Sample records for specific preventive measures

  1. A systematic review of the literature on safety measures to prevent railway suicides and trespassing accidents.

    PubMed

    Havârneanu, Grigore M; Burkhardt, Jean-Marie; Paran, Françoise

    2015-08-01

    This review covers a central aspect in railway safety which is the prevention of suicides and trespassing accidents. The paper attempts to answer the following research question: 'What measures are available to reduce railway suicide and trespass, and what is the evidence for their effectiveness?' The review is based on 139 relevant publications, ranging from 1978 to 2014. The analysis aimed to identify the past and current trend in the prevention practice by looking both quantitatively and qualitatively at the recommended measures. According to the results, there has been a constant focus on suicide prevention, and only relatively recent interest in trespass countermeasures. The content analysis revealed 19 main preventative categories which include more than 100 specific measures. We identified 16 common categories against railway suicide and trespass, and 3 categories of specific measures to prevent suicide. There are only 22 studies which provide empirical support for the effectiveness of measures. Actual combinations of measures are barely evaluated, but several challenges emerge from the literature. The discussion focuses on the need for a unified approach to suicide and trespass prevention, and on the importance to consider the effect mechanism of the measures in order to design better interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. A trial of a job-specific workers' health surveillance program for construction workers: study protocol

    PubMed Central

    2011-01-01

    Background Dutch construction workers are offered periodic health examinations. This care can be improved by tailoring this workers health surveillance (WHS) to the demands of the job and adjust the preventive actions to the specific health risks of a worker in a particular job. To improve the quality of the WHS for construction workers and stimulate relevant job-specific preventive actions by the occupational physician, we have developed a job-specific WHS. The job-specific WHS consists of modules assessing both physical and psychological requirements. The selected measurement instruments chosen, are based on their appropriateness to measure the workers' capacity and health requirements. They include a questionnaire and biometrical tests, and physical performance tests that measure physical functional capabilities. Furthermore, our job-specific WHS provides occupational physicians with a protocol to increase the worker-behavioural effectiveness of their counselling and to stimulate job-specific preventive actions. The objective of this paper is to describe and clarify our study to evaluate the behavioural effects of this job-specific WHS on workers and occupational physicians. Methods/Design The ongoing study of bricklayers and supervisors is a nonrandomised trial to compare the outcome of an intervention (job-specific WHS) group (n = 206) with that of a control (WHS) group (n = 206). The study includes a three-month follow-up. The primary outcome measure is the proportion of participants who have undertaken one or more of the preventive actions advised by their occupational physician in the three months after attending the WHS. A process evaluation will be carried out to determine context, reach, dose delivered, dose received, fidelity, and satisfaction. The present study is in accordance with the TREND Statement. Discussion This study will allow an evaluation of the behaviour of both the workers and occupational physician regarding the preventive actions undertaken by them within the scope of a job-specific WHS. Trial registration NTR3012 PMID:21958019

  3. Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review.

    PubMed

    Pássaro, Leonor; Harbarth, Stephan; Landelle, Caroline

    2016-01-01

    Pneumonia is one of the leading hospital-acquired infections worldwide and has an important impact. Although preventive measures for ventilator-associated pneumonia (VAP) are well known, less is known about appropriate measures for prevention of hospital-acquired pneumonia (HAP). The purpose of this narrative review is to provide an overview of the current standards for preventing HAP in non-ventilated adult patients. A search of the literature up to May 2015 was conducted using Medline for guidelines published by national professional societies or professional medical associations. In addition, a comprehensive search for the following preventive measures was performed: hand hygiene, oral care, bed position, mobilization, diagnosis and treatment of dysphagia, aspiration prevention, viral infections and stress bleeding prophylaxis. Regarding international guidelines, several measures were recommended for VAP, whilst no specific recommendations for HAP prevention in non-ventilated patients are available. There is reasonable evidence available that oral care is associated with a reduction in HAP. Early mobilization interventions, swift diagnosis and treatment of dysphagia, and multimodal programmes for the prevention of nosocomial influenza cross-infection, have a positive impact on HAP reduction. The impact of bed position and stress bleeding prophylaxis remains uncertain. Systematic antibiotic prophylaxis for HAP prevention should be avoided. Scant literature and little guidance is available for the prevention of HAP among non-ventilated adult patients. In addition, the criteria used for the diagnosis of HAP and the populations targeted in the studies selected are heterogeneous. Oral care was the most studied measure and was commonly associated with a decrease in HAP rate, although a broad range of interventions are proposed. No robust evidence is available for other measures. Further high-quality studies are required to evaluate the impact of specific measures on HAP prevention in non-ventilated adult patients.

  4. Validity Evidence for the Use of the Preventive Resources Inventory with College Students

    ERIC Educational Resources Information Center

    Lambert, Richard G.; McCarthy, Christopher J.; Gilbert, Trae; Sebree, Mikaela; Steinley-Bumgarner, Michelle

    2006-01-01

    Measurement properties of scores from the Preventive Resources Inventory (C. J. McCarthy & R. G. Lambert, 2001), a measure of stress-prevention resources, were evaluated. Sample-specific construct validity of 3 primary scales was supported. A 4th, Self-Acceptance, functioned as a higher order factor. Differences were found between those reporting…

  5. [Surface disinfection in the context of infection prevention in intensive care units].

    PubMed

    Kossow, A; Schaber, S; Kipp, F

    2013-03-01

    The highest proportion of nosocomial infections occurs on intensive care units (ICU) and infections with multiresistant pathogens are an ever increasing problem. Preventative measures should consist of a bundle of different measures including measures that address a specific problem and standard hygiene measures that are relevant in all areas. Specific measures in ICUs primarily aim at the prevention of ventilator associated pneumonia, blood vessel catheter associated infections and nosocomial urinary tract infections. Surface disinfection belongs to the standard hygiene measures and plays an inferior role compared to hand hygiene; however, surfaces come into focus in outbreak situations. The Commission on Hospital Hygiene (KRINKO) at the Robert Koch Institute (the German health protection agency) published recommendations regarding the cleaning and disinfection of surfaces. The frequency with which cleaning and/or disinfection is required varies according to defined areas of risk. The frequency and the disinfection agents used are documented in the disinfection plan.

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

    PubMed

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

    2015-01-01

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

  7. Public Attitudes towards Prevention of Obesity

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    1998-02-01

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

  9. Primary prevention of psychiatric illness in special populations.

    PubMed

    Sajatovic, Martha; Sanders, Renata; Alexeenko, Lada; Madhusoodanan, Subramoniam

    2010-11-01

    Some populations appear to be particularly vulnerable to the development of psychiatric symptomatology related to life events and biologic or social/cultural factors. Such groups include individuals who have experienced traumatic events, military personnel, individuals with serious medical conditions, postpartum women, and immigrants. This study reviews the literature regarding primary prevention of psychiatric disorders in special populations and identifies a variety of universal, selective, and indicated prevention measures aimed at minimizing the psychiatric sequelae in these groups. The authors reviewed the literature regarding the prevention of psychiatric symptoms in trauma/abuse victims, individuals in the military, oncology patients, patients with diabetes, pregnant/postpartum women, and immigrants. The literature on primary prevention of psychiatric illness in the special populations identified is rather limited. Universal prevention may be beneficial in some instances through public awareness campaigns and disaster planning. In other instances, more specific and intensive interventions for individuals at high risk of psychiatric illness may improve outcomes, for example, crisis counseling for those who have experienced severe trauma. Primary prevention of psychiatric illness may be an attainable goal via implementation of specific universal, selected, and indicated primary prevention measures in special populations.

  10. Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: A systematic review of the literature.

    PubMed

    Kilic, O; Maas, M; Verhagen, E; Zwerver, J; Gouttebarge, V

    2017-07-01

    Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies.

  11. Pathway to Prevention of Nosocomial Clostridium difficile Infection.

    PubMed

    Goldstein, Ellie J C; Johnson, Stuart; Maziade, Pierre-Jean; McFarland, Lynne V; Trick, William; Dresser, Linda; Millette, Mathieu; Mazloum, Hadi; Low, Donald E

    2015-05-15

    To address the significant morbidity and mortality rates associated with nosocomial Clostridium difficile-associated diarrhea (CDAD), a series of recommendations and a pathway to prevention were developed. An expert panel of infectious disease (ID) specialists participated in a modified Delphi process with specific objectives: (1) conduct a review for CDAD and prevention; (2) develop statements based upon panel members' opinions; (3) hold a panel meeting during the 2012 IDWeek; and (4) review the final recommendations and prevention pathway prior to submission for publication. The panel voted on (1) antibiotic stewardship (7 of 8 panelists); (2) reduction of other potentially modifiable risk factors (variable); (3) utilization of specific probiotics to prevent C. difficile overgrowth (8/8); (4) staff education regarding CDAD preventive measures (8/8); (5) appropriate hand hygiene for everyone (7/8); (6) environmental cleaning (8/8); (7) medical equipment disinfection (7/8); (8) early detection of CDAD in symptomatic patients (7/8); (9) usage of protective clothing/gloves (8/8); (10) proper measures during outbreak (8/8); and (11) surveillance to monitor efficacy data of preventive measures (8/8). The panel members agreed with 11 of 17 recommendations presented. The additional recommendations by the panel were proton pump inhibitor use as a risk factor and the use of adjunctive therapy with specific probiotic, as it was approved by Health Canada for the risk reduction of CDAD in hospitalized patients. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  12. Examination of Preventive Resources, Life Events, and Coping Strategies.

    ERIC Educational Resources Information Center

    McCarthy, Christopher J.; Lambert, Richard G.; Beard, Michelle; Canipe, Kara

    The Preventive Coping Resources Inventory (PRI) was developed to assess specific coping resources most useful for stress prevention and also applicable to education settings. Undergraduates (N=501) at a large, southwestern university completed the inventory and other measures of adjustment and coping. Exploratory factor analysis revealed five…

  13. The 'Sequence of Prevention' for musculoskeletal injuries among recreational basketballers: a systematic review of the scientific literature.

    PubMed

    Kilic, Özgür; Van Os, Vivian; Kemler, Ellen; Barendrecht, Maarten; Gouttebarge, Vincent

    2018-05-01

    Currently, there is no overview of the incidence and (basketball-specific) risk factors of musculoskeletal injuries among recreational basketball players, nor any insight into the effect of preventive measures on the incidence of basketball injuries. This study aimed to gather systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures for musculoskeletal injuries among recreational basketball players. Highly sensitive search strategies were built based on three groups of keywords (and related search terms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The incidence of musculoskeletal injuries among recreational basketball players ranged from 0.0047 injuries per 1,000 athlete-exposures (AE) for dental injuries to 10.1 injuries per 1000 AE for overall injuries during match play. Significant risk factors for injuries were defending, postural sway, high vertical ground reaction force during jumping and weight >75 kg. All prevention studies have shown to have a significant effect on reducing the risk of injury ranging from an odds ratio (95% confidence interval (CI)) of 0.175 (0.049-0.626) for training injuries and a relative risk (95% CI) of 0.83 (0.57-1.19) achieved with FIFA 11+ prevention exercises and sport-specific balance training, relatively. In order to gain insight in the aetiology of basketball-specific injuries and consequently facilitate the development of preventive strategies, more high quality basketball-specific and injury-specific studies among recreational basketball players are needed.

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

    PubMed

    Wilson, Kenneth C; Merli, Geno J

    2011-10-01

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

  15. Prevention of nosocomial infection in the ICU setting.

    PubMed

    Corona, A; Raimondi, F

    2004-05-01

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

  16. Fleet equipment performance measure preventive maintenance model.

    DOT National Transportation Integrated Search

    2013-02-28

    The Texas Department of Transportation : (TxDOT) operates a large fleet of on-road and : off-road equipment. Consequently, fleet : maintenance procedures (specifically preventive : maintenance such as oil changes) represent a : significant cost to th...

  17. Proactive prevention in occupational safety and health: how to identify tomorrow's prevention priorities and preventive measures.

    PubMed

    Hauke, Angelika; Flaspöler, Eva; Reinert, Dietmar

    2018-04-17

    Global trends such as digitalisation, globalisation and demographic change are changing workplaces, and accordingly occupational safety and health (OSH) needs. To better prepare for the future and to foster proactive prevention, the German Social Accident Insurance (DGUV) established an OSH risk observatory (RO OSH). The RO OSH relies on an online survey and calls upon the expertise of labour inspectors. 398 labour inspectors participated in the first RO OSH enquiry. They rated developments with regard to their sector-specific relevance for OSH in the near future. The RO OSH also provides ideas for preventive measures that can be implemented by the German Social Accident Insurance Institutions. Work intensity, demographic aspects, and digitalisation play a major role for most or all sectors. However, familiar OSH issues such as musculoskeletal strain and noise also continue to be of major importance and require further consideration and specific solutions in prevention. For the DGUV, training and consulting bear great potential for proactive prevention in the above priority areas, e.g. by fostering a prevention culture and supporting companies in (psychosocial) risk assessment (also for mobile work). For instance, concepts for increasing physical activity at sedentary workplaces, and data security require continued research.

  18. AIDS Education under Democracy: Gay Men, Sexual Dissent, and the Limits of Prevention.

    ERIC Educational Resources Information Center

    Rofes, Eric

    This paper reviews past and current Acquired Immune Deficiency Syndrome (AIDS) education and prevention efforts, describes three specific phases of efforts, and analyzes AIDS education and prevention in relation to emancipatory models of education. First the paper reviews data measuring the transmission of Human Immunodeficiency Virus (HIV) among…

  19. Healthy People. The Surgeon General's Report on Health Promotion and Disease Prevention.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Rockville, MD.

    The purpose of this report is to enhance both individual and national perspectives on prevention of ill health and premature death through identification of priorities and specification of measureable goals. Health problems for every age group from infancy through old age are discussed with suggestions for prevention and improvement of…

  20. Associations Between Availability and Coverage of HIV-Prevention Measures and Subsequent Incidence of Diagnosed HIV Infection Among Injection Drug Users

    PubMed Central

    Likatavičius, Giedrius; Klempová, Danica; Hedrich, Dagmar; Nardone, Anthony; Griffiths, Paul

    2009-01-01

    HIV-prevention measures specific to injection drug users (IDUs), such as opioid substitution treatment and needle-and-syringe programs, are not provided in many countries where injection drug use is endemic. We describe the incidence of diagnosed HIV infection in IDUs and the availability and coverage of opioid substitution and needle-and-syringe programs in the European Union and 5 middle- and high-income countries. Countries with greater provision of both prevention measures in 2000 to 2004 had lower incidence of diagnosed HIV infection in 2005 and 2006. PMID:19372511

  1. Preventing Infectious Disease in Sports.

    ERIC Educational Resources Information Center

    Howe, Warren B.

    2003-01-01

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

  2. Solving Power Tool Problems in the School Shop

    ERIC Educational Resources Information Center

    Irvin, Daniel W.

    1976-01-01

    The school shop instructor is largely responsible for the preventive maintenance of power tools. These preventive measures primarily involve proper alignment, good lubrication, a reasonable maintenance program, and good operating procedures. Suggestions for maintenance of specific equipment is provided. (Author/BP)

  3. Assessment of practices, capacities and incentives of poultry chain actors in implementation of highly pathogenic avian influenza mitigation measures in Ghana.

    PubMed

    Turkson, Paa Kobina; Okike, Iheanacho

    2016-02-01

    The animal health services-seeking behaviour of animal owners related to prevention and control of animal diseases may influence their decisions as to whether or not to use services provided by the public or private sectors. The specific objective of this paper was to assess the practices, capacities and incentives of actors involved in highly pathogenic avian influenza (HPAI) control to provide information for prevention and control in Ghana. Questionnaires were designed based on specific practices, incentives and capacities associated with each mitigation measure that was being assessed. Two peacetime preventive mitigation measures (biosecurity and reporting) and two outbreak containment measures (culling with compensation and movement control) were selected for evaluation. Supply chain actors were characterised based on baseline information. Tables were generated showing proportions of respondents in the various response categories in Likert-scale type itemised questionnaire. Mean scores (and their standard deviations) for the various actors with regard to mitigation measures were calculated. Pair-wise comparisons were done using t -ratio statistic and significance of differences were determined at a Bonferroni adjusted P -value of 0.0024. The study found statistically significant differences between certain actors for practices (biosecurity, reporting, culling and compensation and movement controls), incentives (reporting and movement control) and capacities (reporting and movement control). The findings provide lessons to help improve education and messages on HPAI and to help provide technical assistance targeted at specific actors to prevent and control future HPAI H5N1 outbreaks in Ghana.

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

    PubMed

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

    2017-12-01

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

  5. [Extravasation of radiopharmaceuticals: preventive measures and management recommended by SoFRa (Société Française de Radiopharmacie)].

    PubMed

    Barré, E; Nguyen, M-L; Bruel, D; Fournel, C; Hosten, B; Lao, S; Vercellino, L; Rizzo-Padoin, N

    2013-07-01

    Radiopharmaceuticals extravasation is rare but may have serious clinical issues. Because no specific recommendations are being proposed to date, the goals of our working group created within the French Society of Radiopharmacy are to determine preventive measures and to establish a pragmatic management of extravasation of these drugs. Our preventive measures are to recognize the symptoms (erythema, venous discoloration, swelling), to know the risk factors (which are related to radiopharmaceutical, patient, site of injection, injection technique) and severity (from erythema to skin necrosis, depending on the radionuclide) and how to avoid them (training and awareness of staff, choice of injection site, route of drug administration test, use of a catheter for administration of therapeutic radiopharmaceuticals). Management should be immediate. It can be facilitated by a specific emergency kit. General measures recommended are the immediate cessation of injection, aspiration of fluid extravasation, delimitation of the extravasated area with an indelible pen, informing the doctor. Specific measures taking into account the radiotoxicity of the radionuclide and the type of radiopharmaceutical were also established. The patient should be informed by the doctor about the risks and how to take care of. Traceability of the incident must be ensured. A multidisciplinary reflexion is essential to manage the extravasation as early and effectively as possible. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  6. [Dental caries prevention in infants in Cameroon. Status of the place of oro-dental preventive treatments given to children in Cameroon].

    PubMed

    Bouhom, V; Parfait, S; Lagaye, E; Nancy, J

    2007-06-01

    This research main purpose is to determine the different preventive measures applied to children at the dentist's office in Cameroon; and to identify the priorities to be developed in the strategies and access to preventive cares for the whole population in general and for children in particular. The authors present the result of a survey conducted on the dentists established in Cameroon. The survey evaluates the specific preventive dental decay strategies applied to children.

  7. Prevention policies addressing packaging and packaging waste: Some emerging trends.

    PubMed

    Tencati, Antonio; Pogutz, Stefano; Moda, Beatrice; Brambilla, Matteo; Cacia, Claudia

    2016-10-01

    Packaging waste is a major issue in several countries. Representing in industrialized countries around 30-35% of municipal solid waste yearly generated, this waste stream has steadily grown over the years even if, especially in Europe, specific recycling and recovery targets have been fixed. Therefore, an increasing attention starts to be devoted to prevention measures and interventions. Filling a gap in the current literature, this explorative paper is a first attempt to map the increasingly important phenomenon of prevention policies in the packaging sector. Through a theoretical sampling, 11 countries/states (7 in and 4 outside Europe) have been selected and analyzed by gathering and studying primary and secondary data. Results show evidence of three specific trends in packaging waste prevention policies: fostering the adoption of measures directed at improving packaging design and production through an extensive use of the life cycle assessment; raising the awareness of final consumers by increasing the accountability of firms; promoting collaborative efforts along the packaging supply chains. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Acquaintance Rape on Campus: A Model for Institutional Response.

    ERIC Educational Resources Information Center

    Burling, Philip

    This booklet explains the actions that college or university administrators should take to prevent or respond to incidents of acquaintance rape ("date rape") on campus. It outlines specific preventive measures, risk management procedures, and internal disciplinary procedures for acquaintance rape cases. Institutions should define acquaintance rape…

  9. 3 CFR 13544 - Executive Order 13544 of June 10, 2010. Establishing the National Prevention, Health Promotion...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., proper nutrition, appropriate exercise, mental health, behavioral health, substance-use disorder, and... United States; (d) contains specific science-based initiatives to achieve the measurable goals of the... coordinated with science-based prevention recommendations by the Director of the Centers for Disease Control...

  10. Development of the Environmental Strategies Instrument to Measure Adolescent Alcohol Prevention-Related Outcomes in Community Settings

    ERIC Educational Resources Information Center

    Cervantes, Richard C.; Goldbach, Jeremy; Yeung, Albert; Rey, Antonio

    2012-01-01

    Recently, evidence-based community policy approaches to preventing substance use and alcohol abuse, called environmental strategies, have gained in popularity. The environmental survey instrument (ESI) was developed to evaluate perceptions around drinking and related problems. Specifically, the authors were interested in assessing community…

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

    PubMed

    Ierodiakonou, C S

    1988-03-01

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

  12. Device-related infections in critically ill patients. Part II: Prevention of ventilator-associated pneumonia and urinary tract infections.

    PubMed

    Di Filippo, A; De Gaudio, A R

    2003-12-01

    Device utilization in critically ill patients is responsible for a high risk of complications such as catheter-related bloodstream infections (CRBSI), ventilator-associated pneumonia (VAP) and urinary tract infections (UTI). In this article we will review the current status of data regarding the prevention of VAP and UTI. The results of the more recent (5 years) randomized controlled trials are reviewed and discussed. General recommendations include staff education and use of a surveillance program with a restrictive antibiotic policy. Adequate time must be allowed for hand washing and barrier precautions must always be used during device manipulation. Specific measures for VAP prevention are: 1) use of multi-use, closed-system suction catheters; 2) no routine change of the breathing circuit; 3) lubrication of the cuff of the endotracheal tube (ET) with a water-soluble gel; 4) maintenance of patient in semi-recumbent position to improve chest physiotherapy in intubated patients. Specific measures for UTI prevention include: 1) use of a catheter-valve instead of a standard drainage system; 2) use of a silver-alloy, hydro gel-coated latex urinary catheter instead of uncoated catheters. Biofilm represents a new variable: the capacity of bacteria to organize a biofilm on a device surface can explain the difficulty in preventing and eradicating an infection in a critically ill patient. More clinical trials are needed to verify the efficacy of prevention measures of ICU infections.

  13. From mission to measures: performance measure development for a Teen Pregnancy Prevention Program.

    PubMed

    Farb, Amy Feldman; Burrus, Barri; Wallace, Ina F; Wilson, Ellen K; Peele, John E

    2014-03-01

    The Office of Adolescent Health (OAH) sought to create a comprehensive set of performance measures to capture the performance of the Teen Pregnancy Prevention (TPP) program. This performance measurement system needed to provide measures that could be used internally (by both OAH and the TPP grantees) for management and program improvement as well as externally to communicate the program's progress to other interested stakeholders and Congress. This article describes the selected measures and outlines the considerations behind the TPP measurement development process. Issues faced, challenges encountered, and lessons learned have broad applicability for other federal agencies and, specifically, for TPP programs interested in assessing their own performance and progress. Published by Elsevier Inc.

  14. 49 CFR 172.700 - Purpose and scope.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... recognize and identify hazardous materials, has knowledge of specific requirements of this subchapter applicable to functions performed by the employee, and has knowledge of emergency response information, self-protection measures and accident prevention methods and procedures (see § 172.704). (c) Modal-specific...

  15. Review of transmission routes of 24 infectious diseases preventable by biosecurity measures and comparison of the implementation of these measures in pig herds in six European countries.

    PubMed

    Filippitzi, M E; Brinch Kruse, A; Postma, M; Sarrazin, S; Maes, D; Alban, L; Nielsen, L R; Dewulf, J

    2018-04-01

    This study aimed to review the transmission routes of important infectious pig diseases and to translate these into biosecurity measures preventing or reducing the transmission between and within pig herds. Furthermore, it aimed to identify the level of implementation of these measures in different European countries and discuss the observed variations to identify potentials for improvement. First, a literature review was performed to show which direct and indirect transmission routes of 24 infectious pig diseases can be prevented through different biosecurity measures. Second, a quantitative analysis was performed using the Biocheck.UGent™, a risk-based scoring system to evaluate biosecurity in pig herds, to obtain an insight into the implementation of these biosecurity measures. The database contained farm-specific biosecurity data from 574 pig farms in Belgium, Denmark, France, Germany, the Netherlands and Sweden, entered between January 2014 and January 2016. Third, a qualitative analysis based on a review of literature and other relevant information resources was performed for every subcategory of internal and external biosecurity in the Biocheck.UGent™ questionnaire. The quantitative analysis indicated that at the level of internal, external and overall biosecurity, Denmark had a significantly distinct profile with higher external biosecurity scores and less variation than the rest of the countries. This is likely due to a widely used specific pathogen-free (SPF) system with extensive focus on biosecurity since 1971 in Denmark. However, the observed pattern may also be attributed to differences in data collection methods. The qualitative analysis identified differences in applied policies, legislation, disease status, pig farm density, farming culture and habits between countries that can be used for shaping country-specific biosecurity advice to attain improved prevention and control of important pig diseases in European pig farms. © 2017 Blackwell Verlag GmbH.

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

    PubMed

    Schneede, P; Schlenker, B

    2018-04-01

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

  17. Risk factors for injury in sport climbing and bouldering: a systematic review of the literature.

    PubMed

    Woollings, Kaikanani Y; McKay, Carly D; Emery, Carolyn A

    2015-09-01

    Rock climbing is an increasingly popular sport worldwide, as a recreational activity and a competitive sport. Several disciplines including sport climbing and bouldering have developed, each employing specific movements and techniques, leading to specific injuries. To examine risk factors and prevention measures for injury in sport climbing and bouldering, and to assess the methodological quality of existing studies. 12 electronic databases and several other sources were searched systematically using predetermined inclusion and exclusion criteria. Eligible articles were peer-reviewed, based on primary research using original data; outcome measures included injury, morbidity or mortality in rock climbing, and included one or more potential risk factor or injury prevention strategy. Two independent reviewers assessed the methodology of research in each study using the Downs and Black Quality Index. The data extracted is summarised, and appraisals of the articles are presented with respect to the quality of evidence presented. 19 studies met the inclusion criteria, and introduced 35 possible risk factors or injury prevention measures in climbing. Age, increasing years of climbing experience, highest climbing grade achieved (skill level), high climbing intensity score (CIS) and participating in lead climbing are potential risk factors. Results regarding injury prevention measures remain inconclusive. This field is relatively new and, as such, the data are not as robust as for more established sports with a larger research foundation. The key need is establishing modifiable risk factors using prospective studies and high quality methodology, such that injury prevention strategies can be developed. The CIS may be a useful measure in this field of research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Development of a Survey to Assess Local Health Department Organizational Processes and Infrastructure for Supporting Obesity Prevention.

    PubMed

    Xiao, Ting; Stamatakis, Katherine A; McVay, Allese B

    Local health departments (LHDs) have an important function in controlling the growing epidemic of obesity in the United States. Data are needed to gain insight into the existence of routine functions and structures of LHDs that support and sustain obesity prevention efforts. The purpose of this study was to develop and examine the reliability of measures to assess foundational LHD organizational processes and functions specific to obesity prevention. Survey measures were developed using a stratified, random sample of US LHDs to assess supportive organizational processes and infrastructure for obesity prevention representing different domains. Data were analyzed using weighted κ and intraclass correlation coefficient for assessing test-retest reliability. Most items and summary indices in the majority of survey domains had moderate/substantial or almost perfect reliability. The overall findings support this survey instrument to be a reliable measurement tool for a large number of processes and functions that comprise obesity prevention-related capacity in LHDs.

  19. Epigenetic Biomarkers of Breast Cancer Risk: Across the Breast Cancer Prevention Continuum.

    PubMed

    Terry, Mary Beth; McDonald, Jasmine A; Wu, Hui Chen; Eng, Sybil; Santella, Regina M

    2016-01-01

    Epigenetic biomarkers, such as DNA methylation, can increase cancer risk through altering gene expression. The Cancer Genome Atlas (TCGA) Network has demonstrated breast cancer-specific DNA methylation signatures. DNA methylation signatures measured at the time of diagnosis may prove important for treatment options and in predicting disease-free and overall survival (tertiary prevention). DNA methylation measurement in cell free DNA may also be useful in improving early detection by measuring tumor DNA released into the blood (secondary prevention). Most evidence evaluating the use of DNA methylation markers in tertiary and secondary prevention efforts for breast cancer comes from studies that are cross-sectional or retrospective with limited corresponding epidemiologic data, raising concerns about temporality. Few prospective studies exist that are large enough to address whether DNA methylation markers add to the prediction of tertiary and secondary outcomes over and beyond standard clinical measures. Determining the role of epigenetic biomarkers in primary prevention can help in identifying modifiable pathways for targeting interventions and reducing disease incidence. The potential is great for DNA methylation markers to improve cancer outcomes across the prevention continuum. Large, prospective epidemiological studies will provide essential evidence of the overall utility of adding these markers to primary prevention efforts, screening, and clinical care.

  20. Hantavirus infection--southwestern United States: interim recommendations for risk reduction. Centers for Disease Control and Prevention.

    PubMed

    Childs, J E; Kaufmann, A F; Peters, C J; Ehrenberg, R L

    1993-07-30

    This report provides interim recommendations for prevention and control of hantavirus infections associated with rodents in the southwestern United States. It is based on principles of rodent and infection control and contains specific recommendations for reducing rodent shelter and food sources in and around the home, recommendations for eliminating rodents inside the home and preventing them from entering the home, precautions for preventing hantavirus infection while rodent-contaminated areas are being cleaned up, prevention measures for persons who have occupational exposure to wild rodents, and precautions for campers and hikers.

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

    PubMed Central

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

    1996-01-01

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

  2. The Tentative Drug Use Scale: A Quick and Relatively Problem Free Outcome Measure for Drug Abuse Prevention Projects

    ERIC Educational Resources Information Center

    Horan, John J.; Williams, John M.

    1975-01-01

    Difficulties involved with the evaluation of drug abuse prevention programs are numerous. Tentative Drug Use Scale (TDUS) was designed in response to a number of specific problems associated with obtaining behavioral data. Advantages of this scale over others are discussed. Reliability and validity information are provided. (Author)

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

    PubMed Central

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

    2016-01-01

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

  4. 46 CFR 162.050-39 - Measurement of oil content.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 6 2012-10-01 2012-10-01 false Measurement of oil content. 162.050-39 Section 162.050-39 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL ENGINEERING EQUIPMENT Pollution Prevention Equipment § 162.050-39 Measurement of oil content. The collection and...

  5. Awarding and promoting excellence in hearing loss prevention

    PubMed Central

    Meinke, Deanna K.; Morata, Thais C.

    2015-01-01

    Objective To describe the rationale and creation of a national award to recognize and promote hearing loss prevention. Design In 2007, the National Institute for Occupational Safety and Health partnered with the National Hearing Conservation Association to create the Safe-in-Sound Excellence in Hearing Loss Prevention Award™ (www.safeinsound.us). The objectives of this initiative were to recognize organizations that document measurable achievements and to share leading edge information to a broader community. Results An expert committee developed specific and explicit award evaluation criteria of excellence in hearing loss prevention for organizations in different industrial sectors. The general approach toward award criteria was to incorporate current ‘best practices’ and familiar benchmarks of hearing loss prevention programs. This approach was reviewed publicly. In addition, mechanisms were identified to measure the impact of the award itself. Interest in the award was recorded through the monitoring of the visitor traffic registered by the award web site and is increasing yearly. Specific values and strategies common across award winners are presented. Conclusion The Safe-in-Sound Award™ has obtained high quality field data; identified practical solutions, disseminated successful strategies to minimize the risk of hearing loss, generated new partnerships, and shared practical solutions with others in the field. PMID:22264064

  6. Refining Intervention Targets in Family-Based Research: Lessons From Quantitative Behavioral Genetics

    PubMed Central

    Leve, Leslie D.; Harold, Gordon T.; Ge, Xiaojia; Neiderhiser, Jenae M.; Patterson, Gerald

    2010-01-01

    The results from a large body of family-based research studies indicate that modifying the environment (specifically dimensions of the social environment) through intervention is an effective mechanism for achieving positive outcomes. Parallel to this work is a growing body of evidence from genetically informed studies indicating that social environmental factors are central to enhancing or offsetting genetic influences. Increased precision in the understanding of the role of the social environment in offsetting genetic risk might provide new information about environmental mechanisms that could be applied to prevention science. However, at present, the multifaceted conceptualization of the environment in prevention science is mismatched with the more limited measurement of the environment in many genetically informed studies. A framework for translating quantitative behavioral genetic research to inform the development of preventive interventions is presented in this article. The measurement of environmental indices amenable to modification is discussed within the context of quantitative behavioral genetic studies. In particular, emphasis is placed on the necessary elements that lead to benefits in prevention science, specifically the development of evidence-based interventions. An example from an ongoing prospective adoption study is provided to illustrate the potential of this translational process to inform the selection of preventive intervention targets. PMID:21188273

  7. Effects of 8 Weeks’ Specific Physical Training on the Rotator Cuff Muscle Strength and Technique of Javelin Throwers

    PubMed Central

    Kim, Hyeyoung; Lee, Youngsun; Shin, Insik; Kim, Kitae; Moon, Jeheon

    2014-01-01

    [Purpose] For maximum efficiency and to prevent injury during javelin throwing, it is critical to maintain muscle balance and coordination of the rotator cuff and the glenohumeral joint. In this study, we investigated the change in the rotator cuff muscle strength, throw distance and technique of javelin throwers after they had performed a specific physical training that combined elements of weight training, function movement screen training, and core training. [Subjects] Ten javelin throwers participated in this study: six university athletes in the experimental group and four national-level athletes in the control group. [Methods] The experimental group performed 8 weeks of the specific physical training. To evaluate the effects of the training, measurements were performed before and after the training for the experimental group. Measurements comprised anthropometry, isokinetic muscle strength measurements, the function movement screen test, and movement analysis. [Results] After the specific physical training, the function movement screen score and external and internal rotator muscle strength showed statistically significant increases. Among kinematic factors, only pull distance showed improvement after training. [Conclusion] Eight weeks of specific physical training for dynamic stabilizer muscles enhanced the rotator cuff muscle strength, core stability, throw distance, and flexibility of javelin throwers. These results suggest that specific physical training can be useful for preventing shoulder injuries and improving the performance for javelin throwers. PMID:25364111

  8. Effects of 8 weeks' specific physical training on the rotator cuff muscle strength and technique of javelin throwers.

    PubMed

    Kim, Hyeyoung; Lee, Youngsun; Shin, Insik; Kim, Kitae; Moon, Jeheon

    2014-10-01

    [Purpose] For maximum efficiency and to prevent injury during javelin throwing, it is critical to maintain muscle balance and coordination of the rotator cuff and the glenohumeral joint. In this study, we investigated the change in the rotator cuff muscle strength, throw distance and technique of javelin throwers after they had performed a specific physical training that combined elements of weight training, function movement screen training, and core training. [Subjects] Ten javelin throwers participated in this study: six university athletes in the experimental group and four national-level athletes in the control group. [Methods] The experimental group performed 8 weeks of the specific physical training. To evaluate the effects of the training, measurements were performed before and after the training for the experimental group. Measurements comprised anthropometry, isokinetic muscle strength measurements, the function movement screen test, and movement analysis. [Results] After the specific physical training, the function movement screen score and external and internal rotator muscle strength showed statistically significant increases. Among kinematic factors, only pull distance showed improvement after training. [Conclusion] Eight weeks of specific physical training for dynamic stabilizer muscles enhanced the rotator cuff muscle strength, core stability, throw distance, and flexibility of javelin throwers. These results suggest that specific physical training can be useful for preventing shoulder injuries and improving the performance for javelin throwers.

  9. Nasa langley research center and the tidewater interagency pollution prevention program

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

    Houlihan, J.; Binkley, K.

    1994-09-01

    National Aeronautics and Space Administration (NASA)`s Langley Research Center (LaRC) is an 807-acre research center devoted to aeronautics and space research. LaRC has initiated a broad-based pollution prevention program guided by a Pollution Prevention Program Plan and implemented through specific projects. Over twenty specific source reduction or recycling projects have been initiated since 1991. Recycling activities and use of conservation measures have reduced the use of various freon chlorofluorocarbons, ozone depleting substances (ODCs), by 84 percent in 1993 compared with 1990 figures. In addition, improved silver recovery procedures reduced the amount of photographic laboratory waste by 70 percent, or 11,982more » pounds, during 1993. Total hazardous waste, excluding abrasive blasting debris generated by specific remediation projects, has been reduced by 25 percent, or about 50,000 pounds, in 1993 compared to 1992.« less

  10. A specific hygiene hypothesis.

    PubMed

    Shunsheng Han, Cliff

    2016-08-01

    Allergic diseases have reached epidemic proportions in Western populations in the last several decades. The hygiene hypothesis proposed more than twenty years ago has helped us to understand the epidemic and has been verified with numerous studies. However, translational measures deduced from these studies to prevent allergic diseases have not proven effective. Recent studies on immigrants' allergies and any potential association between oral infection and allergic diseases prompt me to propose a specific hygiene hypothesis to explain how oral hygiene practices might have contributed to the uprising of hay fever, the most common allergic disease. The historic oral hygiene level in US is closely associated with the emerging allergic epidemic. Future studies to test the hypothesis are needed and verification of the hypothesis can potentially yield highly effective measures to prevent allergic diseases. Published by Elsevier Ltd.

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

    PubMed

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

    2016-07-16

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

  12. 46 CFR 162.050-39 - Measurement of oil content.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Measurement of oil content. 162.050-39 Section 162.050-39 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL ENGINEERING EQUIPMENT Pollution Prevention Equipment § 162.050-39...

  13. Development and validation of measures to assess prevention and control of AMR in hospitals.

    PubMed

    Flanagan, Mindy; Ramanujam, Rangaraj; Sutherland, Jason; Vaughn, Thomas; Diekema, Daniel; Doebbeling, Bradley N

    2007-06-01

    The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. To develop and validate a measurement scale for assessing hospitals' efforts to implement recommended AMR prevention and control measures. Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. : Four hundred forty-eight infection control professionals participated (67% response rate). Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. "Derivation" and "validation" samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

  14. Prevention of acute kidney injury in Intensive Care Units.

    PubMed

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

    2017-03-01

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

  15. Measurement Characteristics of Dietary Psychosocial Scales in a Weight Gain Prevention Study with 8- to 10-Year-Old African-American Girls

    ERIC Educational Resources Information Center

    Sherrill-Mittleman, D. A.; Klesges, L. M.; Lanctot, J. Q.; Stockton, M. B.; Klesges, R. C.

    2009-01-01

    Few measurement instruments for children's eating behaviors and beliefs have been specifically validated for African-American children. Validation within this population is important because of potential cultural and ethnic influences. Objectives were to evaluate established and newly developed or adapted dietary psychosocial measures in a sample…

  16. [Consensus document and recommendations for the prevention of cardiovascular disease in Italy - 2018].

    PubMed

    Volpe, Massimo; Tocci, Giuliano; Accettura, Domenico; Battistoni, Allegra; Bellone, Simonetta; Bellotti, Paolo; Bertolotti, Marco; Borghi, Claudio; Casasco, Maurizio; Consoli, Agostino; Coppini, Raffaele; Corsini, Alberto; Costanzo, Gianfranco; Desideri, Giovambattista; Ferri, Claudio; Galanti, Giorgio; Giada, Franco; Icardi, Giancarlo; Lombardi, Niccolò; Modena, Maria Grazia; Modesti, Pietro Amedeo; Monti, Giorgio; Mugelli, Alessandro; Orsi, Andrea; Parati, Gianfranco; Pedretti, Roberto F.E.; Perseghin, Gianluca; Pirro, Matteo; Ricotti, Roberta; Rizzoni, Damiano; Rotella, Carlo; Rubattu, Speranza; Salvetti, Guido; Sarto, Patrizio; Tassinari, Federico; Trimarco, Bruno; de Kreutzenberg, Saula Vigili; Volpe, Roberto

    2018-02-01

    Cardiovascular prevention represents a cornerstone of modern strategies to reduce the burden of cardiovascular disease. It is of key importance to prevent cardiovascular diseases and associated events, not only to reduce morbidity and mortality, but also to increase the years of wellness in the aging population and to make the growing socio-economic burden imposed by cardiovascular events more sustainable.The current approach to prevention is based on an integrated use of effective lifestyle measures and, whenever appropriate, of antihypertensive and antidiabetic drugs, lipid-lowering agents and antiplatelet drugs.Given that population characteristics, in terms of ethnicity, demography and lifestyle habits, and healthcare system organizations differ among countries, international guidelines are not always applicable to specific countries and, often, are difficult to translate into daily clinical practice.In order to afford the specific features of Italy, 10 Scientific Societies and Research Institutions, mostly involved in preventive strategies, contributed to the present Italian consensus document, which includes brief, practical recommendations to support the preventive actions within the physician community and the general practice setting.

  17. [Preventive measures against plague and the control of Chinese coolies in colonial Korea].

    PubMed

    Kim, Youngsoo

    2014-12-01

    This paper aims to examine the preventive measures taken against the plague in colonial Korea, particularly as applied to the control of Chinese coolies in 1911, soon after the annexation. The Government General of Korea began preventive measures with a train quarantine in Shin'uiju and Incheon in response to the spread of the plague to the Southern Manchuria. Shin' uiju had become urbanized due the development of the transportation network, and the seaport of Incheon was the major hub for traffic with China. Examining the transportation routes for the entry and exit of Chinese to and from Korea makes clear the reason why the Korea Government General initiated preventive measures in mid-January, 1911. The Government General of Korea tried to block the entry of Chinese through the land border crossing with China and through ports of entry, primarily Incheon. During the implementation of the preventive measures, quarantine facilities were built, including a quarantine station and isolation facility in Incheon. It was also needed to investigate the population and residential locations of Chinese in Korea to prevent the spread of plague. A certificate of residence was issued to all Chinese in Korea, which they needed to carry when they travelled. The preventive measures against plague which broke out in Manchuria were removed gradually. However, there was no specific measures against Chinese coolies, those who had migrated from China to work in the spring in Korea. Still the Government General of Korea had doubt about an infection of the respiratory system. As a result, the labor market in colonial Korea underwent changes in this period. The Government General recruited Korean laborers, instead of Chinese coolies whose employment had been planned. This move explains the Government General's strong preventive measures against plague and uncertainty in the route of plague infection, which influenced subsequent regulations on the prohibition of Chinese coolies working on the public enterprise sites and the improvement of labor conditions for Korean laborers.

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

    PubMed

    Moskowitz, J M

    1989-01-01

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

  19. Methods for assessing the preventability of adverse drug events: a systematic review.

    PubMed

    Hakkarainen, Katja Marja; Andersson Sundell, Karolina; Petzold, Max; Hägg, Staffan

    2012-02-01

    Preventable adverse drug events (ADEs) are common in both outpatient and inpatient settings. However, the proportion of preventable ADEs varies considerably in different studies, even when conducted in the same setting, and methods for assessing the preventability of ADEs are diverse. The aim of this article is to identify and systematically evaluate methods for assessing the preventability of ADEs. Seven databases (Cochrane, CINAHL, EMBASE, IPA, MEDLINE, PsycINFO and Web of Science) were searched in September 2010 utilizing the databases' index terms and other common terminology on preventable ADEs. No limits for the years of publication were set. Reference lists of included original articles and relevant review articles were also screened. After applying predetermined inclusion and exclusion criteria on 4161 unique citations, 142 (3.4%) original research articles were included in the review. One additional article was included from reference lists. Outcome measures of included studies had to include the frequency of ADEs and the assessment of their preventability. Studies were excluded if they focused on individuals with one specific type of treatment, medical condition, medical procedure or ADE. Measurement instruments for determining the preventability of ADEs in each article were extracted and unique instruments were compared. The process of assessing the preventability of ADEs was described based on reported actions taken to standardize and conduct the assessment, and on information about the reliability and validity of the assessment. Eighteen unique instruments for determining the preventability of ADEs were identified. They fell under the following four groups: (i) instruments using a definition of preventability only (n = 3); (ii) instruments with a definition of preventability and an assessment scale for determining preventability (n = 5); (iii) instruments with specific criteria for each preventability category (n = 3); and (iv) instruments with an algorithm for determining preventability (n = 7). Of actions to standardize the assessment process, performing a pilot study was reported in 21 (15%), and use of a standardized protocol was reported in 18 (13%), of the included 143 articles. Preventability was assessed by physicians in 86 (60%) articles and by pharmacists in 41 (29%) articles. In 29 (20%) articles, persons conducting the assessment were described as trained for or experienced in preventability assessment. In 94 (66%) articles, more than one person assessed the preventability of each case. Among these 94 articles, assessment was done independently in 73 (51%) articles. Procedures for managing conflicting assessments were diverse. The reliability of the preventability assessment was tested in 39 (27%) articles, and 16 (11%) articles referred to a previous reliability assessment. Reliability ranged from poor to excellent (kappa 0.19-0.98; overall agreement 26-97%). Four (3%) articles mentioned assessing validity, but no sensitivity or specificity analyses or negative or positive predictive values were presented. Instruments for assessing the preventability of ADEs vary from implicit instruments to explicit algorithms. There is limited evidence for the validity of the identified instruments, and instrument reliability varied significantly. The process of assessing the preventability of ADEs is also commonly imprecisely described, which hinders the interpretation and comparison of studies. For measuring the preventability of ADEs more accurately and precisely in future, we believe that existing instruments should be further studied and developed, or that one or more new instruments should be developed, and the validity and reliability of the existing and new instruments be established.

  20. Rationale and methods of the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA).

    PubMed

    Rodríguez-Artalejo, Fernando; Guallar, Eliseo; Borghi, Claudio; Dallongeville, Jean; De Backer, Guy; Halcox, Julian P; Hernández-Vecino, Ramón; Jiménez, Francisco Javier; Massó-González, Elvira L; Perk, Joep; Steg, Philippe Gabriel; Banegas, José R

    2010-06-30

    The EURIKA study aims to assess the status of primary prevention of cardiovascular disease (CVD) across Europe. Specifically, it will determine the degree of control of cardiovascular risk factors in current clinical practice in relation to the European guidelines on cardiovascular prevention. It will also assess physicians' knowledge and attitudes about CVD prevention as well as the barriers impeding effective risk factor management in clinical practice. Cross-sectional study conducted simultaneously in 12 countries across Europe. The study has two components: firstly at the physician level, assessing eight hundred and nine primary care and specialist physicians with a daily practice in CVD prevention. A physician specific questionnaire captures information regarding physician demographics, practice settings, cardiovascular prevention beliefs and management. Secondly at the patient level, including 7641 patients aged 50 years or older, free of clinical CVD and with at least one classical risk factor, enrolled by the participating physicians. A patient-specific questionnaire captures information from clinical records and patient interview regarding sociodemographic data, CVD risk factors, and current medications. Finally, each patient provides a fasting blood sample, which is sent to a central laboratory for measuring serum lipids, apolipoproteins, hemoglobin-A1c, and inflammatory biomarkers. Primary prevention of CVD is an extremely important clinical issue, with preventable circulatory diseases remaining the leading cause of major disease burden. The EURIKA study will provide key information to assess effectiveness of and attitudes toward primary prevention of CVD in Europe. A transnational study creates opportunities for benchmarking good clinical practice across countries and improving outcomes. (ClinicalTrials.gov number, NCT00882336).

  1. Malaria control aimed at the entire population in KwaZulu-Natal negates the need for policies to prevent malaria in pregnancy.

    PubMed

    Tsoka-Gwegweni, J M; Kleinschmidt, I

    2013-01-24

    South Africa has no policy to prevent malaria in pregnancy, despite the adverse effects of the disease in pregnancy. However, malaria control measures consisting of indoor residual spraying and specific antimalarial treatment have been in place since the 1970s. Information on the burden of malaria in pregnancy in South Africa is needed to indicate whether a specific policy for malaria prevention in pregnancy is necessary. To determine the burden of malaria in pregnancy in KwaZulu-Natal (KZN) province, South Africa. Pregnant women were enrolled at their first antenatal care visit to three health facilities in Umkhanyakude health district in northern KZN during May 2004 - September 2005 and followed up until delivery. Data collection included demographic details, current and previous malaria infection during pregnancy, haemoglobin concentrations and birth outcomes. Of the 1 406 study participants, more than a quarter were younger than 20 years of age, and more than 90% were unemployed and unmarried. Although 33.2% of the women were anaemic, this was not related to malaria. The prevalence and incidence of malaria were very low, and low birth weight was only weakly associated with malaria (1/10). The low burden of malaria in these pregnant women suggests that they have benefited from malaria control strategies in the study area. The implication is that additional measures specific for malaria prevention in pregnancy are not required. However, ongoing monitoring is needed to ensure that malaria prevalence remains low.

  2. [School shootings in Germany: current trends in the prevention of severe, targeted violence in German schools].

    PubMed

    Bondü, Rebecca; Scheithauer, Herbert

    2009-01-01

    In March and September 2009 the school shootings in Winnenden and Ansbach once again demonstrated the need for preventive approaches in order to prevent further offences in Germany. Due to the low frequency of such offences and the low specificity of relevant risk factors known so far, prediction and prevention seems difficult though. None the less, several preventive approaches are currently discussed. The present article highlights these approaches and their specific advantages and disadvantages. As school shootings are multicausally determined, approaches focussing only on single aspects (i.e. prohibiting violent computer games or further strengthening gun laws) do not meet requirements. Other measures such as installing technical safety devices or optimizing actions of police and school attendants are supposed to reduce harm in case of emergency. Instead, scientifically founded and promising preventive approaches focus on secondary prevention and for this purpose employ the threat assessment approach, which is widespread within the USA. In this framework, responsible occupational groups such as teachers, school psychologists and police officers are to be trained in identifying students' warning signs, judging danger of these students for self and others in a systematic process and initiating suitable interventions.

  3. A Comparison of the Preventive Health Care Provided by Women's Health Centers and General Internal Medicine Practices

    PubMed Central

    Harpole, Linda H; Mort, Elizabeth A; Freund, Karen M; Orav, John; Brennan, Troyen A

    2000-01-01

    OBJECTIVE To evaluate women's health centers as alternatives to traditional internal medicine practices. DESIGN Cross-sectional mailed survey. SETTING A women's health center and an internal medicine practice at each of three university-affiliated teaching hospitals. PATIENTS There were 3,035 female patients randomly selected to receive a mailed survey after their office visits. MEASUREMENTS AND MAIN RESULTS The survey asked for patient characteristics, patient satisfaction, and rates of gender-specific preventive health services. The survey response rate was 64% (1,942/3,035). Patients at women's health centers were younger, more educated, had higher physical functioning but lower mental health functioning, and more of them were single and employed. Patient satisfaction was similar at the two types of practices, although patients at women's health centers were more satisfied with certain aspects of the patient-provider interaction. After adjusting for measured differences in patient characteristics and site, patients at women's health centers were more likely to receive discussions on hormone replacement therapy (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.1, 2.2) and dietary calcium (OR 1.3; 95% CI 1.1, 1.6). They were also more likely to receive their gender-specific preventive health services from their primary care provider: breast examination (OR 2.0; 95% CI 1.5, 2.6), Pap smear (OR 2.4; 95% CI 1.9, 3.1), hormone replacement therapy discussion (OR 2.2; 95% CI 1.5, 3.3), and dietary calcium discussion (OR 2.6; 95% CI 1.7, 3.9). These findings remained when the analyses were limited to patients of female providers only. CONCLUSIONS In this study, patients at women's health centers were more likely to receive gender-specific health prevention counseling than patients at internal medicine practices. Moreover, patients were more likely to receive their gender-specific preventive health services from their primary care providers. PMID:10632827

  4. Preventing Drug Abuse Among Adolescent Girls: Outcome Data from an Internet-Based Intervention

    PubMed Central

    Schinke, Steven P.; Di Noia, Jennifer

    2009-01-01

    This study developed and tested an Internet-based gender-specific drug abuse prevention program for adolescent girls. A sample of seventh, eighth, and ninth grade girls (N = 236) from 42 states and 4 Canadian provinces were randomly assigned to an intervention or control group. All girls completed an online pretest battery. Following pretest, intervention girls interacted with a 12-session, Internet-based gender-specific drug prevention program. Girls in both groups completed the measurement battery at posttest and 6-month follow-up. Analysis of posttest scores revealed no differences between groups for 30-day reports of alcohol, marijuana, poly drug use, or total substance use (alcohol and drugs). At 6-month follow-up, between-group effects were found on measures of 30-day alcohol use, marijuana use, poly drug use, and total substance use. Relative to girls in the control group, girls exposed to the Internet-based intervention reported lower rates of use for these substances. Moreover, girls receiving the intervention achieved gains over girls in the control group on normative beliefs and self-efficacy at posttest and 6-month follow-up, respectively. PMID:19728091

  5. Preventing School Employee Sexual Misconduct: An Outcome Survey Analysis of Making Right Choices.

    PubMed

    Lipson, Glenn; Grant, Billie-Jo; Mueller, Jessica; Sonnich, Steve

    2018-05-30

    This treatment-only study examines the impact of Making Right Choices, an online course prevention program designed to promote the knowledge, awareness, and prevention of school employee sexual misconduct. The sample included 13,007 school employee participants who took the Making Right Choices course between May 6, 2011, and March 12, 2017, in California and New York. The 20-item measure, Preventing Misconduct Assessment, was administered to participants at the end of the online course; completion of the measure was voluntary. Descriptive statistics revealed that a large majority of participants reported increasing their knowledge and awareness of school employee sexual misconduct because of their participation in the Making Right Choices online course. This study yields important findings regarding the impact of a sexual misconduct prevention program and, specifically, the difference it may make for non-licensed school employees. These findings indicate that school employees are accepting of sexual misconduct training programs and rate them as having value.

  6. Control technique of spontaneous combustion in fully mechan ized stope during period of end caving under complex mining influence

    NASA Astrophysics Data System (ADS)

    Yuan, Benqing

    2018-01-01

    In view of the phenomenon of spontaneous combustion of coal seam occurring during the period of end caving under complex mining conditions, taking the 1116 (3) stope of Guqiao mine as the object of study, the causes of spontaneous combustion during the period of end caving are analyzed, according to the specific geological conditions of the stope to develop corresponding fire prevention measures, including the reduction of air supply and air leakage in goaf, reduce the amount of coal left, reasonable drainage, nitrogen injection for spontaneous combustion prevention, grouting for spontaneous combustion prevention and permanent closure, fundamentally eliminates the potential for spontaneous combustion during the period of 1116(3) stope end caving. The engineering practice shows that this kind of measure has reference value for the prevention and control of spontaneous combustion during the period of stope end caving.

  7. There is more to life than risk avoidance - elderly people's experiences of falls, fall-injuries and compliant flooring.

    PubMed

    Gustavsson, Johanna; Jernbro, Carolina; Nilson, Finn

    2018-12-01

    Falls are the most common cause of injury in all ages and are especially difficult to prevent among residential care residents. Compliant flooring that absorbs energy generated within the fall, has been proposed as a measure to prevent fall-injury, however little is known regarding the implementation aspects in clinical settings. The aim of this study is to explore the experiences of falls, the risk of fall-injury, prevention in general and specifically compliant flooring as an injury preventative measure amongst frail elderly people living in a residential care facility with compliant flooring. Through this, generate a theory that further explains the underlying barriers of active prevention amongst elderly people. We used the grounded theory method and conducted semi-structured in-depth interviews with eight elderly people in residential care (data collected between February and December 2017). The identified categories were Falling as a part of life, Fearing the consequences and A wish to prevent falls and injuries. Through the results it was clear that There is more to life than risk avoidance, permeated the interviews, therefore forming the grounded theory. The interviewees viewed falls as something common and normal, and were uninterested in focusing on the risk of falls. Although they wanted to prevent falls, it was often difficult to integrate preventative measures into their everyday life. They embraced the idea of an injury-reducing compliant flooring, however their main interests lay elsewhere, preferring to focus on social interaction and issues concerning daily activities. The theory generated in this paper proposes explanations on the obstacles of implementing fall prevention measures in an elderly frail population. The findings give insights as to why interest and compliance for active fall prevention measures are low. We conclude that complaint flooring, from the perspective of the residents, can work well in residential care.

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

    PubMed

    Cho, Yoshinori; Inagaki, Masatoshi

    2014-01-01

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

  9. ENVIRONMENTAL PUBLIC HEALTH INDICATORS

    EPA Science Inventory

    Environmental Public Health Indicators (EPHIs), quantitative measures of health factors and environmental influences tracked over time, can be used to identify specific areas and populations for intervention and prevention efforts and to evaluate the outcomes of implemented polic...

  10. [Online gaming. Potential risk and prevention programs].

    PubMed

    Malischnig, Doris

    2014-12-01

    Online gaming is more and more common and increasingly accessible. Due to a lack of social control the participation could be a potential risk for certain customers. The given article focuses on prevention measures that are provided by the Austrian online gaming operator, the Austrian Lotteries, provider of the online gaming platform win2day, in the light of the specifics of Internet gaming in order to avoid problems with gaming.

  11. Mapping the Use of Engineered NM in Quebec's Industries and Research Laboratories

    NASA Astrophysics Data System (ADS)

    Ostiguy, Claude; Emond, Claude; Dossa, Inès; Malki, Yasmina; Boily, Chantale; Roughley, David; Plavski, Anton; Endo, Charles-Anica

    2013-04-01

    Engineered NanoMaterials (NM) offer an opportunity to develop a wide variety of new products with unique properties but many studies have shown potential OHS risks specific to NM. Addressing these risks requires knowledge about release of NM into the workplaces. This research aimed to map the state of nanotechnology OHS practices in Quebec through a questionnaire following a first contact by telephone when possible and by compiling the type and volumes of NM used as well as gathering information related to the working conditions and OHS aspects. This survey was conducted among 1310 Quebec industries and 653 researchers working in different specialties potentially involved in the development/production/distribution/integration of NM and use of NM containing products. Overall, 90 questionnaires, including 51 from the industries, were completed. These showed that NM are mainly used into the powder form, in many different sectors and deserve a wide range of markets. The prevention measures implemented vary widely from a workplace to another but about one third of the participants report that they have implemented NP adapted prevention measures but they remain worried on some specific operations. More than 50% of the participants request more information about the safe laboratory/plant design, toxicity, regulation, good work practices and prevention measures, efficiency of personal protective equipment and environmental impacts.

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

    PubMed

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

    2016-10-01

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

  13. Metrics to assess injury prevention programs for young workers in high-risk occupations: a scoping review of the literature.

    PubMed

    Jennifer, Smith; Purewal, Birinder Praneet; Macpherson, Alison; Pike, Ian

    2018-05-01

    Despite legal protections for young workers in Canada, youth aged 15-24 are at high risk of traumatic occupational injury. While many injury prevention initiatives targeting young workers exist, the challenge faced by youth advocates and employers is deciding what aspect(s) of prevention will be the most effective focus for their efforts. A review of the academic and grey literatures was undertaken to compile the metrics-both the indicators being evaluated and the methods of measurement-commonly used to assess injury prevention programs for young workers. Metrics are standards of measurement through which efficiency, performance, progress, or quality of a plan, process, or product can be assessed. A PICO framework was used to develop search terms. Medline, PubMed, OVID, EMBASE, CCOHS, PsychINFO, CINAHL, NIOSHTIC, Google Scholar and the grey literature were searched for articles in English, published between 1975-2015. Two independent reviewers screened the resulting list and categorized the metrics in three domains of injury prevention: Education, Environment and Enforcement. Of 174 acquired articles meeting the inclusion criteria, 21 both described and assessed an intervention. Half were educational in nature (N=11). Commonly assessed metrics included: knowledge, perceptions, self-reported behaviours or intentions, hazardous exposures, injury claims, and injury counts. One study outlined a method for developing metrics to predict injury rates. Metrics specific to the evaluation of young worker injury prevention programs are needed, as current metrics are insufficient to predict reduced injuries following program implementation. One study, which the review brought to light, could be an appropriate model for future research to develop valid leading metrics specific to young workers, and then apply these metrics to injury prevention programs for youth.

  14. Update on infection control challenges in special pediatric populations.

    PubMed

    Balkhy, Hanan H; Zingg, Walter

    2014-08-01

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

  15. Defining and Measuring Safety Climate: A Review of the Construction Industry Literature.

    PubMed

    Schwatka, Natalie V; Hecker, Steven; Goldenhar, Linda M

    2016-06-01

    Safety climate measurements can be used to proactively assess an organization's effectiveness in identifying and remediating work-related hazards, thereby reducing or preventing work-related ill health and injury. This review article focuses on construction-specific articles that developed and/or measured safety climate, assessed safety climate's relationship with other safety and health performance indicators, and/or used safety climate measures to evaluate interventions targeting one or more indicators of safety climate. Fifty-six articles met our inclusion criteria, 80% of which were published after 2008. Our findings demonstrate that researchers commonly defined safety climate as perception based, but the object of those perceptions varies widely. Within the wide range of indicators used to measure safety climate, safety policies, procedures, and practices were the most common, followed by general management commitment to safety. The most frequently used indicators should and do reflect that the prevention of work-related ill health and injury depends on both organizational and employee actions. Safety climate scores were commonly compared between groups (e.g. management and workers, different trades), and often correlated with subjective measures of safety behavior rather than measures of ill health or objective safety and health outcomes. Despite the observed limitations of current research, safety climate has been promised as a useful feature of research and practice activities to prevent work-related ill health and injury. Safety climate survey data can reveal gaps between management and employee perceptions, or between espoused and enacted policies, and trigger communication and action to narrow those gaps. The validation of safety climate with safety and health performance data offers the potential for using safety climate measures as a leading indicator of performance. We discuss these findings in relation to the related concept of safety culture and offer suggestions for future research and practice including (i) deriving a common definition of safety climate, (ii) developing and testing construction-specific indicators of safety climate, and (iii) focusing on construction-specific issues such as the transient workforce, subcontracting, work organization, and induction/acculturation processes. © The Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

  16. ENVIRONMENTAL HELATH INDICATORS-DIVERSE PROGRAMS, COMMON METHODOLOGICAL CHALLENGES

    EPA Science Inventory

    Abstract: Environmental Health Indicators are quantitative measures of important environmental health factors that can be used to identify specific areas and populations for intervention and prevention efforts and to evaluate the outcomes of implemented policies or programs for ...

  17. The effect of a translating research into practice intervention to promote use of evidence-based fall prevention interventions in hospitalized adults: A prospective pre-post implementation study in the U.S.

    PubMed

    Titler, Marita G; Conlon, Paul; Reynolds, Margaret A; Ripley, Robert; Tsodikov, Alex; Wilson, Deleise S; Montie, Mary

    2016-08-01

    Falls are a major public health problem internationally. Many hospitals have implemented fall risk assessment tools, but few have implemented interventions to mitigate patient-specific fall risks. Little research has been done to examine the effect of implementing evidence-based fall prevention interventions to mitigate patient-specific fall risk factors in hospitalized adults. To evaluate the impact of implementing, in 3 U.S. hospitals, evidence-based fall prevention interventions targeted to patient-specific fall risk factors (Targeted Risk Factor Fall Prevention Bundle). Fall rates, fall injury rates, types of fall injuries and adoption of the Targeted Risk Factor Fall Prevention Bundle were compared prior to and following implementation. A prospective pre-post implementation cohort design. Thirteen adult medical-surgical units from three community hospitals in the Midwest region of the U.S. Nurses who were employed at least 20hours/week, provided direct patient care, and licensed as an RN (n=157 pre; 140 post); and medical records of patients 21years of age or older, who received care on the study unit for more than 24hours during the designated data collection period (n=390 pre and post). A multi-faceted Translating Research Into Practice Intervention was used to implement the Targeted Risk Factor Fall Prevention Bundle composed of evidence-based fall prevention interventions designed to mitigate patient-specific fall risks. Dependent variables (fall rates, fall injury rates, fall injury type, use of Targeted Risk Factor Fall Prevention Bundle) were collected at baseline, and following completion of the 15month implementation phase. Nurse questionnaires included the Stage of Adoption Scale, and the Use of Research Findings in Practice Scale to measure adoption of evidence-based fall prevention practices. A Medical Record Abstract Form was used to abstract data about use of targeted risk-specific fall prevention interventions. Number of falls, and number and types of fall injuries were collected for each study unit for 3months pre- and post-implementation. Data were analyzed using multivariate analysis. Fall rates declined 22% (p=0.09). Types of fall injuries changed from major and moderate to minor injuries. Fall injury rates did not decline. Use of fall prevention interventions improved significantly (p<0.001) for mobility, toileting, cognition, and risk reduction for injury, but did not change for those targeting medications. Using the Translating Research Into Practice intervention promoted use of many evidence-based fall prevention interventions to mitigate patient-specific fall risk factors in hospitalized adults. Copyright © 2015. Published by Elsevier Inc.

  18. Infection prevention and control.

    PubMed

    Pegram, Anne; Bloomfield, Jacqueline

    2015-03-18

    All newly registered graduate nurses are required to have the appropriate knowledge and understanding to perform the skills required for patient care, specifically the competencies identified in the Nursing and Midwifery Council's essential skills clusters. This article focuses on the third essential skills cluster - infection prevention and control. It provides an overview and discussion of the key skills and behaviours that must be demonstrated to meet the standards set by the Nursing and Midwifery Council. In doing so, it considers the key principles of infection prevention and control, including local and national policies, standard infection control precautions, risk assessment, standard isolation measures and asepsis.

  19. Evaluating leadership training in African American HIV prevention organizations.

    PubMed

    Coleman, Jason D; Dauner, Kim Nichols; Richter, Donna L; Annang, Lucy; Sellers, Denethia B; Lindley, Lisa L

    2011-09-01

    This article aimed to examine changes in the HIV prevention capacity of HIV prevention program managers who completed the Institute for HIV Prevention Leadership ("Institute") between 2002 and 2004, and who worked in community-based organizations that primarily served African Americans. Participants completed a survey at three points in time, in which they rated the frequency with which they conducted activities related to HIV prevention practice. Participants also rated their confidence in performing activities. Repeated measures ANOVA was conducted to detect differences at three time points (baseline, immediate posttest, and 6 months posttest). A significant overall positive trend was found in the frequency and confidence of participants to perform specific HIV prevention practices and an overall positive trend in the frequency of processes that support HIV prevention practice. Investment in long-term, intensive, capacity-building programs like the Institute is critical to address the increasing incidence of HIV in many African American communities.

  20. Minnesota's Baskets-of-Care Project: scope, components, and measurement.

    PubMed

    Vinz, Cally; Foreman, Joann; Bonneville, Sara

    2010-01-01

    One idea that has emerged from health care reform discussions in Minnesota is the concept of "baskets of care", a method of reimbursing health care providers for episodes of care, rather than specific services and procedures. As a requirement of the state's 2008 health care reform legislation, the Minnesota Department of Health, with help from providers, payers, employers, and consumers, developed baskets of care for pediatric asthma care, diabetes care, prediabetes care, acute low back pain care, obstetric care, preventive care for adults, preventive care for children, and total knee replacement.This article describes those eight baskets of care, their development, and the recommended quality measures for each one.

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

    PubMed

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

    2014-08-19

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

  2. THE EFFECT OF A CULTURALLY TAILORED SUBSTANCE ABUSE PREVENTION INTERVENTION WITH PLAINS INDIAN ADOLESCENTS.

    PubMed

    Patchell, Beverly A; Robbins, Leslie K; Lowe, John A; Hoke, Mary M

    2015-01-01

    To examine the effects of incorporating tribal specific cultural beliefs into a tailored substance abuse prevention intervention for at risk rural Oklahoma Native American Indian (NAI) Plains adolescents. The 10 hour Native American Talking Circle Intervention, a school-based, group substance abuse prevention program, was implemented over a 8.5 week period and evaluated using a one group, pretest-posttest design. Measurements were from the Native Self-Reliance Questionnaire and the Substance Problems Scale from Global Appraisal of Individual Needs-Quick (GAIN-Q). One-tailed, paired sample t-tests demonstrated significant increase in self-reliance, from 86.227 to 92.204 (t (43) = -2.580, p = .007) and a decrease in substance abuse/use, from 2.265 to 1.265 (t (33) = 1.844, p = .007). The Native Talking Circle Intervention based on tribal-specific values and beliefs was shown to be effective with substance abuse/use at-risk NAI Plains tribal adolescents.

  3. Personal involvement of young people in HIV prevention campaign messages: the role of message format, culture, and gender.

    PubMed

    Geary, Cynthia Waszak; Burke, Holly M; Johnson, Laura; Liku, Jennifer; Castelnau, Laure; Neupane, Shailes; Niang, Cheikh

    2008-04-01

    To examine young people's reactions to and understanding of HIV prevention messages developed for MTV's global HIV prevention campaign Staying Alive, videotaped campaign materials were shown to focus group discussion (FGD) participants living in urban areas of Brazil, Kenya, Nepal, and Senegal. Responses related to "personal involvement" with the message were identified in the data from these FGDs and were examined in relationship to the emerging message themes, the message format (public service announcements [PSAs] vs. documentary), cultural context (site), and participant gender. Across groups, greater personal involvement (measured by personal connections, emotional reactions, and lessons learned) was found in responses about the documentary format compared to the PSA format. Exceptions were found for specific PSAs that were considered more relevant within specific gender or cultural contexts. Implications of findings for global campaigns were considered.

  4. [Alcohol consumption in adolescents (12 to 17 years): the point of view of health professionals].

    PubMed

    March Cerdá, Joan Carles; Prieto Rodríguez, María Ángeles; Danet, Alina; Suess, Amets; Ruiz Román, Paloma; García Toyos, Noelia

    2012-09-01

    To find out the opinions of health professionals on adolescent alcohol drinking and their evaluation of the existing legal regulation measures. Qualitative and exploratory study, based on semi-structured interviews. Four cities representing four different regions in Spain: Palma de Mallorca, Granada, Barcelona and Pamplona. A total of 36 physicians and nurses from four Spanish regions, working in Primary Care and Emergency Care, selected by intentiones samples. A total of 36 deep interviews, analysed using the software Nudist Vivo 4.0. Health professionals accept their important role in preventing and intervening in adolescent alcohol drinking. Generally, they consider it as a public health problem. Prevention is associated with Primary Care, while the Emergency Departments act in specific situations of alohol abuse. Adolescents infrequently visit Primary Care, thus prevention must centre on education system and constant coordination between health professional and parents. Health personnel do not have sufficient knowledge on legal regulations. They consider educational measures as more efficient than sanctions. Specific professional training is required in order to guarantee the coordination between the health and education systems and the family. Copyright © 2008 Elsevier España, S.L. All rights reserved.

  5. [Female alcoholic consumption between search for equality and increase of risk: which prevention?].

    PubMed

    Pala, Bastiana

    2004-01-01

    During the latest 5 years, Italy noticed an increase in the number of consumers, mainly among women and young people, together with a general drop in the consumption of alcohol. Among women, and particularly among young women, the trend toward higher and extra meals consumption is growing, mainly in bars or discos, in accordance with a pattern imported by North Europe countries. We suppose that the success of such a model of consumption among women is linked, for its peculiarities, customs and contexts involved, to the attainment of a status of a greater emancipation and equality with men, which is considered an important value in this historical period. Nowadays women seem to be more exposed to the risk of alcohol-related problems just because of their search for emancipation and equality. In that situation, we need measures of prevention specifically aimed at the female population, informing women about the specific risks and responsibilities connected with the female role in the field of alcohol consumption. In the mean time these measures of prevention must be able to respect the search of equality and emancipation that has been motivating the evolution of female behaviours for the latest years.

  6. Measurements of Sexuality-Based Stigma among Gay, Bisexual, and Other Men Who Have Sex with Men (GBMSM) in Resource-Poor Settings: A Review.

    PubMed

    Freeland, Ryan; Rogers, Erin; van Rooyen, Heidi; Darbes, Lynae; Saylor, Kate; Stephenson, Rob

    2018-05-01

    Gay, bisexual, and other men who have sex with men (GBMSM) in resource-poor settings are disproportionately affected by the HIV/AIDS epidemic. GBMSM living in these settings may face unique barriers to HIV prevention, including legal barriers and increased sexuality-based stigma. It is therefore imperative to tailor HIV prevention and care resources to recognize the lived realities of GBMSM in these settings. Central to this is the accurate measurement of sexuality-based stigma. However, there is wide inconsistency in how sexuality-based stigma is measured among GBMSM in resource-poor settings. This paper reviews recent studies of sexuality-based stigma among GBMSM in resource-poor settings, finding great variability in measurements. The results of the review call for greater attention to the development of contextually and culturally specific measures of sexuality-based stigma for GBMSM living in resource-poor settings.

  7. Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges.

    PubMed

    Al-Abri, Seif S; Abdel-Hady, Doaa M; Al-Abaidani, Idris S

    2016-06-01

    Although the majority of travel-associated communicable diseases can be prevented, the public health burden of these diseases remains significant. Relatively little is known about how travelers know and perceive the health risks associated with travel and how they utilize preventive measures before and while traveling abroad. This study was conducted to determine the level of the knowledge, attitudes, and practices (KAP) of Muscat International Airport travelers about travel health in order to assess the knowledge gap and the need for travel health services in Oman. A cross-sectional study was conducted over a period of 1week using a self-administered questionnaire. The overall level of knowledge about vaccine-preventable diseases, food safety, and preventive measures against insect bites of the participants was inadequate. The practice concerning preventive travel health measures, such as the use of specific immunizations and antimalarial prophylaxis, was very limited, and influenced by some personal and travel-related factors. The inadequate level of travelers' knowledge and poor utilization of travel medicine services highlights the need for the provisions of specialized travel medicine services at the national level and to develop educational materials promoting the importance of pre-travel health advice. Copyright © 2016 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

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

    PubMed

    Rabin, Borsika; Glasgow, Russell E

    2015-01-01

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

  9. A study of passive safety features by utilizing intra-subassembly-equipped self-actuated shutdown mechanism for future large fast breeder reactors

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

    Uto, N.; Niwa, H.; Ieda, Y.

    1996-08-01

    Passive prevention of core disruptive accidents (CDAs) is desired in terms of enhancement of safety for future fast breeder reactors. In addition, mitigation of CDA`s consequences should be required because mitigation measures have a potential of applying to all accidents, while prevention measures are prepared for specific accident initiators. In this paper, the Intra-Subassembly-equipped Self-Actuated Shutdown System (IS-SASS) , which is considered effective on passive prevention and mitigation of CDAs, is described. The IS-SASS is introduced in a fuel subassembly and consists of absorber materials at the top of the active core and an inner duct through which molten fuelmore » can be excluded out of the core. The determination of the appropriate number of the IS-SASS units, their arrangement in the core and their suitable structure are found to be suited to prevention and mitigation of CDAs for liquid metal-cooled large fast breeder reactors.« less

  10. PCT Databank: A Tool for Planning, Implementation and Monitoring of Integrated Preventive Chemotherapy for Control of Neglected Tropical Diseases (NTD)

    PubMed Central

    Mikhailov, Alexei; Yajima, Aya; Mbabazi, PS; Gabrielli, Albis F.; Montresor, Antonio; Engels, Dirk

    2017-01-01

    The integration of vertical control programmes of neglected tropical diseases (NTDs) aims at containing operational cost, simplifies the application of the control measures and extends the intervention coverage. The Preventive Chemotherapy and Transmission Control (PCT) Databank was established by the World Health Organization to facilitate the sharing of data among the different partners involved in control activities and collects and compiles historical and current information on disease-specific epidemiological situation, the geographical overlapping of NTDs and the progress of control activities in all the NTD-endemic countries. The summary of country-specific epidemiological maps and the progress of control activities is available online as the online PCT Databank and Country Profiles. The annual progress of preventive chemotherapy (PC) interventions targeting at specific NTDs is also annually reported in the Weekly Epidemiological Record (WER). In this paper, we elucidated the methodology of data collection, compilation and mapping to establish the PCT Databank and presented the key features of the associated three online outputs, i.e. the online PCT Databank, the Country Profile and the WER. PMID:22357399

  11. Ventilatory Requirements of M1 Tank Crew Members during Simulated Battlefield Conditions

    DTIC Science & Technology

    1989-05-15

    replicated the environment and activity"’, but did not measure ventilation whereas the tanadian study did tiuL •w• i tha ccmbat cn-irro.ent cr...measure’ cl ambient CO concentration, human hazards for that measured environment can be determined. The physical configuration and operational requirements...to prevent inhalation of unfiltered air around the mask, when the soldier is fighting in a contaminated environment . Current design specifications

  12. [Seclusion and mechanical restraints in psychiatric care: Prescriptions procedures, pharmacological management, and monitoring].

    PubMed

    Tezenas du Montcel, Chloé; Kowal, Célia; Leherle, Audrey; Kabbaj, Soraya; Frajerman, Ariel; Le Guen, Emmanuel; Hamdani, Nora; Schürhoff, Franck; Leboyer, Marion; Pelissolo, Antoine; Pignon, Baptiste

    2018-04-18

    We will briefly summarize the French recommendations concerning the use of seclusion and mechanical restraint. Acute agitation and aggression or self-injurious activity during psychotic and manic episodes are the main indication of prescription of the coercive measures. Their prescriptions respect specific modalities that will be explained. Although they proved to be efficient, seclusion and restrain need to stay a last resort option, considering the risk of physical complications and psychological consequences. Specific pharmacological prescription will necessarily be associated with coercive measures and we present prescription guidelines. Finally, physical complications need to be prevented and we submit specific protocol concerning constipation and thromboembolic risk management. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  13. Factors associated with reduced compliance of children to dental preventive measures.

    PubMed

    Ashkenazi, Malka; Bidoosi, Mervat; Levin, Liran

    2012-07-01

    The aim of this study was to record self-reported factors for non-compliance to 'dental home' preventive measures among pediatric patients, and to clarify whether number or frequency of recall appointments increases their long-term compliance to dental home. Children attending recall appointments in a pediatric dental clinic were interviewed regarding their compliance as well as factors for non-compliance with the previously recommended preventive measures. Files of 651 children were analyzed. A significant positive correlation was found between compliance with regular teeth brushing twice a day (p < 0.0001), using correct fluoride concentration toothpaste (p < 0.0001), drinking water between meals (p < 0.0001), using Elmex gel (p < 0.0001), flossing (p < 0.002) and number of recall appointments. The most common factor for non-compliance to 'dental home' was 'I forgot'. Not flossing was commonly justified by performance difficulty while non-compliance to Elmex gel or to mouth rinses was attributed mainly to 'bad taste'. Additional common reasons were 'it was finished', 'my parents did not purchase', 'I did not find it at home', 'I did not know I need to'. Frequency and number of recall appointments might improve compliance with dental preventive measures. Referring to the specific factors of personal non-compliance may increase compliance.

  14. Nutrition in clinical practice-the refeeding syndrome: illustrative cases and guidelines for prevention and treatment.

    PubMed

    Stanga, Z; Brunner, A; Leuenberger, M; Grimble, R F; Shenkin, A; Allison, S P; Lobo, D N

    2008-06-01

    The refeeding syndrome is a potentially lethal complication of refeeding in patients who are severely malnourished from whatever cause. Too rapid refeeding, particularly with carbohydrate may precipitate a number of metabolic and pathophysiological complications, which may adversely affect the cardiac, respiratory, haematological, hepatic and neuromuscular systems leading to clinical complications and even death. We aimed to review the development of the refeeding syndrome in a variety of situations and, from this and the literature, devise guidelines to prevent and treat the condition. We report seven cases illustrating different aspects of the refeeding syndrome and the measures used to treat it. The specific complications encountered, their physiological mechanisms, identification of patients at risk, and prevention and treatment are discussed. Each case developed one or more of the features of the refeeding syndrome including deficiencies and low plasma levels of potassium, phosphate, magnesium and thiamine combined with salt and water retention. These responded to specific interventions. In most cases, these abnormalities could have been anticipated and prevented. The main features of the refeeding syndrome are described with a protocol to anticipate, prevent and treat the condition in adults.

  15. Enhancing treatment fidelity in psychotherapy research: novel approach to measure the components of cognitive behavioural therapy for relapse prevention in first-episode psychosis.

    PubMed

    Alvarez-Jimenez, Mario; Wade, Darryl; Cotton, Sue; Gee, Donna; Pearce, Tracey; Crisp, Kingsley; McGorry, Patrick D; Gleeson, John F

    2008-12-01

    Establishing treatment fidelity is one of the most important aspects of psychotherapy research. Treatment fidelity refers to the methodological strategies used to examine and enhance the reliability and validity of psychotherapy. This study sought to develop and evaluate a measure specifically designed to assess fidelity to the different therapeutic components (i.e. therapy phases) of the individual intervention of a psychotherapy clinical trial (the EPISODE II trial). A representative sample of sessions stratified by therapy phase was assessed using a specifically developed fidelity measure (Relapse Prevention Therapy-Fidelity Scale, RPT-FS). Each RPT-FS subscale was designed to include a different component/phase of therapy and its major therapeutic ingredients. The measure was found to be reliable and had good internal consistency. The RPT-FS discriminated, almost perfectly, between therapy phases. The analysis of the therapeutic strategies implemented during the intervention indicated that treatment fidelity was good throughout therapy phases. While therapists primarily engaged in interventions from the appropriate therapeutic phase, flexibility in therapy was evident. This study described the development of a brief, reliable and internally consistent measure to determine both treatment fidelity and the therapy components implemented throughout the intervention. This methodology can be potentially useful to determine those components related to therapeutic change.

  16. Using quality improvement methods to increase use of pain prevention strategies for childhood vaccination.

    PubMed

    Schurman, Jennifer Verrill; Deacy, Amanda D; Johnson, Rebecca J; Parker, Jolynn; Williams, Kristi; Wallace, Dustin; Connelly, Mark; Anson, Lynn; Mroczka, Kevin

    2017-02-08

    To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology. Specific intervention strategies ( i.e ., comfort positioning, nonnutritive sucking and sucrose analgesia, distraction) were identified, selected and introduced in three waves, using a Plan-Do-Study-Act framework. System-wide change was measured from baseline to post-intervention by: (1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and (2) caregiver satisfaction ratings following the visit. Additionally, self-reported staff and caregiver attitudes and beliefs about pain prevention were measured at baseline and 1-year post-intervention to assess for possible long-term cultural shifts. Significant improvements were noted post-intervention. Use of at least one pain prevention strategy was documented at 99% of patient visits and 94% of caregivers were satisfied or very satisfied with the pain prevention care received. Parents/caregivers reported greater satisfaction with the specific pain prevention strategy used [ t (143) = 2.50, P ≤ 0.05], as well as greater agreement that the pain prevention strategies used helped their children's pain [ t (180) = 2.17, P ≤ 0.05] and that they would be willing to use the same strategy again in the future [ t (179) = 3.26, P ≤ 0.001] as compared to baseline. Staff and caregivers also demonstrated a shift in attitudes from baseline to 1-year post-intervention. Specifically, staff reported greater agreement that the pain felt from vaccinations can result in harmful effects [2.47 vs 3.10; t (70) = -2.11, P ≤ 0.05], less agreement that pain from vaccinations is "just part of the process" [3.94 vs 3.23; t (70) = 2.61, P ≤ 0.05], and less agreement that parents expect their children to experience pain during vaccinations [4.81 vs 4.38; t (69) = 2.24, P ≤ 0.05]. Parents/caregivers reported more favorable attitudes about pain prevention strategies for vaccinations across a variety of areas, including safety, cost, time, and effectiveness, as well as less concern about the pain their children experience with vaccination [4.08 vs 3.26; t (557) = 6.38, P ≤ 0.001], less need for additional pain prevention strategies [3.33 vs 2.81; t (476) = 4.51, P ≤ 0.001], and greater agreement that their doctors' office currently offers pain prevention for vaccinations [3.40 vs 3.75; t (433) = -2.39, P ≤ 0.05]. Quality improvement methodology can be used to help close the gap in implementing pain prevention strategies during routine vaccination procedures for children.

  17. [National Disease Management Guideline for Asthma: recommendations and evidence for "asthma prevention" issues].

    PubMed

    Berdel, Dietrich; Buhl, Roland; Dierkesmann, Rainer; Niebling, Wilhelm; Schultz, Konrad; Ukena, Dieter; Worth, Heinrich; von Wichert, Peter; Ollenschläger, Günter; Kopp, Ina

    2006-01-01

    The National Disease Management Program (NDM Program) represents the basic content of structured, cross-sectoral healthcare. In particular, the NDM Program is directed towards coordinating different disciplines and areas of healthcare. The recommendations are developed through interdisciplinary consensus of the scientific medical societies on the basis of the best available evidence. Within this scope the scientific medical societies concerned with the prevention, diagnosis, therapy and rehabilitation of asthma consented upon a National Disease Management Guideline for Asthma in 2005. Among other things, the following cornerstones of asthma prevention were agreed upon: Breastfeeding and non-smoking were suggested as primary prevention measures for (expectant) parents. With respect to secondary prevention, recommendations have been made for allergen avoidance, active/passive smoking and immunotherapy. Regarding tertiary prevention, position statements on vaccination and specific immunotherapy are developed. The present paper presents both the original texts of the recommendations and the evidence underlying them.

  18. An Online Drug Abuse Prevention Program for Adolescent Girls: Posttest and 1-Year Outcomes.

    PubMed

    Schwinn, Traci M; Schinke, Steven P; Hopkins, Jessica; Keller, Bryan; Liu, Xiang

    2018-03-01

    Early adolescent girls' rates of drug use have matched, and in some instances, surpassed boys' rates. Though girls and boys share risk factors for drug use, girls also have gender-specific risks. Tailored interventions to prevent girls' drug use are warranted. This study developed and tested a web-based, drug abuse prevention program for adolescent girls. The nationwide sample of 13- and 14-year-old girls (N = 788) was recruited via Facebook ads. Enrolled girls were randomly assigned to the intervention or control condition. All girls completed pretest measures online. Following pretest, intervention girls interacted with the 9-session, gender-specific prevention program online. The program aimed to reduce girls' drug use and associated risk factors by improving their cognitive and behavioral skills around such areas as coping with stress, managing mood, maintaining a healthy body image, and refusing drug use offers. Girls in both conditions again completed measures at posttest and 1-year follow-up. At posttest, and compared to girls in the control condition, girls who received the intervention smoked fewer cigarettes and reported higher self-esteem, goal setting, media literacy, and self-efficacy. At 1-year follow-up, and compared to girls in the control condition, girls who received the intervention reported engaging in less binge drinking and cigarette smoking; girls assigned to the intervention condition also had higher alcohol, cigarette, and marijuana refusal skills, coping skills, and media literacy and lower rates of peer drug use. This study's findings support the use of tailored, online drug abuse prevention programming for early adolescent girls.

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

    PubMed Central

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

    2014-01-01

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

  20. Measures to prevent nosocomial infections during mechanical ventilation.

    PubMed

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

    2012-02-01

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

  1. Alcohol outlet density, drinking contexts and intimate partner violence: a review of environmental risk factors.

    PubMed

    Cunradi, Carol B; Mair, Christina; Todd, Michael

    2014-01-01

    Alcohol use is a robust predictor of intimate partner violence (IPV). A critical barrier to progress in preventing alcohol-related IPV is that little is known about how an individual's specific drinking contexts (where, how often, and with whom one drinks) are related to IPV, or how these contexts are affected by environmental characteristics, such as alcohol outlet density and neighborhood disadvantage. The putative mechanism is the social environment in which drinking occurs that may promote or strengthen aggressive norms. Once these contexts are known, specific prevention measures can be put in place, including policy-oriented (e.g., regulating outlet density) and individually oriented (e.g., brief interventions to reduce risk for spousal aggression) measures targeting at-risk populations. This paper reviews applicable theories and empirical research evidence that links IPV to drinking contexts and alcohol outlet density, highlights research gaps, and makes recommendations for future research. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  2. Prevention of lassa Fever in Nigeria.

    PubMed

    Inegbenebor, Ute; Okosun, John; Inegbenebor, Josephine

    2010-01-01

    Although specific treatment is available for Lassa fever, early diagnosis is still difficult in most Nigerian primary and secondary health centers. This study was carried out to compare the case-fatality rates of Lassa fever and other medical diseases commonly seen in adult medical wards, to determine the community habits that make Lassa fever endemic in Edo Central District of Nigeria, with the aim of prescribing preventive measures for its control in Nigeria. The records of 908 inpatients in the adult medical wards of Irrua Specialist Teaching Hospital, Irrua and responses from respondents interviewed by trained interviewers on their knowledge, attitudes and practices pertaining to Lassa fever were used for this study. The case-fatality rate of Lassa fever in this center was 28%. Cultural factors and habits were found to favor endemicity of Lassa fever in Edo Central District of Nigeria. Preventive measures were prescribed for families and communities.

  3. [Identification of pathologic alcohol use and its prevention. Results of employee interviews in a clinic].

    PubMed

    Ennenbach, M; Soyka, M

    2007-05-01

    After a short review of the literature about addiction in the working place, a study is presented that evaluates the alcohol use of all employees (n=301) in a clinic. The readiness to cooperate was very strong (72%). The openness (investigated with the FPI subscale for openness) was also satisfactory. Results showed a surprisingly high proportion of notable alcohol use by employees (26%). Especially the group of young female employees showed a high range of stress indicators: alcohol use (28.6%), nicotine (24.2%) and eating disorders (22.9%), and moderate-to-strong consumption of medication (12.1%). A sex-specific model of the development of addiction will be suggested based on these study results. A program of preventive measures was implemented integrating well-known components of established successful preventive measures and considering the special environment of the clinic.

  4. The effects of feed-borne Fusarium mycotoxins and glucomannan in turkey poults based on specific and non-specific parameters.

    PubMed

    Devreese, Mathias; Girgis, George N; Tran, Si-Trung; De Baere, Siegrid; De Backer, Patrick; Croubels, Siska; Smith, Trevor K

    2014-01-01

    An experiment was conducted to investigate the effects of feeding grains naturally contaminated with Fusarium mycotoxins and a yeast derived glucomannan mycotoxin adsorbent (GMA) on selected specific and non-specific parameters in turkey poults. Two hundred and forty 1-day-old male turkey poults were fed the experimental diets for twelve weeks. Experimental diets were formulated with control grains, control grains+0.2% GMA, naturally-contaminated grains, or naturally-contaminated grains+0.2% GMA. Deoxynivalenol (DON) was the major contaminant of the contaminated grains and concentrations varied from 4.0 to 6.5 mg/kg in the contaminated diets. Non-specific parameters measured included: performance parameters, plasma biochemistry profiles, morphometry and CD8(+) T-lymphocyte counts in the duodenum. Plasma concentrations of DON and de-epoxydeoxynivalenol (DOM-1) were used as specific parameters. Performance parameters and plasma biochemistry were altered by the feeding of contaminated diets and GMA but this was not consistent throughout the trial. The feeding of contaminated diets reduced duodenal villus height and apparent villus surface area. This effect was prevented by GMA supplementation. The feeding of contaminated diets elevated total duodenal CD8(+) T-lymphocyte counts but this effect was not prevented by GMA. No significant differences were seen in plasma concentrations of DON and DOM-1 comparing birds fed contaminated and contaminated+GMA diets suggesting that GMA did not prevent DON absorption under these conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Adapting a Particle Model for Computing Sulfur Dioxide Concentrations in Mount Rainier Area and Comparing Them to Measured Values

    NASA Astrophysics Data System (ADS)

    Givati, Reuven

    In this work the SO_2 concentrations measured in the Mt. Rainier area during PREVENT Pacific Northwest Regional Visibility Experiment Using Natural Tracers, June to September 1990), were analyzed with the aid of the MATHEW/ADPIC models (a diagnostic wind model and a particle model) developed by Lawrence Livermore National Laboratory. Some changes were made in the models to adapt them to the specific conditions of this experiment. The models were run on a large domain in western Washington, and the SO_2 concentrations were evaluated at two specific points, Tahoma Woods and Paradise in the Nisqually Valley, the only points near Mt. Rainier where SO_2 concentrations were measured during PREVENT. The changes that were made were: including loss rates of SO_2 by oxidation, using different heights of the top of the boundary layer at different locations, enabling limited area of influence of specific meteorological stations when interpolating the wind fields, and including the possibility of reflection of the air "particles", from the top of the mixed layer. Because of the paucity of the meteorological measurements near the sampling points, an estimation was made about the wind behavior in the valley, based on the phenomena of wind channeling, mountain and valley winds, and historical wind measurements near Mt. Rainier. The models were run for several non-rainy days of PREVENT having large SO_2 concentrations, or that were interesting for other reasons. The agreement between the measured and modeled SO_2 concentrations at Tahoma Woods during the daytime periods, was quite good. Out of 14 days, for which the emissions of the previous night were taken into account, for 12 days (86%) the ratio of the modeled to the measured SO_2 concentrations, at Tahoma Woods during the daytime periods, was in the interval 0.45-2.00. The agreement between the modeled and measured SO_2 concentrations at Tahoma Woods during the nights, and at Paradise, during the day and the night, were not good. It seems that the wind flow near Tahoma Woods during the nights (stable conditions), and near Paradise (steep terrain), could not be modeled correctly, with the limited meteorological observations available.

  6. 10 CFR 850.26 - Regulated areas.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Regulated areas. 850.26 Section 850.26 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Specific Program Requirements § 850.26 Regulated areas. (a) If airborne concentrations of beryllium in areas in DOE facilities are measured at or...

  7. When Students Say School Makes Them Sick, Sometimes They're Right.

    ERIC Educational Resources Information Center

    Reecer, Marcia

    1988-01-01

    "Sick building syndrome" results mainly from tightly sealed, poorly ventilated buildings with low levels of airborne pollutants. This article describes the problem at a Pennsylvania elementary school, examines roles of specific contaminants, and discusses credibility problems, prescriptions, and preventive measures. Insets explain causes…

  8. Schools, Society, and "Teen" Pregnancy.

    ERIC Educational Resources Information Center

    Males, Mike

    1993-01-01

    Reality of widespread adult/teen sex--as revealed through age-specific pregnancy, birth, and sexually transmitted disease (STD) statistics--has profound implications for public school sex education and efforts to reduce incidence of teen pregnancy and STDs. Many public school "prevention" measures have failed because male half of "teen" pregnancy…

  9. 9 CFR 3.56 - Sanitation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... WELFARE STANDARDS Specifications for the Humane Handling, Care, Treatment and Transportation of Rabbits.... Measures shall be taken to prevent the wetting of rabbits in such enclosures if a washing process is used... primary enclosures. (1) Primary enclosures for rabbits shall be sanitized at least once every 30 days in...

  10. Network Security Is Manageable

    ERIC Educational Resources Information Center

    Roberts, Gary

    2006-01-01

    An effective systems librarian must understand security vulnerabilities and be proactive in preventing problems. Specifics of future attacks or security challenges cannot possibly be anticipated, but this paper suggests some simple measures that can be taken to make attacks less likely to occur: program the operating system to get automatic…

  11. Agreement, the F-Measure, and Reliability in Information Retrieval

    PubMed Central

    Hripcsak, George; Rothschild, Adam S.

    2005-01-01

    Information retrieval studies that involve searching the Internet or marking phrases usually lack a well-defined number of negative cases. This prevents the use of traditional interrater reliability metrics like the κ statistic to assess the quality of expert-generated gold standards. Such studies often quantify system performance as precision, recall, and F-measure, or as agreement. It can be shown that the average F-measure among pairs of experts is numerically identical to the average positive specific agreement among experts and that κ approaches these measures as the number of negative cases grows large. Positive specific agreement—or the equivalent F-measure—may be an appropriate way to quantify interrater reliability and therefore to assess the reliability of a gold standard in these studies. PMID:15684123

  12. The prevention of oral mucositis in patients with blood cancers: current concepts and emerging landscapes.

    PubMed

    Niscola, Pasquale; Tendas, Andrea; Cupelli, Luca; Catalano, Gianfranco; Scaramucci, Laura; Giovannini, Marco; Trinchieri, Vito; Sharma, Atul; Efficace, Fabio; Cartoni, Claudio; Piccioni, Daniela; Perrotti, Alessio; Dentamaro, Teresa; de Fabritiis, Paolo; Keefe, Dorothy M K

    2012-12-01

    The prevention of oral mucositis (OM) in the management of hematological malignancies continues to represent an unmet clinical need. Addressing this issue has major clinical implications as OM can also greatly impair patient's quality of life. To review currently available measures and investigational agents to prevent OM in hematological patients. we searched for OM and related issues using Medline; the abstract books of the most important hematological and oncological meetings were also reviewed. Many agents targeting different mechanisms of mucosal damage have been applied in order to prevent OM; most of them have failed or its efficacy has not been fully demonstrated. Palifermin is the first pharmaceutical/biological agent approved for the prevention of OM; its use is currently restricted to patients who have received radiotherapy-containing conditioning regimens prior to autologous hematopoietic stem cell transplantation. No clear benefit by this agent has been demonstrated outside of this specific setting and its application should be limited to clinical trials. Other interventions, such as other growth factors and non mitogenic measures are under investigation or in development and their application in the hematological setting is expected in the short term.

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

    PubMed

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

    2018-05-30

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

  14. Asthma and exposure to cleaning products - a European Academy of Allergy and Clinical Immunology task force consensus statement.

    PubMed

    Siracusa, A; De Blay, F; Folletti, I; Moscato, G; Olivieri, M; Quirce, S; Raulf-Heimsoth, M; Sastre, J; Tarlo, S M; Walusiak-Skorupa, J; Zock, J-P

    2013-12-01

    Professional and domestic cleaning is associated with work-related asthma (WRA). This position paper reviews the literature linking exposure to cleaning products and the risk of asthma and focuses on prevention. Increased risk of asthma has been shown in many epidemiological and surveillance studies, and several case reports describe the relationship between exposure to one or more cleaning agents and WRA. Cleaning sprays, bleach, ammonia, disinfectants, mixing products, and specific job tasks have been identified as specific causes and/or triggers of asthma. Because research conclusions and policy suggestions have remained unheeded by manufactures, vendors, and commercial cleaning companies, it is time for a multifaceted intervention. Possible preventive measures encompass the following: substitution of cleaning sprays, bleach, and ammonia; minimizing the use of disinfectants; avoidance of mixing products; use of respiratory protective devices; and worker education. Moreover, we suggest the education of unions, consumer, and public interest groups to encourage safer products. In addition, information activities for the general population with the purpose of improving the knowledge of professional and domestic cleaners regarding risks and available preventive measures and to promote strict collaboration between scientific communities and safety and health agencies are urgently needed. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Health Behavior Changes After Genetic Risk Assessment for Alzheimer Disease: The REVEAL Study

    PubMed Central

    Chao, Serena; Roberts, J. Scott; Marteau, Theresa M.; Silliman, Rebecca; Cupples, L. Adrienne; Green, Robert C.

    2008-01-01

    Risk information for Alzheimer disease (AD) may be communicated through susceptibility gene disclosure, even though this is not currently in clinical use. The REVEAL Study is the first randomized clinical trial of risk assessment for AD with apolipoprotein E (APOE) genotype and numerical risk estimate disclosure. We examined whether APOE genotype and numerical risk disclosure to asymptomatic individuals at high risk for AD alters health behaviors. One hundred sixty-two participants were randomized to either intervention (APOE disclosure) or control (no genotype disclosure) groups. Subjects in both groups received numerical lifetime risk estimates of future AD development based on sex and family history of AD. The intervention group received their APOE genotype. Subjects were informed that no proven preventive measures for AD existed and given an information sheet on preventative therapies under investigation. Participants who learned they were ε4 positive were significantly more likely than ε4 negative participants to report AD-specific health behavior change 1 year after disclosure (adjusted odds ratio: 2.73; 95% confidence interval: 1.14, 6.54; P = 0.02). Post hoc analyses revealed similar significant associations between numerical lifetime risk estimates and self-report of AD-specific health behavior change. Despite lack of preventive measures for AD, knowledge of APOE genotype, numerical lifetime risk, or both, influences health behavior. PMID:18317253

  16. Health behavior changes after genetic risk assessment for Alzheimer disease: The REVEAL Study.

    PubMed

    Chao, Serena; Roberts, J Scott; Marteau, Theresa M; Silliman, Rebecca; Cupples, L Adrienne; Green, Robert C

    2008-01-01

    Risk information for Alzheimer disease (AD) may be communicated through susceptibility gene disclosure, even though this is not currently in clinical use. The REVEAL Study is the first randomized clinical trial of risk assessment for AD with apolipoprotein E (APOE) genotype and numerical risk estimate disclosure. We examined whether APOE genotype and numerical risk disclosure to asymptomatic individuals at high risk for AD alters health behaviors. One hundred sixty-two participants were randomized to either intervention (APOE disclosure) or control (no genotype disclosure) groups. Subjects in both groups received numerical lifetime risk estimates of future AD development based on sex and family history of AD. The intervention group received their APOE genotype. Subjects were informed that no proven preventive measures for AD existed and given an information sheet on preventative therapies under investigation. Participants who learned they were epsilon 4 positive were significantly more likely than epsilon 4 negative participants to report AD-specific health behavior change 1 year after disclosure (adjusted odds ratio: 2.73; 95% confidence interval: 1.14, 6.54; P=0.02). Post hoc analyses revealed similar significant associations between numerical lifetime risk estimates and self-report of AD-specific health behavior change. Despite lack of preventive measures for AD, knowledge of APOE genotype, numerical lifetime risk, or both, influences health behavior.

  17. Dairy farmers' perceptions toward the implementation of on-farm Johne's disease prevention and control strategies.

    PubMed

    Ritter, C; Jansen, J; Roth, K; Kastelic, J P; Adams, C L; Barkema, H W

    2016-11-01

    Implementation of specific management strategies on dairy farms is currently the most effective way to reduce the prevalence of Johne's disease (JD), an infectious chronic enteritis of ruminants caused by Mycobacterium avium subspecies paratuberculosis (MAP). However, dairy farmers often fail to implement recommended strategies. The objective of this study was to assess perceptions of farmers participating in a JD prevention and control program toward recommended practices, and explore factors that influence whether or not a farmer adopts risk-reducing measures for MAP transmission. Semi-structured interviews were conducted with 25 dairy farmers enrolled in a voluntary JD control program in Alberta, Canada. Principles of classical grounded theory were used for participant selection, interviewing, and data analysis. Additionally, demographic data and MAP infection status were collected and analyzed using quantitative questionnaires and the JD control program database. Farmers' perceptions were distinguished according to 2 main categories: first, their belief in the importance of JD, and second, their belief in recommended JD prevention and control strategies. Based on these categories, farmers were classified into 4 groups: proactivists, disillusionists, deniers, and unconcerned. The first 2 groups believed in the importance of JD, and proactivists and unconcerned believed in proposed JD prevention and control measures. Groups that regarded JD as important had better knowledge about best strategies to reduce MAP transmission and had more JD risk assessments conducted on their farm. Although not quantified, it also appeared that these groups had more JD prevention and control practices in place. However, often JD was not perceived as a problem in the herd and generally farmers did not regard JD control as a "hot topic" in communications with their herd veterinarian and other farmers. Recommendations regarding how to communicate with farmers and motivate various groups of farmers according to their specific perceptions were provided to optimize adoption of JD prevention and control measures and thereby increase success of voluntary JD control programs. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  18. Environmental Approaches to Prevention in College Settings

    PubMed Central

    Saltz, Robert F.

    2011-01-01

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

  19. A Comprehensive Approach to Risk Reduction for Asian and Pacific Islander American Women With HIV/AIDS.

    PubMed

    Sabato, Todd M

    2014-07-01

    As HIV incidence rises globally, Asian and Pacific Islander communities are increasingly affected. While often overlooked, Asian and Pacific Islander American women have shown the greatest percentage increase in HIV diagnosis rates. The development of a multilevel and multistrategy approach to HIV/AIDS education, prevention, and treatment among Asian and Pacific Islander females requires health care providers to identify personal and cultural barriers to prevention and treatment and implement culturally sensitive and specific measures. The purpose of this article is to illuminate barriers to HIV-related prevention, treatment, and care among Asian and Pacific Islander American females and provide practical application-based suggestions for providers, which may enhance Asian and Pacific Islander female inclusion in comprehensive HIV prevention. © The Author(s) 2014.

  20. Systematic review of mental health and well-being outcomes following community-based obesity prevention interventions among adolescents

    PubMed Central

    Hoare, Erin; Fuller-Tyszkiewicz, Matthew; Skouteris, Helen; Millar, Lynne; Nichols, Melanie; Allender, Steven

    2015-01-01

    Objectives This paper aimed to systematically evaluate the mental health and well-being outcomes observed in previous community-based obesity prevention interventions in adolescent populations. Setting Systematic review of literature from database inception to October 2014. Articles were sourced from CINAHL, Global Health, Health Source: Nursing and Academic Edition, MEDLINE, PsycARTICLES and PsycINFO, all of which were accessed through EBSCOhost. The Cochrane Database was also searched to identify all eligible articles. PRISMA guidelines were followed and search terms and search strategy ensured all possible studies were identified for review. Participants Intervention studies were eligible for inclusion if they were: focused on overweight or obesity prevention, community-based, targeted adolescents (aged 10–19 years), reported a mental health or well-being measure, and included a comparison or control group. Studies that focused on specific adolescent groups or were treatment interventions were excluded from review. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Primary and secondary outcome measures Primary outcomes were measures of mental health and well-being, including diagnostic and symptomatic measures. Secondary outcomes included adiposity or weight-related measures. Results Seven studies met the inclusion criteria; one reported anxiety/depressive outcomes, two reported on self-perception well-being measures such as self-esteem and self-efficacy, and four studies reported outcomes of quality of life. Positive mental health outcomes demonstrated that following obesity prevention, interventions included a decrease in anxiety and improved health-related quality of life. Quality of evidence was graded as very low. Conclusions Although positive outcomes for mental health and well-being do exist, controlled evaluations of community-based obesity prevention interventions have not often included mental health measures (n=7). It is recommended that future interventions incorporate mental health and well-being measures to identify any potential mechanisms influencing adolescent weight-related outcomes, and equally to ensure interventions are not causing harm to adolescent mental health. PMID:25564145

  1. Accurate Measurements of Spectral Reflectance in Picasso's Guernica Painting.

    PubMed

    de Luna, Javier Muñoz; Fernandez-Balbuena, Antonio Alvarez; Vázquez, Daniel; Melgosa, Manuel; Durán, Humberto; García, Jorge; Muro, Carmen

    2016-01-01

    The use of non-invasive spectral measurements to control the conservation status is a part of the preventive conservation of artworks which nowadays is becoming increasingly interesting. This paper describes how to use a spectral measuring device and an illumination system specifically designed for such a task in a very large dimension artwork painting (7.8 m wide × 3.5 m high). The system, controlled by a Cartesian robot, allows spectral measurements in a spectral range of 400-780 nm. The measured data array has a total of 2201 circular regions with 5.5 mm spot diameter placed on a square grid. Colorimetric calculations performed from these spectral measurements may be used to characterize color shifts related to reflectance changes in specific areas of the paint. A color shifting from the expected gray has been shown. © The Author(s) 2015.

  2. Prevention of occupational dermatitis.

    PubMed

    Sartorelli, P; Kezic, S; Larese Filon, F; John, S M

    2011-01-01

    Occupational dermatitis is among the most frequent occupational diseases. Dermal exposure risk affects many professional categories such as healthcare workers, hairdressers, bakers, cleaning and kitchen employees. The economical burden of occupational dermatitis (OD) is huge (greater than 5 billion Euro per year in Europe), comprising direct costs (treatment, compensation), as well as indirect costs due to sick leave and lack of productivity. A scientifically based preventive program consisting of skin protection during work, cleaning and skin care after work has generally been recommended to prevent occupational contact dermatitis. However the rate of reported occupational skin diseases seems unchanged in the recent years. In cases of impaired skin condition the secondary prevention (i.e. therapeutic treatment by dermatologists and health-educational intervention seminars) is fundamental. For cases of occupational dermatoses in which these outpatient prevention measures are not successful, interdisciplinary inpatient rehabilitation measures have been developed (tertiary individual prevention). In the past years, various pilot-concepts to improve occupational dermatitis prevention have been successfully put into practice focussing on interdisciplinary (dermatological and educational) skin protection training programmes for high-risk professions. Currently a multi-step intervention approach is implemented which is aiming at offering quick preventive help at all levels of severity of occupational contact dermatitis. Recent data reveals that there are reliable evidence-based options for multidisciplinary prevention and patient management of occupational dermatitis using a combined approach by a network of clinics, practices and statutory social insurance bodies. At this stage, it seemed reasonable to form a European joint initiative for skin prevention. Recently a European network of preventive dermatology (European Initiative for the Prevention of Occupational Skin Diseases-EPOS) has been organized based on the German experience in the specific field.

  3. Global progress in prevention of cardiovascular disease

    PubMed Central

    2017-01-01

    Although there is measurable global progress in prevention of cardiovascular disease (CVD), it has been highly uneven and inadequate, particularly in low- and middle-income countries. Voluntary global targets have helped to galvanize attention, resources and accountability on tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity which are the major behavioural drivers of CVD. Many obstacles and challenges continue to impede the progress of cardiovascular prevention. The inclusion of noncommunicable diseases (NCDs) in the sustainable development agenda as a specific target, offers an unprecedented opportunity to further advance the global progress of cardiovascular prevention. In order to seize this opportunity, a paradigm shift is required in the way key challenges to cardiovascular prevention are addressed. Such an approach must provide leadership for intersectoral policy coherence, identify effective means of tackling commercial determinants of behavioural risk factors, use rights based arguments, enhance public engagement and ensure accountability. PMID:28529920

  4. The "RESEAU MATER": An efficient infection control for endometritis, but not for urinary tract infection after vaginal delivery.

    PubMed

    Ayzac, Louis; Caillat-Vallet, Emmanuelle; Girard, Raphaële; Berland, Michel

    "RESEAU MATER" is useful to monitor nosocomial infections in maternity and contributes to the decreasing trend of it, since its implementation. Specifically, this network demonstrates its efficiency in the control of endometritis following vaginal deliveries, but not in the control of urinary tract infections. The aim of this study is to determine whether the difference between the control of endometritis and of urinary tract infection could be explained by an unsuitable regression model or by an unsuitable care policy concerning urinary cares. This study includes (1) the analysis of historic data of the network and (2) the description of French guidelines for maternity cares and available evaluations, concerning endometritis and urinary tract infection prevention. Univariate and multivariate odds ratios (ORs) were calculated for the total study period of 1999-2013, for these infections and their risk factors. The endometritis frequency is decreasing, in association with no significant evolution of associated risk factors, but urinary tract infection frequency is constant, in association with a increasing trend of its risk factors such as intermittent catheterization and epidural analgesia. In French guidelines, all preventive measures against endometritis are clearly broadcasted by all field operators, and repeated audits have reinforced the control of their application. But preventive measures against urinary tract infection seem to be broadcasted exclusively in the circle of infection prevention agencies and not in the obstetrics societies or in the Health Ministry communication. Urinary tract infection prevention requires a clearer public and professional policy in favor of a more efficient urinary cares, with a specific target to maternity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  5. Fast therapeutic hypothermia prevents post-cardiac arrest syndrome through cyclophilin D-mediated mitochondrial permeability transition inhibition.

    PubMed

    Jahandiez, Vincent; Cour, Martin; Bochaton, Thomas; Abrial, Maryline; Loufouat, Joseph; Gharib, Abdallah; Varennes, Annie; Ovize, Michel; Argaud, Laurent

    2017-07-01

    The opening of the mitochondrial permeability transition pore (PTP), which is regulated by the matrix protein cyclophilin D (CypD), plays a key role in the pathophysiology of post-cardiac arrest (CA) syndrome. We hypothesized that therapeutic hypothermia could prevent post-CA syndrome through a CypD-mediated PTP inhibition in both heart and brain. In addition, we investigated whether specific pharmacological PTP inhibition would confer additive protection to cooling. Adult male New Zealand White rabbits underwent 15 min of CA followed by 120 min of reperfusion. Five groups (n = 10-15/group) were studied: control group (CA only), hypothermia group (HT, hypothermia at 32-34 °C induced by external cooling at reperfusion), NIM group (injection at reperfusion of 2.5 mg/kg NIM811, a specific CypD inhibitor), HT + NIM, and sham group. The following measurements were taken: hemodynamics, echocardiography, and cellular damage markers (including S100β protein and troponin Ic). Oxidative phosphorylation and PTP opening were assessed on mitochondria isolated from both brain and heart. Acetylation of CypD was measured by immunoprecipitation in both the cerebral cortex and myocardium. Hypothermia and NIM811 significantly prevented cardiovascular dysfunction, pupillary areflexia, and early tissue damage. Hypothermia and NIM811 preserved oxidative phosphorylation, limited PTP opening in both brain and heart mitochondria and prevented increase in CypD acetylation in brain. There were no additive beneficial effects in the combination of NIM811 and therapeutic hypothermia. In conclusion, therapeutic hypothermia limited post-CA syndrome by preventing mitochondrial permeability transition mainly through a CypD-dependent mechanism.

  6. Problematics of empowerment: sex worker HIV prevention in the Pacific.

    PubMed

    McMillan, Karen E; Worth, Heather

    2016-12-01

    A recent overview of HIV/STI prevention programmes for sex workers in the Pacific region indicates that, despite a regional policy shift from universal to targeted interventions, Pacific Island countries currently lack core HIV/STI prevention services for sex workers. Across the region, condom distribution, peer outreach and support services for sex workers have ceased even in countries where such programmes had previously existed. This article cautions that the endorsement of empowerment projects does not negate the important role of condom access in HIV and STI prevention efforts for Pacific sex workers. While community empowerment underpins, and is essential to the sustainability of, effective interventions, it does not constitute an adequate form of HIV and STI prevention in and of itself. We contend that in the context of the Pacific Islands, timely and effective HIV prevention measures must specifically attend to the implementation of, and sustained support for, behavioural interventions such as sex-worker-specific peer education, condom and lubricant distribution, and access to appropriate sexual health services. Further, the responsibility for delivery of these should not be borne solely by fledgling sex worker organizations and communities. The evolution of targeted interventions in the Pacific and the current lack of funded condom distribution programmes highlight a more generalizable imperative within HIV prevention to ensure that behaviour change efforts are not considered to be extraneous to, or rendered redundant by, empowerment-based interventions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Acute kidney injury: Global health alert

    PubMed Central

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

    2013-01-01

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

  8. Acute Kidney Injury: Global Health Alert

    PubMed Central

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

    2013-01-01

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

  9. Falls prevention for the elderly.

    PubMed

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

    2012-01-01

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

  10. 15 CFR 291.4 - National industry-specific pollution prevention and environmental compliance resource centers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., external evaluation for assessing outcomes of the activity, and “customer satisfaction” measures of... requirements. (d) Project customers. (1) The customers for this center will be the businesses in the industrial...) The center should assist the customer in choosing the most cost- effective, environmentally sound...

  11. Disincentives, Identities, and Smoking.

    ERIC Educational Resources Information Center

    Norman, Nancy M.

    When smoking decisions are understood in terms of the beliefs and attitudes which determine them, prevention programs can focus on changing these beliefs and attitudes. A study was conducted to measure students' attitudes and beliefs on the short-term health effects of smoking, on the social consequences of smoking, and on specific identities…

  12. Dust prevention in bulk material transportation and handling

    NASA Astrophysics Data System (ADS)

    Kirichenko, A. V.; Kuznetsov, A. L.; Pogodin, V. A.

    2017-10-01

    The environmental problem of territory and atmosphere pollution caused by transportation and handling of dust-generating bulk cargo materials is quite common for the whole world. The reducing of weight of fine class coal caused by air blowing reaches the level of 0.5-0.6 t per railcar over the 500 km transportation distance, which is equal to the loss of 1 % of the total weight. The studies showed that all over the country in the process of the railroad transportation, the industry loses 3-5 metric tonnes of coal annually. There are several common tactical measurers to prevent dust formation: treating the dust-producing materials at dispatch point with special liquid solutions; watering the stacks and open handling points of materials; frequent dust removing and working area cleaning. Recently there appeared several new radical measures for pollution prevention in export of ore and coal materials via sea port terminals, specifically: wind-dust protection screens, the container cargo handling system of delivery materials to the hold of the vessels. The article focuses on the discussion of these measures.

  13. Phytochrome-mediated germination and early development in spores of Dryopteris filix-mas L.: phase-specific and non phase-specific inhibition by staurosporine

    NASA Technical Reports Server (NTRS)

    Haas, C. J.; Scheuerlein, R.; Roux, S. J.

    1991-01-01

    The alkaloid staurosporine, currently known as the most potent inhibitor of protein kinase C, PKC, was tested for its ability to inhibit phytochrome-mediated spore germination in Dryopteris filix-mas L., evaluated by the induction of chlorophyll synthesis. Approximately half-maximal inhibition was obtained at a concentration of 10(-5) M. This effect of staurosporine was phase-specific and was found during the same period in which the presence of extracellular calcium is necessary for realization of the light signal. Furthermore, the ability of staurosporine to prevent progression of a germinated spore into early gametophyte development, evaluated by the accumulation of chlorophyll, was examined. Again, staurosporine (10(-5) M) significantly diminished chlorophyll accumulation, determined quantitatively in vivo by single-cell measurements, in a non-phase specific way. The fact that the phase-specific inhibitory effect of staurosporine in preventing germination was coincident with the phase-specific requirement of Ca2+ suggests that both Ca2+ and staurosporine affect the same step in the signal-transduction chain. A phosphorylation event catalysed by PKC or any Ca2+ -dependent protein kinase is proposed as the target of staurosporine and Ca2+.

  14. Invited review: Mastitis in dairy heifers: nature of the disease, potential impact, prevention, and control.

    PubMed

    De Vliegher, S; Fox, L K; Piepers, S; McDougall, S; Barkema, H W

    2012-03-01

    Heifer mastitis is a disease that potentially threatens production and udder health in the first and subsequent lactations. In general, coagulase-negative staphylococci (CNS) are the predominant cause of intramammary infection and subclinical mastitis in heifers around parturition, whereas Staphylococcus aureus and environmental pathogens cause a minority of the cases. Clinical heifer mastitis is typically caused by the major pathogens. The variation in proportions of causative pathogens between studies, herds, and countries is considerable. The magnitude of the effect of heifer mastitis on an individual animal is influenced by the form of mastitis (clinical versus subclinical), the virulence of the causative pathogen(s) (major versus minor pathogens), the time of onset of infection relative to calving, cure or persistence of the infection when milk production has started, and the host's immunity. Intramammary infection in early lactation caused by CNS does not generally have a negative effect on subsequent productivity. At the herd level, the impact will depend on the prevalence and incidence of the disease, the nature of the problem (clinical, subclinical, nonfunctional quarters), the causative pathogens involved (major versus minor pathogens), the ability of the animals to cope with the disease, and the response of the dairy manager to control the disease through management changes. Specific recommendations to prevent and control mastitis in late gestation in periparturient heifers are not part of the current National Mastitis Council mastitis and prevention program. Control and prevention is currently based on avoidance of inter-sucking among young stock, fly control, optimal nutrition, and implementation of hygiene control and comfort measures, especially around calving. More risk factors for subclinical and clinical heifer mastitis have been identified (e.g., season, location of herd, stage of pregnancy) although they do not lend themselves to the development of specific intervention strategies designed to prevent the disease. Pathogen-specific risk factors and associated control measures need to be identified due to the pathogen-related variation in epidemiology and effect on future performance. Prepartum intramammary treatment with antibiotics has been proposed as a simple and effective way of controlling heifer mastitis but positive long-lasting effects on somatic cell count and milk yield do not always occur, ruling out universal recommendation of this practice. Moreover, use of antibiotics in this manner is off-label and results in an increased risk of antibiotic residues in milk. Prepartum treatment can be implemented only as a short-term measure to assist in the control of a significant heifer mastitis problem under supervision of the herd veterinarian. When CNS are the major cause of intramammary infection in heifers, productivity is not affected, making prepartum treatment redundant and even unwanted. In conclusion, heifer mastitis can affect the profitability of dairy farming because of a potential long-term negative effect on udder health and milk production and an associated culling risk, specifically when major pathogens are involved. Prevention and control is not easy but is possible through changes in young stock and heifer management. However, the pathogenesis and epidemiology of the disease remain largely unknown and more pathogen-specific risk factors should be identified to optimize current prevention programs. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  15. Nurses' Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors.

    PubMed

    Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G

    2016-08-01

    Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. © The Author(s) 2016.

  16. Food security practice in Kansas schools and health care facilities.

    PubMed

    Yoon, Eunju; Shanklin, Carol W

    2007-02-01

    This pilot study investigated perceived importance and frequency of specific preventive measures, and food and nutrition professionals' and foodservice directors' willingness to develop a food defense management plan. A mail questionnaire was developed based on the US Department of Agriculture document, Biosecurity Checklist for School Foodservice Programs--Developing a Biosecurity Management Plan. The survey was sent to food and nutrition professionals and foodservice operators in 151 acute care hospitals, 181 long-term-care facilities, and 450 school foodservice operations. Chemical use and storage was perceived as the most important practice to protect an operation and was the practice implemented most frequently. Results of the study indicate training programs on food security are needed to increase food and nutrition professionals' motivation to implement preventive measures.

  17. Occupational health hazards in a prosthodontic practice: review of risk factors and management strategies

    PubMed Central

    Arunachalam, Kuthalingam Subbiah; Solomon, EGR

    2012-01-01

    The intent of this article was to analyze the potential hazards and risks involved in persons exposed to prosthodontic practice. These risks include exposure to physical and chemical hazards, dental materials, infectious environment, inappropriate working pattern and psychosocial stress. The potential harm of these hazards and its prevention is highlighted. Prosthodontists, students, dental technicians, and others working in the prosthodontic clinics and laboratory should be aware of the specific risk factors and take measures to prevent and overcome these hazards. PMID:23236581

  18. Eco-innovations for waste prevention--best practices, drivers and barriers.

    PubMed

    Wilts, Henning; Dehoust, Günter; Jepsen, Dirk; Knappe, Florian

    2013-09-01

    Several studies in Germany aimed at the development of a sound database on existing waste prevention measures by public bodies at the local, regional and federal levels. These results are the starting point for the creation of a national prevention program, which has to be presented by all European Member States until the end of 2013--due to the revised European Waste Framework Directive. Based on this empirical foundation, this paper draws conclusions with regard to drivers and barriers for eco-innovations in the field of waste prevention. The analysis shows that an optimized adaptation of information on waste prevention to the needs of specific target groups is still missing but could be a relevant driver. With regard to barriers the results of the study show that waste prevention is by no means always a win-win-situation. Institutional frameworks are missing to coordinate the different interests and for the exchange of experiences that could help to realize learning effects regarding innovation approaches. Copyright © 2013. Published by Elsevier B.V.

  19. Evidence Based Weighing Policy during the First Week to Prevent Neonatal Hypernatremic Dehydration while Breastfeeding.

    PubMed

    Boer, Suzanne; Unal, Sevim; van Wouwe, Jacobus P; van Dommelen, Paula

    2016-01-01

    Neonatal hypernatremic dehydration is prevented by daily neonatal weight monitoring. We aim to provide evidence-based support of this universally promoted weighing policy and to establish the most crucial days of weighing. Weight measurements of 2,359 healthy newborns and of 271 newborns with clinical hypernatremic dehydration were used within the first seven days of life to simulate various weighting policies to prevent hypernatremic dehydration; its sensitivity, specificity and positive predictive value (PPV) of these policies were calculated. Various referral criteria were also evaluated. A policy of daily weighing with a cut-off value of -2.5 Standard Deviation Score (SDS) on the growth chart for weight loss, had a 97.6% sensitivity, 97.6% specificity and a PPV of 2.80%. Weighing at birth and only at days two, four and seven with the same -2.5 SDS cut-off, resulted in 97.3% sensitivity, 98.5% specificity and a PPV of 4.43%. A weighing policy with measurements restricted to birth and day two, four and seven applying the -2.5 SDS cut-off seems an optimal policy to detect hypernatremic dehydration. Therefore we recommend to preferably weigh newborns at least on day two (i.e. ~48h), four and seven, and refer them to clinical pediatric care if their weight loss increases below -2.5 SDS. We also suggest lactation support for the mother, full clinical assessment of the infant and weighing again the following day in all newborns reaching a weight loss below -2.0 SDS.

  20. Assessing quality of care for migraineurs: a model health plan measurement set.

    PubMed

    Leas, Brian F; Gagne, Joshua J; Goldfarb, Neil I; Rupnow, Marcia F T; Silberstein, Stephen

    2008-08-01

    Quality of care measures are increasingly important to health plans, purchasers, physicians, and patients. Appropriate measures can be used to assess quality and evaluate improvement and are necessary components of pay-for-performance programs. Despite the broad scope of activity in the development of quality measures, migraine headache has received little attention. Given the enormous costs associated with migraine, especially in terms of lost productivity and preventable health care utilization, health plans could gain from a structured approach to measuring the quality of migraine care their beneficiaries receive. A potential migraine quality measurement set was developed through a review of migraine care literature and guidelines, interviews with leaders in migraine care, health care purchasing, and managed care, and the assembly of an advisory board. The board discussed candidate measures and established consensus on a testable measurement set. Twenty measures were developed, focused primarily on diagnosis and utilization. Areas of utilization include physician visits, emergency department visits, hospitalizations, and imaging. Use of both acute and preventive medications is included. More complex aspects of migraine care are also addressed, including triptan overuse, the relationship between acute and preventive medications, and follow-up after emergency department visits. The measures are currently being tested in health plans to assess their feasibility and value. A compelling case can be made for the development of migraine-specific quality measures for health plans. This effort to develop and test a starter set of measures should lead to new and innovative efforts to assess and improve quality of care for migraineurs.

  1. Preventing re-entry to foster care.

    PubMed

    Carnochan, Sarah; Rizik-Baer, Daniel; Austin, Michael J

    2013-01-01

    Re-entry to foster care generally refers to circumstances in which children who have been discharged from foster care to be reunified with their family of origin, adopted, or provided kinship guardianship are returned to foster care. In the context of the federal performance measurement system, re-entry refers specifically to a return to foster care following an unsuccessful reunification. The federal Children and Family Services Review measures re-entry to foster care with a single indicator, called the permanency of reunification indicator, one of four indicators comprising the reunification composite measure. This review focuses on research related to the re-entry indicator, including the characteristics of children, caregivers and families, as well as case and child welfare services that are associated with a higher or lower risk of re-entry to foster care. Promising post-reunification services designed to prevent re-entry to foster care are described.

  2. Psychometric Properties of the German Version of the Health Regulatory Focus Scale

    PubMed Central

    Schmalbach, Bjarne; Spina, Roy; Steffens-Guerra, Ileana; Franke, Gabriele H.; Kliem, Sören; Michaelides, Michalis P.; Hinz, Andreas; Zenger, Markus

    2017-01-01

    The Health Regulatory Focus Scale (HRFS) is a short scale which measures an individual's prevention and promotion focus in a health-specific context. The main objective of this study was to examine the psychometric properties of the newly translated German version of the HRFS. Reliability and item characteristics were found to be satisfactory. Validity of both subscales toward other psychological constructs including behavioral approach and avoidance, core self-evaluations, optimism, pessimism, neuroticism, as well as several measures of physical and mental health was shown. In addition, invariance of the measure across age and gender groups was shown. Exploratory as well as confirmatory factor analyses clearly indicated a two-factorial structure with a moderate correlation between the two latent constructs. Differences in health promotion and prevention focus between socio-demographic groups are discussed. The HRFS is found to be a valid and reliable instrument for the assessment of regulatory focus in health-related environments. PMID:29184528

  3. Monitoring environmental burden reduction from household waste prevention.

    PubMed

    Matsuda, Takeshi; Hirai, Yasuhiro; Asari, Misuzu; Yano, Junya; Miura, Takahiro; Ii, Ryota; Sakai, Shin-Ichi

    2018-01-01

    In this study, the amount of prevented household waste in Kyoto city was quantified using three methods. Subsequently, the greenhouse gas (GHG) emission reduction by waste prevention was calculated in order to monitor the impact of waste prevention. The methods of quantification were "relative change from baseline year (a)," "absolute change from potential waste generation (b)," and "absolute amount of activities (c)." Method (a) was popular for measuring waste prevention, but method (b) was the original approach to determine the absolute amount of waste prevention by estimating the potential waste generation. Method (c) also provided the absolute value utilizing the information of activities. Methods (b) and (c) enable the evaluation of the waste prevention activities with a similar baseline for recycling. Methods (b) and (c) gave significantly higher GHG reductions than method (a) because of the difference in baseline between them. Therefore, setting a baseline is very important for evaluating waste prevention. In practice, when focusing on the monitoring of a specific policy or campaign, method (a) is an appropriate option. On the other hand, when comparing the total impact of waste prevention to that of recycling, methods (b) and (c) should be applied. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. 40 CFR Appendix F to Part 112 - Facility-Specific Response Plan

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Prevention, Control, and Countermeasures (SPCC) Plan as required by 40 CFR 112.3. In these cases, owners or... sections for the non-transportation-related and transportation-related components, as described in § 112.20... of measure Response Action Actions Taken to Correct, Control or Mitigate Incident: Impact Number of...

  5. 40 CFR Appendix F to Part 112 - Facility-Specific Response Plan

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Prevention, Control, and Countermeasures (SPCC) Plan as required by 40 CFR 112.3. In these cases, owners or... sections for the non-transportation-related and transportation-related components, as described in § 112.20... of measure Response Action Actions Taken to Correct, Control or Mitigate Incident: Impact Number of...

  6. Prevalence of Teachers' Professional Malpractices in Tanzanian Public Secondary Schools: What Ought to Be Done?

    ERIC Educational Resources Information Center

    Mfaume, Hamisi; Bilinga, Margareth

    2017-01-01

    This study explored stakeholders' views on preventive measures towards increasing teachers' malpractices in schools in Tanzania. Specifically, the study sought to identify prevalent forms of teachers' malpractices; explore factors for their occurrence; and explore views on how to forestall the problem. It draws on qualitative and quantitative data…

  7. 77 FR 65215 - In the Matter of Licensee Identified in Attachment 1 and all Other Persons Who Obtain Safeguards...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-25

    ... a computing environment that has adequate computer security controls in place to prevent... NRC intends to issue a security Order to this Licensee in the near future. The Order will require compliance with specific Additional Security Measures to enhance the security for certain radioactive...

  8. Considerations for the Development of a Substance-Related Care and Prevention Continuum Model

    PubMed Central

    Perlman, David C.; Jordan, Ashly E.

    2017-01-01

    There are significant gaps in the identification and engagement in care and prevention services of people who use illicit substances. Care continuum models have proven to be useful tools in the evaluation of care for HIV and other conditions; numerous issues in substance-related care and prevention resemble those identified in other continua models. Systems of care for substance misuse and substance use disorders (SUDs) can be viewed as consisting of a prevention and care continuum, reflecting incidence and prevalence of substance misuse and SUDs, screening and identification, medical and psychosocial evaluation for treatment, engagement in evidence-based treatment, treatment retention, relapse prevention, timeliness of step completion, and measures of overall and substance use-related specific morbidity and mortality. Care and prevention continuum models could potentially be applied at program, local, regional, state, and national levels. We discuss important lessons that can be drawn from applications of continuum models in other fields. The development and use of a substance-related care and prevention continuum may yield significant patient care, program evaluation and improvement, and population-level benefits. PMID:28770195

  9. Biosecurity procedures for the environmental management of carcasses burial sites in Korea.

    PubMed

    Kim, Geon-Ha; Pramanik, Sudipta

    2016-12-01

    Avian influenza and foot-and-mouth disease are two main contagious pathogenic viral disease which are responsible for the massive burials of livestock in Korea since burial is the primary measure to control these outbreaks. Biosecurity is a set of preventive measures designed to prevent the risk of spreading of these infectious diseases. The main objective of this paper is to discuss about the requirements of biosecurity and develop protocol outlines for environmental management of burial sites in Korea. Current practice prescribes to minimize the potential for on-farm pollution and the spread of the infectious diseases. Specific biosecurity procedures such as proper assessment of leachate quality, safe handling and disposal of leachate, adequate leachate pollution monitoring, necessary seasonal management of burial site, and appropriate sterilization process must be carried out to prevent the indirect transmission of pathogens from the burial sites. Policy makers should acquire robust knowledge of biosecurity for establishing more effective future legislation for carcasses disposal in Korea.

  10. Knowledge, attitudes and barriers towards prevention of pressure ulcers in intensive care units: a descriptive cross-sectional study.

    PubMed

    Strand, Tillan; Lindgren, Margareta

    2010-12-01

    Pressure ulcer incidence varies between 1 and 56% in intensive care and prevention is an important quest for nursing staff. Critically ill patients that develop pressure ulcers suffer from increased morbidity and mortality and also requires prolonged intensive care. The aim of this study was to investigate registered nurses' and enrolled nurses' (1) attitudes, (2) knowledge and (3) perceived barriers and opportunities towards pressure ulcer prevention, in an ICU setting. These are important aspects in the Theory of Planned Behaviour, a conceptual framework when trying to predict, understand and change specific behaviours. The study is descriptive. Questionnaires were distributed to registered nurses and enrolled nurses in four ICUs in a Swedish hospital. The mean score regarding attitude was 34 ± 4. Correct categorisation of pressure ulcers was made by 46.8% of nursing staff with enrolled nurses having significantly less correct categorisation (p=0.019). Pressure relief (97.3%) and nutritional support (36.1%) were the most frequently reported preventive measures. Reported barriers were lack of time (57.8%) and severely ill patients (28.9%); opportunities were knowledge (38%) and access to pressure relieving equipment (35.5%). This study highlights areas where measures can be made to facilitate pressure ulcer prevention in intensive care units, such as raising knowledge and making pressure ulcer prevention a part of daily care. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

    PubMed Central

    Al-Hablani, Bader

    2017-01-01

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

  12. Perioperative Acute Kidney Injury: Prevention, Early Recognition, and Supportive Measures.

    PubMed

    Romagnoli, Stefano; Ricci, Zaccaria; Ronco, Claudio

    2018-06-26

    Acute kidney injury (AKI) is a frequent complication of both cardiac and major non-cardiac surgery. AKI is independently associated with morbidity, mortality, and long-term adverse events including chronic kidney disease in postsurgical patients. Since specific treatment options for kidney failure are very limited, early identification, diagnosis, and renal support strategies are key steps to improve patients' outcome. According to current Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, AKI diagnosis is based on 2 functional markers, serum creatinine increase and urine output decrease, that are not renal-specific and have important limitations. However, preoperative risk stratification for postoperative AKI and/or early diagnosis after surgery could be the best way to apply preventive or timely supportive therapeutic measures. Clinical prediction scores, renal functional reserve assessment, and new biomarkers of kidney stress (suppression of tumorigenicity-2, insulin-like growth factor binding protein-7, tissue inhibitor metalloproteinase-2) may help the clinicians to identify patients at risk of AKI and that could benefit from the application of nephroprotective bundles suggested by the KDIGO guidelines. In severe AKI patients with oligoanuria and fluid accumulation, renal replacement therapy is the only supportive measure even if mode and timing remain open to investigation. Key messages: Perioperative AKI is an important and underdiagnosed complication. Identifying patients at high risk of AKI and diagnosing AKI early are major goals. Preventive interventions are mainly based on the KDIGO guidelines and bundles. Furthermore, a personalized multidisciplinary approach should always be considered to minimize the progression of disease and the complications related to kidney damage. © 2018 S. Karger AG, Basel.

  13. [Best practice in risk management of Neisseria meningitidis bacterial meningitis at nurseries].

    PubMed

    Santoro, A; Vinci, M R; Menichella, A; Montaldi, V; Camisa, V; Di Felice, C; Musolino, A M C; Zaffina, S

    2012-01-01

    In many contexts is often underestimated the biological risk and schools can be an example. Proof of this is the exclusion of work in the school from the example of the work activities of biohazard included in Annex XLIV of Legislative Decree 81/08. Our work proposes a protocol for risk management meningitis contagious in the specific environment of the nursery taking a cue from the specific experience gained by the Service of Prevention and Protection Bambino Gesù Children's Hospital following the course accreditation Joint Commision. This is primary prevention measures (training and information) and secondary (vaccination, reporting of suspected cases, chemoprophylaxis of contacts, contact tracing, counseling) to be applied consistently even and especially in the absence of sick people, at which time the shares are aimed exclusively to control its spread to be taken and monitored, with the cooperation of all subject involved in various capacities in the protection of the health of workers, within these specific working environments.

  14. Prevention of Postoperative Bile Leak in Partial Cystectomy for Hydatid Liver Disease: Tricks of the Trade.

    PubMed

    Peker, Kivanc Derya; Gumusoglu, Alpen Yahya; Seyit, Hakan; Kabuli, Hamit Ahmet; Salik, Aysun Erbahceci; Gonenc, Murat; Kapan, Selin; Alis, Halil

    2015-12-01

    The presence of postoperative bile leak is the major outcome measure for the assessment of operative success in partial cystectomy for hydatid liver disease. However, the optimal operative strategy to reduce the postoperative bile leak rate is yet to be defined. Medical records of patients who underwent partial cystectomy for hydatid liver disease between January 2013 and January 2015 were reviewed in this retrospective analysis. All patients were managed with a specific operative protocol. The primary outcome measure was the rate of persistent postoperative bile leak. The secondary outcome measures were the morbidity and mortality rate, and the length of hospital stay. Twenty-eight patients were included in the study. Only one patient (3.6 %) developed persistent postoperative bile leak. The overall morbidity and mortality rate was 17.8 and 0 %, respectively. The median length of hospital stay was 5 days. Aggressive preventative surgical measures have led to low persistent bile leak rates with low morbidity and mortality.

  15. Condom Use Following a Pilot Test of the Popular Opinion Leader Intervention in the Barbados Defence Force

    DTIC Science & Technology

    2013-01-01

    and if it exhibited effects on condom use in the BDF population. The POL intervention was originally designed to reduce sexual risk behavior in...increase condom use in the BDF. We adapted the POL intervention as an improvement to the peer educator model in the context of the BDF’s ongoing prevention...measuring respondent demographics, detailed questions regarding specific sexual behaviors and condom use, alcohol abuse, and psychoso- cial measurements

  16. Internet-based site-specific interventions for syphilis prevention among gay and bisexual men.

    PubMed

    Klausner, J D; Levine, D K; Kent, C K

    2004-11-01

    Recent increases in syphilis in gay men in urban areas in the US and Europe have been associated with men meeting new sex partners on the Internet in chat-rooms and at websites that facilitate partner meeting. In response to the syphilis epidemic in San Francisco, the San Francisco Department of Public Health partnered with a community-based organization, Internet Sexuality Information Services, Inc., to develop, implement and evaluate a broad range of innovative Internet-based prevention interventions including the creation of a website, individual online outreach, banner advertisements, chats, an educational site, message boards, warnings and an online syphilis testing program. This paper documents the varied success of these interventions with process measures and calls for greater emphasis on impact measures in the evaluation of these types of intervention.

  17. The cost of pressure ulcer prevention and treatment in hospitals and nursing homes in Flanders: A cost-of-illness study.

    PubMed

    Demarré, Liesbet; Verhaeghe, Sofie; Annemans, Lieven; Van Hecke, Ann; Grypdonck, Maria; Beeckman, Dimitri

    2015-07-01

    The economic impact of pressure ulcer prevention and treatment is high. The results of cost-of-illness studies can assist the planning, allocation, and priority setting of healthcare expenditures to improve the implementation of preventive measures. Data on the cost of current practice of pressure ulcer prevention or treatment in Flanders, a region of Belgium, is lacking. To examine the cost of pressure ulcer prevention and treatment in an adult population in hospitals and nursing homes from the healthcare payer perspective. A cost-of-illness study was performed using a bottom-up approach. Hospitals and nursing homes in Flanders, a region of Belgium. Data were collected in a series of prospective multicentre cross-sectional studies between 2008 and 2013. Data collection included data on risk assessment, pressure ulcer prevalence, preventive measures, unit cost of materials for prevention and treatment, nursing time measurements for activities related to pressure ulcer prevention and treatment, and nursing wages. The cost of pressure ulcer prevention and treatment in hospitals and nursing homes was calculated as annual cost for Flanders, per patient, and per patient per day. The mean (SD) cost for pressure ulcer prevention was €7.88 (8.21) per hospitalised patient at risk per day and €2.15 (3.10) per nursing home resident at risk per day. The mean (SD) cost of pressure ulcer prevention for patients and residents identified as not at risk for pressure ulcer development was €1.44 (4.26) per day in hospitals and €0.50 (1.61) per day in nursing homes. The main cost driver was the cost of labour, responsible for 79-85% of the cost of prevention. The mean (SD) cost of local treatment per patient per day varied between €2.34 (1.14) and €77.36 (35.95) in hospitals, and between €2.42 (1.15) and €16.18 (4.93) in nursing homes. Related to methodological differences between studies, the cost of pressure ulcer prevention and treatment in hospitals and nursing homes in Flanders was found to be low compared to other international studies. Recommendations specific to pressure ulcer prevention are needed as part of methodological guidelines to conduct cost-of-illness studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Yugoslavia: preventing the spread of HIV and STDs.

    PubMed

    Dzeletovic, A; Popovic, R

    1999-01-01

    This article discusses the specific actions taken by Yugoslavia in preventing the spread of HIV and AIDS in their country. Two years after the first HIV infection was diagnosed and recognized in 1985, a national level program was established based on the Global AIDS Strategy as defined in 1986 and the Global AIDS Program in 1987. Three essential elements in the program were prevention and control of risky behavior; safe public health procedures, and social tolerance. Among the first major activities organized was the First Conference on AIDS, held in 1987; it was followed in the following year by another conference which registered almost 150 papers regarding epidemiology, transfusiology, health education and drug dependence. In 1988, the Institute of Public Health of Serbia, Belgrade, published and distributed numerous pamphlets, folders, posters and video cassettes including 5,000 copies of the multi-colored poster "Beware of AIDS." The program activities have resulted in the design of a variety of projects that focused on specific problems and segments of the population, namely: AIDS Information for Dentists, The Health Education Program for Elementary School Children and AIDS, and Measures on AIDS Prevention in Health Facilities. Furthermore, The Resolution on Protecting the Population from STDs was passed in 1994 and a new Program of Protecting the Population from STDs was been adopted; this program includes activities on the prevention and control of HIV/AIDS, gonorrhea, syphilis and Hepatitis B.

  19. Effectiveness of videos improving cancer prevention knowledge in people with profound hearing loss.

    PubMed

    Zazove, Philip; Meador, Helen E; Reed, Barbara D; Sen, Ananda; Gorenflo, Daniel W

    2012-06-01

    Deaf persons have a poorer understanding of cancer prevention, which is felt to be partly due to communication barriers. One hundred ninety-seven d/Deaf persons completed a survey and video on cancer prevention. Half viewed a spoken English program designed for hearing persons (control group); the other half viewed an amended program that had American Sign Language, captions, and printed English options added (experimental group). Knowledge was measured before and after the video, including 1 and 6 months later. Respondents were primarily Caucasian, had low incomes, lost hearing at young ages, and had d/Deaf spouses. Although overall knowledge improved after viewing the video, the presence of culture-specific communications (American Sign Language, captions) did not improve scores compared to the control group, either immediately after the intervention or over time. Moreover, percentage correct on all pretest, and almost all post-test, questions was <50% for both experimental and control groups. For all subjects, regardless of which group they were in, a hearing spouse (p  < 0.001) and more healthcare information sources (p = 0.001) improved knowledge, while African-Americans showed a trend to lesser improvement (p = 0.06). Using culture-specific language did not improve cancer prevention knowledge in this d/Deaf population, and overall knowledge remained low. More study is needed to determine the best way to increase cancer prevention knowledge in this population.

  20. Diagnostic approach in cases with suspected work-related asthma

    PubMed Central

    2013-01-01

    Background Work-related asthma (WRA) is a major cause of respiratory disease in modern societies. The diagnosis and consequently an opportunity for prevention are often missed in practice. Methods Based on recent studies and systematic reviews of the literature methods for detection of WRA and identification of specific causes of allergic WRA are discussed. Results and Conclusions All workers should be asked whether symptoms improve on days away from work or on holidays. Positive answers should lead to further investigation. Spirometry and non-specific bronchial responsiveness should be measured, but carefully performed and validly analysed serial peak expiratory flow or forced expiratory volume in one second (FEV1) measurements are more specific and confirm occupational asthma in about 82% of those still exposed to the causative agent. Skin prick testing or specific immunoglobulin E assays are useful to document allergy to high molecular weight allergens. Specific inhalational challenge tests come closest to a gold standard test, but lack standardisation, availability and sensitivity. Supervised workplace challenges can be used when specific challenges are unavailable or the results non-diagnostic, but methodology lacks standardisation. Finally, if the diagnosis remains unclear a follow-up with serial measurements of FEV1 and non-specific bronchial hyperresponsiveness should detect those likely to develop permanent impairment from their occupational exposures. PMID:23768266

  1. Use of a commercial ELISA for the detection of measles-specific immunoglobulin G (IgG) in dried blood spots collected from children living in low-resource settings.

    PubMed

    Colson, K Ellicott; Potter, Alan; Conde-Glez, Carlos; Hernandez, Bernardo; Ríos-Zertuche, Diego; Zúñiga-Brenes, Paola; Iriarte, Emma; Mokdad, Ali H

    2015-09-01

    Seroepidemiological monitoring of population immunity to vaccine-preventable diseases is critical to prevent future outbreaks. Dried blood spots (DBS), drops of capillary blood dried on filter paper, are an affordable, minimally invasive alternative to venipuncture for collecting blood in field settings. However, few proven methods exist to analyze DBS for the presence of protective antibodies. This study validates a novel technique for measuring measles-specific immunoglobulin G (IgG) in capillary DBS using a commercial ELISA. The predictive performance of a new method for analyzing DBS was tested by comparing matched serum and DBS samples from 50 children. The accuracy, precision, and reliability of the procedure were evaluated, and the optimal cut points to classify positive and negative samples were determined. The method was then applied to 1,588 DBS collected during a large survey of children in Mexico and Nicaragua. Measles-specific IgG in serum samples were 62% negative, 10% equivocal, and 28% positive. In comparisons with matched serum, DBS results were 100% sensitive and 96 · 8% specific, and agreed in 46 of 50 (92%) cases. The inter-assay and intra-assay coefficients of variation from kit-provided controls were greater than desired (24.8% and 8.4%, respectively). However, in predictive simulations the average misclassification was only 3.9%. Procedures were found to be acceptable to surveyors and participants. Analyzing DBS collected in low-resources settings is a feasible and accurate means of measuring population immunity to measles and should be used to generate objective measures of health status and health system performance. © 2015 Wiley Periodicals, Inc.

  2. [Development of methods and instruments for external quality assurance in inpatient parent-child rehabilitation and prevention].

    PubMed

    Neuderth, S; Lukasczik, M; Musekamp, G; Gerlich, C; Saupe-Heide, M; Löbmann, R; Vogel, H

    2013-02-01

    There so far is no standardized program for external quality assurance in inpatient parent-child prevention and rehabilitation in Germany. Therefore, instruments and methods of external quality assurance were developed and evaluated on behalf of the federal-level health insurance institutions. On the level of structure quality, a modular questionnaire for assessing structural features of rehabilitation/prevention centers, basic and allocation criteria as well as a checklist for visitations were developed. Structural data were collected in a nationwide survey of parent-child prevention and rehabilitation centers. Process and outcome quality data were collected in n=38 centers. Process quality was assessed using multiple methods (process-related structural features, case-related routine documentation, and incident-related patient questionnaires). Outcome quality was measured via patient questionnaires (n=1 799 patients). We used a multi-level modelling approach by adjusting relevant confounders on institutional and patient levels. The methods, instruments and analyzing procedures developed for measuring quality on the level of structure, processes and outcomes were adjusted in cooperation with all relevant stakeholders. Results are exemplarily presented for all quality assurance tools. For most of the risk-adjusted outcome parameters, we found no significant differences between institutions. For the first time, a comprehensive, standardized and generally applicable set of methods and instruments for routine use in comparative quality measurement of inpatient parent-child prevention and rehabilitation is available. However, it should be considered that the very heterogeneous field of family-oriented measures can not be covered entirely by an external quality assurance program. Therefore, methods and instruments have to be adapted continuously to the specifics of this area of health care and to new developments. © Georg Thieme Verlag KG Stuttgart · New York.

  3. [Preventive measures for avoiding transmission of microorganisms between hospitalised patients. Hand hygiene].

    PubMed

    Lupión, Carmen; López-Cortés, Luis Eduardo; Rodríguez-Baño, Jesús

    2014-11-01

    Health-care associated infections are an important public health problem worldwide. The rates of health-care associated infections are indicators of the quality of health care. The infection control activities related to prevention of transmission of hospital microorganisms can be grouped in 4 mayor areas: standard precautions, specific precautions (including isolation if appropriate), environmental cleaning and disinfection, and surveillance activities (including providing infection rates and monitoring procedures). Hand hygiene and the correct use of gloves are the most important measures to prevent health-care associated infections and to avoid the dissemination of multidrug-resistant microorganisms. Continuous educational activities aimed at improving adherence to hand hygiene are needed. Periodical assessment of adherence to hand hygiene recommendations with feed-back have been shown to provide sustained improvement. Several complementary activities are being evaluated, including skin decolonization prior to certain surgeries, a package of measures in patients with central venous catheters or mechanical ventilation, and universal body hygiene with chlorhexidine. The present area of discussion concerns in which situations and in which groups would such measures be effective and efficient. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

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

    PubMed

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

    2016-11-16

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

  5. The exit interview as a proxy measure of malaria case management practice: sensitivity and specificity relative to direct observation.

    PubMed

    Pulford, Justin; Siba, Peter M; Mueller, Ivo; Hetzel, Manuel W

    2014-12-03

    This paper aims to assess the sensitivity and specificity of exit interviews as a measure of malaria case management practice as compared to direct observation. The malaria case management of 1654 febrile patients attending 110 health facilities from across Papua New Guinea was directly observed by a trained research officer as part of a repeat cross sectional survey. Patient recall of 5 forms of clinical advice and 5 forms of clinical action were then assessed at service exit and statistical analyses on matched observation/exit interview data conducted. The sensitivity of exit interviews with respect to clinical advice ranged from 36.2% to 96.4% and specificity from 53.5% to 98.6%. With respect to clinical actions, sensitivity of the exit interviews ranged from 83.9% to 98.3% and specificity from 70.6% to 98.1%. The exit interview appears to be a valid measure of objective malaria case management practices such as the completion of a diagnostic test or the provision of antimalarial medication, but may be a less valid measure of low frequency, subjective practices such as the provision of malaria prevention advice.

  6. National athletic trainers' association position statement: skin diseases.

    PubMed

    Zinder, Steven M; Basler, Rodney S W; Foley, Jack; Scarlata, Chris; Vasily, David B

    2010-01-01

    To present recommendations for the prevention, education, and management of skin infections in athletes. Trauma, environmental factors, and infectious agents act together to continually attack the integrity of the skin. Close quarters combined with general poor hygiene practices make athletes particularly vulnerable to contracting skin diseases. An understanding of basic prophylactic measures, clinical features, and swift management of common skin diseases is essential for certified athletic trainers to aid in preventing the spread of infectious agents. These guidelines are intended to provide relevant information on skin infections and to give specific recommendations for certified athletic trainers and others participating in athletic health care.

  7. Are Cultural Values and Beliefs Included in U.S. Based HIV Interventions?

    PubMed Central

    Wyatt, Gail E.; Williams, John K.; Gupta, Arpana; Malebranche, Dominique

    2013-01-01

    Objective To determine the extent to which current U.S. based HIV/AIDS prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. Method A comprehensive literature review was conducted to determine which published HIV/AIDS prevention and risk reduction interventions incorporated aspects of cultural beliefs. Results This review of 166 HIV prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. Conclusion HIV interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual’s risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. PMID:21884721

  8. Vitamin D and Autism Spectrum Disorder: A Literature Review

    PubMed Central

    Mazahery, Hajar; Camargo, Carlos A.; Conlon, Cathryn; Beck, Kathryn L.; Kruger, Marlena C.; von Hurst, Pamela R.

    2016-01-01

    Low vitamin D status in early development has been hypothesised as an environmental risk factor for Autism Spectrum Disorder (ASD), given the concurrent increase in the prevalence of these two conditions, and the association of vitamin D with many ASD-associated medical conditions. Identification of vitamin D-ASD factors may provide indications for primary and secondary prevention interventions. We systematically reviewed the literature for studies on vitamin D-ASD relationship, including potential mechanistic pathways. We identified seven specific areas, including: latitude, season of conception/birth, maternal migration/ethnicity, vitamin D status of mothers and ASD patients, and vitamin D intervention to prevent and treat ASD. Due to differences in the methodological procedures and inconsistent results, drawing conclusions from the first three areas is difficult. Using a more direct measure of vitamin D status—that is, serum 25(OH)D level during pregnancy or childhood—we found growing evidence for a relationship between vitamin D and ASD. These findings are supported by convincing evidence from experimental studies investigating the mechanistic pathways. However, with few primary and secondary prevention intervention trials, this relationship cannot be determined, unless randomised placebo-controlled trials of vitamin D as a preventive or disease-modifying measure in ASD patients are available. PMID:27110819

  9. Prevention of hospital-onset Clostridium difficile infection in the New York metropolitan region using a collaborative intervention model.

    PubMed

    Koll, Brian S; Ruiz, Rafael E; Calfee, David P; Jalon, Hillary S; Stricof, Rachel L; Adams, Audrey; Smith, Barbara A; Shin, Gina; Gase, Kathleen; Woods, Maria K; Sirtalan, Ismail

    2014-01-01

    The incidence, severity, and associated costs of Clostridium difficile (C. difficile) infection (CDI) have dramatically increased in hospitals over the past decade, indicating an urgent need for strategies to prevent transmission of C. difficile. This article describes a multifaceted collaborative approach to reduce hospital-onset CDI rates in 35 acute care hospitals in the New York metropolitan region. Hospitals participated in a comprehensive CDI reduction intervention and formed interdisciplinary teams to coordinate their efforts. Standardized clinical infection prevention and environmental cleaning protocols were implemented and monitored using checklists. Monthly data reports were provided to hospitals for facility-specific performance evaluation and comparison to aggregate data from all participants. Hospitals also participated in monthly teleconferences to review data and highlight successes, challenges, and strategies to reduce CDI. Incidence of hospital-onset CDI per 10,000 patient days was the primary outcome measure. Additionally, the incidence of nonhospital-associated, community-onset, hospital-associated, and recurrent CDIs were measured. The use of a collaborative model to implement a multifaceted infection prevention strategy was temporally associated with a significant reduction in hospital-onset CDI rates in participating New York metropolitan regional hospitals. © 2013 National Association for Healthcare Quality.

  10. Adherence to cancer prevention guidelines and risk of breast cancer.

    PubMed

    Catsburg, Chelsea; Miller, Anthony B; Rohan, Thomas E

    2014-11-15

    Healthy eating patterns and keeping physically active are potentially more important for chronic disease prevention than intake or exclusion of specific food items or nutrients. To this end, many health organizations routinely publish dietary and lifestyle recommendations aimed at preventing chronic disease. Using data from the Canadian National Breast Screening Study, we investigated the association between breast cancer risk and adherence to two sets of guidelines specific for cancer prevention, namely the American Cancer Society (ACS) Guidelines and the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Recommendations. At baseline, 49,613 women completed dietary and lifestyle questionnaires and height and weight measurements were taken. During a mean follow-up of 16.6 years, 2,503 incident cases of breast cancer were ascertained. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of meeting each guideline, and number of guidelines met, with breast cancer risk. The two sets of guidelines yielded similar results. Specifically, adherence to all six ACS guidelines was associated with a 31% reduction in breast cancer risk when compared to subjects adhering to at most one guideline (HR=0.69; 95% CI=0.49-0.97); similarly, adherence to six or seven of the WCRF/AICR guidelines was also associated with a 31% reduction in breast cancer risk (HR=0.69; 95% CI=0.47-1.00). Under either classification, meeting each additional guideline was associated with a 4-6% reduction in breast cancer risk. These results suggest that adherence to cancer prevention guidelines is associated with a reduced risk of breast cancer. © 2014 UICC.

  11. Integrated injury prevention program improves balance and vertical jump height in children.

    PubMed

    DiStefano, Lindsay J; Padua, Darin A; Blackburn, J Troy; Garrett, William E; Guskiewicz, Kevin M; Marshall, Stephen W

    2010-02-01

    Implementing an injury prevention program to athletes under age 12 years may reduce injury rates. There is limited knowledge regarding whether these young athletes will be able to modify balance and performance measures after completing a traditional program that has been effective with older athletes or whether they require a specialized program for their age. The purpose of this study was to compare the effects of a pediatric program, which was designed specifically for young athletes, and a traditional program with no program in the ability to change balance and performance measures in youth athletes. We used a cluster-randomized controlled trial to evaluate the effects of the programs before and after a 9-week intervention period. Sixty-five youth soccer athletes (males: n = 37 mass = 34.16 +/- 5.36 kg, height = 143.07 +/- 6.27 cm, age = 10 +/- 1 yr; females: n = 28 mass = 33.82 +/- 5.37 kg, height = 141.02 +/- 6.59 cm) volunteered to participate and attended 2 testing sessions in a research laboratory. Teams were cluster-randomized to either a pediatric or traditional injury prevention program or a control group. Change scores for anterior-posterior and medial-lateral time-to-stabilization measures and maximum vertical jump height and power were calculated from pretest and post-test sessions. Contrary with our original hypotheses, the traditional program resulted in positive changes, whereas the pediatric program did not result in any improvements. Anterior-posterior time-to-stabilization decreased after the traditional program (mean change +/- SD = -0.92 +/- 0.49 s) compared with the control group (-0.49 +/- 0.59 s) (p = 0.003). The traditional program also increased vertical jump height (1.70 +/- 2.80 cm) compared with the control group (0.20 +/- 0.20 cm) (p = 0.04). There were no significant differences between control and pediatric programs. Youth athletes can improve balance ability and vertical jump height after completing an injury prevention program. Training specificity appears to affect improvements and should be considered with future program design.

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

    PubMed

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

    2017-10-01

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

  13. [Empowerment in prevention and health promotion--a critical conceptual evaluation of basic understanding, dimensions and assessment problems].

    PubMed

    Kliche, T; Kröger, G

    2008-12-01

    Empowerment is an important concept in health care, but despite its prevalence it seems to be more of a buzz word. Thus, a conceptual review on empowerment in prevention and health promotion was carried out. 62 German and international theoretical contributions, reviews and studies were incorporated, covering the fields of prevention, care and therapy, rehabilitation, health-care research, nursing and work-related stress. The analysis revealed eight main dimensions of empowerment: (1) shared decision-making, (2) self-efficacy, (3) social support and social capital, (4) skills and competences, (5) health care utilisation, (6) goal setting and attainment, (7) reflexive thought and (8) innovation. Their empirical assessment can be carried out on a micro-, meso-, or macro-level. Three distinct basic conceptual notions emerged from the analysis, each applying its own specific research questions and measurement instruments: clinical, organizational-professional and political understanding of "empowerment". Therefore, these three specific conceptual notions should each be developed and tested separately, in particular in reviews, and empirical studies should embrace all eight subdimensions.

  14. [Prevention of occupational dermatitis in an international perspective].

    PubMed

    Montomoli, L; Paolucci, V; Sartorelli, P

    2012-01-01

    Occupational dermatitis (OD) have always been a significant part of the occupational disease with huge social and economic costs. Traditionally, the standard program of OD prevention takes place in the three phases of protection, cleansing and use of emollient creams and other products able to improve the cutaneous trophism (skincare) at the end of the shiftwork. However, in countries like Germany where protection measures and skincare were widespread, there was not a simultaneous decrease in the OD. In recent years pilot programs for the prevention of OD have been implemented with positive results. In particular the integrated approach that includes three steps of primary, secondary and tertiary prevention (Osnabrueck model) is of great interest. Primary prevention is represented by introduction of technical regulations, pre-employment counselling and specific initiatives to promote health (healthy skin campaign). In the case of initial/minor OD, secondary prevention is accomplished through the dermatological treatment of the patient and 1-2 days outpatient education initiatives/skin protection training. In severe cases of individual OD, tertiary prevention involves the hospitalization of the patient in a dermatology department. In 2009 the European network EPOS (European Initiative for the Prevention of Occupational Skin Diseases) of preventive dermatology has been organized basing on the integrated approach of primary, secondary and tertiary prevention.

  15. Caries risk and orthodontic treatment.

    PubMed

    Opsahl Vital, Sibylle; Haignere-Rubinstein, Claire; Lasfargues, Jean-Jacques; Chaussain, Catherine

    2010-03-01

    It is now established that orthodontic treatment increases the risk of carious lesions, with consequent harm to the patient and a high risk of compromising treatment outcome. This risk is related to the appliances, which increase the number of sites where plaque can accumulate as well as to changes in the bacterial flora and the age of the patient. A thorough evaluation of the risk of caries is therefore needed before any appliance is put in place and further evaluations should then be performed regularly throughout the course of treatment. In addition, preventive measures should be taken, involving first and foremost educating and motivating patients regarding the need for good oral hygiene. Prevention also implies adequate usage of the various sources of local fluoride administration, notably the application of fluoride-rich varnish. Other prophylactic measures such as using chlorhexidine varnish and sealing dental grooves are also recommended. Finally, the orthodontist can reduce to a minimum the use of items likely to retain dental plaque such as bands and elastomeric ties. The aim of this article is to suggest a specific diagnostic approach and to present the scientifically validated prevention measures, which need to be applied throughout orthodontic treatment. Copyright 2010 CEO. Published by Elsevier Masson SAS. All rights reserved.

  16. An integrated quality function deployment and capital budgeting methodology for occupational safety and health as a systems thinking approach: the case of the construction industry.

    PubMed

    Bas, Esra

    2014-07-01

    In this paper, an integrated methodology for Quality Function Deployment (QFD) and a 0-1 knapsack model is proposed for occupational safety and health as a systems thinking approach. The House of Quality (HoQ) in QFD methodology is a systematic tool to consider the inter-relationships between two factors. In this paper, three HoQs are used to consider the interrelationships between tasks and hazards, hazards and events, and events and preventive/protective measures. The final priority weights of events are defined by considering their project-specific preliminary weights, probability of occurrence, and effects on the victim and the company. The priority weights of the preventive/protective measures obtained in the last HoQ are fed into a 0-1 knapsack model for the investment decision. Then, the selected preventive/protective measures can be adapted to the task design. The proposed step-by-step methodology can be applied to any stage of a project to design the workplace for occupational safety and health, and continuous improvement for safety is endorsed by the closed loop characteristic of the integrated methodology. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    1980-07-01

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

  18. Global Burden of Stroke.

    PubMed

    Feigin, Valery L; Norrving, Bo; Mensah, George A

    2017-02-03

    On the basis of the GBD (Global Burden of Disease) 2013 Study, this article provides an overview of the global, regional, and country-specific burden of stroke by sex and age groups, including trends in stroke burden from 1990 to 2013, and outlines recommended measures to reduce stroke burden. It shows that although stroke incidence, prevalence, mortality, and disability-adjusted life-years rates tend to decline from 1990 to 2013, the overall stroke burden in terms of absolute number of people affected by, or who remained disabled from, stroke has increased across the globe in both men and women of all ages. This provides a strong argument that "business as usual" for primary stroke prevention is not sufficiently effective. Although prevention of stroke is a complex medical and political issue, there is strong evidence that substantial prevention of stroke is feasible in practice. The need to scale-up the primary prevention actions is urgent. © 2017 American Heart Association, Inc.

  19. Strategies for prevention of ventilator-associated pneumonia: bundles, devices, and medications for improved patient outcomes.

    PubMed

    Alroumi, Fahad; Sarwar, Akmal; Grgurich, Philip E; Lei, Yuxiu; Hudcova, Jana; Craven, Donald E

    2012-02-01

    Ventilator-associated pneumonia is associated with significant patient morbidity, mortality, and increased health care costs. In the current economic climate, it is crucial to implement cost-effective prevention strategies that have proven efficacy. Multiple prevention measures have been proposed by various expert panels. Global strategies have focused on infection control, and reduction of lower airway colonization with bacterial pathogens, intubation, duration of mechanical ventilation, and length of stay in the intensive care unit. Routine use of the Institute for Healthcare Improvement ventilator care bundle is widespread, and has been clearly demonstrated to be an effective method for reducing the incidence of ventilator-associated pneumonia. In this article, we examine specific aspects of the Institute for Healthcare Improvement bundle, better-designed endotracheal tubes, use of antibiotics and probiotics, and treatment of ventilator-associated tracheobronchitis to prevent ventilator-associated pneumonia.

  20. Implementation of tsunami disaster prevention measures in the municipality of San Rafael del Sur, Nicaragua

    NASA Astrophysics Data System (ADS)

    Strauch, W.; Talavera, E.; Acosta, N.; Sanchez, M.; Mejia, E.

    2007-05-01

    The Nicaraguan Pacific coast presents considerable tsunami risk. On September 1, 1992, a tsunami caused enormous damage in the infrastructure and killed more than 170 people. A pilot project was conducted between 2006 and 2007 in the municipality of San Rafel del Sur, area of Masachapa, The project included multiple topics of tsunami prevention measures and considering the direct participation of the local population, as: -General education on disaster prevention, participative events; -Investigation of awareness level and information needs for different population groups; -Specific educational measures in the schools; -Publication of brochures, calendars, news paper articles, radio programs, TV spots -Development of local tsunami hazard maps, 1:5,000 scale; (based on previous regional tsunami hazard mapping projects and local participation) -Development of a tsunami warning plan; -Improvements of the national tsunami warning system. -Installation of sirens for tsunami warning -Installation of tsunami signs, indicating hazardous areas, evacuation routes, safe places; -Realization of evacuation drills in schools. Based on the experiences gained in Masachapa it is planned to run similar projects in other areas along the Nicaraguan Pacific coast. In the project participated the local municipality and local stakeholders of San Rafael del Sur, Ministry of Education, National Police, Nicaraguan Red Cross, Ministry of Health, Ministry of Tourism, Nicaraguan Geosciences Institute (INETER), National System for Disaster Prevention (SINAPRED), Swiss Agency for Development and Cooperation (SDC). It was financed by SDC and INETER.

  1. Involving the consumers: An exploration of users' and caregivers' needs and expectations on a fall prevention brochure: A qualitative study.

    PubMed

    Schoberer, Daniela; Breimaier, Helga E; Mandl, Manuela; Halfens, Ruud J G; Lohrmann, Christa

    2016-01-01

    This study aims to explore and compare nursing home residents', family members', and nursing staff's needs and expectations regarding a fall prevention brochure. Focus groups were carried out with 25 residents, 12 family members and 14 nursing staff separately, from three randomly selected nursing homes. Qualitative content analysis was used to analyze the data using a concept-driven coding frame. Results showed that residents want to be informed about dealing with extrinsic fall risks and coping strategies after a fall event. In addition, family members wanted to have detailed information on intrinsic fall risks as well as specific fall prevention strategies, such as body exercises. Of special importance for nursing staff was that not all falls are preventable even when preventive measures were taken. As the need and expectations of users differ substantially, one brochure could not comprise all postulated criteria and different brochures are necessary for residents and for family members. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    PubMed

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

    2014-12-01

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

  3. A wireless multi-channel bioimpedance measurement system for personalized healthcare and lifestyle.

    PubMed

    Ramos, Javier; Ausín, José Luis; Lorido, Antonio Manuel; Redondo, Francisco; Duque-Carrillo, Juan Francisco

    2013-01-01

    Miniaturized, noninvasive, wearable sensors constitute a fundamental prerequisite for pervasive, predictive, and preventive healthcare systems. In this sense, this paper presents the design, realization, and evaluation of a wireless multi-channel measurement system based on a cost-effective high-performance integrated circuit for electrical bioimpedance (EBI) measurements in the frequency range from 1 kHz to 1 MHz. The resulting on-chip spectrometer provides high measuring EBI capabilities and together with a low-cost, commercially available radio frequency transceiver device. It provides reliable wireless communication, constitutes the basic node to build EBI wireless sensor networks (EBI-WSNs). The proposed EBI-WSN behaves as a high-performance wireless multi-channel EBI spectrometer, where the number of channels is completely scalable and independently configurable to satisfy specific measurement requirements of each individual. A prototype of the EBI node leads to a very small printed circuit board of approximately 8 cm2 including chip-antenna, which can operate several years on one 3-V coin cell battery and make it suitable for long-term preventive healthcare monitoring.

  4. Promoting Prosocial Behaviors to Prevent Dating Violence among College Students: Evaluation of a Bystander Intervention

    ERIC Educational Resources Information Center

    Borsky, Amanda E.

    2014-01-01

    The objective of this dissertation was to evaluate a bystander behavior program at the Jefferson College of Health Sciences (JCHS) in Roanoke, Virginia. Specifically, this dissertation examined the: (1) preliminary measurement properties of a newly developed bystander behavior intention scale; (2) impact of the bystander intervention at JCHS; and…

  5. 40 CFR 1039.505 - How do I test engines using steady-state duty cycles, including ramped-modal testing?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... You may extend the sampling time to improve measurement accuracy of PM emissions, using good...-speed engines whose design prevents full-load operation for extended periods, you may ask for approval... designed to operate for extended periods. (e) See 40 CFR part 1065 for detailed specifications of...

  6. PREVENTION REFERENCE MANUAL: CHEMICAL SPECIFIC. VOLUME 2. CONTROL OF ACCIDENTAL RELEASES OF CHLORINE (SCAQMD) (SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT)

    EPA Science Inventory

    The manual discusses reducing the risk associated with an accidental release of chlorine. It identifies some of the potential causes of accidental releases that apply to the processes that use chlorine. It also identifies examples of potential causes, as well as measures that may...

  7. 40 CFR 63.7522 - Can I use emissions averaging to comply with this subpart?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... monitored for each averaging group; (iii) The specific control technology or pollution prevention measure to... section. You may not include new boilers or process heaters in an emissions average. (b) For a group of... heater in the averaging group, the emission rate achieved during the initial compliance test for the HAP...

  8. 40 CFR 52.919 - Identification of plan-conditional approval.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... sections 110(a)(2)(C) and 110(a)(2)(J) as they both relate to Prevention of Significant Deterioration (PSD... requirements promulgated in the New Source Review (NSR) PM2.5 Rule related to the PM2.5 standard for their PSD... specific enforceable measures related the structural PSD requirements of the PSD and NNSR requirements...

  9. 40 CFR 52.919 - Identification of plan-conditional approval.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... sections 110(a)(2)(C) and 110(a)(2)(J) as they both relate to Prevention of Significant Deterioration (PSD... requirements promulgated in the New Source Review (NSR) PM2.5 Rule related to the PM2.5 standard for their PSD... specific enforceable measures related the structural PSD requirements of the PSD and NNSR requirements...

  10. Research Methods

    DTIC Science & Technology

    1992-01-01

    cognitive function. For example. physiological methods allow for visual sensitivity measurements in infants and children with about the same level of...potential (ERP), the event-related magnetic field (ERF), and pupillometry . Where possible, we cite specific experiments that deal with display or stimulus...technical barrier preventing the application of these methods to the analysis of human performance with color displays. Pupillometry . The pupillary

  11. 40 CFR 63.7522 - Can I use emissions averaging to comply with this subpart?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... monitored for each averaging group; (iii) The specific control technology or pollution prevention measure to... section. You may not include new boilers or process heaters in an emissions average. (b) For a group of... heater in the averaging group, the emission rate achieved during the initial compliance test for the HAP...

  12. 15 CFR 291.4 - National industry-specific pollution prevention and environmental compliance resource centers.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false National industry-specific pollution... § 291.4 National industry-specific pollution prevention and environmental compliance resource centers... information on pollution prevention opportunities, regulatory compliance and technologies and techniques for...

  13. Comparison of tai chi vs. strength training for fall prevention among female cancer survivors: study protocol for the GET FIT trial

    PubMed Central

    2012-01-01

    Background Women with cancer are significantly more likely to fall than women without cancer placing them at higher risk of fall-related fractures, other injuries and disability. Currently, no evidence-based fall prevention strategies exist that specifically target female cancer survivors. The purpose of the GET FIT (Group Exercise Training for Functional Improvement after Treatment) trial is to compare the efficacy of two distinct types of exercise, tai chi versus strength training, to prevent falls in women who have completed treatment for cancer. The specific aims of this study are to: 1) Determine and compare the efficacy of both tai chi training and strength training to reduce falls in older female cancer survivors, 2) Determine the mechanism(s) by which tai chi and strength training each reduces falls and, 3) Determine whether or not the benefits of each intervention last after structured training stops. Methods/Design We will conduct a three-group, single-blind, parallel design, randomized controlled trial in women, aged 50–75 years old, who have completed chemotherapy for cancer comparing 1) tai chi 2) strength training and 3) a placebo control group of seated stretching exercise. Women will participate in supervised study programs twice per week for six months and will be followed for an additional six months after formal training stops. The primary outcome in this study is falls, which will be prospectively tracked by monthly self-report. Secondary outcomes are maximal leg strength measured by isokinetic dynamometry, postural stability measured by computerized dynamic posturography and physical function measured by the Physical Performance Battery, all measured at baseline, 3, 6 and 12 months. The sample for this trial (N=429, assuming 25% attrition) will provide adequate statistical power to detect at least a 47% reduction in the fall rate over 1 year by being in either of the 2 exercise groups versus the control group. Discussion The GET FIT trial will provide important new knowledge about preventing falls using accessible and implementable exercise interventions for women following chemotherapy for cancer. ClinicalTrials.gov NCT01635413 PMID:23217054

  14. Long-term effect of intensive prevention on dental health of primary school children by socioeconomic status.

    PubMed

    Winter, Julia; Jablonski-Momeni, Anahita; Ladda, Annett; Pieper, Klaus

    2017-12-29

    Children in a German region took part in regular toothbrushing with fluoride gel during their time in primary school after having received a preventive program in kindergarten. The study aimed at determining the dental health of the students as a function of prevention in kindergarten and at school while taking into account their socioeconomic status and other confounders. The subjects were in six groups: groups 1 and 2, intensive prevention in kindergarten with and without fluoride gel at school; groups 3 and 4, basic prevention in kindergarten with and without fluoride gel at school; groups 5 and 6, no organized prevention in kindergarten with and without fluoride gel at school. Two dental examinations were performed for assessing caries experience and calculating caries increment from second grade (7-year-olds) to fourth grade (9-year-olds). A standardized questionnaire was used to record independent variables. To compare caries scores and preventive measures of various subgroups, non-parametric tests and a binary logistic regression analysis were performed. A significant difference was found in the mean decayed, missing, and filled tooth/teeth (DMFT) depending on socioeconomic status (no prevention in kindergarten, fluoride gel at school in children with low SES: DMFT = 0.47 vs. DMFT = 0.18 in children with high SES; p = 0.023). Class-specific differences were no longer visible among children who had taken part in an intensive preventive program combining daily supervised toothbrushing in kindergarten and application of fluoride gel in school. Early prevention, focusing on professionally supported training of toothbrushing in kindergarten and at school, has a positive effect on dental health and is able to reduce class-specific differences in caries distribution. Early training of toothbrushing and fissure sealing of first permanent molars are the most important factors for the dental health of primary school children.

  15. Early identification in primary health care of people at risk for sick leave due to work-related stress - study protocol of a randomized controlled trial (RCT).

    PubMed

    Holmgren, Kristina; Sandheimer, Christine; Mårdby, Ann-Charlotte; Larsson, Maria E H; Bültmann, Ute; Hange, Dominique; Hensing, Gunnel

    2016-11-25

    Early identification of persons at risk of sickness absence due to work-related stress is a crucial problem for society in general, and primary health care in particular. Tho date, no established method to do this exists. This project's aim is to evaluate whether systematic early identification of work-related stress can prevent sickness absence. This paper presents the study design, procedure and outcome measurements, as well as allocation and baseline characteristics of the study population. The study is a two-armed randomized controlled trial with follow-up at 3, 6 and 12 months. Non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers (PHCC) were eligible to participate. At baseline work-related stress was measured by the Work Stress Questionnaire (WSQ), combined with feedback at consultation, at PHCC. The preventive intervention included early identification of work-related stress by the WSQ, GP training in the use of WSQ, GP feedback at consultation and finding suitable preventive measures. A process evaluation was used to explore how to facilitate future implementation and structural use of the WSQ at the PHCC. The primary outcome to compare the preventive sick leave intervention by the general practitioner (GP) versus treatment as usual is sick leave data obtained from the Swedish Social Insurance Agency register. Early screening for sick leave due to work-related stress makes it possible not only to identify those at risk for sick leave, but also to put focus on the patient's specific work-related stress problems, which can be helpful in finding suitable preventive measures. This study investigates if use of the WSQ by GPs at PHCCs, combined with feedback at consultation, prevents future sickness absence. ClinicalTrials.gov. Identifier: NCT02480855 . Registered 20 May 2015.

  16. The prevention of psychopathology in African Americans: an epidemiologic perspective.

    PubMed

    Neighbors, H W

    1990-04-01

    Although improving the mental health status of African Americans is an important goal, it is not clear that this can be accomplished by increasing access to professional services. Many have argued that stressful social conditions are the major cause of mental disorder in blacks and thus, psychopathology can be prevented by eliminating racism, oppression and poor economic conditions. This review argues that while the notion of primary prevention with African Americans should be taken seriously, there is still a need for more and better epidemiologic research. Three bodies of knowledge relevant to black mental health are addressed: 1) the need for an epidemiologic knowledge base for prevention; 2) coping capacity and vulnerability to stress; 3) risk factor identification. Findings from a national survey of adult African Americans are presented as an example of risk factor identification for the purpose of specifying targets for preventive interventions. The paper concludes that before the prevention of psychopathology in black populations can be achieved, a number of measurement, theoretical and policy issues must be addressed. Specific directions for future research are outlined.

  17. The management of women at high risk for the development of breast cancer: risk estimation and preventative strategies.

    PubMed

    Sakorafas, George H

    2003-04-01

    Despite recent progress in the diagnostic and therapeutic approaches to the management of women with breast cancer, at least one third of these women will ultimately die from their disease. This resulted in a new focus on breast cancer prevention, especially for the woman designed as "high-risk". The continuing challenge is to identify reliable markers to accurately recognize this group of women, who are more likely to develop breast cancer. This will allow a targeted specific counseling and the application of preventative measures. Management options in high-risk women include intensive cancer surveillance, chemoprevention (mainly using tamoxifen), and prophylactic surgery (preferentially total mastectomy). Cancer surveillance is the most preferred management option. Currently, no data exists comparing prophylactic mastectomy vs. surveillance vs. chemoprevention. Thus, despite significant advances in our understanding of the biology of breast cancer, many questions remain unanswered concerning the optimal management of the high-risk woman. Patient counseling has a central role in the decision-making process and should be based on a multidisciplinary approach. The individual woman will make the final decision based on the amount of risk she is willing to accept. It is hoped that other preventative methods, such as gene therapy based on an accurate identification of specific genetic changes, will be developed in the future.

  18. Psychiatric comorbidity and response to preventative therapy in the treatment of severe migraine trial.

    PubMed

    Seng, Elizabeth K; Holroyd, Kenneth A

    2012-04-01

    Mood and anxiety disorders are comorbid with migraine and commonly assumed to portend a poor response to preventive migraine therapies. However, there is little evidence to support this assumption. We examined impact of a mood and/or anxiety disorder diagnosis using American Psychiatric Association Diagnostic and Statistical Manual criteria on response to the three preventative migraine therapies evaluated in the Treatment of Severe Migraine trial (n = 177): β-blocker, behavioral migraine management, or behavioral migraine management +β-blocker. Daily diaries assessed migraine activity for the 16 months of the trial. The Migraine Specific Quality of Life Questionnaire and Headache Disability Inventory assessed headache-related disability at regular intervals. Mixed models for repeated measures examined changes in these three outcomes with preventative migraine therapy in participants with and without a mood or anxiety disorder diagnosis. Participants with a comorbid mood or anxiety disorder diagnosis recorded larger reductions in migraine days (p < .05) and larger reductions in the Migraine Specific Quality of Life Questionnaire (p < .001) and Headache Disability Inventory (p < .01) than did participants with neither diagnosis. Significantly larger reductions in migraine activity and migraine-related disability were observed in participants with a mood and/or anxiety disorder diagnosis than in participants who did not receive either diagnosis.

  19. The new World Organisation for Animal Health standards on avian influenza and international trade.

    PubMed

    Thiermann, Alex B

    2007-03-01

    In 2002, the World Organisation for Animal Health began a review of the chapter on avian influenza by convening a group of experts to revise the most recent scientific literature. The group drafted the initial text that would provide the necessary recommendations on avian influenza control and prevention measures. The main objectives of this draft were to provide clear notification criteria, as well as commodity-specific, risk-based mitigating measures, that would provide safety when trading and encourage transparent reporting.

  20. A model of urban rational growth based on grey prediction

    NASA Astrophysics Data System (ADS)

    Xiao, Wenjing

    2017-04-01

    Smart growth focuses on building sustainable cities, using compact development to prevent urban sprawl. This paper establishes a series of models to implement smart growth theories into city design. Besides two specific city design cases are shown. Firstly, We establishes Smart Growth Measure Model to measure the success of smart growth of a city. And we use Full Permutation Polygon Synthetic Indicator Method to calculate the Comprehensive Indicator (CI) which is used to measure the success of smart growth. Secondly, this paper uses the principle of smart growth to develop a new growth plan for two cities. We establish an optimization model to maximum CI value. The Particle Swarm Optimization (PSO) algorithm is used to solve the model. Combined with the calculation results and the specific circumstances of cities, we make their the smart growth plan respectively.

  1. Exploring Attitudes and Beliefs towards Implementing Cattle Disease Prevention and Control Measures: A Qualitative Study with Dairy Farmers in Great Britain.

    PubMed

    Brennan, Marnie L; Wright, Nick; Wapenaar, Wendela; Jarratt, Susanne; Hobson-West, Pru; Richens, Imogen F; Kaler, Jasmeet; Buchanan, Heather; Huxley, Jonathan N; O'Connor, Heather M

    2016-10-11

    Disease prevention and control practices are frequently highlighted as important to ensure the health and welfare of farmed animals, although little is known as to why not many practices are carried out. The aim of this study was to identify the motivators and barriers of dairy cattle farmers towards the use of biosecurity measures on dairy farms using a health psychology approach. Twenty-five farmers on 24 farms in Great Britain (GB) were interviewed using the Theory of Planned Behaviour framework. Results indicated that farmers perceived they had the ability to control what happened on their farms in terms of preventing and controlling disease, and described benefits from being proactive and vigilant. However, barriers were cited in relation to testing inaccuracies, effectiveness and time-efficiency of practices, and disease transmission route (e.g., airborne transmission). Farmers reported they were positively influenced by veterinarians and negatively influenced by the government (Department for Environment Food & Rural Affairs (DEFRA)) and the general public. Decisions to implement practices were influenced by the perceived severity of the disease in question, if disease was diagnosed on the farm already, or was occurring on other farms. Farmers described undertaking a form of personal risk assessment when deciding if practices were worth doing, which did not always involve building in disease specific factors or opinions from veterinarians or other advisors. These results indicate that further guidance about the intricacies of control and prevention principles in relation to specific animal diseases may be required, with an obvious role for veterinarians. There appears to be an opportunity for farm advisors and herd health professionals to further understand farmer beliefs behind certain attitudes and target communication and advice accordingly to further enhance dairy cattle health and welfare.

  2. Glucosamine prevents in vitro collagen degradation in chondrocytes by inhibiting advanced lipoxidation reactions and protein oxidation

    PubMed Central

    Tiku, Moti L; Narla, Haritha; Jain, Mohit; Yalamanchili, Praveen

    2007-01-01

    Osteoarthritis (OA) affects a large segment of the aging population and is a major cause of pain and disability. At present, there is no specific treatment available to prevent or retard the cartilage destruction that occurs in OA. Recently, glucosamine sulfate has received attention as a putative agent that may retard cartilage degradation in OA. The precise mechanism of action of glucosamine is not known. We investigated the effect of glucosamine in an in vitro model of cartilage collagen degradation in which collagen degradation induced by activated chondrocytes is mediated by lipid peroxidation reaction. Lipid peroxidation in chondrocytes was measured by conjugated diene formation. Protein oxidation and aldehydic adduct formation were studied by immunoblot assays. Antioxidant effect of glucosamine was also tested on malondialdehyde (thiobarbituric acid-reactive substances [TBARS]) formation on purified lipoprotein oxidation for comparison. Glucosamine sulfate and glucosamine hydrochloride in millimolar (0.1 to 50) concentrations specifically and significantly inhibited collagen degradation induced by calcium ionophore-activated chondrocytes. Glucosamine hydrochloride did not inhibit lipid peroxidation reaction in either activated chondrocytes or in copper-induced oxidation of purified lipoproteins as measured by conjugated diene formation. Glucosamine hydrochloride, in a dose-dependent manner, inhibited malondialdehyde (TBARS) formation by oxidized lipoproteins. Moreover, we show that glucosamine hydrochloride prevents lipoprotein protein oxidation and inhibits malondialdehyde adduct formation in chondrocyte cell matrix, suggesting that it inhibits advanced lipoxidation reactions. Together, the data suggest that the mechanism of decreasing collagen degradation in this in vitro model system by glucosamine may be mediated by the inhibition of advanced lipoxidation reaction, preventing the oxidation and loss of collagen matrix from labeled chondrocyte matrix. Further studies are needed to relate these in vitro findings to the retardation of cartilage degradation reported in OA trials investigating glucosamine. PMID:17686167

  3. Improving substance use prevention efforts with executive function training.

    PubMed

    Pentz, Mary Ann; Riggs, Nathaniel R; Warren, Christopher M

    2016-06-01

    Executive function (EF) includes emotional regulation, planning and decision-making, and behavioral impulse control. Improving youth substance use (SU) prevention by targeting EF poses challenges including determining whether specific sub-domains of EF are more associated with SU than others, whether EF is related to some types of SU more than others, and whether EF programs might be enhanced by inclusion of mindfulness training. Data were drawn from two studies from the Pathways to Health project: a randomized controlled trial of 4th-6th graders and a cross-sectional pilot study of the relationship of EF to specific types of SU in a sample of 7th graders. Survey measures included assessment of the EF subdomains of inhibitory control (IC), emotional control, working memory, organization/planning, lifetime SU (tobacco and alcohol use), and mindfulness. Analyses included multivariate and multiple group path analysis. Results suggested that the EF sub-domain of IC was the strongest and most consistent predictor of SU, particularly cigarette and e-cigarette use, though emotional control was predictive of alcohol use among late-elementary school students. In the 7th grade sample, IC was predictive of alcohol, cigarette, and e-cigarette use only among students in the low 75% of mindfulness. Findings from the present studies suggest that improvements in SU prevention efforts may result from increased curricular emphasis on IC and its application to multiple substance use prevention, and systematically integrating mindfulness with EF skills training. Future research should examine whether EF-SU relationships vary across patterns of SU and types of measures used to assess EF. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  4. SOCIOECONOMIC DISPARITIES IN MORTALITY AMONG CHINESE ELDERLY*

    PubMed Central

    Luo, Weixiang; Xie, Yu

    2014-01-01

    This study examines the association of three different SES indicators (education, economic independence, and household per-capita income) with mortality, using a large, nationally representative longitudinal sample of 12,437 Chinese ages 65 and older. While the results vary by measures used, we find overall strong evidence for a negative association between SES and all-cause mortality. Exploring the association between SES and cause-specific mortality, we find that SES is more strongly related to a reduction of mortality from more preventable causes (i.e., circulatory disease and respiratory disease) than from less preventable causes (i.e., cancer). Moreover, we consider mediating causal factors such as support networks, health-related risk behaviors, and access to health care in contributing to the observed association between SES and mortality. Among these mediating factors, medical care is of greatest importance. This pattern holds true for both all-cause and cause-specific mortality. PMID:25098961

  5. Immediately modifiable risk factors attributable to colorectal cancer in Malaysia.

    PubMed

    Naing, Cho; Lai, Pei Kuan; Mak, Joon Wah

    2017-08-04

    This study aimed to estimate potential reductions in case incidence of colorectal cancer attributable to the modifiable risk factors such as alcohol consumption, overweight and physical inactivity amongst the Malaysian population. Gender specific population-attributable fractions (PAFs) for colorectal cancer in Malaysia were estimated for the three selected risk factors (physical inactivity, overweight, and alcohol consumptions). Exposure prevalence were sourced from a large-scale national representative survey. Risk estimates of the relationship between the exposure of interest and colorectal cancer were obtained from published meta-analyses. The overall PAF was then estimated, using the 2013 national cancer incidence data from the Malaysian Cancer Registry. Overall, the mean incidence rate for colorectal cancer in Malaysia from 2008 to 2013 was 21.3 per 100,000 population, with the mean age of 61.6 years (±12.7) and the majority were men (56.6%). Amongst 369 colorectal cancer cases in 2013, 40 cases (20 men, 20 women), 10 cases (9 men, 1 woman) or 20 cases (16 men,4 women) would be prevented, if they had done physical exercises, could reduce their body weight to normal level or avoided alcohol consumption, assuming that these factors are causally related to colorectal cancer. It was estimated that 66 (17.8%;66/369) colorectal cancer cases (42 men, 24 women) who had all these three risk factors for the last 10 years would have been prevented, if they could control these three risk factors through effective preventive measures. Findings suggest that approximately 18% of colorectal cancer cases in Malaysia would be prevented through appropriate preventive measures such as doing regular physical exercises, reducing their body weight to normal level and avoiding alcohol consumption, if these factors are causally related to colorectal cancer. Scaling-up nationwide public health campaigns tailored to increase physical activity, controlling body weight within normal limits and avoid alcohol intake are recommended. Future studies with other site-specific cancers and additional risk factors are needed.

  6. Systematic review of mental health and well-being outcomes following community-based obesity prevention interventions among adolescents.

    PubMed

    Hoare, Erin; Fuller-Tyszkiewicz, Matthew; Skouteris, Helen; Millar, Lynne; Nichols, Melanie; Allender, Steven

    2015-01-05

    This paper aimed to systematically evaluate the mental health and well-being outcomes observed in previous community-based obesity prevention interventions in adolescent populations. Systematic review of literature from database inception to October 2014. Articles were sourced from CINAHL, Global Health, Health Source: Nursing and Academic Edition, MEDLINE, PsycARTICLES and PsycINFO, all of which were accessed through EBSCOhost. The Cochrane Database was also searched to identify all eligible articles. PRISMA guidelines were followed and search terms and search strategy ensured all possible studies were identified for review. Intervention studies were eligible for inclusion if they were: focused on overweight or obesity prevention, community-based, targeted adolescents (aged 10-19 years), reported a mental health or well-being measure, and included a comparison or control group. Studies that focused on specific adolescent groups or were treatment interventions were excluded from review. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Primary outcomes were measures of mental health and well-being, including diagnostic and symptomatic measures. Secondary outcomes included adiposity or weight-related measures. Seven studies met the inclusion criteria; one reported anxiety/depressive outcomes, two reported on self-perception well-being measures such as self-esteem and self-efficacy, and four studies reported outcomes of quality of life. Positive mental health outcomes demonstrated that following obesity prevention, interventions included a decrease in anxiety and improved health-related quality of life. Quality of evidence was graded as very low. Although positive outcomes for mental health and well-being do exist, controlled evaluations of community-based obesity prevention interventions have not often included mental health measures (n=7). It is recommended that future interventions incorporate mental health and well-being measures to identify any potential mechanisms influencing adolescent weight-related outcomes, and equally to ensure interventions are not causing harm to adolescent mental health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Evaluation of participatory training in managing mental health for supervisory employees in the financial industry.

    PubMed

    Yoshikawa, Toru; Ogami, Ayumi; Muto, Takashi

    2013-12-01

    Industry-specific primary prevention measures for promoting mental health of workers were undertaken in 2008 and 2009 as a result of participatory training involving 130 supervisory employees in workplaces of the financial industry. These measures included the following five points suggested to be effective in the industry: 1) proper opportunities for training and career building, 2) control of work time and improving work organization, 3) standardization of tasks, 4) job rotation for sharing work responsibilities, and 5) increasing communication and mutual support. A post-training follow-up survey revealed that participatory, action-oriented training facilitated sharing of feasible measures and mutual support, leading to the development of measures easily introduced and established at each workplace. We concluded that mutually supportive group work of teams composed of members who held similar duty positions and were engaged in similar operations, using the Mental Health Action Checklist as a guiding tool, was effective for realizing implementation of optimally practical and specific measures.

  8. Prevention of musculoskeletal disorders in workers: classification and health surveillance - statements of the Scientific Committee on Musculoskeletal Disorders of the International Commission on Occupational Health.

    PubMed

    Hagberg, Mats; Violante, Francesco Saverio; Bonfiglioli, Roberta; Descatha, Alexis; Gold, Judith; Evanoff, Brad; Sluiter, Judith K

    2012-06-21

    The underlying purpose of this commentary and position paper is to achieve evidence-based recommendations on prevention of work-related musculoskeletal disorders (MSDs). Such prevention can take different forms (primary, secondary and tertiary), occur at different levels (i.e. in a clinical setting, at the workplace, at national level) and involve several types of activities. Members of the Scientific Committee (SC) on MSDs of the International Commission on Occupational Health (ICOH) and other interested scientists and members of the public recently discussed the scientific and clinical future of prevention of (work-related) MSDs during five round-table sessions at two ICOH conferences (in Cape Town, South Africa, in 2009, and in Angers, France, in 2010). Approximately 50 researchers participated in each of the sessions. More specifically, the sessions aimed to discuss new developments since 1996 in measures and classification systems used both in research and in practice, and agree on future needs in the field. The discussion focused on three questions: At what degree of severity does musculoskeletal ill health, and do health problems related to MSDs, in an individual worker or in a group of workers justify preventive action in occupational health? What reliable and valid instruments do we have in research to distinguish 'normal musculoskeletal symptoms' from 'serious musculoskeletal symptoms' in workers? What measures or classification system of musculoskeletal health will we need in the near future to address musculoskeletal health and related work ability? Four new, agreed-upon statements were extrapolated from the discussions: 1. Musculoskeletal discomfort that is at risk of worsening with work activities, and that affects work ability or quality of life, needs to be identified. 2. We need to know our options of actions before identifying workers at risk (providing evidence-based medicine and applying the principle of best practice). 3. Classification systems and measures must include aspects such as the severity, frequency, and intensity of pain, as well as measures of impairment of functioning, which can help in prevention, treatment and prognosis. 4. We need to be aware of economic and/or socio-cultural consequences of classification systems and measures.

  9. Pilot evaluation of a media literacy program for tobacco prevention targeting early adolescents shows mixed results.

    PubMed

    Kaestle, Christine E; Chen, Yvonnes; Estabrooks, Paul A; Zoellner, Jamie; Bigby, Brandon

    2013-01-01

    The purpose of this pilot study was to assess the impact of media literacy for tobacco prevention for youth delivered through a community site. A randomized pretest-posttest evaluation design with matched-contact treatment and control conditions. The pilot study was delivered through the YMCA in a lower-income suburban and rural area of Southwest Virginia, a region long tied, both economically and culturally, to the tobacco industry. Children ages 8 to 14 (76% white, 58% female) participated in the study (n = 38). The intervention was an antismoking media literacy program (five 1-hour lessons) compared with a matched-contact creative writing control program. General media literacy, three domains of tobacco-specific media literacy ("authors and audiences," "messages and meanings," and "representation and reality"), tobacco attitudes, and future expectations were assessed. Multiple regression modeling assessed the impact of the intervention, controlling for pretest measures, age, and sex. General media literacy and tobacco-specific "authors and audiences" media literacy improved significantly for treatment compared with control (p < .05); results for other tobacco-specific media literacy measures and for tobacco attitudes were not significant. Future expectations of smoking increased significantly for treatment participants ages 10 and younger (p < .05). Mixed results indicated that improvements in media literacy are accompanied by an increase in future expectations to smoke for younger children.

  10. Determination of strontium-90 in deer bones by liquid scintillation spectrometry after separation on Sr-specific ion exchange columns.

    PubMed

    Landstetter, Claudia; Wallner, Gabriele

    2006-01-01

    The activity concentration of (90)Sr was determined in several deer bones from Austria. Strontium specific ion exchange columns with 4',4''(5'')-di-t-butylcyclohexane-18-crown-6 from Eichrom Industries, Inc. were used for separation. The yield of the chemical procedure was quantified with AAS. Directly after column separation, the solution containing (90)Sr was mixed with the scintillation cocktail HiSafe III and measured by liquid scintillation counting. Prevention of (210)Pb contamination and reusability of the separation columns was investigated as well as the activity distribution within the bones. Results were compared with pre-Chernobyl measurements in Austria; a correlation between activity concentration of (90)Sr and site altitude was found.

  11. Believability of messages about preventing breast cancer and heart disease through physical activity.

    PubMed

    Berry, Tanya R; Jones, Kelvin E; Courneya, Kerry S; McGannon, Kerry R; Norris, Colleen M; Rodgers, Wendy M; Spence, John C

    2018-01-18

    The purpose of this research was to examine the relationships of self-reported physical activity to involvement with messages that discuss the prevention of heart disease and breast cancer through physical activity, the explicit believability of the messages, and agreement (or disagreement) with specific statements about the messages or disease beliefs in general. A within subjects' design was used. Participants (N = 96) read either a breast cancer or heart disease message first, then completed a corresponding task that measured agreement or disagreement and confidence in the agreement or disagreement that 1) physical activity 'reduces risk/does not reduce risk' of breast cancer or heart disease, 2) that breast cancer or heart disease is a 'real/not real risk for me', 3) that women who get breast cancer or heart disease are 'like/not like me', and 4) that women who get breast cancer or heart disease are 'to blame/not to blame'. This task was followed by a questionnaire measuring message involvement and explicit believability. They then read the other disease messages and completed the corresponding agreement and confidence task and questionnaire measures. Lastly, participants completed a questionnaire measuring physical activity related attitudes and intentions, and demographics. There was no difference in message involvement or explicit believability of breast cancer compared to heart disease messages. Active participants had a higher confidence in their agreement that physical activity is preventive of heart disease compared to breast cancer. Multinomial regression models showed that, in addition to physical activity related attitudes and intentions, agreement that physical activity was preventive of heart disease and that women with heart disease are 'like me' were predictors of being more active compared to inactive. In the breast cancer model only attitudes and intentions predicted physical activity group. Active women likely internalized messages about heart disease prevention through physical activity, making the prevention messages more readily available within memory, and active women may therefore process such information differently. The study of how health-related beliefs are created and are related to perceptions of prevention messages is a rich area of study that may contribute to more effective health promotion.

  12. Are context-specific measures of parental-reported physical activity and sedentary behaviour associated with accelerometer data in 2-9-year-old European children?

    PubMed

    Verbestel, Vera; De Henauw, Stefaan; Bammann, Karin; Barba, Gianvincenzo; Hadjigeorgiou, Charalambos; Eiben, Gabriele; Konstabel, Kenn; Kovács, Eva; Pitsiladis, Yannis; Reisch, Lucia; Santaliestra-Pasías, Alba M; Maes, Lea; De Bourdeaudhuij, Ilse

    2015-04-01

    The aim of the present study was to investigate if context-specific measures of parental-reported physical activity and sedentary behaviour are associated with objectively measured physical activity and sedentary time in children. Cross-sectional study. Seven European countries taking part in the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants) study. Data were analysed from 2-9-year-old children (n 5982) who provided both parental-reported and accelerometer-derived physical activity/sedentary behaviour measures. Parents reported their children's daily screen-time, weekly sports participation and daily outdoor playtime by means of the Outdoor Playtime Checklist (OPC) and Outdoor Playtime Recall Questions (OPRQ). Sports participation, OPC- and OPRQ-derived outdoor play were positively associated with accelerometer-derived physical activity. Television viewing and computer use were positively associated with accelerometer-derived sedentary time. All parental-reported measures that were significantly associated with accelerometer outcomes explained only a minor part of the variance in accelerometer-derived physical activity or sedentary time. Parental-reported measures of physical activity and sedentary behaviour are not useful as a proxy for 2-9-year-old children's physical activity and sedentary time. Findings do not preclude the use of context-specific measures but imply that conclusions should be limited to the context-specific behaviours that are actually measured. Depending on the aim of the study, future research should carefully consider the choice of measurements, including the use of subjective or objective measures of the behaviour of interest or a combination of both.

  13. Caries prevention during orthodontic treatment: In-vivo assessment of high-fluoride varnish to prevent white spot lesions.

    PubMed

    Perrini, Federico; Lombardo, Luca; Arreghini, Angela; Medori, Silvia; Siciliani, Giuseppe

    2016-02-01

    Our objective was to evaluate the efficacy of a fluoridated varnish in preventing white spot lesions in patients with fixed appliances. A laser-induced fluorescence device was used to determine any correlations between the degree of demineralization and the length of the observation period, the arch sector, the frequency of varnish application, and the specific tooth site. A split-mouth study design was used for 24 orthodontic patients, allocated randomly to 2 subgroups with differing frequencies of Duraphat varnish (Colgate-Palmolive, New York, NY) application. Repeated measures of the degree of demineralization were taken on the vestibular surfaces of 12 teeth (6 varnished and 6 unvarnished controls). Measurements were taken at 4 sites using a DIAGNOdent Pen 2190 laser (KaVo, Biberach an der Riss, Germany) and then subjected to statistical analysis. Generalized linear model and coefficient model analysis showed differences in the degrees of demineralization between treated and untreated teeth, but this was not statistically significant in terms of time point, frequency of application, or specific tooth site. However, when we analyzed the position of the teeth, the varnished anterior teeth showed a statistically significant reduction in demineralization compared with their unvarnished counterparts. Periodic application of fluoride varnish can offer some protection against white spots, but not to a statistically significant degree if the patients have excellent oral hygiene. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  14. Family planning counseling for women living with HIV: a systematic review of the evidence of effectiveness on contraceptive uptake and pregnancy incidence, 1990 to 2011.

    PubMed

    O'Reilly, Kevin R; Kennedy, Caitlin E; Fonner, Virginia A; Sweat, Michael D

    2013-10-08

    Family planning is an important public health intervention with numerous potential health benefits for all women. One of those key benefits is the prevention of mother-to-child transmission of HIV, through the prevention of unintended pregnancies among women living with HIV. We conducted a systematic review of the effectiveness of family planning counseling interventions for HIV infected women in low- and middle-income countries. We found nine articles which met the inclusion criteria for this review, all from Africa. Though these studies varied in the specifics of the interventions provided, research designs and measures of outcomes, key features were discernible. Providing concerted information and support for family planning use, coupled with ready access to a wide range of contraceptive methods, seemed most effective in increasing use. Effects on pregnancy overall were difficult to measure, however: no studies assessed the effect on unintended pregnancy. Though these results are far from definitive, they do highlight the need for strengthened efforts to integrate family planning counseling and access to services into HIV prevention, and for greater consistency of effort over time. Studies which specifically investigate fertility intentions and desires of women living with HIV, contraception use following interventions to increase knowledge, awareness, motivation and access to the means to act on those intentions and unintended pregnancies would be valuable to help clinic personnel, programme planners and policy makers guide the development of the integrated services they offer.

  15. Serum virus neutralization assay for detection and quantitation of serum neutralizing antibodies to influenza A virus in swine

    USDA-ARS?s Scientific Manuscript database

    The serum virus neutralization (SVN) assay is a serological test to detect the presence and magnitude of functional systemic antibodies that prevent infectivity of a virus. The SVN assay is a highly sensitive and specific test that may be applied to influenza A viruses (IAV) in swine to measure the ...

  16. Wisconsin Youth Risk Behavior Survey. Executive Summary and Report, 1997.

    ERIC Educational Resources Information Center

    Kadel, Ben

    Part of a national survey effort by the U.S. Centers for Disease Control and Prevention (CDC), the Youth Risk Behavior Survey (YRBS) conducted in Wisconsin public schools in 1997 is presented. The core of the survey measures 16 objectives set by CDC as part of its Year 2000 initiative. Additional questions were added specifically for Wisconsin.…

  17. Comparison of two cash transfer strategies to prevent catastrophic costs for poor tuberculosis-affected households in low- and middle-income countries: An economic modelling study.

    PubMed

    Rudgard, William E; Evans, Carlton A; Sweeney, Sedona; Wingfield, Tom; Lönnroth, Knut; Barreira, Draurio; Boccia, Delia

    2017-11-01

    Illness-related costs for patients with tuberculosis (TB) ≥20% of pre-illness annual household income predict adverse treatment outcomes and have been termed "catastrophic." Social protection initiatives, including cash transfers, are endorsed to help prevent catastrophic costs. With this aim, cash transfers may either be provided to defray TB-related costs of households with a confirmed TB diagnosis (termed a "TB-specific" approach); or to increase income of households with high TB risk to strengthen their economic resilience (termed a "TB-sensitive" approach). The impact of cash transfers provided with each of these approaches might vary. We undertook an economic modelling study from the patient perspective to compare the potential of these 2 cash transfer approaches to prevent catastrophic costs. Model inputs for 7 low- and middle-income countries (Brazil, Colombia, Ecuador, Ghana, Mexico, Tanzania, and Yemen) were retrieved by literature review and included countries' mean patient TB-related costs, mean household income, mean cash transfers, and estimated TB-specific and TB-sensitive target populations. Analyses were completed for drug-susceptible (DS) TB-related costs in all 7 out of 7 countries, and additionally for drug-resistant (DR) TB-related costs in 1 of the 7 countries with available data. All cost data were reported in 2013 international dollars ($). The target population for TB-specific cash transfers was poor households with a confirmed TB diagnosis, and for TB-sensitive cash transfers was poor households already targeted by countries' established poverty-reduction cash transfer programme. Cash transfers offered in countries, unrelated to TB, ranged from $217 to $1,091/year/household. Before cash transfers, DS TB-related costs were catastrophic in 6 out of 7 countries. If cash transfers were provided with a TB-specific approach, alone they would be insufficient to prevent DS TB catastrophic costs in 4 out of 6 countries, and when increased enough to prevent DS TB catastrophic costs would require a budget between $3.8 million (95% CI: $3.8 million-$3.8 million) and $75 million (95% CI: $50 million-$100 million) per country. If instead cash transfers were provided with a TB-sensitive approach, alone they would be insufficient to prevent DS TB-related catastrophic costs in any of the 6 countries, and when increased enough to prevent DS TB catastrophic costs would require a budget between $298 million (95% CI: $219 million-$378 million) and $165,367 million (95% CI: $134,085 million-$196,425 million) per country. DR TB-related costs were catastrophic before and after TB-specific or TB-sensitive cash transfers in 1 out of 1 countries. Sensitivity analyses showed our findings to be robust to imputation of missing TB-related cost components, and use of 10% or 30% instead of 20% as the threshold for measuring catastrophic costs. Key limitations were using national average data and not considering other health and social benefits of cash transfers. A TB-sensitive cash transfer approach to increase all poor households' income may have broad benefits by reducing poverty, but is unlikely to be as effective or affordable for preventing TB catastrophic costs as a TB-specific cash transfer approach to defray TB-related costs only in poor households with a confirmed TB diagnosis. Preventing DR TB-related catastrophic costs will require considerable additional investment whether a TB-sensitive or a TB-specific cash transfer approach is used.

  18. Nosocomial Spread of Viral Disease

    PubMed Central

    Aitken, Celia; Jeffries, Donald J.

    2001-01-01

    Viruses are important causes of nosocomial infection, but the fact that hospital outbreaks often result from introduction(s) from community-based epidemics, together with the need to initiate specific laboratory testing, means that there are usually insufficient data to allow the monitoring of trends in incidences. The most important defenses against nosocomial transmission of viruses are detailed and continuing education of staff and strict adherence to infection control policies. Protocols must be available to assist in the management of patients with suspected or confirmed viral infection in the health care setting. In this review, we present details on general measures to prevent the spread of viral infection in hospitals and other health care environments. These include principles of accommodation of infected patients and approaches to good hygiene and patient management. They provide detail on individual viral diseases accompanied in each case with specific information on control of the infection and, where appropriate, details of preventive and therapeutic measures. The important areas of nosocomial infection due to blood-borne viruses have been extensively reviewed previously and are summarized here briefly, with citation of selected review articles. Human prion diseases, which present management problems very different from those of viral infection, are not included. PMID:11432812

  19. 41 CFR 102-74.360 - What are the specific accident and fire prevention responsibilities of occupant agencies?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... accident and fire prevention responsibilities of occupant agencies? 102-74.360 Section 102-74.360 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Accident and Fire Prevention § 102-74.360 What are the specific accident and fire prevention responsibilities of occupant agencies...

  20. Guidelines for reporting methodological challenges and evaluating potential bias in dementia research

    PubMed Central

    Weuve, Jennifer; Proust-Lima, Cécile; Power, Melinda C.; Gross, Alden L.; Hofer, Scott M.; Thiébaut, Rodolphe; Chêne, Geneviève; Glymour, M. Maria; Dufouil, Carole

    2015-01-01

    Clinical and population research on dementia and related neurologic conditions, including Alzheimer’s disease, faces several unique methodological challenges. Progress to identify preventive and therapeutic strategies rests on valid and rigorous analytic approaches, but the research literature reflects little consensus on “best practices.” We present findings from a large scientific working group on research methods for clinical and population studies of dementia, which identified five categories of methodological challenges as follows: (1) attrition/sample selection, including selective survival; (2) measurement, including uncertainty in diagnostic criteria, measurement error in neuropsychological assessments, and practice or retest effects; (3) specification of longitudinal models when participants are followed for months, years, or even decades; (4) time-varying measurements; and (5) high-dimensional data. We explain why each challenge is important in dementia research and how it could compromise the translation of research findings into effective prevention or care strategies. We advance a checklist of potential sources of bias that should be routinely addressed when reporting dementia research. PMID:26397878

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

    PubMed

    Aladag, I; Guven, M; Songu, M

    2016-05-01

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

  2. Mechanisms and methods for biofouling prevention via aeration

    NASA Astrophysics Data System (ADS)

    Dickenson, Natasha; Henoch, Charles; Belden, Jesse

    2013-11-01

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

  3. National Athletic Trainers' Association Position Statement: Skin Diseases

    PubMed Central

    Zinder, Steven M.; Basler, Rodney S. W.; Foley, Jack; Scarlata, Chris; Vasily, David B.

    2010-01-01

    Abstract Objective: To present recommendations for the prevention, education, and management of skin infections in athletes. Background: Trauma, environmental factors, and infectious agents act together to continually attack the integrity of the skin. Close quarters combined with general poor hygiene practices make athletes particularly vulnerable to contracting skin diseases. An understanding of basic prophylactic measures, clinical features, and swift management of common skin diseases is essential for certified athletic trainers to aid in preventing the spread of infectious agents. Recommendations: These guidelines are intended to provide relevant information on skin infections and to give specific recommendations for certified athletic trainers and others participating in athletic health care. PMID:20617918

  4. [Reducing inequality by improving preventing measures].

    PubMed

    Valsecchi, M

    2014-01-01

    Terms of inequalities issue in health service are defined and the consolidated scientific acquisitions are recalled. Three prioritary areas of action are defined and described, that Prevention Departments are suggested to activate through focused programs in order to reduce specific inequalities. First area of action: includes three types of vital interventions: vaccinations, contrasting of tuberculosis infection and oncological screening that have to be granted to specific disadvantaged groups of population as Rom communities, immigrant women, prisoners e psychiatric patients. Second area of action: actions on focused urban planning aiming to improve conditions of social housing (with a special focus on thermal insulation, minimal distances to be kept towards streets of havy traffic), increase of increase of urban green spaces enjoyed by the population and contrasting degradation of housing (with particular attention to poisoning by carbon monoxide). Third area of action: actions contrasting cardiovascular diseases, that is the leading cause of death and inequalities in health for the working class population. A coordinated intervention directly in the workplace is proposed, where a particularly high percentage of individuals exposed to specific risk factors is present.

  5. Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R, and Lactobacillus rhamnosus CLR2 (Bio-K+): Characterization, Manufacture, Mechanisms of Action, and Quality Control of a Specific Probiotic Combination for Primary Prevention of Clostridium difficile Infection.

    PubMed

    Auclair, Julie; Frappier, Martin; Millette, Mathieu

    2015-05-15

    A specific probiotic formulation composed of Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R, and Lactobacillus rhamnosus CLR2 (Bio-K+) has been marketed in North America since 1996. The strains and the commercial products have been evaluated for safety, identity, gastrointestinal survival, and stability throughout shelf life. The capacity of both the fermented beverages and the capsules to reduce incidences of antibiotic-associated diarrhea and Clostridium difficile infection (CDI) has been demonstrated in human clinical trials. Individual strains and the finished products have shown antimicrobial activity against C. difficile and toxin A/B neutralization capacity in vitro. The use of this specific probiotic formulation as part of a bundle of preventive measures to control CDI in healthcare settings is discussed. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  6. A Review of Preventative Methods against Human Leishmaniasis Infection

    PubMed Central

    Stockdale, Lisa; Newton, Robert

    2013-01-01

    Background Leishmaniasis is an intracellular parasitic infection transmitted to humans via the sandfly. Approximately 350 million people are at risk of contracting the disease and an estimated 1.6 million new cases occur annually. Of the two main forms, visceral and cutaneous, the visceral form is fatal in 85–90% of untreated cases. Aims This literature review aims to identify and evaluate the current evidence base for the use of various preventative methods against human leishmaniasis. Methods A literature search was performed of the relevant database repositories for primary research conforming to a priori inclusion and exclusion criteria. Results A total of 84 controlled studies investigating 12 outcome measures were identified, implementing four broad categories of preventative interventions: animal reservoir control, vector population control, human reservoir control and a category for multiple concurrently implemented interventions. The primary studies investigated a heterogeneous mix of outcome measures using a range of different methods. Conclusions This review highlights an absence of research measuring human-specific outcomes (35% of the total) across all intervention categories. The apparent inability of study findings to be generalizable across different geographic locations, points towards gaps in knowledge regarding the biology of transmission of Leishmania in different settings. More research is needed which investigates human infection as the primary outcome measure as opposed to intermediate surrogate markers, with a focus on developing a human vaccine. PMID:23818997

  7. Developing measures of community-relevant outcomes for violence prevention programs: a community-based participatory research approach to measurement.

    PubMed

    Hausman, Alice J; Baker, Courtney N; Komaroff, Eugene; Thomas, Nicole; Guerra, Terry; Hohl, Bernadette C; Leff, Stephen S

    2013-12-01

    Community-Based Participatory Research is a research paradigm that encourages community participation in designing and implementing evaluation research, though the actual outcome measures usually reflect the "external" academic researchers' view of program effect and the policy-makers' needs for decision-making. This paper describes a replicable process by which existing standardized psychometric scales commonly used in youth-related intervention programs were modified to measure indicators of program success defined by community partners. This study utilizes a secondary analysis of data gathered in the context of a community-based youth violence prevention program. Data were retooled into new measures developed using items from the Alabama Parenting Questionnaire, the Hare Area Specific Self-Esteem Scale, and the Youth Asset Survey. These measures evaluated two community-defined outcome indicators, "More Parental Involvement" and "Showing Kids Love." Results showed that existing scale items can be re-organized to create measures of community-defined outcomes that are psychometrically reliable and valid. Results also show that the community definitions of parent or parenting caregivers exemplified by the two indicators are similar to how these constructs have been defined in previous research, but they are not synonymous. There are nuanced differences that are important and worthy of better understanding, in part through better measurement.

  8. Development and testing of an algorithm to detect implantable cardioverter-defibrillator lead failure.

    PubMed

    Gunderson, Bruce D; Gillberg, Jeffrey M; Wood, Mark A; Vijayaraman, Pugazhendhi; Shepard, Richard K; Ellenbogen, Kenneth A

    2006-02-01

    Implantable cardioverter-defibrillator (ICD) lead failures often present as inappropriate shock therapy. An algorithm that can reliably discriminate between ventricular tachyarrhythmias and noise due to lead failure may prevent patient discomfort and anxiety and avoid device-induced proarrhythmia by preventing inappropriate ICD shocks. The goal of this analysis was to test an ICD tachycardia detection algorithm that differentiates noise due to lead failure from ventricular tachyarrhythmias. We tested an algorithm that uses a measure of the ventricular intracardiac electrogram baseline to discriminate the sinus rhythm isoelectric line from the right ventricular coil-can (i.e., far-field) electrogram during oversensing of noise caused by a lead failure. The baseline measure was defined as the product of the sum (mV) and standard deviation (mV) of the voltage samples for a 188-ms window centered on each sensed electrogram. If the minimum baseline measure of the last 12 beats was <0.35 mV-mV, then the detected rhythm was considered noise due to a lead failure. The first ICD-detected episode of lead failure and inappropriate detection from 24 ICD patients with a pace/sense lead failure and all ventricular arrhythmias from 56 ICD patients without a lead failure were selected. The stored data were analyzed to determine the sensitivity and specificity of the algorithm to detect lead failures. The minimum baseline measure for the 24 lead failure episodes (0.28 +/- 0.34 mV-mV) was smaller than the 135 ventricular tachycardia (40.8 +/- 43.0 mV-mV, P <.0001) and 55 ventricular fibrillation episodes (19.1 +/- 22.8 mV-mV, P <.05). A minimum baseline <0.35 mV-mV threshold had a sensitivity of 83% (20/24) with a 100% (190/190) specificity. A baseline measure of the far-field electrogram had a high sensitivity and specificity to detect lead failure noise compared with ventricular tachycardia or fibrillation.

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

    PubMed

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

    2015-06-01

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

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

    PubMed Central

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

    2015-01-01

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

  11. Guidelines for the diagnosis, prevention and management of osteoporosis.

    PubMed

    Rossini, M; Adami, S; Bertoldo, F; Diacinti, D; Gatti, D; Giannini, S; Giusti, A; Malavolta, N; Minisola, S; Osella, G; Pedrazzoni, M; Sinigaglia, L; Viapiana, O; Isaia, G C

    2016-06-23

    Osteoporosis poses a significant public health issue. National Societies have developed Guidelines for the diagnosis and treatment of this disorder with an effort of adapting specific tools for risk assessment on the peculiar characteristics of a given population. The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, riskassessment, prevention and management of primary and secondary osteoporosis. The guidelines were first drafted by a working group and then approved by the board of SIOMMMS. Subsequently they received also the endorsement of other major Scientific Societies that deal with bone metabolic disease. These recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on leading experts' experience and opinion, and on good clinical practice. The osteoporosis prevention should be based on the elimination of specific risk factors. The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk, and this is the case only when the risk of fracture is rather high as measured with variables susceptible to pharmacological effect. DeFRA (FRAX® derived fracture risk assessment) is recognized as a useful tool for easily estimate the long-term fracture risk. Several secondary forms of osteoporosis require a specific diagnostic and therapeutic management.

  12. [Individual prevention of occupational contact dermatitis: protective gloves and skin protection recommendations as part of the patient management scheme by the public statutory employers' liability insurance].

    PubMed

    Wilke, A; Skudlik, C; Sonsmann, F K

    2018-05-02

    The dermatologist's procedure is a pivotal tool for early recognition of occupational contact dermatitis (OCD), for reporting OCD cases to the statutory accident insurance and for treating the diseases. The employer is in charge of implementing skin protection measures at the workplace. However, in terms of an individual prevention approach it may be necessary to propose targeted skin protection recommendations in specific patient cases. The patient's own skin protection behavior significantly contributes to regenerating and maintaining healthy skin. This behavior includes the use of occupational skin products, and in particular the correct use of appropriately selected protective gloves. Protective gloves are the most important personal protective measure in the prevention of OCD. Prevention services, occupational health and safety specialists, occupational physicians and centers specialized in occupational dermatology can support the identification of suitable protective measures. Nowadays, suitable protective gloves exist for (almost) every occupational activity and exposure. However, improper use in practice can become a risk factor by itself for the skin (e. g., incorrectly used gloves). Therefore, it is of utmost importance to identify application errors, to educate patients in terms of skin protection and to motivate them to perform an appropriate skin protection behavior. With particular focus on protective gloves, this article gives an overview of various types, materials and potentially glove-related allergens, presents strategies for reducing occlusion effects and discusses some typical application errors and solutions.

  13. Caries preventive measures in orthodontic practice: the development of a clinical practice guideline.

    PubMed

    Oosterkamp, B C M; van der Sanden, W J M; Frencken, J E F M; Kuijpers-Jagtman, A M

    2016-02-01

    White spot lesions (WSLs) are a side effect of orthodontic treatment, causing esthetic problems and a risk of deeper enamel and dentine lesions. Many strategies have been developed for preventing WSLs, but great variability exists in preventive measures between orthodontists. This study developed statements on which a clinical practice guideline (CPG) can be developed in order to help orthodontists select preventive measures based on the best available evidence. A nominal group technique (RAND-e modified Delphi procedure) was used. A multidisciplinary expert panel rated 264 practice- and evidence-based statements related to the management of WSLs. To provide panel members with the same knowledge, a total of six articles obtained from a systematic review of the literature were read by the panel in preparation of three consensus rounds. According to the technique, a threshold of 75% of all ratings within any 3-point section of the 9-point scale regarding a specific statement was accepted as consensus. After the first and second consensus rounds, consensus was reached on 37.5 and 31.1% of statements, respectively. For the remaining 31.4% of statements, consensus was reached during a 4-h consensus meeting. Statements on the management of WSLs derived from a systematic literature review combined with expert opinion were formally integrated toward consensus through a nominal group technique. These statements formed the basis for developing a CPG on the management of WSLs before and during orthodontic treatment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Environmental evaluation of municipal waste prevention

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

    Gentil, Emmanuel C.; Gallo, Daniele; Christensen, Thomas H., E-mail: thho@env.dtu.dk

    Highlights: > Influence of prevention on waste management systems, excluding avoided production, is relatively minor. > Influence of prevention on overall supply chain, including avoided production is very significant. > Higher relative benefits of prevention are observed in waste management systems relying mainly on landfills. - Abstract: Waste prevention has been addressed in the literature in terms of the social and behavioural aspects, but very little quantitative assessment exists of the environmental benefits. Our study evaluates the environmental consequences of waste prevention on waste management systems and on the wider society, using life-cycle thinking. The partial prevention of unsolicited mail,more » beverage packaging and food waste is tested for a 'High-tech' waste management system relying on high energy and material recovery and for a 'Low-tech' waste management system with less recycling and relying on landfilling. Prevention of 13% of the waste mass entering the waste management system generates a reduction of loads and savings in the waste management system for the different impacts categories; 45% net reduction for nutrient enrichment and 12% reduction for global warming potential. When expanding our system and including avoided production incurred by the prevention measures, large savings are observed (15-fold improvement for nutrient enrichment and 2-fold for global warming potential). Prevention of food waste has the highest environmental impact saving. Prevention generates relatively higher overall relative benefit for 'Low-tech' systems depending on landfilling. The paper provides clear evidence of the environmental benefits of waste prevention and has specific relevance in climate change mitigation.« less

  15. Understanding the role of waste prevention in local waste management: A literature review.

    PubMed

    Zacho, Kristina O; Mosgaard, Mette A

    2016-10-01

    Local waste management has so far been characterised by end-of-pipe solutions, landfilling, incineration, and recycling. End-of-pipe solutions build on a different mind-set than life cycle-based approaches, and for this reason, local waste managers are reluctant to consider strategies for waste prevention. To accelerate the transition of waste and resource management towards a more integrated management, waste prevention needs to play a larger role in the local waste management. In this review article, we collect knowledge from the scientific community on waste prevention of relevance to local waste management. We analyse the trends in the waste prevention literature by organising the literature into four categories. The results indicate an increasing interest in waste prevention, but not much literature specifically concerns the integration of prevention into the local waste management. However, evidence from the literature can inform local waste management on the prevention potential; the environmental and social effects of prevention; how individuals in households can be motivated to reduce waste; and how the effects of prevention measures can be monitored. Nevertheless, knowledge is still lacking on local waste prevention, especially regarding the methods for monitoring and how local waste management systems can be designed to encourage waste reduction in the households. We end the article with recommendations for future research. The literature review can be useful for both practitioners in the waste sector and for academics seeking an overview of previous research on waste prevention. © The Author(s) 2016.

  16. Aspiration pneumonia. Pathophysiological aspects, prevention and management. A review.

    PubMed

    Petroianni, A; Ceccarelli, D; Conti, V; Terzano, C

    2006-12-01

    Aspiration pneumonias occur more frequently than reported and, in many cases, the disease is not recognised. In hospitalised and institutionalised patients with predisposing diseases prompt diagnosis of this complication and correct preventive measures can drastically reduce the worsening of clinical conditions and the deaths due to aspiration pneumonia. Normal airway structure, effective defence mechanisms, and preventive measures are decisive in reducing aspiration episodes. An increased aspiration risk for food, fluids, medications, or secretions may lead to the development of pneumonia. Pneumonia is the most common respiratory complication in all stroke deaths and in mechanical ventilation patients. In addition, the increased incidence of aspiration pneumonia with aging may be a consequence of impairment of swallowing and the cough reflex. Dysphagia, compromised consciousness, invasive procedures, anaesthesia, insufficient oral care, sleep disorders, and vomiting are all risk factors. Aspiration pneumonia includes different characteristic syndromes based on the amount (massive, acute, chronic) and physical character of the aspirated material (acid, infected, lipoid), needing a different therapeutic approach. Chronic patients education and correct health care practices are the keys for preventing the events of aspiration. In patients at risk a clinical and instrumental assessment of dysphagia should be evaluated. Management includes the removal of etiologic factors (drugs, tubes, mobilisation, oral hygiene), supportive care, and in bacterial pneumonias a specific antibiotic therapy for community-acquired or nosocomial events.

  17. A randomized, placebo-controlled trial of patient education for acute low back pain (PREVENT Trial): statistical analysis plan.

    PubMed

    Traeger, Adrian C; Skinner, Ian W; Hübscher, Markus; Lee, Hopin; Moseley, G Lorimer; Nicholas, Michael K; Henschke, Nicholas; Refshauge, Kathryn M; Blyth, Fiona M; Main, Chris J; Hush, Julia M; Pearce, Garry; Lo, Serigne; McAuley, James H

    Statistical analysis plans increase the transparency of decisions made in the analysis of clinical trial results. The purpose of this paper is to detail the planned analyses for the PREVENT trial, a randomized, placebo-controlled trial of patient education for acute low back pain. We report the pre-specified principles, methods, and procedures to be adhered to in the main analysis of the PREVENT trial data. The primary outcome analysis will be based on Mixed Models for Repeated Measures (MMRM), which can test treatment effects at specific time points, and the assumptions of this analysis are outlined. We also outline the treatment of secondary outcomes and planned sensitivity analyses. We provide decisions regarding the treatment of missing data, handling of descriptive and process measure data, and blinded review procedures. Making public the pre-specified statistical analysis plan for the PREVENT trial minimizes the potential for bias in the analysis of trial data, and in the interpretation and reporting of trial results. ACTRN12612001180808 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612001180808). Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. Changes in Caries Experience, Untreated Caries, Sealant Prevalence, and Preventive Behavior Among Third-Graders in New York State, 2002-2004 and 2009-2012.

    PubMed

    Kumar, Jayanth V; Tavares, Vinicius; Kandhari, Priyanka; Moss, Mark; Jolaoso, I Adeyemi

    2015-01-01

    This study assessed changes in caries experience, untreated caries, sealant prevalence, and preventive behavior among third-grade children in New York State to monitor progress toward state health objectives. We analyzed children's data from the 2002-2004 (n=10,865) and 2009-2012 (n=6,758) New York State Oral Health Survey. We calculated differences in weighted percentages and 95% confidence intervals for caries experience, untreated caries, sealant prevalence, and preventive behavior. We used logistic regression procedures to assess the independent effects and interaction terms on dental caries experience. The percentage of children with dental caries and untreated caries decreased from 54.1% and 33.0% in 2002-2004 to 45.2% and 23.6% in 2009-2012, respectively. While this decrease was not uniform across income subgroups, the prevalence of sealants, a key measure of the use of preventive services, increased significantly from 16.7% to 36.0% among lower-income children. Measurable improvement in reducing dental caries prevalence among third-grade children has been made in New York State, but this improvement was not uniform across subgroups. Specifically, disease prevalence among lower-income children remained high, underscoring the need to strengthen existing programs and identify additional policy and programmatic interventions.

  19. A comprehensive analysis of breast cancer news coverage in leading media outlets focusing on environmental risks and prevention.

    PubMed

    Atkin, Charles K; Smith, Sandi W; McFeters, Courtnay; Ferguson, Vanessa

    2008-01-01

    Breast cancer has a high profile in the news media, which are a major source of information for cancer patients and the general public. To determine the nature of breast cancer news coverage available to audiences, particularly on the topics of environmental risks and prevention, this content analysis measured a broad array of dimensions in 231 stories appearing in nine leading newspapers, newsmagazines, and television networks in 2003 and 2004. One fourth of all stories reported on various risks such as hormone replacement therapy (HRT) use. Very few items specifically addressed risks related to controllable lifestyle practices such as prepubertal obesity or chemical contaminants in the environment. About one third of the stories included prevention content, primarily focusing narrowly on use of pharmaceutical products. Little information described risk reduction via other individual preventive behaviors (e.g., diet, exercise, and smoking), parental protective measures, or collective actions to combat contamination sites. The more traditional categories of prevalence, detection, and treatment were featured in one third, one quarter, and two fifths of the news items, respectively. There were twice as many stories featuring personal narratives as statistical figures, and two thirds of all the news items cited expert medical professionals, researchers, or organizations. Implications of these findings and directions for future research are addressed.

  20. Are cultural values and beliefs included in U.S. based HIV interventions?

    PubMed

    Wyatt, Gail E; Williams, John K; Gupta, Arpana; Malebranche, Dominique

    2012-11-01

    To determine the extent to which current United States based human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. A comprehensive literature review was conducted to determine which published human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions incorporated aspects of cultural beliefs. This review of 166 human immunodeficiency virus (HIV) prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. human immunodeficiency virus (HIV) interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual's risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. Copyright © 2011. Published by Elsevier Inc.

  1. Project Prevention - A Curriculum Specifically Designed To Prevent Illegal Drug Use among Students with Disabilities: Elementary.

    ERIC Educational Resources Information Center

    Devlin, Sandy; And Others

    The Project Prevention curriculum is specifically designed for the prevention of substance abuse among students with disabilities and was piloted in 10 classroom serving students with mild, moderate, and severe disabilities. This component of the curriculum is intended for elementary students and includes four sections with a total of 81 lesson…

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

    PubMed

    Meylakhs, Peter; Aasland, Aadne; Grønningsæter, Arne

    2017-06-05

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

  3. Skin cancer prevention and detection campaign at golf courses on Spain's Costa del Sol.

    PubMed

    del Boz, J; Fernández-Morano, T; Padilla-España, L; Aguilar-Bernier, M; Rivas-Ruiz, F; de Troya-Martín, M

    2015-01-01

    Skin cancer prevention and detection campaigns targeting specific groups are necessary and have proven to be more effective than those aimed at the general population. Interventions in outdoor tourist spots have proven successful, although none have specifically targeted golf courses. The aims of this study were to describe the risk profile of golfers and golf course workers and evaluate the impact of a skin cancer prevention and early detection intervention. This was a cross-sectional descriptive study conducted at 6 golf courses. The intervention included a skin examination and completion of a questionnaire about demographic details, risk factors, and sun exposure and sun protection habits. Participants were also given advice on sun protection measures, self-examination, and use of sunscreens, and were asked about their satisfaction with the intervention and their intention to change their current behaviors. The effect was measured in terms of the diagnoses made, satisfaction with the intervention, reported intention to change, and potential effect in terms of existing risk factors. Of the 351 participants (57% golfers and 43% golf course workers), 70.4% had fair skin, 11.7% had a family history of skin cancer, and 8.5% had a personal history of skin cancer. Skin cancer and actinic keratoses were diagnosed in 10.7% and 40% of the golfers, respectively. The session was rated positively by 99.4% of the participants; 93.9% stated that they intended to improve their sun exposure habits and 93.4% said that they planned to examine their skin more frequently. Our findings confirm that golf course workers and, in particular, golfers are an important target for skin cancer prevention campaigns. This is the first intervention to specifically target golf courses, and it proved to be both feasible and useful. Its success appears to be attributable to numerous factors: it was conducted at golf courses, had multiple components, and was preceded by a motivational campaign. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  4. Preventing land loss in coastal Louisiana: estimates of WTP and WTA.

    PubMed

    Petrolia, Daniel R; Kim, Tae-Goun

    2011-03-01

    A dichotomous-choice contingent-valuation survey was conducted in the State of Louisiana (USA) to estimate compensating surplus (CS) and equivalent surplus (ES) welfare measures for the prevention of future coastal wetland losses in Louisiana. Valuations were elicited using both willingness to pay (WTP) and willingness to accept compensation (WTA) payment vehicles. Mean CS (WTP) estimates based on a probit model using a Box-Cox specification on income was $825 per household annually, and mean ES (WTA) was estimated at $4444 per household annually. Regression results indicate that the major factors influencing support for land-loss prevention were income (positive, WTP model only), perceived hurricane protection benefits (positive), environmental and recreation protection (positive), distrust of government (negative), age (positive, WTA model only), and race (positive for whites). Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. [Serial clinical examinations as the main approach to dental caries prevention in children].

    PubMed

    Skripkina, G I; Garifullina, A Zh

    2015-01-01

    Leading scientific and organizational prerequisites for the feasibility of clinical examination of the entire child population of the Russian Federation to the dentist is, above all, the high prevalence and intensity of dental diseases in children of all ages. As a result of many years of research and follow-up of children of preschool and school age we have proved the need to distinguish a group of children with zero activity of dental caries. The referring criteria are determined according to the results of comprehensive clinical and laboratory examination in order to determine the degree of risk of dental caries and individual caries resistance. The age-specific risk group is settled by "Stop caries" software. In order to optimize the preventive activities children are divided in 5 groups for routine preventive dental care. Unfortunately the efforts of modern dental services aimed at eliminating the consequences of caries process by filling cavities. Individualized preventive approach will increase the effectiveness of preventive measures and save public funds allocated in the amount of compulsory health insurance for pediatric dentistry.

  6. Gordon Wilson Lecture: Infectious Disease Causes of Cancer: Opportunities for Prevention and Treatment.

    PubMed

    Howley, Peter M

    2015-01-01

    The role of infectious agents in cancer is generally underappreciated. However, approximately 20% of human cancers are caused by infectious agents and as such they rank second only to tobacco as a potentially preventable cause in humans. Specific viruses, parasites, and bacteria have been linked to specific human cancers. The infectious etiology for these specific cancers provides opportunities for prevention and treatment.

  7. Early interventions for youths at high risk for bipolar disorder: a developmental approach.

    PubMed

    Benarous, Xavier; Consoli, Angèle; Milhiet, Vanessa; Cohen, David

    2016-03-01

    In recent decades, ongoing research programmes on primary prevention and early identification of bipolar disorder (BD) have been developed. The aim of this article is to review the principal forms of evidence that support preventive interventions for BD in children and adolescents and the main challenges associated with these programmes. We performed a literature review of the main computerised databases (MEDLINE, PUBMED) and a manual search of the literature relevant to prospective and retrospective studies of prodromal symptoms, premorbid stages, risk factors, and early intervention programmes for BD. Genetic and environmental risk factors of BD were identified. Most of the algorithms used to measure the risk of developing BD and the early interventions programmes focused on the familial risk. The prodromal signs varied greatly and were age dependent. During adolescence, depressive episodes associated with genetic or environmental risk factors predicted the onset of hypomanic/manic episodes over subsequent years. In prepubertal children, the lack of specificity of clinical markers and difficulties in mood assessment were seen as impeding preventive interventions at these ages. Despite encouraging results, biomarkers have not thus far been sufficiently validated in youth samples to serve as screening tools for prevention. Additional longitudinal studies in youths at high risk of developing BD should include repeated measures of putative biomarkers. Staging models have been developed as an integrative approach to specify the individual level of risk based on clinical (e.g. prodromal symptoms and familial history of BD) and non-clinical (e.g. biomarkers and neuroimaging) data. However, there is still a lack of empirically validated studies that measure the benefits of using these models to design preventive intervention programmes.

  8. Exploring geological and socio-demographic factors associated with under-five mortality in the Wenchuan earthquake using neural network model.

    PubMed

    Hu, Yi; Wang, Jinfeng; Li, Xiaohong; Ren, Dan; Driskell, Luke; Zhu, Jun

    2012-01-01

    On 12 May 2008, a devastating earthquake occurred in Sichuan Province, China, taking tens of thousands of lives and destroying the homes of millions of people. Among the large number of dead or missing were children, particularly children aged less than five years old, a fact which drew significant media attention. To obtain relevant information specifically to aid further studies and future preventative measures, a neural network model was proposed to explore some geological and socio-demographic factors associated with earthquake-related child mortality. Sensitivity analysis showed that topographic slope (mean 35.76%), geomorphology (mean 24.18%), earthquake intensity (mean 13.68%), and average income (mean 11%) had great contributions to child mortality. These findings could provide some clues to researchers for further studies and to policy makers in deciding how and where preventive measures and corresponding policies should be implemented in the reconstruction of communities.

  9. Measuring higher order ambiguity preferences.

    PubMed

    Baillon, Aurélien; Schlesinger, Harris; van de Kuilen, Gijs

    2018-01-01

    We report the results from an experiment designed to measure attitudes towards ambiguity beyond ambiguity aversion. In particular, we implement recently-proposed model-free preference conditions of ambiguity prudence and ambiguity temperance. Ambiguity prudence has been shown to play an important role in precautionary behavior and the mere presence of ambiguity averse agents in markets. We observe that the majority of individuals' decisions are consistent with ambiguity aversion, ambiguity prudence and ambiguity temperance. This finding confirms the prediction of many popular (specifications of) ambiguity models and has important implications for models of prevention behavior.

  10. Barriers to the effective treatment and prevention of malaria in Africa: A systematic review of qualitative studies

    PubMed Central

    2009-01-01

    Background In Africa, an estimated 300-500 million cases of malaria occur each year resulting in approximately 1 million deaths. More than 90% of these are in children under 5 years of age. To identify commonly held beliefs about malaria that might present barriers to its successful treatment and prevention, we conducted a systematic review of qualitative studies examining beliefs and practices concerning malaria in sub-Saharan African countries. Methods We searched Medline and Scopus (1966-2009) and identified 39 studies that employed qualitative methods (focus groups and interviews) to examine the knowledge, attitudes, and practices of people living in African countries where malaria is endemic. Data were extracted relating to study characteristics, and themes pertaining to barriers to malaria treatment and prevention. Results The majority of studies were conducted in rural areas, and focused mostly or entirely on children. Major barriers to prevention reported included a lack of understanding of the cause and transmission of malaria (29/39), the belief that malaria cannot be prevented (7/39), and the use of ineffective prevention measures (12/39). Thirty-seven of 39 articles identified barriers to malaria treatment, including concerns about the safety and efficacy of conventional medicines (15/39), logistical obstacles, and reliance on traditional remedies. Specific barriers to the treatment of childhood malaria identified included the belief that a child with convulsions could die if given an injection or taken to hospital (10/39). Conclusion These findings suggest that large-scale malaria prevention and treatment programs must account for the social and cultural contexts in which they are deployed. Further quantitative research should be undertaken to more precisely measure the impact of the themes uncovered by this exploratory analysis. PMID:19852857

  11. Hardware Trojans - Prevention, Detection, Countermeasures (A Literature Review)

    DTIC Science & Technology

    2011-07-01

    Phase and Location . . . . . . . . . . . . . . . . . . . . . . . . . 4 2.2 Hardware Trojan Actions...12 3.4 Trigger Design Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 4 Prevention 14 4.1 Prevention...The specification is then realised into specific tar- 4 UNCLASSIFIED UNCLASSIFIED DSTO–TN–1012 get technologies with consideration of functional and

  12. Changing attitudes and beliefs towards a woman's right to protect against HIV risk in Malawi.

    PubMed

    Fedor, Theresa M; Kohler, Hans-Peter; McMahon, James M

    2016-01-01

    Female empowerment and positive attitudes towards women's rights in sexual relationships have been found to be key elements of successful behaviour-based HIV prevention programmes. However, HIV prevention programmes that do not specifically engage with gender issues may also affect attitudes and beliefs towards women's rights within sexual relationships. Using data from the Malawi Longitudinal Study of Families and Health we compare measures of female empowerment and changing gender norms between intervention participants and non-participants. Results suggest that female intervention participants were more likely than non-participants to believe that: (1) women have more rights within sexual relationships in general and (2) women have the right to protect themselves against HIV risk (indicating possible increases in female self-efficacy in making HIV prevention decisions). Male intervention participants showed no substantial positive change in attitudes towards women's rights. These results highlight an important positive effect of HIV prevention programmes on women's attitudes towards their own rights.

  13. Changing attitudes and beliefs towards a woman’s right to protect against HIV risk in Malawi

    PubMed Central

    Fedor, Theresa Marie; Kohler, Hans-Peter; McMahon, James M.

    2016-01-01

    Female empowerment and positive attitudes towards women’s rights in sexual relationships have been found to be key elements of successful behaviour-based HIV prevention programmes. However, HIV prevention programmes that do not specifically engage with gender issues may also affect attitudes and beliefs towards women’s rights within sexual relationships. Using data from the Malawi Longitudinal Study of Families and Health (MLSFH) we compare measures of female empowerment and changing gender norms between intervention participants and non-participants. Results suggest that female intervention participants were more likely than non-participants to believe that (1) women have more rights within sexual relationships in general, and (2) women have the right to protect themselves against HIV risk (indicating possible increases in female self-efficacy in making HIV prevention decisions). Male intervention participants showed no substantial positive change in attitudes towards women’s rights. These results highlight an important positive effect of HIV prevention programmes on women’s attitudes towards their own rights. PMID:26503918

  14. Will Culling White-Tailed Deer Prevent Lyme Disease?

    PubMed

    Kugeler, K J; Jordan, R A; Schulze, T L; Griffith, K S; Mead, P S

    2016-08-01

    White-tailed deer play an important role in the ecology of Lyme disease. In the United States, where the incidence and geographic range of Lyme disease continue to increase, reduction of white-tailed deer populations has been proposed as a means of preventing human illness. The effectiveness of this politically sensitive prevention method is poorly understood. We summarize and evaluate available evidence regarding the effect of deer reduction on vector tick abundance and human disease incidence. Elimination of deer from islands and other isolated settings can have a substantial impact on the reproduction of blacklegged ticks, while reduction short of complete elimination has yielded mixed results. To date, most studies have been conducted in ecologic situations that are not representative to the vast majority of areas with high human Lyme disease risk. Robust evidence linking deer control to reduced human Lyme disease risk is lacking. Currently, there is insufficient evidence to recommend deer population reduction as a Lyme disease prevention measure, except in specific ecologic circumstances. © 2015 Blackwell Verlag GmbH.

  15. Technical Packages in Injury and Violence Prevention to Move Evidence into Practice: Systematic Reviews and Beyond

    PubMed Central

    Haegerich, Tamara M.; David-Ferdon, Corinne; Noonan, Rita K.; Manns, Brian J.; Billie, Holly C.

    2016-01-01

    Injury and violence prevention strategies have greater potential for impact when they are based on scientific evidence. Systematic reviews of the scientific evidence can contribute key information about which policies and programs might have the greatest impact when implemented. However, systematic reviews have limitations, such as lack of implementation guidance and contextual information, that can limit the application of knowledge. “Technical packages,” developed by knowledge brokers such as the federal government, nonprofit agencies, and academic institutions, have the potential to be an efficient mechanism for making information from systematic reviews actionable. Technical packages provide information about specific evidence-based prevention strategies, along with the estimated costs and impacts, and include accompanying implementation and evaluation guidance to facilitate adoption, implementation, and performance measurement. We describe how systematic reviews can inform the development of technical packages for practitioners, provide examples of technical packages in injury and violence prevention, and explain how enhancing review methods and reporting could facilitate the use and applicability of scientific evidence. PMID:27604301

  16. Will Culling White-Tailed Deer Prevent Lyme Disease?

    PubMed Central

    Kugeler, K. J.; Jordan, R. A.; Schulze, T. L.; Griffith, K. S.; Mead, P. S.

    2015-01-01

    Summary White-tailed deer play an important role in the ecology of Lyme disease. In the United States, where the incidence and geographic range of Lyme disease continue to increase, reduction of white-tailed deer populations has been proposed as a means of preventing human illness. The effectiveness of this politically sensitive prevention method is poorly understood. We summarize and evaluate available evidence regarding the effect of deer reduction on vector tick abundance and human disease incidence. Elimination of deer from islands and other isolated settings can have a substantial impact on the reproduction of blacklegged ticks, while reduction short of complete elimination has yielded mixed results. To date, most studies have been conducted in ecologic situations that are not representative to the vast majority of areas with high human Lyme disease risk. Robust evidence linking deer control to reduced human Lyme disease risk is lacking. Currently, there is insufficient evidence to recommend deer population reduction as a Lyme disease prevention measure, except in specific ecologic circumstances. PMID:26684932

  17. [Frequency and prevention of childhood domestic injury according to age].

    PubMed

    Kanaizumi, Shiomi; Shibata, Mariko; Miyazaki, Yukiko; Nakashita, Tomiko; Sakou, Keiko; Hoshino, Yasue; Ichinohe, Shinko; Ohno, Ayako; Manabe, Shigeo

    2009-04-01

    This study aimed to: 1) obtain data about occurrence of childhood domestic injuries in Gunma prefecture according to children's age; 2) ascertain parental awareness of injury prevention; and 3) develop ideas for creating concrete strategies of childhood injury prevention. The participants were 551 parents of children living in 14 cities/towns in Gunma prefecture that showed interest in cooperating with this survey. A self-reported questionnaire was handed to parents when they took their children to health check-ups provided by the cities/towns either during the child's first year, at 18 months, or at 3 years. Parents completed the questionnaire asking whether their child had been injured at home during the past year, and if so, they were asked about the type of injury, the cause of injury, and what action they took. We also asked whether the parents took specific injury prevention measures at home. Data were analyzed statistically. The injury experienced most frequently during the first year of life was "fall" (30.8%), followed by "ingestion of a foreign body" (22.7%), and then "choking" (11.5%). For children around the age of 18 months, the most frequently experienced injury was "fall" (41.0%), followed by "burn" (20.3%), and "ingestion of a foreign body" (19.3%). At 3 years, "burn" was reported most frequently (32.3%), followed by "fall" (31.0%), and "choking" (14.5%). Chi2-test revealed significant correlations among the three age groups concerning the rate of burn injury, foreign body ingestion, and drowning. The rate of burn injury was higher at 3 years than at 18 months, and also higher at 18 months as compared to under the age of one. In contrast, the rate of foreign body ingestion was higher under the age of one than at 18 months, and also higher at 18 months as compared to the age of 3 years. Drowning was more common at 18 months and 3 years than under the age of one. As for prevention of domestic injury, investigation of preventive means taken according to type of injury revealed that parents taking any of the measures to prevent an injury were significantly more likely to also take other means to prevent that injury. Characteristics of injury differed according to children's age. Furthermore, it was clarified that parents' performance of injury prevention depends on their awareness of preventive measures.

  18. [Clinical effectiveness and economical evaluation of preventive vaccination].

    PubMed

    Vaz Carneiro, António; Belo, Ana Isabel; Gouveia, Miguel; Costa, João; Borges, Margarida

    2011-01-01

    The value of mass vaccination as a preventive measure for infectious diseases is one of the most important advances of modern Medicine. The impact on incidence of several infectious diseases, until recently responsible for significant morbidity and mortality at world level, is well proved in a series of high quality epidemiological studies. In this scientific review we aimed firstly to briefly resume the history of mass vaccination and its scientists, responsible for synthesis and marketing of these drugs. In second place we present a group of a few disease preventable by vaccines as well as the Portuguese National Vaccination Plan and its benefits. In third place we identified groups of subjects in which a well structured vaccination plan is particularly important, as well as the correspondent diseases to be covered by vaccination. Fourthly, we discussed the ethical considerations of vaccination, and its tensions between subject autonomy and society advantages in com pulsive programs. Fifthly, we analyzed clinical effectiveness of vaccines through the concept of herd immunity, clinical evaluation of immune response to vaccines and some examples of systematic reviews on three relevant diseases (influenza, meningococcal and pneumococcal infections). In sixth place we discussed vaccine safety presenting monitoring methods of vaccination risks, as well as discussing the public myths concerning vaccines. Finally we present a economic analysis of preventive vaccination with a review of some published literature on specific diseases. We conclude that mass vaccination is a efficacious preventive measure, as well as a economic rational choice, and that this public health intervention should be a pillar of a modern preventive system.

  19. OARSI Clinical Trials Recommendations: Design and conduct of clinical trials for primary prevention of osteoarthritis by joint injury prevention in sport and recreation.

    PubMed

    Emery, C A; Roos, E M; Verhagen, E; Finch, C F; Bennell, K L; Story, B; Spindler, K; Kemp, J; Lohmander, L S

    2015-05-01

    The risk of post-traumatic osteoarthritis (PTOA) substantially increases following joint injury. Research efforts should focus on investigating the efficacy of preventative strategies in high quality randomized controlled trials (RCT). The objective of these OARSI RCT recommendations is to inform the design, conduct and analytical approaches to RCTs evaluating the preventative effect of joint injury prevention strategies. Recommendations regarding the design, conduct, and reporting of RCTs evaluating injury prevention interventions were established based on the consensus of nine researchers internationally with expertise in epidemiology, injury prevention and/or osteoarthritis (OA). Input and resultant consensus was established through teleconference, face to face and email correspondence over a 1 year period. Recommendations for injury prevention RCTs include context specific considerations regarding the research question, research design, study participants, randomization, baseline characteristics, intervention, outcome measurement, analysis, implementation, cost evaluation, reporting and future considerations including the impact on development of PTOA. Methodological recommendations for injury prevention RCTs are critical to informing evidence-based practice and policy decisions in health care, public health and the community. Recommendations regarding the interpretation and conduct of injury prevention RCTs will inform the highest level of evidence in the field. These recommendations will facilitate between study comparisons to inform best practice in injury prevention that will have the greatest public health impact. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  20. Improving the Sensitivity of Needs Assessment for Substance Abuse Prevention Planning: The Measurement of Differential Severity of Consequences for Individual Substance Types

    ERIC Educational Resources Information Center

    Shamblen, Stephen R.; Springer, J. Fred

    2007-01-01

    There is an absence of systematic, comparative research examining the negative consequences that are experienced as a result of using specific substances. Further, techniques typically used for needs assessment (i.e., prevalence proportions) do not take into account the probability of experiencing a negative consequence as a result of using…

  1. Measuring quality of dental care: Caries prevention services for children.

    PubMed

    Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J

    2015-08-01

    The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries: sealants for 6- to 9-year-olds, sealants for 10- to 14-year-olds, and topical fluoride. Using evidence-based guidelines, the Dental Quality Alliance developed measures for implementation with administrative data at the plan and program levels. To validate the measures, the authors used data from the Florida and Texas Medicaid programs and Children's Health Insurance Programs and from national commercial dental benefit plans. Data were extracted from 414 randomly selected dental office records to validate the use of administrative data to accurately calculate the measures. The authors also assessed statistically significant variations in overall measure performance. Agreement between administrative data and dental records was 95% for sealants (κ = 0.82) and 90% for topical fluoride (κ = 0.78). Sensitivity and specificity were 90.7% and 88.5% for topical fluoride and 77.8% and 98.8% for sealants, respectively. Variation in overall measure performance was greatest for topical fluoride (χ(2) = 5,887.1; P < .01); 18% to 37% of children with an elevated risk of experiencing caries received at least 2 topical fluoride applications during the reporting year. Although there was greater variation in performance for sealants for 6- to 9-year-olds (range, 21.0-31.3%; χ(2) = 548.6; P < .01) compared with sealants for 10- to 14-year-olds (range, 8.4-11.1%; χ(2) = 22.7; P < .01), overall sealant placement rates were lower for 10- to 14-year-olds. These evidence-based, caries prevention process-of-care quality measures can be implemented feasibly and validly using administrative claims data. The measures can be used to assess, monitor, and improve the proportion of children with an elevated risk of experiencing dental caries who receive evidence-based caries prevention services. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  2. [Strategic framework for cholera prevention and control in Chengdu: construction and effectiveness evaluation].

    PubMed

    Liang, Xian; Du, Chang-hui; Yang, Lan; Ma, Lin; Huang, Zhong-hang; Tuo, Xiao-Li; Yin, Zhong-liang

    2011-02-01

    To construct an operable strategic framework for cholera prevention and control which mobilized the advantages of local resources and adapted to social developments in Chengdu, and to evaluate its application effects. (1) After analyzing the local epidemic data of cholera in Chengdu from 1994 to 2004, we determined the main problems of cholera prevention and control works as well as the efficiency and deficiency of employed measures, and then formed a basic strategic framework. (2) After 55 invited experts preliminarily scored the strategic framework, we selected 72 specific measures to establish a measure entry database, and then the importance and operability of each measure were scored by 17 core experts. (3) Finally, the effectiveness of this strategic framework was evaluated according to the analyzing results of infection control, health education and etiological monitoring. (1) The framework took government leadership as main scenario and the informatization as subordination scenario. Meanwhile, it focused on three points: the improvement of social environment, the completion of system and mechanisms for monitoring and early warning, and the enhancement of CDC response to public health emergencies. Total importance score and operability score of 35 specific measures included in this framework was 4.20 ± 0.86 and 4.09 ± 0.87, respectively. (2) Chengdu had maintained zero cholera incidence for five consecutive years from 2005 to 2009 since it gradually began to implement the strategic framework in 2002. There were 19 positive cholera cases detected by etiological monitoring and all of them were seafood or fishery products including soft-shelled turtles, silver carps and bullfrogs. The coverage rate and qualification rate of the training for grassroots cadres, grassroots medical workers, mobile cooks and their assistants was 98.14% (198 452/202 220) and 98.17% (194 820/198 452) in average, respectively. The qualification rate of the training for employees in food industry was over 96.00% (912 470/950 489). The average awareness rate of cholera prevention and cure knowledge in rural residents, grassroots cadres, grassroots medical workers, mobile cooks and their assistants was 93.87% (1653/1761) and the average formation rate of good hygiene habits was 70.58% (1243/1761). A strategic framework suitable for cholera prevention and control in Chengdu has been successfully established in this study. The incidence rate of cholera has maintained zero in Chengdu for five consecutive years under incessant threatening conditions such as the occurrence of cholera cases from time to time in its surrounding areas and the continuous existence of Bacillus comma in seafood or fishery products that entered local markets. Therefore, it demonstrated a good application effects.

  3. Assessment of a training programme for the prevention of ventilator-associated pneumonia.

    PubMed

    Jam Gatell, M Rosa; Santé Roig, Montserrat; Hernández Vian, Óscar; Carrillo Santín, Esther; Turégano Duaso, Concepción; Fernández Moreno, Inmaculada; Vallés Daunis, Jordi

    2012-01-01

    Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units (ICUs). Most published studies have analysed nurses' theoretical knowledge about a specific procedure; however, the transfer of this knowledge to the practice has received little attention. To assess the impact of training session on nurses' knowledge regarding VAP, compliance with VAP preventive measures, VAP incidence and determining whether nursing workload affects compliance. A prospective, quasiexperimental, pre- and post-study of the nursing team in a 16-bed medical/surgical ICU. Pre-intervention phase: a questionnaire to assess nurses' knowledge of VAP prevention measures, direct observation and review of clinical records to assess compliance. Intervention phase: eight training sessions for nurses. The post-intervention phase mirrored the pre-intervention phase. Nurses answered more questions correctly on the post-intervention questionnaire than on the pre-intervention (17·87 ± 2·69 versus 15·91 ± 2·68, p = 0·002). Compliance with the following measures was better during the post-intervention period (p = 0·001): use of the smallest possible nasogastric tube, controlled aspiration of subglottic secretions and endotracheal tube cuff pressure, use of oral chlorhexidine and recording the endotracheal tube fixation number. VAP incidence remained unchanged throughout the study. However, a trend towards lower incidence of late (>4 days after intubation) VAP was observed (4·6 versus 3·1 episodes/1000 ventilation days, p = 0·37). The programme improved both knowledge of and compliance with VAP preventive measures, although improved knowledge did not always result in improved compliance. © 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.

  4. [Primary Prevention And Health Promotion in Bavaria: Taking Stock].

    PubMed

    Reisig, V; Kuhn, J; Loos, S; Nennstiel-Ratzel, U; Wildner, M; Caselmann, W H

    2017-04-01

    Background: Health promotion and prevention are key elements of Bavarian health policy and are currently being re-oriented along the framework of the "Bavarian Prevention Plan". In this context, a stock taking of prevention and health promotion in Bavaria was conducted with the aim to contribute to the continued strategic and quality-orientated development of this field. Methods: The investigation was restricted to activities of primary prevention and health promotion with a focus on the action areas of the Bavarian Prevention Plan. The prevention actors, not projects, were the smallest units that were surveyed. During the 3-month field phase in 2014/2015, 595 prevention players were contacted and asked to complete an online questionnaire on their activities and target groups as well as quality and structural aspects. In addition, 9 expert interviews were conducted in an urban and a rural area in order to explore the field of small commercial and civic prevention actors. Results: 135 prevention players took part in the survey (return rate 23%). The most commonly cited themes of activities are health literacy (62% of players) and mental health (58%). The target groups are often broadly defined, gender specific measures and those for socially disadvantaged groups are comparatively rare. Provision of health-related information is the most commonly used approach (58-69% of players depending on the action area), least used are community work approaches (9-12%). 77% of the respondents state to use models of best practice and 55% scientific results in the development of measures; 43% conduct outcome evaluations and 80% take part in committee work and networks. The latter are mainly used to exchange information (90% of actors), 55 and 54% state to use them for joint planning and delivery of interventions, respectively. Conclusions: The most important prevention players took part in the survey. Methodologically it proved difficult to achieve a meaningful depiction of central aspects of the prevention scene via a quantitative survey approach. There is a lack of well-tried instruments and approaches for such cross-agency surveys. Nevertheless, the study allows trend statements on the spectrum, structure and quality of prevention in Bavaria. Thus, a starting line for the implementation of the Bavarian Prevention Plan as well as the basis of prevention reporting as intended by the new national prevention law could be established. © Georg Thieme Verlag KG Stuttgart · New York.

  5. A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand

    PubMed Central

    2013-01-01

    Background Indigenous peoples of Australia, Canada, United States and New Zealand experience disproportionately high rates of suicide. As such, the methodological quality of evaluations of suicide prevention interventions targeting these Indigenous populations should be rigorously examined, in order to determine the extent to which they are effective for reducing rates of Indigenous suicide and suicidal behaviours. This systematic review aims to: 1) identify published evaluations of suicide prevention interventions targeting Indigenous peoples in Australia, Canada, United States and New Zealand; 2) critique their methodological quality; and 3) describe their main characteristics. Methods A systematic search of 17 electronic databases and 13 websites for the period 1981–2012 (inclusive) was undertaken. The reference lists of reviews of suicide prevention interventions were hand-searched for additional relevant studies not identified by the electronic and web search. The methodological quality of evaluations of suicide prevention interventions was assessed using a standardised assessment tool. Results Nine evaluations of suicide prevention interventions were identified: five targeting Native Americans; three targeting Aboriginal Australians; and one First Nation Canadians. The main intervention strategies employed included: Community Prevention, Gatekeeper Training, and Education. Only three of the nine evaluations measured changes in rates of suicide or suicidal behaviour, all of which reported significant improvements. The methodological quality of evaluations was variable. Particular problems included weak study designs, reliance on self-report measures, highly variable consent and follow-up rates, and the absence of economic or cost analyses. Conclusions There is an urgent need for an increase in the number of evaluations of preventive interventions targeting reductions in Indigenous suicide using methodologically rigorous study designs across geographically and culturally diverse Indigenous populations. Combining and tailoring best evidence and culturally-specific individual strategies into one coherent suicide prevention program for delivery to whole Indigenous communities and/or population groups at high risk of suicide offers considerable promise. PMID:23663493

  6. A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand.

    PubMed

    Clifford, Anton C; Doran, Christopher M; Tsey, Komla

    2013-05-13

    Indigenous peoples of Australia, Canada, United States and New Zealand experience disproportionately high rates of suicide. As such, the methodological quality of evaluations of suicide prevention interventions targeting these Indigenous populations should be rigorously examined, in order to determine the extent to which they are effective for reducing rates of Indigenous suicide and suicidal behaviours. This systematic review aims to: 1) identify published evaluations of suicide prevention interventions targeting Indigenous peoples in Australia, Canada, United States and New Zealand; 2) critique their methodological quality; and 3) describe their main characteristics. A systematic search of 17 electronic databases and 13 websites for the period 1981-2012 (inclusive) was undertaken. The reference lists of reviews of suicide prevention interventions were hand-searched for additional relevant studies not identified by the electronic and web search. The methodological quality of evaluations of suicide prevention interventions was assessed using a standardised assessment tool. Nine evaluations of suicide prevention interventions were identified: five targeting Native Americans; three targeting Aboriginal Australians; and one First Nation Canadians. The main intervention strategies employed included: Community Prevention, Gatekeeper Training, and Education. Only three of the nine evaluations measured changes in rates of suicide or suicidal behaviour, all of which reported significant improvements. The methodological quality of evaluations was variable. Particular problems included weak study designs, reliance on self-report measures, highly variable consent and follow-up rates, and the absence of economic or cost analyses. There is an urgent need for an increase in the number of evaluations of preventive interventions targeting reductions in Indigenous suicide using methodologically rigorous study designs across geographically and culturally diverse Indigenous populations. Combining and tailoring best evidence and culturally-specific individual strategies into one coherent suicide prevention program for delivery to whole Indigenous communities and/or population groups at high risk of suicide offers considerable promise.

  7. Use of Candida-specific chicken egg yolk antibodies to inhibit the adhering of Candida to denture base materials: prevention of denture stomatitis.

    PubMed

    Kamikawa, Yoshiaki; Fujisaki, Junichi; Nagayama, Tomohiro; Kawasaki, Kiyotsugu; Hirabayashi, Daisuke; Hamada, Tomofumi; Sakamoto, Ryoich; Mukai, Hiroshi; Sugihara, Kazumasa

    2016-09-01

    Polyclonal anti-Candida chicken egg yolk antibodies (anti-IgY) were used to investigate the prevention of adherence of Candida species to denture base material in vitro. Candida is a potential virulence factor that can cause systemic infection and even death in immunocompromised individuals. Because long-term antifungal treatment may lead to the emergence of drug-resistant strains, it is necessary to develop novel preventive measures and treatments for candidiasis. Three types of chicken egg yolk antibodies were used in this study: non-specific antibody (control IgY), Candida albicans-specific antibody (anti-C.a.IgY) and Candida glabrata-specific antibody (anti-C.g.IgY). A mixture of different dilutions of each antibody with a suspension of Candida species and denture base material was incubated for 3 h, and then the colony-forming units of Candida on the denture base material were counted. Compared with control IgY, anti-C.a.IgY and anti-C.g.IgY significantly inhibited the adherence of C. albicans, but anti-C.a.IgY tended to be more potent than anti-C.g.IgY. The adherence of C. glabrata was also inhibited significantly by anti-C.a.IgY and anti-C.g.IgY with almost equivalent potency, indicating that their actions against C. glabrata were comparable. This study revealed the inhibitory effects of anti-C.a.IgY and anti-C.g.IgY against the adherence of C. albicans and C. glabrata to denture base material. This finding indicates the possibility of a beneficial effect of IgYs for the prevention of denture stomatitis and candidiasis in clinical settings. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

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

    PubMed

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

    2016-01-01

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

  9. Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians.

    PubMed

    Portincasa, Piero; Di Ciaula, Agostino; Grattagliano, Ignazio

    2016-07-01

    Gallstone formation is the result of a complex interaction between genetic and nongenetic factors. We searched and reviewed the available literature to define how the primary prevention of gallstones (cholesterol gallstones in particular) could be applied in general practice. Electronic bibliographical databases were searched. Prospective and retrospective cohort studies and case-controlled studies were analyzed and graded for evidence quality. The epidemiological data confirmed that genetic factors are estimated to account for only approximately 25% of the overall risk of gallstones, while metabolic/environmental factors are at least partially modifiable in stone-free risk groups, and are thus modifiable by primary prevention measures related to diet, lifestyle, and environmental factors (i.e., rapid weight loss, bariatric surgery, somatostatin or analogues therapy, transient gallbladder stasis, and hormone therapy). There is no specific recommendation for the secondary prevention of recurrent gallstones. Family physicians can contribute to preventing gallstones due to their capability to identify and effectively manage several risk factors discussed in this study. Although further studies are needed to better elucidate the involvement of epigenetic factors that may regulate the effect of environment and lifestyle on gene expression in the primary prevention of gallstone formation, preventive interventions are feasible and advisable in the general practice setting.

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

    PubMed

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

    2007-01-01

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

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

    PubMed

    Mikhail, Judy Nanette; Nemeth, Lynne Sheri

    2016-12-01

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

  12. ["Because we feel, we have to do something" - Barriers in the prevention of violence and key areas requiring action : A qualitative interview study with professional nurses and managers in the field of elderly care].

    PubMed

    Siegel, Melanie; Mazheika, Yuliya; Mennicken, Regina; Ritz-Timme, Stefanie; Graß, Hildegard; Gahr, Britta

    2018-04-01

    In recent years, politics and society have shown an increasing interest in the prevention of violence. Despite the scientific studies and prevention programs that have been conducted over the past few years, there is no indication that the prevalence of violence in elderly care is falling. A high number of unreported cases may still be assumed. The present study examined the barriers in transferring research knowledge into practice. Furthermore, it dealt with the requirements of an interventional approach which is practical and which effectively addresses the barriers. The data were collected in qualitative interviews (n = 20) and analyzed by using qualitative content analysis. The study revealed uncertainties in dealing with violence. The institutions lacked a clear definition of violence and the respondents did not have a clear concept of when and where violence starts. A high proportion of the respondents stated that violence occurred in various forms in daily nursing care but that there were no specific strategies for action. Only very few cases were documented at all. Moreover, a lack of practical further training was reported. The visibility of these barriers opens up new approaches to developing preventive measures which work in practice. A common definition of violence, clear and binding standards, regular training and education measures are central to the prevention of violence in care.

  13. Nutrition and Physical Activity Cancer Prevention Guidelines, Cancer Risk, and Mortality in the Women's Health Initiative

    PubMed Central

    Thomson, Cynthia A.; McCullough, Marjorie L.; Wertheim, Betsy C.; Chlebowski, Rowan T.; Martinez, Maria Elena; Stefanick, Marcia L.; Rohan, Thomas E.; Manson, JoAnn E.; Tindle, Hilary A.; Ockene, Judith; Vitolins, Mara Z.; Wactawski-Wende, Jean; Sarto, Gloria E.; Lane, Dorothy S.; Neuhouser, Marian L.

    2014-01-01

    Healthy lifestyle behaviors are recommended to reduce cancer risk and overall mortality. Adherence to cancer-preventive health behaviors and subsequent cancer risk has not been evaluated in a diverse sample of postmenopausal women. We examined the association between the American Cancer Society (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines score and risk of incident cancer, cancer-specific mortality, and all-cause mortality in 65,838 postmenopausal women enrolled in the Women’s Health Initiative Observational Study. ACS guidelines scores (0–8 points) were determined from a combined measure of diet, physical activity, body mass index (current and at age 18 years), and alcohol consumption. After a mean follow-up of 12.6 years, 8,632 incident cancers and 2,356 cancer deaths were identified. The highest ACS guidelines scores compared with the lowest were associated with a 17% lower risk of any cancer [HR, 0.83; 95% confidence interval (CI), 0.75–0.92], 22% lower risk of breast cancer (HR, 0.78; 95% CI, 0.67–0.92), 52% lower risk of colorectal cancer (HR, 0.48; 95% CI, 0.32–0.73), 27% lower risk of all-cause mortality, and 20% lower risk of cancer-specific mortality (HR, 0.80; 95% CI, 0.71–0.90). Associations with lower cancer incidence and mortality were generally strongest among Asian, black, and Hispanic women and weakest among non-Hispanic whites. Behaviors concordant with Nutrition and Physical Activity Cancer Prevention Guidelines were associated with lower risk of total, breast, and colorectal cancers and lower cancer-specific mortality in postmenopausal women. PMID:24403289

  14. Comparison of two cash transfer strategies to prevent catastrophic costs for poor tuberculosis-affected households in low- and middle-income countries: An economic modelling study

    PubMed Central

    Lönnroth, Knut; Boccia, Delia

    2017-01-01

    Background Illness-related costs for patients with tuberculosis (TB) ≥20% of pre-illness annual household income predict adverse treatment outcomes and have been termed “catastrophic.” Social protection initiatives, including cash transfers, are endorsed to help prevent catastrophic costs. With this aim, cash transfers may either be provided to defray TB-related costs of households with a confirmed TB diagnosis (termed a “TB-specific” approach); or to increase income of households with high TB risk to strengthen their economic resilience (termed a “TB-sensitive” approach). The impact of cash transfers provided with each of these approaches might vary. We undertook an economic modelling study from the patient perspective to compare the potential of these 2 cash transfer approaches to prevent catastrophic costs. Methods and findings Model inputs for 7 low- and middle-income countries (Brazil, Colombia, Ecuador, Ghana, Mexico, Tanzania, and Yemen) were retrieved by literature review and included countries' mean patient TB-related costs, mean household income, mean cash transfers, and estimated TB-specific and TB-sensitive target populations. Analyses were completed for drug-susceptible (DS) TB-related costs in all 7 out of 7 countries, and additionally for drug-resistant (DR) TB-related costs in 1 of the 7 countries with available data. All cost data were reported in 2013 international dollars ($). The target population for TB-specific cash transfers was poor households with a confirmed TB diagnosis, and for TB-sensitive cash transfers was poor households already targeted by countries’ established poverty-reduction cash transfer programme. Cash transfers offered in countries, unrelated to TB, ranged from $217 to $1,091/year/household. Before cash transfers, DS TB-related costs were catastrophic in 6 out of 7 countries. If cash transfers were provided with a TB-specific approach, alone they would be insufficient to prevent DS TB catastrophic costs in 4 out of 6 countries, and when increased enough to prevent DS TB catastrophic costs would require a budget between $3.8 million (95% CI: $3.8 million–$3.8 million) and $75 million (95% CI: $50 million–$100 million) per country. If instead cash transfers were provided with a TB-sensitive approach, alone they would be insufficient to prevent DS TB-related catastrophic costs in any of the 6 countries, and when increased enough to prevent DS TB catastrophic costs would require a budget between $298 million (95% CI: $219 million–$378 million) and $165,367 million (95% CI: $134,085 million–$196,425 million) per country. DR TB-related costs were catastrophic before and after TB-specific or TB-sensitive cash transfers in 1 out of 1 countries. Sensitivity analyses showed our findings to be robust to imputation of missing TB-related cost components, and use of 10% or 30% instead of 20% as the threshold for measuring catastrophic costs. Key limitations were using national average data and not considering other health and social benefits of cash transfers. Conclusions A TB-sensitive cash transfer approach to increase all poor households’ income may have broad benefits by reducing poverty, but is unlikely to be as effective or affordable for preventing TB catastrophic costs as a TB-specific cash transfer approach to defray TB-related costs only in poor households with a confirmed TB diagnosis. Preventing DR TB-related catastrophic costs will require considerable additional investment whether a TB-sensitive or a TB-specific cash transfer approach is used. PMID:29112693

  15. 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.

  16. Coronary heart disease in South Asian immigrants: synthesis of research and implications for health promotion and prevention in nursing practice.

    PubMed

    Mathews, Rahel; Zachariah, Rachel

    2008-07-01

    Although the literature reflects that Asian Indians in the United States and globally have the highest rates of morbidity and mortality because of coronary heart disease (CHD) and diabetes, few studies have described the clinical implications in the United States. Traditional risk factors dictate practice, yet these risk factors do not fully explain the rates. Central obesity, lipoprotein (a), and insulin resistance may have a strong role. The literature suggests that proactive nursing using culturally specific clinical measures are necessary to reduce risk factors for CHD and diabetes in South Asians. Additional research and prevention strategies focused on immigrant South Asians in the United States are recommended.

  17. Industrial pollution prevention programs in selected developing Asian countries

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

    Chiu, Shen-yann

    1995-12-31

    This paper presents the information on current activities to promote industrial pollution prevention (P2) in five selected Asian economies including Hong Kong, Republic of Korea, the Philippines, ROC in Taiwan, and Thailand. These activities, generally initiated in the last 5 years, are classified into 6 categories: awareness promotion, education and training, information transfer, technology development an demonstration, technical assistance, and financial incentives. Although participation is voluntary, these programs are all important at the early stages of P2 promotion and should be useful in informing industries of the benefit of P2 and helping them identify specific P2 measures as viable environmentalmore » management alternatives.« less

  18. Mindfulness-based treatment to prevent addictive behavior relapse: theoretical models and hypothesized mechanisms of change.

    PubMed

    Witkiewitz, Katie; Bowen, Sarah; Harrop, Erin N; Douglas, Haley; Enkema, Matthew; Sedgwick, Carly

    2014-04-01

    Mindfulness-based treatments are growing in popularity among addiction treatment providers, and several studies suggest the efficacy of incorporating mindfulness practices into the treatment of addiction, including the treatment of substance use disorders and behavioral addictions (i.e., gambling). The current paper provides a review of theoretical models of mindfulness in the treatment of addiction and several hypothesized mechanisms of change. We provide an overview of mindfulness-based relapse prevention (MBRP), including session content, treatment targets, and client feedback from participants who have received MBRP in the context of empirical studies. Future research directions regarding operationalization and measurement, identifying factors that moderate treatment effects, and protocol adaptations for specific populations are discussed.

  19. Research gaps in the care of women with female genital mutilation: an analysis.

    PubMed

    Abdulcadir, J; Rodriguez, M I; Say, L

    2015-02-01

    Female genital mutilation (FGM) includes procedures involving the partial or total removal of the external female genitals for non-therapeutic reasons. They can have negative psychosexual and health consequences that need specific care. In this paper, we review some key knowledge gaps in the clinical care of women with FGM, focusing on obstetric outcomes, surgical interventions (defibulation and clitoral reconstruction), and the skills and training of healthcare professionals involved in the prevention and management of FGM. We identify research priorities to improve the evidence necessary to establish guidelines for the best multidisciplinary care, communication, and prevention, and to improve health-promotion measures for women with FGM. © 2014 Royal College of Obstetricians and Gynaecologists.

  20. Rehabilitation in Guillian Barre syndrome.

    PubMed

    Khan, Fary

    2004-12-01

    Guillian Barre syndrome (GBS) is the most common form of neuromuscular paralysis. It mostly affects young people and can cause long-term residual disability. This article outlines the rehabilitation treatment for patients recovering from GBS. Recovery from GBS can be prolonged. Early rehabilitation intervention ensures medical stability, appropriate treatment and preventive measures to minimise long term complications. Specific problems include deep venous thrombosis prevention, complications of immobility, dysautonomia, de-afferent pain syndromes, muscle pain and fatigue. Longer-term issues include psychosocial adjustment, return to work and driving, and resumption of the role within the family and community. Effective communication between the GP and rehabilitation physicians is imperative for improved functional outcomes and successful social reintegration.

  1. The relationship between attitude, assertiveness and condom use.

    PubMed

    Treffke, H; Tiggemann, M; Ross, M W

    1992-01-01

    The Australian study investigated condom-specific assertiveness and condom use as a means of prevention infection from sexually transmitted diseases. 211 men participated including 83 homosexual men (aged 19-62 years) and 128 heterosexual men (aged 17-49) who completed a questionnaire that comprised demographic details such as age, monogamy, and sexual activity as well as attitudinal and assertiveness measures. General assertiveness was measured by the Rathus Assertiveness Schedule (RAS) which had been widely used across a wide range of social situations. Assertiveness relating specifically to situations involving condoms was measured by the Condom Assertiveness Scale (CAS). Intention to use condoms was positively related to favorable attitudes, which were related to condom-specific assertiveness for both groups. For the heterosexual men only, general social assertiveness was negatively related to attitudes toward condoms. For both groups, the condom-specific measure of assertiveness was positively correlated with attitudes toward condoms. Condom-specific assertiveness was positively related to general social assertiveness as measured by the Rathus Assertiveness Schedule for the homosexual, but not for the heterosexual men. The negative relationship between general assertiveness and attitude to condoms among the heterosexual men implies that the risk reducing behavior of condom use did not seem to accord with the perceptions of masculinity and social assertiveness among heterosexual men. Thus, female partners of such heterosexual men exhibiting negative attitudes toward condom use combined with assertiveness would have to overcome resistance to insist on the use of condoms. Recently some advertising campaigns have been directed at women. The promotion of condom use among heterosexual men has to deal with the perceptions of condom use as unmasculine behavior.

  2. Precautionary measures reduce risk of definite neuroleptic malignant syndrome in newly typical neuroleptic-treated schizophrenia inpatients.

    PubMed

    Shiloh, Roni; Valevski, Avi; Bodinger, Liron; Misgav, Sagit; Aizenberg, Dov; Dorfman-Etrog, Pnina; Weizman, Abraham; Munitz, Hanan

    2003-05-01

    Neuroleptic malignant syndrome (NMS) is a potentially lethal antipsychotic drug (APD)-induced thermoregulatory disturbance. We hypothesized that several precautionary measures taken after administeration of APDs might prevent progression to definite NMS. The study group included 657 consecutively admitted drug-free schizophrenia inpatients who received various typical APDs for 28 days. Specific predefined precautionary measures were employed for this group. The comparison group (n=192) consisted of typical APD-treated schizophrenia inpatients in whom such precautionary measures were not imposed. The study group exhibited a significantly lower incidence of definite NMS (1/657=0.2% versus 4/192=2.1%; P=0.01, odds ratio=13.96; 95% confidence interval 1.55-125.63). Antipsychotics were discontinued in 28 patients (28/657=4.3%) from the study group due to NMS (n=1) or early detection of potential NMS-related signs (probable abortive NMS) (n=27). Our findings suggest that specific precautionary measures can effectively reduce the incidence of definite NMS by approximately one order in newly medicated schizophrenia inpatients.

  3. Are habitual overgeneral recollection and prospection maladaptive?

    PubMed

    Robinaugh, Donald J; Lubin, Rebecca E; Babic, Luka; McNally, Richard J

    2013-06-01

    Individuals with depression exhibit difficulty retrieving specific memories and imagining specific future events when instructed to do so relative to non-clinical comparison groups. Instead of specific events, depressed individuals frequently retrieve or imagine "overgeneral" memories that span a long period of time or that denote a category of similar events. Recently, Raes, Hermans, Williams, and Eelen (2007) developed a sentence completion procedure (SCEPT) to assess the tendency to recall overgeneral autobiographical memories. They found that specificity on this measure was associated with depression and rumination. We aimed to replicate these findings and to examine the tendency to imagine overgeneral future events. We had 170 subjects complete past (SCEPT) and future-oriented (SCEFT) sentence completion tasks and measures of depression severity, PTSD severity, hopelessness, and repetitive negative thought. Although specificities of past and future events were correlated, neither SCEPT nor SCEFT specificity was negatively associated with depression severity, posttraumatic stress symptoms, repetitive negative thought (RNT), or hopelessness. Our data are cross-sectional, preventing any determination of causality and limiting our assessment of whether specificity is associated with psychological distress following a stressful life event. In addition, we observed poor internal consistency for both the SCEPT and SCEFT. These findings fail to support the hypothesis that overgeneral memory and prospection on these tasks are associated with psychological distress. Copyright © 2012. Published by Elsevier Ltd.

  4. [Skin care and prevention of bed sores in bedridden patients].

    PubMed

    Martínez Cuervo, Fernando; Soldevilla Agreda, J Javier; Verdú Soriano, José; Segovia Gómez, Teresa; García Fernández, Francisco Pedro; Pancorbo Hidalgo, Pedro Luís

    2007-12-01

    The aging process and environmental aggressions will leave their imprints on the state of a person's skin, possibly compromising some of its functions. Age is a risk factor for the development of bed sores, but not the only factor nor the most important one; therefore, we need to develop prevention programs directed to all patients who spend long periods of time sedentary or bedridden. Prevention programs for bed sores must be based on the best evidence available and include a risk evaluation on these factors: suffering a lesion due to pressure, specific skin treatment, incontinence control, excessive humidity posture changes and the use of special surfaces to manage pressure during an increase in mobility or activity by the patient, local pressure reducing devices as well as paying attention to special situations. All of these care measures have to be developed based on a continuity of treatment among the institutions and caretakers involved with treating each patient.

  5. Community-based pilot intervention to tackle childhood obesity: a whole-system approach.

    PubMed

    Vamos, E P; Lewis, E; Junghans, C; Hrobonova, E; Dunsford, E; Millett, C

    2016-11-01

    Go-Golborne is a pilot intervention to prevent childhood obesity in the Royal Borough of Kensington and Chelsea between 2014 and 2018. It is a multistrategy approach targeting children aged 0-16 years and their families in all settings where children live, learn and play. This paper describes the methodology and the practical steps in the development of Go-Golborne. The programme uses a quasi-experimental design for the evaluation of changes in weight status using data from the extended National Child Measurement Programme across local schools. For specific behavioural change objectives, baseline self-reported lifestyle measures will be compared against annual follow-up data over the 3-year study period. Qualitative methods will be used to explore the perceptions of stakeholders and participants and organizational change. Go-Golborne aims to mobilize everyone in the community who has a role or interest in shaping the local environment, norms and behaviours across a range of sectors. A community network of local organizations has been established to codesign all programme activities. The Steering Group of Council officers support programme implementation and environmental changes. The programme has identified six specific behaviour change objectives representing the key areas of need in Golborne and all activities in the council and the community target these objectives during specific programme phases. Key components include community capacity building, community-wide social marketing, environment and policy change and evaluation. The programme is currently at the beginning of its implementation phase with activities in the community and council targeting the first behaviour change objective. The pilot aims to test the effectiveness of this approach to support behaviour change and prevent unhealthy weight gain in children using multiple strategies. This programme will inform the development of an intervention model that defines essential programme components, accountability of partner organizations delivering obesity prevention programmes and the effective use of existing assets. Copyright © 2016 The Royal Society for Public Health. All rights reserved.

  6. Culturally Grounded Prevention for Minority Youth Populations: A Systematic Review of the Literature

    PubMed Central

    Lauricella, Michela; Valdez, Jessica K.; Okamoto, Scott K.; Helm, Susana; Zaremba, Colleen

    2016-01-01

    Contemporary prevention science has focused on the application of cultural adaptations of evidence-based prevention programs for minority youth populations. Far less is known about culturally grounded methods that are intended to organically develop prevention programs within specific populations and communities. This article systematically reviews recent literature on culturally grounded interventions used to prevent health disparities in ethnic minority youth populations. In this review, we assessed 31 peer-reviewed articles published in 2003 or later that fit inclusionary criteria pertaining to the development and evaluation of culturally grounded prevention programs. The evaluated studies indicated different approaches toward cultural grounding, as well as specific populations, geographic regions, and health issues that have been targeted. Specifically, the findings indicated that most of the studies focused on the development and evaluation of culturally grounded HIV/STI and substance abuse prevention programs for Mexican American, African American, and American Indian/Alaska Native youth residing in the South or Southwestern U.S. These studies largely relied on community-based participatory or qualitative research methods to develop programs from the “ground up.” This review has implications for the development of future culturally grounded and culturally adapted prevention programs targeting underserved minority youth populations and geographic regions. Specifically, it identifies populations and regions where culturally grounded prevention efforts are underdeveloped or non-existent, providing some scientific direction for the future development of these types of programs. PMID:26733384

  7. Culturally Grounded Prevention for Minority Youth Populations: A Systematic Review of the Literature.

    PubMed

    Lauricella, Michela; Valdez, Jessica K; Okamoto, Scott K; Helm, Susana; Zaremba, Colleen

    2016-02-01

    Contemporary prevention science has focused on the application of cultural adaptations of evidence-based prevention programs for minority youth populations. Far less is known about culturally grounded methods that are intended to organically develop prevention programs within specific populations and communities. This article systematically reviews recent literature on culturally grounded interventions used to prevent health disparities in ethnic minority youth populations. In this review, we assessed 31 peer-reviewed articles published in 2003 or later that fit inclusionary criteria pertaining to the development and evaluation of culturally grounded prevention programs. The evaluated studies indicated different approaches toward cultural grounding, as well as specific populations, geographic regions, and health issues that have been targeted. Specifically, the findings indicated that most of the studies focused on the development and evaluation of culturally grounded HIV/STI and substance abuse prevention programs for Mexican-American, African American, and American Indian/Alaska Native youth residing in the South or Southwestern US. These studies largely relied on community-based participatory or qualitative research methods to develop programs from the "ground up." This review has implications for the development of future culturally grounded and culturally adapted prevention programs targeting underserved minority youth populations and geographic regions. Specifically, it identifies populations and regions where culturally grounded prevention efforts are underdeveloped or non-existent, providing some scientific direction for the future development of these types of programs.

  8. The impact of experiential exercises on communication and relational skills in a suicide prevention gatekeeper-training program for college resident advisors.

    PubMed

    Pasco, Susan; Wallack, Cory; Sartin, Robert M; Dayton, Rebecca

    2012-01-01

    In an effort to identify students at risk for suicide, many colleges are implementing suicide prevention training for campus gatekeepers. This study evaluated the efficacy of a 3-hour, experiential-based gatekeeper training that included an emphasis on enhancing communication skills and relational connection in addition to the didactic foci of standard gatekeeper training. Sixty-five college student resident advisors (RAs) were trained with Campus Connect. The training was dismantled to examine the specific contribution of experiential exercises on training outcomes. Compared to didactic training alone, following participation in experiential exercises RAs' training outcome scores exhibited additional improvement on the Suicide Intervention Response Inventory-2 and a 14-item self-report measure of self-efficacy for specific suicide- and crisis-related knowledge and skills. In gatekeeper training, experiential exercises emphasizing awareness and empathic responding and practice of these skills contribute to an improvement in crisis response skills above and beyond that of didactic training alone.

  9. Homogenizing and diversifying effects of intensive agricultural land-use on plant species beta diversity in Central Europe - A call to adapt our conservation measures

    Treesearch

    Constanze Buhk; Martin Alt; Manuel J. Steinbauer; Carl Beierkuhnlein; Steve Warren; Anke Jentsch

    2017-01-01

    The prevention of biodiversity loss in agricultural landscapes to protect ecosystem stability and functions is of major importance to stabilize overall diversity. Intense agriculture leads to a loss in species richness and homogenization of species pools, but the processes behind are poorly understood due to a lack of systematic case studies: The specific...

  10. North Field 󈨛 Rapid Runway Repair Test Report. Volume 1.

    DTIC Science & Technology

    1988-11-01

    dynamic loads experienced by the mats during trafficking. 1 2. Upheaval Measurement Since 1985, AFESC has been investigating mehods of determining...method was faster and less labor-intensive. AFESC continued developing the polymer spall repair system; environmentally safe polymer resins manufactured...accordance with AFR 127-4, through AFESC/SEG and 437 MAW/SE. 267 SECTION IX RISKS Specific risks which may prevent the accomplishment of all or part of

  11. SNPs at IL-2 and IL-10 genes are associated with respiratory infection in the elderly and may modulate the effect of vitamin E on lower respiratory infections in elderly women

    USDA-ARS?s Scientific Manuscript database

    Vitamin E (E) supplementation has been suggested as a preventative measure against respiratory infections (RI) in the elderly. Previously, we showed that E reduced RI in some but not all nursing home residents. The efficacy of E supplementation may depend on individual factors, including specific si...

  12. The role of trust in residents’ fire wise actions

    Treesearch

    Jim Absher; Jerry J. Vaske

    2011-01-01

    Residents’ trust in the managing agency has been heralded as a necessary precursor to success in preventing wildland fire losses in the wildland–urban interface. Trust, however, is a complex concept. Homeowners’ specific fire wise actions may not be easily linked to general measures of trust. This article uses two distinct trust indices to predict residents’ intention...

  13. Cluster randomised control trial for cricket injury prevention programme (CIPP): a protocol paper.

    PubMed

    Soomro, Najeebullah; Chua, Nina; Freeston, Jonathan; Ferdinands, Rene E D; Sanders, Ross

    2017-09-28

    Injury prevention programmes (IPPs) are effective in reducing injuries among adolescent team sports. However, there is no validated cricket-specific IPP despite the high incidence of musculoskeletal injuries among amateur cricketers. To evaluate whether a cricket injury prevention programme (CIPP) as a pretraining warm-up or post-training cool-down can reduce injury rates in amateur cricket players. CIPP is a cluster randomised controlled trial which includes 36 male amateur club teams having cricket players aged 14-40 years to be randomly assigned to three study arms: warm-up, cool-down and control (n=12 teams, 136 players in each arm). The intervention groups will perform 15 min CIPP either as a pretraining warm-up or a post-training cool-down. The primary outcome measure will be injury incidence per 1000 player hours and the secondary outcome measures will be whether IPP as a warm-up is better than IPP as a cool-down, and the adherence to the intervention. ACTRN 1261700047039. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. A systematic review protocol investigating tests for physical or physiological qualities and game-specific skills commonly used in rugby and related sports and their psychometric properties.

    PubMed

    Chiwaridzo, Matthew; Ferguson, Gillian D; Smits-Engelsman, Bouwien C M

    2016-07-27

    Scientific focus on rugby has increased over the recent years, providing evidence of the physical or physiological characteristics and game-specific skills needed in the sport. Identification of tests commonly used to measure these characteristics is important for the development of test batteries, which in turn may be used for talent identification and injury prevention programmes. Although there are a number of tests available in the literature to measure physical or physiological variables and game-specific skills, there is limited information available on the psychometric properties of the tests. Therefore, the purpose of this study is to systematically review the literature for tests commonly used in rugby to measure physical or physiological characteristics and rugby-specific skills, documenting evidence of reliability and validity of the identified tests. A systematic review will be conducted. Electronic databases such as Scopus, MEDLINE via EBSCOhost and PubMed, Academic Search Premier, CINAHL and Africa-Wide Information via EBSCOhost will be searched for original research articles published in English from January 1, 1995, to December 31, 2015, using a pre-defined search strategy. The principal investigator will select potentially relevant articles from titles and abstracts. To minimise bias, full text of titles and abstracts deemed potentially relevant will be retrieved and reviewed by two independent reviewers based on the inclusion criteria. Data extraction will be conducted by the principal investigator and verified by two independent reviewers. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist will be used to assess the methodological quality of the selected studies. Choosing an appropriate test to be included in the screening test battery should be based on sound psychometric properties of the test available. This systematic review will provide an overview of the tests commonly used in rugby union and other related high intermittent team sports characterised by skill executions using the hands and legs such as Rugby League and Australian Rules Football. In addition, the review will highlight the psychometric properties of the identified tests. This information is crucial in developing a sport-specific test battery which can be used for talent identification, especially among young adolescent players, and injury prevention programmes. PROSPERO CRD42015029747.

  15. Systemic review of dry socket: aetiology, treatment, and prevention.

    PubMed

    Tarakji, Bassel; Saleh, Lubna Ahmed; Umair, Ayesha; Azzeghaiby, Saleh Nasser; Hanouneh, Salah

    2015-04-01

    Our systemic review is to make a comprehensive review about the aetiology, treatment and the prevention of dry socket, the inclusion criteria were all the studies that discuss the dry socket and its etiology, treatment and prevention and exclusion criteria were all the studies that discuss the other complications of tooth extraction, the materials and methods used for this systemic review was to search in the Pub Medline database between 2008 to 2013, using specific words "dry socket, aetiology, treatment and prevention" and published in the English language, the articles were screened by abstract for relevance to aetiology, treatment and prevention of dry socket, 82 papers were identified in pub med but a total of 36 out of Publications were included in the final systemic review according to the specific keywords and materials mentioned above. The occurrence of dry socket in an everyday oral surgery or dental practice is unavoidable. The risk factors are smoking, surgical trauma, single extractions, age, sex, medical history, systemic disorder, extraction site, amount of anaesthesia, operator experience, antibiotics use prior to surgery, difficulty of the surgery and the previous surgical site infection in addition to oral Contraceptives, menstrual cycle and immediate postextraction socket irrigation with normal saline. The traditional options of treatment are directed toward palliative care, such as the irrigation of the surgical site, avoiding curetting the extraction socket, Packing with a zinc oxide- eugenol paste on iodoform gauze can be considered to relieve acute pain episodes, there is also new agents in the market can accelerate the healing of the socket such as PRGF and GECB. The prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, the other preventive measures such as chlorhecidine rinse or gel can be effective in the reduction of dry socket incidence.

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

    PubMed Central

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

    2016-01-01

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

  17. A Comprehensive Analysis of Breast Cancer News Coverage in Leading Media Outlets Focusing on Environmental Risks and Prevention

    PubMed Central

    ATKIN, CHARLES K.; SMITH, SANDI W.; McFETERS, COURTNAY; FERGUSON, VANESSA

    2010-01-01

    Breast cancer has a high profile in the news media, which are a major source of information for cancer patients and the general public. To determine the nature of breast cancer news coverage available to audiences, particularly on the topics of environmental risks and prevention, this content analysis measured a broad array of dimensions in 231 stories appearing in nine leading newspapers, newsmagazines, and television networks in 2003 and 2004. One fourth of all stories reported on various risks such as hormone replacement therapy (HRT) use. Very few items specifically addressed risks related to controllable lifestyle practices such as prepubertal obesity or chemical contaminants in the environment. About one third of the stories included prevention content, primarily focusing narrowly on use of pharmaceutical products. Little information described risk reduction via other individual preventive behaviors (e.g., diet, exercise, and smoking), parental protective measures, or collective actions to combat contamination sites. The more traditional categories of prevalence, detection, and treatment were featured in one third, one quarter, and two fifths of the news items, respectively. There were twice as many stories featuring personal narratives as statistical figures, and two thirds of all the news items cited expert medical professionals, researchers, or organizations. Implications of these findings and directions for future research are addressed. PMID:18307133

  18. Guidelines for reporting methodological challenges and evaluating potential bias in dementia research.

    PubMed

    Weuve, Jennifer; Proust-Lima, Cécile; Power, Melinda C; Gross, Alden L; Hofer, Scott M; Thiébaut, Rodolphe; Chêne, Geneviève; Glymour, M Maria; Dufouil, Carole

    2015-09-01

    Clinical and population research on dementia and related neurologic conditions, including Alzheimer's disease, faces several unique methodological challenges. Progress to identify preventive and therapeutic strategies rests on valid and rigorous analytic approaches, but the research literature reflects little consensus on "best practices." We present findings from a large scientific working group on research methods for clinical and population studies of dementia, which identified five categories of methodological challenges as follows: (1) attrition/sample selection, including selective survival; (2) measurement, including uncertainty in diagnostic criteria, measurement error in neuropsychological assessments, and practice or retest effects; (3) specification of longitudinal models when participants are followed for months, years, or even decades; (4) time-varying measurements; and (5) high-dimensional data. We explain why each challenge is important in dementia research and how it could compromise the translation of research findings into effective prevention or care strategies. We advance a checklist of potential sources of bias that should be routinely addressed when reporting dementia research. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Immunization of Mice with Anthrax Protective Antigen Limits Cardiotoxicity but Not Hepatotoxicity Following Lethal Toxin Challenge.

    PubMed

    Devera, T Scott; Prusator, Dawn K; Joshi, Sunil K; Ballard, Jimmy D; Lang, Mark L

    2015-06-25

    Protective immunity against anthrax is inferred from measurement of vaccine antigen-specific neutralizing antibody titers in serum samples. In animal models, in vivo challenges with toxin and/or spores can also be performed. However, neither of these approaches considers toxin-induced damage to specific organ systems. It is therefore important to determine to what extent anthrax vaccines and existing or candidate adjuvants can provide organ-specific protection against intoxication. We therefore compared the ability of Alum, CpG DNA and the CD1d ligand α-galactosylceramide (αGC) to enhance protective antigen-specific antibody titers, to protect mice against challenge with lethal toxin, and to block cardiotoxicity and hepatotoxicity. By measurement of serum cardiac Troponin I (cTnI), and hepatic alanine aminotransferase (ALT), and aspartate aminotransferase (AST), it was apparent that neither vaccine modality prevented hepatic intoxication, despite high Ab titers and ultimate survival of the subject. In contrast, cardiotoxicity was greatly diminished by prior immunization. This shows that a vaccine that confers survival following toxin exposure may still have an associated morbidity. We propose that organ-specific intoxication should be monitored routinely during research into new vaccine modalities.

  20. Introduction and Rationale for Individualized Substance Abuse Prevention from an Ontogenetic Perspective

    PubMed Central

    Ridenour, Ty A.; Stormshak, Elizabeth A.

    2009-01-01

    Background Progress in substance abuse prevention science could be accelerated by more closely aligning studies, methodologies, and intervention program testing with the ontogenetic orientations of its underlying theories and etiology research. This article introduces the Ontogenetic Prevention approach, describes some aspects of what this orientation offers for substance abuse prevention, and provides an overview of this full special issue. Methods Review of the substance abuse prevention literature illustrates specific aspects of Ontogenetic Prevention. Conclusions The Ontogenetic Prevention perspective and each of the manuscripts in this special issue provide channels whereby substance abuse prevention can evolve from a science that relies largely on universal intervention to diversification for meeting the needs of individuals under specific developmental circumstances. PMID:20180671

  1. Barriers to physical activity among working mothers.

    PubMed

    Dombrowski, Jill J

    2011-04-01

    Working mothers experience several barriers to physical activity. If these barriers can be identified by occupational health nurses and they can partner with working mothers to reduce these perceived barriers, the health of these workers can be improved and chronic disease risk prevented. The purpose of this study was to measure the effect of self-regulatory efficacy on physical activity among working mothers and to describe specific barriers to physical activity. The Barriers Specific Self-Efficacy Scale (BARSE) and the Kaiser Physical Activity Survey (KPAS) were used to measure the variables. Self-regulatory efficacy was found to be a strong predictor of physical activity in a diverse sample of working mothers who did not meet current recommendations for physical activity. Occupational health nurses can use these findings to design programs for groups and for counseling individuals. Copyright 2011, SLACK Incorporated.

  2. Assessing local health department performance in diabetes prevention and control--North Carolina, 2005.

    PubMed

    Porterfield, Deborah S; Reaves, Janet; Konrad, Thomas R; Weiner, Bryan J; Garrett, Joanne M; Davis, Mary; Dickson, Curtis W; Plescia, Marcus; Alexander, Janet; Baker, Edward L

    2009-07-01

    To improve the public health system's ability to prevent and control chronic diseases, we must first understand current practice and develop appropriate strategies for measuring performance. The objectives of this study were to measure capacity and performance of local health departments in diabetes prevention and control and to investigate characteristics associated with performance. In 2005, we conducted a cross-sectional mailed survey of all 85 North Carolina local health departments to assess capacity and performance in diabetes prevention and control based on the 10 Essential Public Health Services and adapted from the Local Public Health System Performance Assessment Instrument. We linked survey responses to county-level data, including data from a national survey of local health departments. Local health departments reported a median of 0.05 full-time equivalent employees in diabetes prevention and 0.1 in control. Performance varied across the 10 Essential Services; activities most commonly reported included providing information to the public and to policy makers (76%), providing diabetes education (58%), and screening (74%). The mean score on a 10-point performance index was 3.5. Characteristics associated with performance were population size, health department size and accreditation status, and diabetes-specific external funding. Performance was not better in localities where the prevalence of diabetes was high or availability of primary care was low. Most North Carolina local health departments had limited capacity to conduct diabetes prevention or control programs in their communities. Diabetes is a major cause of illness and death, yet it is neglected in public health practice. These findings suggest opportunities to enhance local public health practice, particularly through targeted funding and technical assistance.

  3. Sustainability of the Communities That Care prevention system by coalitions participating in the Community Youth Development Study.

    PubMed

    Gloppen, Kari M; Arthur, Michael W; Hawkins, J David; Shapiro, Valerie B

    2012-09-01

    Community prevention coalitions are a common strategy to mobilize stakeholders to implement tested and effective prevention programs to promote adolescent health and well-being. This article examines the sustainability of Communities That Care (CTC) coalitions approximately 20 months after study support for the intervention ended. The Community Youth Development Study is a community-randomized trial of the CTC prevention system. Using data from 2007 and 2009 coalition leader interviews, this study reports changes in coalition activities from a period of study support for CTC (2007) to 20 months following the end of study support for CTC (2009), measured by the extent to which coalitions continued to meet specific benchmarks. Twenty months after study support for CTC implementation ended, 11 of 12 CTC coalitions in the Community Youth Development Study still existed. The 11 remaining coalitions continued to report significantly higher scores on the benchmarks of phases 2 through 5 of the CTC system than did prevention coalitions in the control communities. At the 20-month follow-up, two-thirds of the CTC coalitions reported having a paid staff person. This study found that the CTC coalitions maintained a relatively high level of implementation fidelity to the CTC system 20 months after the study support for the intervention ended. However, the downward trend in some of the measured benchmarks indicates that continued high-quality training and technical assistance may be important to ensure that CTC coalitions maintain a science-based approach to prevention, and continue to achieve public health impacts on adolescent health and behavior outcomes. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  4. Emotion regulation strategies and childhood obesity in high risk preschoolers.

    PubMed

    Power, Thomas G; Olivera, Yadira A; Hill, Rachael A; Beck, Ashley D; Hopwood, Veronica; Garcia, Karina Silva; Ramos, Guadalupe G; Fisher, Jennifer Orlet; O'Connor, Teresia M; Hughes, Sheryl O

    2016-12-01

    The current study examined the relationships between the specific strategies that preschool children use to regulate their emotions and childhood weight status to see if emotion regulation strategies would predict childhood weight status over and above measures of eating self-regulation. 185 4- to 5-year-old Latino children were recruited through Head Start centers in a large city in the southeastern U.S. Children completed both a delay of gratification task (emotion regulation) and an eating in the absence of hunger task (eating regulation). Eating regulation also was assessed by maternal reports. Four emotion regulation strategies were examined in the delay of gratification task: shut out stimuli, prevent movement, distraction, and attention to reward. Hierarchical linear regressions predicting children's weight status showed that both measures of eating regulation negatively predicted child obesity, and the use of prevent movement negatively predicted child obesity. Total wait time during the delay of gratification tasks was not a significant predictor. The current findings are consistent with studies showing that for preschool children, summary measures of emotion regulation (e.g., wait time) are not concurrently associated with child obesity. In contrast, the use of emotion regulation strategies was a significant predictor of lower child weight status. These findings help identify emotion regulation strategies that prevention programs can target for helping children regulate their emotions and decrease their obesity risk. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Healthcare-associated infections in a tunisian university hospital: from analysis to action

    PubMed Central

    Mahjoub, Mohamed; Bouafia, Nebiha; Bannour, Waadia; Masmoudi, Tasnim; Bouriga, Rym; Hellali, Radhia; Cheikh, Asma Ben; Ezzi, Olfa; Abdeljellil, Amel Ben; Mansour, Njah

    2015-01-01

    Introduction Our study was conducted, in university hospital center (UHC) Farhat Hached of Sousse (city in Tunisian center-east), within healthcare-associated infections (HAI) epidemiological surveillance (ES) program, based, among others, on HAI regular prevalence surveys. Our objectives are to resituate HAI prevalence rate and to identify their risk factors (RF) in order to adjust, in our hospital, prevention programs. Methods It is a transversal descriptive study, including all patients who had been hospitalized for at least 48 hours, measuring prevalence of HAI a “given day”, with only one passage by service. Risk factors were determined using Epiinfo 6.0, by uni-varied analysis, then, logistic regression stepwise descending for the variables whose p Results The study focused on 312 patients. Infected patients prevalence was 12.5% and that of HAI was 14.5%. Infections on peripheral venous catheter (PVC) dominated (42.2%) among all HAI identified. HAI significant RF were neutropenia (p < 10−4) for intrinsic factors, and PVC for extrinsic factors (p = 0,003). Conclusion Predominance of infections on PVC should be subject of specific prevention actions, including retro-information strategy, prospective ES, professional practices evaluation and finally training and increasing awareness of health personnel with hygiene measures. Finally, development of a patient safety culture with personnel ensures best adherence to hygiene measures and HAI prevention. PMID:26113928

  6. Knowledge and use of prevention measures for chikungunya virus among visitors — Virgin Islands National Park, 2015

    PubMed Central

    Cherry, Cara C.; Beer, Karlyn D.; Fulton, Corey; Wong, David; Buttke, Danielle; Staples, J. Erin; Ellis, Esther M.

    2016-01-01

    Summary Background In June 2014, the mosquito-borne chikungunya virus (CHIKV) emerged in the U.S. Virgin Islands (USVI), a location where tourists comprise the majority of the population during peak season (January–April). Limited information is available concerning visitors’ CHIKV awareness and prevention measures. Methods We surveyed a convenience sample of Virgin Islands National Park visitors aged ≥18 years. Respondents completed a questionnaire assessing CHIKV knowledge, attitudes, and practices; health information-seeking practices; and demographics. Results Of 783 persons contacted, 443 (57%) completed the survey. Fewer than half (208/441 [47%]) were aware of CHIKV. During trip preparation, 28% of respondents (126/443) investigated USVI-specific health concerns. Compared with persons unaware of CHIKV, CHIKV-aware persons were more likely to apply insect repellent (134/207 [65%] versus 111/231 [48%]; p < 0.001), wear long-sleeves and long pants (84/203 [41%] versus 57/227 [25%]; p < 0.001), and wear insect repellent-treated clothing (36/204 [18%] versus 22/227 [10%]; p = 0.02). Conclusions The majority of visitors surveyed did not research destination-related health concerns and were unaware of CHIKV. However, CHIKV awareness was associated with using multiple prevention measures to reduce disease risk. These findings underscore the importance of providing tourists with disease education upon destination arrival. PMID:27597388

  7. The Importance of Socio-Economic Versus Environmental Risk Factors for Reported Dengue Cases in Java, Indonesia.

    PubMed

    Wijayanti, Siwi P M; Porphyre, Thibaud; Chase-Topping, Margo; Rainey, Stephanie M; McFarlane, Melanie; Schnettler, Esther; Biek, Roman; Kohl, Alain

    2016-09-01

    Dengue is a major mosquito-borne viral disease and an important public health problem. Identifying which factors are important determinants in the risk of dengue infection is critical in supporting and guiding preventive measures. In South-East Asia, half of all reported fatal infections are recorded in Indonesia, yet little is known about the epidemiology of dengue in this country. Hospital-reported dengue cases in Banyumas regency, Central Java were examined to build Bayesian spatial and spatio-temporal models assessing the influence of climatic, demographic and socio-economic factors on the risk of dengue infection. A socio-economic factor linking employment type and economic status was the most influential on the risk of dengue infection in the Regency. Other factors such as access to healthcare facilities and night-time temperature were also found to be associated with higher risk of reported dengue infection but had limited explanatory power. Our data suggest that dengue infections are triggered by indoor transmission events linked to socio-economic factors (employment type, economic status). Preventive measures in this area should therefore target also specific environments such as schools and work areas to attempt and reduce dengue burden in this community. Although our analysis did not account for factors such as variations in immunity which need further investigation, this study can advise preventive measures in areas with similar patterns of reported dengue cases and environment.

  8. Emotion Regulation Strategies and Childhood Obesity in High Risk Preschoolers

    PubMed Central

    Power, Thomas G.; Olivera, Yadira A.; Hill, Rachael A.; Beck, Ashley D.; Hopwood, Veronica; Garcia, Karina Silva; Ramos, Guadalupe G.; Fisher, Jennifer Orlet; O’Connor, Teresia M.; Hughes, Sheryl O.

    2016-01-01

    The current study examined the relationships between the specific strategies that preschool children use to regulate their emotions and childhood weight status to see if emotion regulation strategies would predict childhood weight status over and above measures of eating self-regulation. 185 4- to 5-year-old Latino children were recruited through Head Start centers in a large city in the southeastern U.S. Children completed both a delay of gratification task (emotion regulation) and an eating in the absence of hunger task (eating regulation). Eating regulation also was assessed by maternal reports. Four emotion regulation strategies were examined in the delay of gratification task: shut out stimuli, prevent movement, distraction, and attention to reward. Hierarchical linear regressions predicting children’s weight status showed that both measures of eating regulation negatively predicted child obesity, and the use of prevent movement negatively predicted child obesity. Total wait time during the delay of gratification tasks was not a significant predictor. The current findings are consistent with studies showing that for preschool children, summary measures of emotion regulation (e.g., wait time) are not concurrently associated with child obesity. In contrast, the use of emotion regulation strategies was a significant predictor of lower child weight status. These findings help identify emotion regulation strategies that prevention programs can target for helping children regulate their emotions and decrease their obesity risk. PMID:27620645

  9. Probiotics for respiratory tract infections in children attending day care centers-a systematic review.

    PubMed

    Laursen, Rikke Pilmann; Hojsak, Iva

    2018-05-12

    Probiotics have been suggested to have a preventive effect on respiratory tract infections (RTIs), but limited evidence exist on strain-specific effects. The main aim of this systematic review and meta-analysis was to evaluate strain-specific probiotic effects on RTIs in children attending day care. We included 15 RCTs with 5121 children in day care settings (aged 3 months to 7 years), but due to high diversity in reported outcomes, different number of RCTs were available for evaluated outcomes. Twelve RCTs (n = 4527) reported results which could be compared in at least one outcome of the meta-analysis. Compared to placebo, Lactobacillus rhamnosus GG (LGG) significantly reduced duration of RTIs (three RCTs, n = 1295, mean difference - 0.78 days, 95% confidence interval (CI) - 1.46; - 0.09), whereas no effect was found on other evaluated outcomes. Based on the results from two studies (n = 343), Bifidobacterium animalis subsp. lactis BB-12 showed no effect on duration of RTIs or on absence from day care. Meta-analyses on other strains or their combination were not possible due to limited data and different outcome measures. LGG is modestly effective in decreasing the duration of RTIs. More RCTs investigating specific probiotic strains or their combinations in prevention of RTIs are needed. What is known: • Previously published systematic reviews have suggested that probiotics may have a preventive effect on respiratory infections, but limited data exist on strain specific effects. What is new: • This systematic review showed that use of Lactobacillus rhamnosus GG modestly reduces the duration of respiratory tract infections.

  10. Vital Signs: Obesity Among Low-Income, Preschool-Aged Children — United States, 2008–2011

    PubMed Central

    May, Ashleigh L.; Pan, Liping; Sherry, Bettylou; Blanck, Heidi M.; Galuska, Deborah; Dalenius, Karen; Polhamus, Barbara; Kettel-Khan, Laura; Grummer-Strawn, Laurence M.

    2013-01-01

    Background The prevalence of obesity among U.S. preschoolers has doubled in recent decades. Childhood obesity increases the risk for adult obesity and is associated with negative health consequences. Trends in the state-specific prevalence of obesity among low-income U.S. preschool children have not been examined since 2008. State-specific obesity prevalence surveillance helps determine the need for and impact of state and local obesity prevention strategies. Methods Measured weight and height data from approximately 11.6 million low-income children aged 2–4 years from 40 states, the District of Columbia, and two U.S. territories who participated in the Pediatric Nutrition Surveillance System during 2008–2011 were used to estimate state obesity prevalence. Obesity was defined as having an age- and sex-specific body mass index ≥95th percentile, according to the 2000 CDC growth charts. Logistic regression models adjusted for age, sex, and race/ethnicity were used to examine trends in the state-specific obesity prevalence. Results During 2008–2011, statistically significant downward trends in obesity prevalence were observed in 18 states and the U.S. Virgin Islands. Florida, Georgia, Missouri, New Jersey, South Dakota, and the U.S. Virgin Islands had the largest absolute decreases in obesity prevalence, each with a decrease of ≥1 percentage point. Twenty states and Puerto Rico experienced no significant change, and obesity prevalence increased significantly in three states. Conclusions and Implications for Public Health Practice Small but significant declines in obesity among low-income preschoolers were observed in 19 of 43 states/territories examined. Continued prevention efforts are needed to sustain and expand the implementation and evaluation of population-level interventions to prevent childhood obesity. PMID:23925173

  11. [Atopic dermatitis and domestic animals].

    PubMed

    Song, M

    2000-09-01

    Several arguments are raised attributing to aeroallergens an important role in atopic dermatitis. The aeroallergens that penetrate the epidermis could be fixed by IgE on the Langerhans cells and then induce a cellular mediator reaction comparable to that of allergic contact eczema. Patch tests have been developed to evaluate the role of aeroallergens (dust mites, animal dander, etc.). Preventive anti-dust mites measures in the home of atopic patients are recommended. Eviction of domestic animals (cat, dog, etc.) or avoidance measures for animal dander in the home can produce improvement in atopic dermatitis. Oral specific immunotherapy is being validated as a treatment for this disease.

  12. The effect of Haemophilus influenzae type B and pneumococcal conjugate vaccines on childhood meningitis mortality: a systematic review.

    PubMed

    Davis, Stephanie; Feikin, Daniel; Johnson, Hope L

    2013-01-01

    Two of the most prevalent causes of severe bacterial meningitis in children, Haemophilus influenzae type B (Hib) and Streptococcus pneumoniae, are preventable by existing vaccines increasingly available in developing countries. Our objective was to estimate the dose-specific effect of Hib and pneumococcal conjugate vaccines (PCV) on childhood meningitis mortality in low-income countries for use in the Lives Saved Tool (LiST). We systematically searched and reviewed published vaccine efficacy trials and observational studies reporting the effect of Hib or PCV vaccines on organism-specific meningitis, bacterial meningitis and all-cause meningitis incidence and mortality among children less than five years old in low- and middle-income countries. Data collection and quality assessments were performed using standardized guidelines. For outcomes available across multiple studies (≥ 2) and approximating meningitis mortality, we pooled estimates reporting dose-specific effects using random effects meta-analytic methods, then combined these with meningitis etiology data to determine the preventable fraction of childhood meningitis mortality for inclusion in LiST. We identified 18 studies of Hib conjugate vaccines reporting relevant meningitis morbidity and mortality outcomes (2 randomized controlled trials [RCTs], 16 observational studies) but few provided dose-specific effects. A meta-analysis of four case-control studies examined the dose-specific effect of Hib conjugate vaccines on Hib meningitis morbidity (1 dose: RR=0.64, 95% CI 0.38-1.06; 2 doses: RR=0.09, 95% CI 0.03-0.27; 3 doses: RR=0.06, 95% CI 0.02-0.22), consistent with results from single RCTs. Pooled estimates of two RCTs provided evidence for the effect of three doses of PCV on vaccine-serotype meningitis morbidity (RR=0.16, 95% CI 0.02-1.20). We considered these outcomes of severe disease as proxy estimates for meningitis mortality and combined the estimates of protective effects with meningitis etiology data to provide an estimate of the preventable fraction of childhood meningitis mortality with three doses of Hib (38-43%) and pneumococcal conjugate vaccines (28-35%) for use in LiST. Few RCTs or vaccine effectiveness studies evaluated the dose-specific impact of Hib and PCV vaccines on childhood meningitis mortality, necessitating use of proxy measures to estimate population impact in LiST. Our analysis indicates that approximately three-quarters of meningitis deaths are preventable with existing Hib and PCV vaccines.

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

    PubMed

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

    2014-11-19

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

  14. Translating basic psychopathology research to preventive interventions: A tribute to John Abela

    PubMed Central

    Garber, Judy; Korelitz, Katherine E.; Larkin, Silvia Samanez

    2012-01-01

    This paper highlights how the many important contributions of John R. Z. Abela’s research program can inform the development and implementation of interventions for preventing depression in youth. Abela provided evidence of multiple vulnerabilities to depression including cognitive (e.g., inferential style, dysfunctional attitudes, ruminative response style), interpersonal (e.g., reassurance seeking, attachment, dependency), personality (e.g., neuroticism, self-criticism), and contextual (e.g., stress, parental depression). He introduced important methodological advances to the study of the hopelessness model of depression, especially in children, including the “weakest link” approach, cognitive priming, and idiographic measurement of stress. We briefly review what is currently known about the prevention of depression regarding intervention targets, content, outcomes, effect sizes, moderators, mediators, specificity, and durability. Next, we summarize several of Abela’s contributions that are most relevant to the prevention of depression. We describe the implications of Abela’s work for the development, implementation, and testing of programs aimed at preventing depression, and discuss important challenges such as the transfer of training to and the personalization of interventions so as to capitalize on individuals’ strengths versus compensate for their weaknesses. PMID:22891820

  15. Neuroplus biofeedback improves attention, resilience, and injury prevention in elite soccer players.

    PubMed

    Rusciano, Aiace; Corradini, Giuliano; Stoianov, Ivilin

    2017-06-01

    Performance and injury prevention in elite soccer players are typically investigated from physical-tactical, biomechanical, and metabolic perspectives. However, executive functions, visuospatial abilities, and psychophysiological adaptability or resilience are also fundamental for efficiency and well-being in sports. Based on previous research associating autonomic flexibility with prefrontal cortical control, we designed a novel integrated autonomic biofeedback training method called Neuroplus to improve resilience, visual attention, and injury prevention. Herein, we introduce the method and provide an evaluation of 20 elite soccer players from the Italian Soccer High Division (Serie-A): 10 players trained with Neuroplus and 10 trained with a control treatment. The assessments included psychophysiological stress profiles, a visual search task, and indexes of injury prevention, which were measured pre- and posttreatment. The analysis showed a significant enhancement of physiological adaptability, recovery following stress, visual selective attention, and injury prevention that were specific to the Neuroplus group. Enhancing the interplay between autonomic and cognitive functions through biofeedback may become a key principle for obtaining excellence and well-being in sports. To our knowledge, this is the first evidence that shows improvement in visual selective attention following intense autonomic biofeedback. © 2017 Society for Psychophysiological Research.

  16. Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border

    PubMed Central

    Moreno Ramírez, Denise; Ramírez-Andreotta, Mónica D.; Vea, Lourdes; Estrella-Sánchez, Rocío; Wolf, Ann Marie A.; Kilungo, Aminata; Spitz, Anna H.; Betterton, Eric A.

    2015-01-01

    Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras) can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered “hard-to-reach” by government-led programs. PMID:26371028

  17. Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border.

    PubMed

    Ramírez, Denise Moreno; Ramírez-Andreotta, Mónica D; Vea, Lourdes; Estrella-Sánchez, Rocío; Wolf, Ann Marie A; Kilungo, Aminata; Spitz, Anna H; Betterton, Eric A

    2015-09-09

    Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras) can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered "hard-to-reach" by government-led programs.

  18. Assessing the knowledge, attitudes and practices regarding cholera preparedness and prevention in Ga-Mampuru village, Limpopo, South Africa

    PubMed Central

    Jordaan, Andries J.; Mabela, Beverly M.

    2016-01-01

    The study assessed the knowledge, attitudes and practices of cholera prevention and preparedness in Ga-Mampuru village (Limpopo, South Africa). Interviewers collected data using a two-pronged method, namely a household questionnaire (open- and closed-ended questions) to assess knowledge and attitudes about cholera and observations to assess practices in the prevention and management of the disease. Additionally, interviewers took pictures with the respondents’ permission. Ninety-six respondents were interviewed. Most respondents (86%) indicated they knew how cholera was contracted with 84% indicating contaminated water as a source. Ninety percent of the respondents indicated they knew how to prevent contracting cholera. All respondents generally knew that cholera could be treated with medicine received at a health-care facility or worker. Fewer respondents (58%) had specific knowledge such as the use of rehydration solutions. The respondents’ high level of prevention practices could be biased. Interviewers observed that many practices were not adhered to, like not washing hands, not using toilet paper and throwing waste in respondents’ yards. Therefore, the community of Ga-Mampuru had not reached a stage of adequate cholera prevention and preparedness in spite of the fact that they were aware of cholera risks and risk-reduction measures.

  19. Reversible Lithium Neurotoxicity: Review of the Literature

    PubMed Central

    Netto, Ivan

    2012-01-01

    Objective: Lithium neurotoxicity may be reversible or irreversible. Reversible lithium neurotoxicity has been defined as cases of lithium neurotoxicity in which patients recovered without any permanent neurologic sequelae, even after 2 months of an episode of lithium toxicity. Cases of reversible lithium neurotoxicity differ in clinical presentation from those of irreversible lithium neurotoxicity and have important implications in clinical practice. This review aims to study the clinical presentation of cases of reversible lithium neurotoxicity. Data Sources: A comprehensive electronic search was conducted in the following databases: MEDLINE (PubMed), 1950 to November 2010; PsycINFO, 1967 to November 2010; and SCOPUS (EMBASE), 1950 to November 2010. MEDLINE and PsycINFO were searched by using the OvidSP interface. Study Selection: A combination of the following search terms was used: lithium AND adverse effects AND central nervous system OR neurologic manifestation. Publications cited include articles concerned with reversible lithium neurotoxicity. Data Extraction: The age, sex, clinical features, diagnostic categories, lithium doses, serum lithium levels, precipitating factors, and preventive measures of 52 cases of reversible lithium neurotoxicity were extracted. Data Synthesis: Among the 52 cases of reversible lithium neurotoxicity, patients ranged in age from 10 to 80 years and a greater number were female (P = .008). Most patients had affective disorders, schizoaffective disorders, and/or depression (P < .001) and presented mainly with acute organic brain syndrome. In most cases, the therapeutic serum lithium levels were less than or equal to 1.5 mEq/L (P < .001), and dosage regimens were less than 2,000 mg/day. Specific drug combinations with lithium, underlying brain pathology, abnormal tissue levels, specific diagnostic categories, and elderly populations were some of the precipitating factors reported for reversible lithium neurotoxicity. The preventive measures were also described. Conclusions: Reversible lithium neurotoxicity presents with a certain clinical profile and precipitating factors for which there are appropriate preventive measures. This recognition will help in early diagnosis and prompt treatment of lithium neurotoxicity. PMID:22690368

  20. Immunological Prediction of Cytomegalovirus (CMV) Replication Risk in Solid Organ Transplantation Recipients: Approaches for Regulating the Targeted Anti-CMV Prevention Strategies

    PubMed Central

    2017-01-01

    The current cytomegalovirus (CMV) prevention strategies in solid organ transplantation (SOT) recipients have contributed towards overcoming the detrimental effects caused by CMV lytic infection, and improving the long-term success rate of graft survival. Although the quantification of CMV in peripheral blood is the standard method, and an excellent end-point for diagnosing CMV replication and modulating the anti-CMV prevention strategies in SOT recipients, a novel biomarker mimicking the CMV control mechanism is required. CMV-specific immune monitoring can be employed as a basic tool predicting CMV infection or disease after SOT, since uncontrolled CMV replication mostly originates from the impairment of immune responses against CMV under immunosuppressive conditions in SOT recipients. Several studies conducted during the past few decades have indicated the possibility of measuring the CMV-specific cell-mediated immune response in clinical situations. Among several analytical assays, the most advancing standardized tool is the QuantiFERON®-CMV assay. The T-Track® CMV kit that uses the standardized enzyme-linked immunospot assay is also widely employed. In addition to these assays, immunophenotyping and intracellular cytokine analysis using flow cytometry (with fluorescence-labeled monoclonal antibodies or peptide-major histocompatibility complex multimers) needs to be adequately standardized and validated for potential clinical applications. PMID:29027383

  1. Skin-specific training experience of workers assessed for contact dermatitis.

    PubMed

    Zack, B; Arrandale, V; Holness, D L

    2018-05-17

    Contact dermatitis is a common and preventable work-related disease. Skin-specific training may be effective for preventing occupational contact dermatitis, but little information is available regarding actual workplace training and its effectiveness. To describe workplace skin-specific training among workers with suspected contact dermatitis. Patch test patients being assessed for suspected contact dermatitis at an occupational health clinic in Toronto, Canada, completed a questionnaire on training experiences, workplace characteristics, exposures and skin protection practices. Of 175 patients approached, 122 (71%) workers completed questionnaires. Many (80%) had received general occupational health and safety and hazardous materials training (76%). Fewer (39%) received skin-specific training. Of those with work-related contact dermatitis, 52% did not receive skin-specific training. Skin-specific training was commonly provided by health and safety professionals or supervisors using video, classroom and online techniques. Content included glove use, exposure avoidance and hand washing information. Workers that received skin-specific training found it memorable (87%), useful (85%) and common sense in nature (100%). This study indicates gaps in workplace training on skin disease prevention for workers with contact dermatitis. Workers perceived skin-specific training to be useful. Understanding worker training experiences is important to prevention programme development and reducing work-related skin disease.

  2. Evaluation of the ThinkFirst Canada, Smart Hockey, brain and spinal cord injury prevention video

    PubMed Central

    Cook, D; Cusimano, M; Tator, C; Chipman, M; Macarthur, C

    2003-01-01

    Objective: The ThinkFirst Canada Smart Hockey program is an educational injury prevention video that teaches the mechanisms, consequences, and prevention of brain and spinal cord injury in ice hockey. This study evaluates knowledge transfer and behavioural outcomes in 11–12 year old hockey players who viewed the video. Design: Randomized controlled design. Setting: Greater Toronto Minor Hockey League, Toronto Ontario. Subjects: Minor, competitive 11–12 year old male ice hockey players and hockey team coaches. Interventions: The Smart Hockey video was shown to experimental teams at mid-season. An interview was conducted with coaches to understand reasons to accept or refuse the injury prevention video. Main outcome measures: A test of concussion knowledge was administered before, immediately after, and three months after exposure to the video. The incidence of aggressive penalties was measured before and after viewing the video. Results: The number of causes and mechanisms of concussion named by players increased from 1.13 to 2.47 and from 0.67 to 1.22 respectively. This effect was maintained at three months. There was no significant change in control teams. There was no significant change in total penalties after video exposure; however, specific body checking related penalties were significantly reduced in the experimental group. Conclusion: This study showed some improvements in knowledge and behaviours after a single viewing of a video; however, these findings require confirmation with a larger sample to understand the sociobehavioural aspects of sport that determine the effectiveness and acceptance of injury prevention interventions. PMID:14693901

  3. Toxoplasmosis-Related Knowledge and Practices Among Pregnant Women in the United States

    PubMed Central

    Ogunmodede, Folashade; Scheftel, Joni; Kirkland, Elizabeth; Lopez, Adriana; Schulkin, Jay; Lynfield, Ruth

    2003-01-01

    Background: Infection with Toxoplasma gondii during pregnancy can lead to severe illness in the fetus. Many T. gondii infections are preventable by simple hygienic measures. Methods: We surveyed pregnant women in the US to determine their knowledge about toxoplasmosis and their practices to prevent infection. Volunteer obstetricians selected to be demographically representative of the American College of Obstetricians and Gynecologists recruited the participants. Results: Of 403 women responding to the survey, 48% indicated that they had heard or seen information about toxoplasmosis; however, only 7% were aware of being tested for the disease. Forty percent of responding women knew that toxoplasmosis is caused by an infection, but 21% thought that a poison causes it. The highest level of knowledge was about cats and T. gondii ; 61% responded that the organism is shed in the feces of infected cats and 60% responded that people could acquire toxoplasmosis by changing cat litter. There was a low level of knowledge about other risk factors; only 30% of the women were aware that T. gondii may be found in raw or undercooked meat. Nevertheless, a high percentage of women indicated that they do not eat undercooked meat during pregnancy and that they practice good hygienic measures such as washing their hands after handling raw meat, gardening or changing cat litter. Conclusion: Except for the risk of transmission from cats, knowledge among pregnant women about toxoplasmosis is low. However, toxoplasmosis-preventive practices are generally good, suggesting that providers should continue to offer education about practices that help prevent foodborne diseases in general as well as information about preventing toxoplasmosis specifically. PMID:15022874

  4. Health care-associated infection prevention in Japan: the role of safety culture.

    PubMed

    Sakamoto, Fumie; Sakihama, Tomoko; Saint, Sanjay; Greene, M Todd; Ratz, David; Tokuda, Yasuharu

    2014-08-01

    Limited data exist on the use of infection prevention practices in Japan. We conducted a nationwide survey to examine the use of recommended infection prevention strategies and factors affecting their use in Japanese hospitals. Between April 1, 2012, and January 31, 2013, we surveyed 971 hospitals in Japan. The survey instrument assessed general hospital and infection prevention program characteristics and use of infection prevention practices, including practices specific to preventing catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). Logistic regression models were used to examine multivariable associations between hospital characteristics and the use of the various prevention practices. A total of 685 hospitals (71%) responded to the survey. Maintaining aseptic technique during catheter insertion and maintenance, avoiding routine central line changes, and using maximum sterile barrier precautions and semirecumbent positioning were the only practices regularly used by more than one-half of the hospitals to prevent CAUTI, CLABSI, and VAP, respectively. Higher safety-centeredness was associated with regular use of prevention practices across all infection types. Although certain practices were used commonly, the rate of regular use of many evidence-based prevention practices was low in Japanese hospitals. Our findings highlight the importance of fostering an organization-wide atmosphere that prioritizes patient safety. Such a commitment to patient safety should in turn promote the use of effective measures to reduce health care-associated infections in Japan. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  5. Using Reputation Based Trust to Overcome Malfunctions and Malicious Failures in Electric Power Protection Systems

    DTIC Science & Technology

    2011-09-01

    concert with a physical attack. Additionally, the importance of preventive measures implemented by a social human network to counteract a cyber attack...integrity of the data stored on specific computers. This coordinated cyber attack would have been successful if not for the trusted social network...established by Mr. Hillar Aarelaid, head of the Estonian computer 6 emergency response team (CERT). This social network consisted of Mr. Hillar Aarelaid

  6. Fishing and casing repairs

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

    Short, J.A.

    1982-01-01

    Up to 1/4 of a total drilling budget can be spent on fishing failures and downhole remedial operations. The book presented is aimed at cutting these costs. Specific examples of operations are included throughout the book to illustrate conditions in field situations. The author also discusses background conditions causing the problems and possible solutions, along with preventive measures. Also included are chapters on types of fishing tools, fishing procedures and operations, casing failures and repairs. (JMT)

  7. Developing recombinant HPA-1a-specific antibodies with abrogated Fcgamma receptor binding for the treatment of fetomaternal alloimmune thrombocytopenia.

    PubMed

    Ghevaert, Cedric; Wilcox, David A; Fang, Juan; Armour, Kathryn L; Clark, Mike R; Ouwehand, Willem H; Williamson, Lorna M

    2008-08-01

    Fetomaternal alloimmune thrombocytopenia (FMAIT) is caused by maternal generation of antibodies specific for paternal platelet antigens and can lead to fetal intracranial hemorrhage. A SNP in the gene encoding integrin beta3 causes a clinically important maternal-paternal antigenic difference; Leu33 generates the human platelet antigen 1a (HPA-1a), whereas Pro33 generates HPA-1b. As a potential treatment to prevent fetal intracranial hemorrhage in HPA-1a alloimmunized pregnancies, we generated an antibody that blocks the binding of maternal HPA-1a-specific antibodies to fetal HPA-1a1b platelets by combining a high-affinity human HPA-1a-specific scFv (B2) with an IgG1 constant region modified to minimize Fcgamma receptor-dependent platelet destruction (G1Deltanab). B2G1Deltanab saturated HPA-1a+ platelets and substantially inhibited binding of clinical HPA-1a-specific sera to HPA-1a+ platelets. The response of monocytes to B2G1Deltanab-sensitized platelets was substantially less than their response to unmodified B2G1, as measured by chemiluminescence. In addition, B2G1Deltanab inhibited chemiluminescence induced by B2G1 and HPA-1a-specific sera. In a chimeric mouse model, B2G1 and polyclonal Ig preparations from clinical HPA-1a-specific sera reduced circulating HPA-1a+ platelets, concomitant with transient thrombocytopenia. As the Deltanab constant region is uninformative in mice, F(ab')2 B2G1 was used as a proof of principle blocking antibody and prevented the in vivo platelet destruction seen with B2G1 and polyclonal HPA-1a-specific antibodies. These results provide rationale for human clinical studies.

  8. Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies.

    PubMed

    Saha, Manish; Allon, Michael

    2017-02-07

    Given the high comorbidity in patients on hemodialysis and the complexity of the dialysis treatment, it is remarkable how rarely a life-threatening complication occurs during dialysis. The low rate of dialysis emergencies can be attributed to numerous safety features in modern dialysis machines; meticulous treatment and testing of the dialysate solution to prevent exposure to trace elements, toxins, and pathogens; adherence to detailed treatment protocols; and extensive training of dialysis staff to handle medical emergencies. Most hemodialysis emergencies can be attributed to human error. A smaller number are due to rare idiosyncratic reactions. In this review, we highlight major emergencies that may occur during hemodialysis treatments, describe their pathogenesis, offer measures to minimize them, and provide specific interventions to prevent catastrophic consequences on the rare occasions when such emergencies arise. These emergencies include dialysis disequilibrium syndrome, venous air embolism, hemolysis, venous needle dislodgement, vascular access hemorrhage, major allergic reactions to the dialyzer or treatment medications, and disruption or contamination of the dialysis water system. Finally, we describe root cause analysis after a dialysis emergency has occurred to prevent a future recurrence. Copyright © 2017 by the American Society of Nephrology.

  9. Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies

    PubMed Central

    Saha, Manish

    2017-01-01

    Given the high comorbidity in patients on hemodialysis and the complexity of the dialysis treatment, it is remarkable how rarely a life-threatening complication occurs during dialysis. The low rate of dialysis emergencies can be attributed to numerous safety features in modern dialysis machines; meticulous treatment and testing of the dialysate solution to prevent exposure to trace elements, toxins, and pathogens; adherence to detailed treatment protocols; and extensive training of dialysis staff to handle medical emergencies. Most hemodialysis emergencies can be attributed to human error. A smaller number are due to rare idiosyncratic reactions. In this review, we highlight major emergencies that may occur during hemodialysis treatments, describe their pathogenesis, offer measures to minimize them, and provide specific interventions to prevent catastrophic consequences on the rare occasions when such emergencies arise. These emergencies include dialysis disequilibrium syndrome, venous air embolism, hemolysis, venous needle dislodgement, vascular access hemorrhage, major allergic reactions to the dialyzer or treatment medications, and disruption or contamination of the dialysis water system. Finally, we describe root cause analysis after a dialysis emergency has occurred to prevent a future recurrence. PMID:27831511

  10. Epidemiology of hepatitis C in the Republic of Moldova: achievements and remaining challenges in prevention and control.

    PubMed

    Guriev, Vladimir; Spinu, Constantin; Sajen, Octavian; Isac, Maria; Spinu, Igor; Cebotari, Svetlana; Donos, Ala

    2016-11-24

    Viral hepatitis, especially those with parenteral and sexual transmission, still remain a major problem of public health, both globally and for the Republic of Moldova, due to wide spreading, endemicity, increased morbidity and mortality and high rate of invalidity following the chronization of infection, but usually neglected by population and public health authorities. This paper describes the epidemiology and preventive and control measures of hepatitis C in Moldova. Epidemiological analysis of the surveillance data on hepatitis C incidence in the Republic of Moldova was conducted. The data were obtained from the national reporting system of infectious diseases and serosurvey studies. Epidemiological particularities of acute and chronic hepatitis C in general Moldovan population and specific risk groups were evaluated. National hepatitis policies for prevention and control were analyzed. Only consolidation of all the actions stipulated in the national and international normative documents on the prevention and control of hepatitis, will help to reduce the morbidity of viral hepatitis C and probably to eliminate the new cases of disease in some regions.

  11. A knock to the system: A new sociotechnical systems approach to sport-related concussion.

    PubMed

    Clacy, Amanda; Goode, Natassia; Sharman, Rachael; Lovell, Geoff P; Salmon, Paul M

    2017-11-01

    Broader contextual factors that influence concussion management have tended to be overlooked. To address this, the present study used a sociotechnical systems approach to identify perceived responsibilities and applied strategies for three domains of concussion management (i.e., prevention, identification and treatment). Participants were 118 members of the community rugby union system in Australia (69.2% male). Participants from throughout the rugby system (e.g., players, parents, coaches, club management) were asked open-ended questions about their perceived responsibilities and the strategies they use for concussion management. It was found that (a) proper training, technique correction and education were recurrent prevention themes; (b) the majority of key stakeholders felt that they could consistently identify concussion; however, medical aids (medics) were the only system actors who stated a responsibility to use standardised concussion assessment measures and (c) less than one third of the respondents indicated their involvement in treating concussion. This study identifies specific junctures in the system that prevents effective concussion management strategies. A sociotechnical systems approach improves the understanding of concussion prevention, and management beliefs and behaviours.

  12. Cure rate is not a valid indicator for assessing drug efficacy and impact of preventive chemotherapy interventions against schistosomiasis and soil-transmitted helminthiasis

    PubMed Central

    Montresor, Antonio

    2017-01-01

    Every year, in endemic countries, several million individuals are given anthelminthic drugs in the context of preventive chemotherapy programmes for morbidity control of schistosomiasis and soil-transmitted helminthiasis. The capacity of accurately evaluating the efficacy of the drugs used as well as the health impact produced by treatment is of utmost importance for the appropriate planning and implementation of these interventions. The cure rate is an indicator of drug efficacy that was originally developed for assessing the clinical efficacy of antibiotics on selected bacterial diseases. Over time, this indicator has also been widely applied to anthelminthic drugs and consequently used to monitor and evaluate preventive chemotherapy interventions. In the author's opinion, however, measurement of cure rate provides information of limited usefulness in the context of helminth control programmes. The present article analyses the peculiarities of helminth infections and those of the drugs used in preventive chemotherapy, explaining the reasons why the cure rate is not an adequate indicator in this specific public health context. PMID:21612808

  13. Technical Packages in Injury and Violence Prevention to Move Evidence Into Practice: Systematic Reviews and Beyond.

    PubMed

    Haegerich, Tamara M; David-Ferdon, Corinne; Noonan, Rita K; Manns, Brian J; Billie, Holly C

    2016-09-07

    Injury and violence prevention strategies have greater potential for impact when they are based on scientific evidence. Systematic reviews of the scientific evidence can contribute key information about which policies and programs might have the greatest impact when implemented. However, systematic reviews have limitations, such as lack of implementation guidance and contextual information, that can limit the application of knowledge. "Technical packages," developed by knowledge brokers such as the federal government, nonprofit agencies, and academic institutions, have the potential to be an efficient mechanism for making information from systematic reviews actionable. Technical packages provide information about specific evidence-based prevention strategies, along with the estimated costs and impacts, and include accompanying implementation and evaluation guidance to facilitate adoption, implementation, and performance measurement. We describe how systematic reviews can inform the development of technical packages for practitioners, provide examples of technical packages in injury and violence prevention, and explain how enhancing review methods and reporting could facilitate the use and applicability of scientific evidence. © The Author(s) 2016.

  14. Online media report on a Hungarian double suicide case: comparison of consecutively published articles.

    PubMed

    Balázs, Judit; Keresztény, Agnes; Pelbát, Gergely; Sinka, Lea; Szilvás, Fanni; Torzsa, Tímea

    2013-09-01

    Certain types of news coverage can increase the likelihood of suicide. This study explores, how media covered a suicide case in a country, where there was no available guideline, though it was among the leading countries in suicide statistics. The specific aim was to compare the first and second waves of reporting on suicide from the same website. In 2011, two young women committed double suicide in Budapest, Hungary. We analyzed the first and second waves of the reported articles about this double suicide case, in online daily newspapers, news portals and also the readers' comments. Provocative aspects were present in 38.9-100.0% of the articles, while preventive aspects were found in 0-22.2% of the articles. Readers commented in 49.6% "Other Aspects" (comments about all other aspects not belonging to any other category, i.e. Risk Behavior, Family Relations, Suicide Place and Methods, Prevention, Media Style Reporting) and in 25.4% "Without Content" (comments without a specific content: e.g. chatting), while "Prevention" (comments about possible safety preventive measures) was mentioned only in 1.5% of the comments. In 34.1% the emotional tonality of the comments was "Neutral" (indifferent comments: e.g. chatting). Though articles published for the second time were significantly longer than the firstly published ones, the preventive aspects of reporting were not added to the second articles either, but significantly more provocative aspects were found in them. The suicide reports, both in the first and second waves of reporting, were not in line with the recommendation of the international guidelines on suicide reporting. It draws the attention of professionals to the importance of developing national guidelines on media suicide coverage.

  15. The effect of maternal and child health and family planning services on mortality: is prevention enough?

    PubMed Central

    Fauveau, V; Wojtyniak, B; Chakraborty, J; Sarder, A M; Briend, A

    1990-01-01

    OBJECTIVE--To examine the impact on mortality of a child survival strategy, mostly based on preventive interventions. DESIGN--Cross sectional comparison of cause specific mortality in two communities differing in the type, coverage, and quality of maternal and child health and family planning services. In the intervention area the services were mainly preventive, community based, and home delivered. SUBJECTS--Neonates, infants, children, and mothers in two contiguous areas of rural Bangladesh. INTERVENTIONS--In the intervention area community health workers provided advice on contraception and on feeding and weaning babies; distributed oral rehydration solution, vitamin A tablets for children under 5, and ferrous fumarate and folic acid during pregnancy; immunised children; trained birth attendants in safe delivery and when to refer; treated minor ailments; and referred seriously ill people and malnourished children to a central clinic. MAIN OUTCOME MEASURES--Overall and age and cause specific death rates, obtained by a multiple step "verbal autopsy" process. RESULTS--During the two years covered by the study overall mortality was 17% lower among neonates, 9% lower among infants aged 1-5 months, 30% lower among children aged 6-35 months, and 19% lower among women living in the study area than in those living in the control area. These differences were mainly due to fewer deaths from neonatal tetanus, measles, persistent diarrhoea with severe malnutrition among children, and fewer abortions among women. CONCLUSIONS--The programme was effective in preventing some deaths. In addition to preventive components such as tetanus and measles immunisation, health and nutrition education, and family planning, curative services are needed to reduce mortality further. PMID:2390566

  16. Testing the validity of preventing chronic regional pain syndrome with vitamin C after distal radius fracture. [Corrected].

    PubMed

    Malay, Sunitha; Chung, Kevin C

    2014-11-01

    The American Academy of Orthopaedic Surgeons recommends the use of vitamin C to prevent complex regional pain syndrome (CRPS) for patients with distal radius fractures (DRFs). We hypothesized that the evidence for supporting this recommendation is weak, based on epidemiological principles of association and causality. The specific aim of this project was to test the validity of this recommendation. We conducted a literature review to retrieve articles reporting on the use of vitamin C to prevent CRPS. Data collected included sample size, study design type, dose of vitamin C used, and outcome measures of association expressed as relative risk (RR) and odds ratio. We then applied Hill criteria to evaluate the relationship between vitamin C and CRPS. We obtained 225 articles from the database search. After the exclusion of duplicates, unrelated articles, editorial letters, and commentaries, we found 4 articles and 1 systematic review relevant to our topic. Six of the 9 Hill criteria were met, and an earlier meta-analysis showed a quantified reduction in CRPS risk. However, criteria like biological plausibility, specificity, and coherence were not met. The number of causal/association criteria met was adequate to support the scientific premise of the effect of vitamin C in preventing CRPS after DRF. Furthermore, vitamin C administration is of relatively low cost and has few complications unless administered in large doses. Owing to sufficient epidemiological evidence availability, the American Academy of Orthopaedic Surgeons recommendation of vitamin C to prevent CRPS has practical merit. Therapeutic II. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  17. 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

  18. Mindfulness-Based Treatment to Prevent Addictive Behavior Relapse: Theoretical Models and Hypothesized Mechanisms of Change

    PubMed Central

    Witkiewitz, Katie; Bowen, Sarah; Harrop, Erin N.; Douglas, Haley; Enkema, Matthew; Sedgwick, Carly

    2017-01-01

    Mindfulness-based treatments are growing in popularity among addiction treatment providers, and several studies suggest the efficacy of incorporating mindfulness practices into the treatment of addiction, including the treatment of substance use disorders and behavioral addictions (i.e., gambling). The current paper provides a review of theoretical models of mindfulness in the treatment of addiction and several hypothesized mechanisms of change. We provide an overview of mindfulness-based relapse prevention (MBRP), including session content, treatment targets, and client feedback from participants who have received MBRP in the context of empirical studies. Future research directions regarding operationalization and measurement, identifying factors that moderate treatment effects, and protocol adaptations for specific populations are discussed. PMID:24611847

  19. How I Learned to Stop Worrying and Love 3D Printing

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

    Pete, Cassandra; Morrell, Sean; Maloney, Jillian

    The nuclear nonproliferation regime has many robust measures in place to prevent the acquisition of a nuclear weapon, a key pillar of which is denying or preventing the transfer of technology to specific actors. Additive manufacturing (AM) is a rapidly advancing, not fully understood technology that could dramatically alter the landscape of the safeguarded fuel cycle. However, many of the benefits of AM could also be used to circumvent or defeat current safeguard practices and controls. Because the AM capability is not fully understood, research and integration is necessary early in the technology development stages in order for nonproliferation tomore » remain on the leading edge of discovery and not the tail end of technology deployment.« less

  20. Introduction to the Special Series: Current Directions for Measuring Parenting Constructs to Inform Prevention Science.

    PubMed

    Lindhiem, Oliver; Shaffer, Anne

    2017-04-01

    Parenting behaviors are multifaceted and dynamic and therefore challenging to quantify. Measurement methods have critical implications for study results, particularly for prevention trials designed to modify parenting behaviors. Although multiple approaches can complement one another and contribute to a more complete understanding of prevention trials, the assumptions and implications of each approach are not always clearly addressed. Greater attention to the measurement of complex constructs such as parenting is needed to advance the field of prevention science. This series examines the challenges of measuring changes in parenting behaviors in the context of prevention trials. All manuscripts in the special series address measurement issues and make practical recommendations for prevention researchers. Manuscripts in this special series include (1) empirical studies that demonstrate novel measurement approaches, (2) re-analyses of prevention trial outcome data directly comparing and contrasting two or more methods, and (3) a statistical primer and practical guide to analyzing proportion data.

  1. Handbook of Youth Prevention Science

    ERIC Educational Resources Information Center

    Doll, Beth, Ed.; Pfohl, William, Ed.; Yoon, Jina S., Ed.

    2010-01-01

    The "Handbook of Youth Prevention Science" describes current research and practice in mental health preventive interventions for youth. Traditional prevention research focused on preventing specific disorders, e.g. substance abuse, conduct disorders, or criminality. This produced "silos" of isolated knowledge about the…

  2. Economic aspects of hydro geological risk mitigation measures management in Italy: the ReNDiS project experience

    NASA Astrophysics Data System (ADS)

    Spizzichino, D.; Campobasso, C.; Gallozzi, P. L.; Dessi', B.; Traversa, F.

    2009-04-01

    ReNDiS project is a useful tool for monitoring, analysis and management of information data on mitigation measures and restoration works of soil protection at national scale. The main scope of the project, and related monitoring activities, is to improve the knowledge about the use of national funds and efforts against floods and landslides risk and, as a consequence, to better address the preventive policies in future. Since 1999 after the disastrous mudflow event occurred in Sarno in 1998, which caused the loss of 160 human lives, an extraordinary effort was conducted by the Italian Government in order to promote preventive measures against the hydro geological risk over the entire Italian territory. The Italian Ministry for the Environment promoted several and annual soil protection programmes. The ReNDiS project (Repertory of mitigation measures for National Soil Protection) is carried out by ISPRA - Institute for Environmental protection and Research, with the aim of improving the knowledge about the results of preventive policies against floods and landslides in order to better address national funds as requested by the Minister itself. The repertory is composed by a main archive and two secondary interface, the first for direct data management (ReNDiS-ist) and the latter (ReNDiS-web) for the on-line access and public consultation. At present, ReNDiS database contains about 3000 records concerning those programmes, focused on restoration works but including also information on landslide typologies and processes. The monitoring project is developed taking into account all the information about each step of every mitigation measure from the initial funding phase until the end of the work. During present work, we have statistically analyzed the ReNDiS database in order to highlight the conformity between the characteristic and type of the hazard (identified in a specific area) and the corresponding mitigation measures adopted for risk reduction. Through specific queries, we have grouped engineering works in several categories that have been related to the characteristics and type of hazards Vs cost-benefit analysis and timing of each work. Implementing a statistical analysis of the ReNDiS database, it has been possible to attempt a first spatial and temporal comparison between zoning of risk and distribution of preventive measures with relative cost at national level. In synthesis, this study has shown that although the total amount of resources devoted to preventive measures are not enough to remove the risk over the entire territory, the response of Italian institutions is in general well calibrated on the characteristic and type of hazard, but still very complex. Further efforts are necessary in order to improve the knowledge on landslides and flood prone areas, also in the perspective of adaptation to climate changes and to better address the public investments where the hydro geological risk is more critical. The importance of this monitoring activities is mainly due to limited financial resources of the Italian public sector in soil protection. Data collection, monitoring activities and statistical analysis like the ones carried out in ReNDiS experience is one of the best way in order to optimise the allocation of financial resources for the mitigation of natural hazard and risk.

  3. Should modest elevations in prostate-specific antigen, International Prostate Symptom Score, or their rates of increase over time be used as surrogate measures of incident benign prostatic hyperplasia?

    PubMed

    Schenk, Jeannette M; Hunter-Merrill, Rachel; Zheng, Yingye; Etzioni, Ruth; Gulati, Roman; Tangen, Catherine; Thompson, Ian M; Kristal, Alan R

    2013-09-01

    Although surrogate measures of benign prostatic hyperplasia (BPH) are often used in epidemiologic studies, their performance characteristics are unknown. Using data from the Prostate Cancer Prevention Trial (n = 5,986), we evaluated prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS), and their rates of change as predictors of incident BPH. BPH (n = 842 cases) was defined as medical or surgical treatment or at least 2 IPSS of 15 or higher. Proportional hazards models were used to measure the associations of baseline PSA, IPSS, and their velocities over 2 years with BPH risk, and time-dependent receiver-operating characteristic curves were used to measure their discriminatory performance. Unit increases in PSA, IPSS, and IPSS velocity were associated with 34%, 35%, and 29% (all P < 0.001) increases in BPH risk, respectively. The areas under the receiver-operating characteristic curves were significantly greater than 0.5 for PSA (0.58, 95% confidence interval (CI): 0.56, 0.60), IPSS (0.77, 95% CI: 0.75, 0.78), and IPSS velocity (0.63, 95% CI: 0.61, 0.65); however there were no cut points at which sensitivity and specificity were both above 75%. We concluded that moderate elevations in PSA, IPSS, or their rates of change should not be used as surrogate measures of incident BPH.

  4. A wakeup call to the prevention field: are prevention programs for substance use effective for girls?

    PubMed

    Kumpfer, Karol L; Smith, Paula; Summerhays, Julia Franklin

    2008-07-01

    Substance misuse in adolescent girls has increased dramatically since 1992. This article reviews trends in use rates and etiological theories tested by gender that suggest that family protective factors have more influence on girls. Next, a literature review reveals that few prevention programs have published their outcomes by gender or developed gender-specific programs. Nationwide community coalition results found positive effects on boys but increased drug use in young girls. The most effective programs are family focused targeting family bonding, supervision, and communication. Recent gender-specific prevention programs with positive results address stress, depression, social assertiveness, and body image. The authors recommend additional research testing programs by gender and also gender-specific versus generic versions of evidence-based programs to determine how to improve prevention program effectiveness for girls.

  5. Consensus guidelines for implementation of quality processes to prevent invasive fungal disease and enhanced surveillance measures during hospital building works, 2014.

    PubMed

    Chang, C C; Ananda-Rajah, M; Belcastro, A; McMullan, B; Reid, A; Dempsey, K; Athan, E; Cheng, A C; Slavin, M A

    2014-12-01

    Healthcare-associated fungal outbreaks impose a substantial economic burden on the health system and typically result in high patient morbidity and mortality, particularly in the immunocompromised host. As the population at risk of invasive fungal infection continues to grow due to the increased burden of cancer and related factors, the need for hospitals to employ preventative measures has become increasingly important. These guidelines outline the standard quality processes hospitals need to accommodate into everyday practice and at times of healthcare-associated outbreak, including the role of antifungal stewardship programmes and best practice environmental sampling. Specific recommendations are also provided to help guide the planning and implementation of quality processes and enhanced surveillance before, during and after high-risk activities, such as hospital building works. Areas in which information is still lacking and further research is required are also highlighted. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  6. Understanding and preventing contrast-induced acute kidney injury.

    PubMed

    Fähling, Michael; Seeliger, Erdmann; Patzak, Andreas; Persson, Pontus B

    2017-03-01

    Contrast-induced acute kidney injury (CIAKI) occurs in up to 30% of patients who receive iodinated contrast media and is generally considered to be the third most common cause of hospital-acquired AKI. Accurate assessment of the incidence of CIAKI is obscured, however, by the use of various definitions for diagnosis, the different populations studied and the prophylactic measures put in place. A deeper understanding of the mechanisms that underlie CIAKI is required to enable reliable risk assessment for individual patients, as their medical histories will determine the specific pathways by which contrast media administration might lead to kidney damage. Here, we highlight common triggers that prompt the development of CIAKI and the subsequent mechanisms that ultimately cause kidney damage. We also discuss effective protective measures, such as rapidly acting oral hydration schemes and loop diuretics, in the context of CIAKI pathophysiology. Understanding of how CIAKI arises in different patient groups could enable a marked reduction in incidence and improved outcomes. The ultimate goal is to shape CIAKI prevention strategies for individual patients.

  7. Longitudinal Association of HIV Conspiracy Beliefs with Sexual Risk Among Black Males Living with HIV

    PubMed Central

    Galvan, Frank H.; Wagner, Glenn J.; Klein, David J.

    2010-01-01

    Research is needed to identify culturally relevant factors that may contribute to sexual risk among African Americans. We investigated HIV-specific medical mistrust as one such cultural factor, often exhibited as conspiracy beliefs about HIV (e.g., “AIDS was produced in a government laboratory”), which may be indicative of general suspicion of HIV treatment and prevention messages. Over a 6-month time-period, we measured endorsement of HIV conspiracy beliefs three times and frequency of condom use monthly among 181 HIV-positive African American males. A hierarchical multivariate repeated-measures logistic random effects model indicated that greater belief in HIV conspiracies was associated with a higher likelihood of reporting unprotected intercourse across all time-points. An average of 54% of participants who endorsed conspiracies reported unprotected intercourse, versus 39% who did not endorse conspiracies. Secondary prevention interventions may need to address medical mistrust as a contributor to sexual risk among African Americans living with HIV. PMID:20734227

  8. Voice care knowledge among clinicians and people with healthy voices or dysphonia.

    PubMed

    Fletcher, Helen M; Drinnan, Michael J; Carding, Paul N

    2007-01-01

    An important clinical component in the prevention and treatment of voice disorders is voice care and hygiene. Research in voice care knowledge has mainly focussed on specific groups of professional voice users with limited reporting on the tool and evidence base used. In this study, a questionnaire to measure voice care knowledge was developed based on "best evidence." The questionnaire was validated by measuring specialist voice clinicians' agreement. Preliminary data are then presented using the voice care knowledge questionnaire with 17 subjects with nonorganic dysphonia and 17 with healthy voices. There was high (89%) agreement among the clinicians. There was a highly significant difference between the dysphonic and the healthy group scores (P = 0.00005). Furthermore, the dysphonic subjects (63% agreement) presented with less voice care knowledge than the subjects with healthy voices (72% agreement). The questionnaire provides a useful and valid tool to investigate voice care knowledge. The findings have implications for clinical intervention, voice therapy, and health prevention.

  9. School accidents to children: time to act.

    PubMed Central

    Maitra, A

    1997-01-01

    OBJECTIVE: To describe the profile of injuries sustained by children in school accidents and suggest preventive measures. DESIGN: A five month prospective study of children attending an urban accident and emergency (A&E) department. SUBJECTS: 500 children who sustained injuries in school due to a variety of activities. RESULTS: 10 and 12 year old pupils suffered most injuries in school grounds/playgrounds, on concrete, or on grass/soil surfaces due to random activities resulting in striking or being struck by objects/persons, tripping or slipping, and sports (mainly football); 65.5% of these activities were not supervised and 67.4% occurred "out of lessons"; 22% sustained fractures or dislocations, 28.2% needed follow up treatment, and 1.4% were admitted. CONCLUSIONS: Injuries to children in school are a cause for concern. Effective preventive measures should concentrate on (a) specific target areas using schemes based on individual school, and (b) establishing a credible system of monitoring of their effectiveness. Images Figure 1 Figure 2 PMID:9248914

  10. Conceptualizing the multidimensional nature of self-efficacy: assessment of situational context and level of behavioral challenge to maintain safer sex. National Institute of Mental Health Multisite HIV Prevention Trial Group.

    PubMed

    Murphy, D A; Stein, J A; Schlenger, W; Maibach, E

    2001-07-01

    A. Bandura (1991) argued that self-efficacy measurement should be specific both to the situation in which the behavior occurs and level of challenge in that situation. Measures consistent with the 2 dimensions were developed with graded challenge levels and differing gender-appropriate situations. Participants were 1,496 controls in the National Institute of Mental Health Multisite HIV Prevention Trial recruited from STD clinics and health service centers (925 women and 571 men). The authors tested 4 separate-sex confirmatory factor analysis models as follows: (a) Condom negotiation efficacy as a unitary construct across situations and gradation of difficulty; (b) situation as preeminent, which transfers across skills whatever the gradation of difficulty; (c) skill as predominant, irrespective of situation; and (d) a multidimensional design that simultaneously accounts for both situation and graded difficulty. Consistent with Bandura's theory, the multidimensional model provided the best fit for both samples.

  11. Preventing EMS workplace violence: A mixed-methods analysis of insights from assaulted medics.

    PubMed

    Maguire, Brian J; O'Neill, Barbara J; O'Meara, Peter; Browne, Matthew; Dealy, Michael T

    2018-05-31

    To describe measures that assaulted EMS personnel believe will help prevent violence against EMS personnel. This mixed- methods study includes a thematic analysis and directed content analysis of one survey question that asked the victims of workplace violence how the incident might have been prevented. Of 1778 survey respondents, 633 reported being assaulted in the previous 12 months; 203 of them believed the incident could have been prevented and 193 of them (95%) answered this question. Six themes were identified using Haddon's Matrix as a framework. The themes included: Human factors, including specialized training related to specific populations and de-escalation techniques as well as improved situational awareness; Equipment factors, such as restraint equipment and resources; and, Operational and environment factors, including advanced warning systems. Persons who could have prevented the violence were identified as police, self, other professionals, partners and dispatchers. Restraints and training were suggested as violence-prevention tools and methods CONCLUSIONS: This is the first international study from the perspective of victimized EMS personnel, to report on ways that violence could be prevented. Ambulance agencies should consider these suggestions and work with researchers to evaluate risks at the agency level and to develop, implement and test interventions to reduce the risks of violence against EMS personnel. These teams should work together to both form an evidence-base for prevention and to publish findings so that EMS medical directors, administrators and professionals around the world can learn from each experience. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Accidental falls in hospital inpatients: evaluation of sensitivity and specificity of two risk assessment tools.

    PubMed

    Lovallo, Carmela; Rolandi, Stefano; Rossetti, Anna Maria; Lusignani, Maura

    2010-03-01

    This paper is a report of a study comparing the effectiveness of two falls risk assessment tools (Conley Scale and Hendrich Risk Model) by using them simultaneously with the same sample of hospital inpatients. Different risk assessment tools are available in literature. However, neither recent critical reviews nor international guidelines on fall prevention have identified tools that can be generalized to all categories of hospitalized patients. A prospective observational study was carried out in acute medical, surgical wards and rehabilitation units. From October 2007 to January 2008, 1148 patients were assessed with both instruments, subsequently noting the occurrence of falls. The sensitivity, specificity, positive and negative predictive values, and Receiver Operating Characteristics curves were calculated. The number of patients correctly identified with the Conley Scale (n = 41) was higher than with the Hendrich Model (n = 27). The Conley Scale gave sensitivity and specificity values of 69.49% and 61% respectively. The Hendrich Model gave a sensitivity value of 45.76% and a specificity value of 71%. Positive and negative predictive values were comparable. The Conley Scale is indicated for use in the medical sector, on the strength of its high sensitivity. However, since its specificity is very low, it is deemed useful to submit individual patients giving positive results to more in-depth clinical evaluation in order to decide whether preventive measures need to be taken. In surgical sectors, the low sensitivity values given by both scales suggest that further studies are warranted.

  13. Time of elevation of head of bed for patients receiving mechanical ventilation and its related factors.

    PubMed

    Martí-Hereu, L; Arreciado Marañón, A

    The semirecumbent position is a widespread recommendation for the prevention of pneumonia associated with mechanical ventilation. To identify the time of elevation of head of bed for patients under mechanical ventilation and the factors related to such elevation in an intensive care unit. An observational, descriptive cross-sectional study. Conducted in an intensive care unit of a tertiary hospital from April to June 2015. The studied population were mechanically ventilated patients. Daily hours in which patients remained with the head of the bed elevated (≥30°), socio-demographic data and clinical variables were recorded. 261 head elevation measurements were collected. The average daily hours that patients remained at ≥30° was 16h28' (SD ±5h38'), equivalent to 68.6% (SD ±23.5%) of the day. Factors related to elevations ≥30° for longer were: enteral nutrition, levels of deep sedation, cardiac and neurocritical diagnostics. Factors that hindered the position were: sedation levels for agitation and abdominal pathologies. Sex, age and ventilation mode did not show a significant relationship with bed head elevation. Although raising the head of the bed is an easy to perform, economical and measurable preventive measure, its compliance is low due to specific factors specific related o the patient's clinical condition. Using innovations such as continuous measurement of the head position helps to evaluate clinical practice and allows to carry out improvement actions whose impact is beneficial to the patient. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Mobile Health Technology Interventions for Suicide Prevention: Protocol for a Systematic Review and Meta-Analysis.

    PubMed

    Melia, Ruth; Francis, Kady; Duggan, Jim; Bogue, John; O'Sullivan, Mary; Chambers, Derek; Young, Karen

    2018-01-26

    Previous research has reported that two of the major barriers to help-seeking for individuals at risk of suicide are stigma and geographical isolation. Mobile technology offers a potential means of delivering evidence-based interventions with greater specificity to the individual, and at the time that it is needed. Despite documented motivation by at-risk individuals to use mobile technology to track mental health and to support psychological interventions, there is a shortfall of outcomes data on the efficacy of mobile health (mHealth) technology on suicide-specific outcomes. The objective of this study is to develop a protocol for a systematic review and meta-analysis that aims to evaluate the effectiveness of mobile technology-based interventions for suicide prevention. The search includes the Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library), MEDLINE, Embase, PsycINFO, CRESP and relevant sources of gray literature. Studies that have evaluated psychological or nonpsychological interventions delivered via mobile computing and communication technology, and have suicidality as an outcome measure will be included. Two authors will independently extract data and assess the study suitability in accordance with the Cochrane Collaboration Risk of Bias Tool. Studies will be included if they measure at least one suicide outcome variable (ie, suicidal ideation, suicidal intent, nonsuicidal self-injurious behavior, suicidal behavior). Secondary outcomes will be measures of symptoms of depression. Where studies are sufficiently homogenous and reported outcomes are amenable for pooled synthesis, meta-analysis will be performed. A narrative synthesis will be conducted if the data is unsuitable for a meta-analysis. The review is in progress, with findings expected by summer 2018. To date, evaluations of mobile technology-based interventions in suicide prevention have focused on evaluating content as opposed to efficacy. Indeed, previous research has identified mobile applications that appear to present harmful content. The current review will address a gap in the literature by evaluating the efficacy of stand-alone mobile technology tools in suicide prevention. It is imperative that research identifies the evidence base for such tools in suicide prevention in order to inform policy, guide clinical practice, inform users and focus future research. PROSPERO International Prospective Register of Systematic Reviews CRD42017072899; https:// www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42017072899  (Archived by WebCite at http://www.webcitation.org/ 6tZAj0yqJ). ©Ruth Melia, Kady Francis, Jim Duggan, John Bogue, Mary O'Sullivan, Derek Chambers, Karen Young. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 26.01.2018.

  15. [The role of infection prevention in the control of antimicrobial resistance : Any avoided infection contributes to the reduction of antibiotic use].

    PubMed

    Mielke, Martin

    2018-05-01

    Clinically relevant infections are the primary indication for the use of antimicrobial agents in human medicine. Consequently, the prevention of infections is the fundament of all measures to rationally reduce the use of antibiotics. A prevented infection must not be treated. For the prevention of several community-acquired infections, vaccines are available. In addition, several infections may be prevented on the basis of knowledge and responsible behavior. However, the prevention of nosocomial infections depends mainly on the responsibility of third parties in the context of medical procedures. Effective preventive measures are described in guidelines carefully prepared by the commission for hospital hygiene and infection prevention in Germany. The consequent implementation of these guidelines contributes to patient safety and the prevention of the spread of multidrug-resistant bacteria. Highly cost-effective measures are a high degree of compliance with the rules for hand hygiene, perioperative antiseptic measures, and guidelines for the use of perioperative antimicrobial prophylaxis. The documentation of decreasing or low rates of infections and antimicrobial resistance helps to verify the success of preventive measures.

  16. Succinylacetone as Primary Marker to Detect Tyrosinemia Type I in Newborns and its Measurement by Newborn Screening Programs

    PubMed Central

    De Jesús, Víctor R.; Adam, Barbara W.; Mandel, Daniel; Cuthbert, Carla D.; Matern, Dietrich

    2015-01-01

    Tyrosinemia type I (TYR I) is caused by autosomal recessive fumarylacetoacetate hydrolase deficiency and is characterized by development of severe liver disease in infancy and neurologic crises. If left untreated, most patients die of liver failure in the first years of life. Intervention with medication is effective when initiated during the first month of life. This improvement in the treatment of TYR I patients influenced the decision to include TYR I in the US Secretary of the Department of Health and Human Services’ (HHS) Recommended Uniform Screening Panel. However, while tyrosine is routinely measured in newborn screening (NBS) by tandem mass spectrometry (MS/MS), elevated tyrosine levels are not specific to TYR I. To improve the specificity of NBS for TYR I, several assays were developed to measure succinylacetone (SUAC) in dried blood spots (DBS). SUAC is a pathognomonic marker of TYR I, and its detection by NBS MS/MS is possible. This review of the current status of NBS for TYR I in the US is the result of discussions at the HHS Secretary’s (Discretionary) Advisory Committee on Heritable Disorders in Newborns and Children about the inconsistent implementation of effective NBS for TYR I in the US. We sought to understand the different TYR I screening practices in US NBS programs. Results indicate that 50 out of 51 NBS programs in the US screen for TYR I, and a successful SUAC performance evaluation scheme is available from the Centers for Disease Control and Prevention. Programmatic and methodological barriers were identified that prevent widespread adoption of SUAC measurements in NBS laboratories. However, since SUAC detection is currently the best approach to NBS for TYR I, a further delay of the addition of SUAC measurement into NBS procedures is discouraged. SUAC measurement should improve both the false positive and false negative rate in NBS for TYR I thereby yielding the desired benefits for affected patients at no expense to the overall population served. PMID:25066104

  17. The non-specific effects of vaccines and other childhood interventions: the contribution of INDEPTH Health and Demographic Surveillance Systems

    PubMed Central

    Sankoh, Osman; Welaga, Paul; Debpuur, Cornelius; Zandoh, Charles; Gyaase, Stephney; Poma, Mary Atta; Mutua, Martin Kavao; Hanifi, SM Manzoor Ahmed; Martins, Cesario; Nebie, Eric; Kagoné, Moubassira; Emina, Jacques BO; Aaby, Peter

    2014-01-01

    Most childhood interventions (vaccines, micronutrients) in low-income countries are justified by their assumed effect on child survival. However, usually the interventions have only been studied with respect to their disease/deficiency-specific effects and not for their overall effects on morbidity and mortality. In many situations, the population-based effects have been very different from the anticipated effects; for example, the measles-preventive high-titre measles vaccine was associated with 2-fold increased female mortality; BCG reduces neonatal mortality although children do not die of tuberculosis in the neonatal period; vitamin A may be associated with increased or reduced child mortality in different situations; effects of interventions may differ for boys and girls. The reasons for these and other contrasts between expectations and observations are likely to be that the immune system learns more than specific prevention from an intervention; such training may enhance or reduce susceptibility to unrelated infections. INDEPTH member centres have been in an ideal position to document such additional non-specific effects of interventions because they follow the total population long term. It is proposed that more INDEPTH member centres extend their routine data collection platform to better measure the use and effects of childhood interventions. In a longer perspective, INDEPTH may come to play a stronger role in defining health research issues of relevance to low-income countries. PMID:24920644

  18. Discordance of Self-report and Laboratory Measures of HIV Viral Load Among Young Men Who Have Sex with Men and Transgender Women in Chicago: Implications for Epidemiology, Care, and Prevention.

    PubMed

    Mustanski, Brian; Ryan, Daniel T; Remble, Thomas A; D'Aquila, Richard T; Newcomb, Michael E; Morgan, Ethan

    2018-04-10

    Suppressing HIV viral load through daily antiretroviral therapy (ART) substantially reduces the risk of HIV transmission, however, the potential population impact of treatment as prevention (TasP) is mitigated due to challenges with sustained care engagement and ART adherence. For an undetectable viral load (VL) to inform decision making about transmission risk, individuals must be able to accurately classify their VL as detectable or undetectable. Participants were 205 HIV-infected young men who have sex with men (YMSM) and transgender women (TGW) from a large cohort study in the Chicago area. Analyses examined correspondence among self-reported undetectable VL, study-specific VL, and most recent medical record VL. Among HIV-positive YMSM/TGW, 54% had an undetectable VL (< 200 copies/mL) via study-specific laboratory testing. Concordance between self-report and medical record VL values was 80% and between self-report and study-specific laboratory testing was 73%; 34% of participants with a detectable study-specific VL self-reported an undetectable VL at last medical visit, and another 28% reported not knowing their VL status. Periods of lapsed viral suppression between medical visits may represent a particular risk for the TasP strategy among YMSM/TGW. Strategies for frequent viral load monitoring, that are not burdensome to patients, may be necessary to optimize TasP.

  19. [Prevention concerning the different alternative routes for transmission of Trypanosoma cruzi in Brazil].

    PubMed

    Dias, João Carlos Pinto; Amato Neto, Vicente

    2011-01-01

    Vectorial, transfusion and congenital are considered the main transmission mechanisms in human Chagas disease. Alternative mechanisms are accidental, oral and by organ transplantation. Other hypothetic mechanisms could be by other vectors, sexual, criminal and by means of marsupial anal secretions. The present accorded strategies for prevention are: CONGENITAL: early case detection and immediate treatment. If possible, start during the pre natal period, throughout mothers serology, performing parasitological tests in the new born from positive women. For positive cases, immediate treatment; for those negative babies, conventional serology at the 8th month, treating specifically those with positive results. ACCIDENTAL TRANSMISSION: Rigorous training and utilization of protection equipments. IF accident occurs, immediate disinfection, conventional serology and beginning of specific treatment by ten days. Revision of the serology after 30 days: if positive, extend the treatment until the total dose (60 days or more). ORGAN TRANSPLANTATION: previous serology for donor and receptor. When the former is infected and the last negative, cancel the surgery or install the specific treatment by ten days before the surgery for the donor, followed by the receptor during ten days after the transplantation. ORAL TRANSMISSION: Specific measures are not available, food hygiene is recommended, including the cooking of meats delivered from possible reservoirs. Nowadays, the detection and immediate treatment of the case is recommended, followed by active research of new cases around the detected one.

  20. A strain-, cow-, and herd-specific bio-economic simulation model of intramammary infections in dairy cattle herds.

    PubMed

    Gussmann, Maya; Kirkeby, Carsten; Græsbøll, Kaare; Farre, Michael; Halasa, Tariq

    2018-07-14

    Intramammary infections (IMI) in dairy cattle lead to economic losses for farmers, both through reduced milk production and disease control measures. We present the first strain-, cow- and herd-specific bio-economic simulation model of intramammary infections in a dairy cattle herd. The model can be used to investigate the cost-effectiveness of different prevention and control strategies against IMI. The objective of this study was to describe a transmission framework, which simulates spread of IMI causing pathogens through different transmission modes. These include the traditional contagious and environmental spread and a new opportunistic transmission mode. In addition, the within-herd transmission dynamics of IMI causing pathogens were studied. Sensitivity analysis was conducted to investigate the influence of input parameters on model predictions. The results show that the model is able to represent various within-herd levels of IMI prevalence, depending on the simulated pathogens and their parameter settings. The parameters can be adjusted to include different combinations of IMI causing pathogens at different prevalence levels, representing herd-specific situations. The model is most sensitive to varying the transmission rate parameters and the strain-specific recovery rates from IMI. It can be used for investigating both short term operational and long term strategic decisions for the prevention and control of IMI in dairy cattle herds. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Epidemiology & preventive aspects of railway suicides and fatalities related to trespassing accidents.

    PubMed

    Kumar, Sachil; Verma, Anoop K; Bhattacharya, Sandeep; Singh, Uma Shankar

    2013-11-01

    Suicide and trespass are major contributors to risk on the railway, resulting in around 170-180 fatalities per year in Lucknow region, as well as associated major disruption to the rail network. Lucknow is the capital city of the state of Uttar Pradesh in India. The analysis included train-pedestrian fatalities during 2007-2012. The data for 2007-2012 were collected from the autopsy reports of the university, case sheets from the hospital, the general prosecutor's investigations report and the inquest reports from police. The results show that the majority of victims were males. Half of the suicide victims were 20-39 years old. Accidents happened most frequently in situations when a person was walking on the tracks/in front of train (22.7%) or were crossing the tracks illegally (20.9%). Among all train-pedestrian fatalities, about half of the victims (42.8%) were intoxicated by alcohol. Female suicide victims suffered from mental health problems more frequently (55.8%) than male suicide victims. Overall, there is no reason to believe that train-pedestrian fatalities are unavoidable. By contrast, the effective prevention of railway suicides and accidents should be based on a systems approach involving effective measures introduces by several organisations such as government, railway organisations, various authorities (such as public health, education, enforcement, urban planning) and communities. Same measures can often be used to prevent both trespassing and suicides, even though their effectiveness may depend on the target group. In addition, there are measures specifically targeted to prevent either trespassing or suicides. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  2. Laboratory animals and respiratory allergies: The prevalence of allergies among laboratory animal workers and the need for prophylaxis

    PubMed Central

    Ferraz, Erica; Arruda, Luisa Karla de Paula; Bagatin, Ericson; Martinez, Edson Z; Cetlin, Andrea A; Simoneti, Christian S; Freitas, Amanda S; Martinez, José A B; Borges, Marcos C; Vianna, Elcio O

    2013-01-01

    OBJECTIVE: Subjects exposed to laboratory animals are at a heightened risk of developing respiratory and allergic diseases. These diseases can be prevented by simple measures such as the use of personal protective equipment. We report here the primary findings of the Laboratory Animals and Respiratory Allergies Study regarding the prevalence of allergic diseases among laboratory animal workers, the routine use of preventive measures in laboratories and animal facilities, and the need for prevention programs. METHODS: Animal handlers and non-animal handlers from 2 Brazilian universities (University of São Paulo and State University of Campinas) answered specific questionnaires to assess work conditions and symptoms. These subjects also underwent spirometry, a bronchial challenge test with mannitol, and skin prick tests for 11 common allergens and 5 occupational allergens (rat, mouse, guinea pig, hamster, and rabbit). RESULTS: Four hundred fifty-five animal handlers (32±10 years old [mean±SD], 209 men) and 387 non-animal handlers (33±11 years old, 121 men) were evaluated. Sensitization to occupational allergens was higher among animal handlers (16%) than non-animal handlers (3%, p<0.01). Accessibility to personal protective equipment was measured at 85% (median, considering 73 workplaces of the animal handler group). Nineteen percent of the animal handlers indicated that they wear a respirator at all times while handling animals or working in the animal room, and only 25% of the animal handlers had received an orientation about animal-induced allergies, asthma, or rhinitis. CONCLUSION: In conclusion, our data indicate that preventive programs are necessary. We suggest providing individual advice to workers associated with institutional programs to promote a safer work environment. PMID:23778494

  3. A review of the vector management methods to prevent and control outbreaks of West Nile virus infection and the challenge for Europe

    PubMed Central

    2014-01-01

    West Nile virus infection is a growing concern in Europe. Vector management is often the primary option to prevent and control outbreaks of the disease. Its implementation is, however, complex and needs to be supported by integrated multidisciplinary surveillance systems and to be organized within the framework of predefined response plans. The impact of the vector control measures depends on multiple factors and the identification of the best combination of vector control methods is therefore not always straightforward. Therefore, this contribution aims at critically reviewing the existing vector control methods to prevent and control outbreaks of West Nile virus infection and to present the challenges for Europe. Most West Nile virus vector control experiences have been recently developed in the US, where ecological conditions are different from the EU and vector control is organized under a different regulatory frame. The extrapolation of information produced in North America to Europe might be limited because of the seemingly different epidemiology in the European region. Therefore, there is an urgent need to analyse the European experiences of the prevention and control of outbreaks of West Nile virus infection and to perform robust cost-benefit analysis that can guide the implementation of the appropriate control measures. Furthermore, to be effective, vector control programs require a strong organisational backbone relying on a previously defined plan, skilled technicians and operators, appropriate equipment, and sufficient financial resources. A decision making guide scheme is proposed which may assist in the process of implementation of vector control measures tailored on specific areas and considering the available information and possible scenarios. PMID:25015004

  4. PubMed

    Junne, Florian; Rieger, Monika; Michaelis, Martina; Nikendei, Christoph; Gündel, Harald; Zipfel, Stephan; Rothermund, Eva

    2017-04-01

    Psycho-mental stressors and increased perceived stress in workplace settings may determine the onset and course of stress-related mental and psychosomatic disorders. For the description of psycho-mental stressors three distinct models have widely been used in the analyses of the matter: the Demand-Control-Model by Karasek and Theorell, the Effort-Reward-Imbalance Model by Siegrist, and the Model of Organisational Justice.The interactional or social dimension in work-place settings can be seen as a cross-sectional dimension to the above mentioned models. Here, social conflicts and mobbing, as specific forms of interactional problems, are of importance.Besides measures of primary prevention which can be derived from applying the above mentioned models, attention is paid increasingly to secondary and tertiary preventive measures in work-place settings. Concepts such as the psychosomatic consultation-hour within the context of workplace showed to be effective measures for the early detection of people at risk or early stages of e. g. stress-related psychosomatic disorders.Furthermore, step-wise reintegration of members of the work-force play an important role within the effort to retain the ability to work and the workplace of individuals who suffered from stress-related mental disorders, as it has to be stressed that working and social interactions at the workplace may well be a resource that enhances and stipulates psycho-mental well-being and mental health.This CME-Article describes the above mentioned models and discusses selected perspectives of preventive measures to avoid stress-related mental disorders in members of the work-force. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Assessing the Efficacy of Restricting Access to Barbecue Charcoal for Suicide Prevention in Taiwan: A Community-Based Intervention Trial

    PubMed Central

    Chen, Ying-Yeh; Chen, Feng; Chang, Shu-Sen; Wong, Jacky; Yip, Paul S F

    2015-01-01

    Objective Charcoal-burning suicide has recently been spreading to many Asian countries. There have also been several cases involving this new method of suicide in Western countries. Restricting access to suicide means is one of the few suicide-prevention measures that have been supported by empirical evidence. The current study aims to assess the effectiveness of a community intervention program that restricts access to charcoal to prevent suicide in Taiwan. Methods and Findings A quasi-experimental design is used to compare method-specific (charcoal-burning suicide, non-charcoal-burning suicide) and overall suicide rates in New Taipei City (the intervention site, with a population of 3.9 million) with two other cities (Taipei City and Kaohsiung City, the control sites, each with 2.7 million residents) before (Jan 1st 2009- April 30th 2012) and after (May 1st 2012-Dec. 31st 2013) the initiation of a charcoal-restriction program on May 1st 2012. The program mandates the removal of barbecue charcoal from open shelves to locked storage in major retail stores in New Taipei City. No such restriction measure was implemented in the two control sites. Generalized linear regression models incorporating secular trends were used to compare the changes in method-specific and overall suicide rates before and after the initiation of the restriction measure. A simulation approach was used to estimate the number of lives saved by the intervention. Compared with the pre-intervention period, the estimated rate reduction of charcoal-burning suicide in New Taipei City was 37% (95% CI: 17%, 50%) after the intervention. Taking secular trends into account, the reduction was 30% (95% CI: 14%, 44%). No compensatory rise in non-charcoal-burning suicide was observed in New Taipei City. No significant reduction in charcoal-burning suicide was observed in the other two control sites. The simulation approach estimated that 91 (95%CI [55, 128]) lives in New Taipei City were saved during the 20 months of the intervention. Conclusion Our results demonstrate that the charcoal-restriction program reduced method-specific and overall suicides. This study provides strong empirical evidence that restricting the accessibility of common lethal methods of suicide can effectively reduce suicide rates. PMID:26305374

  6. The genesis of the AIDS policy and AIDS Space in Brazil (1981-1989)

    PubMed Central

    de Barros, Sandra Garrido; Vieira-da-Silva, Ligia Maria

    2016-01-01

    ABSTRACT OBJECTIVE To analyze the genesis of the policy for controlling AIDS in Brazil. METHODS Socio-historical study (1981-1989), based on Bordieu’s genetic sociology, by document analysis, bibliographical review, and in-depth interviews. It consisted of a connection between the analysis of the paths of 33 agents involved in the creation of a social space focusing on AIDS-related issues and the historical possibility conditions of the drafting of a specific policy. RESULTS AIDS Space is a gathering point for the paths of agents from several social fields (medical, scientific, political, and bureaucratic fields). A specific space for relationships, which enabled the drafting of a policy for controlling the AIDS epidemic, but also a place where the authority to talk about the meaning of the disease, the methods to prevent and treat it was under dispute. The analysis showed how the various structures (democratic administrations in Sao Paulo and at the national level, with public health officers taking important positions) and the lack of a specific therapy contributed to social agents of different ranks and backgrounds to initially set prevention as a priority. CONCLUSIONS The rise of the sanitary movement, the organization of SUS, and the dominance of the medical field at the AIDS Space contributed to foster treatment as a part of the measures to control the epidemic. These conditions allowed drafting a policy based on the integrality of care, by linking prevention and treatment in the following decade, with important participation from state bureaucracy and researchers. PMID:27463255

  7. Mobile Application Removes Societal Barriers to P4 Medicine.

    PubMed

    Michel, J-P

    2017-01-01

    The overlap between one innovative paradigm (P4 medicine: predictive, personalized, participatory and preventive) and another (a new definition of "Healthy ageing") is fertile ground for new technologies; a new mobile application (app) that could broaden our scientific knowledge of the ageing process and help us to better analyse the impact of possible interventions in slowing the ageing decline. A novel mobile application is here presented as a game including questions and tests will allow in 10 minutes the assessment of the following domains: robustness, flexibility (lower muscle strength), balance, mental and memory complaints, semantic memory and visual retention. This game is completed by specific measurements, which could allow establishing precise information on functional and cognitive abilities. A global evaluation precedes advice and different types of exercises. The repetition of the tests and measures will allow a long follow up of the individual performances which could be shared (on specific request) with family members and general practitioners.

  8. Juvenile Psychopathic Personality Traits are Associated with Poor Reading Achievement

    PubMed Central

    DeLisi, Matt; Beaver, Kevin M.; Wexler, Jade; Barth, Amy; Fletcher, Jack

    2011-01-01

    The current study sought to further the understanding of the linkage between maladaptive behavior and cognitive problems by examining the relations between psychopathic personality traits and reading comprehension performance. Data were derived from a study of 432 predominately African-American and Hispanic middle-school students. Dependent variables consisted of three measures of reading comprehension. Psychopathy measures included the Inventory of Callous-Unemotional traits (ICU—teacher rated) and the self-reported Youth Psychopathic traits Inventory (YPI). Findings from regression models indicated that self-report and teacher ratings of psychopathy were statistically significant inverse predictors of reading performance. Specifically, affective facets of psychopathy were potent predictors of reading comprehension over and above ADHD, IQ, and an impulsivity component of psychopathy. Study results extend the utility of psychopathy construct generally and affective traits specifically to reading achievement, which has broad implications. Findings are discussed with respect to future research and prevention. PMID:20957434

  9. Preventive and social cost implications of Ebola Virus Disease (EVD) outbreak on selected organizations in Lagos state, Nigeria

    PubMed Central

    Olugasa, Babasola Oluseyi; Oshinowo, Oluwafunmilola Yemisi; Odigie, Eugene Amienwanlen

    2015-01-01

    Introduction As Ebola virus disease (EVD) continues to pose public health challenge in West Africa, with attending fears and socio-economic implications in the current epidemic challenges. It is compelling to estimate the social and preventive costs of EVD containment in a Nigerian city. Hence, this study was to determine the social and preventive cost implications of EVD among selected public institutions in Lagos, Nigeria, from July to December, 2014. Methods Questionnaires and key-informants interview were administered to respondents and administrators of selected hospitals, hotels and schools in Eti-Osa Local Government Area of Lagos State. Knowledge of disease transmission, mortality and protocols for prevention, including cost of specific preventive measures adopted against EVD were elicited from respondents. Descriptive statistics and categorical analysis were used to summarize and estimate social and preventive costs incurred by respective institutions. Results An estimated five million, nineteen thousand, three hundred and seventy-nine Naira and eighty kobo (N5,019,379.80) only was observed as direct and social cost implication of EVD prevention. This amount translated into a conservative estimate of one billion, twenty-seven million, ninety-four thousand, seven hundred and fifty-six Naira (N1,027,094,756.10) for a total of four thousand schools, two hundred and fifty-three hospitals and one thousand, four hundred and fifty one hotels in Lagos during the period (July 20-November 20, 2014). Conclusion The high cost of prevention of EVD within the short time-frame indicated high importance attached to a preventive policy against highly pathogenic zoonotic disease in Nigeria. PMID:26740848

  10. Systemic Review of Dry Socket: Aetiology, Treatment, and Prevention

    PubMed Central

    Saleh, Lubna Ahmed; Umair, Ayesha; Azzeghaiby, Saleh Nasser; Hanouneh, Salah

    2015-01-01

    Our systemic review is to make a comprehensive review about the aetiology, treatment and the prevention of dry socket, the inclusion criteria were all the studies that discuss the dry socket and its etiology, treatment and prevention and exclusion criteria were all the studies that discuss the other complications of tooth extraction, the materials and methods used for this systemic review was to search in the Pub Medline database between 2008 to 2013, using specific words “dry socket, aetiology, treatment and prevention” and published in the English language, the articles were screened by abstract for relevance to aetiology, treatment and prevention of dry socket, 82 papers were identified in pub med but a total of 36 out of Publications were included in the final systemic review according to the specific keywords and materials mentioned above. The occurrence of dry socket in an everyday oral surgery or dental practice is unavoidable. The risk factors are smoking, surgical trauma, single extractions, age, sex, medical history, systemic disorder, extraction site, amount of anaesthesia, operator experience, antibiotics use prior to surgery, difficulty of the surgery and the previous surgical site infection in addition to oral Contraceptives, menstrual cycle and immediate postextraction socket irrigation with normal saline. The traditional options of treatment are directed toward palliative care, such as the irrigation of the surgical site, avoiding curetting the extraction socket, Packing with a zinc oxide– eugenol paste on iodoform gauze can be considered to relieve acute pain episodes, there is also new agents in the market can accelerate the healing of the socket such as PRGF and GECB. The prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, the other preventive measures such as chlorhecidine rinse or gel can be effective in the reduction of dry socket incidence. PMID:26023661

  11. Air travellers' awareness of the preventability of otic barotrauma.

    PubMed

    Mitchell-Innes, A; Young, E; Vasiljevic, A; Rashid, M

    2014-06-01

    Otic barotrauma is common among air travellers and can cause severe otalgia, perforation of the tympanic membrane and hearing loss. Many prevention measures exist, with varying evidence to support their use. There are no data to establish if air travellers are aware of them or indeed use them. We aimed to establish air travellers' knowledge of such prevention measures. We surveyed air travellers at two UK airports by means of a questionnaire. Answers to the questionnaire were collected over a two-week period. Overall, 179 air travellers with a mean age of 28 years (range: 15-72 years) completed the questionnaire. There were 66 female and 113 male air travellers. The majority (84 per cent) complained of symptoms while flying and 30 per cent were not aware of any prevention measures. Barotrauma-related symptoms were reported in 25 per cent of air travellers who were unaware of any prevention measures. Nearly all air travellers (86 per cent) indicated that more information regarding prevention measures would be useful. Air travellers are often not aware of prevention measures to avoid otic barotrauma, and the majority suffer as a result. Increasing public awareness of simple prevention measures would have a significant impact on air travellers.

  12. Preventive actions taken by workers after workers' health surveillance: a controlled trial.

    PubMed

    Boschman, J S; Van der Molen, H F; Frings-Dresen, M H W; Sluiter, J K

    2013-12-01

    To evaluate construction workers' preventive actions and occupational physician's (OPs) recommendations after a job-specific workers' health surveillance (WHS) compared with the currently used generic WHS. After the WHS, the OPs' written recommendations were captured. At the 3-month follow-up, the workers were asked about the preventive actions they had undertaken. A generalized linear mixed model was used to compare proportions of workers. At follow-up, the proportion of workers who reported taking preventive actions was significantly higher in the intervention group (80%, 44/55) than in the control group (67%, 80 of 121), (P = 0.04). In the intervention group, the OPs provided a higher proportion of workers with written recommendations (82%, 63 of 77, vs 57%, 69 of 121; P = 0.03). The job-specific WHS aided OPs in providing workers with recommendations and workers in undertaking (job-specific) preventive actions.

  13. [Status of measures against angiography room infection as determined by questionnaire].

    PubMed

    Tsukamoto, Atsuko; Ito, Makiko; Takahashi, Kanji; Watanabe, Emi; Kikuchi, Tatsuya; Tajima, Osamu; Masuda, Kazuhiro; Wakamatsu, Osamu; Sato, Tsugio; Nakazawa, Yasuo

    2006-11-20

    Although the cleanliness of the angiography room and that of the operating room have long been equally attended to, the concept of Standard Precautions (including the basic measures and procedures to prevent infection) of the Centers for Disease Control and Prevention (CDC), 1996, as well as the introduction of transmission-based precautions, have been changing to preventive measures that are based on concrete measures. Therefore, a questionnaire was introduced in order to determine the actual status of countermeasures against infection used in the angiography room. The questionnaire was sent to 530 institutions, and 286 responded, a response rate of 54.0%. Its results significantly revealed the following: 1) unexpectedly low recognition of the need and importance for the CDC preventive measures against infection, 2) a considerable number of institutions continuing to perform the conventional preventive measures, 3) problems with education systems on preventive measures, and 4) handwashing, the most important measure against infection, failing to be adequately carried out noticeably among radiological technologists.

  14. The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial.

    PubMed

    Overbeek, Mathilde M; de Schipper, J Clasien; Lamers-Winkelman, Francien; Schuengel, Carlo

    2012-02-06

    Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors. This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140) are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health) care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program starts (T1), and one week (T2) and six months (T3) after finishing the program. Both intention-to-treat and completer analyses will be done. Adverse outcomes after witnessing interparental violence are highly diverse and may be explained by multiple risk factors. An important question for prevention programs is therefore to what extent a specific focus on potential psychotrauma is useful. This trial may point to several directions for optimizing public health response to children's exposure to interparental violence.

  15. Nurses critical to quality, safety, and now financial performance.

    PubMed

    Kohlbrenner, Janis; Whitelaw, George; Cannaday, Denise

    2011-03-01

    Preventable hospital errors are the accepted impetus to the establishment of quality measures and served as a catalyst for the ongoing evolution of healthcare reform. Nurses are crucial members of the hospital quality team, and their actions are integral to the hospital's quality performance. The authors explore some of the practical challenges created by quality performance standards, specifically around venous thromboembolism, and the contribution nurses can make, to patient safety, quality of care, and the institutions financial performance.

  16. Barefoot running: does it prevent injuries?

    PubMed

    Murphy, Kelly; Curry, Emily J; Matzkin, Elizabeth G

    2013-11-01

    Endurance running has evolved over the course of millions of years and it is now one of the most popular sports today. However, the risk of stress injury in distance runners is high because of the repetitive ground impact forces exerted. These injuries are not only detrimental to the runner, but also place a burden on the medical community. Preventative measures are essential to decrease the risk of injury within the sport. Common running injuries include patellofemoral pain syndrome, tibial stress fractures, plantar fasciitis, and Achilles tendonitis. Barefoot running, as opposed to shod running (with shoes), has recently received significant attention in both the media and the market place for the potential to promote the healing process, increase performance, and decrease injury rates. However, there is controversy over the use of barefoot running to decrease the overall risk of injury secondary to individual differences in lower extremity alignment, gait patterns, and running biomechanics. While barefoot running may benefit certain types of individuals, differences in running stance and individual biomechanics may actually increase injury risk when transitioning to barefoot running. The purpose of this article is to review the currently available clinical evidence on barefoot running and its effectiveness for preventing injury in the runner. Based on a review of current literature, barefoot running is not a substantiated preventative running measure to reduce injury rates in runners. However, barefoot running utility should be assessed on an athlete-specific basis to determine whether barefoot running will be beneficial.

  17. Acute injuries in soccer, ice hockey, volleyball, basketball, judo, and karate: analysis of national registry data.

    PubMed Central

    Kujala, U. M.; Taimela, S.; Antti-Poika, I.; Orava, S.; Tuominen, R.; Myllynen, P.

    1995-01-01

    OBJECTIVE--To determine the acute injury profile in each of six sports and compare the injury rates between the sports. DESIGN--Analysis of national sports injury insurance registry data. SETTING--Finland during 1987-91. SUBJECTS--621,691 person years of exposure among participants in soccer, ice hockey, volleyball, basketball, judo, or karate. MAIN OUTCOME MEASURES--Acute sports injuries requiring medical treatment and reported to the insurance company on structured forms by the patients and their doctors. RESULTS--54,186 sports injuries were recorded. Injury rates were low in athletes aged under 15, while 20-24 year olds had the highest rates. Differences in injury rates between the sports were minor in this adult age group. Overall injury rates were higher in sports entailing more frequent and powerful body contact. Each sport had a specific injury profile. Fractures and dental injuries were most common in ice hockey and karate and least frequent in volleyball. Knee injuries were the most common cause of permanent disability. CONCLUSIONS--Based on the defined injury profiles in the different sports it is recommended that sports specific preventive measures should be employed to decrease the number of violent contacts between athletes, including improved game rules supported by careful refereeing. To prevent dental injuries the wearing of mouth guards should be encouraged, especially in ice hockey, karate, and basketball. PMID:8520333

  18. AIDS Community Demonstration Projects for HIV prevention among hard-to-reach groups.

    PubMed Central

    O'Reilly, K R; Higgins, D L

    1991-01-01

    The AIDS Community Demonstration Projects are multicenter prevention projects directing community-based interventions to members of hard-to-reach groups at risk of infection from human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). The projects are supported by the Centers for Disease Control (CDC). Interventions are derived from theories of behavior change and have as their goal reducing HIV and other sexually transmitted diseases in the communities. The current objectives, intentionally narrow to improve the project's specificity and clarity, are to increase the use of condoms in sexual activity and the use of bleach to clean injecting drug equipment. Additional objectives may be added. The impact of the interventions is seen in increases in the use of HIV counseling and testing services, decreases in all or specific sexual and drug-use risk behaviors, and requests for related social and public health services. A quasi-experimental research design is being used to evaluate the projects. Multiple evaluation measures are used, including a street-based interview with randomly identified respondents in both intervention and control communities. Success in facilitating HIV and AIDS risk reduction is being measured using a model of behavior change describing stages of change. Upon successful completion of these projects in 1994, CDC may be able to offer models of effective, feasible, and easy-to-monitor State and local health departments and community-based organizations. PMID:1659721

  19. Non-Specific Microbicide Product Development: Then and Now

    PubMed Central

    Romano, Joseph W.; Robbiani, Melissa; Doncel, Gustavo F.; Moench, Thomas

    2015-01-01

    Despite the identification of HIV-1 as the etiological agent responsible for AIDS nearly 30 years ago, a sterilizing vaccine capable of preventing transmission of the virus remains elusive. In response to struggles on the vaccine development front, significant effort has been devoted to preventing the transmission of HIV with alternative products, technologies, and strategies. One of the early alternative HIV prevention strategies was microbicides, which are topical products that can be used to prevent sexual transmission of HIV either vaginally or rectally. First generation microbicide products were designed to be simple gel formulations comprised of readily available active agents that were inexpensive and broadly active (i.e., non-specific). Unfortunately, despite the clinical investigation of multiple product concepts satisfying these requirements, none were shown to be efficacious in pivotal trials. More recently, microbicide and oral prevention strategies involving highly specific and potent anti-retroviral (ARV) drugs have shown to be efficacious in trials. Although building on these successes continues, these products have a number of issues including potential toxicity with long term use, selection of HIV resistance, and cost. Further, all of the original justifications for non-specific microbicide products remain valid. This review provides a brief history of non-specific microbicide development, outlines the evolution to, and limitations of, ARV based microbicides, and summarizes the current activity on non-specific microbicide product development. PMID:22264041

  20. Occupational Health Management in the Lead Industry: The Korean Experience

    PubMed Central

    2011-01-01

    In 1967, the problem of occupational lead exposure came to public attention in Korea. Since then, regular progress has been made in lowering workplace lead exposures, instituting new workplace controls, and implementing health examinations of exposed workers. Past serious lead poisoning episodes made it possible to introduce biological monitoring programs on a voluntary basis in high-lead-exposure facilities in Korea. Industry-specific occupational health services for lead workers in Korea during the last 22 years can be categorized into three phases. During the first phase (1988-1993), efforts were directed at increasing awareness among workers about the hazards of lead exposure, biological monitoring of blood zinc protoporphyrin began, and a respiratory protection program was introduced. During the second phase (1994-1997), a computerized health management system for lead workers was developed, blood-lead measurement was added to biologic monitoring, and engineering controls were introduced in the workplace to lower air-lead levels to comply with air-lead regulations. Finally, during the third phase (1998-present), a new biomarker, bone-lead measurement by X-ray fluorescence, was introduced. Bone-lead measurement proved to be useful for assessing body burden and to demonstrate past lead exposure in retired workers. Occupational health service practice for lead workers, including the industry-specific group occupational health system, has brought considerable success in the prevention of lead poisoning and in reducing the lead burden in Korean lead workers during the last several decades. The successful achievement of prevention of lead poisoning in Korea was a result of the combined efforts of lead workers, employers, relevant government agencies, and academic institutes. PMID:22953192

  1. The SOBANE strategy for the management of risk, as applied to whole-body or hand-arm vibration.

    PubMed

    Malchaire, J; Piette, A

    2006-06-01

    The objective was to develop a coherent set of methods to be used effectively in industry to prevent and manage the risks associated with exposure to vibration, by coordinating the progressive intervention of the workers, their management, the occupational health and safety (OHS) professionals and the experts. The methods were developed separately for the exposure to whole-body and hand-arm vibration. The SOBANE strategy of risk prevention includes four levels of intervention: level 1, Screening; level 2, Observation; level 3, Analysis and; level 4, Expertise. The methods making it possible to apply this strategy were developed for 14 types of risk factors. The article presents the methods specific to the prevention of the risks associated with the exposure to vibration. The strategy is similar to those published for the risks associated with exposure to noise, heat and musculoskeletal disorders. It explicitly recognizes the qualifications of the workers and their management with regard to the work situation and shares the principle that measuring the exposure of the workers is not necessarily the first step in order to improve these situations. It attempts to optimize the recourse to the competences of the OHS professionals and the experts, in order to come more rapidly, effectively and economically to practical control measures.

  2. Establishing survey validity and reliability for American Indians through "think aloud" and test-retest methods.

    PubMed

    Hauge, Cindy Horst; Jacobs-Knight, Jacque; Jensen, Jamie L; Burgess, Katherine M; Puumala, Susan E; Wilton, Georgiana; Hanson, Jessica D

    2015-06-01

    The purpose of this study was to use a mixed-methods approach to determine the validity and reliability of measurements used within an alcohol-exposed pregnancy prevention program for American Indian women. To develop validity, content experts provided input into the survey measures, and a "think aloud" methodology was conducted with 23 American Indian women. After revising the measurements based on this input, a test-retest was conducted with 79 American Indian women who were randomized to complete either the original measurements or the new, modified measurements. The test-retest revealed that some of the questions performed better for the modified version, whereas others appeared to be more reliable for the original version. The mixed-methods approach was a useful methodology for gathering feedback on survey measurements from American Indian participants and in indicating specific survey questions that needed to be modified for this population. © The Author(s) 2015.

  3. Measuring Physical Activity in Outdoor Community Recreational Environments: Implications for Research, Policy, and Practice.

    PubMed

    Aytur, Semra A; Jones, Sydney A; Stransky, Michelle; Evenson, Kelly R

    2015-01-01

    Chronic diseases such as cardiovascular disease (CVD) are major contributors to escalating health care costs in the USA. Physical activity is an important protective factor against CVD, and the National Prevention Strategy recognizes active living (defined as a way of life that integrates physical activity into everyday routines) as a priority for improving the nation's health. This paper focuses on developing more inclusive measures of physical activity in outdoor community recreational environments, specifically parks and trails, to enhance their usability for at-risk populations such as persons with mobility limitations. We develop an integrated conceptual framework for measuring physical activity in outdoor community recreational environments, describe examples of evidence-based tools for measuring physical activity in these settings, and discuss strategies to improve measurement of physical activity for persons with mobility limitations. Addressing these measurement issues is critically important to making progress towards national CVD goals pertaining to active community environments.

  4. Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review

    PubMed Central

    Traversini, Veronica; Rinaldo, Francesca; Colasanti, Valerio; Buomprisco, Giuseppe; Perri, Roberto; Mormone, Federica; La Torre, Giuseppe; Guerra, Fabrizio

    2018-01-01

    Introduction Dental practitioners are exposed to different occupational hazards during the course of their professional activity, such as physical, chemical, biological, ergonomic factors. The ergonomic hazards, caused by strained posture and prolonged repetitive movements, can induce musculoskeletal disorders. It occurs in 54–93% of dental professionals and involve the spine, shoulder and hand-wrist tract. Through a systematic review of international literature, we analyzed specific ergonomic risk factors and preventive measures of musculoskeletal disorders in professional dental activity. Methods This systematic review is coherent with the PRISMA statement. The scientific research on the major online databases was based on the following keywords: dentist, prevention, ergonomic, dentistry, musculoskeletal, neck pain, posture, ergonomics, work and occupational. The studies included in this review focus on disorders related to ergonomics and on the most effective preventive measures to be adopted. No restrictions were applied for language or publication type. We excluded reports not related to ergonomic prevention in dentistry, reports of minor academic significance, editorial articles, individual contributions, and studies published in scientific conferences. Results Online research indicated 4188 references: PubMed (2919), Scopus (1257) e Cochrane Library (12). We excluded 3012 of these, because they were unrelated to ergonomics theme and 187 due to duplication. From the remaining 989 studies, 960 papers did not meet inclusion criteria and they were excluded. Therefore, we analyzed 29 articles, including 16 narrative reviews and 13 original article. The main risk factor for the development of musculoskeletal disorders found in our analysis is static posture adopted during work, highlighted in 87.5% of reviews and 84% of original articles. With regard to preventive measures, 75% of the reviews highlighted the importance of stretching after each working session and at the end of the working day, while 61.5% of the original articles emphasized the use of modern and ergonomic instruments. Discussion This review showed that static postures are strongly responsible in the etiology of musculoskeletal disorders. The awkward postures more frequently identified among dental professionals are: extreme forward-head and neck flexion; trunk inclination and rotation towards one side; lifting one or both shoulders; increased curvature of the thoracic vertebral column; incorrect positioning of the lower limbs with thigh-leg angle of less than 90°. It is really important to use of a modern workstation with appropriate ergonomic supports. Among the preventive ergonomic measures, literature has widely recognized the role of physical activity and of a neutral and balanced posture. The present review has some limits: a large part of the selected studies did not have a high methodological quality score and an inadequate statistical analysis. PMID:29362689

  5. Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review.

    PubMed

    De Sio, Simone; Traversini, Veronica; Rinaldo, Francesca; Colasanti, Valerio; Buomprisco, Giuseppe; Perri, Roberto; Mormone, Federica; La Torre, Giuseppe; Guerra, Fabrizio

    2018-01-01

    Dental practitioners are exposed to different occupational hazards during the course of their professional activity, such as physical, chemical, biological, ergonomic factors. The ergonomic hazards, caused by strained posture and prolonged repetitive movements, can induce musculoskeletal disorders. It occurs in 54-93% of dental professionals and involve the spine, shoulder and hand-wrist tract. Through a systematic review of international literature, we analyzed specific ergonomic risk factors and preventive measures of musculoskeletal disorders in professional dental activity. This systematic review is coherent with the PRISMA statement. The scientific research on the major online databases was based on the following keywords: dentist, prevention, ergonomic, dentistry, musculoskeletal, neck pain, posture, ergonomics, work and occupational. The studies included in this review focus on disorders related to ergonomics and on the most effective preventive measures to be adopted. No restrictions were applied for language or publication type. We excluded reports not related to ergonomic prevention in dentistry, reports of minor academic significance, editorial articles, individual contributions, and studies published in scientific conferences. Online research indicated 4188 references: PubMed (2919), Scopus (1257) e Cochrane Library (12). We excluded 3012 of these, because they were unrelated to ergonomics theme and 187 due to duplication. From the remaining 989 studies, 960 papers did not meet inclusion criteria and they were excluded. Therefore, we analyzed 29 articles, including 16 narrative reviews and 13 original article. The main risk factor for the development of musculoskeletal disorders found in our analysis is static posture adopted during work, highlighted in 87.5% of reviews and 84% of original articles. With regard to preventive measures, 75% of the reviews highlighted the importance of stretching after each working session and at the end of the working day, while 61.5% of the original articles emphasized the use of modern and ergonomic instruments. This review showed that static postures are strongly responsible in the etiology of musculoskeletal disorders. The awkward postures more frequently identified among dental professionals are: extreme forward-head and neck flexion; trunk inclination and rotation towards one side; lifting one or both shoulders; increased curvature of the thoracic vertebral column; incorrect positioning of the lower limbs with thigh-leg angle of less than 90°. It is really important to use of a modern workstation with appropriate ergonomic supports. Among the preventive ergonomic measures, literature has widely recognized the role of physical activity and of a neutral and balanced posture. The present review has some limits: a large part of the selected studies did not have a high methodological quality score and an inadequate statistical analysis.

  6. The Importance of Socio-Economic Versus Environmental Risk Factors for Reported Dengue Cases in Java, Indonesia

    PubMed Central

    Chase-Topping, Margo; Rainey, Stephanie M.; McFarlane, Melanie; Schnettler, Esther; Biek, Roman; Kohl, Alain

    2016-01-01

    Background Dengue is a major mosquito-borne viral disease and an important public health problem. Identifying which factors are important determinants in the risk of dengue infection is critical in supporting and guiding preventive measures. In South-East Asia, half of all reported fatal infections are recorded in Indonesia, yet little is known about the epidemiology of dengue in this country. Methodology/Principal findings Hospital-reported dengue cases in Banyumas regency, Central Java were examined to build Bayesian spatial and spatio-temporal models assessing the influence of climatic, demographic and socio-economic factors on the risk of dengue infection. A socio-economic factor linking employment type and economic status was the most influential on the risk of dengue infection in the Regency. Other factors such as access to healthcare facilities and night-time temperature were also found to be associated with higher risk of reported dengue infection but had limited explanatory power. Conclusions/Significance Our data suggest that dengue infections are triggered by indoor transmission events linked to socio-economic factors (employment type, economic status). Preventive measures in this area should therefore target also specific environments such as schools and work areas to attempt and reduce dengue burden in this community. Although our analysis did not account for factors such as variations in immunity which need further investigation, this study can advise preventive measures in areas with similar patterns of reported dengue cases and environment. PMID:27603137

  7. An airport occupational health and safety management system from the OHSAS 18001 perspective.

    PubMed

    Dejanović, Dejana; Heleta, Milenko

    2016-09-01

    Occupational health and safety represents a set of technical, medical, legal, psychological, pedagogical and other measures with the aim to detect and eliminate hazards that threaten the lives and health of employees. These measures should be applied in a systematic way. Therefore, the aim of this study is to review occupational health and safety legislation in Serbia and the requirements that airports should fulfill for Occupational Health and Safety Assessment Series certification. Analyzing the specificity of airport activities and injuries as their outcomes, the article also proposes preventive measures for the health and safety of employees. Furthermore, the airport activities which are the most important from the standpoint of risks are defined, as the goals for occupational health and safety performance improvement.

  8. Sensitivity and specificity of a brief personality screening instrument in predicting future substance use, emotional, and behavioral problems: 18-month predictive validity of the Substance Use Risk Profile Scale.

    PubMed

    Castellanos-Ryan, Natalie; O'Leary-Barrett, Maeve; Sully, Laura; Conrod, Patricia

    2013-01-01

    This study assessed the validity, sensitivity, and specificity of the Substance Use Risk Profile Scale (SURPS), a measure of personality risk factors for substance use and other behavioral problems in adolescence. The concurrent and predictive validity of the SURPS was tested in a sample of 1,162 adolescents (mean age: 13.7 years) using linear and logistic regressions, while its sensitivity and specificity were examined using the receiver operating characteristics curve analyses. Concurrent and predictive validity tests showed that all 4 brief scales-hopelessness (H), anxiety sensitivity (AS), impulsivity (IMP), and sensation seeking (SS)-were related, in theoretically expected ways, to measures of substance use and other behavioral and emotional problems. Results also showed that when using the 4 SURPS subscales to identify adolescents "at risk," one can identify a high number of those who developed problems (high sensitivity scores ranging from 72 to 91%). And, as predicted, because each scale is related to specific substance and mental health problems, good specificity was obtained when using the individual personality subscales (e.g., most adolescents identified at high risk by the IMP scale developed conduct or drug use problems within the next 18 months [a high specificity score of 70 to 80%]). The SURPS is a valuable tool for identifying adolescents at high risk for substance misuse and other emotional and behavioral problems. Implications of findings for the use of this measure in future research and prevention interventions are discussed. Copyright © 2012 by the Research Society on Alcoholism.

  9. Sexual Health Behavior Interventions for U.S. Latino Adolescents: A Systematic Review of the Literature

    PubMed Central

    Cardoza, Vicky J.; Documét, Patricia I.; Fryer, Craig S.; Gold, Melanie A.; Butler, James

    2012-01-01

    Study Objective To identify sexual health behavior interventions targeting U.S. Latino adolescents. Design A systematic literature review. Setting Peer-reviewed articles published between 1993 and 2011, conducted in any type of setting. Participants Male and female Latino adolescents ages 11–21 years. Interventions Interventions promoting sexual abstinence, pregnancy prevention, sexually transmitted infection (STI) prevention, and/or HIV/AIDS prevention. Main Outcome Measures Changes in knowledge, attitudes, engagement in risky sexual behaviors, rates of STIs, and/or pregnancy. Results Sixty-eight articles were identified. Fifteen were included in this review that specifically addressed Latino adolescent sexual health behavior. Among the reviewed interventions, most aimed to prevent or reduce STI and HIV/AIDS incidence by focusing on behavior change at two levels of the social ecological model: individual and interpersonal. Major strengths of the articles included addressing the most critical issues of sexual health; using social ecological approaches; employing different strategies to deliver sexual health messages; and employing different intervention designs in diverse geographical locations with the largest population of Latino communities. Most of the interventions targeted female adolescents, stressing the need for additional interventions that target Latino adolescent males. Conclusions Latino adolescent sexual health is a new research field with gaps that need to be addressed in reducing negative sexual health outcomes among this population. More research is needed to produce new or validate existing, age-specific, and culturally-sensitive sexual health interventions for Latino male and female adolescents. Further, this research should also be conducted in areas of the U.S. with the newest Latino migration (e.g., North Carolina). PMID:22206687

  10. A Preliminary Study of a Spanish Graphic Novella Targeting Hearing Loss Prevention.

    PubMed

    Guiberson, Mark; Wakefield, Emily

    2017-09-18

    This preliminary study developed a digital graphic novella targeting hearing protection beliefs of Spanish-speaking agricultural workers. Researchers used pretest-posttest interview surveys to establish if the novella had an immediate influence on the participants' beliefs about noise-induced hearing loss and usage of hearing protection devices. Researchers developed a digital graphic novella directed to increase knowledge about noise-induced hearing loss and increase the proper use of hearing protection devices. The novella was tailored to meet the specific linguistic and literacy needs of Spanish-speaking agricultural workers. Thirty-one Spanish-speaking farmworkers of Mexican nationality participated. This study included an interview survey with specific questions on noise-induced hearing loss, myths, and hearing protection device usage. A pretest-posttest design was applied to measure the graphic novella's immediate influence on workers. The posttest scores on Hearing Protection Beliefs statements were significantly better than pretest scores, with a large effect size observed. Digital media may be an effective way to overcome language and literacy barriers with Spanish-speaking workers when providing health education and prevention efforts.

  11. A Preliminary Study of a Spanish Graphic Novella Targeting Hearing Loss Prevention

    PubMed Central

    Wakefield, Emily

    2017-01-01

    Purpose This preliminary study developed a digital graphic novella targeting hearing protection beliefs of Spanish-speaking agricultural workers. Researchers used pretest–posttest interview surveys to establish if the novella had an immediate influence on the participants' beliefs about noise-induced hearing loss and usage of hearing protection devices. Method Researchers developed a digital graphic novella directed to increase knowledge about noise-induced hearing loss and increase the proper use of hearing protection devices. The novella was tailored to meet the specific linguistic and literacy needs of Spanish-speaking agricultural workers. Thirty-one Spanish-speaking farmworkers of Mexican nationality participated. This study included an interview survey with specific questions on noise-induced hearing loss, myths, and hearing protection device usage. A pretest–posttest design was applied to measure the graphic novella's immediate influence on workers. Results The posttest scores on Hearing Protection Beliefs statements were significantly better than pretest scores, with a large effect size observed. Conclusion Digital media may be an effective way to overcome language and literacy barriers with Spanish-speaking workers when providing health education and prevention efforts. PMID:28651254

  12. Quantifying the indirect effects of key child survival interventions for pneumonia, diarrhoea, and measles.

    PubMed

    Fischer Walker, C L; Munos, M K; Black, R E

    2013-01-01

    To date many studies have measured the effect of key child survival interventions on the main cause of mortality while anecdotally reporting effects on all-cause mortality. We conducted a systematic literature review and abstracted cause-specific and all-cause mortality data from included studies. We then estimated the effect of the intervention on the disease of primary interest and calculated the additional deaths prevented (i.e. the indirect effect). We calculated that insecticide-treated nets have been shown to result in a 12% reduction [95% confidence interval (CI) 0·0-23] among non-malaria deaths. We found pneumonia case management to reduce non-pneumonia mortality by 20% (95% CI 8-22). For measles vaccine, seven of the 10 studies reporting an effect on all-cause mortality demonstrated an additional benefit of vaccine on all-cause mortality. These interventions may have benefits on causes of death beyond the specific cause of death they are targeted to prevent and this should be considered when evaluating the effects of implementation of interventions.

  13. Evaluation of the 113Online Suicide Prevention Crisis Chat Service: Outcomes, Helper Behaviors and Comparison to Telephone Hotlines.

    PubMed

    Mokkenstorm, Jan K; Eikelenboom, Merijn; Huisman, Annemiek; Wiebenga, Jasper; Gilissen, Renske; Kerkhof, Ad J F M; Smit, Johannes H

    2017-06-01

    Recognizing the importance of digital communication, major suicide prevention helplines have started offering crisis intervention by chat. To date there is little evidence supporting the effectiveness of crisis chat services. To evaluate the reach and outcomes of the 113Online volunteer-operated crisis chat service, 526 crisis chat logs were studied, replicating the use of measures that were developed to study telephone crisis calls. Reaching a relatively young population of predominantly females with severe suicidality and (mental) health problems, chat outcomes for this group were found to be comparable to those found for crisis calls to U.S. Lifeline Centers in 2003-2004, with similar but not identical associations with specific helpers' styles and attitudes. Our findings support a positive effect of the 113Online chat service, to be enhanced by practice standards addressing an apparent lack of focus on the central issue of suicidality during chats, as well as by the development of best practices specific for online crisis intervention. © 2016 The American Association of Suicidology.

  14. Occupational Hazards Education for Nursing Staff through Web-Based Learning

    PubMed Central

    Tung, Chen-Yin; Chang, Chia-Chen; Ming, Jin-Lain; Chao, Keh-Ping

    2014-01-01

    This study aims to explore the efficiency of using online education as an intervention measure to prevent occupational hazards in a clinical nursing setting. The subjects were 320 female nursing staff from two hospitals in Taiwan. The questionnaire results indicated that the subjects primarily experienced human factor occupational hazards, as well as psychological and social hazards. Specifically, 73.1% and 69.8% of the subjects suffered from poor sleep quality and low back pain, respectively. After web-based learning, the experimental group had higher post-test scores than the control group in terms of knowledge, attitudes, and practices (KAP). However, there was only a significant difference (p < 0.05) in their knowledge about the prevention of occupational hazards. It is suggested that an online discussion may enhance nursing staff’s participation in web-based learning, and further facilitate their comments on negative factors. The findings can highly promote nursing staff’s attitudes and practices toward preventing occupational hazards through web-based learning. PMID:25514154

  15. [Interdisciplinary strategies versus doping].

    PubMed

    Vitzthum, Karin; Mache, Stefanie; Quarcoo, David; Groneberg, David A; Schöffel, Norman

    2010-06-01

    Doping is a phenomenon which in the past years through the various incidences in professional cycling has come more and more into the focus of the public interest. Whilst in the young past the problems were to define the term "doping" exactly, today's problem is to prevent adolescents and children of doping. This shall be achieved by carrying out controls and serious sanctions for doping violations. Scientific research proved that doping usage can be avoided by broad specific prevention measures. In general, the earlier the athletes dope the higher the risk to become addicted later on in life to other legal or illegal drugs. The aim of this review is to analyse the prevalence of doping regarding youth-, competitive-, high performance and recreational sports and to examine further aspects of doping abuse, risks of addiction, the legal situation, current strategies in the fight against doping and to enhance chances of further doping prevention opportunities. By means of this data an all-embracing view should be given over the current situation, problems and prospects in German-speaking countries.

  16. European guidelines for prevention and management of influenza in hematopoietic stem cell transplantation and leukemia patients: summary of ECIL-4 (2011), on behalf of ECIL, a joint venture of EBMT, EORTC, ICHS, and ELN.

    PubMed

    Engelhard, D; Mohty, B; de la Camara, R; Cordonnier, C; Ljungman, P

    2013-06-01

    Influenza may cause severe disease and mortality in leukemia patients and in hematopoietic stem cell transplantation recipients. The 4th European Conference of Infections in Leukemia (ECIL-4) has developed evidence-based guidelines for prevention and management of influenza infections in these patients. Real-time reverse-transcription polymerase chain reaction is the diagnostic test of choice, as it is the most sensitive and specific test for influenza. The risks for severe influenza and fatal outcome include lymphopenia, older age, influenza soon after transplantation or chemotherapy, steroid treatment, and lack of early antiviral therapy. Neuraminidase inhibitors (oral oseltamivir or inhalation of zanamivir) are currently the most effective therapeutic agents for influenza. Main preventive measures include annual vaccination of patients, household contacts, and hospital staff. This review summarizes ECIL-4's main recommendations. © 2013 John Wiley & Sons A/S.

  17. Stillbirths: ending preventable deaths by 2030.

    PubMed

    de Bernis, Luc; Kinney, Mary V; Stones, William; Ten Hoope-Bender, Petra; Vivio, Donna; Leisher, Susannah Hopkins; Bhutta, Zulfiqar A; Gülmezoglu, Metin; Mathai, Matthews; Belizán, Jose M; Franco, Lynne; McDougall, Lori; Zeitlin, Jennifer; Malata, Address; Dickson, Kim E; Lawn, Joy E

    2016-02-13

    Efforts to achieve the new worldwide goals for maternal and child survival will also prevent stillbirth and improve health and developmental outcomes. However, the number of annual stillbirths remains unchanged since 2011 and is unacceptably high: an estimated 2.6 million in 2015. Failure to consistently include global targets or indicators for stillbirth in post-2015 initiatives shows that stillbirths are hidden in the worldwide agenda. This Series paper summarises findings from previous papers in this Series, presents new analyses, and proposes specific criteria for successful integration of stillbirths into post-2015 initiatives for women's and children's health. Five priority areas to change the stillbirth trend include intentional leadership; increased voice, especially of women; implementation of integrated interventions with commensurate investment; indicators to measure effect of interventions and especially to monitor progress; and investigation into crucial knowledge gaps. The post-2015 agenda represents opportunities for all stakeholders to act together to end all preventable deaths, including stillbirths. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Obesity Prevention for Individuals with Spina Bifida.

    PubMed

    Polfuss, Michele; Bandini, Linda G; Sawin, Kathleen J

    2017-06-01

    Obesity is a common comorbidity in individuals with spina bifida. Carrying excess weight exacerbates the inherent health challenges associated with spina bifida, impedes the individual's ability to self-manage their condition, and creates further challenges for family members and caregivers. This manuscript provides a narrative review of key issues for understanding and prevention of obesity in persons with spina bifida within the context of the social ecological model. Specific variables related to obesity and spina bifida include individual factors (i.e., body composition and measurement issues, energy needs, eating patterns, physical activity, and sedentary activity) family factors (i.e., parenting/family, peers), community factors (i.e., culture, built environment, healthcare and healthcare providers, and school), and societal factors (i.e., policy issues). Due to the complex etiology of obesity and its increased prevalence in individuals with spina bifida, it is critical to initiate prevention efforts early with a multifactorial approach for this at-risk population. Increased research is warranted to support these efforts.

  19. Acute care to prevent back disability. Ten years of progress.

    PubMed

    Bigos, S J; Battié, M C

    1987-08-01

    Efforts to curb back problems through preemployment screening, safety measures, and educational programs have had little effect on this most expensive musculoskeletal malady. Present knowledge raises doubts about the possibility of preventing back pain. However, recent scientific investigations indicate that chronic back pain disability, which accounts for 80% of the costs for back problems, can be prevented. In Gothenburg, Sweden, the collective use of proven treatment methods during the acute stage of back symptoms markedly reduced the period of time patients were disabled from back problems. Effective early intervention centers around: teaching patients about back care, including how to control symptoms through improved body mechanics; applying these educational principles, specifically to the patient's livelihood; avoiding the debilitation that results from overusing bed rest and medication; recommendations to increase cardiovascular fitness; and the judicious use of orthopedic surgery. This approach targets the few patients who tend to be disabled the longest, suffer the most, and become the most costly to society.

  20. Between worst and best: developing criteria to identify promising practices in health promotion and disease prevention for the Canadian Best Practices Portal.

    PubMed

    Fazal, Nadia; Jackson, Suzanne F; Wong, Katy; Yessis, Jennifer; Jetha, Nina

    2017-11-01

    In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. The promising practices criteria were developed using the Public Health Agency of Canada's (PHAC's) existing best practices criteria as the foundation. They were modified and pilot tested (three rounds) using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal's screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.

  1. Measuring, Reversing, and Modeling the Mechanical Changes Due to the Absence of Fibulin-4 in Mouse Arteries

    PubMed Central

    Le, Victoria P.; Yamashiro, Yoshito; Yanagisawa, Hiromi; Wagenseil, Jessica E.

    2014-01-01

    Mice with a smooth muscle cell (SMC) specific deletion of fibulin-4 (SMKO) show decreased expression of SMC contractile genes, decreased circumferential compliance, and develop aneurysms in the ascending aorta. Neonatal administration of drugs that inhibit the angiotensin II pathway encourage expression of contractile genes and prevent aneurysm development, but do not increase compliance in SMKO aorta. We hypothesized that multidimensional mechanical changes in the aorta and/or other elastic arteries may contribute to aneurysm pathophysiology. We found that the SMKO ascending aorta and carotid artery showed mechanical changes in the axial direction. These changes were not reversed by angiotensin II inhibitors, hence reversing the axial changes is not required for aneurysm prevention. Mechanical changes in the circumferential direction were specific to the ascending aorta, therefore mechanical changes in the carotid do not contribute to aortic aneurysm development. We also hypothesized that a published model of postnatal aortic growth and remodeling could be used to investigate mechanisms behind the changes in SMKO aorta and aneurysm development over time. Dimensions and mechanical behavior of adult SMKO aorta were reproduced by the model after modifying the initial component material constants and the aortic dilation with each postnatal time step. The model links biological observations to specific mechanical responses in aneurysm development and treatment. PMID:24526456

  2. Measuring, reversing, and modeling the mechanical changes due to the absence of Fibulin-4 in mouse arteries.

    PubMed

    Le, Victoria P; Yamashiro, Yoshito; Yanagisawa, Hiromi; Wagenseil, Jessica E

    2014-10-01

    Mice with a smooth muscle cell (SMC)-specific deletion of Fibulin-4 (SMKO) show decreased expression of SMC contractile genes, decreased circumferential compliance, and develop aneurysms in the ascending aorta. Neonatal administration of drugs that inhibit the angiotensin II pathway encourages the expression of contractile genes and prevents aneurysm development, but does not increase compliance in SMKO aorta. We hypothesized that multidimensional mechanical changes in the aorta and/or other elastic arteries may contribute to aneurysm pathophysiology. We found that the SMKO ascending aorta and carotid artery showed mechanical changes in the axial direction. These changes were not reversed by angiotensin II inhibitors, hence reversing the axial changes is not required for aneurysm prevention. Mechanical changes in the circumferential direction were specific to the ascending aorta; therefore, mechanical changes in the carotid do not contribute to aortic aneurysm development. We also hypothesized that a published model of postnatal aortic growth and remodeling could be used to investigate mechanisms behind the changes in SMKO aorta and aneurysm development over time. Dimensions and mechanical behavior of adult SMKO aorta were reproduced by the model after modifying the initial component material constants and the aortic dilation with each postnatal time step. The model links biological observations to specific mechanical responses in aneurysm development and treatment.

  3. 16 CFR 1702.11 - Product specifications.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Product specifications. 1702.11 Section 1702.11 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT REQUIREMENTS; PETITION PROCEDURES...

  4. 16 CFR 1702.12 - Packaging specifications.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Packaging specifications. 1702.12 Section 1702.12 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT REQUIREMENTS; PETITION PROCEDURES...

  5. 16 CFR 1702.12 - Packaging specifications.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Packaging specifications. 1702.12 Section 1702.12 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT REQUIREMENTS; PETITION PROCEDURES...

  6. 16 CFR 1702.11 - Product specifications.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Product specifications. 1702.11 Section 1702.11 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT REQUIREMENTS; PETITION PROCEDURES...

  7. 16 CFR 1702.12 - Packaging specifications.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Packaging specifications. 1702.12 Section 1702.12 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT REQUIREMENTS; PETITION PROCEDURES...

  8. 16 CFR 1702.11 - Product specifications.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Product specifications. 1702.11 Section 1702.11 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT REQUIREMENTS; PETITION PROCEDURES...

  9. 16 CFR 1702.12 - Packaging specifications.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Packaging specifications. 1702.12 Section 1702.12 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT REQUIREMENTS; PETITION PROCEDURES...

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

    PubMed

    Al-Hablani, Bader

    2017-01-01

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

  11. Using Google Analytics to evaluate the impact of the CyberTraining project.

    PubMed

    McGuckin, Conor; Crowley, Niall

    2012-11-01

    A focus on results and impact should be at the heart of every project's approach to research and dissemination. This article discusses the potential of Google Analytics (GA: http://google.com/analytics ) as an effective resource for measuring the impact of academic research output and understanding the geodemographics of users of specific Web 2.0 content (e.g., intervention and prevention materials, health promotion and advice). This article presents the results of GA analyses as a resource used in measuring the impact of the EU-funded CyberTraining project, which provided a well-grounded, research-based training manual on cyberbullying for trainers through the medium of a Web-based eBook ( www.cybertraining-project.org ). The training manual includes review information on cyberbullying, its nature and extent across Europe, analyses of current projects, and provides resources for trainers working with the target groups of pupils, parents, teachers, and other professionals. Results illustrate the promise of GA as an effective tool for measuring the impact of academic research and project output with real potential for tracking and understanding intra- and intercountry regional variations in the uptake of prevention and intervention materials, thus enabling precision focusing of attention to those regions.

  12. Young adults' opinions of Philip Morris and its television advertising

    PubMed Central

    Henriksen, L; Fortmann, S

    2002-01-01

    Objective: To determine what young people think about the tobacco company Philip Morris and how it affects their evaluations of the company's new television advertising. Design: Data were gathered in the context of a controlled experiment in which participants saw four Philip Morris ads about youth smoking prevention, four Philip Morris ads about charitable works, or four Anheuser-Busch ads about preventing underage drinking (the control group). Knowledge and opinion of Philip Morris were measured before ad exposure. Setting: A California state university in the San Francisco Bay area. Subjects: A convenience sample of undergraduates (n = 218) aged 18–25 years. Main outcome measures: Advertising evaluation measured by 12 semantic differential scales. Results: A little more than half of the students knew that Philip Morris is a tobacco company. Neither this knowledge nor students' smoking status was related to their opinion of the company. Philip Morris ads were rated less favourably by students who were aware that the sponsor is a tobacco company than by students who were unaware. Conclusions: Advertisements designed to discredit the tobacco industry typically avoid references to specific companies. This study suggests that such counter-advertising would benefit from teaching audiences about the industry's corporate identities. PMID:12198275

  13. Bacterial adhesion capacity on food service contact surfaces.

    PubMed

    Fink, Rok; Okanovič, Denis; Dražič, Goran; Abram, Anže; Oder, Martina; Jevšnik, Mojca; Bohinc, Klemen

    2017-06-01

    The aim of this study was to analyse the adhesion of E. coli, P. aeruginosa and S. aureus on food contact materials, such as polyethylene terephthalate, silicone, aluminium, Teflon and glass. Surface roughness, streaming potential and contact angle were measured. Bacterial properties by contact angle and specific charge density were characterised. The bacterial adhesion analysis using staining method and scanning electron microscopy showed the lowest adhesion on smooth aluminium and hydrophobic Teflon for most of the bacteria. However, our study indicates that hydrophobic bacteria with high specific charge density attach to those surfaces more intensively. In food services, safety could be increased by selecting material with low adhesion to prevent cross contamination.

  14. What's wrong with CYP?

    PubMed

    Shelton, J D

    1991-01-01

    The weaknesses of using couple years protection (CYP) for assessing the effectiveness of various measures of family planning are discussed. Limitations had been recognized in the past but have been largely ignored in the present context. This has been due to the unavailability of local data, and other standardizations have been too cumbersome for practical use. The advantage of using CYP is that it allows for easy calculation of a level of contraceptive use without differentiation by method. This measure reflects to some extent, for instance, access to family planning services, and prevention of unwanted fertility. It also measures output, and provides program managers with a tool to adjust supply to demand. The weakness are categorized in terms of contraceptive failure rates, sporadic and infrequent use with secondary partners, wastage, substitution, differences in fecundity, local specificity, lack of a discount for time, ability to reach high priority or underserved clients, secondary effects, quality of care, and so on. These weaknesses broadly effect the relationship of CYP with fertility; it is possible that adjustments can be made to improve the measure. The deficiencies in accounting for hard to reach clients, in measuring the secondary effects in AIDs and STD prevention, and in measuring satisfaction and continuation or other facets of quality of care not be accounted for in CYP. This suggests that a comprehensive assessment must utilize a variety of indicators, such as a direct measure of contraceptive prevalence, the proportion of children born to high risk women, continuation rates, and qualitative measures of the impact of care. Improvement of CYP is suggested as an inexpensive solution. Local data should be used, since the average age at sterilization in a particular population impacts greatly on the actual CYP provided by sterilization in a specific program. Cookbook conversion factors should be revised so that condoms (100 per CYP) credit is reduced and IUDs (2.5 CYP per IUD) is increased; CYP factors need to be developed for Norplant and Lactational Amenorrhea Method (LAM). An effort by the AID Cooperating Agency Task Force on Performance Indicators is underway to address these issues, but in the meantime awareness of the issues is advised.

  15. Guidelines for preventing common medical complications of catatonia: case report and literature review.

    PubMed

    Clinebell, Kimberly; Azzam, Pierre N; Gopalan, Priya; Haskett, Roger

    2014-06-01

    Comprehensive hospital-based care for individuals with catatonia relies on preventive approaches to reduce medical morbidity and mortality. Without syndrome-specific guidelines, psychiatrists must draw from measures used for general medical and surgical inpatients. We employ a prototypical case to highlight medical complications of catatonia and review preventive guidelines for implementation in the inpatient setting. Searches of the PubMed and Ovid databases were conducted from September-November 2013 using keywords relevant to 4 medical complications of catatonia: deep vein thrombosis/pulmonary embolism, pressure ulcers, muscle contractures, and nutritional deficiencies. A complementary general web-browser search was performed to help ensure that unpublished guidelines were considered. A search for deep vein thrombosis/pulmonary embolism guidelines yielded 478 articles that were appraised for relevance, and 6 were chosen for review; the pressure ulcer guideline search yielded 5,665 articles, and 5 were chosen; the muscle contractures guideline search yielded 1,481 articles, and 3 were chosen; and the nutritional deficiencies guideline search yielded 16,937 articles, and 4 were chosen. Guidelines were reviewed for content and summarized in a manner relevant to the audience. No quantitative analyses were conducted. Guidelines for deep vein thrombosis/pulmonary embolism prophylaxis support use of anticoagulant therapies for patients with catatonia who are at lower risk for acute bleeding. Pressure ulcer prevention hinges on frequent skin evaluation, use of support surfaces, and repositioning. Muscle contracture data are less clear and must be extrapolated from studies of patients with neurologic injuries. Early initiation of enteral nutrition should be considered in patients with prolonged immobility. As medical complications are common with catatonia, implementation of preventive measures is imperative. © Copyright 2014 Physicians Postgraduate Press, Inc.

  16. Promoting prevention with economic arguments – The case of Finnish occupational health services

    PubMed Central

    Kankaanpää, Eila; Suhonen, Aki; Valtonen, Hannu

    2008-01-01

    Background Both social and ethical arguments have been used to support preventive occupational health services (OHS). During the 1990s it became more common to support political argumentation for occupational health and safety by converting the consequences of ill health at work into monetary units. In addition, OHS has been promoted as a profitable investment for companies, and this aspect has been used by OHS providers in their marketing. Our intention was to study whether preventive occupational health services positively influence a company's economic performance. Methods We combined the financial statements provided by Statistics Finland and employers' reimbursement applications for occupational health services (OHS) costs to the Social Insurance Institution. The data covered the years 1997, 1999 and 2001 and over 6000 companies. We applied linear regression analysis to assess whether preventive OHS had had a positive influence on the companies' economic performance after two or four years. Results Resources invested in preventive OHS were not positively related to a company's economic performance. In fact, the total cost of preventive OHS per turnover was negatively correlated to economic performance. Conclusion Even if OHS has no effect on the economic performance of companies, it may have other effects more specific to OHS. Therefore, we recommend that the evaluation of prevention in OHS should move towards outcome measures, such as sickness absence, disability pension and productivity, when applicable, both in occupational health service research and in practice at workplaces. PMID:18430218

  17. Regulatory focus and generalized trust: the impact of prevention-focused self-regulation on trusting others.

    PubMed

    Keller, Johannes; Mayo, Ruth; Greifeneder, Rainer; Pfattheicher, Stefan

    2015-01-01

    The current research suggests that taking self-regulatory mechanisms into account provides insights regarding individuals' responses to threats in social interactions. In general, based on the notion that a prevention-focused orientation of self-regulation is associated with a need for security and a vigilant tendency to avoid losses and other types of negative events we advocate that a prevention-focused orientation, both as a disposition as well as a situationally induced state, lowers generalized trust, thus hindering cooperation within social interactions that entail threats. Specifically, we found that the more individuals' habitual self-regulatory orientation is dominated by a prevention focus, the less likely they are to score high on a self-report measure of generalized trust (Study 1), and to express trust in a trust game paradigm as manifested in lower sums of transferred money (Studies 2 and 3). Similar findings were found when prevention focus was situationally manipulated (Study 4). Finally, one possible factor underlying the impact of prevention-focused self-regulation on generalized trust was demonstrated as individuals with a special sensitivity to negative information were significantly affected by a subtle prevention focus manipulation (versus control condition) in that they reacted with reduced trust in the trust game (Study 5). In sum, the current findings document the crucial relevance of self-regulatory orientations as conceptualized in regulatory focus theory regarding generalized trust and responses to threats within a social interaction. The theoretical and applied implications of the findings are discussed.

  18. [Settings-based prevention of overweight in childhood and adolescents : Theoretical foundation, determinants and intervention planning].

    PubMed

    Quilling, Eike; Dadaczynski, Kevin; Müller, Merle

    2016-11-01

    Childhood and adolescent overweight can still be seen as a global public health problem. Based on our socioeconomic understanding, overweight is the result of a complex interplay of a diverse array of factors acting on different levels. Hence, in addition to individual level determinants overweight prevention should also address environmental related factors as part of a holistic and integrated setting approach. This paper aims to discuss the setting approach with regard to overweight prevention in childhood and adolescence. In addition to a summary of environmental factors and their empirical influence on the determinants of overweight, theoretical approaches and planning models of settings-based overweight prevention are discussed. While settings can be characterized as specific social-spatial subsystems (e. g. kindergarten, schools), living environments relate to complex subject-oriented environments that may include various subsystems. Direct social contexts, educational contexts and community contexts as relevant systems for young people contain different evidence-based influences that need to be taken into account in settings based overweight prevention. To support a theory-driven intervention, numerous planning models exist, which are presented here. Given the strengthening of environments for health within the prevention law, the underlying settings approach also needs further development with regard to overweigth prevention. This includes the improvement of the theoretical foundation by aligning intervention practice of planning models, which also has a positive influence on the ability to measure its success.

  19. [Suicide Prevention and Mental Health Measures for Japanese University Students].

    PubMed

    Ohnishi, Masaru; Koyama, Shihomi; Senoo, Akiko; Kawahara, Hiroko; Shimizu, Yukito

    2016-01-01

    According to the nationwide survey of the National University students in Japan, the annual suicide rate in 2012 was 15.7 per 100,000 undergraduate students. In many universities, suicide prevention is an important issue regarding mental health measures, and each university is actively examining this. The current situation concerning measures for suicide prevention in the Japanese National Universities was investigated in 2009. In 2010, the "college student's suicide prevention measures guideline, 2010" was established based on the results of this investigation. This guideline refers to the basic philosophy of suicide prevention in Chapter 1, risk factors for suicide in Chapter 2, and systems and activities for suicide prevention in Chapter 3. The Health Service Center, Okayama University plays central roles in mental health and suicide prevention measures on the Medical Campus. The primary prevention includes a mini-lecture on mental health, classes on mental health, and periodic workshops and lectures for freshmen. The secondary prevention includes interviews with students with mental health disorders by a psychiatrist during periodic health check-ups and introducing them to a hospital outside the university. The tertiary prevention includes support for students taking a leave of absence to return to school, periodic consultation with such students with mental disorders, and postvention following a suicide. We believe that for mental health measures on the university campus, it is important to efficiently make use of limited resources, and that these efforts will eventually lead to suicide prevention.

  20. Preventing cardiac diseases in childhood.

    PubMed

    Petropoulos, Andreas; Ehringer-Schetitska, Doris; Fritsch, Peter; Jokinen, Eero; Dalla Pozza, Robert; Oberhoffer, Renate

    2015-01-01

    The burden of cardiac disease in childhood is unknown. It will be a sum of 1% of living births in the general population, suffering from Congenital Heart Disease (CHD) + approximately 2.5% of the general population suffering from bicuspid aortic valve diseases + an unknown higher prevalence of acquired diseases. Cardiomyopathies, arrhythmias - sudden cardiac death (SCD), rheumatic heard disease, hypertension and accelerating atherosclerosis are among the most frequent. Adding on, genetic syndromes including cardiac defects, endocarditis and myocarditis we can address a large pediatric population worldwide, suffering from heart disease. Diagnosis and treatment of these diseases are not afforded in many countries worldwide due to luck of human and material resources. The aim of this paper is to describe how some of the above mentioned diseases can be either early detected or prevented. The working Group "Cardiovascular Prevention" of the Association of European Pediatric and Congenital Cardiology (AEPC) focused on some forms of them since its formation in 2011. These areas are: 1) some forms of critical CHD, 2) sudden cardiac death linked to sport activities and 3) detecting- preventing cardio vascular diseases CVD in the young. Methods-Populations: Measurements of pre and post ductal saturation of oxygen using pulse oximeters, after the first day from birth, can early and cheaply detect critical Ductal Arteriosus dependent pulmonary or systemic and cyanotic CHD, saving lives and decreasing significantly the cost of medical care. This screening test can be applied to all neonates as late as possible after their birth and before released to their homes. A combination of detailed medical history, physical examination and 12 lead ECG, during a pre-participation in sport activities medical screening test can prevent SCD, related to a variety of nosology. This combined screening test can be applied to all children before they are exposed to school or leisure sport activities. Screening to early detect and treating existent risk factors (RF) for CVD as well as preventing obesity and hypertension, contributes in lowering the burden of CVD. Specific screening tests as laboratory measurements of lipids, fasting glucose or regular measurements of Blood Pressure and waist to hip ratio in children with a family history of CVD or other co-morbidity that provokes accelerating atherosclerosis must be done on a regular basis. Since 2010, four European studies reporting the test accuracy of routine pulse oximetry screening, in over 150.000 babies, have delivered new data. A systematic review and meta-analysis of 230.000 screened babies, reported high specificity, moderate sensitivity and a low false-positive rate. Routine screening for critical CHD using pulse oximetry is being increasingly supported and was added to the recommended uniform screening panel in the USA in 2011. Evaluating children with CHD before their involvement in sport activities, so a clear view in what they can and what they can't to is vital for their safety. For children involved in competitive or leisure sport activities, an initial evaluation and a yearly F/U is vital. In cases of near SCD events an additional thorough investigation and appropriate management is required. Investigating the severity of the existing RF and cooperating with Pediatricians in their treatment (e.g. heredity forms of hyperlipidemias, existing hypertension) of them is essential. Furthermore preventing acceleration of atherosclerosis in patients with: Diabetes Mellitus I, II, chronic renal disease, post Kawasaki disease, post heart transplantation patients, Cardio-Metabolic Syndrome patients, by eradicating RF primordially or by alternating them by opposing a healthy life style or by medicine treatment, has sown in many studies to post pone clinical events in adulthood. As many studies have proved the role of preventive measures that can alternate the outcome of cardiac diseases in childhood. AEPC/Preventive Cardiology working group is in the process to publish in the near future guidelines on this topic.

  1. Venous Thromboembolism Quality Measures Fail to Accurately Measure Quality.

    PubMed

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

    2018-03-20

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

  2. Are HIV/AIDS Prevention Interventions for Heterosexually Active Men in the United States Gender-Specific?

    PubMed Central

    Fullilove, Robert E.; Peacock, Dean

    2009-01-01

    Although gender-specific theories are often deployed in interventions to reduce women's HIV risks, the same is often not true for interventions among men. Theories of masculinity are not guiding most US research on the risky sexual behavior of heterosexual men or on what can be done to intervene. We first assess the extent to which evidence-based HIV-prevention interventions among heterosexually active men in the United States draw upon relevant theories of masculinity. Next, we introduce a useful framework within masculinity and gender studies that can be applied to HIV-prevention interventions with heterosexually active men. Finally, we make suggestions to improve the gender specificity of HIV-prevention interventions for heterosexually active men in the United States. PMID:19372506

  3. Immunological Prediction of Cytomegalovirus (CMV) Replication Risk in Solid Organ Transplantation Recipients: Approaches for Regulating the Targeted Anti-CMV Prevention Strategies.

    PubMed

    Han, Sang Hoon

    2017-09-01

    The current cytomegalovirus (CMV) prevention strategies in solid organ transplantation (SOT) recipients have contributed towards overcoming the detrimental effects caused by CMV lytic infection, and improving the long-term success rate of graft survival. Although the quantification of CMV in peripheral blood is the standard method, and an excellent end-point for diagnosing CMV replication and modulating the anti-CMV prevention strategies in SOT recipients, a novel biomarker mimicking the CMV control mechanism is required. CMV-specific immune monitoring can be employed as a basic tool predicting CMV infection or disease after SOT, since uncontrolled CMV replication mostly originates from the impairment of immune responses against CMV under immunosuppressive conditions in SOT recipients. Several studies conducted during the past few decades have indicated the possibility of measuring the CMV-specific cell-mediated immune response in clinical situations. Among several analytical assays, the most advancing standardized tool is the QuantiFERON®-CMV assay. The T-Track® CMV kit that uses the standardized enzyme-linked immunospot assay is also widely employed. In addition to these assays, immunophenotyping and intracellular cytokine analysis using flow cytometry (with fluorescence-labeled monoclonal antibodies or peptide-major histocompatibility complex multimers) needs to be adequately standardized and validated for potential clinical applications. Copyright © 2017 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy.

  4. How decision reversibility affects motivation.

    PubMed

    Bullens, Lottie; van Harreveld, Frenk; Förster, Jens; Higgins, Tory E

    2014-04-01

    The present research examined how decision reversibility can affect motivation. On the basis of extant findings, it was suggested that 1 way it could affect motivation would be to strengthen different regulatory foci, with reversible decision making, compared to irreversible decision making, strengthening prevention-related motivation relatively more than promotion-related motivation. If so, then decision reversibility should have effects associated with the relative differences between prevention and promotion motivation. In 5 studies, we manipulated the reversibility of a decision and used different indicators of regulatory focus motivation to test these predictions. Specifically, Study 1 tested for differences in participants' preference for approach versus avoidance strategies toward a desired end state. In Study 2, we used speed and accuracy performance as indicators of participants' regulatory motivation, and in Study 3, we measured global versus local reaction time performance. In Study 4, we approached the research question in a different way, making use of the value-from-fit hypothesis (Higgins, 2000, 2002). We tested whether a fit between chronic regulatory focus and focus induced by the reversibility of the decision increased participants' subjective positive feelings about the decision outcome. Finally, in Study 5, we tested whether regulatory motivation, induced by decision reversibility, also influenced participants' preference in specific product features. The results generally support our hypothesis showing that, compared to irreversible decisions, reversible decisions strengthen a prevention focus more than a promotion focus. Implications for research on decision making are discussed.

  5. Passive Antibody Administration (Immediate Immunity) as a Specific Defense Against Biological Weapons

    PubMed Central

    2002-01-01

    The potential threat of biological warfare with a specific agent is proportional to the susceptibility of the population to that agent. Preventing disease after exposure to a biological agent is partially a function of the immunity of the exposed individual. The only available countermeasure that can provide immediate immunity against a biological agent is passive antibody. Unlike vaccines, which require time to induce protective immunity and depend on the host’s ability to mount an immune response, passive antibody can theoretically confer protection regardless of the immune status of the host. Passive antibody therapy has substantial advantages over antimicrobial agents and other measures for postexposure prophylaxis, including low toxicity and high specific activity. Specific antibodies are active against the major agents of bioterrorism, including anthrax, smallpox, botulinum toxin, tularemia, and plague. This article proposes a biological defense initiative based on developing, producing, and stockpiling specific antibody reagents that can be used to protect the population against biological warfare threats. PMID:12141970

  6. Systematic review of research on railway and urban transit system suicides.

    PubMed

    Mishara, Brian L; Bardon, Cécile

    2016-03-15

    We critically review research on railway suicides to inform suicide prevention initiatives and future studies, including who is at risk and why, and behaviours at track locations. Literature was identified from Scopus, Web of Science, Google Scholar and our documentation centre, and contacting 71 railway companies, resulting in 716 articles and eight unpublished reports, with 94 having empirical data on 55 unique studies. Research quality was critically assessed. The quality of studies varies greatly with frequent shortcomings: no justification of sample size, lacking information on the reliability and validity of measures, no explanation nor theoretical understanding of findings. Railway suicides resemble closely people who use other methods, although they tend to be younger. As with other suicide methods, mental health problems are likely to be present. Railway suicide attempters usually die, but most urban transportation systems attempters survive. Railway suicides are rarely impulsive; people usually go to the railway for the purpose of killing themselves. Hotspots have been the focus of some prevention measures. We know little about why people choose railway suicide, but studies of survivors suggest they often thought they would have an immediate, certain and painless death. Media reports on railway suicides can increase their incidence. Most research focuses on the incidence and characteristics of events and attempters. Research has not shown that railway suicides are different from suicides by other means. Better quality research is needed, particularly studies that investigate why people use railways to kill themselves and how railway suicides can be effectively prevented, as well as more evaluations of prevention programmes. Because of significant variations by country and region in characteristics of railway suicides, prevention programmes should conduct a local assessment of the characteristics of attempters and incidents. We need more research on indicators of suicide risk in attempters on railway property, and studies of how suicidal people on railway property are prevented from suicide. Changing beliefs and attitudes about railway suicides, reducing media reports, offering help onsite, controlling access at hotspots and better staff training in mental health facilities near tracks are promising prevention strategies. However, local specificities must be considered in planning prevention strategies. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. 16 CFR § 1702.12 - Packaging specifications.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Packaging specifications. § 1702.12 Section § 1702.12 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT REQUIREMENTS...

  8. Measuring Promotion and Prevention Orientations of Secondary School Students: It Is More Than Meets the Eye

    ERIC Educational Resources Information Center

    Hodis, Flaviu A.; Hattie, John A. C.; Hodis, Georgeta M.

    2016-01-01

    The General Regulatory Focus Measure has been used extensively in psychological research to gauge promotion and prevention orientations. Findings of this research show that for New Zealand secondary school students, the General Regulatory Focus Measure does not measure promotion and prevention as theoretically independent constructs.

  9. The effect of Haemophilus influenzae type B and pneumococcal conjugate vaccines on childhood meningitis mortality: a systematic review

    PubMed Central

    2013-01-01

    Background Two of the most prevalent causes of severe bacterial meningitis in children, Haemophilus influenzae type B (Hib) and Streptococcus pneumoniae, are preventable by existing vaccines increasingly available in developing countries. Our objective was to estimate the dose-specific effect of Hib and pneumococcal conjugate vaccines (PCV) on childhood meningitis mortality in low-income countries for use in the Lives Saved Tool (LiST). Methods We systematically searched and reviewed published vaccine efficacy trials and observational studies reporting the effect of Hib or PCV vaccines on organism-specific meningitis, bacterial meningitis and all-cause meningitis incidence and mortality among children less than five years old in low- and middle-income countries. Data collection and quality assessments were performed using standardized guidelines. For outcomes available across multiple studies (≥2) and approximating meningitis mortality, we pooled estimates reporting dose-specific effects using random effects meta-analytic methods, then combined these with meningitis etiology data to determine the preventable fraction of childhood meningitis mortality for inclusion in LiST. Results We identified 18 studies of Hib conjugate vaccines reporting relevant meningitis morbidity and mortality outcomes (2 randomized controlled trials [RCTs], 16 observational studies) but few provided dose-specific effects. A meta-analysis of four case-control studies examined the dose-specific effect of Hib conjugate vaccines on Hib meningitis morbidity (1 dose: RR=0.64, 95% CI 0.38-1.06; 2 doses: RR=0.09, 95% CI 0.03-0.27; 3 doses: RR=0.06, 95% CI 0.02-0.22), consistent with results from single RCTs. Pooled estimates of two RCTs provided evidence for the effect of three doses of PCV on vaccine-serotype meningitis morbidity (RR=0.16, 95% CI 0.02-1.20). We considered these outcomes of severe disease as proxy estimates for meningitis mortality and combined the estimates of protective effects with meningitis etiology data to provide an estimate of the preventable fraction of childhood meningitis mortality with three doses of Hib (38-43%) and pneumococcal conjugate vaccines (28-35%) for use in LiST. Conclusions Few RCTs or vaccine effectiveness studies evaluated the dose-specific impact of Hib and PCV vaccines on childhood meningitis mortality, necessitating use of proxy measures to estimate population impact in LiST. Our analysis indicates that approximately three-quarters of meningitis deaths are preventable with existing Hib and PCV vaccines. PMID:24564188

  10. Combined effects of prevention and quarantine on a breakout in SIR model.

    PubMed

    Kato, Fuminori; Tainaka, Kei-Ichi; Sone, Shogo; Morita, Satoru; Iida, Hiroyuki; Yoshimura, Jin

    2011-01-01

    Recent breakouts of several epidemics, such as flu pandemics, are serious threats to human health. The measures of protection against these epidemics are urgent issues in epidemiological studies. Prevention and quarantine are two major approaches against disease spreads. We here investigate the combined effects of these two measures of protection using the SIR model. We use site percolation for prevention and bond percolation for quarantine applying on a lattice model. We find a strong synergistic effect of prevention and quarantine under local interactions. A slight increase in protection measures is extremely effective in the initial disease spreads. Combination of the two measures is more effective than a single protection measure. Our results suggest that the protection policy against epidemics should account for both prevention and quarantine measures simultaneously.

  11. [ Contact isolation and prevention of spreading of serious infections in an intensive care unit. Description of a protocol].

    PubMed

    Morán Marmaneu, Marian; Tejedor López, Rosa; Sanchís Muñoz, Josefa; Reig Valero, Roberto; Abizanda Campos, Ricardo; Bernat Adell, Amparo

    2006-01-01

    Hospital infection (HI) represents a serious care problem in critical patients. The presence of this complication is associated to an increase in the baseline seriousness of the patient, that is translated into greater care effort, multiplication of workload and greater mortality. This situation is clearly complicated when the causal agent of the infection is a multiresistant bacteria, since it also requires specific measures aimed at avoiding crossed transmission of the infection to other patients in addition to route treatment. The objective of the Nursing Note is to communicate our routine action in the face of this problem. From January 2003 to December 2004, 2420 patients were admitted to our Department. Of these 190 had some ICU hospital acquired infection (8.48%). Isolation steps were begun in 112 patients (4.62%) and also preventive measures as they were immunodepressed patients (inverse isolation) or patients at risk of presenting colonization or infection by multiresistant germs (preventive isolation) or due to suffering a demonstrated infection by said microorganisms. The mean seriousness, measured by the Simplified Acute Physiology Score (SAPS II), of the sample was 30+/-16 points. Those infected had a mean seriousness of 44+/-15 points and those isolated 49+/-19 points. Nursing workloads, measured by Nine Equivalents of Nursing Manpower Use Score (NEMST) were 150+/-274 points for all the sample, while the infected patients had 737+/-460 and the isolated ones 811+/-452 points. Global mortality in said period was 12.6%, while those infected had a mortality of 32% and the isolated ones 43%. The average costs per stay were 5069 euro. Patients who suffered any infection during their stay in the ICU increased their stay cost up to 26,630 euro and those isolated up to 29,050 euro. Faced with this situation, it was decided to stress the Contact Isolation procedures to achieve correct fulfillment of the preventive measures and achieve reduction in the hospital infection rates and crossed transmission between patients by multiresistant pathogens.

  12. Development and initial validation of the Cardiovascular Disease Acceptance and Action Questionnaire (CVD-AAQ) in an Italian sample of cardiac patients

    PubMed Central

    Spatola, Chiara A. M.; Cappella, Emanuele A. M.; Goodwin, Christina L.; Baruffi, Matteo; Malfatto, Gabriella; Facchini, Mario; Castelnuovo, Gianluca; Manzoni, Gian Mauro; Molinari, Enrico

    2014-01-01

    Psychological inflexibility refers to the attempt to decrease internal distress even when doing so is inconsistent with life values, and has been identified as a potential barrier to making and maintaining health behavior changes that are consistent with a heart-healthy lifestyle. Disease- and behavior-specific measures of psychological inflexibility have been developed and utilized in treatment research. However, no specific measure has been created for patients with heart disease. Thus, the CardioVascular Disease Acceptance and Action Questionnaire (CVD-AAQ) was developed. The present study is aimed to evaluate the psychometric properties of the CVD-AAQ and to explore its association with measures of psychological adjustment and cardiovascular risk factors in an Italian sample of 275 cardiac patients. Exploratory factor analysis showed a structural one-factor solution with satisfactory internal consistency and test–retest reliability. The relation with other measures was in the expected direction with stronger correlations for the theoretically consistent variables, supporting convergent and divergent validity. CVD-AAQ scores were associated with general psychological inflexibility, anxiety and depression and inversely correlated with psychological well-being. Moreover, the results showed that CVD-AAQ scores are associated with two relevant risk factors for cardiac patients, namely low adherence to medication and being overweight. In sum, results suggest that the CVD-AAQ is a reliable and valid measure of heart disease-specific psychological inflexibility with interesting clinical applications for secondary prevention care. PMID:25452737

  13. Development and Field Test of Task-Based MOS-Specific Criterion Measures. Volume 1. Appendixes A-E

    DTIC Science & Technology

    1988-04-01

    WOUND 081-831-1033 APPLY A DRESSING TO AN OPEN HEAD WOUND 081-831-1005 PREVENT SHOCK 081-831-1034 SPLINT A SUSPECTED FRACTURE 081-831-1007 GTVE FIRST...Check seat belts and shoulder harnesses Check unit vehicle/trailer blackout system Service refrigeration unit Check and clean cab interior/exterior...DRESSING TO AN OPEN HEAD WOUND 081-831-1040 TRANSPORT A CASUALTY USING A ONE MAN CARRY 081-831-1041 TRANSPORT A CASUALTY USING A TWO MAN CARRY OR

  14. A case of nosocomial Legionnaires' disease: The importance of early diagnosis, adequate prevention and eradication measures.

    PubMed

    Lucardie, A; Rogiers, Ph; Floré, K

    2016-02-03

    This case-report describes a patient with confirmed nosocomial Legionnaires' disease, a diagnosis which should be suspected when pneumonia does not respond to empiric therapy with beta-lactam antibiotics, or develops in the presence of certain risk factors. Culture is currently the golden standard for diagnosis, although the use of more modern techniques, such as a combination of urinary antigen testing and polymerase chain reaction, are on the rise. Specific detection and eradication methods are discussed.

  15. [Diseases transmitted by ticks locally and abroad].

    PubMed

    Gétaz, L; Loutan, L; Mezger, N

    2012-05-09

    This article provides a brief overview of some diseases transmitted by ticks. These vectors do not transmit only Lyme disease and tickborne-encephalitis, even in Switzerland. Several tick-borne diseases cause nonspecific flu-like symptoms. Nevertheless sometimes severe, some of these diseases can be treated with specific treatments. Repellents, appropriate clothes impregnated with permethrine and prompt removal of the tick are effective preventive measures to limit the risk of infection. There is an effective vaccine which protects against tick-borne encephalitis.

  16. Disease management with ARIMA model in time series.

    PubMed

    Sato, Renato Cesar

    2013-01-01

    The evaluation of infectious and noninfectious disease management can be done through the use of a time series analysis. In this study, we expect to measure the results and prevent intervention effects on the disease. Clinical studies have benefited from the use of these techniques, particularly for the wide applicability of the ARIMA model. This study briefly presents the process of using the ARIMA model. This analytical tool offers a great contribution for researchers and healthcare managers in the evaluation of healthcare interventions in specific populations.

  17. Allergy and parasites: the measurement of total and specific IgE levels in urban and rural communities in Rhodesia.

    PubMed

    Merrett, T G; Merrett, J; Cookson, J B

    1976-03-01

    Eighty adult asthmatics living in an African city had a significantly higher serum IgE level (799 u/ml) than the control group (350 u/ml). A high proportion (78.7%) of the asthmatics had demonstrable circulating mite-specific IgE antibodies. The rural population of a filariasis endemic region was investigated and although no allergic subjects were identified, the group had a significantly higher IgE level (1613 u/ml) than the asthmatics and also showed a relatively high incidence of grass pollen-specific IgE antibodies (35%). The discrepancy between clinical history and laboratory results supports the mast cell saturation hypothesis and suggests: (a) an explanation for the susceptibility to allergy of African and Asian immigrants to Great Britain, and (b) a practical approach for preventing allergic reactions in vivo.

  18. Nurses' knowledge of prevention and management of pressure ulcer at a health insurance hospital in Alexandria.

    PubMed

    El Enein, Nagwa Younes Abou; Zaghloul, Ashraf Ahmad

    2011-06-01

    Nurses' knowledge of pressure ulcer prediction, prevention and management plays a very important role in the incidence and prevalence of pressure ulcers in health-care systems. The aim of the current study was to assess the nurse's knowledge about prevention and management of pressure ulcer at one of the largest health insurance hospitals in Alexandria. A descriptive cross-sectional study using an interview questionnaire format to assess the nurses' knowledge (n = 122) regarding prevention of pressure ulcers. The overall mean per cent score for nurses was below the minimum acceptable level. The mean per cent score for nurses was below 70% for nine measures of the 15 correct measures, which accounted for 60% of the measures of pressure ulcer prevention. Correct answers for non-useful measures for preventing pressure ulcers accounted for 66% of the non-useful measures on the questionnaire. It had been concluded that the nurses' knowledge regarding pressure ulcer prevention is below the acceptable levels. © 2011 Blackwell Publishing Asia Pty Ltd.

  19. Development of Disease-specific, Context-specific Surveillance Models: Avian Influenza (H5N1)-Related Risks and Behaviours in African Countries.

    PubMed

    Fasina, F O; Njage, P M K; Ali, A M M; Yilma, J M; Bwala, D G; Rivas, A L; Stegeman, A J

    2016-02-01

    Avian influenza virus (H5N1) is a rapidly disseminating infection that affects poultry and, potentially, humans. Because the avian virus has already adapted to several mammalian species, decreasing the rate of avian-mammalian contacts is critical to diminish the chances of a total adaptation of H5N1 to humans. To prevent the pandemic such adaptation could facilitate, a biology-specific disease surveillance model is needed, which should also consider geographical and socio-cultural factors. Here, we conceptualized a surveillance model meant to capture H5N1-related biological and cultural aspects, which included food processing, trade and cooking-related practices, as well as incentives (or disincentives) for desirable behaviours. This proof of concept was tested with data collected from 378 Egyptian and Nigerian sites (local [backyard] producers/live bird markets/village abattoirs/commercial abattoirs and veterinary agencies). Findings revealed numerous opportunities for pathogens to disseminate, as well as lack of incentives to adopt preventive measures, and factors that promoted epidemic dissemination. Supporting such observations, the estimated risk for H5N1-related human mortality was higher than previously reported. The need for multidimensional disease surveillance models, which may detect risks at higher levels than models that only measure one factor or outcome, was supported. To develop efficient surveillance systems, interactions should be captured, which include but exceed biological factors. This low-cost and easily implementable model, if conducted over time, may identify focal instances where tailored policies may diminish both endemicity and the total adaptation of H5N1 to the human species. © 2015 Blackwell Verlag GmbH.

  20. Preliminary Evaluation of a New German Translated Tobacco Quality of Life Impact Tool to Discriminate Between Healthy Current and Former Smokers and to Explore the Effect of Switching Smokers to a Reduced Toxicant Prototype Cigarette.

    PubMed

    Kulasekaran, Anuradha; Proctor, Christopher; Papadopoulou, Ermioni; Shepperd, Christopher J; Guyer, Rick; Gandek, Barbara; Ware, John E

    2015-12-01

    Assessment of health-related quality of life (HRQoL) is well established in clinical research, but ceiling effects in validated tools might prevent detection of changes in well respondents. Tobacco Quality of Life Impact Tool (TQOLITv1) uses conceptual and psychometric advances to enhance detection of HRQoL changes. In a 6-month, forced-switch study, the German TQOLITv1 was assessed in healthy adult (age 23-55 years) current and matched former-smokers. At baseline, smokers were switched to reduced toxicant prototype (RTP) or conventional cigarette for 6 months. TQOLITv1 responses were collected at baseline, 3 and 6 months from current smokers whilst former smokers completed it at the latter two time points. TQOLITv1 includes SF-36v2 and new smoking-specific, physical and general-health measures. Reliability at baseline was good (Cronbach's coefficient alpha > 0.70) for all measures. The baseline percentage with the best possible score (ceiling effect) for former and current smokers was substantially better for the new physical function than SF-36 physical function measure (35% vs. 59% at ceiling, respectively). New smoking-specific measures discriminated current from former smokers better than general health measures. Smoking-specific symptoms (r = 0.73) were more stable from baseline to 6 months than other measures (r = 0.38-0.54) particularly more than the SF-36 mental component score (r = 0.24). Although both product smoking groups worsened in most HRQoL measures, changes in general and smoking-specific HRQoL impact measures favored RTP smokers. The German TQOLITv1 is sufficiently reliable and valid to assess HRQoL and may be more useful than SF-36v2 in evaluation of interventions in well smoking populations including those consuming RTPs. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

  1. 16 CFR § 1702.11 - Product specifications.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Product specifications. § 1702.11 Section § 1702.11 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS PETITIONS FOR EXEMPTIONS FROM POISON PREVENTION PACKAGING ACT REQUIREMENTS; PETITION PROCEDURES...

  2. Practical management of bleeding in patients receiving non-vitamin K antagonist oral anticoagulants.

    PubMed

    Weitz, Jeffrey I; Pollack, Charles V

    2015-11-25

    Non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used in the prevention and treatment of venous thromboembolism and in the prevention of stroke in patients with non-valvular atrial fibrillation. In phase III clinical trials and meta-analyses, the NOACs were at least as effective as vitamin K antagonists (VKAs) and were associated with a similar or lower incidence of major bleeding, including consistent and significant decreases in intracranial bleeding, although with an increase in gastrointestinal bleeding for some agents compared with VKAs. Subsequent real-world evidence supports these outcomes. Despite this, physicians have concerns about serious bleeding or emergencies because there are no specific reversal agents for the NOACs. However, in clinical trials, patients receiving NOACs generally had similar or better outcomes after these events than those taking VKAs. As with any bleeding, anticoagulant-related bleeding should first be stratified according to severity and location; risk can be minimised by ongoing assessment. Management protocols for NOAC-related bleeding are similar to those for VKAs but should take into account the pharmacological profile of the specific drug. Because of their short half-lives, NOAC-related mild bleeding can often be controlled by temporarily withholding treatment. More severe bleeding requires standard escalating haemodynamic support measures, and non-specific reversal agents can be considered in life-threatening situations, based on limited clinical data. Specific and rapid reversal agents are not currently available for any oral anticoagulant and restoration of coagulation may not necessarily lead to better outcomes. Nevertheless, specific NOAC reversal agents are in development and show promise in healthy volunteers.

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

    PubMed

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

    2011-09-01

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

  4. Measurement in comparative effectiveness research.

    PubMed

    Chubak, Jessica; Rutter, Carolyn M; Kamineni, Aruna; Johnson, Eric A; Stout, Natasha K; Weiss, Noel S; Doria-Rose, V Paul; Doubeni, Chyke A; Buist, Diana S M

    2013-05-01

    Comparative effectiveness research (CER) on preventive services can shape policy and help patients, their providers, and public health practitioners select regimens and programs for disease prevention. Patients and providers need information about the relative effectiveness of various regimens they may choose. Decision makers need information about the relative effectiveness of various programs to offer or recommend. The goal of this paper is to define and differentiate measures of relative effectiveness of regimens and programs for disease prevention. Cancer screening is used to demonstrate how these measures differ in an example of two hypothetical screening regimens and programs. Conceptually and algebraically defined measures of relative regimen and program effectiveness also are presented. The measures evaluate preventive services that range from individual tests through organized, population-wide prevention programs. Examples illustrate how effective screening regimens may not result in effective screening programs and how measures can vary across subgroups and settings. Both regimen and program relative effectiveness measures assess benefits of prevention services in real-world settings, but each addresses different scientific and policy questions. As the body of CER grows, a common lexicon for various measures of relative effectiveness becomes increasingly important to facilitate communication and shared understanding among researchers, healthcare providers, patients, and policymakers. Copyright © 2013 American Journal of Preventive Medicine. All rights reserved.

  5. A quasi-experimental evaluation of a community-based HIV prevention intervention for Mexican American female adolescents: the SHERO's program.

    PubMed

    Harper, Gary W; Bangi, Audrey K; Sanchez, Bernadette; Doll, Mimi; Pedraza, Ana

    2009-10-01

    This article describes a quasi-experimental evaluation of a community-based, culturally and ecologically tailored HIV prevention intervention for Mexican American female adolescents grounded in the AIDS risk reduction model. A total of 378 Mexican American female adolescents (mean age = 15.2) participated in either the nine-session SHERO's (a female-gendered version of the word hero) intervention or a single session information-only HIV prevention intervention. Assessment data were collected at pretest, posttest, and 2-month follow up. Significant improvements across all time points were revealed on measures of self-esteem, condom attitudes, beliefs regarding a woman's control of her sexuality, beliefs regarding sexual assault, perceived peer norms, and HIV/AIDS and STI knowledge. At posttest SHERO's participants were more likely to carry condoms and to report abstaining from vaginal sex in the previous 2 months; and at 2-month follow up they reported using condoms more often in the preceding 2 months and planned on using them more frequently in the coming 2 months. Findings support the development of community-based adolescent HIV prevention interventions that address culturally specific ecological factors.

  6. Pediatric melanoma: incidence, treatment, and prognosis

    PubMed Central

    Saiyed, Faiez K; Hamilton, Emma C; Austin, Mary T

    2017-01-01

    The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it continues to be the deadliest form of skin cancer in children and adolescents. Pediatric melanoma presents differently from adult melanoma; thus, the traditional asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution (ABCDE) criteria have been modified to include features unique to pediatric melanoma (amelanotic, bleeding/bump, color uniformity, de novo/any diameter, evolution of mole). Surgical and medical management of pediatric melanoma continues to derive guidelines from adult melanoma treatment. However, more drug trials are being conducted to determine the specific impact of drug combinations on pediatric patients. Alongside medical and surgical treatment, prevention is a central component of battling the incidence, as ultraviolet (UV)-related mutations play a central role in the vast majority of pediatric melanoma cases. Aggressive prevention measures targeting sun safety and tanning bed usage have shown positive sun-safety behavior trends, as well as the potential to decrease melanomas that manifest later in life. As research into the field of pediatric melanoma continues to expand, a prevention paradigm needs to continue on a community-wide level. PMID:29388632

  7. Engineering behaviour change in an epidemic: the epistemology of NIH-funded HIV prevention science.

    PubMed

    Green, Adam; Kolar, Kat

    2015-05-01

    Social scientific and public health literature on National Institutes of Health-funded HIV behavioural prevention science often assumes that this body of work has a strong biomedical epistemological orientation. We explore this assumption by conducting a systematic content analysis of all NIH-funded HIV behavioural prevention grants for men who have sex with men between 1989 and 2012. We find that while intervention research strongly favours a biomedical orientation, research into the antecedents of HIV risk practices favours a sociological, interpretive and structural orientation. Thus, with respect to NIH-funded HIV prevention science, there exists a major disjunct in the guiding epistemological orientations of how scientists understand HIV risk, on the one hand, and how they engineer behaviour change in behavioural interventions, on the other. Building on the extant literature, we suggest that the cause of this disjunct is probably attributable not to an NIH-wide positivist orientation, but to the specific standards of evidence used to adjudicate HIV intervention grant awards, including randomised controlled trials and other quantitative measures of intervention efficacy. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  8. Cure rate is not a valid indicator for assessing drug efficacy and impact of preventive chemotherapy interventions against schistosomiasis and soil-transmitted helminthiasis.

    PubMed

    Montresor, Antonio

    2011-07-01

    Every year in endemic countries, several million individuals are given anthelminthic drugs in the context of preventive chemotherapy programmes for morbidity control of schistosomiasis and soil-transmitted helminthiasis. The capacity to evaluate accurately the efficacy of the drugs used as well as the health impact produced by treatment is of utmost importance for appropriate planning and implementation of these interventions. Cure rate is an indicator of drug efficacy that was originally developed for assessing the clinical efficacy of antibiotics on selected bacterial diseases. Over time, this indicator has also been widely applied to anthelminthic drugs and consequently used to monitor and evaluate preventive chemotherapy interventions. In the author's opinion, however, measurement of cure rate provides information of limited usefulness in the context of helminth control programmes. The present article analyses the peculiarities of helminth infections and those of the drugs used in preventive chemotherapy, explaining the reasons why the cure rate is not an adequate indicator in this specific public health context. Copyright © 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  9. Steady-state levels of G-protein beta-subunit expression are regulated by treatment of cells with bacterial toxins

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

    Watkins, D.C.; Northup, J.K.; Malbon, C.C.

    1987-05-01

    Cultures of 3T3-L1 cells were incubated with either 10 ng/ml cholera toxin or 10 ng/ml pertussis toxin from 4 days prior to the initiation of differentiation and throughout the subsequent incubation. Toxin concentrations were sufficient to completely prevent the labelling of alpha-subunits with (/sup 32/P)NAD/sup +/ and pertussis toxin and to prevent by more than 90% the labelling with (/sup 32/P)NAD/sup +/ and cholera toxin in membranes prepared from these cells. Neither toxin prevented the differentiation to the adipocyte phenotype. Neither toxin prevented the increases in the relative amounts of G-proteins which occur upon differentiation. Both toxins dramatically decreased themore » amount of beta-subunits. As measured by quantitative immunoblotting with antisera specific for both the 35 kDa and 36 kDa beta-subunits, levels of beta-subunit were decreased by more than 50% of steady-state level of control cells. Thus, bacterial toxins which modifies G-protein alpha-subunits are capable of modulating the levels of beta-subunits in vivo. The basis for the regulation of G-protein subunit expression by bacterial toxins is under study.« less

  10. An assessment of the Pacific Regional Cancer Coalition: outcomes and implications of a regional coalition internal and external assessment.

    PubMed

    Sy, Angela U; Heckert, Karen A; Buenconsejo-Lum, Lee; Hedson, Johnny; Tamang, Suresh; Palafox, Neal

    2011-11-01

    The Pacific Regional Cancer Coalition (PRCC) provides regional leadership in the U.S. Affiliated Pacific Islands (USAPI) to implement the Regional Comprehensive Control Plan: 2007-2012, and to evaluate its coalition and partnerships. The Pacific Center of Excellence in the Elimination of Disparities (CEED), aims to reduce cancer disparities and conducts evaluation activities relevant to cancer prevention and control in the USAPI. The PRCC Self (internal) and Partner (external) Assessments were conducted to assess coalition functioning, regional and national partnerships, sustainability, and the role of regionalism for integrating all chronic disease prevention and control in the Pacific. Self-administered questionnaires and key informant telephone interviews with PRCC members (N=20), and representatives from regional and national partner organizations were administered (N=26). Validated multi item measures using 5-point scales on coalition and partnership characteristics were used. Chronbach's alphas and averages for the measures were computed. Internal coalition measures: satisfaction (4.2, SD=0.48) communication (4.0, SD=0.56), respect (4.0, SD=0.60) were rated more highly than external partnership measures: resource sharing (3.5, SD=0.74), regionalism (3.9, SD=0.47), use of findings (3.9, SD=0.50). The PRCC specifically identified its level of "collaboration" with external partners including Pacific CEED. External partners identified its partnership with the PRCC in the "coalition" stage. PRCC members and external partners are satisfied with their partnerships. All groups should continue to focus on building collaboration with partners to reflect a truly regional approach to sustain the commitment, the coalitions and the programming to reduce cancer in the USAPI. PRCC and partners should also work together to integrate all chronic disease prevention and control efforts in the Pacific.

  11. Potentially preventable deaths from the five leading causes of death--United States, 2008-2010.

    PubMed

    Yoon, Paula W; Bastian, Brigham; Anderson, Robert N; Collins, Janet L; Jaffe, Harold W

    2014-05-02

    In 2010, the top five causes of death in the United States were 1) diseases of the heart, 2) cancer, 3) chronic lower respiratory diseases, 4) cerebrovascular diseases (stroke), and 5) unintentional injuries. The rates of death from each cause vary greatly across the 50 states and the District of Columbia (2). An understanding of state differences in death rates for the leading causes might help state health officials establish disease prevention goals, priorities, and strategies. States with lower death rates can be used as benchmarks for setting achievable goals and calculating the number of deaths that might be prevented in states with higher rates. To determine the number of premature annual deaths for the five leading causes of death that potentially could be prevented ("potentially preventable deaths"), CDC analyzed National Vital Statistics System mortality data from 2008-2010. The number of annual potentially preventable deaths per state before age 80 years was determined by comparing the number of expected deaths (based on average death rates for the three states with the lowest rates for each cause) with the number of observed deaths. The results of this analysis indicate that, when considered separately, 91,757 deaths from diseases of the heart, 84,443 from cancer, 28,831 from chronic lower respiratory diseases, 16,973 from cerebrovascular diseases (stroke), and 36,836 from unintentional injuries potentially could be prevented each year. In addition, states in the Southeast had the highest number of potentially preventable deaths for each of the five leading causes. The findings provide disease-specific targets that states can use to measure their progress in preventing the leading causes of deaths in their populations.

  12. Measuring migraine-related quality of care across 10 health plans.

    PubMed

    Pracilio, Valerie P; Silberstein, Stephen; Couto, Joseph; Bumbaugh, Jon; Hopkins, Mary; Ng-Mak, Daisy; Sennett, Cary; Goldfarb, Neil I

    2012-08-01

    To refine a previously published standardized quality and utilization measurement set for migraine care and to establish performance benchmarks. Retrospective application of the migraine measurement set to health plan data in order to assess patterns of health service utilization. Measurement specifications were applied to data from 10 health plans for measurement year 2009. Of the 2.9 million continuously enrolled members of the health plans, 138,004 (4.7%) met inclusion criteria for the migraine population. Of these, 26% did not have a migraine diagnosis, but were utilizing migraine drugs; 12% had a computed tomography scan within the year (range 8%-25% across plans); and 8% had magnetic resonance imaging (range 6%-11%). Nearly 18% of the migraineurs had 1 or more visits to an emergency department/urgent care center for migraine; few (6%) were followed up with primary care visits. Approximately one-fourth of the migraineurs were not being routinely monitored by a physician. Medication utilization also was examined for members of the migraine population with pharmacy benefits. A significant proportion (42%) were given a migraine preventive, 38% had at least 1 prescription for a triptan, and 2% of those on triptans were potentially overutilizing the medication. Among patients aged 18 to 49 years who were given triptans, 3% had a cardiac contraindication; this percentage rose to 7% for patients aged 50 to 64 years. This study demonstrates the value of standardized measures in identifying potential quality issues for migraine care, including underdiagnosis, overutilization of imaging, and underutilization of preventive drugs.

  13. Gendered empowerment and HIV prevention: policy and programmatic pathways to success in the MENA region.

    PubMed

    Dworkin, Shari L; Kambou, Sarah Degnan; Sutherland, Carla; Moalla, Khadija; Kapoor, Archana

    2009-07-01

    Although HIV in the Middle East and North Africa is currently characterized as a low seroprevalence epidemic, there are numerous factors that are present in the region that could prevent-or exacerbate-the epidemic. The time to invest substantially in prevention-and gender-specific prevention in particular-is now. Given that most policy makers do not make gender-specific plans as epidemics progress, our research team-which draws upon expertise from both within and outside the region-worked together to make programmatic and policy suggestions in the Middle East and North Africa region in 5 key areas: (1) gender-specific and gender transformative HIV prevention interventions; (2) access to quality education and improvements in life skills and sex education; (3) economic empowerment; (4) property rights; and (5) antiviolence. In short, this work builds upon many ongoing efforts in the region and elucidates some of the links between gendered empowerment and health outcomes around the world, particularly HIV and AIDS.

  14. Impact of the Prevention Plan on Employee Health Risk Reduction

    PubMed Central

    Edington, Dee W.; Bég, Sami

    2010-01-01

    Abstract This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coaching, contests, group events, and employer incentives. Specifically, we analyzed changes in 15 health risk measures among a cohort of 2606 employees from multiple employer groups who completed a baseline health risk appraisal, blood tests, and biometric screening in 2008 and who were reassessed in 2009. We then compared the data to the Edington Natural Flow of risks. The cohort showed significant reduction in 10 of the health risks measured (9 at P ≤ 0.01 and 1 at P ≤ 0.05). The most noticeable changes in health risks were a reduction in the proportion of employees with high-risk blood pressure (42.78%), high-risk fasting blood sugar (31.13%), and high-risk stress (24.94%). There was an overall health risk transition among the cohort with net movement from higher risk levels to lower risk levels (P < 0.01). There was a net increase of 9.40% of people in the low-risk category, a decrease of 3.61% in the moderate-risk category, and a 5.79% decrease in the high-risk category. Compared to Edington's Natural Flow model, 48.70% of individuals in the high-risk category moved from high risk to moderate risk (Natural Flow 31%), 46.35% moved from moderate risk to low risk (Natural Flow 35%), 15.65% moved from high risk to low risk (Natural Flow 6%), and 87.33% remained in the low-risk category (Natural Flow 70%) (P < 0.001). (Population Health Management 2010;13:275–284) PMID:20879909

  15. Impact of the prevention plan on employee health risk reduction.

    PubMed

    Loeppke, Ronald; Edington, Dee W; Bég, Sami

    2010-10-01

    This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coaching, contests, group events, and employer incentives. Specifically, we analyzed changes in 15 health risk measures among a cohort of 2606 employees from multiple employer groups who completed a baseline health risk appraisal, blood tests, and biometric screening in 2008 and who were reassessed in 2009. We then compared the data to the Edington Natural Flow of risks. The cohort showed significant reduction in 10 of the health risks measured (9 at P≤ 0.01 and 1 at P≤0.05). The most noticeable changes in health risks were a reduction in the proportion of employees with high-risk blood pressure (42.78%), high-risk fasting blood sugar (31.13%), and high-risk stress (24.94%). There was an overall health risk transition among the cohort with net movement from higher risk levels to lower risk levels (P<0.01). There was a net increase of 9.40% of people in the low-risk category, a decrease of 3.61% in the moderate-risk category, and a 5.79% decrease in the high-risk category. Compared to Edington's Natural Flow model, 48.70% of individuals in the high-risk category moved from high risk to moderate risk (Natural Flow 31%), 46.35% moved from moderate risk to low risk (Natural Flow 35%), 15.65% moved from high risk to low risk (Natural Flow 6%), and 87.33% remained in the low-risk category (Natural Flow 70%) (P<0.001).

  16. Yarning about fall prevention: community consultation to discuss falls and appropriate approaches to fall prevention with older Aboriginal and Torres Strait Islander people.

    PubMed

    Lukaszyk, Caroline; Coombes, Julieann; Turner, Norma Jean; Hillmann, Elizabeth; Keay, Lisa; Tiedemann, Anne; Sherrington, Cathie; Ivers, Rebecca

    2017-08-01

    Fall related injury is an emerging issue for older Indigenous people worldwide, yet few targeted fall prevention programs are currently available for Indigenous populations. In order to inform the development of a new Aboriginal-specific fall prevention program in Australia, we conducted community consultation with older Aboriginal people to identify perceptions and beliefs about falls, and to identify desired program elements. Yarning Circles were held with Aboriginal and Torres Strait Islander people aged 45 years and over. Each Yarning Circle was facilitated by an Aboriginal researcher who incorporated six indicative questions into each discussion. Questions explored the impact of falls on Yarning Circle participants, their current use of fall prevention services and investigated Yarning Circle participant's preferences regarding the design and mode of delivery of a fall prevention program. A total of 76 older Aboriginal people participated in ten Yarning Circles across six sites in the state of New South Wales. Participants associated falls with physical disability, a loss of emotional well-being and loss of connection to family and community. Many participants did not use existing fall prevention services due to a lack of availability in their area, having no referral provided by their GP and/or being unaware of fall prevention programs in general. Program elements identified as important by participants were that it be Aboriginal-specific, group-based, and on-going, with the flexibility to be tailored to specific communities, with free transport provided to and from the program. Older Aboriginal people reported falls to be a priority health issue, with a significant impact on their health and well-being. Few older Aboriginal people accessed prevention programs, suggesting there is an important need for targeted Aboriginal-specific programs. A number of important program elements were identified which if incorporated into prevention programs, may help to address the rising burden of falls.

  17. Respiratory and Allergic Health Effects of Dampness, Mold, and Dampness-Related Agents: A Review of the Epidemiologic Evidence

    PubMed Central

    Mendell, Mark J.; Mirer, Anna G.; Cheung, Kerry; Tong, My; Douwes, Jeroen

    2011-01-01

    Objectives Many studies have shown consistent associations between evident indoor dampness or mold and respiratory or allergic health effects, but causal links remain unclear. Findings on measured microbiologic factors have received little review. We conducted an updated, comprehensive review on these topics. Data sources We reviewed eligible peer-reviewed epidemiologic studies or quantitative meta-analyses, up to late 2009, on dampness, mold, or other microbiologic agents and respiratory or allergic effects. Data extraction We evaluated evidence for causation or association between qualitative/subjective assessments of dampness or mold (considered together) and specific health outcomes. We separately considered evidence for associations between specific quantitative measurements of microbiologic factors and each health outcome. Data synthesis Evidence from epidemiologic studies and meta-analyses showed indoor dampness or mold to be associated consistently with increased asthma development and exacerbation, current and ever diagnosis of asthma, dyspnea, wheeze, cough, respiratory infections, bronchitis, allergic rhinitis, eczema, and upper respiratory tract symptoms. Associations were found in allergic and nonallergic individuals. Evidence strongly suggested causation of asthma exacerbation in children. Suggestive evidence was available for only a few specific measured microbiologic factors and was in part equivocal, suggesting both adverse and protective associations with health. Conclusions Evident dampness or mold had consistent positive associations with multiple allergic and respiratory effects. Measured microbiologic agents in dust had limited suggestive associations, including both positive and negative associations for some agents. Thus, prevention and remediation of indoor dampness and mold are likely to reduce health risks, but current evidence does not support measuring specific indoor microbiologic factors to guide health-protective actions. PMID:21269928

  18. Rubella antibodies in Australian immunoglobulin products.

    PubMed

    Young, Megan K; Bertolini, Joseph; Kotharu, Pushpa; Maher, Darryl; Cripps, Allan W

    2017-08-03

    Rubella antibodies are not routinely measured in immunoglobulin products and there is a lack of information on the titer in Australian products. To facilitate future studies of the effectiveness of passive immunisation for preventing rubella and congenital rubella syndrome, this study measured the concentration of rubella-specific antibodies in Australian intramuscular (IM) and intravenous (IV) human immunoglobulin products suitable for post-exposure prophylaxis using a chemiluminescent immunoassay. The GMT ± GSD for the IM product was 19 ± 1.2 IU/mg (2980 ± 1.2 IU/mL). The GMT ± GSD for the IV product was 12 ± 1.5 IU/mg (729 ± 1.5 IU/mL). At present, Australian guidelines recommend offering non-immune pregnant women exposed to rubella 20 mL of intramuscular immunoglobulin within 72 hours of exposure. This equates to 42,160 IU of rubella antibodies if the lowest titer obtained for the Australian IM product is considered. The same dose would be delivered by 176 mL of the Australian IV product at the lowest measured rubella-specific antibody titer.

  19. 2014 consensus statement from the first Economics of Physical Inactivity Consensus (EPIC) conference (Vancouver).

    PubMed

    Davis, Jennifer C; Verhagen, Evert; Bryan, Stirling; Liu-Ambrose, Teresa; Borland, Jeff; Buchner, David; Hendriks, Marike R C; Weiler, Richard; Morrow, James R; van Mechelen, Willem; Blair, Steven N; Pratt, Mike; Windt, Johann; al-Tunaiji, Hashel; Macri, Erin; Khan, Karim M

    2014-06-01

    This article describes major topics discussed from the 'Economics of Physical Inactivity Consensus Workshop' (EPIC), held in Vancouver, Canada, in April 2011. Specifically, we (1) detail existing evidence on effective physical inactivity prevention strategies; (2) introduce economic evaluation and its role in health policy decisions; (3) discuss key challenges in establishing and building health economic evaluation evidence (including accurate and reliable costs and clinical outcome measurement) and (4) provide insight into interpretation of economic evaluations in this critically important field. We found that most methodological challenges are related to (1) accurately and objectively valuing outcomes; (2) determining meaningful clinically important differences in objective measures of physical inactivity; (3) estimating investment and disinvestment costs and (4) addressing barriers to implementation. We propose that guidelines specific for economic evaluations of physical inactivity intervention studies are developed to ensure that related costs and effects are robustly, consistently and accurately measured. This will also facilitate comparisons among future economic evidence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. National Suicide Prevention Lifeline

    MedlinePlus

    ... Initiatives Best Practices Our Network Media Resources National Suicide Prevention Lifeline We can all help prevent suicide. ... About The Lifeline Anyone could be struggling with suicide. Find more specific resources below. I'm Struggling ...

  1. A study of health effects of long-distance ocean voyages on seamen using a data classification approach

    PubMed Central

    2010-01-01

    Background Long-distance ocean voyages may have substantial impacts on seamen's health, possibly causing malnutrition and other illness. Measures can possibly be taken to prevent such problems from happening through preparing special diet and making special precautions prior or during the sailing if a detailed understanding can be gained about what specific health effects such voyages may have on the seamen. Methods We present a computational study on 200 seamen using 41 chemistry indicators measured on their blood samples collected before and after the sailing. Our computational study is done using a data classification approach with a support vector machine-based classifier in conjunction with feature selections using a recursive feature elimination procedure. Results Our analysis results suggest that among the 41 blood chemistry measures, nine are most likely to be affected during the sailing, which provide important clues about the specific effects of ocean voyage on seamen's health. Conclusions The identification of the nine blood chemistry measures provides important clues about the effects of long-distance voyage on seamen's health. These findings will prove to be useful to guide in improving the living and working environment, as well as food preparation on ships. PMID:20219089

  2. The non-specific effects of vaccines and other childhood interventions: the contribution of INDEPTH Health and Demographic Surveillance Systems.

    PubMed

    Sankoh, Osman; Welaga, Paul; Debpuur, Cornelius; Zandoh, Charles; Gyaase, Stephney; Poma, Mary Atta; Mutua, Martin Kavao; Hanifi, S M Manzoor Ahmed; Martins, Cesario; Nebie, Eric; Kagoné, Moubassira; Emina, Jacques B O; Aaby, Peter

    2014-06-01

    Most childhood interventions (vaccines, micronutrients) in low-income countries are justified by their assumed effect on child survival. However, usually the interventions have only been studied with respect to their disease/deficiency-specific effects and not for their overall effects on morbidity and mortality. In many situations, the population-based effects have been very different from the anticipated effects; for example, the measles-preventive high-titre measles vaccine was associated with 2-fold increased female mortality; BCG reduces neonatal mortality although children do not die of tuberculosis in the neonatal period; vitamin A may be associated with increased or reduced child mortality in different situations; effects of interventions may differ for boys and girls. The reasons for these and other contrasts between expectations and observations are likely to be that the immune system learns more than specific prevention from an intervention; such training may enhance or reduce susceptibility to unrelated infections. INDEPTH member centres have been in an ideal position to document such additional non-specific effects of interventions because they follow the total population long term. It is proposed that more INDEPTH member centres extend their routine data collection platform to better measure the use and effects of childhood interventions. In a longer perspective, INDEPTH may come to play a stronger role in defining health research issues of relevance to low-income countries. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  3. Inhibition of MMP-9-dependent Degradation of Gelatin, but Not Other MMP-9 Substrates, by the MMP-9 Hemopexin Domain Blades 1 and 4*

    PubMed Central

    Ugarte-Berzal, Estefanía; Vandooren, Jennifer; Bailón, Elvira; Opdenakker, Ghislain; García-Pardo, Angeles

    2016-01-01

    Degradation and remodeling of the extracellular matrix by matrix metalloproteinases (MMPs) plays important roles in normal development, inflammation, and cancer. MMP-9 efficiently degrades the extracellular matrix component gelatin, and the hemopexin domain of MMP-9 (PEX9) inhibits this degradation. To study the molecular basis of this inhibition, we generated GST fusion proteins containing PEX9 or truncated forms corresponding to specific structural blades (B1–B4) of PEX9. GST-PEX9 inhibited MMP-9-driven gelatin proteolysis, measured by gelatin zymography, FITC-gelatin conversion, and DQ-gelatin degradation assays. However, GST-PEX9 did not prevent the degradation of other MMP-9 substrates, such as a fluorogenic peptide, αB crystalline, or nonmuscular actin. Therefore, PEX9 may inhibit gelatin degradation by shielding gelatin and specifically preventing its binding to MMP-9. Accordingly, GST-PEX9 also abolished the degradation of gelatin by MMP-2, confirming that PEX9 is not an MMP-9 antagonist. Moreover, GST-B4 and, to a lesser extent, GST-B1 also inhibited gelatin degradation by MMP-9, indicating that these regions are responsible for the inhibitory activity of PEX9. Accordingly, ELISAs demonstrated that GST-B4 and GST-B1 specifically bound to gelatin. Our results establish new functions of PEX9 attributed to blades B4 and B1 and should help in designing specific inhibitors of gelatin degradation. PMID:27044750

  4. [Obstacles for the use of early childhood prevention services : The role of expected ability to control sources].

    PubMed

    Neumann, Anna; Renner, Ilona

    2016-10-01

    It is well established that preventive measures for pregnant women and families with small children do not reach all families alike. Often enough, it is those families, who due to heightened stresses and strains might gain the most from these measures, who cannot be reached (dilemma of prevention). This investigation explores whether parents can be grouped according to their views on health, prevention and measures available to young families, and whether belonging to one of the identified groups explains differences in the use of (primary and secondary) preventive measures for pregnant women and young families. In the context of home visits, parents of children aged two to four years (N = 273) completed questionnaires. Additionally, 203 parents took part in qualitative interviews. Based on interview data, parents from different sociocultural backgrounds could be grouped along their expected ability to control sources for parental support (Steuerungskompetenz). Parents high and low in Steuerungskompetenz differ regarding their knowledge of, use of, and satisfaction with (primary) preventive measures. Steuerungskompetenz explains the use of primary preventive measures above and beyond socioeconomic control variables as well as family stresses and strains. The use of secondary preventive measures is better explained by family stresses and strains. Results are discussed in terms of untapped services, needs and possibilities of target group-oriented approach.

  5. Antibiotic Resistant Bacteria--What Everyone Needs To Know.

    ERIC Educational Resources Information Center

    Pascoe, Neil; Felkner, Marilyn; Maldonado, Maria

    2003-01-01

    Notes the overuse of antibiotics and the resulting resistant bacterial strains. Describes how to control and prevent staphylococcal infections specifically, and almost all infectious diseases generally. Specific sections address: (1) what are staph infections; (2) preventing staph infections; (3) caring for wounds; and (4) controlling staph…

  6. An Evaluation of the California Injury and Illness Prevention Program

    PubMed Central

    Mendeloff, John; Gray, Wayne B.; Haviland, Amelia M.; Main, Regan; Xia, Jing

    2012-01-01

    Abstract The Injury and Illness Prevention Program (IIPP) requirement has been the most frequently cited standard in California workplace health and safety inspections almost every year since it became effective in July 1991. Every workplace safety inspection must assess compliance with the IIPP. This article presents the results of an evaluation of the IIPP's effects on worker injuries in California and should inform policy both in California and in the federal Occupational Safety and Health Administration (OSHA) program, which has made the adoption of a similar national requirement a top priority. Using data from the Workers' Compensation Information System, OSHA Data Initiative statistics, and Workers' Compensation Insurance Rating Bureau of California reports on medical and indemnity claims from single-establishment firms, the evaluation team analyzed the impact of citations for violations of the IIPP on safety performance by (1) using the number of citations as a measure of effectiveness and (2) assessing the number of establishments that were cited for noncompliance and then came into compliance. They found that enforcement of the IIPP appears to prevent injuries only when inspectors cite firms for violations of specific subsections of that standard. Eighty percent of the citations of the IIPP by the California Division of Occupational Safety and Health program are for only a different section, the one that requires employers to have a written IIPP. The specific subsections refer to the provisions that mandate surveying and fixing hazards, investigating the causes of injuries, and training employees to work safely. Because about 25 percent of all inspections cite the IIPP, citations of the specific subsections occur in about 5 percent of all inspections. In those inspections, the total recordable injury rate falls by more than 20 percent in the two years following the inspection. PMID:28083238

  7. Evaluation of a Technology-Based Adaptive Learning and Prevention Program for Stress Response-A Randomized Controlled Trial.

    PubMed

    Wesemann, Ulrich; Kowalski, Jens T; Jacobsen, Thomas; Beudt, Susan; Jacobs, Herbert; Fehr, Julia; Büchler, Jana; Zimmermann, Peter L

    2016-08-01

    To prevent deployment-related disorders, Chaos Driven Situations Management Retrieval System (CHARLY), a computer-aided training platform with a biofeedback interface has been developed. It simulates critical situations photorealistic for certain target and occupational groups. CHARLY was evaluated as a 1.5 days predeployment training method comparing it with the routine training. The evaluation was carried out for a matched random sample of N = 67 soldiers deployed in Afghanistan (International Security Assistance Force). Data collection took place before and after the prevention program and 4 to 6 weeks after deployment, which included mental state, post-traumatic stress disorder (PTSD) symptoms, knowledge of and attitude toward PTSD, and deployment-specific stressors. CHARLY has been significantly superior to the control group in terms of psychoeducation and attitude change. As to the mental state, both groups showed a significant increase in stress after deployment with significant lower increase in CHARLY. For PTSD-specific symptoms, CHARLY achieved a significant superiority. The fact that PTSD-specific scales showed significant differences at the end of deployment substantiates the validity of a specifically preventive effect of CHARLY. The study results tentatively indicate that highly standardized, computer-based primary prevention of mental disorders in soldiers on deployment might be superior to other more personal and less standardized forms of prevention. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  8. Nursing workload and adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia. A pilot study.

    PubMed

    Jam, R; Hernández, O; Mesquida, J; Turégano, C; Carrillo, E; Pedragosa, R; Gómez, V; Martí, L; Vallés, J; Delgado-Hito, P

    To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score). Phases: 1) the nurses carried out a educational programme, consisting of 60-minute lectures on non-pharmacological measures for VAP prevention, and at the end completed a questionnaire knowledge; 2) observation period; 3) knowledge questionnaire. Among 67 ICU-staff nurses, 54 completed the educational programme and were observed. A total of 160 observations of 49 nurses were made. Adequate knowledge was confirmed in both the initial and final questionnaires. Application of preventive measures ranged from 11% for hand washing pre-aspiration to 97% for the use of a sterile aspiration probe. The Nine Equivalents of Nursing Manpower Use Score was 50±13. No significant differences were observed between the association of the nurses' knowledge and the application of preventive measures or between workload and the application of preventive measures. Nurses' knowledge of VAP prevention measures is not necessarily applied in daily practice. Failure to follow these measures is not subject to lack of knowledge or to increased workload, but presumably to contextual factors. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. 40 CFR 63.1332 - Emissions averaging provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... if pollution prevention measures are used to control five or more of the emission points included in... additional emission points if pollution prevention measures are used to control five or more of the emission... which emissions are reduced by pollution prevention measures shall be determined using the procedures...

  10. 40 CFR 63.1332 - Emissions averaging provisions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... if pollution prevention measures are used to control five or more of the emission points included in... additional emission points if pollution prevention measures are used to control five or more of the emission... which emissions are reduced by pollution prevention measures shall be determined using the procedures...

  11. 40 CFR 63.652 - Emissions averaging provisions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...; and (3) Emission points from which emissions are reduced by pollution prevention measures. Percentages... this section. (i) For a Group 1 emission point, the pollution prevention measure must reduce emissions...)(3)(ii) of this section. (ii) If a pollution prevention measure is used in conjunction with other...

  12. 40 CFR 63.1332 - Emissions averaging provisions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... if pollution prevention measures are used to control five or more of the emission points included in... additional emission points if pollution prevention measures are used to control five or more of the emission... which emissions are reduced by pollution prevention measures shall be determined using the procedures...

  13. A family beliefs framework for socially and culturally specific preventive interventions with refugee youths and families.

    PubMed

    Weine, Stevan; Feetham, Suzanne; Kulauzovic, Yasmina; Knafl, Kathleen; Besic, Sanela; Klebic, Alma; Mujagic, Aida; Muzurovic, Jasmina; Spahovic, Dzemila; Pavkovic, Ivan

    2006-01-01

    To assist in designing socially and culturally specific preventive interventions for refugee youths and families, this study identified the processes by which refugee families adapt and apply family beliefs concerning youths. A grounded-theory model constructed with ATLAS/ti for Windows and named the family beliefs framework describes (a) family beliefs concerning refugee youths, (b) contextual factors interacting with these family beliefs, (c) adaptation of family beliefs concerning refugee youths, and (d) the interplay of adapting family beliefs and behaviors concerning refugee youths. Preventive interventions for refugee youths and families would be more socially and culturally specific if they addressed the specific processes of adapting family beliefs experienced by refugee youths and their families amid transitions and traumas. 2006 APA, all rights reserved

  14. Injury prevention and future research.

    PubMed

    Emery, Carolyn A

    2005-01-01

    To critically examine and summarize the literature identifying risk factors and prevention strategies for injury in child and adolescent sport. Seven electronic databases were searched including: Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychinfo, Cochrane Database for Systematic and Complete Reviews, Cochrane Controlled Trials Registry, HealthSTAR and SPORTDiscus. Medical subject headings and text words included: athletic injury, sport injury, risk factors, adolescent and child. Additional articles were reviewed based on sport-specific contributions in the previous chapters of this book. Despite the diversity of injuries occurring in various pediatric sporting populations, the uniformity with respect to many of the risk factors identified in the literature is noteworthy (i.e. previous injury, age, sport specificity, psychosocial factors, decreased strength and endurance). The literature is significantly limited with respect to the prospective evaluation of risk factors and prevention strategies for injury in pediatric sport. The consistencies, however, between the adult and pediatric literature are encouraging with respect to prevention strategies involving neuromuscular training programs (i.e. balance training programs) to reduce lower extremity injuries in some sports and the use of sport-specific protective equipment (i.e. helmets). Notwithstanding the limitations in the literature, the successful evaluation of some sport-specific prevention strategies to reduce injury in pediatric sport is encouraging. There is significant opportunity to methodologically improve upon the current pediatric sport injury literature in descriptive surveillance research, risk factor evaluation research, and prevention research. There is a need for prospective studies, ideally randomized controlled trials, in the evaluation of prevention strategies in pediatric sport. The integration of basic science, laboratory and epidemiological research is critical in evaluating the mechanisms associated with injury and injury prevention in pediatric sport. Finally, long-term studies are needed to identify the public health impact of pediatric sport injury.

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

    PubMed

    Korczak, Dieter; Schöffmann, Christine

    2010-03-16

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

  16. Measurement in Comparative Effectiveness Research

    PubMed Central

    Chubak, Jessica; Rutter, Carolyn M.; Kamineni, Aruna; Johnson, Eric A.; Stout, Natasha K.; Weiss, Noel S.; Doria-Rose, V. Paul; Doubeni, Chyke A.; Buist, Diana S.M.

    2013-01-01

    Comparative effectiveness research (CER) on preventive services can shape policy and help patients, their providers, and public health practitioners select regimens and programs for disease prevention. Patients and providers need information about the relative effectiveness of various regimens they may choose. Decision makers need information about the relative effectiveness of various programs to offer or recommend. The goal of this paper is to define and differentiate measures of relative effectiveness of regimens and programs for disease prevention. Cancer screening is used to demonstrate how these measures differ in an example of two hypothetic screening regimens and programs. Conceptually and algebraically defined measures of relative regimen and program effectiveness are also presented. The measures evaluate preventive services that range from individual tests through organized, population-wide prevention programs. Examples illustrate how effective screening regimens may not result in effective screening programs and how measures can vary across subgroups and settings. Both regimen and program relative effectiveness measures assess benefits of prevention services in real-world settings, but each addresses different scientific and policy questions. As the body of CER grows, a common lexicon for various measures of relative effectiveness becomes increasingly important to facilitate communication and shared understanding among researchers, healthcare providers, patients, and policymakers. PMID:23597816

  17. Development of an Incarceration-Specific Overdose Prevention Video: "Staying Alive on the Outside"

    ERIC Educational Resources Information Center

    Green, Traci C.; Bowman, Sarah E.; Ray, Madeline; McKenzie, Michelle; Lord, Sarah E.; Rich, Josiah D.

    2015-01-01

    Objectives: The first 2 weeks following release from prison are associated with extraordinary risk of fatal drug overdose. However, bystanders can reverse opioid overdoses using rescue breathing and naloxone, an overdose antidote. We reviewed overdose prevention and naloxone administration training videos for incarceration specific and behaviour…

  18. [Personal protection measures against blood-sucking insects and ticks].

    PubMed

    Orshan, Laor; Wilamowski, Amos; Pener, Hedva

    2010-09-01

    Blood-sucking arthropods are major vectors of various pathogens like viruses, bacteria, protozoa and nematodes. Preventing exposure to the vector is imperative especially when vaccine and prophylactic treatments are not available. Personal protection measures (PPM) are essential and often the only means available when dealing with blood-sucking disease transmitting arthropods. Awareness of the risk in the specific areas of travel is the first step to be taken before and while traveling. PPM include preventive personal behavior, suitable clothing, application of insect repellents to the skin, the use of space repellents, impregnation of clothing, camping gear and bed nets and, when necessary, ground spraying of insecticides. The registered and recommended active ingredients for skin application are Deet, picaridin (icaridin), p-menthane-3,8-diol (PMD) and IR3535. Volatile pyrethrins are used as space repellents while pyrethroids, especially permethrin, are employed for impregnation and for ground spraying. It is recommended to purchase only products registered in Israel or other developed countries. These products should have a detailed label specifying the concentration of the active ingredient, application instructions and the duration of protection.

  19. Familial Gastric Cancers

    PubMed Central

    Setia, Namrata; Clark, Jeffrey W.; Duda, Dan G.; Hong, Theodore S.; Kwak, Eunice L.; Mullen, John T.

    2015-01-01

    Although the majority of gastric carcinomas are sporadic, approximately 10% show familial aggregation, and a hereditary cause is determined in 1%–3% cases. Of these, hereditary diffuse gastric cancer is the most recognized predisposition syndrome. Although rare, the less commonly known syndromes also confer a markedly increased risk for development of gastric cancer. Identification and characterization of these syndromes require a multidisciplinary effort involving oncologists, surgeons, genetic counselors, biologists, and pathologists. This article reviews the molecular genetics, clinical and pathologic features, surveillance guidelines, and preventive measures of common and less common hereditary gastric cancer predisposition syndromes. Implications for Practice: Although the majority of gastric adenocarcinomas are sporadic with many of those related to chronic Helicobacter pylori infection, approximately 10% of the cases show familial aggregation, and a specific hereditary cause is determined in 1%–3% cases. This review describes the molecular genetics, clinical and pathologic features, surveillance guidelines, and preventive measures of common and less common hereditary gastric cancer predisposition syndromes. Ultimately, a better understanding of the biology of these conditions should allow early identification and intervention as part of a multidisciplinary approach involving oncologists, surgeons, genetic counselors, and pathologists. PMID:26424758

  20. Review of sport-induced groin injuries.

    PubMed

    Sedaghati, Parisa; Alizadeh, Mohammad-Hossein; Shirzad, Elham; Ardjmand, Abolfazl

    2013-12-01

    Groin injuries are among the most common injuries co-existing with sports. The aim of this review was to outline the epidemiology and identify risk factors, as well as examine preventative and interventional measures for reducing the occurrence of this form of injury among athletes. An electronic, systematic search for relevant keywords, either separately or in combination was sought in the academic scientific databases. Groin injuries, acute or chronic, consist of a high percentage of injuries that manifest with pain. Despite the specific tendency for injury among some sports, such injuries make up 2-5% of sport-induced injuries. There are few available reports on lower limb injuries, especially groin injuries, in Iran. Numerous factors predispose to groin injuries. A lengthy list of preventive/ treatment measures, from preliminary to sophisticated, have been proposed. Although using a programmed strategy designed to decrease the risk of groin injuries by taking a strategic approach to exercise may alleviate complications, in some cases the chronic nature of the injury may threaten the professional life of the athlete. More research is required to plan suitable programs for reducing the risk of this type of injury in athletes.

  1. Coping and parenting: Mediators of 12-month outcomes of a family group cognitive-behavioral preventive intervention with families of depressed parents.

    PubMed

    Compas, Bruce E; Champion, Jennifer E; Forehand, Rex; Cole, David A; Reeslund, Kristen L; Fear, Jessica; Hardcastle, Emily J; Keller, Gary; Rakow, Aaron; Garai, Emily; Merchant, Mary Jane; Roberts, Lorinda

    2010-10-01

    In a randomized clinical trial with 111 families of parents with a history of major depressive disorder (86% mothers, 14% fathers; 86% Caucasian, 5% African-American, 3% Hispanic, 1% American Indian or Alaska Native, 4% mixed ethnicity), changes in adolescents' (mean age = 11 years; 42% female, 58% male) coping and parents' parenting skills were examined as mediators of the effects of a family group cognitive-behavioral preventive intervention on adolescents' internalizing and externalizing symptoms. Changes in hypothesized mediators were assessed at 6 months, and changes in adolescents' symptoms were measured at a 12-month follow-up. Significant differences favoring the family intervention compared with a written information comparison condition were found for changes in composite measures of parent-adolescent reports of adolescents' use of secondary control coping skills and direct observations of parents' positive parenting skills. Changes in adolescents' secondary control coping and positive parenting mediated the effects of the intervention on depressive, internalizing, and externalizing symptoms, accounting for approximately half of the effect of the intervention on the outcomes. Further, reciprocal relations between children's internalizing symptoms and parenting were found from baseline to 6-month follow-up. The present study provides the first evidence for specific mediators of a family group cognitive-behavioral preventive intervention for families of parents with a history of major depressive disorder. The identification of both coping and parenting as mediators of children's mental health outcomes suggests that these variables are important active ingredients in the prevention of mental health problems in children of depressed parents. Copyright 2010 APA, all rights reserved.

  2. Personalized modeling for real-time pressure ulcer prevention in sitting posture.

    PubMed

    Luboz, Vincent; Bailet, Mathieu; Boichon Grivot, Christelle; Rochette, Michel; Diot, Bruno; Bucki, Marek; Payan, Yohan

    2018-02-01

    Ischial pressure ulcer is an important risk for every paraplegic person and a major public health issue. Pressure ulcers appear following excessive compression of buttock's soft tissues by bony structures, and particularly in ischial and sacral bones. Current prevention techniques are mainly based on daily skin inspection to spot red patches or injuries. Nevertheless, most pressure ulcers occur internally and are difficult to detect early. Estimating internal strains within soft tissues could help to evaluate the risk of pressure ulcer. A subject-specific biomechanical model could be used to assess internal strains from measured skin surface pressures. However, a realistic 3D non-linear Finite Element buttock model, with different layers of tissue materials for skin, fat and muscles, requires somewhere between minutes and hours to compute, therefore forbidding its use in a real-time daily prevention context. In this article, we propose to optimize these computations by using a reduced order modeling technique (ROM) based on proper orthogonal decompositions of the pressure and strain fields coupled with a machine learning method. ROM allows strains to be evaluated inside the model interactively (i.e. in less than a second) for any pressure field measured below the buttocks. In our case, with only 19 modes of variation of pressure patterns, an error divergence of one percent is observed compared to the full scale simulation for evaluating the strain field. This reduced model could therefore be the first step towards interactive pressure ulcer prevention in a daily set-up. Copyright © 2017 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  3. Effectively engaging stakeholders and the public in developing violence prevention messages.

    PubMed

    Boyko, Jennifer A; Wathen, C Nadine; Kothari, Anita

    2017-05-11

    Preventing family violence requires that stakeholders and the broader public be involved in developing evidence-based violence prevention strategies. However, gaps exist in between what we know (knowledge), what we do (action), and the structures supporting practice (policy). We discuss the broad challenge of mobilizing knowledge-for-action in family violence, with a primary focus on the issue of how stakeholders and the public can be effectively engaged when developing and communicating evidence-based violence prevention messages. We suggest that a comprehensive approach to stakeholder and public engagement in developing violence prevention messages includes: 1) clear and consistent messaging; 2) identifying and using, as appropriate, lessons from campaigns that show evidence of reducing specific types of violence; and 3) evidence-informed approaches for communicating to specific groups. Components of a comprehensive approach must take into account the available research evidence, implementation feasibility, and the context-specific nature of family violence. While strategies exist for engaging stakeholders and the public in messaging about family violence prevention, knowledge mobilization must be informed by evidence, dialogue with stakeholders, and proactive media strategies. This paper will be of interest to public health practitioners or others involved in planning and implementing violence prevention programs because it highlights what is known about the issue, potential solutions, and implementation considerations.

  4. A method for assessing the cost-effectiveness and the break-even point of clinical practice guidelines.

    PubMed

    Gandjour, A; Lauterbach, K W

    2001-01-01

    Assessing the costs and benefits of developing a clinical practice guideline is important because investments in guidelines compete with investments in other clinical programs. Despite the considerable number of guidelines in many industrialized countries, little is known about their costs and cost-effectiveness. The authors have developed specific measures to determine the cost-effectiveness of guidelines, using a German evidence-based guideline on obesity for the diagnosis and treatment of obese patients as a model. The measures are: the number of people needed to cure, the number of people needed to prevent from developing the disease in question, and the number of people to treat in order to break even.

  5. An in vitro comparison of casein phosphopeptide-amorphous calcium phosphate paste, casein phosphopeptide-amorphous calcium phosphate paste with fluoride and casein phosphopeptide-amorphous calcium phosphate varnish on the inhibition of demineralization and promotion of remineralization of enamel.

    PubMed

    Thakkar, Prachi Jayesh; Badakar, Chandrashekhar M; Hugar, Shivayogi M; Hallikerimath, Seema; Patel, Punit M; Shah, Parin

    2017-01-01

    This study aims to determine and compare the extent of inhibition of demineralization and promotion of remineralization of permanent molar enamel with and without application of three remineralizing agents. Forty extracted permanent molars were randomly divided into two groups 1 and 2, longitudinally sectioned into four and divided into subgroups A, B, C, and D. The sections were coated with nail varnish leaving a window of 3 mm × 3 mm. All sections of Group 1 were treated with their respective subgroup-specific agent: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste for subgroup A, CPP-amorphous calcium phosphate fluoride (ACPF) paste for subgroup B, CPP-ACPF varnish for subgroup C and subgroup D served as a control. The sections were then subjected to demineralization for 12 days following which lesional depth was measured under the stereomicroscope. All the sections of Group 2 were subjected to demineralization for 12 days, examined for lesional depth, then treated with their respective subgroup specific agents and immersed in artificial saliva for 7 days. The sections were then examined again under the stereomicroscope to measure the lesional depth. CPP-ACPF varnish caused significant inhibition of demineralization. All three agents showed significant remineralization of previously demineralized lesions. However, CPP-ACPF varnish showed the greatest remineralization, followed by CPP-ACPF paste and then CPP-ACP paste. This study shows that CPP-ACPF varnish is effective in preventing demineralization as well as promoting remineralization of enamel. Thus, it can be used as an effective preventive measure for pediatric patients where compliance with the use of tooth mousse may be questionable.

  6. The effect of temperature on the toxicity of insecticides against Musca domestica L.: implications for the effective management of diarrhea.

    PubMed

    Khan, Hafiz Azhar Ali; Akram, Waseem

    2014-01-01

    Diarrhea is an important cause of childhood mortality in developing countries like Pakistan because of unhygienic conditions, lack of awareness, and unwise use of preventive measures. Mechanical transmission of diarrheal pathogens by house flies, Musca domestica, is believed as the most effective route of diarrhea transmission. Although the use of insecticides as a preventive measure is common worldwide for the management of house flies, success of the measure could be compromised by the prevailing environmental temperature since it significantly affects toxicity of insecticides and thus their efficacy. Peaks of the house fly density and diarrheal cases are usually coincided and season specific, yet little is known about the season specific use of insecticides. To determine the temperature-toxicity relationship in house flies, the effect of post-bioassays temperature (range, 20-34°C) on the toxicity of seven insecticides from organophosphate (chlorpyrifos, profenofos), pyrethroid (cypermethrin, deltamethrin) and new chemical (emamectin benzoate, fipronil, spinosad) classes was evaluated by using a feeding bioassay method. From 20-34°C, the toxicities of chlorpyrifos, profenofos, emamectin and fipronil increased 2.10, 2.93, 2.40 and 3.82 fold (i.e. positive temperature coefficient), respectively. Whereas, the toxicities of cypermethrin, deltamethrin and spinosad decreased 2.21, 2.42 and 3.16 fold (i.e. negative temperature coefficient), respectively. These findings suggest that for the reduction in diarrheal cases, house flies should be controlled with insecticides according to the prevailing environmental temperature. Insecticides with a positive temperature coefficient may serve as potential candidates in controlling house flies and diarrhea epidemics in hot season and vice versa.

  7. Evaluating the care of general medicine inpatients: how good is implicit review?

    PubMed

    Hayward, R A; McMahon, L F; Bernard, A M

    1993-04-01

    Peer review often consists of implicit evaluations by physician reviewers of the quality and appropriateness of care. This study evaluated the ability of implicit review to measure reliably various aspects of care on a general medicine inpatient service. Retrospective review of patients' charts, using structured implicit review, of a stratified random sample of consecutive admissions to a general medicine ward. A university teaching hospital. Twelve internists were trained in structured implicit review and reviewed 675 patient admissions (with 20% duplicate reviews for a total of 846 reviews). Although inter-rater reliabilities for assessments of overall quality of care and preventable deaths (kappa = 0.5) were adequate for aggregate comparisons (for example, comparing mean ratings on two hospital wards), they were inadequate for reliable evaluations of single patients using one or two reviewers. Reviewers' agreement about most focused quality problems (for example, timeliness of diagnostic evaluation and clinical readiness at time of discharge) and about the appropriateness of hospital ancillary resource use was poor (kappa < or = 0.2). For most focused implicit measures, bias due to specific reviewers who were systematically more harsh or lenient (particularly for evaluation of resource-use appropriateness) accounted for much of the variation in reviewers' assessments, but this was not a substantial problem for the measure of overall quality. Reviewers rarely reported being unable to evaluate the quality of care because of deficiencies in documentation in the patient's chart. For assessment of overall quality and preventable deaths of general medicine inpatients, implicit review by peers had moderate degrees of reliability, but for most other specific aspects of care, physician reviewers could not agree. Implicit review was particularly unreliable at evaluating the appropriateness of hospital resource use and the patient's readiness for discharge, two areas where this type of review is often used.

  8. Infection Prevention and Control Programs in United States Nursing Homes: Results of a National Survey

    PubMed Central

    Herzig, Carolyn T. A.; Stone, Patricia W.; Castle, Nicholas; Pogorzelska-Maziarz, Monika; Larson, Elaine L.; Dick, Andrew W.

    2015-01-01

    Objectives The objectives of this study were to (1) obtain a national perspective of the current state of nursing home (NH) infection prevention and control (IPC) programs and (2) examine differences in IPC program characteristics for NHs that had and had not received an infection control deficiency citation. Design A national cross-sectional survey of randomly sampled NHs was conducted and responses were linked with Certification and Survey Provider Enhanced Reporting (CASPER) and NH Compare data. Setting Surveys were completed and returned by 990 NHs (response rate 39%) between December 2013 and December 2014. Participants The person in charge of the IPC program at each NH completed the survey. Measurements The survey consisted of 34 items related to respondent demographics, IPC program staffing, stability of the workforce, resources and challenges, and resident care and employee processes. Facility characteristics and infection control deficiency citations were assessed using CASPER and NH Compare data. Results Most respondents had at least two responsibilities in addition to those related to infection control (54%) and had no specific IPC training (61%). While many practices and processes were consistent with infection prevention guidelines for NHs, there was wide variation in programs across the US. About 36% of responding facilities had received an infection control deficiency citation. NHs that received citations had infection control professionals with less experience (P = .01) and training (P = .02) and were less likely to provide financial resources for continuing education in infection control (P = .01). Conclusion The findings demonstrate that a lack of adequately trained infection prevention personnel is an important area for improvement. Furthermore, there is a need to identify specific evidence-based practices to reduce infection risk in NHs. PMID:26712489

  9. Developing recombinant HPA-1a–specific antibodies with abrogated Fcγ receptor binding for the treatment of fetomaternal alloimmune thrombocytopenia

    PubMed Central

    Ghevaert, Cedric; Wilcox, David A.; Fang, Juan; Armour, Kathryn L.; Clark, Mike R.; Ouwehand, Willem H.; Williamson, Lorna M.

    2008-01-01

    Fetomaternal alloimmune thrombocytopenia (FMAIT) is caused by maternal generation of antibodies specific for paternal platelet antigens and can lead to fetal intracranial hemorrhage. A SNP in the gene encoding integrin β3 causes a clinically important maternal-paternal antigenic difference; Leu33 generates the human platelet antigen 1a (HPA-1a), whereas Pro33 generates HPA-1b. As a potential treatment to prevent fetal intracranial hemorrhage in HPA-1a alloimmunized pregnancies, we generated an antibody that blocks the binding of maternal HPA-1a–specific antibodies to fetal HPA-1a1b platelets by combining a high-affinity human HPA-1a–specific scFv (B2) with an IgG1 constant region modified to minimize Fcγ receptor–dependent platelet destruction (G1Δnab). B2G1Δnab saturated HPA-1a+ platelets and substantially inhibited binding of clinical HPA-1a–specific sera to HPA-1a+ platelets. The response of monocytes to B2G1Δnab-sensitized platelets was substantially less than their response to unmodified B2G1, as measured by chemiluminescence. In addition, B2G1Δnab inhibited chemiluminescence induced by B2G1 and HPA-1a–specific sera. In a chimeric mouse model, B2G1 and polyclonal Ig preparations from clinical HPA-1a–specific sera reduced circulating HPA-1a+ platelets, concomitant with transient thrombocytopenia. As the Δnab constant region is uninformative in mice, F(ab′)2 B2G1 was used as a proof of principle blocking antibody and prevented the in vivo platelet destruction seen with B2G1 and polyclonal HPA-1a–specific antibodies. These results provide rationale for human clinical studies. PMID:18654666

  10. Modifying the food environment for childhood obesity prevention: challenges and opportunities.

    PubMed

    Penney, Tarra L; Almiron-Roig, Eva; Shearer, Cindy; McIsaac, Jessie-Lee; Kirk, Sara F L

    2014-05-01

    The prevention of childhood obesity is a global priority. However, a range of complex social and environmental influences is implicated in the development of obesity and chronic disease that goes beyond the notion of individual choice. A population-level approach recognises the importance of access to and availability of healthy foods outside the home. These external food environments, in restaurants, supermarkets, and in school, or recreation and sports settings, are often characterised by energy dense, nutrient-poor food items that do not reflect the current nutritional guidelines for health. In addition, our understanding of these broader influences on nutritional intake is still limited. Particularly, lacking is a clear understanding of what constitutes the food environment, as well as robust measures of components of the food environment across different contexts. Therefore, this review summarises the literature on food environments of relevance to childhood obesity prevention, with a focus on places where children live, learn and play. Specifically, the paper highlights the approaches and challenges related to defining and measuring the food environment, discusses the aspects of the food environment unique to children and reports on environmental characteristics that are being modified within community, school and recreational settings. Results of the review show the need for a continued focus on understanding the intersection between individual behaviour and external factors; improved instrument development, especially regarding validity and reliability; clearer reported methodology including protocols for instrument use and data management; and considering novel study design approaches that are targeted at measuring the relationship between the individual and their food environment.

  11. Adherence and delivery: Implementation quality and program outcomes for the 7th grade keepin’ it REAL program

    PubMed Central

    Pettigrew, Jonathan; Graham, John W.; Miller-Day, Michelle; Hecht, Michael L.; Krieger, Janice L.; Shin, Young Ju

    2014-01-01

    Poor implementation quality (IQ) is known to reduce program effects making it important to consider IQ for evaluation and dissemination of prevention programs. However, less is known about the ways specific implementation variables relate to outcomes. In this study, two versions of the keepin’ it REAL, 7th grade drug prevention intervention were implemented in 78 classrooms in 25 schools in rural districts in Pennsylvania and Ohio. IQ was measured through observational coding of 276 videos. IQ variables included adherence to the curriculum, teacher engagement (attentiveness, enthusiasm, seriousness, clarity, positivity), student engagement (attention, participation), and a global rating of teacher delivery quality. Factor analysis showed that teacher engagement, student engagement, and delivery quality formed one factor, which was labeled delivery. A second factor was adherence to the curriculum. Self-report student surveys measured substance use, norms (beliefs about prevalence and acceptability of use), and efficacy (beliefs about one’s ability to refuse substance offers) at two waves (pretest, immediate posttest). Mixed model regression analysis which accounted for missing data and controlled for pretest levels examined implementation quality’s effects on individual level outcomes, statistically controlling for cluster level effects. Results show that when implemented well, students show positive outcomes compared to students receiving a poorly implemented program. Delivery significantly influenced substance use and norms, but not efficacy. Adherence marginally significantly predicted use and significantly predicted norms, but not efficacy. Findings underscore the importance of comprehensively measuring and accounting for IQ, particularly delivery, when evaluating prevention interventions. PMID:24442403

  12. Measurement Noninvariance of Safer Sex Self-Efficacy Between Heterosexual and Sexual Minority Black Youth.

    PubMed

    Gerke, Donald; Budd, Elizabeth L; Plax, Kathryn

    2016-01-01

    Black and lesbian, gay, bisexual, or questioning (LGBQ) youth in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs). Although self-efficacy is strongly, positively associated with safer sex behaviors, no studies have examined the validity of a safer sex self-efficacy scale used by many federally funded HIV/STD prevention programs. This study aims to test factor validity of the Sexual Self-Efficacy Scale by using confirmatory factor analysis (CFA) to determine if scale validity varies between heterosexual and LGBQ Black youth. The study uses cross-sectional data collected through baseline surveys with 226 Black youth (15 to 24 years) enrolled in community-based HIV-prevention programs. Participants use a 4-point Likert-type scale to report their confidence in performing 6 healthy sexual behaviors. CFAs are conducted on 2 factor structures of the scale. Using the best-fitting model, the scale is tested for measurement invariance between the 2 groups. A single-factor model with correlated errors of condom-specific items fits the sample well and, when tested with the heterosexual group, the model demonstrates good fit. However, when tested with the LGBQ group, the same model yields poor fit, indicating factorial noninvariance between the groups. The Sexual Self-Efficacy Scale does not perform equally well among Black heterosexual and LGBQ youth. Study findings suggest additional research is needed to inform development of measures for safer sex self-efficacy among Black LGBQ youth to ensure validity of conceptual understanding and to accurately assess effectiveness of HIV/STD prevention interventions among this population.

  13. Who is that masked person: the use of face masks on Mexico City public transportation during the Influenza A (H1N1) outbreak.

    PubMed

    Condon, Bradly John; Sinha, Tapen

    2010-04-01

    This article examines three issues: (1) the use, over time, of facemasks in a public setting to prevent the spread of a respiratory disease for which the mortality rate is unknown; (2) the difference between the responses of male and female subjects in a public setting to unknown risks; and (3) the effectiveness of mandatory and voluntary public health measures in a public health emergency. The use of facemasks to prevent the spread of respiratory diseases in a public setting is controversial. At the height of the influenza epidemic in Mexico City in the spring of 2009, the federal government of Mexico recommended that passengers on public transport use facemasks to prevent contagion. The Mexico City government made the use of facemasks mandatory for bus and taxi drivers, but enforcement procedures differed for these two categories. Using an evidence-based approach, we collected data on the use of facemasks over a 2-week period. In the specific context of the Mexico City influenza outbreak, these data showed mask usage rates mimicked the course of the epidemic and gender difference in compliance rates among metro passengers. Moreover, there was not a significant difference in compliance with mandatory and voluntary public health measures where the effect of the mandatory measures was diminished by insufficiently severe penalties, the lack of market forces to create compliance incentives and sufficient political influence to diminish enforcement. Voluntary compliance was diminished by lack of trust in the government. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  14. Alternatives to petroleum-based biocides for protecting hardwood lumber and manufactured products. Transferring technologies for industry No. 4. Final report

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

    Murdoch, C.W.

    1993-03-30

    The report addresses the current and prospective mechanisms for developing environmentally responsible treatments for wood products that prevent stain, decay, and insect damage. The author examines various aspects of the problem and current prevention techniques, including an extended discussion of the attributes and shortcomings of six treatments reviewed by the Animal and Plant Health Inspection Service, US Department of Agriculture, in An Efficacy Review of Control Measures for Potential Pests of Imported Soviet Timber. The portion of the report labeled Uncommercialized Technologies presents the new, uncommercialized technologies discovered through this project. They include: guayule shrub-derived wood preservative; biological control strategies;more » tannins derived from tree bark; insect-specific toxins from arthropod and vertebrate venoms; and natural biocidal repellents.« less

  15. Strategies to reduce driving under the influence of alcohol.

    PubMed

    DeJong, W; Hingson, R

    1998-01-01

    The purpose of this review is to update research on the prevention of alcohol-related traffic deaths since the 1988 Surgeon General's Workshop on Drunk Driving. Four primary areas of research are reviewed here: (a) general deterrence policies, (b) alcohol control policies, (c) mass communications campaigns, including advertising restrictions, and (d) community traffic safety programs. Modern efforts to combat drunk driving in the United States began with specific deterrence strategies to punish convicted drunk drivers, and then evolved to include general deterrence strategies that were targeted to the population as a whole. Efforts next expanded to include the alcohol side of the problem, with measures installed to decrease underage drinking and excessive alcohol consumption. In the next several years, greater efforts are needed on all these fronts. Also needed, however, are programs that integrate drunk driving prevention with other traffic safety initiatives.

  16. Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation and Injury Prevention

    PubMed Central

    Heiderscheit, Bryan C.; Sherry, Marc A.; Silder, Amy; Chumanov, Elizabeth S.; Thelen, Darryl G.

    2010-01-01

    Synopsis Hamstring strain injuries remain a challenge for both athletes and clinicians given the high incidence rate, slow healing, and persistent symptoms. Moreover, nearly one-third of these injuries recur within the first year following a return to sport, with subsequent injuries often being more severe than the original. This high reinjury rate suggests that commonly utilized rehabilitation programs may be inadequate at resolving possible muscular weakness, reduced tissue extensibility, and/or altered movement patterns associated with the injury. Further, the traditional criteria used to determine the readiness of the athlete to return to sport may be insensitive to these persistent deficits, resulting in a premature return. There is mounting evidence that the risk of reinjury can be minimized by utilizing rehabilitation strategies that incorporate neuromuscular control exercises and eccentric strength training, combined with objective measures to assess musculotendon recovery and readiness to return to sport. In this paper, we first describe the diagnostic examination of an acute hamstring strain injury, including discussion of the value of determining injury location in estimating the duration of the convalescent period. Based on the current available evidence, we then propose a clinical guide for the rehabilitation of acute hamstring injuries including specific criteria for treatment progression and return to sport. Finally, we describe directions for future research including injury-specific rehabilitation programs, objective measures to assess reinjury risk, and strategies to prevent injury occurrence. Level of evidence: Diagnosis/therapy, level 5. PMID:20118524

  17. Safe procedure development to manage hazardous drugs in the workplace.

    PubMed

    Gaspar Carreño, Marisa; Achau Muñoz, Rubén; Torrico Martín, Fátima; Agún Gonzalez, Juan José; Sanchez Santos, Jose Cristobal; Cercos Lletí, Ana Cristina; Ramos Orozco, Pedro

    2017-03-01

    To develop a safety working procedure for the employees in the Intermutual Hospital de Levante (HIL) in those areas of activity that deal with the handling of hazardous drugs (MP). The procedure was developed in six phases: 1) hazard definition; 2) definition and identification of processes and development of general correct work practices about hazardous drugs' selection and special handling; 3) detection, selection and set of specific recommendations to handle with hazardous drugs during the processes of preparation and administration included in the hospital GFT; 4) categorization of risk during the preparation/administration and development of an identification system; 5) information and training of professionals; 6) implementation of the identification measures and prevention guidelines. Six processes were detected handling HD. During those processes, thirty HD were identified included in the hospital GFT and a safer alternative was found for 6 of them. The HD were classified into 4 risk categories based on those measures to be taken during the preparation and administration of each of them. The development and implementation of specific safety-work processes dealing with medication handling, allows hospital managers to accomplish effectively with their legal obligations about the area of prevention and provides healthcare professional staff with the adequate techniques and safety equipment to avoid possible dangers and risks of some drugs. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  18. Security Issues for Mobile Medical Imaging: A Primer.

    PubMed

    Choudhri, Asim F; Chatterjee, Arindam R; Javan, Ramin; Radvany, Martin G; Shih, George

    2015-10-01

    The end-user of mobile device apps in the practice of clinical radiology should be aware of security measures that prevent unauthorized use of the device, including passcode policies, methods for dealing with failed login attempts, network manager-controllable passcode enforcement, and passcode enforcement for the protection of the mobile device itself. Protection of patient data must be in place that complies with the Health Insurance Portability and Accountability Act and U.S. Federal Information Processing Standards. Device security measures for data protection include methods for locally stored data encryption, hardware encryption, and the ability to locally and remotely clear data from the device. As these devices transfer information over both local wireless networks and public cell phone networks, wireless network security protocols, including wired equivalent privacy and Wi-Fi protected access, are important components in the chain of security. Specific virtual private network protocols, Secure Sockets Layer and related protocols (especially in the setting of hypertext transfer protocols), native apps, virtual desktops, and nonmedical commercial off-the-shelf apps require consideration in the transmission of medical data over both private and public networks. Enterprise security and management of both personal and enterprise mobile devices are discussed. Finally, specific standards for hardware and software platform security, including prevention of hardware tampering, protection from malicious software, and application authentication methods, are vital components in establishing a secure platform for the use of mobile devices in the medical field. © RSNA, 2015.

  19. [Burnout, work disruptions, interpersonal and psychosomatic problems--degree-specific comparison of students at a German university].

    PubMed

    Gumz, A; Brähler, E; Heilmann, V K; Erices, R

    2014-03-01

    In the context of the public debate on psychological strain among students, the prevalence of burnout, procrastination, test anxiety, other work disruptions, interpersonal problems and psychic symptoms were analyzed depending on academic degree. The data of 358 college students (of Leipzig University) were examined. The academic degree had only a marginal effect on burnout- and work disruptions-related variables. In terms of interpersonal problems and psychic symptoms, differences between students were identified, depending on the academic degree. Diploma students reported many complaints, whereas undergraduates aspiring for a State Examination, were comparatively less affected. Knowledge of the population-specific psychological load is useful in order to develop preventive and therapeutic measures. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Regulation of Alternative Splicing in Vivo by Overexpression of Antagonistic Splicing Factors

    NASA Astrophysics Data System (ADS)

    Caceres, Javier F.; Stamm, Stefan; Helfman, David M.; Krainer, Adrian R.

    1994-09-01

    The opposing effects of SF2/ASF and heterogeneous nuclear ribonucleoprotein (hnRNP) A1 influence alternative splicing in vitro. SF2/ASF or hnRNP A1 complementary DNAs were transiently overexpressed in HeLa cells, and the effect on alternative splicing of several cotransfected reporter genes was measured. Increased expression of SF2/ASF activated proximal 5' splice sites, promoted inclusion of a neuron-specific exon, and prevented abnormal exon skipping. Increased expression of hnRNP A1 activated distal 5' splice sites. Therefore, variations in the intracellular levels of antagonistic splicing factors influence different modes of alternative splicing in vivo and may be a natural mechanism for tissue-specific or developmental regulation of gene expression.

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