the Osteo-cise: Strong Bones for Life study will provide new information on the efficacy of a targeted multi-modal community-based exercise program incorporating high velocity resistance training, together with an osteoporosis education and behavioural change program for improving multiple risk factors for falls and fracture in older adults at risk of fragility fracture. Trial registration Australian New Zealand Clinical Trials Registry reference ACTRN12609000100291 PMID:22640372

Reduction of Family Violence in Aboriginal Communities: A Systematic Review of Interventions and Approaches1

PubMed Central

Shea, Beverley; Nahwegahbow, Amy; Andersson, Neil

2010-01-01

Many efforts to reduce family violence are documented in the published literature. We conducted a systematic review of interventions intended to prevent family violence in Aboriginal communities. We retrieved studies published up to October 2009; 506 papers included one systematic review, two randomized controlled trials, and fourteen nonrandomized studies or reviews. Two reviews discussed interventions relevant to primary prevention (reducing the risk factors for family violence), including parenting, role modelling, and active participation. More studies addressed secondary prevention (where risk factors exist, reducing outbreaks of violence) such as restriction on the trading hours for take away alcohol and home visiting programs for high risk families. Examples of tertiary prevention (preventing recurrence) include traditional healing circles and group counselling. Most studies contributed a low level of evidence. PMID:21052554

A Group-Based Motivational Interviewing Brief Intervention to Reduce Substance Use and Sexual Risk Behavior among Homeless Young Adults

PubMed Central

Tucker, Joan S.; D’Amico, Elizabeth J.; Ewing, Brett A.; Miles, Jeremy N. V.; Pedersen, Eric R.

2017-01-01

Homeless young adults ages 18–25 exhibit high rates of alcohol and other drug (AOD) use, and sexual risk behaviors such as unprotected sex. Yet few programs exist for this population that are both effective and can be easily incorporated into settings serving this population. This pilot cluster cross-over randomized controlled trial evaluates AWARE, a voluntary four session group-based motivational interviewing (MI) intervention to reduce AOD use and sexual risk behavior. We evaluated AWARE with 200 homeless young adults using drop-in center services in Los Angeles County (mean age=21.8 years; 73% male; 79% heterosexual; 31% non-Hispanic White, 25% African American, 24% Hispanic, 21% multiracial/other). Surveys were completed at baseline and three months after program completion. Retention in the AWARE program was excellent (79% attended multiple sessions) and participants reported high levels of satisfaction with the program. AWARE participants self-reported positive change in their past 3 month and past 30 day alcohol use (ps ≤ .05), motivation to change drug use (ps < .05), and condom use self-efficacy (p = .05) compared to the control group. Among those with multiple sex partners, AWARE participants showed a decrease in unprotected sexual events (p < .05), whereas the control group did not. Results from this pilot evaluation are promising, suggesting that a brief group-MI risk reduction intervention can be effective in helping homeless young adults make positive changes in their alcohol and condom use. Further work is needed to more fully evaluate the efficacy of AWARE on AOD behavior and sexual risk behavior outcomes. PMID:28340904

Evaluation of a workshop on Public Education Messages for Reducing Health Risks from Ultraviolet Radiation.

PubMed

Ramsingh, R; Mills, C J

1997-01-01

The objective of this paper is to assess the impact of the 1994 Workshop on Public Education Messages for Reducing Health Risks from Ultraviolet Radiation (UVR). The target audience was any organization in Canada doing education on the health risks of UVR. A mailed survey with telephone follow-up was distributed to 130 addresses, including workshop participants, recipients of the workshop report and 40 local public health units. The response rate was 62%. Public health messages from the workshop served as an added impetus or helped to initiate activities around UVR in approximately 40% of organizations over the two years since the workshop. The public health messages were used directly in programming by approximately 38% of all organizations responding. However, looking at those who had previously seen the messages, 61% used them directly in programming. Forty percent of those sampled had never seen a copy of the messages. The results suggest the need for improved dissemination of consensus statements.

Texting for Health: An Evaluation of a Population Approach to Type 2 Diabetes Risk Reduction With a Personalized Message.

PubMed

Khurshid, Anjum; Brown, Lisanne; Mukherjee, Snigdha; Abebe, Nebeyou; Kulick, David

2015-11-01

txt4health is an innovative, 14-week, interactive, population-based mobile health program for individuals at risk of type 2 diabetes, developed under the Beacon Community Program in the Greater New Orleans, La., area. A comprehensive social marketing campaign sought to enroll hard-to-reach, at-risk populations using a combination of mass media and face-to-face engagement in faith-based and retail environments. Little is known about the effectiveness of social marketing for mobile technology application in the general population. A systematic evaluation of the campaign identified successes and barriers to implementing a population-based mobile health program. Face-to-face engagement helped increase program enrollment after the initial launch; otherwise, enrollment leveled off over time. Results show positive trends in reaching target populations and in the use of mobile phones to record personal health information and set goals for reducing the risk of type 2 diabetes. The lessons from the txt4health campaign can help inform the development and programmatic strategies to provide a person-level intervention using a population-level approach for individuals at risk for diabetes as well as aid in chronic disease management.

Eliminating Residents Increases the Cost of Care.

PubMed

DeMarco, Deborah M; Forster, Richard; Gakis, Thomas; Finberg, Robert W

2017-08-01

Academic health centers are facing a potential reduction in Medicare financing for graduate medical education (GME). Both the Medicare Payment Advisory Commission and the National Commission on Fiscal Responsibility and Reform (Deficit Commission) have suggested cutting approximately half the funding that teaching hospitals receive for indirect medical education. Because of the effort that goes into teaching trainees, who are only transient employees, hospital executives often see teaching programs as a drain on resources. In light of the possibility of a Medicare cut to GME programs, we undertook an analysis to assess the financial risk of training programs to our institution and the possibility of saving money by reducing resident positions. The chief administrative officer, in collaboration with the hospital chief financial officer, performed a financial analysis to examine the possibility of decreasing costs by reducing residency programs at the University of Massachusetts Memorial Medical Center. Despite the real costs of our training programs, the analysis demonstrated that GME programs have a positive impact on hospital finances. Reducing or eliminating GME programs would have a negative impact on our hospital's bottom line.

A National Model for Diabetes Prevention and Treatment Program in Civilian and Military Healthcare Beneficiary Populations

DTIC Science & Technology

2010-03-01

Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC...evidence-based pediatric and adult primary prevention and management programs would reduce risk for diabetes and its complications in civilian and... management system for childhood obesity; (3) implemented primary prevention by disseminating the modified Diabetes Prevention Program strategies

Bending The Spending Curve By Altering Care Delivery Patterns: The Role Of Care Management Within A Pioneer ACO.

PubMed

Hsu, John; Price, Mary; Vogeli, Christine; Brand, Richard; Chernew, Michael E; Chaguturu, Sreekanth K; Weil, Eric; Ferris, Timothy G

2017-05-01

Accountable care organizations (ACOs) appear to lower medical spending, but there is little information on how they do so. We examined the impact of patient participation in a Pioneer ACO and its care management program on rates of emergency department (ED) visits and hospitalizations and on Medicare spending. We used data for the period 2009-14, exploiting naturally staggered program entry to create concurrent controls to help isolate the program effects. The care management program (the ACO's primary intervention) targeted beneficiaries with elevated but modifiable risks for future spending. ACO participation had a modest effect on spending, in line with previous estimates. Participation in the care management program was associated with substantial reductions in rates for hospitalizations and both all and nonemergency ED visits, as well as Medicare spending, when compared to preparticipation levels and to rates and spending for a concurrent sample of beneficiaries who were eligible for but had not yet started the program. Rates of ED visits and hospitalizations were reduced by 6 percent and 8 percent, respectively, and Medicare spending was reduced by 6 percent. Targeting beneficiaries with modifiable high risks and shifting care away from the ED represent viable mechanisms for altering spending within ACOs. Project HOPE—The People-to-People Health Foundation, Inc.

A public health approach to cholesterol. Confronting the 'TV-auto-supermarket society'.

PubMed Central

Bodenheimer, T.

1991-01-01

Coronary heart disease has been proved to be associated with a "high-risk" diet and with elevated blood cholesterol levels. The National Cholesterol Education Program has embarked on a campaign based on intensive medical treatment of 60 million Americans with high blood cholesterol levels, but the degree of benefit of dietary change or pharmaceutical intervention or both to reduce blood cholesterol values remains a subject of disagreement within the scientific community. Evidence from comparative international studies suggests that to lower coronary heart disease mortality substantially, dietary alterations and general societal changes must be greater than those possible under the National Cholesterol Education Program's approach of physician-centered patient counseling. The nation's priority to prevent coronary heart disease should be a public policy approach, the goal of which is to reduce for the entire population all coronary disease risk factors. In the dietary area, three proposals to reduce the availability of atherogenic foods are the use of warning labels on atherogenic foods, the prohibition of advertising for such high-risk foods, and the imposition of an excise tax on the same foods. We must confront the "TV-auto-supermarket society" that underlies our nation's high rate of coronary heart disease. PMID:2028608

Fighting an Epidemic: The Role of Schools in Reducing Childhood Obesity

ERIC Educational Resources Information Center

Pyle, Sara A.; Sharkey, Jill; Yetter, Georgette; Felix, Erika; Furlong, Michael J.; Poston, W. S. Carlos

2006-01-01

Obesity among children and adolescents is a major public health concern affecting the physical and emotional health of youth while increasing their risk of reduced quality and duration of life. Schools and communities have begun to galvanize to address this epidemic and need quality empirical information to guide their policy, programming, and…

Fitness Promotion Strategies for K-12 Physical Education Programs

ERIC Educational Resources Information Center

Hill, Grant; Turner, Bud

2004-01-01

In recent years efforts have been made to emphasize the need for physical education by showing how physical activity helps students reduce the risk of cardiovascular disease; strengthen bones and muscles; supply energy, reduce stress, and help maintain a healthy body weight. This article describes a variety of proactive fitness strategies…

Influences of a Church-Based Intervention on Falls Risk Among Seniors.

PubMed

Briggs, Morgan; Morzinski, Jeffrey A; Ellis, Julie

2017-08-01

Prior studies illustrate that community-based programs effectively decrease falls risk in older adults and that faith-based programs improve health behaviors. The literature is unclear whether faith-based initiatives reduce seniors' fall risks. To tackle this gap, a long-term partnership led by 10 urban churches, a nearby nursing school, and a medical school developed a study with 3 objectives: determine baseline health concerns associated with falls (eg, depression, polypharmacy), implement a nurse-led, faith-based health education initiative for community-dwelling African American seniors at-risk of hospitalization, and assess pre- to post -program fall frequency. The 100 Healthy, At-Risk Families study team implemented 8 monthly educational health sessions promoting self-care and social support. Community nurses led the 60- to 90-minute sessions at each of 10 churches. To collect study data, nurses interviewed enrolled seniors pre- and post-intervention. Descriptive and comparison statistics were analyzed in Excel and Statistical Package for Social Sciences. Senior data at baseline found high rates of polypharmacy and physical imbalance, and no significant depression or gaps in social support. There was not a statistically significant change pre- to post-program in fall frequency "in prior year." Study findings reveal insights about African American senior health and fall risks. Church settings may provide a protective, psychosocial buffer for seniors, while polypharmacy and mobility/balance concerns indicate need for continued attention to fall risks. No increase in pre- to post-program falls was encouraging.

Prevention and Treatment of Cardiovascular Disease in Adolescents and Adults through the Transcendental Meditation(®) Program: A Research Review Update.

PubMed

Barnes, Vernon A; Orme-Johnson, David W

2012-08-01

The pathogenesis and progression of cardiovascular diseases are thought to be exacerbated by stress. Basic research indicates that the Transcendental Meditation(®) technique produces acute and longitudinal reductions in sympathetic tone and stress reactivity. In adolescents at risk for hypertension, the technique has been found to reduce resting and ambulatory blood pressure, left ventricular mass, cardiovascular reactivity, and to improve school behavior. Research on adults with mild or moderate essential hypertension has reported decreased blood pressure and reduced use of anti-hypertensive medication. The technique has also been reported to decrease symptoms of angina pectoris and carotid atherosclerosis, to reduce cardiovascular risk factors, including alcohol and tobacco use, to markedly reduce medical care utilization for cardiovascular diseases, and to significantly decrease cardiovascular and all-cause morbidity and mortality. These findings have important implications for inclusion of the Transcendental Meditation program in efforts to prevent and treat cardiovascular diseases and their clinical consequences.(®)Transcendental Meditation and TM are trademarks registered in the US. Patent and Trademark Office, licensed to Maharishi Vedic Education Development Corporation and are used with permission.

Enhancing the ecological risk assessment process.

PubMed

Dale, Virginia H; Biddinger, Gregory R; Newman, Michael C; Oris, James T; Suter, Glenn W; Thompson, Timothy; Armitage, Thomas M; Meyer, Judith L; Allen-King, Richelle M; Burton, G Allen; Chapman, Peter M; Conquest, Loveday L; Fernandez, Ivan J; Landis, Wayne G; Master, Lawrence L; Mitsch, William J; Mueller, Thomas C; Rabeni, Charles F; Rodewald, Amanda D; Sanders, James G; van Heerden, Ivor L

2008-07-01

The Ecological Processes and Effects Committee of the US Environmental Protection Agency Science Advisory Board conducted a self-initiated study and convened a public workshop to characterize the state of the ecological risk assessment (ERA), with a view toward advancing the science and application of the process. That survey and analysis of ERA in decision making shows that such assessments have been most effective when clear management goals were included in the problem formulation; translated into information needs; and developed in collaboration with decision makers, assessors, scientists, and stakeholders. This process is best facilitated when risk managers, risk assessors, and stakeholders are engaged in an ongoing dialogue about problem formulation. Identification and acknowledgment of uncertainties that have the potential to profoundly affect the results and outcome of risk assessments also improves assessment effectiveness. Thus we suggest 1) through peer review of ERAs be conducted at the problem formulation stage and 2) the predictive power of risk-based decision making be expanded to reduce uncertainties through analytical and methodological approaches like life cycle analysis. Risk assessment and monitoring programs need better integration to reduce uncertainty and to evaluate risk management decision outcomes. Postdecision audit programs should be initiated to evaluate the environmental outcomes of risk-based decisions. In addition, a process should be developed to demonstrate how monitoring data can be used to reduce uncertainties. Ecological risk assessments should include the effects of chemical and nonchemical stressors at multiple levels of biological organization and spatial scale, and the extent and resolution of the pertinent scales and levels of organization should be explicitly considered during problem formulation. An approach to interpreting lines of evidence and weight of evidence is critically needed for complex assessments, and it would be useful to develop case studies and/or standards of practice for interpreting lines of evidence. In addition, tools for cumulative risk assessment should be developed because contaminants are often released into stressed environments.

Proactive strategy for long-term biological research aimed at low-dose radiation risk in Korea.

PubMed

Seong, Ki Moon; Kwon, TaeWoo; Park, Jina; Youn, BuHyun; Cha, Hyuk-Jin; Kim, Yonghwan; Moon, Changjong; Lee, Seung-Sook; Jin, Young Woo

2018-06-19

Since the 2011 Fukushima nuclear power plant accident, Korean radiation experts have agreed that reliable data on health risks of low-dose radiation (LDR) are needed to ease the anxiety of lay people. The intent of this study was to devise a sustainable biological program suited for the research environment in Korea and aimed at the health effects of radiation exposures <100 millisieverts (mSv). To address pressing public concerns over LDR risk, we investigated the current understanding of LDR effects by analyzing the previous reports of international authorities for radiation protection and research publications that appeared after the Chernobyl accident. A research program appropriate for societal and scientific inclinations of Korea was then devised based on input from Korean radiation scientists. After review by our advisory committee, program priorities were set, calling for an agenda that focused on dose-response relationships in carcinogenesis, health span responses to lifestyle variations, and systemic metabolic changes. Our long-term biological research program may contribute scientific evidence to reduce the uncertainties of LDR health risks and help stakeholders formulate policies for radiation protection.

Effects of Rational-Emotive Health Education Program on HIV risk perceptions among in-school adolescents in Nigeria.

PubMed

Onyechi, Kay Chinonyelum Nwamaka; Eseadi, Chiedu; Okere, Anthony U; Otu, Mkpoikanke Sunday

2016-07-01

Exploring beliefs about personal risk for human immunodeficiency virus (HIV) infection is essential to understanding what motivates people to engage in behaviors that reduce or increase their risk of HIV infection. Therefore, the current study's objective was to examine the effects of a Rational-Emotive Health Education Program (REHEP) on HIV risk perceptions among in-school adolescents in Anambra State, Nigeria.Forty-four participants were identified as having high-risk perceptions about HIV infection through a self-report questionnaire and met the inclusion criteria. The treatment process was guided by a REHEP manual and consisted of 8 weeks of full intervention and 2 weeks of follow-up meetings that marked the end of intervention. The study used repeated measures analysis of variance to assess improvements in individual participants and across control and treatment group risk perceptions after the intervention.HIV risk perceptions of in-school adolescents did not differ across the treatment and control groups at baseline. Through REHEP, HIV risk perceptions significantly reduced in the treatment group compared to those in the control group. REHEP had significant effect on HIV risk perceptions of in-school adolescents exposed to treatment group, despite their sex. Religious background did not determine the significant effect of REHEP on HIV risk perceptions of in-school adolescents in the treatment group.Follow-up studies that would use a REHEP to assist client population from other parts of the country to promote HIV risk reduction, especially among those with high-risk behavior, are needed in Nigeria.

Effects of Rational-Emotive Health Education Program on HIV risk perceptions among in-school adolescents in Nigeria

PubMed Central

Onyechi, Kay Chinonyelum Nwamaka; Eseadi, Chiedu; Okere, Anthony U.; Otu, Mkpoikanke Sunday

2016-01-01

Abstract Exploring beliefs about personal risk for human immunodeficiency virus (HIV) infection is essential to understanding what motivates people to engage in behaviors that reduce or increase their risk of HIV infection. Therefore, the current study's objective was to examine the effects of a Rational-Emotive Health Education Program (REHEP) on HIV risk perceptions among in-school adolescents in Anambra State, Nigeria. Forty-four participants were identified as having high-risk perceptions about HIV infection through a self-report questionnaire and met the inclusion criteria. The treatment process was guided by a REHEP manual and consisted of 8 weeks of full intervention and 2 weeks of follow-up meetings that marked the end of intervention. The study used repeated measures analysis of variance to assess improvements in individual participants and across control and treatment group risk perceptions after the intervention. HIV risk perceptions of in-school adolescents did not differ across the treatment and control groups at baseline. Through REHEP, HIV risk perceptions significantly reduced in the treatment group compared to those in the control group. REHEP had significant effect on HIV risk perceptions of in-school adolescents exposed to treatment group, despite their sex. Religious background did not determine the significant effect of REHEP on HIV risk perceptions of in-school adolescents in the treatment group. Follow-up studies that would use a REHEP to assist client population from other parts of the country to promote HIV risk reduction, especially among those with high-risk behavior, are needed in Nigeria. PMID:27442633

Challenges to Superfund Community Nutrition Programs in Kentucky

PubMed Central

Gaetke, Lisa; Gaetke, Kara; Bowen, Christa

2008-01-01

Since 2000, the University of Kentucky's (UK's) Superfund Basic Research Program (SBRP) Community Outreach Core has provided support and guidance through Superfund Community Action through Nutrition (SCAN) programs, which meet the needs of individuals and communities affected by environmental contaminants. It has been shown that nutrition may modulate the toxicity of Superfund chemicals. SCAN programs integrate nutrition education, nutrition science research, and health communication to increase understanding of health risks associated with residing near Superfund sites. Two critical tasks must be accomplished. SCAN personnel must identify and recruit affected community members, and then, offer meaningful programs. Certain quantitative outcome measures and legal issues presented both challenges and opportunities. Community members preferred qualitative evaluation discussions, which showed increased knowledge and improved attitudes following SCAN programs. SCAN, in full partnership with affected communities, translates safe, effective nutrition information to reduce health risks associated with exposure to Superfund pollutants. PMID:18443657

Challenges to superfund community nutrition programs in kentucky.

PubMed

Gaetke, Lisa; Gaetke, Kara; Bowen, Christa

2008-03-01

Since 2000, the University of Kentucky's (UK's) Superfund Basic Research Program (SBRP) Community Outreach Core has provided support and guidance through Superfund Community Action through Nutrition (SCAN) programs, which meet the needs of individuals and communities affected by environmental contaminants. It has been shown that nutrition may modulate the toxicity of Superfund chemicals. SCAN programs integrate nutrition education, nutrition science research, and health communication to increase understanding of health risks associated with residing near Superfund sites. Two critical tasks must be accomplished. SCAN personnel must identify and recruit affected community members, and then, offer meaningful programs. Certain quantitative outcome measures and legal issues presented both challenges and opportunities. Community members preferred qualitative evaluation discussions, which showed increased knowledge and improved attitudes following SCAN programs. SCAN, in full partnership with affected communities, translates safe, effective nutrition information to reduce health risks associated with exposure to Superfund pollutants.

[Family-based drug use prevention: the "Familias que Funcionan" ["Families that Work"] program].

PubMed

Errasti Pérez, José M; Al-Halabí Díaz, Susana; Secades Villa, Roberto; Fernández-Hermida, José R; Carballo, José L; García-Rodríguez, Olaya

2009-02-01

Family-based drug use prevention: The program.. [Families that work] is a family-based drug-use prevention program resulting from the adaptation to the Spanish context of the prestigious North-American . The program was applied at four secondary schools (N = 380 pupils) in Asturias (northern Spain). This article presents the results of the assessment of this application after a two-year follow-up, regarding its effectiveness in the reduction of drug use among adolescents and its effects on certain family risk factors. Consistent attendance in the program proved effective for reducing both rates (t= -2.73, p<.05 and t= -4.58, p<.005, for the 1- and 2-year follow-ups, respectively) of increase in adolescent drug use and some family risk factors.

Blending better beverage options: a nutrition education and experiential workshop for youths.

PubMed

Isoldi, Kathy K; Dolar, Veronika

2015-01-01

To reduce intake of sugar-sweetened beverages (SSBs) in youths as a means to reduce obesity risk. Youths 5-14 years old attending a summer program were given a two-hour workshop addressing the sugar content in SSBs, the health risks from drinking SSBs, and hands-on preparation as well as tastings of low-sugar beverage alternatives. Data on usual intake of SSBs was obtained at baseline, and pre- and postprogram surveys were conducted to gauge change in knowledge and/or attitudes regarding SSBs. There were 128 participants (63% male) in the program. SSBs were commonly consumed with over 80% reporting regular consumption (mean daily intake 17.9 ounces). Significant increase in knowledge regarding the sugar content of commonly consumed SSBs was achieved; however change in attitudes was not significant. The large majority of youths reported enjoying the workshop and intention to reduce intake of SSBs following program participation. SSBs are commonly consumed by youths. Knowledge regarding the sugar content of SSBs is easier to impart to youths than influencing attitudes held about these beverages. Long-term interventions that reach out to parents and address the widespread availability of SSBs are needed to influence resistant attitudes and beverage choosing behaviors in youths.

Mission Risk Reduction Regulatory Change Management

NASA Technical Reports Server (NTRS)

Scroggins, Sharon

2007-01-01

NASA Headquarters Environmental Management Division supports NASA's mission to pioneer the future in space exploration, scientific discovery, and aeronautics research by integrating environmental considerations into programs and projects early-on, thereby proactively reducing NASA's exposure to institutional, programmatic and operational risk. As part of this effort, NASA established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) as a resource for detecting, analyzing, and communicating environmental regulatory risks to the NASA stakeholder community. The RRAC PC focuses on detecting emerging environmental regulations and other operational change drivers that may pose risks to NASA programs and facilities, and effectively communicating the potential risks. For example, regulatory change may restrict how and where certain activities or operations may be conducted. Regulatory change can also directly affect the ability to use certain materials by mandating a production phase-out or restricting usage applications of certain materials. Regulatory change can result in significant adverse impacts to NASA programs and facilities due to NASA's stringent performance requirements for materials and components related to human-rated space vehicles. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented a system for proactively managing regulatory change to minimize potential adverse impacts to NASA programs and facilities. This presentation highlights the process utilized by the RRACPC to communicate regulatory change and the associated potential risks within NASA, as well as the process for communicating and cooperating with other government agencies and industry partners, both domestic and international, to ensure mission success.

Depressive Symptoms Moderate Dating Violence Prevention Outcomes Among Adolescent Girls.

PubMed

Collibee, Charlene; Rizzo, Christie J; Kemp, Kathleen; Hood, Erik; Doucette, Hannah; Gittins Stone, Daniel I; DeJesus, Brett

2018-04-01

Few dating violence prevention programs assess how variations in initial violence risk affects responsiveness. This study examines the efficacy of Date SMART, a dating violence and sexual risk prevention program designed to target high-risk adolescent girls, in preventing dating violence in the context of varying initial levels of depressive symptoms. A diverse sample of N = 109 female adolescents with a history of physical dating violence participated in a randomized controlled trial of the Date SMART program and a knowledge only (KO) comparison. Using baseline depression level as a primary risk factor, a series of multilevel models revealed significant main effects of baseline depression such that higher baseline depression was associated with greater physical dating violence perpetration and victimization. Results also showed a three-way interaction for assessment point, depressive symptoms, and condition for physical dating violence perpetration. Specifically, those with higher baseline depression in Date SMART showed significantly less physical dating violence perpetration at follow-ups compared with those with higher baseline depression in the KO group. This difference in violence reduction between conditions was not observed for those with lower baseline depression. Date SMART appears to effectively reduce physical dating violence perpetration in those with higher levels of initial risk. Current findings support that adolescents with different risk profiles respond differently to violence prevention programs.

Primary analysis of the Mandarin-speaking sub-study within the Sydney diabetes prevention program.

PubMed

Taing, Cecilia Y; Gibson, Alice A; Colagiuri, Stephen; Vita, Philip; Cardona-Morrell, Magnolia; Bauman, Adrian; Moore, Michael; Williams, Mandy; Milat, Andrew; Hony, Jacky; Lin, Sophia; Gwizd, Melissa; Fiatarone Singh, Maria A

2017-10-01

There is strong and consistent evidence from large scale randomised controlled trials that type 2 diabetes can be prevented or delayed through lifestyle modification which improves diet quality, increases physical activity and achieves weight loss in people at risk. Worldwide, the prevalence of type 2 diabetes is increasing in individuals of Chinese descent. Culturally tailored programs are required to address the risk in the Chinese population. This paper analyses effectiveness of a culturally tailored community-based lifestyle modification program (Sydney Diabetes Prevention Program (SDPP)) targeting Mandarin speakers. The SDPP was a 12 month translational study aiming to promote increased physical activity and dietary changes. Effectiveness was assessed through the improvement of anthropometric, metabolic, physical activity and dietary outcomes and number of goals met. Seventy-eight Mandarin-speaking participants at a high risk (Australian Diabetes Risk, AUSDRISK≥15) of developing diabetes were recruited for this study. In this cohort, waist circumference, total cholesterol and fat intake significantly improved at the 12-month review. In comparison to the English-speaking stream, the Mandarin-speaking stream achieved fewer improvements in outcomes and goals. The SDPP was not effective in reducing the risk factors associated with developing type 2 diabetes in this cohort of high risk Mandarin-speaking individuals living in Sydney. Copyright © 2017 Elsevier B.V. All rights reserved.

Patient selection and volume in the era surrounding implementation of Medicare conditions of participation for transplant programs.

PubMed

White, Sarah L; Zinsser, Dawn M; Paul, Matthew; Levine, Gregory N; Shearon, Tempie; Ashby, Valarie B; Magee, John C; Li, Yi; Leichtman, Alan B

2015-04-01

To evaluate evidence of practice changes affecting kidney transplant program volumes, and donor, recipient and candidate selection in the era surrounding the introduction of Centers for Medicare and Medicaid Services (CMS) conditions of participation (CoPs) for organ transplant programs. Scientific Registry of Transplant Recipients; CMS ESRD and Medicare claims databases. Retrospective analysis of national registry data. A Cox proportional hazards model of 1-year graft survival was used to derive risks associated with deceased-donor kidney transplants performed from 2001 to 2010. Among programs with ongoing noncompliance with the CoPs, kidney transplant volumes declined by 38 percent (n = 766) from 2006 to 2011, including a 55 percent drop in expanded criteria donor transplants. Volume increased by 6 percent (n = 638) among programs remaining in compliance. Aggregate risk of 1-year graft failure increased over time due to increasing recipient age and obesity, and longer ESRD duration. Although trends in aggregate risk of 1-year kidney graft loss do not indicate that the introduction of the CoPs has systematically reduced opportunities for marginal candidates or that there has been a systematic shift away from utilization of higher risk deceased donor kidneys, total volume and expanded criteria donor utilization decreased overall among programs with ongoing noncompliance. © Health Research and Educational Trust.

Targeting School Factors that Contribute to Youth Alienation: Focused School Counseling Programs

ERIC Educational Resources Information Center

Schulz, Lisa L.

2011-01-01

This article explores students at risk of academic non-completion. Schools and school counselors need to target the factors which put students at risk of academic non-completion to reduce the number of adolescents feeling a sense of alienation from school, from educators, and from learning. The construct of student alienation is examined based on…

Patient-centered computing: can it curb malpractice risk?

PubMed

Bartlett, E E

1993-01-01

The threat of a medical malpractice suit represents a major cause of career dissatisfaction for American physicians. Patient-centered computing may improve physician-patient communications, thereby reducing liability risk. This review describes programs that have sought to enhance patient education and involvement pertaining to 5 major categories of malpractice lawsuits: Diagnosis, medications, obstetrics, surgery, and treatment errors.

Patient-centered computing: can it curb malpractice risk?

PubMed Central

Bartlett, E. E.

1993-01-01

The threat of a medical malpractice suit represents a major cause of career dissatisfaction for American physicians. Patient-centered computing may improve physician-patient communications, thereby reducing liability risk. This review describes programs that have sought to enhance patient education and involvement pertaining to 5 major categories of malpractice lawsuits: Diagnosis, medications, obstetrics, surgery, and treatment errors. PMID:8130563

Feasibility and Acceptability of a Web-Based HIV/STD Prevention Program for Adolescent Girls Targeting Sexual Communication Skills

ERIC Educational Resources Information Center

Widman, L.; Golin, C. E.; Kamke, K.; Massey, J.; Prinstein, M. J.

2017-01-01

Adolescent girls are at substantial risk of sexually transmitted diseases including HIV. To reduce these risks, we developed Health Education And Relationship Training (HEART), a web-based intervention focused on developing sexual assertiveness skills and enhancing sexual decision-making. This study assessed the feasibility and acceptability of…

Pilot Study: Implementing a Brief DBT Skills Program in Schools to Reduce Health Risk Behaviors among Early Adolescents

ERIC Educational Resources Information Center

Zapolski, Tamika C. B.; Smith, Gregory T.

2017-01-01

A significant proportion of youth engage in health risk behaviors, which are of concern, as they are associated with adverse health consequences across development. Two factors associated with engagement in such behaviors are emotion dysregulation and impulsivity. Dialectical behavioral therapy (DBT) is an effective intervention that enhances…

Evaluation of the Matrix Project. Interchange 77.

ERIC Educational Resources Information Center

McIvor, Gill; Moodie, Kristina

The Matrix Project is a program that has been established in central Scotland with the aim of reducing the risk of offending and anti-social behavior among vulnerable children. The project provides a range of services to children between eight and 11 years of age who are at risk in the local authority areas of Clackmannanshire, Falkirk and…

Head over Heels: Impact of a Health Promotion Program to Reduce Falls in the Elderly.

ERIC Educational Resources Information Center

Gallagher, Elaine M.; Brunt, Howard

1996-01-01

The Falls Intervention Trials included 50 older adults as controls and 50 who were given risk assessment, individualized feedback, and a motivational video and booklet. The treatment group acted on only 50% of recommendations for risk reduction. The intervention may not have addressed many of the specific causes of falling. (SK)

The national database of wildfire mitigation programs: state, county and local efforts reduce wildfire risk

Treesearch

Terry Haines; Cheryl Renner; Margaret Reams; James Granskog

2005-01-01

The growth of residential communities within forested areas has increased the danger to life and property from uncontrolled wildfire. In response, states, counties and local governments in the United States have dramatically increased their wildfire mitigation efforts. Policymakers and fire officials are employing a wide range of regulatory and voluntary wildfire risk...

Merging universal and indicated prevention programs: the Fast Track model. Conduct Problems Prevention Research Group.

PubMed

2000-01-01

Fast Track is a multisite, multicomponent preventive intervention for young children at high risk for long-term antisocial behavior. Based on a comprehensive developmental model, this intervention includes a universal-level classroom program plus social-skill training, academic tutoring, parent training, and home visiting to improve competencies and reduce problems in a high-risk group of children selected in kindergarten. The theoretical principles and clinical strategies utilized in the Fast Track Project are described to illustrate the interplay between basic developmental research, the understanding of risk and protective factors, and a research-based model of preventive intervention that integrates universal and indicated models of prevention.

The effect on teen driving outcomes of the Checkpoints Program in a state-wide trial.

PubMed

Simons-Morton, Bruce G; L Hartos, Jessica; Leaf, William A; Preusser, David F

2006-09-01

Crash rates among teenagers are highly elevated during the first months of licensure. Parent-imposed driving restrictions on initial driving privileges can reduce exposure to high-risk driving conditions, thus reducing crash risk while teens' driving proficiency develops. This report describes the effect of the Checkpoints Program on driving limits and outcomes. Connecticut teens who obtained a learners permit over a 9-month period were recruited, providing a final sample of 3743 who obtained driver licenses. Families were randomized to the intervention or comparison condition. Intervention families received by mail a series of persuasive communications related to high-risk teen driving and a parent-teen driving agreement, while comparison families received on the same schedule general information on driving and vehicle maintenance. Relative to the comparison group, teens and parents in the Checkpoints Program reported significantly greater limits on high-risk teen driving conditions at licensure, 3-, and 6-months post-licensure; and intervention teens reported significantly less risky driving at each reporting period. By the 12-month follow up teens in the intervention group were significantly less likely than those in the comparison group to have had a traffic violation. However, no treatment group effect was found for crashes. This is the first study to report significant effects on teen driving behavior and performance of education designed to increase parental-imposed teen driving limits.

[Risk reduction and drug use in detention: study about the detainees of Liancourt Penitentiary].

PubMed

Sannier, Olivier; Verfaillie, Florent; Lavielle, Dorothée

2012-07-01

The prison population is drug users. Recent debates around the provision of devices to reduce the risks associated with drug use (syringe exchange programs and snort kit) lead us to question local practices of the prison population. An anonymous questionnaire was offered to the prison population of the Liancourt penitentiary. The questions addressed the use of drugs before and during incarceration, knowledge of HIV and B and C hepatitis status, taking an opiate substitution treatment and advice on the implementation of syringe exchange programs and snort kit. A percentage of 54.4 of the prisoners responded to the questionnaire. An amount of 60.1 % of respondents consumed at least one drug before incarceration and 43.6 % of respondents consumed at least one drug during their incarceration. Cannabis was the most consumed drug before and during incarceration. Barely half of respondents reported knowing their HIV and hepatitis B and C status. Over 10 % of respondents said they were interesting in establishing needle exchange programs or snort kit. The prison concentrate drug users and is not a repressive tool of efficient risk reduction. The strategies implemented by the medical unit of Liancourt prison require adaptations that warrant development of health resources. Then, only new tools to reduce risks associated with drug use can be established. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

49 CFR 237.31 - Adoption of bridge management programs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... prevent the deterioration of railroad bridges by preserving their capability to safely carry the traffic to be operated over them, and reduce the risk of human casualties, environmental damage, and...

49 CFR 237.31 - Adoption of bridge management programs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... prevent the deterioration of railroad bridges by preserving their capability to safely carry the traffic to be operated over them, and reduce the risk of human casualties, environmental damage, and...

49 CFR 237.31 - Adoption of bridge management programs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... prevent the deterioration of railroad bridges by preserving their capability to safely carry the traffic to be operated over them, and reduce the risk of human casualties, environmental damage, and...

Managing Radon in Schools

EPA Pesticide Factsheets

EPA recommends testing all schools for radon. As part of an effective IAQ management program, schools can take simple steps to test for radon and reduce risks to occupants if high radon levels are found.

Student Curriculum

EPA Pesticide Factsheets

This nine-lesson program was designed to excite kids (ages 9-13) about environmental health and empower them to take steps in their everyday lives to improve the environment for their community and reduce their environmental risks.

Effectiveness of a Group-Based Culturally Tailored Lifestyle Intervention Program on Changes in Risk Factors for Type 2 Diabetes among Asian Indians in the United States

PubMed Central

Raj, Sudha; Balasubramanyam, Ashok

2017-01-01

This study used an experimental, pretest-posttest control group repeated measures design to evaluate the effectiveness of a community-based culturally appropriate lifestyle intervention program to reduce the risk for type 2 diabetes (T2DM) among Gujarati Asian Indians (AIs) in an urban community in the US. Participants included 70 adult AIs in the greater Houston metropolitan area. The primary outcomes were reduction in weight and hemoglobin A1c (HbA1c) and improvement in physical activity. Participants were screened for risk factors and randomly assigned to a 12-week group-based lifestyle intervention program (n = 34) or a control group (n = 36) that received standard print material on diabetes prevention. Participants also completed clinical measures and self-reported questionnaires about physical activity, social, and lifestyle habits at 0, 3, and 6 months. No significant baseline differences were noted between groups. While a significant decline in weight and increase in physical activity was observed in all participants, the intervention group lowered their HbA1c (p < 0.0005) and waist circumference (p = 0.04) significantly as compared to the control group. Findings demonstrated that participation in a culturally tailored, lifestyle intervention program in a community setting can effectively reduce weight, waist circumference, and HbA1c among Gujarati AIs living in the US. PMID:28168201

Effectiveness of a Group-Based Culturally Tailored Lifestyle Intervention Program on Changes in Risk Factors for Type 2 Diabetes among Asian Indians in the United States.

PubMed

Patel, Rupal M; Misra, Ranjita; Raj, Sudha; Balasubramanyam, Ashok

2017-01-01

This study used an experimental, pretest-posttest control group repeated measures design to evaluate the effectiveness of a community-based culturally appropriate lifestyle intervention program to reduce the risk for type 2 diabetes (T2DM) among Gujarati Asian Indians (AIs) in an urban community in the US. Participants included 70 adult AIs in the greater Houston metropolitan area. The primary outcomes were reduction in weight and hemoglobin A1c (HbA1c) and improvement in physical activity. Participants were screened for risk factors and randomly assigned to a 12-week group-based lifestyle intervention program ( n = 34) or a control group ( n = 36) that received standard print material on diabetes prevention. Participants also completed clinical measures and self-reported questionnaires about physical activity, social, and lifestyle habits at 0, 3, and 6 months. No significant baseline differences were noted between groups. While a significant decline in weight and increase in physical activity was observed in all participants, the intervention group lowered their HbA1c ( p < 0.0005) and waist circumference ( p = 0.04) significantly as compared to the control group. Findings demonstrated that participation in a culturally tailored, lifestyle intervention program in a community setting can effectively reduce weight, waist circumference, and HbA1c among Gujarati AIs living in the US.

[Health promotion and primary prevention strategies to fight chronic disease: a systematic review].

PubMed

da Silva, Luciana Saraiva; Cotta, Rosângela Minardi Mitre; Rosa, Carla de Oliveira Barbosa

2013-11-01

To analyze health promotion and primary prevention strategies in the global fight against chronic noncommunicable diseases (NCDs) and to reflect on the challenges of overcoming these diseases. In this systematic literature review, studies were analyzed on health programs identified by the Brazilian Health Ministry as the main global community intervention initiatives: the North Karelia Project, in Finland; the Stanford Three-Community Study, Stanford Five-City Project, Minnesota Heart Health and Pawtucket Heart Health Program, in the United States; the CINDI project, in Europe and Canada; CARMEN in South America; Mirame, in Chile; and Tianjin, in China. The LILACS, Medline, and SciELO databases were searched, as well as the Brazilian Health Ministry, Pan American Health Organization, and World Health Organization websites. Only original articles analyzing primary data were included. The outcomes evaluated in the studies were cholesterol, blood pressure, obesity, physical activity level, tobacco use, dietary habits, and other risk factors for NCDs. Seventeen studies were selected. The North Karelia Project, Three Community Study, and Five-City Multifactor Risk Reduction Project contributed to decrease tobacco use, cholesterol levels, and blood pressure levels. The Minnesota Heart Health Program and the Pawtucket Heart Health Program had moderate success in reducing the risk factors for NCD. The CINDI and CARMEN programs demonstrated the importance of integrated actions for decreasing the main risk factors. The Mirame project, which focused on educational interventions for school children, reached 30,000 students in 2001 without requiring a large financial investment. The Tianjin project was able to reduce salt intake, prevalence of arterial hypertension, and obesity by restructuring primary health care services. These successful experiences in community health improvement may serve as models for the implementation of more effective health policies, aiming at the development of actions that integrate health promotion and primary prevention of the main risk factors for NCDs.

Perceptions of Risk of Developing Skin Cancer for Diverse Audiences: Enhancing Relevance of Sun Protection to Reduce the Risk.

PubMed

Robinson, June K; Friedewald, John; Gordon, Elisa J

2016-03-01

Sixty-five percent of kidney transplant recipients (KTRs) develop squamous cell carcinoma (SCC). Perceptions of risk of developing skin cancer, amelioration of this risk with sun protection, and having choices among sun protection strategies may enhance sun protection use by KTRS, who are at greater risk than the general population. Thirty KTRs stratified among non-Hispanic Whites, non-Hispanic Blacks, and Hispanic/Latinos evaluated three versions of the interactive, web-based, electronic sun protection program and suggested refinements. The sequence of content presentation prepared the participant to accept the credibility, accuracy, and relevance of the message. Beginning with informing participants that using sun protection reduces the chance of developing skin cancer made the information credible to KTRs. Showing skin cancer on all skin types and patient testimonials enhanced participants' awareness of their susceptibility to develop skin cancer and primed patients to receive their personal risk of developing skin cancer. Coupling presentation of knowledge about the benefits of sun protection in reducing the risk of developing skin cancer with the personal risk of getting the disease was essential to KTRs believing that they could influence their health outcome.

Evidence-Based Practice Guideline: Fall Prevention for Older Adults.

PubMed

Kruschke, Cheryl; Butcher, Howard K

2017-11-01

Falls are a major cause of injury and death annually for millions of individuals 65 and older. Older adults are at risk for falls for a variety of reasons regardless of where they live. Falls are defined as any sudden drop from one surface to a lower surface. The purpose of this fall prevention evidence-based practice guideline is to describe strategies that can identify individuals at risk for falls. A 10-step protocol including screening for falls, comprehensive fall assessment, gait and balance screening when necessary, and an individualized fall intervention program addressing specific fall risks is presented. Reassessing fall risk and fall prevention programs will ensure a proactive approach to reducing falls in the aging population. [Journal of Gerontological Nursing, 43(11), 15-21.]. Copyright 2017, SLACK Incorporated.

Utilizing Two-Way Bilingual Education for Reducing the Achievement Lag of LEP Students in Primary Grades: A Longitudinal Study.

ERIC Educational Resources Information Center

Lopez, Maria G.; Tashakkori, Abbas

This study investigated the effect of a bilingual education program on the achievement gap in language development between at-risk kindergarten students with minimal English proficiency and students who were proficient English speakers. Limited English Proficient (LEP) students were included in an Extended Foreign Language (EFL) program designed…

Austin Youth River Watch Program: 1992-93 Final Report. Publication Number 92.33.

ERIC Educational Resources Information Center

Turner, Jeannine

The City of Austin (Texas) provides funds for an educational initiative to involve minority high school students in water quality issues and to reduce the dropout rate through positive role model interaction with academically successful students. Principal program activities were testing river water for pollutants and tutoring at-risk students by…

Free To Grow: Head Start Partnerships to Promote Substance-Free Communities. Program Results Report

ERIC Educational Resources Information Center

De Milto, Lori

2012-01-01

"Free To Grow"--a national program of the Robert Wood Johnson Foundation (RWJF)--supported efforts by Head Start agencies and their community partners to strengthen the families and neighborhood environments of high-risk preschool children living in low-income communities. The goal was to reduce the children's vulnerability to substance…

Evaluation of CHANGE, an Involuntary Cognitive Program for High-Risk Inmates

ERIC Educational Resources Information Center

Hogan, Nancy L.; Lambert, Eric G.; Barton-Bellessa, Shannon M.

2012-01-01

Prison violence is a major concern in most correctional institutions. One intervention frequently used to reduce violent behavior is cognitive therapy. An involuntary cognitive program at a Midwestern state prison was evaluated for its impact on official misconduct. A total of 213 inmates were randomly assigned to the treatment (CHANGE) group (n =…

Randomized Trial Testing a Worksite Sun Protection Program in an Outdoor Recreation Industry

ERIC Educational Resources Information Center

Buller, David B.; Andersen, Peter A.; Walkosz, Barbara J.; Scott, Michael D.; Cutter, Gary R.; Dignan, Mark B.; Zarlengo, Elizabeth M.; Voeks, Jenifer H.; Giese, Aimee J.

2005-01-01

Health communication campaigns intended to reduce chronic and severe exposure to ultraviolet radiation in sunlight and prevent skin cancer are a national priority. Outdoor workers represent an unaddressed, high-risk population. Go Sun Smart (GSS), a worksite sun safety program largely based on the diffusion-of-innovations theory, was evaluated in…

Capacity of scour-damaged bridges, part 2 : Integrated Analysis Program (IAP) - a program for the analysis of lateral performance of pile-supported structures under scour conditions.

DOT National Transportation Integrated Search

2013-11-01

Scour is the removal of soils in the vicinity of bridge foundations, resulting in a reduced capacity of the foundations, which can increase the risk of bridge : failure. To minimize bridge failure, the Federal Highway Administration (FHWA) has establ...

Capacity of scour-damaged bridges, part 2 : Integrated Analysis Program (IAP) - a program for the analysis of lateral performance of pile-supported structures under scour conditions, [technical summary].

DOT National Transportation Integrated Search

2013-11-01

Scour is the removal of soils in the vicinity of bridge foundations, resulting in a reduced capacity of the foundations, which can increase the risk of bridge failure. To minimize bridge failure, the Federal Highway Administration (FHWA) has establis...

Parent-Adolescent Relationship Education (PARE): Program Delivery to Reduce Risks for Adolescent Pregnancy and STDs

ERIC Educational Resources Information Center

Lederman, Regina P.; Chan, Wenyaw; Roberts-Gray, Cynthia

2008-01-01

The first author recruited parent-adolescent dyads (N = 192) into after-school prevention education groups at middle schools in southeast Texas. This author placed participants in either (1) an Interactive Program (IP) in which they role-played, practiced resistance skills, and held parent-child discussions or (2) an Attention Control Program…

A Comparison of the Effect of a Hypertension Education Program among Black and White Participants.

ERIC Educational Resources Information Center

Piane, Ginamarie

1990-01-01

Although Blacks face a higher risk of hypertension than other Americans, a comparison between Blacks and Whites participating in a hypertension education series showed no significant differences. The program reduced by 68 percent the number of participants with high blood pressure. Proposes marketing and adherence strategies to attract and retain…

A Formative Evaluation of Healthy Habits, Healthy U: A Collaborative School-Based Cancer Education Program

ERIC Educational Resources Information Center

Anderson, Alicia; Spear, Caile; Pritchard, Mary; George, Kayla; Young, Kyle; Smith, Carrie

2017-01-01

Purpose: Healthy Habits, Healthy U (HHHU) is a two-day school-based primary prevention cancer education program that uses interactive classroom presentations designed to help students learn how to reduce their cancer risks. HHHU is a collaboration between a local cancer hospital, school district and university. HHHU incorporates real cancerous and…

National Implementation of an Evidence-Based HIV Prevention and Reproductive Health Program for Bahamian Youth

ERIC Educational Resources Information Center

Knowles, Valerie; Kaljee, Linda; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Stanton, Bonita

2012-01-01

A wide range of behavioral prevention interventions have been demonstrated through longitudinal, randomized controlled trials to reduce sexual risk behaviors. Many of these interventions have been made available at little cost for implementation on a public health scale. However, efforts to utilize such programs typically have been met with a…

Eliciting Responsivity: Exploring Programming Interests of Federal Inmates as a Function of Security Classification.

PubMed

Neller, Daniel J; Vitacco, Michael J; Magaletta, Philip R; Phillips-Boyles, A Brooke

2016-03-01

Research supports the effectiveness of the Risk-Needs-Responsivity model for reducing criminal recidivism. Yet programming interests of inmates--one facet of responsivity--remain an understudied phenomenon. In the present study, we explored the programming interests of 753 federal inmates housed across three levels of security. Results suggest that inmates, as a group, prefer specific programs over others, and that some of their interests may differ by security level. We discuss possible implications of these findings. © The Author(s) 2014.

Kā-HOLO Project: a protocol for a randomized controlled trial of a native cultural dance program for cardiovascular disease prevention in Native Hawaiians.

PubMed

Kaholokula, Joseph Keawe'aimoku; Look, Mele A; Wills, Thomas A; de Silva, Māpuana; Mabellos, Tricia; Seto, Todd B; Ahn, Hyeong Jun; Sinclair, Ka'imi A; Buchwald, Dedra

2017-04-17

As a major risk factor for cardiovascular and cerebrovascular disease (CVD), hypertension affects 33% of U.S. adults. Relative to other US races and ethnicities, Native Hawaiians have a high prevalence of hypertension and are 3 to 4 times more likely to have CVD. Effective, culturally-relevant interventions are needed to address CVD risk in this population. Investigators of the Kā-HOLO Project developed a study design to test the efficacy of an intervention that uses hula, a traditional Hawaiian dance, to increase physical activity and reduce CVD risk. A 2-arm randomized controlled trial with a wait-list control design will be implemented to test a 6-month intervention based on hula to manage blood pressure and reduce CVD risk in 250 adult Native Hawaiians with diagnosed hypertension. Half of the sample will be randomized to each arm, stratified across multiple study sites. Primary outcomes are reduction in systolic blood pressure and improvement in CVD risk as measured by the Framingham Risk Score. Other psychosocial and sociocultural measures will be included to determine mediators of intervention effects on primary outcomes. Assessments will be conducted at baseline, 3 months, and 6 months for all participants, and at 12 months for intervention participants only. This trial will elucidate the efficacy of a novel hypertension management program designed to reduce CVD risk in an indigenous population by using a cultural dance form as its physical activity component. The results of this culturally-based intervention will have implications for other indigenous populations globally and will offer a sustainable, culturally-relevant means of addressing CVD disparities. ClinicalTrials.gov: NCT02620709 , registration date November 23, 2015.

Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda.

PubMed

Bunnell, Rebecca; Ekwaru, John Paul; Solberg, Peter; Wamai, Nafuna; Bikaako-Kajura, Winnie; Were, Willy; Coutinho, Alex; Liechty, Cheryl; Madraa, Elizabeth; Rutherford, George; Mermin, Jonathan

2006-01-02

The impact of antiretroviral therapy (ART) on sexual risk behavior and HIV transmission among HIV-infected persons in Africa is unknown. To assess changes in risky sexual behavior and estimated HIV transmission from HIV-infected adults after 6 months of ART. A prospective cohort study was performed in rural Uganda. Between May 2003 and December 2004 a total of 926 HIV-infected adults were enrolled and followed in a home-based ART program that included prevention counselling, voluntary counseling and testing (VCT) for cohabitating partners and condom provision. At baseline and follow-up, participants' HIV plasma viral load and partner-specific sexual behaviors were assessed. Risky sex was defined as inconsistent or no condom use with partners of HIV-negative or unknown serostatus in the previous 3 months. The rates of risky sex were compared using a Poisson regression model and transmission risk per partner was estimated, based on established viral load-specific transmission rates. Six months after initiating ART, risky sexual behavior reduced by 70% [adjusted risk ratio, 0.3; 95% confidence interval (CI), 0.2-0.7; P = 0.0017]. Over 85% of risky sexual acts occurred within married couples. At baseline, median viral load among those reporting risky sex was 122 500 copies/ml, and at follow-up, < 50 copies/ml. Estimated risk of HIV transmission from cohort members declined by 98%, from 45.7 to 0.9 per 1000 person years. Providing ART, prevention counseling, and partner VCT was associated with reduced sexual risk behavior and estimated risk of HIV transmission among HIV-infected Ugandan adults during the first 6 months of therapy. Integrated ART and prevention programs may reduce HIV transmission in Africa.

Nutritional programming of coenzyme Q: potential for prevention and intervention?

PubMed

Tarry-Adkins, Jane L; Fernandez-Twinn, Denise S; Chen, Jian-Hua; Hargreaves, Iain P; Martin-Gronert, Malgorzata S; McConnell, Josie M; Ozanne, Susan E

2014-12-01

Low birth weight and rapid postnatal growth increases risk of cardiovascular-disease (CVD); however, underlying mechanisms are poorly understood. Previously, we demonstrated that rats exposed to a low-protein diet in utero that underwent postnatal catch-up growth (recuperated) have a programmed deficit in cardiac coenzyme Q (CoQ) that was associated with accelerated cardiac aging. It is unknown whether this deficit occurs in all tissues, including those that are clinically accessible. We investigated whether aortic and white blood cell (WBC) CoQ is programmed by suboptimal early nutrition and whether postweaning dietary supplementation with CoQ could prevent programmed accelerated aging. Recuperated male rats had reduced aortic CoQ [22 d (35±8.4%; P<0.05); 12 m (53±8.8%; P<0.05)], accelerated aortic telomere shortening (P<0.01), increased DNA damage (79±13% increase in nei-endonucleaseVIII-like-1), increased oxidative stress (458±67% increase in NAPDH-oxidase-4; P<0.001), and decreased mitochondrial complex II-III activity (P<0.05). Postweaning dietary supplementation with CoQ prevented these detrimental programming effects. Recuperated WBCs also had reduced CoQ (74±5.8%; P<0.05). Notably, WBC CoQ levels correlated with aortic telomere-length (P<0.0001) suggesting its potential as a diagnostic marker of vascular aging. We conclude that early intervention with CoQ in at-risk individuals may be a cost-effective and safe way of reducing the global burden of CVDs. © FASEB.

Balance training reduces falls risk in older individuals with type 2 diabetes.

PubMed

Morrison, Steven; Colberg, Sheri R; Mariano, Mira; Parson, Henri K; Vinik, Arthur I

2010-04-01

This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50-75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also exhibited evidence of mild-to-moderate neuropathy, slower reaction times, and increased postural sway. Following exercise, the diabetic group showed significant improvements in leg strength, faster reaction times, decreased sway, and, consequently, reduced falls risk. Older individuals with diabetes had impaired balance, slower reactions, and consequently a higher falls risk than age-matched control subjects. However, all these variables improved after resistance/balance training. Together these results demonstrate that structured exercise has wide-spread positive effects on physiological function for older individuals with type 2 diabetes.

A crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome.

PubMed

Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T

2012-07-01

Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.

Environmental equity: Reducing risk for all communities. Volume 2. Supporting document

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

NONE

1992-06-01

In targeting its protection efforts to reduce the most serious risks, the Agency has begun to examine how the patterns of environmental problems converge on different places, how the people who live in those places are affected, and how environmental programs should be refined to address identified differences. A community surrounded by Multiple sources of air pollution, ringed by waste treatment facilities and landfills, and whose residences contain lead-based paint clearly faces higher than average potential environmental risks. It is in this context that concerns have been raised about the relative risk burden borne by low-income and racial minority communities.more » Examination of these differences in risk burden and how government agencies respond is known as environmental equity. Although there are many types of equity, this report focuses on racial and socioeconomic equity.« less

Applying a community resilience framework to examine household emergency planning and exposure-reducing behavior among residents of Louisiana's industrial corridor.

PubMed

Reams, Margaret A; Lam, Nina S N; Cale, Tabitha M; Hinton, Corrinthia M

2013-01-01

Residents facing environmental hazards can take steps to reduce their exposure risks, and these actions may be considered adaptations that can enhance the overall resilience of communities. Applying concepts from social-ecological resilience theory, the authors examine emergency planning and exposure-reducing behaviors among residents of the upper Industrial Corridor of Louisiana and explore the extent to which the behaviors are associated with key theoretical influences on community resilience: exposure, vulnerability, and the "adaptive capacity" of residents. The behaviors of interest are adoption of a household emergency plan in the case of acute exposure events (like chemical spills), and limiting outdoor activities in response to Air Quality Index reports, thus potentially reducing chronic exposure risks. Statistical analyses indicate that adaptive behaviors are associated both with greater exposure to hazards and confidence in one's knowledge and ability to reduce exposure risks. Thus, the study yields evidence that "adaptive capacity" is particularly relevant to understanding and encouraging household emergency planning. Residents who believe that they are well-informed about risk-reducing strategies, regardless of education or income, were found to be more likely to have adopted these measures. Evidence that knowledge and confidence levels are linked to adaptive behaviors is good news for those working in public education and outreach programs, as these are attitudes and skills that can be nurtured. While factors associated with exposure and vulnerability to hazards are difficult to change, knowledge of risk-reducing strategies and confidence in one's abilities to reduce exposure risks can be improved through well-designed public education efforts.

EPA OIG Strategic Plan for 2012 - 2016

EPA Pesticide Factsheets

We plan our work with the goals of influencing resolution of the EPA’s major management challenges, reducing risk, improving program operations, and saving taxpayer dollars, leading to positive human health and environmental impacts.

Energy and Environment Guide to Action - Chapter 3: Funding and Financial Incentive Policies

EPA Pesticide Factsheets

Discusses funding and financial incentive programs that have been developed by states and contributed to greater sectoral coverage, partnerships with businesses, and reduced risk associated with investments.

Creating the Action Model for High Risk Infant Follow Up Program in Iran.

PubMed

Heidarzadeh, Mohammad; Jodiery, Behzad; Mirnia, Kayvan; Akrami, Forouzan; Hosseini, Mohammad Bagher; Heidarabadi, Seifollah; HabibeLahi, Abbas

2013-11-01

Intervention in early childhood development as one of the social determinants of health, is important for reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow up program in Iran. This study was carreid out to design high risk infants follow up care program with the practical aim of creating an model action for whole country, in 2012. This qualitative study has been done by the Neonatal Department of the Deputy of Public Health in cooperation with Pediatrics Health Research Center of Tabriz University of Medical Sciences, Iran. After study of international documents, consensus agreement about adapted program for Iran has been accomplished by focus group discussion and attended Delphi agreement technique. After compiling primary draft included evidence based guidelines and executive plan, 14 sessions including expert panels were hold to finalize the program. After finalizing the program, high risk infants follow up care service package has been designed in 3 chapters: Evidence based clinical guidelines; eighteen main clinical guidelines and thirteen subsidiaries clinical guidelines, executive plan; 6 general, 6 following up and 5 backup processes. Education program including general and especial courses for care givers and follow up team, and family education processes. We designed and finalized high risk infants follow up care service package. It seems to open a way to extend it to whole country.

Quantitative Risk Modeling of Fire on the International Space Station

NASA Technical Reports Server (NTRS)

Castillo, Theresa; Haught, Megan

2014-01-01

The International Space Station (ISS) Program has worked to prevent fire events and to mitigate their impacts should they occur. Hardware is designed to reduce sources of ignition, oxygen systems are designed to control leaking, flammable materials are prevented from flying to ISS whenever possible, the crew is trained in fire response, and fire response equipment improvements are sought out and funded. Fire prevention and mitigation are a top ISS Program priority - however, programmatic resources are limited; thus, risk trades are made to ensure an adequate level of safety is maintained onboard the ISS. In support of these risk trades, the ISS Probabilistic Risk Assessment (PRA) team has modeled the likelihood of fire occurring in the ISS pressurized cabin, a phenomenological event that has never before been probabilistically modeled in a microgravity environment. This paper will discuss the genesis of the ISS PRA fire model, its enhancement in collaboration with fire experts, and the results which have informed ISS programmatic decisions and will continue to be used throughout the life of the program.

Eliciting change in at-risk elders (ECARE): evaluation of an elder abuse intervention program.

PubMed

Mariam, Lydia Morris; McClure, Regina; Robinson, J B; Yang, Janet A

2015-01-01

The current study evaluated the effectiveness of a community-based elder abuse intervention program that assists suspected victims of elder abuse and self-neglect through a partnership with local law enforcement. This program, Eliciting Change in At-Risk Elders, involves building alliances with the elder and family members, connecting the elder to supportive services that reduce risk of further abuse, and utilizing motivational interviewing-type skills to help elders overcome ambivalence regarding making difficult life changes. Risk factors of elder abuse decreased over the course of the intervention and nearly three-quarters of participants made progress on their treatment goal, advancing at least one of Prochaska and DiClemente's (1983) stages of change (precontemplation, contemplation, preparation, action, and maintenance). Forty-three percent of elders moved into the stages of action and maintenance regarding their goal. The usefulness of eliciting change via longer-term relationships with vulnerable elders in entrenched elder abuse situations is discussed.

Space Launch System NASA Research Announcement Advanced Booster Engineering Demonstration and/or Risk Reduction

NASA Technical Reports Server (NTRS)

Crumbly, Christopher M.; Craig, Kellie D.

2011-01-01

The intent of the Advanced Booster Engineering Demonstration and/or Risk Reduction (ABEDRR) effort is to: (1) Reduce risks leading to an affordable Advanced Booster that meets the evolved capabilities of SLS (2) Enable competition by mitigating targeted Advanced Booster risks to enhance SLS affordability. Key Concepts (1) Offerors must propose an Advanced Booster concept that meets SLS Program requirements (2) Engineering Demonstration and/or Risk Reduction must relate to the Offeror s Advanced Booster concept (3) NASA Research Announcement (NRA) will not be prescriptive in defining Engineering Demonstration and/or Risk Reduction

Effects of 2 Prevention Programs on High-Risk Behaviors Among African American Youth

PubMed Central

Flay, Brian R.; Graumlich, Sally; Segawa, Eisuke; Burns, James L.; Holliday, Michelle Y.

2008-01-01

Objective To test the efficacy of 2 programs designed to reduce high-risk behaviors among inner-city African American youth. Design Cluster randomized trial. Setting Twelve metropolitan Chicago, Ill, schools and the communities they serve, 1994 through 1998. Participants Students in grades 5 through 8 and their parents and teachers. Interventions The social development curriculum (SDC) consisted of 16 to 21 lessons per year focusing on social competence skills necessary to manage situations in which high-risk behaviors occur. The school/community intervention (SCI) consisted of SDC and school-wide climate and parent and community components. The control group received an attention-placebo health enhancement curriculum (HEC) of equal intensity to the SDC focusing on nutrition, physical activity, and general health care. Main Outcome Measures Student self-reports of violence, provocative behavior, school delinquency, substance use, and sexual behaviors (intercourse and condom use). Results For boys, the SDC and SCI significantly reduced the rate of increase in violent behavior (by 35% and 47% compared with HEC, respectively), provoking behavior (41% and 59%), school delinquency (31% and 66%), drug use (32% and 34%), and recent sexual intercourse (44% and 65%), and improved the rate of increase in condom use (95% and 165%). The SCI was significantly more effective than the SDC for a combined behavioral measure (79% improvement vs 51%). There were no significant effects for girls. Conclusions Theoretically derived social-emotional programs that are culturally sensitive, developmentally appropriate, and offered in multiple grades can reduce multiple risk behaviors for inner-city African American boys in grades 5 through 8. The lack of effects for girls deserves further research. PMID:15066879

Effect of Long-Term Metformin and Lifestyle in the Diabetes Prevention Program and Its Outcome Study on Coronary Artery Calcium.

PubMed

Goldberg, Ronald B; Aroda, Vanita R; Bluemke, David A; Barrett-Connor, Elizabeth; Budoff, Matthew; Crandall, Jill P; Dabelea, Dana; Horton, Edward S; Mather, Kieren J; Orchard, Trevor J; Schade, David; Watson, Karol; Temprosa, Marinella

2017-07-04

Despite the reduced incidence of coronary heart disease with intensive risk factor management, people with diabetes mellitus and prediabetes remain at increased coronary heart disease risk. Diabetes prevention interventions may be needed to reduce coronary heart disease risk. This approach was examined in the DPP (Diabetes Prevention Program) and the DPPOS (Diabetes Prevention Program Outcome Study), a long-term intervention study in 3234 subjects with prediabetes (mean±SD age, 64±10 years) that showed reduced diabetes risk with lifestyle and metformin compared with placebo over 3.2 years. The DPPOS offered periodic group lifestyle sessions to all participants and continued metformin in the originally randomized metformin group. Subclinical atherosclerosis was assessed in 2029 participants with coronary artery calcium (CAC) measurements after an average of 14 years of follow-up. The CAC scores were analyzed continuously as CAC severity and categorically as CAC presence (CAC score >0) and reported separately in men and women. There were no CAC differences between lifestyle and placebo intervention groups in either sex. CAC severity and presence were significantly lower among men in the metformin versus the placebo group (age-adjusted mean CAC severity, 39.5 versus 66.9 Agatston units, P =0.04; CAC presence, 75% versus 84%, P =0.02), but no metformin effect was seen in women. In multivariate analysis, the metformin effect in men was not influenced by demographic, anthropometric, or metabolic factors; by the development of diabetes mellitus; or by use/nonuse of statin therapy. Metformin may protect against coronary atherosclerosis in prediabetes and early diabetes mellitus among men. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00038727. © 2017 American Heart Association, Inc.

Identifying Postpartum Intervention Approaches to Reduce Cardiometabolic Risk Among American Indian Women With Prior Gestational Diabetes, Oklahoma, 2012–2013

PubMed Central

Peercy, Michael; Woods, J. Cedric; Parker, Stephany P.; Jackson, Teresa; Mata, Sara A.; McCage, Shondra; Levkoff, Sue E.; Nicklas, Jacinda M.; Seely, Ellen W.

2015-01-01

Introduction Innovative approaches are needed to reduce cardiometabolic risk among American Indian women with a history of gestational diabetes. We assessed beliefs of Oklahoma American Indian women about preventing type 2 diabetes and cardiovascular disease after having gestational diabetes. We also assessed barriers and facilitators to healthy lifestyle changes postpartum and intervention approaches that facilitate participation in a postpartum lifestyle program. Methods In partnership with a tribal health system, we conducted a mixed-method study with American Indian women aged 19 to 45 years who had prior gestational diabetes, using questionnaires, focus groups, and individual interviews. Questionnaires were used to identify women’s cardiometabolic risk perceptions and feasibility and acceptability of Internet or mobile phone technology for delivery of a postpartum lifestyle modification program. Focus groups and individual interviews were conducted to identify key perspectives and preferences related to a potential program. Results Participants were 26 women, all of whom completed surveys; 11 women participated in focus group sessions, and 15 participated in individual interviews. Most women believed they would inevitably develop diabetes, cardiovascular disease, or both; however, they were optimistic that they could delay onset with lifestyle change. Most women expressed enthusiasm for a family focused, technology-based intervention that emphasizes the importance of delaying disease onset, provides motivation, and promotes accountability while accommodating women’s competing priorities. Conclusions Our findings suggest that an intervention that uses the Internet, text messaging, or both and that emphasizes the benefits of delaying disease onset should be tested as a novel, culturally relevant approach to reducing rates of diabetes and cardiovascular disease in this high-risk population. PMID:25837258

Program design for incentivizing ignition interlock installation for alcohol-impaired drivers: The Ontario approach.

PubMed

Ma, Tracey; Byrne, Patrick A; Bhatti, Junaid A; Elzohairy, Yoassry

2016-10-01

Drinking and driving is a major risk factor for traffic injuries. Although ignition interlocks reduce drinking and driving while installed, several issues undermine their implementation including delayed eligibility for installation, low installation once eligible, and a return to previous risk levels after de-installation. The Canadian province of Ontario introduced a "Reduced Suspension with Ignition Interlock Conduct Review" Program, significantly changing pre-existing interlock policy. The Program incentivizes interlock installation and an "early" guilty plea. It also attempts to reduce long-term recidivism through behavioural feedback and compliance-based removal. This evaluation is the first in assessing Program impact. Ontario drivers with a first time alcohol-impaired driving conviction between July 1, 2005 and November 25, 2014 comprised the study cohort. Longitudinal analyses, using interrupted time series and Cox regression, were conducted in which exposure was the Program and the outcomes were ignition interlock installation (N=30,200), pre-trial elapsed time (N=30,200), and post-interlock recidivism (N=9326). After Program implementation, installation rates increased by 54% and pre-trial elapsed time decreased by 146 days. Results suggest no effect on post-interlock recidivism. Through an incentive-based design, this Program was effective at addressing two commonly cited barriers to interlock implementation- delayed eligibility for installation and low installation once eligible. Results reveal that installation rates are responsive not only to incentivization but also to other external factors, thus presenting an opportunity for policy makers to find unique ways to influence interlock uptake, and thereby, to extend their deterrent effects to a larger subset of the population. This study is one of the few that do not rely on proxy measures of installation rate. Copyright © 2016 Crown. Published by Elsevier Ltd.. All rights reserved.

Effects of a Community-Based Fall Management Program on Medicare Cost Savings.

PubMed

Ghimire, Ekta; Colligan, Erin M; Howell, Benjamin; Perlroth, Daniella; Marrufo, Grecia; Rusev, Emil; Packard, Michael

2015-12-01

Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare. A controlled retrospective cohort study was conducted in 2012-2013, using 2007-2011 MOB program data and 2006-2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls. MOB participation was associated with total medical cost savings of $938 per person (95% CI=$379, $1,498) at 1 year. Savings per person amounted to $517 (95% CI=$265, $769) for unplanned hospitalizations; $81 for home health care (95% CI=$20, $141); and $234 (95% CI=$55, $413) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms. This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

Is the Families First Home Visiting Program Effective in Reducing Child Maltreatment and Improving Child Development?

PubMed

Chartier, Mariette J; Brownell, Marni D; Isaac, Michael R; Chateau, Dan; Nickel, Nathan C; Katz, Alan; Sarkar, Joykrishna; Hu, Milton; Taylor, Carole

2017-05-01

While home visiting programs are among the most widespread interventions to support at-risk families, there is a paucity of research investigating these programs under real-world conditions. The effectiveness of Families First home visiting (FFHV) was examined for decreasing rates of being in care of child welfare, decreasing hospitalizations for maltreatment-related injuries, and improving child development at school entry. Data for 4,562 children from home visiting and 5,184 comparison children were linked to deidentified administrative health, social services, and education data. FFHV was associated with lower rates of being in care by child's first, second, and third birthday (adjusted risk ratio [aRR] = 0.75, 0.79, and 0.81, respectively) and lower rates of hospitalization for maltreatment-related injuries by third birthday (aRR = 0.59). No differences were found in child development at kindergarten. FFHV should be offered to at-risk families to decrease child maltreatment. Program enhancements are required to improve child development at school entry.

Entrepreneurship and state/mental health center relationships.

PubMed

McLaughlin, C P; Zelman, W N

1987-01-01

An effective Community Mental Health Center (CMHC) program in entrepreneurship--the provision of services in the marketplace at a profit to subsidize other programs--requires the support and encouragement of the state-level mental health authority. This paper discusses potential financial, programmatic, political, and managerial risks and rewards to CMHCs and to state authorities from such efforts. As each party faces certain risks as well as rewards from such efforts, it is important that they participate in a process of mutual risk reduction involving: Documenting and legitimizing the entrepreneurship program; Separating funding for seed monies and working capital for ventures, Restructuring the Centers' finances and/or corporate structure to reduce the problems of funds diversion and comingling, Negotiating in advance how the proceeds of the ventures will be used to benefit programs, and Providing technical assistance to enhance the probabilities of success in such ventures. For these steps to work the state authorities must be willing to give up some financial and programmatic control to motivate entrepreneurship on the part of CMHCs.

The impact of workplace screening on the occurrence of cumulative trauma disorders and workers' compensation claims.

PubMed

Melhorn, J M

1999-02-01

Work-related musculoskeletal pain, commonly referred to more specifically as musculoskeletal disorders or cumulative trauma disorders, has continued to occur despite efforts by employers, employees, health care providers, and the government to eradicate it. The National Institute for Occupational Safety and Health has encouraged employers to establish ergonomic prevention programs; however, many employers are concerned that screening, education, and focused attention on workplace pain will cause an increase in the number of OSHA 200 events and the incidence of workers' compensation claims. This prospective cohort study demonstrated that there was no increase in the number of OSHA 200 events and no increase in the incidence of workers' compensation claims after completion of an individual risk screening program that included education and employee awareness about work-related musculoskeletal pain. Incidence of cumulative trauma disorders has been most effectively reduced by use of individual risk-screening programs. Therefore, employers should be encouraged to develop and implement prevention programs that include individual risk screening.

Is the Families First Home Visiting Program Effective in Reducing Child Maltreatment and Improving Child Development?

PubMed Central

Brownell, Marni D.; Isaac, Michael R.; Chateau, Dan; Nickel, Nathan C.; Katz, Alan; Sarkar, Joykrishna; Hu, Milton; Taylor, Carole

2017-01-01

While home visiting programs are among the most widespread interventions to support at-risk families, there is a paucity of research investigating these programs under real-world conditions. The effectiveness of Families First home visiting (FFHV) was examined for decreasing rates of being in care of child welfare, decreasing hospitalizations for maltreatment-related injuries, and improving child development at school entry. Data for 4,562 children from home visiting and 5,184 comparison children were linked to deidentified administrative health, social services, and education data. FFHV was associated with lower rates of being in care by child’s first, second, and third birthday (adjusted risk ratio [aRR] = 0.75, 0.79, and 0.81, respectively) and lower rates of hospitalization for maltreatment-related injuries by third birthday (aRR = 0.59). No differences were found in child development at kindergarten. FFHV should be offered to at-risk families to decrease child maltreatment. Program enhancements are required to improve child development at school entry. PMID:28413917

A randomized controlled trial on the efficacy of carbohydrate-reduced or fat-reduced diets in patients attending a telemedically guided weight loss program.

PubMed

Frisch, Sabine; Zittermann, Armin; Berthold, Heiner K; Götting, Christian; Kuhn, Joachim; Kleesiek, Knut; Stehle, Peter; Körtke, Heinrich

2009-07-18

We investigated whether macronutrient composition of energy-restricted diets influences the efficacy of a telemedically guided weight loss program. Two hundred overweight subjects were randomly assigned to a conventional low-fat diet and a low-carbohydrate diet group (target carbohydrate content: >55% energy and <40% energy, respectively). Both groups attended a weekly nutrition education program and dietary counselling by telephone, and had to transfer actual body weight data to our clinic weekly with added Bluetooth technology by mobile phone. Various fatness and fat distribution parameters, energy and macronutrient intake, and various biochemical risk markers were measured at baseline and after 6, and 12 months. In both groups, energy intake decreased by 400 kcal/d compared to baseline values within the first 6 months and slightly increased again within the second 6 months. Macronutrient composition differed significantly between the groups from the beginning to month 12. At study termination, weight loss was 5.8 kg (SD: 6.1 kg) in the low-carbohydrate group and 4.3 kg (SD: 5.1 kg) in the low-fat group (p = 0.065). In the low-carbohydrate group, triglyceride and HDL-cholesterol levels were lower at month 6 and waist circumference and systolic blood pressure were lower at month 12 compared with the low-fat group (P = 0.005-0.037). Other risk markers improved to a similar extent in both groups. Despite favourable effects of both diets on weight loss, the carbohydrate-reduced diet was more beneficial with respect to cardiovascular risk factors compared to the fat-reduced diet. Nevertheless, compliance with a weight loss program appears to be even a more important factor for success in prevention and treatment of obesity than the composition of the diet. Clinicaltrials.gov as NCT00868387.

A randomized controlled trial on the efficacy of carbohydrate-reduced or fat-reduced diets in patients attending a telemedically guided weight loss program

PubMed Central

2009-01-01

Background We investigated whether macronutrient composition of energy-restricted diets influences the efficacy of a telemedically guided weight loss program. Methods Two hundred overweight subjects were randomly assigned to a conventional low-fat diet and a low-carbohydrate diet group (target carbohydrate content: >55% energy and <40% energy, respectively). Both groups attended a weekly nutrition education program and dietary counselling by telephone, and had to transfer actual body weight data to our clinic weekly with added Bluetooth® technology by mobile phone. Various fatness and fat distribution parameters, energy and macronutrient intake, and various biochemical risk markers were measured at baseline and after 6, and 12 months. Results In both groups, energy intake decreased by 400 kcal/d compared to baseline values within the first 6 months and slightly increased again within the second 6 months. Macronutrient composition differed significantly between the groups from the beginning to month 12. At study termination, weight loss was 5.8 kg (SD: 6.1 kg) in the low-carbohydrate group and 4.3 kg (SD: 5.1 kg) in the low-fat group (p = 0.065). In the low-carbohydrate group, triglyceride and HDL-cholesterol levels were lower at month 6 and waist circumference and systolic blood pressure were lower at month 12 compared with the low-fat group (P = 0.005–0.037). Other risk markers improved to a similar extent in both groups. Conclusion Despite favourable effects of both diets on weight loss, the carbohydrate-reduced diet was more beneficial with respect to cardiovascular risk factors compared to the fat-reduced diet. Nevertheless, compliance with a weight loss program appears to be even a more important factor for success in prevention and treatment of obesity than the composition of the diet. Trial registration Clinicaltrials.gov as NCT00868387 PMID:19615091

Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: a small randomized controlled trial.

PubMed

Creswell, J David; Irwin, Michael R; Burklund, Lisa J; Lieberman, Matthew D; Arevalo, Jesusa M G; Ma, Jeffrey; Breen, Elizabeth Crabb; Cole, Steven W

2012-10-01

Lonely older adults have increased expression of pro-inflammatory genes as well as increased risk for morbidity and mortality. Previous behavioral treatments have attempted to reduce loneliness and its concomitant health risks, but have had limited success. The present study tested whether the 8-week Mindfulness-Based Stress Reduction (MBSR) program (compared to a Wait-List control group) reduces loneliness and downregulates loneliness-related pro-inflammatory gene expression in older adults (N = 40). Consistent with study predictions, mixed effect linear models indicated that the MBSR program reduced loneliness, compared to small increases in loneliness in the control group (treatment condition × time interaction: F(1,35) = 7.86, p = .008). Moreover, at baseline, there was an association between reported loneliness and upregulated pro-inflammatory NF-κB-related gene expression in circulating leukocytes, and MBSR downregulated this NF-κB-associated gene expression profile at post-treatment. Finally, there was a trend for MBSR to reduce C Reactive Protein (treatment condition × time interaction: (F(1,33) = 3.39, p = .075). This work provides an initial indication that MBSR may be a novel treatment approach for reducing loneliness and related pro-inflammatory gene expression in older adults. Copyright © 2012 Elsevier Inc. All rights reserved.

Mindfulness-Based Stress Reduction Training Reduces Loneliness and Pro-Inflammatory Gene Expression in Older Adults: A Small Randomized Controlled Trial

PubMed Central

Creswell, J. David; Irwin, Michael R.; Burklund, Lisa J.; Lieberman, Matthew D.; Arevalo, Jesusa M. G.; Ma, Jeffrey; Breen, Elizabeth Crabb; Cole, Steven W.

2013-01-01

Lonely older adults have increased expression of pro-inflammatory genes as well as increased risk for morbidity and mortality. Previous behavioral treatments have attempted to reduce loneliness and its concomitant health risks, but have had limited success. The present study tested whether the 8-week Mindfulness-Based Stress Reduction (MBSR) program (compared to a Wait-List control group) reduces loneliness and downregulates loneliness-related pro-inflammatory gene expression in older adults (N=40). Consistent with study predictions, mixed effect linear models indicated that the MBSR program reduced loneliness, compared to small increases in loneliness in the control group (treatment condition × time interaction: F(1,35)=7.86, p=.008). Moreover, at baseline, there was an association between reported loneliness and upregulated pro-inflammatory NF-κB-related gene expression in circulating leukocytes, and MBSR downregulated this NF-κB-associated gene expression profile at post-treatment. Finally, there was a trend for MBSR to reduce C Reactive Protein (treatment condition × time interaction: (F(1,33)=3.39, p=.075). This work provides an initial indication that MBSR may be a novel treatment approach for reducing loneliness and related pro-inflammatory gene expression in older adults. PMID:22820409

An overview of the effectiveness and efficiency of HIV prevention programs.

PubMed Central

Holtgrave, D R; Qualls, N L; Curran, J W; Valdiserri, R O; Guinan, M E; Parra, W C

1995-01-01

Because of the enormity of the HIV-AIDS epidemic and the urgency for preventing transmission, HIV prevention programs are a high priority for careful and timely evaluations. Information on program effectiveness and efficiency is needed for decision-making about future HIV prevention priorities. General characteristics of successful HIV prevention programs, programs empirically evaluated and found to change (or not change) high-risk behaviors or in need of further empirical study, and economic evaluations of certain programs are described and summarized with attention limited to programs that have a behavioral basis. HIV prevention programs have an impact on averting or reducing risk behaviors, particularly when they are delivered with sufficient resources, intensity, and cultural competency and are based on a firm foundation of behavioral and social science theory and past research. Economic evaluations have found that some of these behaviorally based programs yield net economic benefits to society, and others are likely cost-effective (even if not cost-saving) relative to other health programs. Still, specific improvements should be made in certain HIV prevention programs. PMID:7630989

A computational future for preventing HIV in minority communities: how advanced technology can improve implementation of effective programs.

PubMed

Brown, C Hendricks; Mohr, David C; Gallo, Carlos G; Mader, Christopher; Palinkas, Lawrence; Wingood, Gina; Prado, Guillermo; Kellam, Sheppard G; Pantin, Hilda; Poduska, Jeanne; Gibbons, Robert; McManus, John; Ogihara, Mitsunori; Valente, Thomas; Wulczyn, Fred; Czaja, Sara; Sutcliffe, Geoff; Villamar, Juan; Jacobs, Christopher

2013-06-01

African Americans and Hispanics in the United States have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations. Although a handful of these programs are just beginning to be disseminated widely, we still have not implemented effective programs to a level that would reduce the population incidence of HIV for minorities. We proposed that innovative approaches involving computational technologies be explored for their use in both developing new interventions and in supporting wide-scale implementation of effective behavioral interventions. Mobile technologies have a place in both of these activities. First, mobile technologies can be used in sensing contexts and interacting to the unique preferences and needs of individuals at times where intervention to reduce risk would be most impactful. Second, mobile technologies can be used to improve the delivery of interventions by facilitators and their agencies. Systems science methods including social network analysis, agent-based models, computational linguistics, intelligent data analysis, and systems and software engineering all have strategic roles that can bring about advances in HIV prevention in minority communities. Using an existing mobile technology for depression and 3 effective HIV prevention programs, we illustrated how 8 areas in the intervention/implementation process can use innovative computational approaches to advance intervention adoption, fidelity, and sustainability.

Healthy Schools-Healthy Kids: a controlled evaluation of a comprehensive universal eating disorder prevention program.

PubMed

McVey, Gail; Tweed, Stacey; Blackmore, Elizabeth

2007-06-01

This study was a controlled evaluation of a comprehensive school-based universal prevention program involving male and female students, parents, teachers, school administrators and local public health professionals. A total of 982 male and female Grades 6 and 7 middle school students (and 91 teachers/school administrators) completed self-report surveys at baseline on measures of body satisfaction, internalization of media ideals, size acceptance, disordered eating, weight-based teasing, weight loss and muscle-gaining behaviours, and perceptions of school climate (teachers only). Eighty-four percent of the students repeated the surveys immediately following the 8-month school-wide intervention and 71% again 6 months later. Repeated measures ANCOVAs revealed that participation in the Healthy Schools-Healthy Kids (HS-HK) program had a positive influence by reducing the internalization of media ideals among male and female students and by reducing disordered eating among female students. The program was also associated with reductions in weight-loss behaviours among the students, although this effect was lost by the 6-month follow-up. When the intervention students were sub-divided into low versus high-risk groups, the high-risk group appeared to benefit most from the intervention with significant reductions in internalization of media ideals, greater body satisfaction, and reduced disordered eating over time. There were no intervention effects for teachers. Challenges of engaging teachers in prevention are discussed.

Dating Violence Prevention Programming: Directions for Future Interventions

PubMed Central

Shorey, Ryan C.; Zucosky, Heather; Brasfield, Hope; Febres, Jeniimarie; Cornelius, Tara L.; Sage, Chelsea; Stuart, Gregory L.

2012-01-01

Dating violence among college students is a widespread and destructive problem. The field of dating violence has seen a substantial rise in research over the past several years, which has improved our understanding of factors that increase risk for perpetration. Unfortunately, there has been less attention paid to dating violence prevention programming, and existing programs have been marred with methodological weaknesses and a lack of demonstrated effectiveness in reducing aggression. In hopes of sparking new research on dating violence prevention programs, the current review examines possible new avenues for dating violence prevention programming among college students. We discuss clinical interventions that have shown to be effective in reducing a number of problematic behaviors, including motivational interventions, dialectical behavior therapy, mindfulness, and bystander interventions, and how they could be applied to dating violence prevention. We also discuss methodological issues to consider when implementing dating violence prevention programs. PMID:22773916

Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.

PubMed

Brouwer, Miranda; Coelho, Eliana; Mosse, Carla das Dores; Brondi, Luciana; Winterton, Laura; van Leth, Frank

2014-01-01

Healthcare Workers (HCWs) have a higher frequency of TB exposure than the general population and have therefore an occupational TB risk that infection prevention and control (IPC) measures aim to reduce. HCWs are crucial in the implementation of these measures. The objective of the study was to investigate Mozambican HCWs' perceptions of their occupational TB risk and the measures they report using to reduce this risk. In addition, we explored the challenges HCWs encounter while using these TBIPC measures. Focus group discussion. Analysis according content method. Four categories of HCWs: auxiliary workers, medical (doctors and clinical officers), nurses and TB program staff. HCWs are aware of their occupational TB risk and use various measures to reduce their risk of infection. HCWs find it challenging to employ measures that minimize such risks and a lack of clear guidelines contributes to these challenges. HCWs' and patient behavior further complicate the use of TBIPC measures. HCWs in Mozambique perceive a high occupational risk of TB infection. They report several challenges using measures to reduce this risk such as shortage of material, lack of clear guidelines, insufficient motivation and inadequate training. Robust training with motivational approaches, alongside supervision and support for HCWs could improve implementation of TBIPC measures. Healthcare management should address the areas for improvement that are beyond the individual HCW's control.

Reaching lost-to-care populations.

PubMed

Jordan, Wilbert C

2007-12-15

Identification of patients who are at high risk for human immunodeficiency virus (HIV) infection can lead to reduced frequencies of high-risk behaviors, provision of timely care for infected individuals, and decreased transmission of HIV. The HIV-associated outreach programs at the OASIS Clinic of the King-Harbor/Drew University complex (Los Angeles, CA) has 3 components: a traditional partner-notification (i.e., contact-tracing) component, a focused-intervention component through which clients are given incentives to bring in persons they feel are at high risk for HIV infection, and an outreach component targeting hard-to-reach populations. These interventions are highly effective in identifying individuals early during the course of their disease, when initiation of antiretroviral therapy is most effective. The partner-services program at the OASIS Clinic has been particularly useful in identifying partners of HIV-positive women, whereas the focused-intervention program is most useful for identifying gay men who are unaware of their positive HIV serostatus. Successful targeted outreach programs can identify many individuals who would not otherwise be aware of their HIV infection, but the programs also require more clinicians to manage these patients.

Healthy Start: a comprehensive health education program for preschool children.

PubMed

Williams, C L; Squillace, M M; Bollella, M C; Brotanek, J; Campanaro, L; D'Agostino, C; Pfau, J; Sprance, L; Strobino, B A; Spark, A; Boccio, L

1998-01-01

Healthy Start is a 3-year demonstration and education research project designed to evaluate the effectiveness of a multidimensional cardiovascular (CV) risk reduction intervention in preschool centers over a 3-year period of time. Two primary interventions are employed. The first is the preschool food service intervention program designed to reduce the total fat in preschool meals and snacks to less than 30% of calories and reduce the saturated fat to less than 10% of calories. The second major intervention is a comprehensive preschool health education curriculum, focused heavily on nutrition. Effectiveness of the intervention will be determined through evaluation of changes in dietary intake of preschool children at school meals and snacks, especially with respect to intake of total and saturated fat. Evaluation of the education component will include assessment of program implementation by teachers, assessment of changes in nutrition knowledge by preschool children, and assessment of changes in home meals that children consume (total and saturated fat content). Blood cholesterol will be evaluated semiannually to evaluate changes that may be due to modification of dietary intake. Growth and body fatness will also be assessed. While substantial efforts have targeted CV risk reduction and health education for elementary school children, similar efforts aimed at preschool children have been lacking. The rationale for beginning CV risk reduction programs for preschool children is based upon the premise that risk factors for heart disease are prevalent by 3 years of age and tend to track over time, most commonly hypercholesterolemia and obesity, both related to nutrition. Since the behavioral antecedents for nutritional risk factors begin to be established very early in life, it is important to develop and evaluate new educational initiatives such as Healthy Start, aimed at the primary prevention of cardiovascular risk factors in preschool children. The purpose of this publication is to describe the rationale and methods for the Healthy Start project.

Barbershop Talk With Brothers: using community-based participatory research to develop and pilot test a program to reduce HIV risk among Black heterosexual men.

PubMed

Wilson, Tracey E; Fraser-White, Marilyn; Williams, Kim M; Pinto, Angelo; Agbetor, Francis; Camilien, Brignel; Henny, Kirk; Browne, Ruth C; Gousse, Yolene; Taylor, Tonya; Brown, Humberto; Taylor, Raekiela; Joseph, Michael A

2014-10-01

There is a need for feasible, evidence-based interventions that support HIV risk reduction among heterosexual Black men. In this article, we describe the process for development of the Barbershop Talk With Brothers (BTWB) program and evaluation. The BTWB program is a theoretically grounded and community-based HIV prevention program that seeks to improve individual skills and motivation to decrease sexual risk, and that builds men's interest in and capacity for improving their community's health. Formative data collection included barbershop observations and barber focus groups, brief behavioral risk assessments of men in barbershops, and focus groups and individual interviews. Based on this information and in consultation with our steering committee, we developed the BTWB program and accompanying program evaluation. From April through November 2011, 80 men were recruited and completed a baseline assessment of a pilot test of the program; 78 men completed the program and 71 completed a 3-month assessment. The pilot evaluation procedures were feasible to implement, and assessments of pre- and post-test measures indicate that key behavioral outcomes and proposed mediators of those outcomes changed in hypothesized directions. Specifically, attitudes and self-efficacy toward consistent condom use improved, and respondents reported lower levels of sexual risk behavior from baseline to follow-up (all p < 0.05). Perceptions of community empowerment also increased (p = 0.06). While HIV stigma decreased, this difference did not reach statistical significance. Our approach to community-engaged program development resulted in an acceptable, feasible approach to reaching and educating heterosexual Black men about HIV prevention in community settings.

The Potential of the Traditional Birth Attendant. WHO Offset Publication No. 95.

ERIC Educational Resources Information Center

Maglacas, A. Mangay, Ed.; Simons, John, Ed.

In nine chapters, this book considers the extent to which training programs can be utilized to improve midwifery practice and reduce the risks surrounding childbirth in rural populations. The book opens with a chapter reviewing the question of whether the availability of trained birth attendants can be linked to a reduced incidence of neonatal…

U.S. Federal Fuel Management Programs: Reducing Risk to Communities and Increasing Ecosystem Resilience and Sustainability

Treesearch

Tim Sexton

2006-01-01

There is no doubt that wildland fuel conditions on large portions of federal wildlands in the United States have changed significantly over the last 100 years. The changes include: Increased density of woody species; Artificial fragmentation of fuel mosaics; Exotic species invasions; Structural changes which reduce ecosystem resilience to fire.

Safe Start: How Early Experiences Can Help Reduce Violence. An Ounce of Prevention Fund Paper.

ERIC Educational Resources Information Center

Hawley, Theresa

Noting that many communities have overlooked a promising approach to reducing violence in the United States, this report examines early risk factors for violence and discusses the potential of prevention and intervention programs for children ages birth to 5 years. The report defines violence and discusses the importance of early experiences in…

Truancy Programs: Are the Effects Too Easily Washed Away?

ERIC Educational Resources Information Center

Huck, Jennifer L.

2011-01-01

Truancy has been identified as a risk factor of criminal behavior but results are mixed as to the best means to reduce this school-based concern. The Truancy Prevention Initiative has been implemented in New Orleans post-Hurricane Katrina under the direction of the Recovery School District to reduce levels of truancy, increase graduation rates,…

[Organized breast cancer screening].

PubMed

Rouëssé, Jacques; Sancho-Garnier, Hélèn

2014-02-01

Breast screening programs are increasingly controversial, especially regarding two points: the number of breast cancer deaths they avoid, and the problem of over-diagnosis and over-treatment. The French national breast cancer screening program was extended to cover the whole country in 2004. Ten years later it is time to examine the risk/benefit ratio of this program and to discuss the need for change. Like all forms of cancer management, screening must be regularly updated, taking into account the state of the art, new evidence, and uncertainties. All screening providers should keep themselves informed of the latest findings. In the French program, women aged 50-74 with no major individual or familial risk factors for breast cancer are offered screening mammography and clinical breast examination every two years. Images considered non suspicious of malignancy by a first reader are re-examined by a second reader. The devices and procedures are subjected to quality controls. Participating radiologists (both public and private) are required to read at least 500 mammographies per year. The program's national participation rate was 52.7 % in 2012. When individual screening outside of the national program is taken into account (nearly 15 % of women), coverage appears close to the European recommendation of 65 %. Breast cancer mortality has been falling in France by 0.6 % per year for over 30 years, starting before mass screening was implemented, and by 1.5 % since 2005. This decline can be attributed in part to earlier diagnosis and better treatment, so that the specific impact of screening cannot easily be measured. Over-treatment, defined as the detection and treatment of low-malignancy tumors that would otherwise not have been detected in a person's lifetime, is a major negative effect of screening, but its frequency is not precisely known (reported to range from 1 % to 30 %). In view of these uncertainties, it would be advisable to modify the program in order to increase its efficiency, by targeting populations at a higher risk than the women currently included, and to reduce the number of mammograms done outside the program, as they are not subject to the same quality controls. Risks could be reduced by increasing the sensitivity of mammography and the specificity of the readings. Moreover, it is mandatory to inform women of both the benefits and risks of screening, in compliance with the principle of enabling patients to make a free and informed choice.

Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial.

PubMed

Pahor, Marco; Guralnik, Jack M; Ambrosius, Walter T; Blair, Steven; Bonds, Denise E; Church, Timothy S; Espeland, Mark A; Fielding, Roger A; Gill, Thomas M; Groessl, Erik J; King, Abby C; Kritchevsky, Stephen B; Manini, Todd M; McDermott, Mary M; Miller, Michael E; Newman, Anne B; Rejeski, W Jack; Sink, Kaycee M; Williamson, Jeff D

2014-06-18

In older adults reduced mobility is common and is an independent risk factor for morbidity, hospitalization, disability, and mortality. Limited evidence suggests that physical activity may help prevent mobility disability; however, there are no definitive clinical trials examining whether physical activity prevents or delays mobility disability. To test the hypothesis that a long-term structured physical activity program is more effective than a health education program (also referred to as a successful aging program) in reducing the risk of major mobility disability. The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, randomized trial that enrolled participants between February 2010 and December 2011, who participated for an average of 2.6 years. Follow-up ended in December 2013. Outcome assessors were blinded to the intervention assignment. Participants were recruited from urban, suburban, and rural communities at 8 centers throughout the United States. We randomized a volunteer sample of 1635 sedentary men and women aged 70 to 89 years who had physical limitations, defined as a score on the Short Physical Performance Battery of 9 or below, but were able to walk 400 m. Participants were randomized to a structured, moderate-intensity physical activity program (n = 818) conducted in a center (twice/wk) and at home (3-4 times/wk) that included aerobic, resistance, and flexibility training activities or to a health education program (n = 817) consisting of workshops on topics relevant to older adults and upper extremity stretching exercises. The primary outcome was major mobility disability objectively defined by loss of ability to walk 400 m. Incident major mobility disability occurred in 30.1% (246 participants) of the physical activity group and 35.5% (290 participants) of the health education group (hazard ratio [HR], 0.82 [95% CI, 0.69-0.98], P = .03).Persistent mobility disability was experienced by 120 participants (14.7%) in the physical activity group and 162 participants (19.8%) in the health education group (HR, 0.72 [95% CI, 0.57-0.91]; P = .006). Serious adverse events were reported by 404 participants (49.4%) in the physical activity group and 373 participants (45.7%) in the health education group (risk ratio, 1.08 [95% CI, 0.98-1.20]). A structured, moderate-intensity physical activity program compared with a health education program reduced major mobility disability over 2.6 years among older adults at risk for disability. These findings suggest mobility benefit from such a program in vulnerable older adults. clinicaltrials.gov Identifier: NCT01072500.

Test Planning Approach and Lessons

NASA Technical Reports Server (NTRS)

Parkinson, Douglas A.; Brown, Kendall K.

2004-01-01

As NASA began technology risk reduction activities and planning for the next generation launch vehicle under the Space Launch Initiative (SLI), now the Next Generation Launch Technology (NGLT) Program, a review of past large liquid rocket engine development programs was performed. The intent of the review was to identify any significant lessons from the development testing programs that could be applied to current and future engine development programs. Because the primary prototype engine in design at the time of this study was the Boeing-Rocketdyne RS-84, the study was slightly biased towards LOX/RP-1 liquid propellant engines. However, the significant lessons identified are universal. It is anticipated that these lessons will serve as a reference for test planning in the Engine Systems Group at Marshall Space Flight Center (MSFC). Towards the end of F-1 and J-2 engine development testing, NASA/MSFC asked Rocketdyne to review those test programs. The result was a document titled, Study to Accelerate Development by Test of a Rocket Engine (R-8099). The "intent (of this study) is to apply this thinking and learning to more efficiently develop rocket engines to high reliability with improved cost effectivenes" Additionally, several other engine programs were reviewed - such as SSME, NSTS, STME, MC-1, and RS-83- to support or refute the R-8099. R-8099 revealed two primary lessons for test planning, which were supported by the other engine development programs. First, engine development programs can benefit from arranging the test program for engine system testing as early as feasible. The best test for determining environments is at the system level, the closest to the operational flight environment. Secondly, the component testing, which tends to be elaborate, should instead be geared towards reducing risk to enable system test. Technical risk can be reduced at the component level, but the design can only be truly verified and validated after engine system testing.

Replicating MISTERS: an epidemiological criminology framework analysis of a program for criminal justice-involved minority males in the community.

PubMed

Potter, Roberto Hugh; Akers, Timothy A; Bowman, Daniel Richard

2013-01-01

The Men in STD Training and Empowerment Research Study (MISTERS) program and epidemiological criminology began their development in Atlanta at about the same time. MISTERS focuses on men recently released from jail to reduce both HIV/STD and crime-related risk factors through a brief educational intervention. This article examines ways in which MISTERS and epidemiological criminology have been used to inform one another in the replication of the MISTERS program in Orange County, Florida. Data from 110 MISTERS participants during the first 10 months of operation are analyzed to examine the overlapping occurrence of health and criminal risk behaviors in the men's lives. This provides a test of core hypotheses from the epidemiological criminology framework. This article also examines application of the epidemiological criminology framework to develop interventions to address health and crime risk factors simultaneously in Criminal Justice-Involved populations in the community.

Worksite health and wellness programs: Canadian achievements & prospects.

PubMed

Després, Jean-Pierre; Alméras, Natalie; Gauvin, Lise

2014-01-01

Canada has experienced a substantial reduction in mortality related to cardiovascular disease (CVD). There is a general consensus that more effective and widespread health promotion interventions may lead to further reductions in CVD risk factors and actual disease states. In this paper, we briefly outline the prevalence of selected risk factors for CVD in Canada, describe characteristics of the Canadian labor market and workforce, and depict what is known about health and wellness program delivery systems in Canadian workplaces. Our review indicates that there have been numerous and diverse relevant legislative and policy initiatives to create a context conducive to improve the healthfulness of Canadian workplaces. However, there is still a dearth of evidence on the effectiveness of the delivery system and the actual impact of workplace health and wellness programs in reducing CVD risk in Canada. Thus, while a promising model, more research is needed in this area. Copyright © 2014 Elsevier Inc. All rights reserved.

Advanced Gas Turbine (AGT) powertrain system development for automotive applications report

NASA Technical Reports Server (NTRS)

1984-01-01

This report describes progress and work performed during January through June 1984 to develop technology for an Advanced Gas Turbine (AGT) engine for automotive applications. Work performed during the first eight periods initiated design and analysis, ceramic development, component testing, and test bed evaluation. Project effort conducted under this contract is part of the DOE Gas Turbine Highway Vehicle System Program. This program is oriented at providing the United States automotive industry the high-risk long-range techology necessary to produce gas turbine engines for automobiles with reduced fuel consumption and reduced environmental impact. Technology resulting from this program is intended to reach the marketplace by the early 1990s.

A study of the effectiveness of a workplace violence intervention for small retail and service establishments.

PubMed

Casteel, Carri; Peek-Asa, Corinne; Greenland, Sander; Chu, Lawrence D; Kraus, Jess F

2008-12-01

Examine the effectiveness of a robbery and violence prevention program in small businesses in Los Angeles. Gas/convenience, liquor and grocery stores, bars/restaurants, and motels were enrolled between 1997 and 2000. Intervention businesses (n = 305) were provided training, program implementation materials, and recommendations for a comprehensive security program. Control businesses (n = 96) received neither training nor program materials. Rate ratios comparing intervention to control businesses were 0.90 for violent crime (95% confidence limits [CL] = 0.53, 1.53) and 0.81 for robbery (95% CL = 0.38, 1.73). The reduction in violent crime was concentrated in high-compliance intervention businesses (risk ratio = 0.74, 95% CL = 0.40, 1.36). Low-compliance intervention businesses had practically the same postintervention crime as the control businesses. Our results suggest that the workplace violence intervention may reduce violent crime among high-risk businesses, especially those with high program compliance.

Cancer Risks Associated with External Radiation From Diagnostic Imaging Procedures

PubMed Central

Linet, Martha S.; Slovis, Thomas L.; Miller, Donald L.; Kleinerman, Ruth; Lee, Choonsik; Rajaraman, Preetha; de Gonzalez, Amy Berrington

2012-01-01

The 600% increase in medical radiation exposure to the US population since 1980 has provided immense benefit, but potential future cancer risks to patients. Most of the increase is from diagnostic radiologic procedures. The objectives of this review are to summarize epidemiologic data on cancer risks associated with diagnostic procedures, describe how exposures from recent diagnostic procedures relate to radiation levels linked with cancer occurrence, and propose a framework of strategies to reduce radiation from diagnostic imaging in patients. We briefly review radiation dose definitions, mechanisms of radiation carcinogenesis, key epidemiologic studies of medical and other radiation sources and cancer risks, and dose trends from diagnostic procedures. We describe cancer risks from experimental studies, future projected risks from current imaging procedures, and the potential for higher risks in genetically susceptible populations. To reduce future projected cancers from diagnostic procedures, we advocate widespread use of evidence-based appropriateness criteria for decisions about imaging procedures, oversight of equipment to deliver reliably the minimum radiation required to attain clinical objectives, development of electronic lifetime records of imaging procedures for patients and their physicians, and commitment by medical training programs, professional societies, and radiation protection organizations to educate all stakeholders in reducing radiation from diagnostic procedures. PMID:22307864

Eliciting Children's Perspectives of Risk and Protection in Liberia: How to Do It and Why Does It Matter?

ERIC Educational Resources Information Center

Ruiz-Casares, Mónica; Rousseau, Cécile; Morlu, Joeta; Browne, Celestine

2013-01-01

Background: After 14 years of civil war and two rounds of democratic elections, Liberia is working to reduce child abuse and exploitation. Young children's perceptions on protection and risk are rarely elicited to inform program planning and intervention. Objective: The aim of the present study was to explore young children's perceptions of child…

School- And Home-Based Drug Prevention: Environmental, Parent, and Child Risk Reduction

ERIC Educational Resources Information Center

Hahn, Ellen J.; Hall, Lynne A.; Rayens, Mary Kay; Myers, April V.; Bonnel, Galadriel

2007-01-01

The study purpose was to test the effect of a school- and home-based alcohol, tobacco, and other drug (ATOD) prevention program on reducing environmental, parent, and child risk factors for ATOD use. The design was a three-group pretest-posttest with interviews at baseline and 1 and 6 months post-intervention. The sample was 126 parents and their…

Academic Achievement Trajectories of Homeless and Highly Mobile Students: Resilience in the Context of Chronic and Acute Risk

ERIC Educational Resources Information Center

Cutuli, J. J.; Desjardins, Christopher David; Herbers, Janette E.; Long, Jeffrey D.; Heistad, David; Chan, Chi-Keung; Hinz, Elizabeth; Masten, Ann S.

2013-01-01

Analyses examined academic achievement data across third through eighth grades ("N" = 26,474), comparing students identified as homeless or highly mobile (HHM) with other students in the federal free meal program (FM), reduced price meals (RM), or neither (General). Achievement was lower as a function of rising risk status (General…

Workplace Wellness Programs to Promote Cancer Prevention.

PubMed

Soldano, Sharon K

2016-08-01

To define the diversity of and business case for workplace wellness programs, highlight best practices for a comprehensive health promotion program, and describe the opportunities for employees to become wellness advocates. Current literature and articles published between 2010 and 2016, Centers for Disease Control and Prevention, Health Enhancement Research Organization, National Business Group on Health, Wellness Councils of America, best practice program guidelines and internet resources. Employers are increasingly affected by rising health care costs and epidemic rates of obesity and associated chronic diseases within the workforce. Employers who offer workplace wellness programs can contribute to the overall health and well-being of their employees, improve employee productivity and retention, and reduce absenteeism and health care costs. Employees participating in workplace wellness programs can reduce their health risks and serve as health promotion advocates. Nurses can lead by example by participating in their workplace wellness programs, serving as an advocate to influence their employers and colleagues, and educating their patients regarding the benefits of workplace wellness programs. Copyright © 2016 Elsevier Inc. All rights reserved.

Topical Backgrounder: New Ways to Prevent Chemical Incidents

EPA Pesticide Factsheets

Part of a May 1999 series of publications on the Risk Management Program Rule and issues related to chemical emergency management. Explains how RMP compliance and the impact of right-to-know will reduce hazards.

HIV Services Provided by STD Programs in State and Local Health Departments - United States, 2013-2014.

PubMed

Cuffe, Kendra M; Esie, Precious; Leichliter, Jami S; Gift, Thomas L

2017-04-07

The incidence of human immunodeficiency virus (HIV) infection in the United States is higher among persons with other sexually transmitted diseases (STDs), and the incidence of other STDs is increased among persons with HIV infection (1). Because infection with an STD increases the risk for HIV acquisition and transmission (1-4), successfully treating STDs might help reduce the spread of HIV among persons at high risk (1-4). Because health department STD programs provide services to populations who are at risk for HIV, ensuring service integration and coordination could potentially reduce the incidence of STDs and HIV. Program integration refers to the combining of STD and HIV prevention programs through structural, service, or policy-related changes such as combining funding streams, performing STD and HIV case matching, or integrating staff members (5). Some STD programs in U.S. health departments are partially or fully integrated with an HIV program (STD/HIV program), whereas other STD programs are completely separate. To assess the extent of provision of HIV services by state and local health department STD programs, CDC analyzed data from a sample of 311 local health departments and 56 state and directly funded city health departments derived from a national survey of STD programs. CDC found variation in the provision of HIV services by STD programs at the state and local levels. Overall, 73.1% of state health departments and 16.1% of local health departments matched STD case report data with HIV data to analyze possible syndemics (co-occurring epidemics that exacerbate the negative health effects of any of the diseases) and overlaps. Similarly, 94.1% of state health departments and 46.7% of local health departments performed site visits to HIV care providers to provide STD information or public health updates. One fourth of state health departments and 39.4% of local health departments provided HIV testing in nonclinical settings (field testing) for STD contacts, and all of these programs linked HIV cases to care. STD programs are providing some HIV services; however, delivery of certain specific services could be improved.

Financial "risk-sharing" or refund programs in assisted reproduction: an Ethics Committee opinion.

PubMed

2016-10-01

Financial "risk-sharing" fee structures in assisted reproduction programs charge patients a higher initial fee but provide reduced fees for subsequent cycles and often a partial or complete refund if treatment fails. This opinion of the ASRM Ethics Committee analyzes the ethical issues raised by these fee structures, including patient selection criteria, conflicts of interest, success rate transparency, and patient informed consent. This document replaces the document of the same name, last published in 2013 (Fertil Steril 2013;100:334-6). Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

The effects of a Pilates-based exercise rehabilitation program on functional outcome and fall risk reduction in an aging adult status-post traumatic hip fracture due to a fall.

PubMed

Stivala, Adam; Hartley, Greg

2014-01-01

Currently, little information describing the relationship of Pilates-based strength and stability exercises with fall risk in the geriatric population exists. The purpose of this report was to examine the impact of a Pilates-based rehabilitation (PBR) program on reducing fall risk in an aging adult status postfall with resulting hip fracture and open reduction and internal fixation. The patient was an 84-year-old woman admitted to a skilled nursing facility (SNF) after a right hip fracture resulting from a fall at home. The patient's relevant medical history included frequent falls due to loss of balance, a previous left hip fracture with resultant arthroplasty, and a stroke roughly 20 years prior. The patient received physical therapy and occupational therapy 6 days per week for 26 days in an SNF. The physical therapy intervention consisted of gait and transfer training, neuromuscular reeducation, and an adjunct of specialized PBR exercises for the following impairments: decreased core strength and awareness and poor dynamic stabilization during functional activities. The patient demonstrated increases in lower extremity strength and active range of motion, ambulation distance and speed, and transfer ability. The patient was able to return home and live with her husband while requiring only incidental assistance with activities of daily living. She was able to independently ambulate around her home with her rolling walker. Her fall risk was also reduced from initial evaluation based on several fall risk assessments, including the Four Square Step Test, the Berg Balance Scale, and the Timed Up and Go. This case illustrates the benefit of integrating PBR exercises into a standard SNF rehabilitation program, which may contribute to decreased fall risk.

International Space Station (ISS) Risk Reduction Activities

NASA Technical Reports Server (NTRS)

Fodroci, Michael

2011-01-01

As the assembly of the ISS nears completion, it is worthwhile to step back and review some of the actions pursued by the Program in recent years to reduce risk and enhance the safety and health of ISS crewmembers, visitors, and space flight participants. While the ISS requirements and initial design were intended to provide the best practicable levels of safety, it is always possible to reduce risk -- given the determination and commitment to do so. The following is a summary of some of the steps taken by the ISS Program Manager, by our International Partners, by hardware and software designers, by operational specialists, and by safety personnel to continuously enhance the safety of the ISS. While decades of work went into developing the ISS requirements, there are many things in a Program like the ISS that can only be learned through actual operational experience. These risk reduction activities can be divided into roughly three categories: (1) Areas that were initially noncompliant which have subsequently been brought into compliance or near compliance (i.e., Micrometeoroid and Orbital Debris [MMOD] protection, acoustics) (2) Areas where initial design requirements were eventually considered inadequate and were subsequently augmented (i.e., Toxicity Level 4 materials, emergency hardware and procedures) (3) Areas where risks were initially underestimated, and have subsequently been addressed through additional mitigation (i.e., Extravehicular Activity [EVA] sharp edges, plasma shock hazards) Due to the hard work and cooperation of many parties working together across the span of nearly a decade, the ISS is now a safer and healthier environment for our crew, in many cases exceeding the risk reduction targets inherent in the intent of the original design. It will provide a safe and stable platform for utilization and discovery.

Scalability of an Evidence-Based Adolescent Pregnancy Prevention Program: New Evidence From 5 Cluster-Randomized Evaluations of the Teen Outreach Program.

PubMed

Francis, Kimberly; Philliber, Susan; Walsh-Buhi, Eric R; Philliber, Ashley; Seshadri, Roopa; Daley, Ellen

2016-09-01

To determine if the Teen Outreach Program (TOP), a youth development and service learning program, can reduce sexual risk-taking behaviors compared with a business as usual or benign counterfactual. We synthesized results of 5 independent studies conducted in 5 geographically and ethnically diverse locations between 2011 and 2015 with 17 194 middle and high school students. Each study cluster-randomized classes, teachers, or schools to treatment or control groups and included the students enrolled in those clusters at baseline in an intent-to-treat analysis. Multilevel models tested impacts on recent sexual activity, recent unprotected sexual activity, and sexual initiation among the sexually inexperienced at baseline at approximately 1 and 2 years after baseline. Precision-weighted average effect sizes showed nonsignificant reductions of 1 percentage point or less in recent sexual activity (5 studies: -0.6; P = .32), recent unprotected sex (5 studies: -0.2; P = .76), and sexual initiation (4 studies: -1.1; P = .10) after 1 year. There was little evidence of the effectiveness of TOP in reducing sexual risk-taking behaviors. Results underscored the importance of continually evaluating evidence-based programs that have previously been shown to be effective.

The "Healthy Teen Girls Project": Comparison of Health Education and STD Risk Reduction Intervention for Incarcerated Adolescent Females

ERIC Educational Resources Information Center

Robertson, Angela R.; St. Lawrence, Janet; Morse, David T.; Baird-Thomas, Connie; Liew, Hui; Gresham, Kathleen

2011-01-01

Adolescent girls incarcerated in a state reformatory (N = 246) were recruited and assigned to an 18-session health education program or a time-equivalent HIV prevention program. Cohorts were assigned to conditions using a randomized block design separated by a washout period to reduce contamination. Post intervention, girls in the HIV risk…

Detection capacity, information gaps and the design of surveillance programs for invasive forest pests

Treesearch

Denys Yemshanov; Frank Koch; Yakov Ben-Haim; William Smith

2010-01-01

Integrated pest risk maps and their underlying assessments provide broad guidance for establishing surveillance programs for invasive species, but they rarely account for knowledge gaps regarding the pest of interest or how these can be reduced. In this study we demonstrate how the somewhat competing notions of robustness to uncertainty and potential knowledge gains...

Student Loans and Foreign Schools: Assessing Risks Could Help Education Reduce Program Vulnerability. Report to Congressional Addressees.

ERIC Educational Resources Information Center

Ashby, Cornelia M.

Recent events have increased concerns about the potential for fraud in student loan programs related to loans for U.S. residents attending foreign schools. In 2002 the Office of Special Investigations of the General Accounting Office (GAO) created a fictitious foreign school that the Department of Education subsequently certified as eligible to…

Locally Operated Levees: Issues and Federal Programs

DTIC Science & Technology

2011-04-05

attention. Congressional authorization of the National Flood Insurance Program ( NFIP ), managed by the Federal Emergency Management Agency (FEMA), expires...levees, FEMA’s Flood Insurance Rate Maps (FIRMs) and levee accreditation (which determine which NFIP requirements and premiums apply in an area), and...investments that reduce flood risk; concerns about the local costs associated with NFIP purchase and levee accreditation requirements; and consideration

The Relationship of School Poverty and Suspension Rates: Finding Ways to Reduce Suspension through Prevention Programming and School Bonding

ERIC Educational Resources Information Center

Shirley, Erica

2012-01-01

What is the relationship between school poverty and school suspension rates and to what extent do prevention programming and school bonding lower the suspension risk for students in high poverty schools? The present study examined the association between school level poverty and suspension rates in addition to investigating whether prevention…

Translating Evidence Based Violence and Drug Use Prevention to Obesity Prevention: Development and Construction of the Pathways Program

ERIC Educational Resources Information Center

Sakuma, Kari-Lyn K.; Riggs, Nathaniel R.; Pentz, Mary Ann

2012-01-01

Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health,…

A spatial database for restoration management capability on national forests in the Pacific Northwest USA

Treesearch

Chris Ringo; Alan A. Ager; Michelle A. Day; Sarah Crim

2016-01-01

Understanding the capacity to reduce wildfire risk and restore dry forests on Western national forests is a key part of prioritizing new accelerated restoration programs initiated by the Forest Service. Although a number of social and biophysical factors influence the ability to implement restoration programs, one key driver is the suite of forest plan land...

An Effectiveness Trial of a Selected Dissonance-Based Eating Disorder Prevention Program for Female High School Students: Long-Term Effects

ERIC Educational Resources Information Center

Stice, Eric; Rohde, Paul; Shaw, Heather; Gau, Jeff

2011-01-01

Objective: Efficacy trials found that a dissonance-based eating disorder prevention program in which female high school and college students with body image concerns critique the thin ideal reduced eating disorder risk factors, eating disorder symptoms, and future eating disorder onset. The present effectiveness trial tested whether this program…

The "10 Keys" to Healthy Aging: 24-Month Follow-Up Results from an Innovative Community-Based Prevention Program

ERIC Educational Resources Information Center

Robare, Joseph F.; Bayles, Constance M.; Newman, Anne B.; Williams, Kathy; Milas, Carole; Boudreau, Robert; McTigue, Kathleen; Albert, Steven M.; Taylor, Christopher; Kuller, Lewis H.

2011-01-01

The purpose of this report was to evaluate a prevention program to reduce risk factors for common diseases among older individuals in a lower income community. This randomized community-based study enrolled older adults into a Brief Education and Counseling Intervention or a Brief Education and Counseling Intervention plus a physical activity and…

New Millenium Program Serving Earth and Space Sciences

NASA Technical Reports Server (NTRS)

Li, Fuk

1999-01-01

A cross-Enterprise program is to identify and validate flight breakthrough technologies that will significantly benefit future space science and earth science missions. The breakthrough technologies are: enable new capabilities to meet earth and space science needs and reducing costs of future missions. The flight validation are: mitigates risks to first users and enables rapid technology infusion into future missions.

Risk Factors for Substance Misuse and Adolescents' Symptoms of Depression.

PubMed

Siennick, Sonja E; Widdowson, Alex O; Woessner, Mathew K; Feinberg, Mark E; Spoth, Richard L

2017-01-01

Depressive symptoms during adolescence are positively associated with peer-related beliefs, perceptions, and experiences that are known risk factors for substance misuse. These same risk factors are targeted by many universal substance misuse prevention programs. This study examined whether a multicomponent universal substance misuse intervention for middle schoolers reduced the associations between depressive symptoms, these risk factors, and substance misuse. The study used data from a place-randomized trial of the Promoting School-Community-University Partnerships to Enhance Resilience model for delivery of evidence-based substance misuse programs for middle schoolers. Three-level within-person regression models were applied to four waves of survey, and social network data from 636 adolescents followed from sixth through ninth grades. When adolescents in control school districts had more symptoms of depression, they believed more strongly that substance use had social benefits, perceived higher levels of substance misuse among their peers and friends, and had more friends who misused substances, although they were not more likely to use substances themselves. Many of the positive associations of depressive symptoms with peer-related risk factors were significantly weaker or not present among adolescents in intervention school districts. The Promoting School-Community-University Partnerships to Enhance Resilience interventions reduced the positive associations of adolescent symptoms of depression with peer-related risk factors for substance misuse. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Enhancing empowerment in eating disorder prevention: Another examination of the REbeL peer education model.

PubMed

Breithaupt, Lauren; Eickman, Laura; Byrne, Catherine E; Fischer, Sarah

2017-04-01

Previously validated eating disorder (ED) prevention programs utilize either a targeted or universal approach. While both approaches have shown to be efficacious, implementing either style of program within a school setting remains a challenge. The current study describes an enhanced version of REbeL, a module based, continuous ED prevention program which utilizes a self-selection model of prevention in high school settings. The purpose of this study was to determine if an enhanced empowerment model of REbeL could increase feelings of empowerment and reduce eating disorder risk. We also aimed to assess the feasibility and acceptability of the intervention. High school peer-educators self-selected into the semi-manualized dissonance based intervention. Following feedback from a pilot trailed, enhanced peer-led group activities, designed to critique the thin ideal and designed to empower macro-changes in societal structures that emphasize the thin ideal, were added. The study (N=83) indicates that the program appears to be effective at reducing eating disorder risk factors and increasing empowerment. Participants reported reductions in body checking and internalization of the thin ideal. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evidence-based HIV/STD prevention intervention for black men who have sex with men.

PubMed

Herbst, Jeffrey H; Painter, Thomas M; Tomlinson, Hank L; Alvarez, Maria E

2014-04-18

This report summarizes published findings of a community-based organization in New York City that evaluated and demonstrated the efficacy of the Many Men, Many Voices (3MV) human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention intervention in reducing sexual risk behaviors and increasing protective behaviors among black men who have sex with men (MSM). The intervention addressed social determinants of health (e.g., stigma, discrimination, and homophobia) that can influence the health and well-being of black MSM at high risk for HIV infection. This report also highlights efforts by CDC to disseminate this evidence-based behavioral intervention throughout the United States. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion to provide an example of a program that might be effective for reducing HIV infection- and STD-related disparities in the United States. 3MV uses small group education and interaction to increase knowledge and change attitudes and behaviors related to HIV/STD risk among black MSM. Since its dissemination by CDC in 2004, 3MV has been used in many settings, including health department- and community-based organization programs. The 3MV intervention is an important component of a comprehensive HIV and STD prevention portfolio for at-risk black MSM. As CDC continues to support HIV prevention programming consistent with the National HIV/AIDS Strategy and its high-impact HIV prevention approach, 3MV will remain an important tool for addressing the needs of black MSM at high risk for HIV infection and other STDs.

Risk taking and refusal assertiveness in a longitudinal model of alcohol use among inner-city adolescents.

PubMed

Epstein, J A; Griffin, K W; Botvin, G J

2001-09-01

Risk taking and refusal assertiveness have been shown to be important determinants of adolescent alcohol use. However, it remains unclear whether youth predisposed to risk taking would be less likely to assertively refuse. This study examined the relationships among risk taking, refusal assertiveness, and alcohol use in a sample of inner-city minority students (N = 1,459), using a cross-lagged longitudinal structural equation model. Data collectors administered the questionnaire to students following a standardized protocol during a 40-min class period. Based on the tested model, risk taking was more stable over time than refusal assertiveness. Furthermore, high risk takers reported less frequent subsequent refusal assertiveness, and less frequent refusal assertiveness predicted greater drinking. A predisposition toward risk taking appears to be an enduring characteristic that is associated with low refusal assertiveness and increased alcohol use. These findings suggest that alcohol prevention programs that emphasize refusal skills training may be less effective for high risk takers. But programs that focus on enhancing competence or reducing normative expectations for peer alcohol use might be more effective for high risk-taking youth.

Effects of perturbation or plyometric training on core control and knee joint loading in women during lateral movements.

PubMed

Weltin, E; Gollhofer, A; Mornieux, G

2017-03-01

Deficits in trunk control are argued to increase the risk of knee injuries. However, no existing training program effectively addresses trunk control during lateral movements, such as cutting maneuvers. The purpose of this study was to investigate whether a combination of perturbation and plyometric training (PPT) would reduce trunk excursions against the new movement direction and reduce knee joint moments during lateral movements. Twenty-four active women participated in a RCT, where trunk and pelvis kinematics and knee joint moments were measured during lateral reactive jumps (LRJ) and unanticipated cutting maneuvers before and after a 4-week PPT program and compared to a control group. During LRJ, trunk rotation away from the new movement direction was reduced (P < 0.001), while pelvis rotation toward the new direction was increased (P = 0.006) after PPT. Moreover, decreased knee extension moments (P = 0.028) and knee internal rotation moments (P < 0.001) were reported after both trainings. Additionally, PPT reduced trunk rotation by 7.2° during unanticipated cuttings. A 4-week PPT improved core control by reducing trunk rotation and reduced knee joint moments during LRJ. During training, perturbations should be introduced to improve core control during dynamic athletic movements, possibly reducing the risk of ACL injuries. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Community-based participatory research to design a faith-enhanced diabetes prevention program: The Better Me Within randomized trial.

PubMed

Kitzman, Heather; Dodgen, Leilani; Mamun, Abdullah; Slater, J Lee; King, George; Slater, Donna; King, Alene; Mandapati, Surendra; DeHaven, Mark

2017-11-01

Reducing obesity positively impacts diabetes and cardiovascular risk; however, evidence-based lifestyle programs, such as the diabetes prevention program (DPP), show reduced effectiveness in African American (AA) women. In addition to an attenuated response to lifestyle programs, AA women also demonstrate high rates of obesity, diabetes, and cardiovascular disease. To address these disparities, enhancements to evidence-based lifestyle programs for AA women need to be developed and evaluated with culturally relevant and rigorous study designs. This study describes a community-based participatory research (CBPR) approach to design a novel faith-enhancement to the DPP for AA women. A long-standing CBPR partnership designed the faith-enhancement from focus group data (N=64 AA adults) integrating five components: a brief pastor led sermon, memory verse, in class or take-home faith activity, promises to remember, and scripture and prayer integrated into participant curriculum and facilitator materials. The faith components were specifically linked to weekly DPP learning objectives to strategically emphasize behavioral skills with religious principles. Using a CBPR approach, the Better Me Within trial was able to enroll 12 churches, screen 333 AA women, and randomize 221 (M age =48.8±11.2; M BMI =36.7±8.4; 52% technical or high school) after collection of objective eligibility measures. A prospective, randomized, nested by church, design will be used to evaluate the faith-enhanced DPP as compared to a standard DPP on weight, diabetes and cardiovascular risk, over a 16-week intervention and 10-month follow up. This study will provide essential data to guide enhancements to evidence-based lifestyle programs for AA women who are at high risk for chronic disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Perceived Benefits and Challenges of Coordinated Approaches to Chronic Disease Prevention in State Health Departments

PubMed Central

Sequeira, Sonia; Best, Leslie; Jones, Ellen; Baker, Elizabeth A.; Brownson, Ross C.

2014-01-01

Introduction Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding. Methods A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ2 tests, and analysis of variance were conducted. Results The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges “lack of communication across programs” (P = .02) and “funding might be reduced” differed by program area (P < .001). Conclusion Findings can be used by funding agencies and state health departments for planning, training, and technical assistance. The information on perceived challenges demonstrates the need to improve communication across programs, enhance organizational support for coordinated approaches, and create benefits for organizational partners. PMID:24809362

Couples-Focused Prevention Program to Reduce HIV Risk Among Transgender Women and Their Primary Male Partners: Feasibility and Promise of the Couples HIV Intervention Program.

PubMed

Operario, Don; Gamarel, Kristi E; Iwamoto, Mariko; Suzuki, Sachico; Suico, Sabrina; Darbes, Lynae; Nemoto, Tooru

2017-08-01

HIV risk among transgender women has been attributed to condomless sex with primary male partners. This study pilot tested a couples-focused HIV intervention program for transgender women and their primary male partners. We analyzed data from 56 transgender women and their male partners (n = 112 participants) who were randomized as a couple to one of two groups. Participants in the intervention group (27 couples) received 3 counseling sessions: 2 couples-focused sessions, which discussed relationship dynamics, communication, and HIV risk, and 1 individual-focused session on HIV prevention concerns. Participants in the control group (29 couples) received 1 session on general HIV prevention information delivered to both partners together. At 3-month follow-up, participants in the intervention reported lower odds of condomless sex with primary partners (OR 0.5, 95 % CI 0.3-1.0), reduced odds of engaging in sex with a casual partner (OR 0.3, 95 % CI 0.1-1.0), and reduction in the number of casual partners (B = -1.45, SE = 0.4) compared with the control group. Findings provide support for the feasibility and promise of a couples-focused HIV prevention intervention for transgender women and their primary male partners.

Tips on establishing a robotics program in an academic setting.

PubMed

Steers, William D

2006-02-17

Over the past 5 years, robotic-assisted laparoscopic surgery has gone from being a novelty to an accepted approach for intra-abdominal and pelvic surgery. Driving this trend has been the large number of robotic-assisted laparoscopic prostatectomies performed throughout the U.S. Nearly a quarter of the prostatectomies done for prostate cancer in the U.S. in 2006 will use robotic assistance, yet reports fail to confirm cost effectiveness. The most important predictor of a successful program is a champion at the institution. Studies have demonstrated safety and immediate benefits with regard to reduced surgical morbidity such as pain, loss of work, quality of life, and blood loss for a variety of surgeries patients. Specific to prostatectomy for cancer, long-term data on biochemical (PSA) failures and cancer cures, as well as validated secondary outcomes for continence and potency, are still unavailable. Benefits accrue for the surgeon as well with improved ergonomics and potential extension of a surgical career. Yet, enthusiasm for robotics must be tempered by this lack of data and economic limitations. However, if a thoughtful and thorough process in initiating a robotic program is undertaken, the risks to the institution can be minimized. With proper training, the risk to the patient is reduced and with due diligence with regard to market and operative resources, the risk to the surgeon can be eliminated. This report reviews the steps to assess, plan, initiate, and maintain a robotics program at an academic institution with the hope that other programs can benefit from lessons acquired by early adopters of this expensive technology.

Tips on Establishing a Robotics Program in an Academic Setting

PubMed Central

Steers, William D.

2006-01-01

Over the past 5 years, robotic-assisted laparoscopic surgery has gone from being a novelty to an accepted approach for intra-abdominal and pelvic surgery. Driving this trend has been the large number of robotic-assisted laparoscopic prostatectomies performed throughout the U.S. Nearly a quarter of the prostatectomies done for prostate cancer in the U.S. in 2006 will use robotic assistance, yet reports fail to confirm cost effectiveness. The most important predictor of a successful program is a champion at the institution. Studies have demonstrated safety and immediate benefits with regard to reduced surgical morbidity such as pain, loss of work, quality of life, and blood loss for a variety of surgeries patients. Specific to prostatectomy for cancer, long-term data on biochemical (PSA) failures and cancer cures, as well as validated secondary outcomes for continence and potency, are still unavailable. Benefits accrue for the surgeon as well with improved ergonomics and potential extension of a surgical career. Yet, enthusiasm for robotics must be tempered by this lack of data and economic limitations. However, if a thoughtful and thorough process in initiating a robotic program is undertaken, the risks to the institution can be minimized. With proper training, the risk to the patient is reduced and with due diligence with regard to market and operative resources, the risk to the surgeon can be eliminated. This report reviews the steps to assess, plan, initiate, and maintain a robotics program at an academic institution with the hope that other programs can benefit from lessons acquired by early adopters of this expensive technology. PMID:17619728

Feasibility of community-based screening for cardiovascular disease risk in an ethnic community: the South Asian Cardiovascular Health Assessment and Management Program (SA-CHAMP).

PubMed

Jones, Charlotte A; Nanji, Alykhan; Mawani, Shefina; Davachi, Shahnaz; Ross, Leanne; Vollman, Ardene; Aggarwal, Sandeep; King-Shier, Kathryn; Campbell, Norman

2013-02-21

South Asian Canadians experience disproportionately high rates of cardiovascular disease (CVD). The goal of this qualitative study was to determine the feasibility of implementing a sustainable, culturally adapted, community-based CVD risk factor screening program for this population. South Asians (≥ 45 years) in Calgary, Alberta underwent opportunistic cardiovascular risk factor screening by lay trained volunteers at local religious facilities. Those with elevated blood pressure (BP) or ≥ 1 risk factor underwent point of care cholesterol testing, 10-year CVD risk calculation, counseling, and referral to family physicians and local culturally tailored chronic disease management (CDM) programs. Participants were invited for re-screening and were surveyed about health system follow-up, satisfaction with the program and suggestions for improvement. Changes in risk factors from baseline were estimated using McNemar's test (proportions) and paired t-tests (continuous measures). Baseline assessment was completed for 238 participants (median age 64 years, 51% female). Mean TC, HDL and TC/HDL were 5.41 mmol/L, 1.12 mmol/L and 4.7, respectively. Mean systolic and diastolic blood pressures (mmHg) were 129 and 75 respectively. Blood pressure and TC/HDL ratios exceeded recommended targets in 36% and 58%, respectively, and 76% were at high risk for CVD. Ninety-nine participants (47% female) attended re-screening. 82% had accessed health care providers, 22% reported medication changes and 3.5% had attended the CDM programs. While BP remained unchanged, TC and TC/HDL decreased and HDL increased significantly (mean differences: -0.52 mmol/L, -1.04 and +0.07 mmol/L, respectively). Participants were very satisfied (80%) or satisfied (20%) with the project. Participants suggested screening sessions and CDM programs be more accessible by: delivering evening or weekends programs at more sites, providing transportation, offering multilingual programs/translation assistance, reducing screening wait times and increasing numbers of project staff. SA-CHAMP demonstrated the feasibility and value of implementing a lay volunteer-led, culturally adapted, sustainable community-based CVD risk factor screening program in South Asian places of worship in Calgary, Alberta, Canada. Subsequent screening and CDM programs were refined based on the learnings from this study. Further research is needed to determine physician and patient factors associated with uptake of and adherence to risk reduction strategies.

Space Launch System (SLS) Program Overview NASA Research Announcement (NRA) Advanced Booster (AB) Engineering Demonstration and Risk Reduction (EDRR) Industry Day

NASA Technical Reports Server (NTRS)

May, Todd A.

2011-01-01

SLS is a national capability that empowers entirely new exploration for missions of national importance. Program key tenets are safety, affordability, and sustainability. SLS builds on a solid foundation of experience and current capacities to enable a timely initial capability and evolve to a flexible heavy-lift capability through competitive opportunities: (1) Reduce risks leading to an affordable Advanced Booster that meets the evolved capabilities of SLS (2) Enable competition by mitigating targeted Advanced Booster risks to enhance SLS affordability and performance The road ahead promises to be an exciting journey for present and future generations, and we look forward to working with you to continue America fs space exploration.

The role of exercise in fall prevention for older adults.

PubMed

Rose, Debra J; Hernandez, Danielle

2010-11-01

This article reviews the evidence for the effectiveness of stand-alone exercise interventions and multifactorial intervention strategies that include exercise in lowering fall incidence rates and/or fall risk among older adults residing in the community, acute, subacute, and long-term care settings. Stand-alone exercise programs that emphasize multiple exercise categories are effective in reducing fall rates and fall risk in community-residing older adults, and may also be effective when conducted for a sufficient duration with older adult patients in subacute settings. In contrast, multifactorial fall risk reduction programs that include exercise as a component and are delivered by a multidisciplinary team are more effective in lowering fall rates in long-term care settings. Copyright © 2010 Elsevier Inc. All rights reserved.

Putting a premium on medical staffs. A novel way to insure physician liability (and loyalty).

PubMed

Jones, T M; O'Hare, P K

1989-05-01

The physician malpractice insurance crisis is having an adverse financial impact on both hospitals and their medical staffs. Innovative hospitals are exploring ways to create insurance arrangements to cover the professional liability of their medical staffs. Hospital risk managers often have theorized that if the same insurer covered both hospitals and their staff physicians, providers and their patients would benefit. These programs--often referred to as "channeling" or "channeled programs"--use a common risk management program, common claims administration, and a common claims defense for insured hospitals and their medical staffs, reducing costs, unfavorable verdicts, and, thus, premiums. Unfortunately only a few commercial carriers now offer such a program. Some hospitals and systems have therefore turned to "captive" insurance companies to provide the benefits of a channeled program. Hospitals or systems and their medical staffs can establish a captive (i.e., a controlled insurance company designed to insure its owners and their affiliates) either offshore (typically in a tax-free jurisdiction such as the Cayman Islands, Barbados, or Bermuda) or onshore (typically in a state with facilitating legislation). The Tax Reform Act of 1986, together with the Liability Risk Retention Act of 1986, generally tips the regulatory balance in favor of onshore captives by allowing these entities to operate as risk retention groups (RRGs).

Current Risk Management Practices in Psychotherapy Supervision.

PubMed

Mehrtens, Ilayna K; Crapanzano, Kathleen; Tynes, L Lee

2017-12-01

Psychotherapy competence is a core skill for psychiatry residents, and psychotherapy supervision is a time-honored approach to teaching this skill. To explore the current supervision practices of psychiatry training programs, a 24-item questionnaire was sent to all program directors of Accreditation Council for Graduate Medical Education (ACGME)-approved adult psychiatry programs. The questionnaire included items regarding adherence to recently proposed therapy supervision practices aimed at reducing potential liability risk. The results suggested that current therapy supervision practices do not include sufficient management of the potential liability involved in therapy supervision. Better protections for patients, residents, supervisors and the institutions would be possible with improved credentialing practices and better documentation of informed consent and supervision policies and procedures. © 2017 American Academy of Psychiatry and the Law.

Effective health care corporate compliance.

PubMed

Saum, T B; Byassee, J

2000-01-01

The pace and intensity of oversight and investigation of health care organizations has greatly increased at all levels. Well run organizations with ethical management committed to following all laws and regulations are still at risk for compliance violations and punitive penalties. Under the Federal Sentencing Guidelines, organizations with an "effective" corporate compliance program may receive reduced penalties. The seven components of an effective program as defined in the guidelines are: (1) Standards and procedures; (2) oversight responsibilities; (3) employee training; (4) monitoring and auditing; (5) reporting systems; (6) enforcement and discipline; and (7) response and prevention. Lack of a compliance program needlessly exposes the organization to an avoidable risk of damage from non-compliance--whether intentional or not. Moreover, an effective program can contribute to the efficient operation of the organization and be a key piece of its corporate culture.

Cost effectiveness of a smoking cessation program in patients admitted for coronary heart disease.

PubMed

Quist-Paulsen, Petter; Lydersen, Stian; Bakke, Per S; Gallefoss, Frode

2006-04-01

Smoking cessation is probably the most important action to reduce mortality after a coronary event. Smoking cessation programs are not widely implemented in patients with coronary heart disease, however, possibly because they are thought not to be worth their costs. Our objectives were to estimate the cost effectiveness of a smoking cessation program, and to compare it with other treatment modalities in cardiovascular medicine. A cost-effectiveness analysis was performed on the basis of a recently conducted randomized smoking cessation intervention trial in patients admitted for coronary heart disease. The cost per life year gained by the smoking cessation program was derived from the resources necessary to implement the program, the number needed to treat to get one additional quitter from the program, and the years of life gained if quitting smoking. The cost effectiveness was estimated in a low-risk group (i.e. patients with stable coronary heart disease) and a high-risk group (i.e. patients after myocardial infarction or unstable angina), using survival data from previously published investigations, and with life-time extrapolation of the survival curves by survival function modeling. In a lifetime perspective, the incremental cost per year of life gained by the smoking cessation program was euro 280 and euro 110 in the low and high-risk group, respectively (2000 prices). These costs compare favorably to other treatment modalities in patients with coronary heart disease, being approximately 1/25 the cost of both statins in the low-risk group and angiotensin-converting enzyme inhibitors in the high-risk group. In a sensitivity analysis, the costs remained low in a wide range of assumptions. A nurse-led smoking cessation program with several months of intervention is very cost-effective compared with other treatment modalities in patients with coronary heart disease.

Preventing cardiovascular disease in primary care: role of a national risk factor management program.

PubMed

McGrath, Emer R; Glynn, Liam G; Murphy, Andrew W; O Conghaile, Aengus; Canavan, Michelle; Reid, Claire; Moloney, Brian; O'Donnell, Martin J

2012-04-01

Heartwatch, a structured risk factor modification program for secondary prevention of cardiovascular (CV) disease (CVD) in primary care, is associated with improvements in CV risk factors in participating patients. However, it is not known whether Heartwatch translates into reductions in clinically important CV events. The aim of the study was to determine the association between participation in Heartwatch and future risk of CV events in patients with CVD. The study consisted of a prospective cohort of 1,609 patients with CVD in primary care practices. Of these, 97.5% had data available on Heartwatch participation status, of whom 15.2% were Heartwatch participants. Cox proportional hazards models were used to determine the association between Heartwatch participation and risk of the CV composite (CV death, nonfatal myocardial infarction, heart failure, and nonfatal stroke). All-cause mortality and CV mortality were secondary outcome measures. During follow-up, the CV composite occurred in 208 patients (13.6%). Of Heartwatch participants, 8.4% experienced the CV composite compared with 14.5% of nonparticipants (P = .003). Participation in Heartwatch was associated with a significantly reduced risk of the CV composite (hazard ratio [HR] 0.52, 95% CI, 0.31-0.87), CV mortality (HR 0.31, 95% CI, 0.11-0.89), and all-cause mortality (HR 0.32, 95% CI, 0.15-0.68). Heartwatch participation was also associated with greater reductions in mean systolic blood pressure (P = .047), mean diastolic blood pressure (P < .001), and greater use of secondary preventative therapies for CVD, such as lipid-lowering agents (P < .001), β-blockers (P < .001), and angiotensin-converting enzyme inhibitors (P < .001). Heartwatch is associated with a reduced risk of major vascular events and improved risk factor modification, supporting its potential as a nationwide program for secondary prevention of CVD. Copyright © 2012 Mosby, Inc. All rights reserved.

Different Approaches for Ensuring Performance/Reliability of Plastic Encapsulated Microcircuits (PEMs) in Space Applications

NASA Technical Reports Server (NTRS)

Gerke, R. David; Sandor, Mike; Agarwal, Shri; Moor, Andrew F.; Cooper, Kim A.

2000-01-01

Engineers within the commercial and aerospace industries are using trade-off and risk analysis to aid in reducing spacecraft system cost while increasing performance and maintaining high reliability. In many cases, Commercial Off-The-Shelf (COTS) components, which include Plastic Encapsulated Microcircuits (PEMs), are candidate packaging technologies for spacecrafts due to their lower cost, lower weight and enhanced functionality. Establishing and implementing a parts program that effectively and reliably makes use of these potentially less reliable, but state-of-the-art devices, has become a significant portion of the job for the parts engineer. Assembling a reliable high performance electronic system, which includes COTS components, requires that the end user assume a risk. To minimize the risk involved, companies have developed methodologies by which they use accelerated stress testing to assess the product and reduce the risk involved to the total system. Currently, there are no industry standard procedures for accomplishing this risk mitigation. This paper will present the approaches for reducing the risk of using PEMs devices in space flight systems as developed by two independent Laboratories. The JPL procedure involves primarily a tailored screening with accelerated stress philosophy while the APL procedure is primarily, a lot qualification procedure. Both Laboratories successfully have reduced the risk of using the particular devices for their respective systems and mission requirements.

Towards Prevention of Breast Cancer: What Are the Clinical Challenges?

PubMed

Borgquist, Signe; Hall, Per; Lipkus, Isaac; Garber, Judy E

2018-05-01

The dramatic increase in breast cancer incidence compels a paradigm shift in our preventive efforts. There are several barriers to overcome before prevention becomes an established part of breast cancer management. The objective of this review is to identify the clinical challenges for improved breast cancer prevention and discuss current knowledge on breast cancer risk assessment methods, risk communication, ethics, and interventional efforts with the aim of covering the aspects relevant for a breast cancer prevention trial. Herein, the following five areas are discussed: (i) Adequate tools for identification of women at high risk of breast cancer suggestively entitled Prevent! Online. (ii) Consensus on the definition of high risk, which is regarded as mandatory for all risk communication and potential prophylactic interventions. (iii) Risk perception and communication regarding risk information. (iv) Potential ethical concerns relevant for future breast cancer prevention programs. (v) Risk-reducing programs involving multileveled prevention depending on identified risk. Taken together, devoted efforts from both policy makers and health care providers are warranted to improve risk assessment and risk counseling in women at risk for breast cancer to optimize the prevention of breast cancer. Cancer Prev Res; 11(5); 255-64. ©2018 AACR . ©2018 American Association for Cancer Research.

A lifestyle intervention program for successfully addressing major cardiometabolic risks in persons with SCI: a three-subject case series.

PubMed

Bigford, Gregory E; Mendez, Armando J; Betancourt, Luisa; Burns-Drecq, Patricia; Backus, Deborah; Nash, Mark S

2017-01-01

This study is a prospective case series analyzing the effects of a comprehensive lifestyle intervention program in three patients with chronic paraplegia having major risks for the cardiometabolic syndrome (CMS). Individuals underwent an intense 6-month program of circuit resistance exercise, nutrition using a Mediterranean diet and behavioral support, followed by a 6-month extension (maintenance) phase involving minimal support. The primary goal was a 7% reduction of body mass. Other outcomes analyzed insulin resistance using the HOMA-IR model, and plasma levels of fasting triglycerides and high-density lipoprotein cholesterol. All participants achieved the goal for 7% reduction of body mass and maintained the loss after the MP. Improvements were observed in 2/3 subjects for HOMA-IR and high-density lipoprotein cholesterol. All participants improved their risk for plasma triglycerides. We conclude, in a three-person case series of persons with chronic paraplegia, a lifestyle intervention program involving circuit resistance training, a calorie-restrictive Mediterranean-style diet and behavioral support, results in clinically significant loss of body mass and effectively reduced component risks for CMS and diabetes. These results were for the most part maintained after a 6-month MP involving minimal supervision.